Characteristics of effective clinical guidelines for general practice.

NARCIS (Netherlands)

Burgers, J.S.; Grol, R.P.T.M.; Zaat, J.O.M.; Spies, T.H.; Bij, A.K. van der; Mokkink, H.G.A.

2003-01-01

BACKGROUND: The use of clinical guidelines in general practice is often limited. Research on barriers to guideline adherence usually focuses on attitudinal factors. Factors linked to the guideline itself are much less studied. AIM: To identify characteristics of effective clinical guidelines for

Identifying and Clarifying Values and Reason Statements that Promote Effective Food Parenting Practices, Using Intensive Interviews

Science.gov (United States)

Beltran, Alicia; Hingle, Melanie D.; Knesek, Jessica; O'Connor, Teresia; Baranowski, Janice; Thompson, Debbe; Baranowski, Tom

2011-01-01

Objective: Generate and test parents' understanding of values and associated reason statements to encourage effective food parenting practices. Methods: This study was cross-sectional. Sixteen parents from different ethnic groups (African American, white, and Hispanic) living with their 3- to 5-year-old child were recruited. Interested parents…

Identifying organisational principles and management practices important to the quality of health care services for chronic conditions

DEFF Research Database (Denmark)

Frølich, Anne

2012-01-01

are limited, it is necessary to identify efficient methods to improve the quality of care. Comparing health care systems is a well-known method for identifying new knowledge regarding, for instance, organisational methods and principles. Kaiser Permanente (KP), an integrated health care delivery system...... in the U.S., is recognized as providing high-quality chronic care; to some extent, this is due to KP's implementation of the chronic care model (CCM). This model recommends a range of evidence-based management practices that support the implementation of evidence-based medicine. However, it is not clear...... which management practices in the CCM are most efficient and in what combinations. In addition, financial incentives and public reporting of performance are often considered effective at improving the quality of health care services, but this has not yet been definitively proved....

Identifying determinants of effective complementary feeding behaviour change interventions in developing countries

Science.gov (United States)

Fabrizio, Cecilia S; van Liere, Marti; Pelto, Gretel

2014-01-01

As stunting moves to the forefront of the global agenda, there is substantial evidence that behaviour change interventions (BCI) can improve infant feeding practices and growth. However, this evidence has not been translated into improved outcomes on a national level because we do not know enough about what makes these interventions work, for whom, when, why, at what cost and for how long. Our objective was to examine the design and implementation of complementary feeding BCI, from the peer-reviewed literature, to identify generalisable key determinants. We identified 29 studies that evaluated BCI efficacy or effectiveness, were conducted in developing countries, and reported outcomes on infant and young children aged 6–24 months. Two potential determinants emerged: (1) effective studies used formative research to identify cultural barriers and enablers to optimal feeding practices, to shape the intervention strategy, and to formulate appropriate messages and mediums for delivery; (2) effective studies delineated the programme impact pathway to the target behaviour change and assessed intermediary behaviour changes to learn what worked. We found that BCI that used these developmental and implementation processes could be effective despite heterogeneous approaches and design components. Our analysis was constrained, however, by the limited published data on how design and implementation were carried out, perhaps because of publishing space limits. Information on cost-effectiveness, sustainability and scalability was also very limited. We suggest a more comprehensive reporting process and a more strategic research agenda to enable generalisable evidence to accumulate. PMID:24798264

Identifying research priorities for effective retention strategies in clinical trials.

Science.gov (United States)

Kearney, Anna; Daykin, Anne; Shaw, Alison R G; Lane, Athene J; Blazeby, Jane M; Clarke, Mike; Williamson, Paula; Gamble, Carrol

2017-08-31

The failure to retain patients or collect primary-outcome data is a common challenge for trials and reduces the statistical power and potentially introduces bias into the analysis. Identifying strategies to minimise missing data was the second highest methodological research priority in a Delphi survey of the Directors of UK Clinical Trial Units (CTUs) and is important to minimise waste in research. Our aim was to assess the current retention practices within the UK and priorities for future research to evaluate the effectiveness of strategies to reduce attrition. Seventy-five chief investigators of NIHR Health Technology Assessment (HTA)-funded trials starting between 2009 and 2012 were surveyed to elicit their awareness about causes of missing data within their trial and recommended practices for improving retention. Forty-seven CTUs registered within the UKCRC network were surveyed separately to identify approaches and strategies being used to mitigate missing data across trials. Responses from the current practice surveys were used to inform a subsequent two-round Delphi survey with registered CTUs. A consensus list of retention research strategies was produced and ranked by priority. Fifty out of seventy-five (67%) chief investigators and 33/47 (70%) registered CTUs completed the current practice surveys. Seventy-eight percent of trialists were aware of retention challenges and implemented strategies at trial design. Patient-initiated withdrawal was the most common cause of missing data. Registered CTUs routinely used newsletters, timeline of participant visits, and telephone reminders to mitigate missing data. Whilst 36 out of 59 strategies presented had been formally or informally evaluated, some frequently used strategies, such as site initiation training, have had no research to inform practice. Thirty-five registered CTUs (74%) participated in the Delphi survey. Research into the effectiveness of site initiation training, frequency of patient contact

Identifying Challenges to Building an Evidence Base for Restoration Practice

CSIR Research Space (South Africa)

Ntshotsho, P

2015-11-01

Full Text Available Global acknowledgement of ecological restoration, as an important tool to complement conservation efforts, requires an effort to increase the effectiveness of restoration interventions. Evidence-based practice is purported to promote effectiveness...

Persistent Identifier Practice for Big Data Management at NCI

Directory of Open Access Journals (Sweden)

Jingbo Wang

2017-04-01

Full Text Available The National Computational Infrastructure (NCI manages over 10 PB research data, which is co-located with the high performance computer (Raijin and an HPC class 3000 core OpenStack cloud system (Tenjin. In support of this integrated High Performance Computing/High Performance Data (HPC/HPD infrastructure, NCI’s data management practices includes building catalogues, DOI minting, data curation, data publishing, and data delivery through a variety of data services. The metadata catalogues, DOIs, THREDDS, and Vocabularies, all use different Uniform Resource Locator (URL styles. A Persistent IDentifier (PID service provides an important utility to manage URLs in a consistent, controlled and monitored manner to support the robustness of our national ‘Big Data’ infrastructure. In this paper we demonstrate NCI’s approach of utilising the NCI’s 'PID Service 'to consistently manage its persistent identifiers with various applications.

A Case Study with an Identified Bully: Policy and Practice Implications

Directory of Open Access Journals (Sweden)

Huddleston, Lillie

2011-07-01

Full Text Available Objective: Bullying is a serious public health problem that may include verbal or physical injury as well as social isolation or exclusion. As a result, research is needed to establish a database for policies and interventions designed to prevent bullying and its negative effects. This paper presented a case study that contributed to the literature by describing an intervention for bullies that has implications for research, practice and related policies regarding bullying.Methods: An individualized intervention for an identified bully was implemented using the Participatory Culture-Specific Intervention Model (PCSIM; Nastasi, Moore, & Varjas, 2004 with a seventh-grade middle school student. Ecological and culture-specific perspectives were used to develop and implement the intervention that included psychoeducational sessions with the student and consultation with the parent and school personnel. A mixed methods intervention design was used with the following informants: the target student, the mother of the student, a teacher and the school counselor. Qualitative data included semi-structured interviews with the parent, teacher and student, narrative classroom observations and evaluation/feedback forms filled out by the student and interventionist. Quantitative data included the following quantitative surveys (i.e., Child Posttraumatic Stress Reaction Index [CPTS-RI] and the Behavior Assessment Scale for Children, 2nd Edition. Both qualitative and quantitative data were used to evaluate the acceptability, integrity and efficacy of this intervention.Results: The process of intervention design, implementation and evaluation are described through an illustrative case study. Qualitative and quantitative findings indicated a decrease in internalizing, externalizing and bullying behaviors as reported by the teacher and the mother, and a high degree of acceptability and treatment integrity as reported by multiple stakeholders.Conclusion: This case

TeenDrivingPlan effectiveness: the effect of quantity and diversity of supervised practice on teens' driving performance.

Science.gov (United States)

Mirman, Jessica H; Albert, W Dustin; Curry, Allison E; Winston, Flaura K; Fisher Thiel, Megan C; Durbin, Dennis R

2014-11-01

The large contribution of inexperience to the high crash rate of newly licensed teens suggests that they enter licensure with insufficient skills. In a prior analysis, we found moderate support for a direct effect of a web-based intervention, the TeenDrivingPlan (TDP), on teens' driving performance. The purpose of the present study was to identify the mechanisms by which TDP may be effective and to extend our understanding of how teens learn to drive. A randomized controlled trial conducted with teen permit holders and parent supervisors (N = 151 dyads) was used to determine if the effect of TDP on driver performance operated through five hypothesized mediators: (1) parent-perceived social support; (2) teen-perceived social support; (3) parent engagement; (4) practice quantity; and (5) practice diversity. Certified driving evaluators, blinded to teens' treatment allocation, assessed teens' driving performance 24 weeks after enrollment. Mediator variables were assessed on self-report surveys administered periodically over the study period. Exposure to TDP increased teen-perceived social support, parent engagement, and practice diversity. Both greater practice quantity and diversity were associated with better driving performance, but only practice diversity mediated the relationship between TDP and driver performance. Practice diversity is feasible to change and increases teens' likelihood of completing a rigorous on-road driving assessment just before licensure. Future research should continue to identify mechanisms that diversify practice driving, explore complementary ways to help families optimize the time they spend on practice driving, and evaluate the long-term effectiveness of TDP. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Identifying industrial best practices for the waste minimization of low-level radioactive materials

Energy Technology Data Exchange (ETDEWEB)

Levin, V.

1996-04-01

In US DOE, changing circumstances are affecting the management and disposal of solid, low-level radioactive waste (LLW). From 1977 to 1991, the nuclear power industry achieved major reductions in solid waste disposal, and DOE is interested in applying those practices to reduce solid waste at DOE facilities. Project focus was to identify and document commercial nuclear industry best practices for radiological control programs supporting routine operations, outages, and decontamination and decommissioning activities. The project team (DOE facility and nuclear power industry representatives) defined a Work Control Process Model, collected nuclear power industry Best Practices, and made recommendations to minimize LLW at DOE facilities.

Identifying Effective Methods of Instruction for Adult Emergent Readers through Community-Based Research

Science.gov (United States)

Blackmer, Rachel; Hayes-Harb, Rachel

2016-01-01

We present a community-based research project aimed at identifying effective methods and materials for teaching English literacy skills to adult English as a second language emergent readers. We conducted a quasi-experimental study whereby we evaluated the efficacy of two approaches, one based on current practices at the English Skills Learning…

Identifying the barriers and enablers in the implementation of the New Zealand and Australian Antenatal Corticosteroid Clinical Practice Guidelines

Directory of Open Access Journals (Sweden)

E. L. Mc Goldrick

2016-10-01

enablers and barriers to implementation of the New Zealand and Australian Antenatal Corticosteroid Clinical Practice Guidelines using the validated Theoretical Domains Framework, as perceived by health professionals. We have identified differences between individual health professional groups and organisations. The identification of these behavioural determinants can be used to enhance an implementation strategy, assist in the design of interventions to achieve improved implementation and facilitate process evaluations to understand why or how change interventions are effective.

Identifying Best Practices for Engaging Faculty in International Agricultural Education

Directory of Open Access Journals (Sweden)

Alexa J. Lamm

2013-10-01

Full Text Available Universities are being called upon to internationalize curriculum as the need for a globally competent workforce increases. Without globally-competent faculty, international integration within higher education cannot occur. Literature indicates that participation in short-term international agricultural education experiences is important to increasing agricultural faculty members’ cultural awareness. However, the best way to design and implement such experiences for faculty is uncharted. The purpose of the study was to identify best practices for facilitating a short-term international education experience for faculty in the agricultural and life sciences that encouraged learning, discussion, and reflection leading faculty to further integrate international perspectives in their agricultural courses in the U.S. Through a qualitative research design, reflective observations and statements from a planning team conducting short-term international agricultural education experience in Ecuador were used to provide a thick, rich description of the successes/challenges faced while designing and implementing the experience. The results provided a list of best practices future planning team members can use to emphasize learning before, during, and after a short-term international agricultural education experience for faculty.

The effectiveness of online cognitive behavioral treatment in routine clinical practice

NARCIS (Netherlands)

Ruwaard, Jeroen; Lange, Alfred; Schrieken, Bart; Dolan, Conor V; Emmelkamp, Paul

2012-01-01

CONTEXT: Randomized controlled trails have identified online cognitive behavioral therapy as an efficacious intervention in the management of common mental health disorders. OBJECTIVE: To assess the effectiveness of online CBT for different mental disorders in routine clinical practice. DESIGN: An

The effectiveness of online cognitive behavioral treatment in routine clinical practice

NARCIS (Netherlands)

Ruwaard, J.; Lange, A.; Schrieken, B.; Dolan, C.V.; Emmelkamp, P.

2012-01-01

Context Randomized controlled trails have identified online cognitive behavioral therapy as an efficacious intervention in the management of common mental health disorders. Objective To assess the effectiveness of online CBT for different mental disorders in routine clinical practice. Design An

Practical Approaches for Identifying and Managing Abused and Neglected Children.

Science.gov (United States)

Radford, Nola T.

1998-01-01

Discusses the exceptional challenges that abused and neglected children may pose for early-intervention providers, particularly speech-language pathologists. It focuses on practical strategies regarding reporting child abuse, effectively assessing the children who have been abused, and managing the bizarre behavior they may exhibit. (Author/CR)

Effective implementation of research into practice: an overview of systematic reviews of the health literature.

Science.gov (United States)

Boaz, Annette; Baeza, Juan; Fraser, Alec

2011-06-22

The gap between research findings and clinical practice is well documented and a range of interventions has been developed to increase the implementation of research into clinical practice. A review of systematic reviews of the effectiveness of interventions designed to increase the use of research in clinical practice. A search for relevant systematic reviews was conducted of Medline and the Cochrane Database of Reviews 1998-2009. 13 systematic reviews containing 313 primary studies were included. Four strategy types are identified: audit and feedback; computerised decision support; opinion leaders; and multifaceted interventions. Nine of the reviews reported on multifaceted interventions. This review highlights the small effects of single interventions such as audit and feedback, computerised decision support and opinion leaders. Systematic reviews of multifaceted interventions claim an improvement in effectiveness over single interventions, with effect sizes ranging from small to moderate. This review found that a number of published systematic reviews fail to state whether the recommended practice change is based on the best available research evidence. This overview of systematic reviews updates the body of knowledge relating to the effectiveness of key mechanisms for improving clinical practice and service development. Multifaceted interventions are more likely to improve practice than single interventions such as audit and feedback. This review identified a small literature focusing explicitly on getting research evidence into clinical practice. It emphasizes the importance of ensuring that primary studies and systematic reviews are precise about the extent to which the reported interventions focus on changing practice based on research evidence (as opposed to other information codified in guidelines and education materials).

Spiritual Values and Spiritual Practices: Interactive Effects on Leadership Effectiveness

Directory of Open Access Journals (Sweden)

Zakiyulfikri Ali

2018-02-01

Full Text Available The relationship between spirituality and leadership effectiveness has been discussed over decades. These relations have been separated in two big perspective—first, an esoteric realm of intangible ideas and emotions; and second, a practical area and scientific inquiry. This research tries to integrate these two different perspectives. Specifically, this research examines the effects of spiritual values and spiritual practices on leadership effectiveness. The findings indicate that spiritual values and spiritual practices have positive effects on leadership effectiveness. This research also shows that spiritual values and spiritual practices have interactive effects on leadership effectiveness. This result implies that organizations should enhance the spiritual values and practices. Discussion, practical, and theoretical implications for further researches are offered. DOI: 10.15408/etk.v17i1.6497

Best practices in identifying, reporting and screening operating experience at nuclear power plants

International Nuclear Information System (INIS)

2008-03-01

IAEA Safety Standards Series No. SF-1 entitled Fundamental Safety Principles: Safety Fundamentals states the need for operating organizations to establish a programme for the collection and analysis of operating experience in nuclear power plants. Such a programme ensures that operating experience is analysed, events important to safety are reviewed in depth, lessons learned are disseminated to the staff of the organization and to relevant national and international organizations, and corrective actions are effectively implemented. This publication has been developed to provide advice and assistance to nuclear installations, and related institutions including contractors and support organizations to strengthen and enhance their own feedback process through the implementation of best practices in identifying, reporting and screening processes and to assess the effectiveness of the above areas. To support a proactive safety management approach the nuclear installations are enhancing the operating experience feedback (OEF) processes. For this purpose, the nuclear industry is striving to collect more information on occurrences that are useful to address the early signs of declining performance and improve operational safety performance. In this environment a strong reporting culture that motivates people to identify and report issues is an important attribute. As a consequence, the number and diversity of issues identified increases, and there is a need to set thresholds of screening for further treatment. Thus, the establishment of an effective identification, reporting and screening process is very beneficial to streamline the efforts, and ensure that major incidents and latent weaknesses are being addressed and that operating experience is treated according to its significance. This leads to improved safety and production. This publication was written to complement the publication IAEA Services Series No. 10 - PROSPER Guidelines - Guidelines for Peer Review and for

Detection of previously undiagnosed cases of COPD in a high-risk population identified in general practice

DEFF Research Database (Denmark)

Løkke, Anders; Ulrik, Charlotte Suppli; Dahl, Ronald

2012-01-01

Background and Aim: Under-diagnosis of COPD is a widespread problem. This study aimed to identify previously undiagnosed cases of COPD in a high-risk population identified through general practice. Methods: Participating GPs (n = 241) recruited subjects with no previous diagnosis of lung disease,...

Preparedness for physiotherapy in private practice: Novices identify key factors in an interpretive description study.

Science.gov (United States)

Atkinson, Robyn; McElroy, Theresa

2016-04-01

Physiotherapists in Australia deliver services to a diverse range of clients, across many settings, however little research exists examining graduate preparedness for practice, even in the populous field of private practice. To explore novice physiotherapist perspectives on preparedness for work in private practice. The qualitative approach of interpretive description was used to guide in-depth interviews with 8 novice physiotherapists from 3 universities working in 5 private practices in Melbourne. All interviews were digitally recorded, transcribed verbatim and analyzed thematically. Four main themes influencing graduate preparedness for work in private practice were identified: 1) non-curricular experiences (e.g. sports training) 2) elective curricular: practicum experiences; 3) curricular: attainment of skills specific to private practice; and 4) the private practice setting: supportive colleagues. This combination of non-curricular, curricular, and practice setting factors offered the necessary scaffolding for the graduates to report feeling prepared for work in private practice. Non-curricular activities, radiological instruction, clinical placements, building supportive colleague relations and professional development in private practice are recommended as potential means of building preparedness in novice therapists. Findings have implications for physiotherapy students, educators and private practice clinics looking to recruit new graduates. Copyright © 2015 Elsevier Ltd. All rights reserved.

The use of random-effects models to identify health care center-related characteristics modifying the effect of antipsychotic drugs.

Science.gov (United States)

Nordon, Clementine; Battin, Constance; Verdoux, Helene; Haro, Josef Maria; Belger, Mark; Abenhaim, Lucien; van Staa, Tjeerd Pieter

2017-01-01

A case study was conducted, exploring methods to identify drugs effects modifiers, at a health care center level. Data were drawn from the Schizophrenia Outpatient Health Outcome cohort, including hierarchical information on 6641 patients, recruited from 899 health care centers from across ten European countries. Center-level characteristics included the following: psychiatrist's gender, age, length of practice experience, practice setting and type, countries' Healthcare System Efficiency score, and psychiatrist density in the country. Mixed multivariable linear regression models were used: 1) to estimate antipsychotic drugs' effectiveness (defined as the association between patients' outcome at 3 months - dependent variable, continuous - and antipsychotic drug initiation at baseline - drug A vs other antipsychotic drug); 2) to estimate the similarity between clustered data (using the intra-cluster correlation coefficient); and 3) to explore antipsychotic drug effects modification by center-related characteristics (using the addition of an interaction term). About 23% of the variance found for patients' outcome was explained by unmeasured confounding at a center level. Psychiatrists' practice experience was found to be associated with patient outcomes ( p =0.04) and modified the relative effect of "drug A" ( p <0.001), independent of center- or patient-related characteristics. Mixed models may be useful to explore how center-related characteristics modify drugs' effect estimates, but require numerous assumptions.

Eliciting, Identifying, Interpreting, and Responding to Students' Ideas: Teacher Candidates' Growth in Formative Assessment Practices

Science.gov (United States)

Gotwals, Amelia Wenk; Birmingham, Daniel

2016-06-01

With the goal of helping teacher candidates become well-started beginners, it is important that methods courses in teacher education programs focus on high-leverage practices. Using responsive teaching practices, specifically eliciting, identifying, interpreting, and responding to students' science ideas (i.e., formative assessment), can be used to support all students in learning science successfully. This study follows seven secondary science teacher candidates in a yearlong practice-based methods course. Course assignments (i.e., plans for and reflections on teaching) as well as teaching videos were analyzed using a recursive qualitative approach. In this paper, we present themes and patterns in teacher candidates' abilities to elicit, identify, interpret, and respond to students' ideas. Specifically, we found that those teacher candidates who grew in the ways in which they elicited students' ideas from fall to spring were also those who were able to adopt a more balanced reflection approach (considering both teacher and student moves). However, we found that even the teacher candidates who grew in these practices did not move toward seeing students' ideas as nuanced; rather, they saw students' ideas in a dichotomous fashion: right or wrong. We discuss implications for teacher preparation, specifically for how to promote productive reflection and tools for better understanding students' ideas.

The effects of PACS on radiographer's work practice

International Nuclear Information System (INIS)

Larsson, W.; Aspelin, P.; Bergquist, M.; Hillergard, K.; Jacobsson, B.; Lindskoeld, L.; Wallberg, J.; Lundberg, N.

2007-01-01

This paper identifies and analyses the effects of picture archiving and communication systems (PACS) on radiographers' work practice. It shows that the introduction of PACS did not simply entail the transfer of data and information from the analogue world to the digital world, but it also led to the introduction of new ways of communicating, and new activities and responsibilities on the part of radiography staff. Radiographers are called upon to work increasingly independently, and individual practitioners require higher levels of professional expertise. In all, this paper demonstrates that new technical solutions sometimes lead to substantial changes in responsibilities in work. In this example, the radiographers' work practice has become more highly scientific and they are enjoying a higher level of prestige

Effective implementation of research into practice: an overview of systematic reviews of the health literature

Directory of Open Access Journals (Sweden)

Fraser Alec

2011-06-01

Full Text Available Abstract Background The gap between research findings and clinical practice is well documented and a range of interventions has been developed to increase the implementation of research into clinical practice. Findings A review of systematic reviews of the effectiveness of interventions designed to increase the use of research in clinical practice. A search for relevant systematic reviews was conducted of Medline and the Cochrane Database of Reviews 1998-2009. 13 systematic reviews containing 313 primary studies were included. Four strategy types are identified: audit and feedback; computerised decision support; opinion leaders; and multifaceted interventions. Nine of the reviews reported on multifaceted interventions. This review highlights the small effects of single interventions such as audit and feedback, computerised decision support and opinion leaders. Systematic reviews of multifaceted interventions claim an improvement in effectiveness over single interventions, with effect sizes ranging from small to moderate. This review found that a number of published systematic reviews fail to state whether the recommended practice change is based on the best available research evidence. Conclusions This overview of systematic reviews updates the body of knowledge relating to the effectiveness of key mechanisms for improving clinical practice and service development. Multifaceted interventions are more likely to improve practice than single interventions such as audit and feedback. This review identified a small literature focusing explicitly on getting research evidence into clinical practice. It emphasizes the importance of ensuring that primary studies and systematic reviews are precise about the extent to which the reported interventions focus on changing practice based on research evidence (as opposed to other information codified in guidelines and education materials.

Identifying Best Practices in Pavement Design, Materials, Construction, and Maintenance in Wet-Freeze Climates Similar to Michigan

Science.gov (United States)

2018-02-28

The intent of this research is to identify best practices for pavements in wet-freeze climates. For the purposes of this report, a best practice is a procedure that has been shown by research or experience to produce improved results and that is esta...

Mind the Gap. A systematic review to identify usability and safety challenges and practices during electronic health record implementation.

Science.gov (United States)

Ratwani, Raj; Fairbanks, Terry; Savage, Erica; Adams, Katie; Wittie, Michael; Boone, Edna; Hayden, Andrew; Barnes, Janey; Hettinger, Zach; Gettinger, Andrew

2016-11-16

Decisions made during electronic health record (EHR) implementations profoundly affect usability and safety. This study aims to identify gaps between the current literature and key stakeholders' perceptions of usability and safety practices and the challenges encountered during the implementation of EHRs. Two approaches were used: a literature review and interviews with key stakeholders. We performed a systematic review of the literature to identify usability and safety challenges and best practices during implementation. A total of 55 articles were reviewed through searches of PubMed, Web of Science and Scopus. We used a qualitative approach to identify key stakeholders' perceptions; semi-structured interviews were conducted with a diverse set of health IT stakeholders to understand their current practices and challenges related to usability during implementation. We used a grounded theory approach: data were coded, sorted, and emerging themes were identified. Conclusions from both sources of data were compared to identify areas of misalignment. We identified six emerging themes from the literature and stakeholder interviews: cost and resources, risk assessment, governance and consensus building, customization, clinical workflow and usability testing, and training. Across these themes, there were misalignments between the literature and stakeholder perspectives, indicating major gaps. Major gaps identified from each of six emerging themes are discussed as critical areas for future research, opportunities for new stakeholder initiatives, and opportunities to better disseminate resources to improve the implementation of EHRs. Our analysis identified practices and challenges across six different emerging themes, illustrated important gaps, and results suggest critical areas for future research and dissemination to improve EHR implementation.

Effectiveness of an Online Educational Module in Improving Evidence-Based Practice Skills of Practicing Registered Nurses.

Science.gov (United States)

Moore, Lora

2017-10-01

Implementation of evidence-based practice (EBP) at the bedside has been difficult to achieve. Significant gaps between current research and actual practice have been identified and must be addressed in effort to increase utilization of EBP. The purpose of this study was to evaluate the efficacy of an online EBP educational intervention and to examine the relationship between educational preparation and years of nursing experience on nurses' practice, attitudes, and knowledge and skills of EBP. An experimental pretest-posttest design study with three randomized groups utilizing the EBPQ instrument was conducted. No significant differences were noted in EBPQ subscale scores of practice, attitude, or knowledge and skills from pre- to posttest. In addition, no statistical difference in EBPQ subscale scores regarding educational preparation or years of experience were noted. While nurses report positive attitudes toward EBP, their perceptions of practice and knowledge and skills score much lower. Educational interventions are needed for practicing nurses to overcome this knowledge deficit to successfully implement EBP. However, the use of online, independent, computer-based learning modules, while cost-efficient and offer several benefits when educating nurses, may not necessarily be the most effective method for teaching EBP knowledge and skills to practicing nurses. © 2017 Sigma Theta Tau International.

Identifying influential spreaders in complex networks through local effective spreading paths

Science.gov (United States)

Wang, Xiaojie; Zhang, Xue; Yi, Dongyun; Zhao, Chengli

2017-05-01

How to effectively identify a set of influential spreaders in complex networks is of great theoretical and practical value, which can help to inhibit the rapid spread of epidemics, promote the sales of products by word-of-mouth advertising, and so on. A naive strategy is to select the top ranked nodes as identified by some centrality indices, and other strategies are mainly based on greedy methods and heuristic methods. However, most of those approaches did not concern the connections between nodes. Usually, the distances between the selected spreaders are very close, leading to a serious overlapping of their influence. As a consequence, the global influence of the spreaders in networks will be greatly reduced, which largely restricts the performance of those methods. In this paper, a simple and efficient method is proposed to identify a set of discrete yet influential spreaders. By analyzing the spreading paths in the network, we present the concept of effective spreading paths and measure the influence of nodes via expectation calculation. The numerical analysis in undirected and directed networks all show that our proposed method outperforms many other centrality-based and heuristic benchmarks, especially in large-scale networks. Besides, experimental results on different spreading models and parameters demonstrates the stability and wide applicability of our method.

Identifying Effective Components of Child Maltreatment Interventions: A Meta-analysis.

Science.gov (United States)

van der Put, Claudia E; Assink, Mark; Gubbels, Jeanne; Boekhout van Solinge, Noëlle F

2018-06-01

There is a lack of knowledge about specific components that make interventions effective in preventing or reducing child maltreatment. The aim of the present meta-analysis was to increase this knowledge by summarizing findings on effects of interventions for child maltreatment and by examining potential moderators of this effect, such as intervention components and study characteristics. Identifying effective components is essential for developing or improving child maltreatment interventions. A literature search yielded 121 independent studies (N = 39,044) examining the effects of interventions for preventing or reducing child maltreatment. From these studies, 352 effect sizes were extracted. The overall effect size was significant and small in magnitude for both preventive interventions (d = 0.26, p child maltreatment. For preventive interventions, larger effect sizes were found for short-term interventions (0-6 months), interventions focusing on increasing self-confidence of parents, and interventions delivered by professionals only. Further, effect sizes of preventive interventions increased as follow-up duration increased, which may indicate a sleeper effect of preventive interventions. For curative interventions, larger effect sizes were found for interventions focusing on improving parenting skills and interventions providing social and/or emotional support. Interventions can be effective in preventing or reducing child maltreatment. Theoretical and practical implications are discussed.

Identifying and ranking implicit leadership strategies to promote evidence-based practice implementation in addiction health services.

Science.gov (United States)

Guerrero, Erick G; Padwa, Howard; Fenwick, Karissa; Harris, Lesley M; Aarons, Gregory A

2016-05-14

Despite a solid research base supporting evidence-based practices (EBPs) for addiction treatment such as contingency management and medication-assisted treatment, these services are rarely implemented and delivered in community-based addiction treatment programs in the USA. As a result, many clients do not benefit from the most current and efficacious treatments, resulting in reduced quality of care and compromised treatment outcomes. Previous research indicates that addiction program leaders play a key role in supporting EBP adoption and use. The present study expanded on this previous work to identify strategies that addiction treatment program leaders report using to implement new practices. We relied on a staged and iterative mixed-methods approach to achieve the following four goals: (a) collect data using focus groups and semistructured interviews and conduct analyses to identify implicit managerial strategies for implementation, (b) use surveys to quantitatively rank strategy effectiveness, (c) determine how strategies fit with existing theories of organizational management and change, and (d) use a consensus group to corroborate and expand on the results of the previous three stages. Each goal corresponded to a methodological phase, which included data collection and analytic approaches to identify and evaluate leadership interventions that facilitate EBP implementation in community-based addiction treatment programs. Findings show that the top-ranked strategies involved the recruitment and selection of staff members receptive to change, offering support and requesting feedback during the implementation process, and offering in vivo and hands-on training. Most strategies corresponded to emergent implementation leadership approaches that also utilize principles of transformational and transactional leadership styles. Leadership behaviors represented orientations such as being proactive to respond to implementation needs, supportive to assist staff members

Communicating Effectively in Pediatric Cancer Care: Translating Evidence into Practice

Directory of Open Access Journals (Sweden)

Lindsay J. Blazin

2018-03-01

Full Text Available Effective communication is essential to the practice of pediatric oncology. Clear and empathic delivery of diagnostic and prognostic information positively impacts the ways in which patients and families cope. Honest, compassionate discussions regarding goals of care and hopes for patients approaching end of life can provide healing when other therapies have failed. Effective communication and the positive relationships it fosters also can provide comfort to families grieving the loss of a child. A robust body of evidence demonstrates the benefits of optimal communication for patients, families, and healthcare providers. This review aims to identify key communication skills that healthcare providers can employ throughout the illness journey to provide information, encourage shared decision-making, promote therapeutic alliance, and empathically address end-of-life concerns. By reviewing the relevant evidence and providing practical tips for skill development, we strive to help healthcare providers understand the value of effective communication and master these critical skills.

Effects of nursing position on transformational leadership practices.

Science.gov (United States)

Herman, Susan; Gish, Mary; Rosenblum, Ruth

2015-02-01

This study sought to identify significant differences in nursing leadership strengths by position title. Recent reports show aspects of transformational leadership (TL) related to position, age, and educational level. This study focuses on differentiating the strength of leadership practices across the range of nursing management positions. The Leadership Practices Inventory-Self-assessment survey, and a variety of demographic questions, were used to anonymously poll voluntary members of the Association of California Nurse Leaders. Nursing positions of director level and above were strongest in leadership practices. Those at manager and below were identified as needing additional leadership development. LPI-S subscales Enable Others to Act and Model the Way were strongest. Those at the manager level and below will benefit most from additional education and training. Even upper levels of management would gain from enhancing the LPI practices of Challenge the Process and Inspire a Shared Vision.

Identified best environmental management practices to improve the energy performance of the retail trade sector in Europe

International Nuclear Information System (INIS)

Galvez-Martos, Jose-Luis; Styles, David; Schoenberger, Harald

2013-01-01

The retail trade sector has been identified as a target sector for the development of sectoral reference documents on best environmental management practices under the Eco-Management and Audit Scheme. This paper focuses on the important energy-related needs in retailers' stores such as for food refrigeration and lighting, as well as heating, ventilation and air conditioning of the building. For the definition of best environmental management practices in the European framework, frontrunner retailers have been identified as those retailers integrating energy minimization and saving measures as standard practice systematically across stores. These best performers also integrate a comprehensive monitoring system in the energy management of every store or building belonging to the company, enabling the rapid identification of energy saving opportunities. An integrative approach is needed to define how best practices should be implemented in combination to optimize energy management within stores: building aspects such as insulation of the building envelope or the heating, ventilation and air conditioning system, should be optimized in combination with best options for refrigeration in food retailers. Refrigeration systems are responsible for half of the final energy use in stores and of their carbon footprint. Natural refrigerants, heat recovery from the condensation stage and covering of display cases are measures with high environmental benefits to reduce the impact of refrigeration. Finally, practices for lighting, as optimal lighting strategies, and the integration of renewable energy sources in overall zero energy building concepts can save considerable amounts of fossil energy, reduce the carbon footprint and produce significant cost-savings in the long term. - highlights: • There is a high energy performance improvement potential of the retail trade sector. • We propose techniques with a high performance level and applied by frontrunners. • We identified

Lessons learned from England's Health Checks Programme: using qualitative research to identify and share best practice.

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Ismail, Hanif; Kelly, Shona

2015-10-20

This study aimed to explore the challenges and barriers faced by staff involved in the delivery of the National Health Service (NHS) Health Check, a systematic cardiovascular disease (CVD) risk assessment and management program in primary care. Data have been derived from three qualitative evaluations that were conducted in 25 General Practices and involved in depth interviews with 58 staff involved all levels of the delivery of the Health Checks. Analysis of the data was undertaken using the framework approach and findings are reported within the context of research and practice considerations. Findings indicated that there is no 'one size fits all' blueprint for maximising uptake although success factors were identified: evolution of the programme over time in response to local needs to suit the particular characteristics of the patient population; individual staff characteristics such as being proactive, enthusiastic and having specific responsibility; a supportive team. Training was clearly identified as an area that needed addressing and practitioners would benefit from CVD specific baseline training and refresher courses to keep them up to date with recent developments in the area. However there were other external factors that impinged on an individual's ability to provide an effective service, some of these were outside the control of individuals and included cutbacks in referral services, insufficient space to run clinics or general awareness of the Health Checks amongst patients. The everyday experiences of practitioners who participated in this study suggest that overall, Health Check is perceived as a worthwhile exercise. But, organisational and structural barriers need to be addressed. We also recommend that clear referral pathways be in place so staff can refer patients to appropriate services (healthy eating sessions, smoking cessation, and exercise referrals). Local authorities need to support initiatives that enable data sharing and linkage so that

Identifying Student Competencies in Macro Practice: Articulating the Practice Wisdom of Field Instructors

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Regehr, Cheryl; Bogo, Marion; Donovan, Kirsten; Lim, April; Anstice, Susan

2012-01-01

Although a growing literature examines competencies in clinical practice, competencies of students in macro social work practice have received comparatively little attention. A grounded-theory methodology was used to elicit field instructor views of student competencies in community, organization, and policy contexts. Competencies described by…

Effectiveness of motor practice in lucid dreams: a comparison with physical and mental practice.

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Stumbrys, Tadas; Erlacher, Daniel; Schredl, Michael

2016-01-01

Motor practice in lucid dreams is a form of mental rehearsal where the dreamer can consciously rehearse motor skills in the dream state while being physically asleep. A previous pilot study showed that practice in lucid dreams can improve subsequent performance. This study aimed to replicate those findings with a different task (finger-tapping) and compare the effectiveness of lucid dream practice (LDP) not only to physical but also to mental practice (MP) in wakefulness. An online experiment was completed by 68 participants within four groups: LDP group, MP group, physical practice (PP) group and control (no practice) group. Pre-test was accomplished in the evening, post-test in the next morning, while the practice was done during the night. All three practice groups significantly improved their performance from pre-test to post-test, but no significant improvements were observed for the control group. Subjective sleep quality was not affected by night practice. This study thus corroborates the previous findings that practice in lucid dreams is effective in improving performance. Its effects seem to be similar to actual PP and MP in wakefulness. Future studies should establish reliable techniques for lucid dream induction and verify the effects of LDP in sleep laboratory conditions.

Evidence-Based Practice and School Nurse Practice: A Review of Literature

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Yonkaitis, Catherine F.

2018-01-01

School nurses report that evidence-based practice (EBP) is not a part of their daily practice, and most have had no formal education regarding EBP or its implementation. The purpose of this review is to identify what strategies might be effective to educate school nurses about EBP as a first step toward establishing EBP in school nurse practice.…

Obstructive sleep apnea among commercial motor vehicle drivers: using evidence-based practice to identify risk factors.

Science.gov (United States)

Olszewski, Kimberly; Wolf, Debra

2013-11-01

Commercial motor vehicle driving is a hazardous occupation, having the third highest fatality rate among common U.S. jobs. Among the estimated 14 million U.S. commercial motor vehicle drivers, the prevalence of obstructive sleep apnea is reported to be 17% to 28%. Despite the identified increased prevalence of obstructive sleep apnea among commercial motor vehicle drivers, federal law does not require that they be screened for obstructive sleep apnea. This article presents an evidence-based practice change project; the authors developed, implemented, and evaluated a screening program to identify commercial motor vehicle drivers' risk for obstructive sleep apnea during commercial driver medical examinations. The results of this practice change indicated screening for obstructive sleep apnea during the commercial driver medical examination led to improved identification of obstructive sleep apnea risk among commercial motor vehicle drivers and should be a clinical standard in occupational health clinics. Copyright 2013, SLACK Incorporated.

Effectiveness of best management practices for sediment reduction at operation forest stream crossings

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Laura R. Wear; Michael W. Aust; M. Chad Bolding; Brian D. Strahm; C. Andrew Dolloff

2013-01-01

Temporary skid trail stream crossings have repeatedly been identified as having considerable potential to introduce sediment to streams. Forestry Best Management Practices (BMPs) have proven to be effective for controlling erosion and subsequent sedimentation, yet few studies have quantified sedimentation associated with various levels of BMPs for skidder stream...

Effective Practice in Inclusive and Special Needs Education

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Buli-Holmberg, Jorun; Jeyaprathaban, Sujathamalini

2016-01-01

The present study attempts to evaluate the effective teaching practice for children with special learning needs. The research question framed in the present study for investigation is which practice will be effective in different inclusive classroom settings and what are the factors that contribute for effective practices? Qualitative research was…

Estimating the effects of wetland conservation practices in croplands: Approaches for modeling in CEAP–Cropland Assessment

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De Steven, Diane; Mushet, David

2018-01-01

Quantifying the current and potential benefits of conservation practices can be a valuable tool for encouraging greater practice adoption on agricultural lands. A goal of the CEAP-Cropland Assessment is to estimate the environmental effects of conservation practices that reduce losses (exports) of soil, nutrients, and pesticides from farmlands to streams and rivers. The assessment approach combines empirical data on reported cropland practices with simulation modeling that compares field-level exports for scenarios “with practices” and “without practices.” Conserved, restored, and created wetlands collectively represent conservation practices that can influence sediment and nutrient exports from croplands. However, modeling the role of wetlands within croplands presents some challenges, including the potential for negative impacts of sediment and nutrient inputs on wetland functions. This Science Note outlines some preliminary solutions for incorporating wetlands and wetland practices into the CEAP-Cropland modeling framework. First, modeling the effects of wetland practices requires identifying wetland hydrogeomorphic type and accounting for the condition of both the wetland and an adjacent upland zone. Second, modeling is facilitated by classifying wetland-related practices into two functional categories (wetland and upland buffer). Third, simulating practice effects requires alternative field configurations to account for hydrological differences among wetland types. These ideas are illustrated for two contrasting wetland types (riparian and depressional).

Good practices for user effect reduction - Status Report

International Nuclear Information System (INIS)

Ashley, R.; El-Shanawany, M.; Eltawila, F.; D'Auria, F.

1999-01-01

User effect has been identified in previous CSNI activities since 1991. The present report has as objectives to outline the consideration given to the user effect problem by various concerned organisations, and to present a consensus about recommended practices for user effect reduction. A survey of relevant literature is summarised, together with the answers collected through the Task Group on Thermal Hydraulics Applications members about characteristics of overall safety analysis process including validation, safety culture, staffing levels, staff competencies and responsibilities, on the job training, required documentation, and quality assurance. An outline is given of the adequacy demonstration process to be undertaken by a code user, when the code is being used in new situations for which assessment has not been performed by the code developers or by other user groups. A list of fifteen recommendations is set up, dealing with organisation and responsibilities, build up of competence, checks and assessments, and uncertainties. In summary: this report provides a review and discussion of earlier work relevant to the user effect on the results of system codes transient analyses; responses to a questionnaire proposed by the OECD/CSNI Task Group on Thermal-Hydraulic Applications are considered, together with results of activities started in 1991 in the same CSNI context. Some recommendations aim at reducing the user effect. These recommendations are generally based on good common practices adopted by organisations involved in safety analyses. Some of the reasons for the user effect are mentioned in the report. Code deficiencies may be to blame in a number of cases; however, here the attention is focussed on the application of the code and not on improving of the code models. A critical aspect is the internal organisation of institutions performing system code applications; the engagement of permanent and hired staff has a role in the quality and reliability of

A Model to Identify the Most Effective Business Rule in Information Systems using Rough Set Theory: Study on Loan Business Process

Directory of Open Access Journals (Sweden)

Mohammad Aghdasi

2011-09-01

In this paper, a practical model is used to identify the most effective rules in information systems. In this model, first, critical business attributes which fit to strategic expectations are taken into account. These are the attributes which their changes are more important than others in achieving the strategic expectations. To identify these attributes we utilize rough set theory. Those business rules which use critical information attribute in their structures are identified as the most effective business rules. The Proposed model helps information system developers to identify scope of effective business rules. It causes a decrease in time and cost of information system maintenance. Also it helps business analyst to focus on managing critical business attributes in order to achieve a specific goal.

Effective Strategies for Achieving Scope of Practice Reform in Pennsylvania.

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Carthon, J Margo Brooks; Wiltse Nicely, Kelly; Altares Sarik, Danielle; Fairman, Julie

2016-05-01

Current regulatory impediments prohibit advanced practice registered nurses from practicing to their full capacity. To examine the process of successful removal of scope of practice barriers in Pennsylvania under the Rx4PA legislation introduced in 2007. We used qualitative research techniques, including purposeful sampling of participants. Twelve stakeholder informed interviews were conducted between October 2013 and May 2014. Participants were closely involved with the development of the Rx4PA legislation. Thematic content analysis was performed to analyze our interviews. Interviews identified overarching themes, including the importance of leveraging years of grass roots advocacy, identifying political allies, and recognizing mutually beneficial compromises. The combination of timing, careful political maneuvering, and compromise were key to scope of practice reform in Pennsylvania and may be useful strategies for other states seeking similar practice changes. © The Author(s) 2016.

Nanocuration workflows: Establishing best practices for identifying, inputting, and sharing data to inform decisions on nanomaterials

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Christina M. Powers

2015-09-01

Full Text Available There is a critical opportunity in the field of nanoscience to compare and integrate information across diverse fields of study through informatics (i.e., nanoinformatics. This paper is one in a series of articles on the data curation process in nanoinformatics (nanocuration. Other articles in this series discuss key aspects of nanocuration (temporal metadata, data completeness, database integration, while the focus of this article is on the nanocuration workflow, or the process of identifying, inputting, and reviewing nanomaterial data in a data repository. In particular, the article discusses: 1 the rationale and importance of a defined workflow in nanocuration, 2 the influence of organizational goals or purpose on the workflow, 3 established workflow practices in other fields, 4 current workflow practices in nanocuration, 5 key challenges for workflows in emerging fields like nanomaterials, 6 examples to make these challenges more tangible, and 7 recommendations to address the identified challenges. Throughout the article, there is an emphasis on illustrating key concepts and current practices in the field. Data on current practices in the field are from a group of stakeholders active in nanocuration. In general, the development of workflows for nanocuration is nascent, with few individuals formally trained in data curation or utilizing available nanocuration resources (e.g., ISA-TAB-Nano. Additional emphasis on the potential benefits of cultivating nanomaterial data via nanocuration processes (e.g., capability to analyze data from across research groups and providing nanocuration resources (e.g., training will likely prove crucial for the wider application of nanocuration workflows in the scientific community.

An information-theoretic approach to assess practical identifiability of parametric dynamical systems.

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Pant, Sanjay; Lombardi, Damiano

2015-10-01

A new approach for assessing parameter identifiability of dynamical systems in a Bayesian setting is presented. The concept of Shannon entropy is employed to measure the inherent uncertainty in the parameters. The expected reduction in this uncertainty is seen as the amount of information one expects to gain about the parameters due to the availability of noisy measurements of the dynamical system. Such expected information gain is interpreted in terms of the variance of a hypothetical measurement device that can measure the parameters directly, and is related to practical identifiability of the parameters. If the individual parameters are unidentifiable, correlation between parameter combinations is assessed through conditional mutual information to determine which sets of parameters can be identified together. The information theoretic quantities of entropy and information are evaluated numerically through a combination of Monte Carlo and k-nearest neighbour methods in a non-parametric fashion. Unlike many methods to evaluate identifiability proposed in the literature, the proposed approach takes the measurement-noise into account and is not restricted to any particular noise-structure. Whilst computationally intensive for large dynamical systems, it is easily parallelisable and is non-intrusive as it does not necessitate re-writing of the numerical solvers of the dynamical system. The application of such an approach is presented for a variety of dynamical systems--ranging from systems governed by ordinary differential equations to partial differential equations--and, where possible, validated against results previously published in the literature. Copyright © 2015 Elsevier Inc. All rights reserved.

The Effects of Quality Management Practices on Key Results: questionnaires sample for the industry of tourist accommodation in Spain

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José Álvarez García

2014-12-01

Full Text Available In this research work, we examine the direct and indirect effects of quality management practices on key results and we identify the relationship between quality practices. To achieve the proposed objective, a structural model was used, taking into account the previous review of the literature, in order to identify the quality practices and causal relationships with the key results. The theoretical model and hypotheses are tested using data collected from a sample of 186 tourist accommodation companies certified with the “Q for Tourist Quality” standard in Spain, from a questionnaire based on quality practices identified in the literature and on the EFQM Model, taking some of the most relevant scales as a reference. The methodology used consists of the application of an Exploratory and Confirmatory Factorial Analysis to validate the scales (reliability, one-dimensionality and validity and define the number of items of each of the measuring instruments of the constructs proposed, to then estimate the causal model proposed, proceeding to test the hypotheses formulated by using the Structural Equation Model (SEM technique. The results achieved support the relationship between quality practices and the direct and positive impact of two of the practices, processes management and quality policy/planning, on the key results. It was also observed that the quality practices that most influence key results are quality policy/planning along with leadership, when considering the total effects (direct and indirect.

Identifying tier one key suppliers.

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Wicks, Steve

2013-01-01

In today's global marketplace, businesses are becoming increasingly reliant on suppliers for the provision of key processes, activities, products and services in support of their strategic business goals. The result is that now, more than ever, the failure of a key supplier has potential to damage reputation, productivity, compliance and financial performance seriously. Yet despite this, there is no recognised standard or guidance for identifying a tier one key supplier base and, up to now, there has been little or no research on how to do so effectively. This paper outlines the key findings of a BCI-sponsored research project to investigate good practice in identifying tier one key suppliers, and suggests a scalable framework process model and risk matrix tool to help businesses effectively identify their tier one key supplier base.

Identifying Best Practices for an Interactive Webinar

Science.gov (United States)

Zoumenou, Virginie; Sigman-Grant, Madeleine; Coleman, Gayle; Malekian, Fatemeh; Zee, Julia M. K.; Fountain, Brent J.; Marsh, Akela

2015-01-01

A webinar or web-seminar is a presentation, seminar, lecture, or workshop transmitted over the internet. This emerging technology is becoming increasingly popular due to its convenience and affordability. However, little research has been conducted on best practices for an interactive webinar that engages learners in a professional development or…

Practices for Identifying and Rejecting Hemolyzed Specimens Are Highly Variable in Clinical Laboratories.

Science.gov (United States)

Howanitz, Peter J; Lehman, Christopher M; Jones, Bruce A; Meier, Frederick A; Horowitz, Gary L

2015-08-01

Hemolysis is an important clinical laboratory quality attribute that influences result reliability. To determine hemolysis identification and rejection practices occurring in clinical laboratories. We used the College of American Pathologists Survey program to distribute a Q-Probes-type questionnaire about hemolysis practices to Chemistry Survey participants. Of 3495 participants sent the questionnaire, 846 (24%) responded. In 71% of 772 laboratories, the hemolysis rate was less than 3.0%, whereas in 5%, it was 6.0% or greater. A visual scale, an instrument scale, and combination of visual and instrument scales were used to identify hemolysis in 48%, 11%, and 41% of laboratories, respectively. A picture of the hemolysis level was used as an aid to technologists' visual interpretation of hemolysis levels in 40% of laboratories. In 7.0% of laboratories, all hemolyzed specimens were rejected; in 4% of laboratories, no hemolyzed specimens were rejected; and in 88% of laboratories, some specimens were rejected depending on hemolysis levels. Participants used 69 different terms to describe hemolysis scales, with 21 terms used in more than 10 laboratories. Slight and moderate were the terms used most commonly. Of 16 different cutoffs used to reject hemolyzed specimens, moderate was the most common, occurring in 30% of laboratories. For whole blood electrolyte measurements performed in 86 laboratories, 57% did not evaluate the presence of hemolysis, but for those that did, the most common practice in 21 laboratories (24%) was centrifuging and visually determining the presence of hemolysis in all specimens. Hemolysis practices vary widely. Standard assessment and consistent reporting are the first steps in reducing interlaboratory variability among results.

Towards an evaluation framework for information quality management (IQM) practices for health information systems--evaluation criteria for effective IQM practices.

Science.gov (United States)

Mohammed, Siti Asma; Yusof, Maryati Mohd

2013-04-01

Poor information quality (IQ) must be understood as a business problem rather than systems problem. In health care organization, what is required is an effective quality management that continuously manages and reviews the factors influencing IQ in health information systems (HIS) so as to achieve the desired outcomes. Hence, in order to understand the issues of information quality management (IQM) practices in health care organizations, a more holistic evaluation study should be undertaken to investigate the IQM practices in health care organizations. It is the aim of this paper to identify the significant evaluation criteria that influence the production of good IQ in HIS. Six selected frameworks and best practices both from health informatics and information systems literature have been reviewed to identify the evaluation criteria from the perspective of human, organizational and technological factors. From the review, it was found that human and organization factors are of greater significance in influencing HIS IQ. Our review depicts that there is still shortage in finding a comprehensive IQM evaluation framework. Thus, the criteria from the frameworks reviewed can be used in combination for more comprehensive evaluation criteria. Integrated IQM evaluation criteria for HIS are then proposed in this study. Poor IQ is the result of complex interdependency within sociotechnical factors in health care organization and lack of formal and structured IQM practices. Thus, a feedback mechanism such as evaluation is needed to understand the issues in depth in the future. © 2012 Blackwell Publishing Ltd.

Problem solving therapy - use and effectiveness in general practice.

Science.gov (United States)

Pierce, David

2012-09-01

Problem solving therapy (PST) is one of the focused psychological strategies supported by Medicare for use by appropriately trained general practitioners. This article reviews the evidence base for PST and its use in the general practice setting. Problem solving therapy involves patients learning or reactivating problem solving skills. These skills can then be applied to specific life problems associated with psychological and somatic symptoms. Problem solving therapy is suitable for use in general practice for patients experiencing common mental health conditions and has been shown to be as effective in the treatment of depression as antidepressants. Problem solving therapy involves a series of sequential stages. The clinician assists the patient to develop new empowering skills, and then supports them to work through the stages of therapy to determine and implement the solution selected by the patient. Many experienced GPs will identify their own existing problem solving skills. Learning about PST may involve refining and focusing these skills.

From Mind to Body: Is Mental Practice Effective on Strength Gains? A Meta-Analysis.

Science.gov (United States)

Manochio, João Paulo; Lattari, Eduardo; Portugal, Eduardo Matta Mello; Monteiro-Junior, Renato Sobral; Paes, Flávia; Budde, Henning; de Tarso Veras Farinatti, Paulo; Arias-Carrión, Oscar; Wegner, Mirko; Carta, Mauro Giovanni; Mura, Gioia; Ferreira Rocha, Nuno Barbosa; Almada, Leonardo Ferreira; Nardi, Antonio Egidio; Yuan, Ti-Fei; Machado, Sergio

2015-01-01

Mental practice is an internal reproduction of a motor act (whose intention is to promote learning and improving motor skills). Some studies have shown that other cognitive strategies also increase the strength and muscular resistance in healthy people by the enhancement of the performance during dynamic tasks. Mental training sessions may be primordial to improving muscle strength in different subjects. The aim of this study was to systematically review and meta-analiyze studies that assessed whether mental practice is effective in improving muscular strength. We conducted an electronic-computed search in Pub-Med/Medline and ISI Web of Knowledge, Scielo and manual searchs, searching papers written in English between 1991 and 2014. There were 44 studies in Pub-Med/Medline, 631 in ISI Web of Knowledge, 11 in Scielo and 3 in manual searchs databases. After exclusion of studies for duplicate, unrelated to the topic by title and summary, different samples and methodologies, a meta-analysis of 4 studies was carried out to identify the dose-response relationship. We did not find evidence that mental practice is effective in increasing strength in healthy individuals. There is no evidence that mental practice alone can be effective to induce strength gains or to optimize the training effects.

Effective maintenance practices to manage system aging

International Nuclear Information System (INIS)

Chockie, A.; Bjorkelo, K.

1992-01-01

For a variety of economic and technical reasons, there has been a growing concern with the aging of complex systems and components and the role that maintenance can play in reducing this degradation. A study for the Nuclear Regulatory Commission was recently undertaken to identify effective maintenance practices that could be adapted by the nuclear industry in the United States to assist in managing the aging degradation of plant systems and components. Four organizations were examined to assess the influence that their maintenance programs have on their ability to address the systems and component aging degradation issues. An effective maintenance program was found to be essential to the management of system and component aging. The four key elements of an effective maintenance program that are important to an aging management program were identified. These are: the selection of critical systems and components; the development of an understanding of aging through the collection and analysis of equipment performance information; the development of appropriate preventive and predictive maintenance tasks to manage equipment and system aging degradation; the use of feedback mechanisms to continuously improve the management of aging systems and components. These elements were found to be common to all four organizations. In examining how the four organizations have structured their maintenance programs to include these key elements provides valuable lessons not only for the nuclear power industry, but also for any industrial organization that is concerned with the management of system and component aging degradation. This document provides detail, of these studies

[Identifying gaps between guidelines and clinical practice in Clostridium difficile infection].

Science.gov (United States)

Rodríguez-Martín, C; Serrano-Morte, A; Sánchez-Muñoz, L A; de Santos-Castro, P A; Bratos-Pérez, M A; Ortiz de Lejarazu-Leonardo, R

2016-01-01

The first aim was to determine whether patients are being treated in accordance with the Society for Healthcare Epidemiology of America and the Infectious Diseases Society of America (IDSA/SHEA) Clostridium difficile guidelines and whether adherence impacts patient outcomes. The second aim was to identify specific action items in the guidelines that are not being translated into clinical practice, for their subsequent implementation. A retrospective, descriptive study was conducted over a 36 month period, on patients with compatible clinical symptoms and positive test for C. difficile toxins A and/or B in stool samples, in an internal medicine department of a tertiary medical centre. Patient demographic and clinical data (outcomes, comorbidity, risk factors) and compliance with guidelines, were examined A total of 77 patients with C. difficile infection were identified (87 episodes). Stratified by disease severity criteria, 49.3% of patients were mild-moderate, 35.1% severe, and 15.6% severe-complicated. Full adherence with the guidelines was observed in only 40.2% of patients, and was significantly better for mild-moderate (71.0%), than in severe (7.4%) or severe-complicated patients (16.6%) (PClostridium difficile infection was poor, especially in severe and severe-complicated patients, being associated with worse clinical outcomes. Educational interventions aimed at improving guideline adherence are warranted. Copyright © 2015 SECA. Published by Elsevier Espana. All rights reserved.

The use of random-effects models to identify health care center-related characteristics modifying the effect of antipsychotic drugs

Directory of Open Access Journals (Sweden)

Nordon C

2017-12-01

Full Text Available Clementine Nordon,1 Constance Battin,1 Helene Verdoux,2 Josef Maria Haro,3 Mark Belger,4 Lucien Abenhaim,1 Tjeerd Pieter van Staa5 On behalf of the IMI GetReal WP2 Group 1Epidemiological Research, Analytica LASER, Paris, 2Population Health Research Center, Team Pharmaco-Epidemiology, UMR 1219, Bordeaux-2 University, INSERM, Bordeaux, France; 3Parc Sanitari Sant Joan de Deu, CIBERSAM, University of Barcelona, Barcelona, Spain; 4Eli Lilly and Company Limited, Erl Wood Manor, Windlesham, 5Farr Institute, University of Manchester, Manchester, UK Purpose: A case study was conducted, exploring methods to identify drugs effects modifiers, at a health care center level.Patients and methods: Data were drawn from the Schizophrenia Outpatient Health Outcome cohort, including hierarchical information on 6641 patients, recruited from 899 health care centers from across ten European countries. Center-level characteristics included the following: psychiatrist’s gender, age, length of practice experience, practice setting and type, countries’ Healthcare System Efficiency score, and psychiatrist density in the country. Mixed multivariable linear regression models were used: 1 to estimate antipsychotic drugs’ effectiveness (defined as the association between patients’ outcome at 3 months – dependent variable, continuous – and antipsychotic drug initiation at baseline – drug A vs other antipsychotic drug; 2 to estimate the similarity between clustered data (using the intra-cluster correlation coefficient; and 3 to explore antipsychotic drug effects modification by center-related characteristics (using the addition of an interaction term.Results: About 23% of the variance found for patients’ outcome was explained by unmeasured confounding at a center level. Psychiatrists’ practice experience was found to be associated with patient outcomes (p=0.04 and modified the relative effect of “drug A” (p<0.001, independent of center- or patient

Identifying and preparing the next generation of part-time clinical teachers from dental practice.

Science.gov (United States)

Radford, D R; Hellyer, P; Meakin, N; Jones, K A

2015-10-09

Part-time general dental practitioners (GDPs) and dental care professionals (DCPs) working in practice are being increasingly utilised to deliver undergraduate clinical dental education to both dental and hygiene/therapy students. As such, there is a need for appropriate recruitment processes and ongoing staff development in the different and complex role of the clinical teacher. Recently a group of experienced dental practitioners, making a journey from GDP to part-time clinical teacher, identified common themes, experiences, challenges and realisations. These were: 'what is clinical dental education?'; 'me as a clinical teacher'; and 'specific teaching issues'. The themes highlighted the complexity of dental education and the different environment of the teaching clinic from general practice. Some of the themes identified could be a starting point for the induction process to facilitate an easier transition from experienced GDP to clinical teacher. With the current demands from both students and patients alike, the 'three way dynamic of patient, student and teacher' needs to be supported if dental schools are to attract and develop the highest quality clinical teachers. It is of critical importance to give an exceptional experience to students in their clinical education as well as to patients in terms of excellent and appropriate treatment. The challenge for deans and directors of education is to find the resources to properly fund teacher recruitment, induction and the development of part-time GDPs in order to produce the expert teachers of tomorrow.

The long-term effects of undertaking a research course on clinical practice.

Science.gov (United States)

Hazel, Rangeley; Joyce, Arthurs

2004-03-01

Purpose. The aim of the study was to examine the students perceptions of the long-term effectiveness of the English National Board (ENB) 870 course (Understanding and Application of Research). Method. Both quantitative and qualitative strategies examined four objectives focusing on: research utilisation, usefulness of the course in the "real world", factors affecting research use and student support. A total sample comprised all 315 students from 1995 to 1998. Data were collected by postal questionnaires and by two focus group interviews. The responding sample of nurses, midwives and health visitors, all with a minimum of one years practice since completing the course totaled 145, achieving a response rate of 45%. Results. Evidence identified that practitioners were using research at a variety of levels to inform everyday practice. The skills developed in the course had transferred well to real life practice and a critical, confident, proactive approach within and across professional boundaries was demonstrated. A generally supportive culture was identified in the workplace but a lack of time and staff had prevented optimum utilisation of the new skills. A much more positive approach to research-based care was reported and many respondents stated that they had become more autonomous, accountable and better practitioners.

Effective practices of international volunteering for health: perspectives from partner organizations.

Science.gov (United States)

Lough, Benjamin J; Tiessen, Rebecca; Lasker, Judith N

2018-01-24

The demand for international volunteer experiences to promote global health and nutrition is increasing and numerous studies have documented the experiences of the international volunteers who travel abroad; however, little is known about effective practices from the perspective of partner organizations. This study aims to understand how variables such as the skill-level of volunteers, the duration of service, cultural and language training, and other key variables affect partner organizations' perceptions of volunteer effectiveness at promoting healthcare and nutrition. This study used a cross-sectional design to survey a convenience sample of 288 volunteer partner organizations located in 68 countries. Principle components analyses and manual coding of cases resulted in a categorization of five generalized types of international volunteering. Differences among these types were compared by the duration of service, skill-level of volunteers, and the volunteers' perceived fit with organizational needs. In addition, a multivariate ordinary least square regression tested associations between nine different characteristics/activities and the volunteers' perceived effectiveness at promoting healthcare and nutrition. Partner organizations viewed highly-skilled volunteers serving for a short-term abroad as the most effective at promoting healthcare and nutrition in their organizations, followed by slightly less-skilled long-term volunteers. The greatest amount of variance in perceived effectiveness was volunteers' ability to speak the local language, followed by their skill level and the duration of service abroad. In addition, volunteer training in community development principles and practices was significantly related to perceived effectiveness. The perceptions of effective healthcare promotion identified by partner organizations suggest that program and volunteer characteristics need to be carefully considered when deciding on methods of volunteer preparation and

Educators' Self-Reported Training, Use, and Perceived Effectiveness of Evidence-Based Classroom Management Practices

Science.gov (United States)

Cooper, Justin T.; Gage, Nicholas A.; Alter, Peter J.; LaPolla, Stefanie; MacSuga-Gage, Ashley S.; Scott, Terrance M.

2018-01-01

A survey study of 248 educators in four states was conducted to identify respondents' formal training, use, and perceived effectiveness of 37 evidence-based classroom management practices within four general categories: (a) antecedent-based, (b) instructionally based, (c) consequence-based, and (d) self-management. Results indicated that, on…

Relative age effect: implications for effective practice.

Science.gov (United States)

Andronikos, Georgios; Elumaro, Adeboye Israel; Westbury, Tony; Martindale, Russell J J

2016-01-01

Physical and psychological differences related to birthdate amongst athletes of the same selection year have been characterised as the "relative age effects" (RAEs). RAEs have been identified in a variety of sports, both at youth and adult level, and are linked with dropout of athletes and a reduction of the talent pool. This study examined the existence, mechanisms and possible solutions to RAEs using qualitative methodology. Seven experts in the field of talent identification and development were interviewed. Inductive analysis of the data showed that, while there was mixed evidence for the existence of RAEs across sports, the eradication of RAEs was attributed to controllable features of the development environment. The factors reported included the structure of "categories" used to group athletes within the sport (e.g. age, weight, size, skills), recognition and prioritisation of long-term development over "short term win focus." Education of relevant parties (e.g. coaches, scouts, clubs) about RAEs and the nature of "talent" within a long-term context was suggested, along with careful consideration of the structure of the development environment (e.g. delayed selection, provision for late developers, focus on skills not results, use of challenge). Implications for research and practice are discussed.

Evaluating the effectiveness of implementing quality management practices in the medical industry.

Science.gov (United States)

Yeh, T-M; Lai, H-P

2015-01-01

To discuss the effectiveness of 30 quality management practices (QMP) including Strategic Management, Balanced ScoreCard, Knowledge Management, and Total Quality Management in the medical industry. A V-shaped performance evaluation matrix is applied to identify the top ten practices that are important but not easy to use or implement. Quality Function Deployment (QFD) is then utilized to find key factors to improve the implementation of the top ten tools. The questionnaires were sent to the nursing staff and administrators in a hospital through e-mail and posts. A total of 250 copies were distributed and 217 copies were valid. The importance, easiness, and achievement (i.e., implementation level) of 30 quality management practices were used. Key factors for QMP implementation were sequenced in order of importance as top management involvement, inter-department communication and coordination, teamwork, hospital-wide participation, education and training, consultant professionalism, continuous internal auditing, computerized process, and incentive compensation. Top management can implement the V-shaped performance matrix to determine whether quality management practices need improvement and if so, utilize QFD to find the key factors for improvement.

Identifying effective actions to guide volunteer-based and nationwide conservation efforts for a ground-nesting farmland bird

OpenAIRE

Santangeli, Andrea; Arroyo, Beatriz; Millon, Alexandre; Bretagnolle, Vincent

2015-01-01

Modern farming practices threaten wildlife in different ways, and failure to identify the complexity of multiple threats acting in synergy may result in ineffective management. To protect ground-nesting birds in farmland, monitoring and mitigating impacts of mechanical harvesting is crucial. Here, we use 6 years of data from a nationwide volunteer-based monitoring scheme of the Montagu's harrier, a ground-nesting raptor, in French farmlands. We assess the effectiveness of alternative nest pro...

Benchmarking to Identify Practice Variation in Test Ordering: A Potential Tool for Utilization Management.

Science.gov (United States)

Signorelli, Heather; Straseski, Joely A; Genzen, Jonathan R; Walker, Brandon S; Jackson, Brian R; Schmidt, Robert L

2015-01-01

Appropriate test utilization is usually evaluated by adherence to published guidelines. In many cases, medical guidelines are not available. Benchmarking has been proposed as a method to identify practice variations that may represent inappropriate testing. This study investigated the use of benchmarking to identify sites with inappropriate utilization of testing for a particular analyte. We used a Web-based survey to compare 2 measures of vitamin D utilization: overall testing intensity (ratio of total vitamin D orders to blood-count orders) and relative testing intensity (ratio of 1,25(OH)2D to 25(OH)D test orders). A total of 81 facilities contributed data. The average overall testing intensity index was 0.165, or approximately 1 vitamin D test for every 6 blood-count tests. The average relative testing intensity index was 0.055, or one 1,25(OH)2D test for every 18 of the 25(OH)D tests. Both indexes varied considerably. Benchmarking can be used as a screening tool to identify outliers that may be associated with inappropriate test utilization. Copyright© by the American Society for Clinical Pathology (ASCP).

12 CFR 337.11 - Effect on other banking practices.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Effect on other banking practices. 337.11 Section 337.11 Banks and Banking FEDERAL DEPOSIT INSURANCE CORPORATION REGULATIONS AND STATEMENTS OF GENERAL POLICY UNSAFE AND UNSOUND BANKING PRACTICES § 337.11 Effect on other banking practices. Nothing in...

Effective use of forensic science in volume crime investigations: identifying recurring themes in the literature.

Science.gov (United States)

Ludwig, Anika; Fraser, Jim

2014-01-01

New scientific, technological and legal developments, particularly the introduction of national databases for DNA and fingerprints, have led to increased use of forensic science in the investigation of crime. There is an assumption, and in some instances specific assertions, that such developments bring improvements either in broad criminal justice terms or more narrowly in terms of economic or practical efficiencies. The underlying presumption is that the new technological opportunities will be understood and effectively implemented. This research investigates whether such increases in activity have also been accompanied by improvements in the effective use of forensic science. A systematic review of thirty-six reports published (predominantly in England and Wales) since the 1980s, which have considered the use of forensic science in the investigation of volume crimes, was carried out. These reports have identified a number of recurrent themes that influenced how effectively forensic science was used in investigations. The themes identified included forensic knowledge and training of investigators, communication and information exchange between specialists and investigators, timeliness of forensic results, interagency relationships and deployment of crime scene examiner resources. The research findings suggest that these factors continue to hinder the effective use of forensic science despite technological advances and this paper considers their potential causes. © 2013.

Assessing cost-effectiveness of specific LID practice designs in response to large storm events

Science.gov (United States)

Chui, Ting Fong May; Liu, Xin; Zhan, Wenting

2016-02-01

Low impact development (LID) practices have become more important in urban stormwater management worldwide. However, most research on design optimization focuses on relatively large scale, and there is very limited information or guideline regarding individual LID practice designs (i.e., optimal depth, width and length). The objective of this study is to identify the optimal design by assessing the hydrological performance and the cost-effectiveness of different designs of LID practices at a household or business scale, and to analyze the sensitivity of the hydrological performance and the cost of the optimal design to different model and design parameters. First, EPA SWMM, automatically controlled by MATLAB, is used to obtain the peak runoff of different designs of three specific LID practices (i.e., green roof, bioretention and porous pavement) under different design storms (i.e., 2 yr and 50 yr design storms of Hong Kong, China and Seattle, U.S.). Then, life cycle cost is estimated for the different designs, and the optimal design, defined as the design with the lowest cost and at least 20% peak runoff reduction, is identified. Finally, sensitivity of the optimal design to the different design parameters is examined. The optimal design of green roof tends to be larger in area but thinner, while the optimal designs of bioretention and porous pavement tend to be smaller in area. To handle larger storms, however, it is more effective to increase the green roof depth, and to increase the area of the bioretention and porous pavement. Porous pavement is the most cost-effective for peak flow reduction, followed by bioretention and then green roof. The cost-effectiveness, measured as the peak runoff reduction/thousand Dollars of LID practices in Hong Kong (e.g., 0.02 L/103 US s, 0.15 L/103 US s and 0.93 L/103 US s for green roof, bioretention and porous pavement for 2 yr storm) is lower than that in Seattle (e.g., 0.03 L/103 US s, 0.29 L/103 US s and 1.58 L/103 US s for

Identifying critical success factors for designing selection processes into postgraduate specialty training: the case of UK general practice.

Science.gov (United States)

Plint, Simon; Patterson, Fiona

2010-06-01

The UK national recruitment process into general practice training has been developed over several years, with incremental introduction of stages which have been piloted and validated. Previously independent processes, which encouraged multiple applications and produced inconsistent outcomes, have been replaced by a robust national process which has high reliability and predictive validity, and is perceived to be fair by candidates and allocates applicants equitably across the country. Best selection practice involves a job analysis which identifies required competencies, then designs reliable assessment methods to measure them, and over the long term ensures that the process has predictive validity against future performance. The general practitioner recruitment process introduced machine markable short listing assessments for the first time in the UK postgraduate recruitment context, and also adopted selection centre workplace simulations. The key success factors have been identified as corporate commitment to the goal of a national process, with gradual convergence maintaining locus of control rather than the imposition of change without perceived legitimate authority.

Practice Patterns of School-Based Occupational Therapists Targeting Handwriting: A Knowledge-to-Practice Gap

Science.gov (United States)

Cramm, Heidi; Egan, Mary

2015-01-01

Poor handwriting is a common reason for referral to school-based occupational therapy. A survey was used to explore the extent to which current practice patterns in Ontario, Canada, align with evidence on effective intervention for handwriting. Knowledge-to-practice gaps were identified related to focus on performance components versus…

The Effectiveness of a Training Program Based on Practice of Careers in Vocational Interests Development

Science.gov (United States)

Mahasneh, Omar. M.; Farajat, Amani. M.

2015-01-01

The present research was conducted to identify the effectiveness of a training program based on practice of careers in vocational interests development, to answer questions about the study and test its hypothesis the training program had been prepared and the adoption of a measure of vocational interests, as validity and reliability of each of…

Identifying educational priorities for occupational therapy students to prepare for mental health practice in Australia and New Zealand: Opinions of practising occupational therapists.

Science.gov (United States)

Scanlan, Justin Newton; Pépin, Geneviève; Haracz, Kirsti; Ennals, Priscilla; Webster, Jayne S; Meredith, Pamela J; Batten, Rachel; Bowman, Siann; Bonassi, Marianne; Bruce, Rosie

2015-10-01

The effective preparation of occupational therapy students for mental health practice is critical to facilitate positive consumer outcomes, underpin optimal practice and support new graduates' professional identity. This project was established to determine a set of 'educational priorities' for occupational therapy students to prepare them for current (and future) entry-level practice in mental health, from the perspective of mental health occupational therapists in Australia and New Zealand. The study included two phases. In Phase One, participants identified what they considered to be important educational priorities for occupational therapy students to prepare them for practice in mental health. For Phase Two, an 'expert panel' was assembled to review and rank these using a Policy Delphi approach. Eighty-five participants provided educational priorities in Phase One. These were grouped into a total of 149 educational themes. In Phase Two, the expert panel (consisting of 37 occupational therapists from diverse locations and practice settings) prioritised these themes across three Delphi rounds. A final priority list was generated dividing educational themes into three prioritised categories: 29 'Essential', 25 'Important' and 44 'Optional' priorities. Highest-ranked priorities were: clinical reasoning, client-centred practice, therapeutic use of self, functional implications of mental illness, therapeutic use of occupation and mental health fieldwork experience. The priority list developed as part of this project provides additional information to support the review of occupational therapy curricula across Australia and New Zealand to ensure that new graduates are optimally prepared for mental health practice. © 2015 Occupational Therapy Australia.

Noteworthy practices as identified by the US Department of Energy environmental, safety, and health first 31 Tiger Team assessments

International Nuclear Information System (INIS)

1992-05-01

Noteworthy Practices are exceptional ways of accomplishing a performance objective or some aspect of it. Other DOE facilities are encouraged to adopt these practices when they are applicable to their operation. Noteworthy Practices included in this report have been drawn from the first 31 Tiger Team Assessments at DOE sites. This report includes all noteworthy practices listed in an earlier tabulation (June 1990) which the Secretary of the US Department of Energy distributed for information on July 31, 1990. This earlier tabulation included noteworthy practices from the first thirteen Tiger Team Assessments. A brief key-word title has been assigned to each Noteworthy Practice. This title provides a brief description of each Noteworthy Practice. The reader may peruse these titles in the table of contents to identify Noteworthy Practices that may be applicable to their site, facility, or operations. A flexible-disk copy of this compilation is also available in ASCII format on personal-computer, DOS-formatted disks from the Office of Special Projects in the Office of Environment, Safety, and Health at the Headquarters of the US Department of Energy. The ASCII file may be used in combination with word processing software for more detailed word and text-string searches

An analysis of narratives to identify critical thinking contexts in psychiatric clinical practice.

Science.gov (United States)

Mun, Mi Suk

2010-02-01

The development of students' critical thinking abilities is one of the greatest challenges facing contemporary nursing educators. Nursing educators should know about what kind of contents or situations need critical thinking. The research was undertaken to identify the critical thinking contexts that nursing students confront in psychiatric clinical practices. Students were asked to document their everyday experience. The narratives were analysed and interpreted from the philosophical notion of hermeneutics. Four themes emerged as critical thinking contexts: anxiety, conflict, hyper-awareness, dilemmas. Writing narratives appear to provide opportunities for reflection in addition to facilitating critical thinking and communicative skills in students. Also, for the instructor, students' clinical narratives could provide insight to understand how students are thinking and to share student's personal difficulties.

Effects of a 12-Month Educational Intervention on Clinicians' Attitudes/Practices Regarding the Screening Spiritual History.

Science.gov (United States)

Koenig, Harold G; Perno, Kathleen; Erkanli, Alaattin; Hamilton, Ted

2017-06-01

Patients' spiritual values, beliefs, and preferences are identified in outpatient medical settings by the taking of a screening spiritual history (SSH). We report the impact of an educational/training program on the attitudes/practices of physicians (MDs) and midlevel practitioners (MLPs). A convenience sample of 1082 MDs or MLPs in outpatient practices was approached to participate in a 12-month educational/training program in this single-group experimental study. Of the 1082 professionals, 48% (427 physicians, 93 MLPs) agreed to complete a questionnaire assessing demographics, practice characteristics, religiosity, and attitudes/practices regarding the SSH. Changes in attitudes/practices over time were examined and baseline predictors identified using mixed-effects regression. Of the 520 participants completing questionnaires at baseline, 436 were assessed at 1 month (83.8%) and 432 were assessed at 12 months (83.1%). The belief that MDs should take a SSH did not significantly change over time (B = -0.022, standard error [SE] 0.028, P = 0.426). However, those who took an SSH often/always increased from 16.7% at baseline to 34.8% at 12-month follow-up (B = 0.328, SE 0.030, P Educational programs of this type may be used to increase SSH taking by outpatient MDs and MLPs.

Good practice or positive action? Using Q methodology to identify competing views on improving gender equality in academic medicine.

Science.gov (United States)

Bryant, Louise D; Burkinshaw, Paula; House, Allan O; West, Robert M; Ward, Vicky

2017-08-22

The number of women entering medicine has increased significantly, yet women are still under-represented at senior levels in academic medicine. To support the gender equality action plan at one School of Medicine, this study sought to (1) identify the range of viewpoints held by staff on how to address gender inequality and (2) identify attitudinal barriers to change. Q methodology. 50 potential interventions representing good practice or positive action, and addressing cultural, organisational and individual barriers to gender equality, were ranked by participants according to their perception of priority. The School of Medicine at the University of Leeds, UK. Fifty-five staff members were purposively sampled to represent gender and academic pay grade. Principal components analysis identified six competing viewpoints on how to address gender inequality. Four viewpoints favoured positive action interventions: (1) support careers of women with childcare commitments, (2) support progression of women into leadership roles rather than focus on women with children, (3) support careers of all women rather than just those aiming for leadership, and (4) drive change via high-level financial and strategic initiatives. Two viewpoints favoured good practice with no specific focus on women by (5) recognising merit irrespective of gender and (6) improving existing career development practice. No viewpoint was strongly associated with gender, pay grade or role; however, latent class analysis identified that female staff were more likely than male to prioritise the setting of equality targets. Attitudinal barriers to the setting of targets and other positive action initiatives were identified, and it was clear that not all staff supported positive action approaches. The findings and the approach have utility for those involved in gender equality work in other medical and academic institutions. However, the impact of such initiatives needs to be evaluated in the longer term. �

Profile of an excellent nurse manager: identifying and developing health care team leaders.

Science.gov (United States)

Kallas, Kathryn D

2014-01-01

The purpose of this research was to identify the profile of an excellent nurse manager who can lead effective health care teams. Leadership attributes and competencies that characterize an excellent nurse manager and tools to identify them are lacking in the literature but are required to efficiently and effectively address the growing shortage of registered nurses (RNs) in health care team leadership roles and the critical linkage of these roles to patient outcomes. A profile of an excellent nurse manager was developed on the basis of the responses of nurse managers across the United States who had been identified as excellent or competent by chief nurse executive assessment or/and the Nurse Manager Ability, Leadership, and Support of Nurses staff survey to the Kouzes and Posner Leadership Practices Inventory: Self Instrument. Statistically significant distinctions exist between nurse managers who are excellent and those who are competent as assessed by the Five Practices of Exemplary Leadership, which together comprise the profile of an excellent nurse manager. The Kouzes and Posner Leadership Practices Inventory: Self Instrument can be used to identify, recruit, and develop RNs in the nurse manager role as excellent leaders of effective health care teams.

The effectiveness of marketing concepts in veterinary practices.

Science.gov (United States)

Molhoek, A W I; Endenburg, N

2009-01-01

What makes pet owners chose one veterinary practice and not another? This survey was performed to gain insight into what factors influence new clients' choice of veterinary practice, and consequently the most effective way to promote veterinary practices. To this end, a questionnaire was completed by 129 pet owners who became new clients of one of eight selected veterinary practices in January 2005 or later. All selected practices are members of the Dierenartsen Dienstgroep Domstad, Utrecht, The Netherlands. This survey showed word-of-mouth referral to be the most effective way to increase a practice client base: 32.8% of all respondents first heard of their practice of choice through a fellow pet owner. Other pet owners first 'heard' of their practice by passing the practice (17.2%), seeing an advertisement in the Yellow Pages (14.1%), visiting the veterinary practice website (13.3%), and looking in the phone book (10.9%). These information sources should be considered for promotional activities. However this is not the case for advertisements in newspapers or magazines: none of the respondents became acquainted with the practice through these media. Respondents primarily based their choice on personnel and product (the total package of services and its quality) and less on location, but many prospective clients also based their choice on promotional activities and prices. Because pet owners apparently take so many aspects into consideration when choosing a veterinary practice, the marketing orientation (focusing on the client with her/his wishes and problems) is crucial.

A qualitative study examining methods of accessing and identifying research relevant to clinical practice among rehabilitation clinicians.

Science.gov (United States)

Patel, Drasti; Koehmstedt, Christine; Jones, Rebecca; Coffey, Nathan T; Cai, Xinsheng; Garfinkel, Steven; Shaewitz, Dahlia M; Weinstein, Ali A

2017-01-01

Research examining the utilization of evidence-based practice (EBP) specifically among rehabilitation clinicians is limited. The objective of this study was to examine how various rehabilitative clinicians including physical therapists, occupational therapists, rehabilitation counselors, and physiatrists are gaining access to literature and whether they are able to implement the available research into practice. A total of 21 total clinicians were interviewed via telephone. Using NVivo, a qualitative analysis of the responses was performed. There were similarities found with respect to the information-seeking behaviors and translation of research across the different clinician types. Lack of time was reported to be a barrier for both access to literature and implementation of research across all clinician types. The majority of clinicians who reported having difficulty with utilizing the published literature indicated that the literature was not applicable to their practice, the research was not specific enough to be put into practice, or the research found was too outdated to be relevant. In addition, having a supportive work environment aided in the search and utilization of research through providing resources central to assisting clinicians in gaining access to health information. Our study identified several barriers that affect EBP for rehabilitation clinicians. The findings suggest the need for researchers to ensure that their work is applicable and specific to clinical practice for implementation to occur.

Methods to Succeed in Effective Knowledge Translation in Clinical Practice.

Science.gov (United States)

Kitson, Alison L; Harvey, Gillian

2016-05-01

To explore the evidence around facilitation as an intervention for the successful implementation of new knowledge into clinical practice. The revised version of the Promoting Action on Research Implementation in Health Services (PARIHS) framework, called the integrated or i-PARIHS framework, is used as the explanatory framework. This framework posits that evidence is a multidimensional construct embedded within innovation and operationalized by clinicians (individuals and within teams), working across multiple layers of context. Facilitation is the active ingredient that promotes successful implementation. An emerging body of evidence supports facilitation as a mechanism to getting new knowledge into clinical practice. Facilitation roles are divided into beginner, experienced, and expert facilitators. Facilitators can be internal or external to the organization they work in, and their skills and attributes complement other knowledge translation (KT) roles. Complex KT projects require facilitators who are experienced in implementation methods. Facilitation is positioned as the active ingredient to effectively introduce new knowledge into a clinical setting. Levels of facilitation experience are assessed in relation to the complexity of the KT task. Three core facilitation roles are identified, and structured interventions are established taking into account the nature and novelty of the evidence, the receptiveness of the clinicians, and the context or setting where the new evidence is to be introduced. Roles such as novice, experienced, and expert facilitators have important and complementary parts to play in enabling the successful translation of evidence into everyday practice in order to provide effective care for patients. © 2016 Sigma Theta Tau International.

Users, Uses, and Effects of Social Media in Dietetic Practice: Scoping Review of the Quantitative and Qualitative Evidence

Science.gov (United States)

2018-01-01

Background Social media platforms are increasingly used by registered dietitians (RDs) to improve knowledge translation and exchange in nutrition. However, a thorough understanding of social media in dietetic practice is lacking. Objective The objective of this study was to map and summarize the evidence about the users, uses, and effects of social media in dietetic practice to identify gaps in the literature and inform future research by using a scoping review methodology. Methods Stages for conducting the scoping review included the following: (1) identifying the research question; (2) identifying relevant studies through a comprehensive multidatabase and gray literature search strategy; (3) selecting eligible studies; (4) charting the data; and (5) collating, summarizing, and reporting results for dissemination. Finally, knowledge users (RDs working for dietetic professional associations and public health organizations) were involved in each review stage to generate practical findings. Results Of the 47 included studies, 34 were intervention studies, 4 were descriptive studies, 2 were content analysis studies, and 7 were expert opinion papers in dietetic practice. Discussion forums were the most frequent social media platform evaluated (n=19), followed by blogs (n=13) and social networking sites (n=10). Most studies targeted overweight and obese or healthy users, with adult populations being most studied. Social media platforms were used to deliver content as part of larger multiple component interventions for weight management. Among intervention studies using a control group with no exposition to social media, we identified positive, neutral, and mixed effects of social media for outcomes related to users’ health behaviors and status (eg, dietary intakes and body weight), participation rates, and professional knowledge. Factors associated with the characteristics of the specific social media, such as ease of use, a design for quick access to desired

Leading for Learning: Leadership Practices of Effective Boards

Science.gov (United States)

Johnson, Paul A.

2010-01-01

Do school boards have a role in student achievement? Recent research suggests that they do. This article identifies 12 board of education leadership practices associated with higher levels of student achievement: creating a vision, using data, setting goals, monitoring progress and taking corrective action, creating awareness and urgency, engaging…

Developing a Clinician Friendly Tool to Identify Useful Clinical Practice Guidelines: G-TRUST.

Science.gov (United States)

Shaughnessy, Allen F; Vaswani, Akansha; Andrews, Bonnie K; Erlich, Deborah R; D'Amico, Frank; Lexchin, Joel; Cosgrove, Lisa

2017-09-01

Clinicians are faced with a plethora of guidelines. To rate guidelines, they can select from a number of evaluation tools, most of which are long and difficult to apply. The goal of this project was to develop a simple, easy-to-use checklist for clinicians to use to identify trustworthy, relevant, and useful practice guidelines, the Guideline Trustworthiness, Relevance, and Utility Scoring Tool (G-TRUST). A modified Delphi process was used to obtain consensus of experts and guideline developers regarding a checklist of items and their relative impact on guideline quality. We conducted 4 rounds of sampling to refine wording, add and subtract items, and develop a scoring system. Multiple attribute utility analysis was used to develop a weighted utility score for each item to determine scoring. Twenty-two experts in evidence-based medicine, 17 developers of high-quality guidelines, and 1 consumer representative participated. In rounds 1 and 2, items were rewritten or dropped, and 2 items were added. In round 3, weighted scores were calculated from rankings and relative weights assigned by the expert panel. In the last round, more than 75% of experts indicated 3 of the 8 checklist items to be major indicators of guideline usefulness and, using the AGREE tool as a reference standard, a scoring system was developed to identify guidelines as useful, may not be useful, and not useful. The 8-item G-TRUST is potentially helpful as a tool for clinicians to identify useful guidelines. Further research will focus on its reliability when used by clinicians. © 2017 Annals of Family Medicine, Inc.

Three novel approaches to structural identifiability analysis in mixed-effects models.

Science.gov (United States)

Janzén, David L I; Jirstrand, Mats; Chappell, Michael J; Evans, Neil D

2016-05-06

Structural identifiability is a concept that considers whether the structure of a model together with a set of input-output relations uniquely determines the model parameters. In the mathematical modelling of biological systems, structural identifiability is an important concept since biological interpretations are typically made from the parameter estimates. For a system defined by ordinary differential equations, several methods have been developed to analyse whether the model is structurally identifiable or otherwise. Another well-used modelling framework, which is particularly useful when the experimental data are sparsely sampled and the population variance is of interest, is mixed-effects modelling. However, established identifiability analysis techniques for ordinary differential equations are not directly applicable to such models. In this paper, we present and apply three different methods that can be used to study structural identifiability in mixed-effects models. The first method, called the repeated measurement approach, is based on applying a set of previously established statistical theorems. The second method, called the augmented system approach, is based on augmenting the mixed-effects model to an extended state-space form. The third method, called the Laplace transform mixed-effects extension, is based on considering the moment invariants of the systems transfer function as functions of random variables. To illustrate, compare and contrast the application of the three methods, they are applied to a set of mixed-effects models. Three structural identifiability analysis methods applicable to mixed-effects models have been presented in this paper. As method development of structural identifiability techniques for mixed-effects models has been given very little attention, despite mixed-effects models being widely used, the methods presented in this paper provides a way of handling structural identifiability in mixed-effects models previously not

Understanding the Effectiveness of Performance Management Practices

Science.gov (United States)

2010-03-01

practitioners.” Priem and Rosenstein (2001) and Rynes, Bartunek, and Daft (2001) have documented the science- practice gap between OB and other...provided the foundation for effective leadership and project management. Informally the author sought ways to motivate and focus the efforts of...predominate part of his leadership and project management philosophy. This thesis further investigates leadership and management practices focused

AID SELECTIVITY PRACTICE AND AID EFFECTIVENESS IN SUB-SAHARAN AFRICA

Directory of Open Access Journals (Sweden)

Adeniyi Jimmy Adedokun

2017-09-01

Full Text Available Foreign aid strategies have undergone restructuring as donors adopt aid selectivity practice to improve aid effectiveness. This study investigates the impact of aid selectivity practice on aid effectiveness (aid-growth relationship in Sub-Saharan Africa (SSA and several groups of countries within SSA from 1980 to 2012. Employing system generalized methods of moments (system GMM technique; the study produces strong evidence that there is significant improvement in aid effectiveness due to aid selectivity practice.

Practical considerations for effective microendoscopy

Science.gov (United States)

Papaioannou, Thanassis; Papazoglou, Theodore G.; Daykhovsky, Leon; Gershman, Alex; Segalowitz, Jacob; Reznik, G.; Beeder, Clain; Chandra, Mudjianto; Grundfest, Warren S.

1991-07-01

This paper reports on the application of angioscopic technology to the endoscopy of previously inaccessible body cavities. Necessary instruments including endoscopes, light sources, cameras, video recorders, monitors, and other accessories are described. Practical considerations for effective instrumentation are discussed. An overview of our clinical microendoscopic applications in more than 630 patients is presented.

Effective Teaching Practices in Handling Non Readers

Directory of Open Access Journals (Sweden)

Jacklyn S. Dacalos

2016-08-01

Full Text Available The study determined the effective teaching practices in handling nonreaders. This seeks to answer the following objectives: describe the adjustments, effective strategies, and scaffolds utilized by teachers in handling nonreaders; differentiate the teachers’ reading adjustments, strategies and scaffolds in teaching nonreaders; analyze the teaching reading efficiency of nonreaders using effective teaching reading strategies; and find significant correlation of nonreaders’ grades and reading teachers’ reading adjustments, strategies and scaffolds. This study utilized mixed methods of research. Case studies of five public schools teachers were selected as primary subjects, who were interviewed in handling nonreaders in the areas of adjustments, strategies, and reading scaffolds. Actual teaching observation was conducted according to the five subjects’ most convenient time. In ascertaining the nonreaders’ academic performance, the students’ grades in English subject was analyzed using T-Test within subject design. Handling nonreaders in order to read and understand better in the lesson is an arduous act, yet; once done with effectiveness and passion, it yielded a great amount of learning success. Effective teaching practices in handling nonreaders comprised the use of teachers’ adjustments, strategies, and scaffolds to establish reading mastery, exposing them to letter sounds, short stories, and the use of follow-up. WH questions enhanced their reading performance significantly. Variations of reading teachers’ nature as: an enabler, a facilitator, a humanist, a behaviorist, and an expert, as regards to their teaching practices, were proven significant to students’ reading effectiveness.

Game-Based Practice versus Traditional Practice in Computer-Based Writing Strategy Training: Effects on Motivation and Achievement

Science.gov (United States)

Proske, Antje; Roscoe, Rod D.; McNamara, Danielle S.

2014-01-01

Achieving sustained student engagement with practice in computer-based writing strategy training can be a challenge. One potential solution is to foster engagement by embedding practice in educational games; yet there is currently little research comparing the effectiveness of game-based practice versus more traditional forms of practice. In this…

Concept mapping-An effective method for identifying diversity and congruity in cognitive style.

Science.gov (United States)

Stoyanov, Slavi; Jablokow, Kathryn; Rosas, Scott R; Wopereis, Iwan G J H; Kirschner, Paul A

2017-02-01

This paper investigates the effects of cognitive style for decision making on the behaviour of participants in different phases of the group concept mapping process (GCM). It is argued that cognitive style should be included directly in the coordination of the GCM process and not simply considered as yet another demographic variable. The cognitive styles were identified using the Kirton Adaption-Innovation Inventory, which locates each person's style on a continuum ranging from very adaptive to very innovative. Cognitive style could explain diversity in the participants' behaviour in different phases of the GCM process. At the same time, the concept map as a group's common cognitive construct can consolidate individual differences and serves as a tool for managing diversity in groups of participants. Some of the results were that: (a) the more adaptive participants generated ideas that fit to a particular, well-established and consensually agreed paradigm, frame of reference, theory or practice; (b) the more innovative participants produced ideas that were more general in scope and required changing a settled structure (paradigm, frame of reference, theory or practice); and (c) the empirical comparison of the map configurations through Procrustes analysis indicated a strong dissimilarity between cognitive styles. Copyright © 2016 Elsevier Ltd. All rights reserved.

Health Physics and Waste Minimization Best Practices benchmarking study

International Nuclear Information System (INIS)

Levin, V.

1995-01-01

The Health Physics and Waste Minimization Best Practices project examines the usefulness of benchmarking as a tool for identifying health physics and waste minimization best practices for low-level solid radioactive waste (LLW) in the U.S. Department of Energy (DOE) complex. The goal of the project is to identify best practices from the nuclear power industry that will reduce the amount of LLW going to disposal in a cost-effective manner. An increase in worker efficiency and productivity is a secondary goal. These practices must be adaptable for implementation in the DOE complex. Once best practices are identified, ranked, and funded for implementation, a pilot implementation will be done at the Chemistry and Metallurgy Research (CMR) building at Los Alamos National Laboratory

Identifying Effectiveness Criteria for Internet Payment Systems.

Science.gov (United States)

Shon, Tae-Hwan; Swatman, Paula M. C.

1998-01-01

Examines Internet payment systems (IPS): third-party, card, secure Web server, electronic token, financial electronic data interchange (EDI), and micropayment based. Reports the results of a Delphi survey of experts identifying and classifying IPS effectiveness criteria and classifying types of IPS providers. Includes the survey invitation letter…

Effects of electronic communication in general practice

NARCIS (Netherlands)

van der Kam, WJ; Moorman, PW; Koppejan-Mulder, MJ

2000-01-01

Objective: To obtain insight into the effects of electronic communication on GPs by studying those publications in literature describing the effects of structured electronic clinical communication in general practice. Methods: We retrieved all publications in the English language indexed in MEDLINE

Users, Uses, and Effects of Social Media in Dietetic Practice: Scoping Review of the Quantitative and Qualitative Evidence.

Science.gov (United States)

Dumas, Audrée-Anne; Lapointe, Annie; Desroches, Sophie

2018-02-20

Social media platforms are increasingly used by registered dietitians (RDs) to improve knowledge translation and exchange in nutrition. However, a thorough understanding of social media in dietetic practice is lacking. The objective of this study was to map and summarize the evidence about the users, uses, and effects of social media in dietetic practice to identify gaps in the literature and inform future research by using a scoping review methodology. Stages for conducting the scoping review included the following: (1) identifying the research question; (2) identifying relevant studies through a comprehensive multidatabase and gray literature search strategy; (3) selecting eligible studies; (4) charting the data; and (5) collating, summarizing, and reporting results for dissemination. Finally, knowledge users (RDs working for dietetic professional associations and public health organizations) were involved in each review stage to generate practical findings. Of the 47 included studies, 34 were intervention studies, 4 were descriptive studies, 2 were content analysis studies, and 7 were expert opinion papers in dietetic practice. Discussion forums were the most frequent social media platform evaluated (n=19), followed by blogs (n=13) and social networking sites (n=10). Most studies targeted overweight and obese or healthy users, with adult populations being most studied. Social media platforms were used to deliver content as part of larger multiple component interventions for weight management. Among intervention studies using a control group with no exposition to social media, we identified positive, neutral, and mixed effects of social media for outcomes related to users' health behaviors and status (eg, dietary intakes and body weight), participation rates, and professional knowledge. Factors associated with the characteristics of the specific social media, such as ease of use, a design for quick access to desired information, and concurrent reminders of use

A nationwide survey concerning practices in pessary use for pelvic organ prolapse in The Netherlands : identifying needs for further research

NARCIS (Netherlands)

Velzel, Joost; Roovers, Jan Paul; van der Vaart, C. H.; Broekman, Bart; Vollebregt, Astrid; Hakvoort, Robert

2015-01-01

Introduction and hypothesis: To identify practice variation in management of patients with a vaginal pessary for pelvic organ prolapse (POP). Methods: A nationwide survey was sent to all Dutch gynecologists with a special interest in urogynecology. Results: The response rate was 59 %. Of the

A nationwide survey concerning practices in pessary use for pelvic organ prolapse in The Netherlands: identifying needs for further research

NARCIS (Netherlands)

J. Velzel (Joost); J.P. Roovers (Jan Paul); C.H. Van der Vaart; B.M.W. Broekman (Bart); A. Vollebregt (Astrid); R. Hakvoort (Robert)

2015-01-01

textabstractIntroduction and hypothesis: To identify practice variation in management of patients with a vaginal pessary for pelvic organ prolapse (POP). Methods: A nationwide survey was sent to all Dutch gynecologists with a special interest in urogynecology. Results: The response rate was 59 %. Of

General practice training and virtual communities of practice - a review of the literature.

Science.gov (United States)

Barnett, Stephen; Jones, Sandra C; Bennett, Sue; Iverson, Don; Bonney, Andrew

2012-08-21

Good General Practice is essential for an effective health system. Good General Practice training is essential to sustain the workforce, however training for General Practice can be hampered by a number of pressures, including professional, structural and social isolation. General Practice trainees may be under more pressure than fully registered General Practitioners, and yet isolation can lead doctors to reduce hours and move away from rural practice. Virtual communities of practice (VCoPs) in business have been shown to be effective in improving knowledge sharing, thus reducing professional and structural isolation. This literature review will critically examine the current evidence relevant to virtual communities of practice in General Practice training, identify evidence-based principles that might guide their construction and suggest further avenues for research. Major online databases Scopus, Psychlit and Pubmed were searched for the terms "Community of Practice" (CoP) AND (Online OR Virtual OR Electronic) AND (health OR healthcare OR medicine OR "Allied Health"). Only peer-reviewed journal articles in English were selected. A total of 76 articles were identified, with 23 meeting the inclusion criteria. There were no studies on CoP or VCoP in General Practice training. The review was structured using a framework of six themes for establishing communities of practice, derived from a key study from the business literature. This framework has been used to analyse the literature to determine whether similar themes are present in the health literature and to identify evidence in support of virtual communities of practice for General Practice training. The framework developed by Probst is mirrored in the health literature, albeit with some variations. In particular the roles of facilitator or moderator and leader whilst overlapping, are different. VCoPs are usually collaborations between stakeholders rather than single company VCoPs. Specific goals are important

POEM: Identifying joint additive effects on regulatory circuits

Directory of Open Access Journals (Sweden)

Maya eBotzman

2016-04-01

Full Text Available Motivation: Expression Quantitative Trait Locus (eQTL mapping tackles the problem of identifying variation in DNA sequence that have an effect on the transcriptional regulatory network. Major computational efforts are aimed at characterizing the joint effects of several eQTLs acting in concert to govern the expression of the same genes. Yet, progress towards a comprehensive prediction of such joint effects is limited. For example, existing eQTL methods commonly discover interacting loci affecting the expression levels of a module of co-regulated genes. Such ‘modularization’ approaches, however, are focused on epistatic relations and thus have limited utility for the case of additive (non-epistatic effects.Results: Here we present POEM (Pairwise effect On Expression Modules, a methodology for identifying pairwise eQTL effects on gene modules. POEM is specifically designed to achieve high performance in the case of additive joint effects. We applied POEM to transcription profiles measured in bone marrow-derived dendritic cells across a population of genotyped mice. Our study reveals widespread additive, trans-acting pairwise effects on gene modules, characterizes their organizational principles, and highlights high-order interconnections between modules within the immune signaling network. These analyses elucidate the central role of additive pairwise effect in regulatory circuits, and provide computational tools for future investigations into the interplay between eQTLs.Availability: The software described in this article is available at csgi.tau.ac.il/POEM/.

Identifying family television practices to reduce children's television time

NARCIS (Netherlands)

Piotrowski, J.; Jordan, A.B.; Bleakley, A.; Hennessy, M.

2015-01-01

The family system plays an important role in shaping children’s television use. The American Academy of Pediatrics has recommended that parents limit screen time, given the risks associated with children’s heavy television viewing. Researchers have highlighted family television practices that may be

Effects of meditation practice on spontaneous eyeblink rate.

Science.gov (United States)

Kruis, Ayla; Slagter, Heleen A; Bachhuber, David R W; Davidson, Richard J; Lutz, Antoine

2016-05-01

A rapidly growing body of research suggests that meditation can change brain and cognitive functioning. Yet little is known about the neurochemical mechanisms underlying meditation-related changes in cognition. Here, we investigated the effects of meditation on spontaneous eyeblink rates (sEBR), a noninvasive peripheral correlate of striatal dopamine activity. Previous studies have shown a relationship between sEBR and cognitive functions such as mind wandering, cognitive flexibility, and attention-functions that are also affected by meditation. We therefore expected that long-term meditation practice would alter eyeblink activity. To test this, we recorded baseline sEBR and intereyeblink intervals (IEBI) in long-term meditators (LTM) and meditation-naive participants (MNP). We found that LTM not only blinked less frequently, but also showed a different eyeblink pattern than MNP. This pattern had good to high degree of consistency over three time points. Moreover, we examined the effects of an 8-week course of mindfulness-based stress reduction on sEBR and IEBI, compared to an active control group and a waitlist control group. No effect of short-term meditation practice was found. Finally, we investigated whether different types of meditation differentially alter eyeblink activity by measuring sEBR and IEBI after a full day of two kinds of meditation practices in the LTM. No effect of meditation type was found. Taken together, these findings may suggest either that individual difference in dopaminergic neurotransmission is a self-selection factor for meditation practice, or that long-term, but not short-term meditation practice induces stable changes in baseline striatal dopaminergic functioning. © 2016 Society for Psychophysiological Research.

A nationwide survey concerning practices in pessary use for pelvic organ prolapse in The Netherlands: identifying needs for further research

NARCIS (Netherlands)

Velzel, Joost; Roovers, Jan Paul; van der Vaart, C. H.; Broekman, Bart; Vollebregt, Astrid; Hakvoort, Robert

2015-01-01

To identify practice variation in management of patients with a vaginal pessary for pelvic organ prolapse (POP). A nationwide survey was sent to all Dutch gynecologists with a special interest in urogynecology. The response rate was 59 %. Of the respondents, 13 % had a written protocol for pessary

The impact of [corrected] expanded nursing practice on professional identify in Denmark.

Science.gov (United States)

Piil, Karin; Kolbæk, Raymond; Ottmann, Goetz; Rasmussen, Bodil

2012-01-01

This article explores the concept of professional identity of Danish nurses working in an expanded practice. The case study explores the experiences of a small group of Danish nurses with a new professional category that reaches into a domain that customarily belonged to physicians. The aim of this case study was to explore the impact of "nurse consultations," representing an expanded nursing role, of 5 nurses focusing on their perception of autonomy, self-esteem, and confidence. The case study used semistructured interviews with 5 participants triangulated and validated with participant observations, a focus group interview, and theoretically derived insights. This study indicates that nurses working within a new expanded professional practice see themselves as still engaged in nursing and not as substitute physicians. The study also suggests that the involved nurses gained a higher sense of autonomy, self-esteem, and confidence in their practice. These elements have a positive impact on their professional identity. The research demonstrates that for the nurses involved in expanded professional practice, the boundaries of professional practice have shifted significantly. The research indicates that an expanded practice generates a new domain within the professional identity of nurses.

Preparing Tomorrow's Administrators: A Quantitative Correlation Study of the Relationship between Emotional Intelligence and Effective Leadership Practices

Science.gov (United States)

May-Vollmar, Kelly

2017-01-01

Purpose: The purpose of this quantitative correlation study was to identify whether there is a relationship between emotional intelligence and effective leadership practices, specifically with school administrators in Southern California K-12 public schools. Methods: This study was conducted using a quantitative descriptive design, correlation…

On the Practice Architectures of Instructional Leadership

Science.gov (United States)

Salo, Petri; Nylund, Jan; Stjernstrøm, Else

2015-01-01

This paper explores the concept of instructional leadership and principals' perceptions of the practices of instructional leadership. Despite the emphasis on the effects of school leadership regarding teaching practices and learning outcomes, research on direct instructional leadership is scarce. It is focused either on identifying overall…

Sustained Large-Scale Collective Climate Action Supported by Effective Climate Change Education Practice

Science.gov (United States)

Niepold, F., III; Crim, H.; Fiorile, G.; Eldadah, S.

2017-12-01

Since 2012, the Climate and Energy Literacy community have realized that as cities, nations and the international community seek solutions to global climate change over the coming decades, a more comprehensive, interdisciplinary approach to climate literacy—one that includes economic and social considerations—will play a vital role in knowledgeable planning, decision-making, and governance. City, county and state leaders are now leading the American response to a changing climate by incubating social innovation to prevail in the face of unprecedented change. Cities are beginning to realize the importance of critical investments to support the policies and strategies that will foster the climate literacy necessary for citizens to understand the urgency of climate actions and to succeed in a resilient post-carbon economy and develop the related workforce. Over decade of federal and non-profit Climate Change Education effective methods have been developed that can support municipality's significant educational capabilities for the purpose of strengthening and scaling city, state, business, and education actions designed to sustain and effectively address this significant social change. Looking to foster the effective and innovative strategies that will enable their communities several networks have collaborated to identify recommendations for effective education and communication practices when working with different types of audiences. U.S. National Science Foundation funded Climate Change Education Partnership (CCEP) Alliance, the National Wildlife Federation, NOAA Climate Program Office, Tri-Agency Climate Change Education Collaborative and the Climate Literacy and Energy Awareness Network (CLEAN) are working to develop a new web portal that will highlight "effective" practices that includes the acquisition and use of climate change knowledge to inform decision-making. The purpose of the web portal is to transfer effective practice to support communities to be

General practice training and virtual communities of practice - a review of the literature

Directory of Open Access Journals (Sweden)

Barnett Stephen

2012-08-01

Full Text Available Abstract Background Good General Practice is essential for an effective health system. Good General Practice training is essential to sustain the workforce, however training for General Practice can be hampered by a number of pressures, including professional, structural and social isolation. General Practice trainees may be under more pressure than fully registered General Practitioners, and yet isolation can lead doctors to reduce hours and move away from rural practice. Virtual communities of practice (VCoPs in business have been shown to be effective in improving knowledge sharing, thus reducing professional and structural isolation. This literature review will critically examine the current evidence relevant to virtual communities of practice in General Practice training, identify evidence-based principles that might guide their construction and suggest further avenues for research. Methods Major online databases Scopus, Psychlit and Pubmed were searched for the terms “Community of Practice” (CoP AND (Online OR Virtual OR Electronic AND (health OR healthcare OR medicine OR “Allied Health”. Only peer-reviewed journal articles in English were selected. A total of 76 articles were identified, with 23 meeting the inclusion criteria. There were no studies on CoP or VCoP in General Practice training. The review was structured using a framework of six themes for establishing communities of practice, derived from a key study from the business literature. This framework has been used to analyse the literature to determine whether similar themes are present in the health literature and to identify evidence in support of virtual communities of practice for General Practice training. Results The framework developed by Probst is mirrored in the health literature, albeit with some variations. In particular the roles of facilitator or moderator and leader whilst overlapping, are different. VCoPs are usually collaborations between stakeholders

Identifying economic hurdles to early adoption of preventative practices: The case of trunk diseases in California winegrape vineyards

Directory of Open Access Journals (Sweden)

Jonathan Kaplan

2016-12-01

Full Text Available Despite the high likelihood of infection and substantial yield losses from trunk diseases, many California practitioners wait to adopt field-tested, preventative practices (delayed pruning, double pruning, and application of pruning-wound protectants until after disease symptoms appear in the vineyard at around 10 years old. We evaluate net benefits from adoption of these practices before symptoms appear in young Cabernet Sauvignon vineyards and after they become apparent in mature vineyards to identify economic hurdles to early adoption. We simulate winegrape production in select counties of California and find widespread benefits from early adoption, increasing vineyard profitable lifespans, in some cases, by close to 50%. However, hurdles may result from uncertainty about the cost and returns from adoption, labor constraints, long time lags in benefits from early adoption, growers’ perceived probabilities of infection, and their discount rate. Development of extension resources communicating benefits and potential hurdles to growers likely reduces uncertainty, increasing early adoption. Improvements in efficacy of preventative practices, perhaps by detecting when pathogen spores are released into the vineyard, will increase early adoption. Lastly, practice cost reductions will increase early adoption too, especially when the time it takes for adoption to payoff and infection uncertainty are influential in adoption decisions.

Effectiveness of organisational infrastructures to promote evidence-based nursing practice.

Science.gov (United States)

Flodgren, Gerd; Rojas-Reyes, Maria Ximena; Cole, Nick; Foxcroft, David R

2012-02-15

Nurses and midwives form the bulk of the clinical health workforce and play a central role in all health service delivery. There is potential to improve health care quality if nurses routinely use the best available evidence in their clinical practice. Since many of the factors perceived by nurses as barriers to the implementation of evidence-based practice (EBP) lie at the organisational level, it is of interest to devise and assess the effectiveness of organisational infrastructures designed to promote EBP among nurses. To assess the effectiveness of organisational infrastructures in promoting evidence-based nursing. We searched the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, LILACS, BIREME, IBECS, NHS Economic Evaluations Database, Social Science Citation Index, Science Citation Index and Conference Proceedings Citation Indexes up to 9 March 2011.We developed a new search strategy for this update as the strategy published in 2003 omitted key terms. Additional search methods included: screening reference lists of relevant studies, contacting authors of relevant papers regarding any further published or unpublished work, and searching websites of selected research groups and organisations.  We considered randomised controlled trials, controlled clinical trials, interrupted times series (ITSs) and controlled before and after studies of an entire or identified component of an organisational infrastructure intervention aimed at promoting EBP in nursing. The participants were all healthcare organisations comprising nurses, midwives and health visitors. Two authors independently extracted data and assessed risk of bias. For the ITS analysis, we reported the change in the slopes of the regression lines, and the change in the level effect of the outcome at 3, 6, 12 and 24 months follow-up. We included one study from the USA (re-analysed as

Ethical Practices For Effective Leadership: Fact Or Fallacy-The ...

African Journals Online (AJOL)

Ethical Practices For Effective Leadership: Fact Or Fallacy-The Kenyan Experience. ... KCA Journal of Business Management ... argue that laws alone cannot 'convert' the society that has developed and perfected the art of unethical practices.

Identifying context factors explaining physician's low performance in communication assessment: an explorative study in general practice.

Science.gov (United States)

Essers, Geurt; van Dulmen, Sandra; van Weel, Chris; van der Vleuten, Cees; Kramer, Anneke

2011-12-13

Communication is a key competence for health care professionals. Analysis of registrar and GP communication performance in daily practice, however, suggests a suboptimal application of communication skills. The influence of context factors could reveal why communication performance levels, on average, do not appear adequate. The context of daily practice may require different skills or specific ways of handling these skills, whereas communication skills are mostly treated as generic. So far no empirical analysis of the context has been made. Our aim was to identify context factors that could be related to GP communication. A purposive sample of real-life videotaped GP consultations was analyzed (N = 17). As a frame of reference we chose the MAAS-Global, a widely used assessment instrument for medical communication. By inductive reasoning, we analyzed the GP behaviour in the consultation leading to poor item scores on the MAAS-Global. In these cases we looked for the presence of an intervening context factor, and how this might explain the actual GP communication behaviour. We reached saturation after having viewed 17 consultations. We identified 19 context factors that could potentially explain the deviation from generic recommendations on communication skills. These context factors can be categorized into doctor-related, patient-related, and consultation-related factors. Several context factors seem to influence doctor-patient communication, requiring the GP to apply communication skills differently from recommendations on communication. From this study we conclude that there is a need to explicitly account for context factors in the assessment of GP (and GP registrar) communication performance. The next step is to validate our findings.

Changing policy and practice in the child welfare system through collaborative efforts to identify and respond effectively to family violence.

Science.gov (United States)

Banks, Duren; Landsverk, John; Wang, Kathleen

2008-07-01

The Greenbook provides a roadmap for child welfare agencies to collaborate and provide effective responses to families who are experiencing co-occurring child maltreatment and domestic violence. A multisite developmental evaluation was conducted of six demonstration sites that received federal funding to implement Greenbook recommendations for child welfare agencies. Surveys of child welfare caseworkers show significant changes in several areas of agency policy and practice, including regular domestic violence training, written guidelines for reporting domestic violence, and working closely and sharing resources with local domestic violence service providers. Case file reviews show significant increases in the level of active screening for domestic violence, although this increase peaks at the midpoint of the initiative. These findings, coupled with on-site interview data, point to the importance of coordinating system change activities in child welfare agencies with a number of other collaborative activities.

Launching Effectiveness Research to Guide Practice in Neurosurgery: A National Institute Neurological Disorders and Stroke Workshop Report

Science.gov (United States)

Walicke, Patricia; Abosch, Aviva; Asher, Anthony; Barker, Fred G.; Ghogawala, Zoher; Harbaugh, Robert; Jehi, Lara; Kestle, John; Koroshetz, Walter; Little, Roderick; Rubin, Donald; Valadka, Alex; Wisniewski, Stephen

2017-01-01

Abstract This workshop addressed challenges of clinical research in neurosurgery. Randomized controlled clinical trials (RCTs) have high internal validity, but often insufficiently generalize to real-world practice. Observational studies are inclusive but often lack sufficient rigor. The workshop considered possible solutions, such as (1) statistical methods for demonstrating causality using observational data; (2) characteristics required of a registry supporting effectiveness research; (3) trial designs combining advantages of observational studies and RCTs; and (4) equipoise, an identified challenge for RCTs. In the future, advances in information technology potentially could lead to creation of a massive database where clinical data from all neurosurgeons are integrated and analyzed, ending the separation of clinical research and practice and leading to a new “science of practice.” PMID:28362926

The effectiveness of online cognitive behavioral treatment in routine clinical practice.

Directory of Open Access Journals (Sweden)

Jeroen Ruwaard

Full Text Available Randomized controlled trails have identified online cognitive behavioral therapy as an efficacious intervention in the management of common mental health disorders.To assess the effectiveness of online CBT for different mental disorders in routine clinical practice.An uncontrolled before-after study, with measurements at baseline, posttest, 6-week follow-up, and 1-year follow-up.1500 adult patients (female: 67%; mean age: 40 years with a GP referral for psychotherapy were treated at a Dutch online mental health clinic for symptoms of depression (n = 413, panic disorder (n = 139, posttraumatic stress (n = 478, or burnout (n = 470.Manualized, web-based, therapist-assisted CBT, of which the efficacy was previously demonstrated in a series of controlled trials. Standardized duration of treatment varied from 5 weeks (online CBT for Posttraumatic stress to 16 weeks (online CBT for Depression.Validated self-report questionnaires of specific and general psychopathology, including the Beck Depression Inventory, the Impact of Event Scale, the Panic Disorder Severity Scale-Self Report, the Oldenburg Burnout Inventory, and the Depression Anxiety Stress Scales.Treatment adherence was 71% (n = 1071. Study attrition was 21% at posttest, 33% at 6-week FU and 65% at 1-year FU. Mixed-model repeated measures regression identified large short-term reductions in all measures of primary symptoms (d = 1.9±0.2 to d = 1.2±0.2; P<.001, which sustained up to one year after treatment. At posttest, rates of reliable improvement and recovery were 71% and 52% in the completer sample (full sample: 55%/40%. Patient satisfaction was high.Results suggest that online therapist-assisted CBT may be as effective in routine practice as it is in clinical trials. Although pre-treatment withdrawal and long-term outcomes require further study, results warrant continued implementation of online CBT.

Effective communication skills in nursing practice.

Science.gov (United States)

Bramhall, Elaine

2014-12-09

This article highlights the importance of effective communication skills for nurses. It focuses on core communication skills, their definitions and the positive outcomes that result when applied to practice. Effective communication is central to the provision of compassionate, high-quality nursing care. The article aims to refresh and develop existing knowledge and understanding of effective communication skills. Nurses reading this article will be encouraged to develop a more conscious style of communicating with patients and carers, with the aim of improving health outcomes and patient satisfaction.

Effects of practice variability on unimanual arm rotation.

Science.gov (United States)

James, Eric G; Conatser, Phillip

2014-01-01

High variability practice has been found to lead to a higher rate of motor learning than low variability practice in sports tasks. The authors compared the effects of low and high levels of practice variability on a simple unimanual arm rotation task. Participants performed rhythmic unimanual internal-external arm rotation as smoothly as possible before and after 2 weeks of low (LV) or high (HV) variability practice and after a 2-week retention interval. Compared to the pretest, the HV group significantly decreased hand, radioulnar, and shoulder rotation jerk on the retention test and shoulder jerk on the posttest. After training the LV group had lower radioulnar and shoulder jerk on the posttest but not the retention test. The results supported the hypothesis that high variability practice would lead to greater learning and reminiscence than low variability practice and the theoretical prediction of a bifurcation in the motor learning dynamics.

Effects of Mental Practice on Balance in the Elderly

Directory of Open Access Journals (Sweden)

Mandana Fallah-Pour

2003-12-01

Full Text Available Objective: Mental practice refers to "The symbolic rehearsal of a physical activity in the absence of any gross muscular movements." It has been shown in a remarkable number of studies that the use of mental practice like physical practice can produces significant improvements in motor skills. Thus this therapeutic technique can be used in elderly rehabilitation. The purpose of this study was to investigate the effects of mental practice on balance in the elderly. Materials & Methods: Thirty healthy old subject over the age of 60 years took part in this study. Subjects solicited from two senior-citizen centers in Tehran and randomly assigned to experimental and control groups. Balance of subjects was assessed in four stage include baseline, pre-treatment, post-treatment and follow-up. Subjects in experimental group performed mental practice of a motor and balance skill for 3 weeks and control group did not perform any practice in that period. Results: The results of this study indicate significant improvement in the motor skill that mentally performed and also in balance of subjects. Conclusion: Mental Practice that performed on the mental skill not only was mentaly effective but also meaningly cause the improvement of balance in elderly.

Effective Pedagogical Practices for Online Teaching: Perception of Experienced Instructors

Science.gov (United States)

Bailey, Craig J.; Card, Karen A.

2009-01-01

Institutions have focused on providing faculty with technological training to enhance their online teaching, but many online instructors would like to learn more effective pedagogical practices. This phenomenological study determines what experienced, award-winning South Dakota e-learning instructors perceive to be effective pedagogical practices.…

Identifying transposon insertions and their effects from RNA-sequencing data.

Science.gov (United States)

de Ruiter, Julian R; Kas, Sjors M; Schut, Eva; Adams, David J; Koudijs, Marco J; Wessels, Lodewyk F A; Jonkers, Jos

2017-07-07

Insertional mutagenesis using engineered transposons is a potent forward genetic screening technique used to identify cancer genes in mouse model systems. In the analysis of these screens, transposon insertion sites are typically identified by targeted DNA-sequencing and subsequently assigned to predicted target genes using heuristics. As such, these approaches provide no direct evidence that insertions actually affect their predicted targets or how transcripts of these genes are affected. To address this, we developed IM-Fusion, an approach that identifies insertion sites from gene-transposon fusions in standard single- and paired-end RNA-sequencing data. We demonstrate IM-Fusion on two separate transposon screens of 123 mammary tumors and 20 B-cell acute lymphoblastic leukemias, respectively. We show that IM-Fusion accurately identifies transposon insertions and their true target genes. Furthermore, by combining the identified insertion sites with expression quantification, we show that we can determine the effect of a transposon insertion on its target gene(s) and prioritize insertions that have a significant effect on expression. We expect that IM-Fusion will significantly enhance the accuracy of cancer gene discovery in forward genetic screens and provide initial insight into the biological effects of insertions on candidate cancer genes. © The Author(s) 2017. Published by Oxford University Press on behalf of Nucleic Acids Research.

Identifying the core competencies of mental health telephone triage.

Science.gov (United States)

Sands, Natisha; Elsom, Stephen; Gerdtz, Marie; Henderson, Kathryn; Keppich-Arnold, Sandra; Droste, Nicolas; Prematunga, Roshani K; Wereta, Zewdu W

2013-11-01

The primary aim of this study was to identify the core competencies of mental health telephone triage, including key role tasks, skills, knowledge and responsibilities, in which clinicians are required to be competent to perform safe and effective triage. Recent global trends indicate an increased reliance on telephone-based health services to facilitate access to health care across large populations. The trend towards telephone-based health services has also extended to mental health settings, evidenced by the growing number of mental health telephone triage services providing 24-hour access to specialist mental health assessment and treatment. Mental health telephone triage services are critical to the early identification of mental health problems and the provision of timely, appropriate interventions. In spite of the rapid growth in mental health telephone triage and the important role these services play in the assessment and management of mental illness and related risks, there has been very little research investigating this area of practice. An observational design was employed to address the research aims. Structured observations (using dual wireless headphones) were undertaken on 197 occasions of mental health telephone triage over a three-month period from January to March 2011. The research identified seven core areas of mental health telephone triage practice in which clinicians are required to be competent in to perform effective mental health telephone triage, including opening the call; performing mental status examination; risk assessment; planning and action; termination of call; referral and reporting; and documentation. The findings of this research contribute to the evidence base for mental health telephone triage by articulating the core competencies for practice. The mental health telephone triage competencies identified in this research may be used to define an evidence-based framework for mental health telephone triage practice that aims to

Hidrogym practice effects: The perception of Wellness of participants in a Community Outreach project

Directory of Open Access Journals (Sweden)

Daiana de Paula e Silva

2016-12-01

Full Text Available The aims of the study were to identify the effects of improvement perceived by hidrogym practitioners and to verify possible associations between these and the time and age of practice. 62 people with average age of 50,80 years old (+ 14,05 participated of this study. An instrument built for this research was used for data collection. The content analysis and the non-parametric testes U the Mann Whitney and Kruskal Wallis were used for data analysis. The results showed that the indicator "disposition" presented the best perception of wellness, though the physical-functional aspects presented more number of cited indicators. The weight diminution indicator did not show index of "much improvement". The participants who had practiced at least six months evidenced better scores in: mood, sleep quality, stress levels and occupational relationship. The participants who were 61 years old or more showed worse perceptions in stress level and articulate pain. In conclusion, hidrogym practice helps to the wellness perception improvement in the psychological, physical-functional and social aspects. Furthermore, aspects related to age group and time of practice could interfere in wellness perception.

Beginning teachers’ challenges in their pursuit of effective teaching practices

Directory of Open Access Journals (Sweden)

Steve Confait

2015-12-01

Full Text Available This article explores the context and experiences of three beginning teachers in their effort to improve their teaching and to implement and align themselves with their schools’ expectations of effective teaching practices. Research findings emerging from a sociocultural-ethnographic framework revealed that participants challenged their own beliefs about effective teaching practices in aligning themselves with their schools’ expectations. In complying with routine expectations, they embraced predominantly teacher-centred practices, rather than a student-centred approach. Given the ongoing effort to augment the quality of education in the Seychelles, beginning teachers’ implementation of and access to evidenced-based practices could be recognised as part of this endeavour.

Differentiation of subsequent memory effects between retrieval practice and elaborative study.

Science.gov (United States)

Liu, Yi; Rosburg, Timm; Gao, Chuanji; Weber, Christine; Guo, Chunyan

2017-07-01

Retrieval practice enhances memory retention more than re-studying. The underlying mechanisms of this retrieval practice effect have remained widely unclear. According to the elaborative retrieval hypothesis, activation of elaborative information occurs to a larger extent during testing than re-studying. In contrast, the episodic context account has suggested that recollecting prior episodic information (especially the temporal context) contributes to memory retention. To adjudicate the distinction between these two accounts, the present study used the classical retrieval practice effect paradigm to compare retrieval practice and elaborative study. In an initial behavioral experiment, retrieval practice produced greater retention than elaboration and re-studying in a one-week delayed test. In a subsequent event-related potential (ERP) experiment, retrieval practice resulted in reliably superior accuracy in the delayed test compared to elaborative study. In the ERPs, a frontally distributed subsequent memory effect (SME), starting at 300ms, occurred in the elaborative study condition, but not in the retrieval practice condition. A parietal SME emerged in the retrieval practice condition from 500 to 700ms, but was absent in the elaborative study condition. After 700ms, a late SME was present in the retrieval practice condition, but not in the elaborative study condition. Moreover, SMEs lasted longer in retrieval practice than in elaboration. The frontal SME in the elaborative study condition might be related to semantic processing or working memory-based elaboration, whereas the parietal and widespread SME in the retrieval practice condition might be associated with episodic recollection processes. These findings contradict the elaborative retrieval theory, and suggest that contextual recollection rather than activation of semantic information contributes to the retrieval practice effect, supporting the episodic context account. Copyright © 2017. Published by

[Effects of practical training to increase motivation for learning and related factors].

Science.gov (United States)

Yamaguchi, Takumi; Akiyama, Shinji; Sagara, Hidenori; Tanaka, Akihiro; Miyauchi, Yoshirou; Araki, Hiroaki; Shibata, Kazuhiko; Izushi, Fumio; Namba, Hiroyuki

2014-01-01

Under the six-year pharmaceutical education system that was initiated in April 2006, students who had completed the course in March 2012 became the first graduates. The six-year system encourages students to develop a well-rounded personality, a deep sense of ethics, knowledge required for health care professionals, abilities to identify and solve problems, and practical skills required in clinical settings, as well as basic knowledge and skills. Under the new education system based on the "pharmaceutical education model core curriculums" and "practical training model core curriculums", general pharmaceutical education is implemented in each college, and five-month practical training is conducted in clinical settings. Clinical tasks experienced by students for the first time are expected to significantly influence their motivation to learn and future prospects. In the present survey research, students who had completed practical training evaluated the training program, and correspondence and logistic regression analyses of the results were conducted to examine the future effects and influences of the training on the students. The results suggest that the students viewed the practical training program positively. In addition, clinical experience during the training sessions not only influenced their decisions on future careers, but also significantly increased their motivation to learn. Furthermore, their motivation for learning was increased most by the enthusiasm of pharmacists who advised them in clinical settings, rather than the training program itself. To improve pharmaceutical clinical learning, it is important to develop teaching and working environments for pharmacists in charge of advising students in clinical training.

Identification of desired outcomes for school nursing practice.

Science.gov (United States)

Selekman, Janice; Guilday, Patricia

2003-12-01

The Scope and Standards of Professional School Nursing Practice states that school nurses should evaluate the quality and effectiveness of their practice. School nurses have not yet identified and adopted outcomes by which this effectiveness can be measured. This study used focus groups during a national meeting of school nurse leaders to identify the desired outcomes that could be used to measure the efficacy of school nursing practice. Ten desired outcome themes were identified with numerous specific indicators as possible ways to measure the desired outcome in each theme. The student-, school-, and nurse-focused outcome themes were as follows: (a) increased student seat time, (b) receipt of first aid and acute care measures, (c) receipt of competent health-related interventions or skills, (d) meeting of the comprehensive needs of children with chronic conditions, (e) enhanced school health via wellness promotion and disease prevention measures, (f) referrals, (g) safe environment, (h) enhanced school health via community outreach, (i) cost-effective school nurse services, and (j) student, parent, and staff satisfaction. The school nurse participants were supportive of having potential outcomes identified and unanimously endorsed the findings at the conclusion of the study. They have provided a comprehensive framework from which evaluation tools can be developed to measure the efficacy of school nursing.

A qualitative study examining methods of accessing and identifying research relevant to clinical practice among rehabilitation clinicians

Directory of Open Access Journals (Sweden)

Patel D

2017-12-01

Full Text Available Drasti Patel,1 Christine Koehmstedt,1 Rebecca Jones,1 Nathan T Coffey,1 Xinsheng Cai,2 Steven Garfinkel,2 Dahlia M Shaewitz,2 Ali A Weinstein1 1Center for Study of Chronic Illness and Disability, College of Health and Human Services, George Mason University, Fairfax, VA, 2American Institutes for Research, Washington, DC, USA Purpose: Research examining the utilization of evidence-based practice (EBP specifically among rehabilitation clinicians is limited. The objective of this study was to examine how various rehabilitative clinicians including physical therapists, occupational therapists, rehabilitation counselors, and physiatrists are gaining access to literature and whether they are able to implement the available research into practice.Methods: A total of 21 total clinicians were interviewed via telephone. Using NVivo, a qualitative analysis of the responses was performed.Results: There were similarities found with respect to the information-seeking behaviors and translation of research across the different clinician types. Lack of time was reported to be a barrier for both access to literature and implementation of research across all clinician types. The majority of clinicians who reported having difficulty with utilizing the published literature indicated that the literature was not applicable to their practice, the research was not specific enough to be put into practice, or the research found was too outdated to be relevant. In addition, having a supportive work environment aided in the search and utilization of research through providing resources central to assisting clinicians in gaining access to health information.Conclusion: Our study identified several barriers that affect EBP for rehabilitation clinicians. The findings suggest the need for researchers to ensure that their work is applicable and specific to clinical practice for implementation to occur. Keywords: health information, information behavior, knowledge utilization

Resistance Training: Identifying Best Practices?

Science.gov (United States)

2010-02-18

were too small to be important. That argument would be particularly powerful when coupled with the knowledge that training effects increase with...interpretation of those facts convert the evidence to reliable scientific knowledge (Ziman, 1978). No single meta-analysis is likely to establish a...Wisloff, U. (1999). Maximal strength training improves work economy in trained female cross-country skiers . Med Sci Sports Exerc, 31, 870- 877

Effects of First-Grade Number Knowledge Tutoring With Contrasting Forms of Practice.

Science.gov (United States)

Fuchs, Lynn S; Geary, David C; Compton, Donald L; Fuchs, Douglas; Schatschneider, Christopher; Hamlett, Carol L; Deselms, Jacqueline; Seethaler, Pamela M; Wilson, Julie; Craddock, Caitlin F; Bryant, Joan D; Luther, Kurstin; Changas, Paul

2013-01-01

The purpose of this study was to investigate the effects of 1st-grade number knowledge tutoring with contrasting forms of practice. Tutoring occurred 3 times per week for 16 weeks. In each 30-min session, the major emphasis (25 min) was number knowledge; the other 5 min provided practice in 1 of 2 forms. Nonspeeded practice reinforced relations and principles addressed in number knowledge tutoring. Speeded practice promoted quick responding and use of efficient counting procedures to generate many correct responses. At-risk students were randomly assigned to number knowledge tutoring with speeded practice ( n = 195), number knowledge tutoring with nonspeeded practice ( n = 190), and control (no tutoring, n = 206). Each tutoring condition produced stronger learning than control on all 4 mathematics outcomes. Speeded practice produced stronger learning than nonspeeded practice on arithmetic and 2-digit calculations, but effects were comparable on number knowledge and word problems. Effects of both practice conditions on arithmetic were partially mediated by increased reliance on retrieval, but only speeded practice helped at-risk children compensate for weak reasoning ability.

An Efficient, Noniterative Method of Identifying the Cost-Effectiveness Frontier.

Science.gov (United States)

Suen, Sze-chuan; Goldhaber-Fiebert, Jeremy D

2016-01-01

Cost-effectiveness analysis aims to identify treatments and policies that maximize benefits subject to resource constraints. However, the conventional process of identifying the efficient frontier (i.e., the set of potentially cost-effective options) can be algorithmically inefficient, especially when considering a policy problem with many alternative options or when performing an extensive suite of sensitivity analyses for which the efficient frontier must be found for each. Here, we describe an alternative one-pass algorithm that is conceptually simple, easier to implement, and potentially faster for situations that challenge the conventional approach. Our algorithm accomplishes this by exploiting the relationship between the net monetary benefit and the cost-effectiveness plane. To facilitate further evaluation and use of this approach, we also provide scripts in R and Matlab that implement our method and can be used to identify efficient frontiers for any decision problem. © The Author(s) 2015.

Referrals and relationships: in-practice referrals meetings in a general practice.

Science.gov (United States)

Rowlands, G; Willis, S; Singleton, A

2001-08-01

GP referrals to secondary care are an important factor in the cost of running the NHS. The known variation in referral rates between doctors has the potential to cause tension within primary care which will be exacerbated by the latest reorganization of primary care and the trend towards capitation-based budgets. The importance of postgraduate learning for GPs has been recognized; continuing professional development is moving towards self-directed practice-based learning programmes. Educational interventions have been shown to alter doctors' prescribing behaviour. This, together with the pressure on accounting for referral activity, makes the prospect of improving, and possibly reducing, referral activity through educational interventions very attractive. This study complemented a randomized controlled trial (RCT) which investigated whether an intervention of the type which had reduced prescribing costs would have a similar effect on referral activity. The context of the study, description of the characteristics of the practice and the issues seen as important by the doctors and practice manager were identified through preliminary semi-structured interviews. The practice then held a series of educational in-practice meetings to discuss referrals and issues arising from referrals. The audio- and videotaped transcripts were interpreted using content and group dynamic analysis. Participants commented upon our preliminary findings. In addition, we used dimensional analysis to induce a preliminary theory describing the effect of the intervention on this general practice which enabled us to review the findings of the parallel RCT. The educational value of the meetings and the learning needs of the participants were also assessed. Our complementary study showed no alteration of practice referral rates following the educational intervention. The qualitative study, unencumbered by the assumptions inherent in the development of the hypothesis tested in the RCT, highlighted

Effectiveness of empathy in general practice: a systematic review

NARCIS (Netherlands)

Derksen, F.; Bensing, J.; Lagro-Janssen, A.

2013-01-01

BACKGROUND: Empathy as a characteristic of patient-physician communication in both general practice and clinical care is considered to be the backbone of the patient-physician relationship. Although the value of empathy is seldom debated, its effectiveness is little discussed in general practice.

Effectiveness of empathy in general practice: a systematic review.

NARCIS (Netherlands)

Derksen, F.; Bensing, J.; Lagro-Janssen, A.

2013-01-01

Background: Empathy as a characteristic of patient-physician communication in both general practice and clinical care is considered to be the backbone of the patient-physician relationship. Although the value of empathy is seldom debated, its effectiveness is little discussed in general practice.

Literacy teacher education principles and effective practices

CERN Document Server

Litt, Deborah G; Place, Nancy A

2014-01-01

Few resources exist to give literacy teacher educators a comprehensive view of effective, innovative practices in their field, making this uniquely practical volume an important addition to the literature. Each chapter describes research findings and pedagogical methods, with an emphasis on what teachers really need to know to succeed. Woven into the text are more than 30 detailed activities and assignments to support teacher development, written by outstanding teacher educators. Links to professional teaching standards and the Common Core State Standards are highlighted throughout. Suppleme

Failure mode and effects analysis: A community practice perspective.

Science.gov (United States)

Schuller, Bradley W; Burns, Angi; Ceilley, Elizabeth A; King, Alan; LeTourneau, Joan; Markovic, Alexander; Sterkel, Lynda; Taplin, Brigid; Wanner, Jennifer; Albert, Jeffrey M

2017-11-01

To report our early experiences with failure mode and effects analysis (FMEA) in a community practice setting. The FMEA facilitator received extensive training at the AAPM Summer School. Early efforts focused on department education and emphasized the need for process evaluation in the context of high profile radiation therapy accidents. A multidisciplinary team was assembled with representation from each of the major department disciplines. Stereotactic radiosurgery (SRS) was identified as the most appropriate treatment technique for the first FMEA evaluation, as it is largely self-contained and has the potential to produce high impact failure modes. Process mapping was completed using breakout sessions, and then compiled into a simple electronic format. Weekly sessions were used to complete the FMEA evaluation. Risk priority number (RPN) values > 100 or severity scores of 9 or 10 were considered high risk. The overall time commitment was also tracked. The final SRS process map contained 15 major process steps and 183 subprocess steps. Splitting the process map into individual assignments was a successful strategy for our group. The process map was designed to contain enough detail such that another radiation oncology team would be able to perform our procedures. Continuous facilitator involvement helped maintain consistent scoring during FMEA. Practice changes were made responding to the highest RPN scores, and new resulting RPN scores were below our high-risk threshold. The estimated person-hour equivalent for project completion was 258 hr. This report provides important details on the initial steps we took to complete our first FMEA, providing guidance for community practices seeking to incorporate this process into their quality assurance (QA) program. Determining the feasibility of implementing complex QA processes into different practice settings will take on increasing significance as the field of radiation oncology transitions into the new TG-100 QA

Effects of reviewing routine practices on learning outcomes in continuing education.

Science.gov (United States)

Mamede, Silvia; Loyens, Sofie; Ezequiel, Oscarina; Tibiriçá, Sandra; Penaforte, Júlio; Schmidt, Henk

2013-07-01

Conventional continuing medical education (CME) has been shown to have modest effects on doctor performance. New educational approaches based on the review of routine practices have brought better results. Little is known about factors that affect the outcomes of these approaches, especially in middle-income countries. This study aimed to investigate factors that influence the learning and quality of clinical performance in CME based on reflection upon experiences. A questionnaire and a clinical performance test were administered to 165 general practitioners engaged in a CME programme in Brazil. The questionnaire assessed behaviours related to four input variables (individual reflection on practices, peer review of experiences, self-regulated learning and learning skills) and two mediating variables (identification of learning needs and engagement in learning activities, the latter consisting of self-study of scientific literature, consultations about patient problems, and attendance at courses). Structural equation modelling was used to test a hypothesised model of relationships between these variables and the outcome variable of clinical performance, measured by the clinical performance test. After minor adjustments, the hypothesised model fit the empirical data well. Individual reflection fostered identification of learning needs, but also directly positively influenced the quality of clinical performance. Peer review did not affect identification of learning needs, but directly positively affected clinical performance. Learning skills and self-regulation did not help in identifying learning needs, but self-regulation enhanced study of the scientific literature, the learning activity that most positively influenced clinical performance. Consultation with colleagues, the activity most frequently triggered by the identification of learning needs, did not affect performance, and attendance of courses had only limited effect. This study shed light on the factors

Teaching reading comprehension to learners with autism spectrum disorder: Discrepancies between teacher and research-recommended practices.

Science.gov (United States)

Accardo, Amy L; Finnegan, Elizabeth G

2017-11-01

Students with autism spectrum disorder have been found to experience difficulty with reading comprehension despite intact decoding and word recognition. This identified need for targeted reading comprehension remediation results in a need for teachers to utilize research-based practices and to individualize instruction for students with autism spectrum disorder; however, teachers report a lack of access to such practices. This study utilized survey methodology to gather perceptions and experiences of teachers and to compare teacher preparedness to use effective instructional practices emerging from the extant research to teacher-reported effective practices in the classroom. Study findings, based on 112 participants, reveal a discrepancy between teacher-reported effective practices, and the practices identified as effective through research, indicating a research to practice gap. Implications for practice include professional development recommendations, and the need for increased communication between researchers and teachers.

Addressing the Research-to-Practice Gap in Autism Treatments: Applying an Effectiveness Research Model to the Picture Exchange Communication System

Science.gov (United States)

Greenberg, Alissa L.

2011-01-01

Despite expansive improvements in both treatments and research, the majority of persons with autism use non-empirically supported interventions. One way to decrease the research-to-practice gap involves increasing the direct applicability of research findings to clinical settings. Effectiveness research achieves this goal by identifying treatments…

Benchmarking on Inspection Practices. First Triennial Report of the Working Group on Inspection Practices

International Nuclear Information System (INIS)

2017-01-01

The WGIP Nuclear Power Plant (NPP) Observed Inspection Practices Program is intended to promote co-operation and learning among member countries and to collect and provide them with information for improving the effectiveness of existing regulatory inspection practices. This is accomplished by observing how inspections are carried out by other member countries and issuing a WGIP observed inspection report that includes observations (e.g. inspection techniques, obstacles encountered), lessons learnt and potential commendable practices that could be used by a regulatory body. This first triennial report documents the results of a consistency check performed between all six WGIP observed inspection reports and ratifies certain observations, lessons learnt and potential commendable practices identified by WGIP observed inspection participants

AID SELECTIVITY PRACTICE AND AID EFFECTIVENESS IN SUB-SAHARAN AFRICA

OpenAIRE

Adedokun, Adeniyi Jimmy; Abiodun O. Folawewo, Abiodun O.

2017-01-01

Foreign aid strategies have undergone restructuring as donors adopt aid selectivity practice to improve aid effectiveness. This study investigates the impact of aid selectivity practice on aid effectiveness (aid-growth relationship) in Sub-Saharan Africa (SSA) and several groups of countries within SSA from 1980 to 2012. Employing system generalized methods of moments (system GMM) technique; the study produces strong evidence that there is significant improvement in aid effectiveness due to a...

Effectiveness of a training course for general practice nurses in motivation support in type 2 diabetes care: a cluster-randomised trial.

Science.gov (United States)

Juul, Lise; Maindal, Helle T; Zoffmann, Vibeke; Frydenberg, Morten; Sandbaek, Annelli

2014-01-01

Type 2 diabetes is a common metabolic disease with the potential for prevention of complications. The prevention requires a high level of lasting actions from the patients, which may be burdensome. The aim of this trial was to evaluate the effectiveness of a training course for general practice nurses in motivation support at 18 months follow-up in the affiliated type 2 diabetes population. Forty general practices with nurse-led diabetes consultations from the area of Aarhus, Denmark were randomised 1∶1 to either intervention or usual practice. Intervention practices were offered a 16-hour Self-determination theory-based course including communication training for general practice nurses delivered over 10 months. The affiliated diabetes populations (aged 40-74 years) were identified from registers (intervention n = 2,005; usual n = 2,029). Primary outcomes were register-based glycated haemoglobin (HbA1c) -, total cholesterol levels, and well-being measured by the Problem Areas In Diabetes scale (PAID) and the mental component summary score, SF12 (SF12, mcs). Intention-to-treat analyses were performed. Predefined subgroups analyses were performed. The differences between the intervention- and the control practices' mean HbA1c and total cholesterol at follow-up adjusted for baseline values and clustering were respectively: -0.02%-points (95% CI: -0.11 to 0.07; p: 0.67); 0.08 mmol/l (95% CI: 0.01 to 0.15; p: 0.02). Differences in median scores adjusted for clustering were for PAID: 1.25; p = 0.31 and SF12, mcs: 0.99; p = 0.15. Women in intervention practices differed from women in usual practices on mean HbA1c: -0.12%-points (-0.23 to -0.02; p = 0.02) and SF12, mcs: 2.6; p = 0.01. Offering a training course for general practice nurses in applying the Self-determination theory in current type 2 diabetes care had no effect compared with usual practice measured by HbA1c and total cholesterol levels and the well-being at 18 months of follow-up in

Immediate effects of adding mental practice to physical practice on the gait of individuals with Parkinson's disease: Randomized clinical trial.

Science.gov (United States)

Santiago, Lorenna Marques de Melo; de Oliveira, Daniel Antunes; de Macêdo Ferreira, Louise Gabriella Lopes; de Brito Pinto, Hyanne Yasmim; Spaniol, Ana Paula; de Lucena Trigueiro, Larissa Coutinho; Ribeiro, Tatiana Souza; de Sousa, Angélica Vieira Cavalcanti; Piemonte, Maria Elisa Pimentel; Lindquist, Ana Raquel Rodrigues

2015-01-01

Mental practice has shown benefits in the rehabilitation of neurological patients, however, there is no evidence of immediate effects on gait of individuals with Parkinson's disease. Determine the effects of mental practice activity added to physical practice on the gait of individuals with Idiopathic Parkinson's Disease (IPD). 20 patients classified with stage 2 and 3, according to the Hoehn and Yahr scale were randomized into 2 groups. The experimental group (N = 10) was submitted to a single session of mental practice and physical practice gait protocol and the control group (N = 10) only to physical practice. The primary outcomes were stride length and total stance and swing time. Secondary outcomes were hip range of motion, velocity and mobility. Subjects were reassessed 10 minutes, 1 day and 7 days after the end of the session. There was no statistically significant difference between the groups. An intragroup difference was observed in velocity, stride length, hip range of motion, and mobility, as well as total stance and swing time. These results were also observed on follow-ups. Mental practice did not have a greater effect on the gait of individuals with IPD than physical practice, after a single session.

Identifying Relevant Studies in Software Engineering

DEFF Research Database (Denmark)

Zhang, He; Ali Babar, Muhammad; Tell, Paolo

2011-01-01

Context: Systematic literature review (SLR) has become an important research methodology in software engineering since the introduction of evidence-based software engineering (EBSE) in 2004. One critical step in applying this methodology is to design and execute appropriate and effective search....... Objective: The main objective of the research reported in this paper is to improve the search step of undertaking SLRs in software engineering (SE) by devising and evaluating systematic and practical approaches to identifying relevant studies in SE. Method: We have systematically selected and analytically...

A side-effect free method for identifying cancer drug targets.

Science.gov (United States)

Ashraf, Md Izhar; Ong, Seng-Kai; Mujawar, Shama; Pawar, Shrikant; More, Pallavi; Paul, Somnath; Lahiri, Chandrajit

2018-04-27

Identifying effective drug targets, with little or no side effects, remains an ever challenging task. A potential pitfall of failing to uncover the correct drug targets, due to side effect of pleiotropic genes, might lead the potential drugs to be illicit and withdrawn. Simplifying disease complexity, for the investigation of the mechanistic aspects and identification of effective drug targets, have been done through several approaches of protein interactome analysis. Of these, centrality measures have always gained importance in identifying candidate drug targets. Here, we put forward an integrated method of analysing a complex network of cancer and depict the importance of k-core, functional connectivity and centrality (KFC) for identifying effective drug targets. Essentially, we have extracted the proteins involved in the pathways leading to cancer from the pathway databases which enlist real experimental datasets. The interactions between these proteins were mapped to build an interactome. Integrative analyses of the interactome enabled us to unearth plausible reasons for drugs being rendered withdrawn, thereby giving future scope to pharmaceutical industries to potentially avoid them (e.g. ESR1, HDAC2, F2, PLG, PPARA, RXRA, etc). Based upon our KFC criteria, we have shortlisted ten proteins (GRB2, FYN, PIK3R1, CBL, JAK2, LCK, LYN, SYK, JAK1 and SOCS3) as effective candidates for drug development.

Identifying, monitoring and implementing "sustainable" agricultural practices for smallholder farmers over large geographic areas in India and Vietnam

Science.gov (United States)

Kritee, K.; Ahuja, R.; Nair, D.; Esteves, T.; Rudek, J.; Thu Ha, T.

2015-12-01

Industrial agriculture systems, mostly in developed and some emerging economies, are far different from the small-holder farms (size management variability from farm to farm and also the current inability to ground-truth remote sensing data due to lack of relaible basic parameters (e.g., yields, N use, farm boundaries) which are necessary for calibrating empirical/biogeochemical models. While we continue to learn from new research, we have found that it is crucial to follow some steps if sustainable farming programs are to succeed at small-holder farms Demographic data collection and GPS plot demarcation to establish farm size and ownership Baseline nutrient, water & energy use and crop yield determination via surveys and self-reporting which are verifiable through farmer networks given the importance of peer to peer learning in the dissemination of new techniques in such landscapes "Sustainable" practice determination in consultation with local universities/NGO experts Measurements on representative plots for 3-4 years to help calibrate biogeochemical models and/or empirical equations and establish which practices are truly "sustainable" (e.g., GHG emission reduction varies from 0-7 tCO2e/acre for different sustainable practices). Propagation of sustainable practices across the landscape via local NGOs/governments after analyzing the replicability of identified farming practices in the light of local financial, cultural or socio-political barriers. We will present results from representative plots (including soil and weather parameters, GHG emissions, yields, inputs, economic and environmental savings), farmer surveys and diary data; and discuss our key conclusions based on our approach and the analysis of the collected data which was enabled by use of a commercially available comprehensive agricultural data collection software.

Practical use of registered veterinary medicinal products in Macedonia in identifying the risk of developing of antimicrobial resistance

Directory of Open Access Journals (Sweden)

Velev Romel

2013-07-01

Full Text Available The use of antimicrobial agents is the key risk factor for the development and spread of antimicrobial resistance. It is therefore generally recognized that data on the usage of antimicrobial agents in food-producing animals are essential for identifying and quantifying the risk of developing and spreading of antimicrobial resistance in the food-chain. According to the WHO guidelines, the Anatomical Therapeutic Chemical system for the classification of veterinary medicines (ATC-vet is widely recognized as a classification tool. The aim of this work is to analyze the list of registered veterinary medicinal products in R. Macedonia and to evaluate the quality and practical use of this list according to the ATC-vet classification in order to identify the risk of developing and spreading of antimicrobial resistance.

Identifying Requirements for Effective Human-Automation Teamwork

Energy Technology Data Exchange (ETDEWEB)

Jeffrey C. Joe; John O' Hara; Heather D. Medema; Johanna H. Oxstrand

2014-06-01

Previous studies have shown that poorly designed human-automation collaboration, such as poorly designed communication protocols, often leads to problems for the human operators, such as: lack of vigilance, complacency, and loss of skills. These problems often lead to suboptimal system performance. To address this situation, a considerable amount of research has been conducted to improve human-automation collaboration and to make automation function better as a “team player.” Much of this research is based on an understanding of what it means to be a good team player from the perspective of a human team. However, the research is often based on a simplified view of human teams and teamwork. In this study, we sought to better understand the capabilities and limitations of automation from the standpoint of human teams. We first examined human teams to identify the principles for effective teamwork. We next reviewed the research on integrating automation agents and human agents into mixed agent teams to identify the limitations of automation agents to conform to teamwork principles. This research resulted in insights that can lead to more effective human-automation collaboration by enabling a more realistic set of requirements to be developed based on the strengths and limitations of all agents.

Identifying strategies to maximise recruitment and retention of practices and patients in a multicentre randomised controlled trial of an intervention to optimise secondary prevention for coronary heart disease in primary care.

LENUS (Irish Health Repository)

Leathem, Claire S

2009-01-01

BACKGROUND: Recruitment and retention of patients and healthcare providers in randomised controlled trials (RCTs) is important in order to determine the effectiveness of interventions. However, failure to achieve recruitment targets is common and reasons why a particular recruitment strategy works for one study and not another remain unclear. We sought to describe a strategy used in a multicentre RCT in primary care, to report researchers\\' and participants\\' experiences of its implementation and to inform future strategies to maximise recruitment and retention. METHODS: In total 48 general practices and 903 patients were recruited from three different areas of Ireland to a RCT of an intervention designed to optimise secondary prevention of coronary heart disease. The recruitment process involved telephoning practices, posting information, visiting practices, identifying potential participants, posting invitations and obtaining consent. Retention involved patients attending reviews and responding to questionnaires and practices facilitating data collection. RESULTS: We achieved high retention rates for practices (100%) and for patients (85%) over an 18-month intervention period. Pilot work, knowledge of the setting, awareness of change in staff and organisation amongst participant sites, rapid responses to queries and acknowledgement of practitioners\\' contributions were identified as being important. Minor variations in protocol and research support helped to meet varied, complex and changing individual needs of practitioners and patients and encouraged retention in the trial. A collaborative relationship between researcher and practice staff which required time to develop was perceived as vital for both recruitment and retention. CONCLUSION: Recruiting and retaining the numbers of practices and patients estimated as required to provide findings with adequate power contributes to increased confidence in the validity and generalisability of RCT results. A

Identifying strategies to maximise recruitment and retention of practices and patients in a multicentre randomised controlled trial of an intervention to optimise secondary prevention for coronary heart disease in primary care

Directory of Open Access Journals (Sweden)

Houlihan Ailish

2009-06-01

Full Text Available Abstract Background Recruitment and retention of patients and healthcare providers in randomised controlled trials (RCTs is important in order to determine the effectiveness of interventions. However, failure to achieve recruitment targets is common and reasons why a particular recruitment strategy works for one study and not another remain unclear. We sought to describe a strategy used in a multicentre RCT in primary care, to report researchers' and participants' experiences of its implementation and to inform future strategies to maximise recruitment and retention. Methods In total 48 general practices and 903 patients were recruited from three different areas of Ireland to a RCT of an intervention designed to optimise secondary prevention of coronary heart disease. The recruitment process involved telephoning practices, posting information, visiting practices, identifying potential participants, posting invitations and obtaining consent. Retention involved patients attending reviews and responding to questionnaires and practices facilitating data collection. Results We achieved high retention rates for practices (100% and for patients (85% over an 18-month intervention period. Pilot work, knowledge of the setting, awareness of change in staff and organisation amongst participant sites, rapid responses to queries and acknowledgement of practitioners' contributions were identified as being important. Minor variations in protocol and research support helped to meet varied, complex and changing individual needs of practitioners and patients and encouraged retention in the trial. A collaborative relationship between researcher and practice staff which required time to develop was perceived as vital for both recruitment and retention. Conclusion Recruiting and retaining the numbers of practices and patients estimated as required to provide findings with adequate power contributes to increased confidence in the validity and generalisability of RCT

Identifying household television practices to reduce children’s television time

NARCIS (Netherlands)

Piotrowski, J.; Jordan, A.B.; Bleakley, A.; Hennessy, M.

2013-01-01

The risks associated with children’s heavy television viewing justify television-reduction efforts. Targeting parents and the household environment provides a promising strategy for limiting television. Research has highlighted household television practices to reduce children’s viewing, but more

SLT Beliefs about Collaborative Practice: Implications for Education and Learning

Science.gov (United States)

Jago, Suzanne; Radford, Julie

2017-01-01

Effective collaborative practice is expected of newly qualified speech and language therapists (SLTs) in order to achieve the best outcomes for clients. Research into collaborative practice has identified a number of barriers to and facilitators of collaborative practice, but there has been limited research into how well prepared newly qualified…

Development of measures to assess the safety of existing NPPs and the effectiveness of regulations and regulatory actions (including 'prescriptive' and 'performance based' approaches). Peer discussions on regulatory practices

International Nuclear Information System (INIS)

1996-09-01

This report arises from the fourth series of peer discussions on regulatory practices entitled D evelopment of measures to assess the safety of existing nuclear power plants and the effectiveness of regulations and regulatory actions (including 'prescriptive' and 'performance based' approaches) . Senior regulators from 23 Member States participated in four peer group discussions during 1995-1996. This report presents the outcome of these meetings and recommendations of good practices identified by these senior regulators. The purpose of this report is to disseminate the views which the senior regulators presented at the meetings relating to measures used for assessing the safety of existing nuclear power plants and evaluating the effectiveness of regulators and regulatory actions. The intention in doing this is to assist Member States in the enhancement of their regulatory practices by identifying commonly accepted good practices. This report is structured so that it covers the subject matter under the following main headings: 'Prescriptive and Performance Based' Approaches to Regulation; Common Features of Regulatory Approaches; Effectiveness of the Regulator and Regulatory Actions; Recommendations of Good Practice. It is important to note that recommendations of good practice are included if they have been identified by at least one of the groups. It does not follow that all of the groups or individual Member States would necessarily endorse all of the recommendations. However, it is considered that if a single group of senior regulators judge that a particular practice is worthy of recommendation then it should be included for serious consideration. In some cases the same recommendations arise from all of the Groups

Effectiveness of the Use of Spiritual Intelligence in Women Academic Leadership Practice

Science.gov (United States)

Ramachandaran, Sharmila Devi; Krauss, Steven Eric; Hamzah, Azimi; Idris, Khairuddin

2017-01-01

Purpose: The purpose of this paper is to explore the effectiveness of the use of spiritual intelligence into women academic leadership practices. The study designed to provide a clear understanding of the effectiveness of the use of spiritual intelligence practices within women academic leadership practices. In addition, the study will be an ideal…

Practices to identify and preclude adverse Aircraft-and-Rotorcraft-Pilot Couplings - A design perspective

Science.gov (United States)

Pavel, Marilena D.; Masarati, Pierangelo; Gennaretti, Massimo; Jump, Michael; Zaichik, Larisa; Dang-Vu, Binh; Lu, Linghai; Yilmaz, Deniz; Quaranta, Giuseppe; Ionita, Achim; Serafini, Jacopo

2015-07-01

Understanding, predicting and supressing the inadvertent aircraft oscillations caused by Aircraft/Rotorcraft Pilot Couplings (A/RPC) is a challenging problem for designers. These are potential instabilities that arise from the effort of controlling aircraft with high response actuation systems. The present paper reviews, updates and discusses desirable practices to be used during the design process for unmasking A/RPC phenomena. These practices are stemming from the European Commission project ARISTOTEL Aircraft and Rotorcraft Pilot Couplings - Tools and Techniques for Alleviation and Detection (2010-2013) and are mainly related to aerodynamic and structural modelling of the aircraft/rotorcraft, pilot modelling and A/RPC prediction criteria. The paper proposes new methodologies for precluding adverse A/RPCs events taking into account the aeroelasticity of the structure and pilot biodynamic interaction. It is demonstrated that high-frequency accelerations due to structural elasticity cause negative effects on pilot control, since they lead to involuntary body and limb-manipulator system displacements and interfere with pilot's deliberate control activity (biodynamic interaction) and, finally, worsen handling quality ratings.

Identifying the Components of Effective Learning Environments Based on Health Students\\' Perception

Directory of Open Access Journals (Sweden)

Yousefi Afrashteh M

2015-08-01

Full Text Available Aims: Effective learning environment can lead to establish and strengthen the appropriate conditions of learning in higher education. This study aimed to identify and define the factors associated with effective learning environment in the field of health education. Participants & Methods: This qualitative study with content analysis approach was conducted in 2013. Participants were 9 graduate and 7 undergraduate students of health majors that were selected using purposive sampling method. Data were recorded by interview and were analyzed using qualitative content analysis. Findings: Analysis of the data revealed 4 themes and 13 classes active and interactive teaching (participating viewpoints of students in educational planning, engaging students in class discussions, providing practical examples to understand the content, relaxing about expressed thoughts, the possibility of constructive criticism master plan of activities and according to the conditions and individual differences between students, Joyful atmosphere (academic motivation, the joy of learning and attendance, a sense of acceptance and respect from teachers and classroom dynamics and vitality and fatigue, relation of courses with professional needs (knowledge of the needs of the job in training course content and related training to the needs of job opportunities and professors’ scientific and power and expert (expertise and scientific capabilities in the field of teaching. Conclusion: 4 major themes and their characteristics can help to organize the learning environment in medical education.

An international survey to identify the intrinsic and extrinsic factors of research studies most likely to change orthopaedic practice.

Science.gov (United States)

Thornley, P; de Sa, D; Evaniew, N; Farrokhyar, F; Bhandari, M; Ghert, M

2016-04-01

Evidence -based medicine (EBM) is designed to inform clinical decision-making within all medical specialties, including orthopaedic surgery. We recently published a pilot survey of the Canadian Orthopaedic Association (COA) membership and demonstrated that the adoption of EBM principles is variable among Canadian orthopaedic surgeons. The objective of this study was to conduct a broader international survey of orthopaedic surgeons to identify characteristics of research studies perceived as being most influential in informing clinical decision-making. A 29-question electronic survey was distributed to the readership of an established orthopaedic journal with international readership. The survey aimed to analyse the influence of both extrinsic (journal quality, investigator profiles, etc.) and intrinsic characteristics (study design, sample size, etc.) of research studies in relation to their influence on practice patterns. A total of 353 surgeons completed the survey. Surgeons achieved consensus on the 'importance' of three key designs on their practices: randomised controlled trials (94%), meta-analyses (75%) and systematic reviews (66%). The vast majority of respondents support the use of current evidence over historical clinical training; however subjective factors such as journal reputation (72%) and investigator profile (68%) continue to influence clinical decision-making strongly. Although intrinsic factors such as study design and sample size have some influence on clinical decision-making, surgeon respondents are equally influenced by extrinsic factors such as investigator reputation and perceived journal quality.Cite this article: Dr M. Ghert. An international survey to identify the intrinsic and extrinsic factors of research studies most likely to change orthopaedic practice. Bone Joint Res 2016;5:130-136. DOI: 10.1302/2046-3758.54.2000578. © 2016 Ghert et al.

Basic practical skills teaching and learning in undergraduate medical education - a review on methodological evidence.

Science.gov (United States)

Vogel, Daniela; Harendza, Sigrid

2016-01-01

Practical skills are an essential part of physicians' daily routine. Nevertheless, medical graduates' performance of basic skills is often below the expected level. This review aims to identify and summarize teaching approaches of basic practical skills in undergraduate medical education which provide evidence with respect to effective students' learning of these skills. Basic practical skills were defined as basic physical examination skills, routine skills which get better with practice, and skills which are also performed by nurses. We searched PubMed with different terms describing these basic practical skills. In total, 3467 identified publications were screened and 205 articles were eventually reviewed for eligibility. 43 studies that included at least one basic practical skill, a comparison of two groups of undergraduate medical students and effects on students' performance were analyzed. Seven basic practical skills and 15 different teaching methods could be identified. The most consistent results with respect to effective teaching and acquisition of basic practical skills were found for structured skills training, feedback, and self-directed learning. Simulation was effective with specific teaching methods and in several studies no differences in teaching effects were detected between expert or peer instructors. Multimedia instruction, when used in the right setting, also showed beneficial effects for basic practical skills learning. A combination of voluntary or obligatory self-study with multimedia applications like video clips in combination with a structured program including the possibility for individual exercise with personal feedback by peers or teachers might provide a good learning opportunity for basic practical skills.

High performance work practices, innovation and performance

DEFF Research Database (Denmark)

Jørgensen, Frances; Newton, Cameron; Johnston, Kim

2013-01-01

Research spanning nearly 20 years has provided considerable empirical evidence for relationships between High Performance Work Practices (HPWPs) and various measures of performance including increased productivity, improved customer service, and reduced turnover. What stands out from......, and Africa to examine these various questions relating to the HPWP-innovation-performance relationship. Each paper discusses a practice that has been identified in HPWP literature and potential variables that can facilitate or hinder the effects of these practices of innovation- and performance...

Mirroring the Object of the Lesson: The Creative Process of Scriptural Rewriting as an Effective Practice for Teaching Sacred Texts

Science.gov (United States)

Palmer, Carmen

2018-01-01

This paper introduces Rewritten Scripture and scriptural rewriting as a creative process that, when mirrored in a teaching exercise, may serve as an effective practice in teaching sacred texts. Observing changes made between scripture and its rewriting may allow readers to identify different contexts among these texts. Furthermore, the act of…

Mentors' Views about Developing Effective English Teaching Practices

Science.gov (United States)

Hudson, Peter; Millwater, Jan

2008-01-01

Effective mentoring in English is considered paramount to a preservice teacher's development. What are mentors' views about developing effective English teaching practices in their mentees? This study used quantitative data (survey) and qualitative data (questionnaire) on 24 mentors' perceptions of mentoring second-year preservice teachers for…

Evaluating the effects of agricultural practices on soil conservation ...

African Journals Online (AJOL)

The main crops were maize, ginger, garden pea, cabbage and mulberry. The objective of the study was to contribute a simple method to evaluate the effect of different agricultural practices on the resistance of soil to erosion. Different agricultural practices were studied on similar relief and soil, and under similar weather ...

Sales Training: Effects of Spaced Practice on Training Transfer

Science.gov (United States)

Kauffeld, Simone; Lehmann-Willenbrock, Nale

2010-01-01

Purpose: The benefits of spaced training over massed training practice are well established in the laboratory setting. In a field study design with sales trainings, the purpose of this paper is to investigate the effects of spaced compared with massed practice on transfer quantity and quality, sales competence, and key figures.…

Modeling Aerobic Carbon Source Degradation Processes using Titrimetric Data and Combined Respirometric-Titrimetric Data: Structural and Practical Identifiability

DEFF Research Database (Denmark)

Gernaey, Krist; Petersen, B.; Dochain, D.

2002-01-01

The structural and practical identifiability of a model for description of respirometric-titrimetric data derived from aerobic batch substrate degradation experiments of a CxHyOz carbon source with activated sludge was evaluated. The model processes needed to describe titrimetric data included su...... the initial substrate concentration S-S(O) is known. The values found correspond to values reported in literature, but, interestingly, also seem able to reflect the occurrence of storage processes when pulses of acetate and dextrose are added. (C) 2002 Wiley Periodicals, Inc....

Key Practice for Green Building Management In Malaysia

OpenAIRE

Aghili Nasim; Bin Mohammed Abdul Hakim; Sheau-Ting Low

2016-01-01

This paper identifies the management practices for green building management in Malaysia. A set of practices was ascertained from the reviewed of various established Green Building Standard in the world. Green building practices are significant role in attaining sustainability particularly in the construction industry. Green building is constructed for minimizing impacts to environment as well as decreasing building effects on occupants. To achieve the goals of green buildings, set of managem...

Multiple Logics as a Source of New Practices and Variations in Employee Recruitment Practices

DEFF Research Database (Denmark)

Holm, Anna

Academic research in recruitment lacks insights into why there are variations in organizations’ recruitment strategies and practices. The contribution of this research is to address this question from the perspective of institutional logic at the organizational level of analysis and thereby go some...... way to filling this gap. The data for the research were collected from a population of organizations in Denmark in 2008-2009, mainly by means of qualitative interviews. Three major institutional logics which guide recruitment practices were identified and are presented in this paper. These logics...... - administration, efficiency and effectiveness – suggest that organizations’ recruitment practices are dominated by diverse goals and different means of achieving them, which can explain the variations in recruitment strategies and practices....

Meeting the challenge of a group practice turnaround.

Science.gov (United States)

Porn, L M

2001-03-01

Many healthcare organizations that acquired group practices to enhance their market share have found that the practices have not met their financial goals. Turning around a financially troubled, hospital-owned group practice is challenging but not impossible for healthcare organizations that take certain basic actions. Direction, data, desire, dedication, and drive must be present to effect the financial turnaround of a group practice. The healthcare organization needs to evaluate the practice's strategy and operations and identify the issues that are hindering the practice's ability to optimize revenues. Efforts to achieve profitable operations have to be ongoing.

Regional effects of agricultural conservation practices on nutrient transport

Science.gov (United States)

Anna Maria Garcia; Richard B. Alexander; Jeffrey G. Arnold; Lee Norfleet; Mike White; Dale M. Robertson; Gregory Schwarz

2016-01-01

The Conservation Effects Assessment Program (CEAP), initiated by USDA Natural Resources Conservation Service (NRCS), has the goal of quantifying the environmental benefits of agricultural conservation practices. As part of this effort, detailed farmer surveyswere compiled to document the adoption of conservation practices. Survey data showed that up to 38...

Comparative effectiveness of asthma interventions within a practice based research network

Directory of Open Access Journals (Sweden)

Hebert Lisa

2011-08-01

Full Text Available Abstract Background Asthma is a chronic lung disease that affects more than 23 million people in the United States, including 7 million children. Asthma is a difficult to manage chronic condition associated with disparities in health outcomes, poor medical compliance, and high healthcare costs. The research network coordinating this project includes hospitals, urgent care centers, and outpatient clinics within Carolinas Healthcare System that share a common electronic medical record and billing system allowing for rapid collection of clinical and demographic data. This study investigates the impact of three interventions on clinical outcomes for patients with asthma. Interventions are: an integrated approach to care that incorporates asthma management based on the chronic care model; a shared decision making intervention for asthma patients in underserved or disadvantaged populations; and a school based care approach that examines the efficacy of school-based programs to impact asthma outcomes including effectiveness of linkages between schools and the healthcare providers. Methods/Design This study will include 95 Practices, 171 schools, and over 30,000 asthmatic patients. Five groups (A-E will be evaluated to determine the effectiveness of three interventions. Group A is the usual care control group without electronic medical record (EMR. Group B practices are a second control group that has an EMR with decision support, asthma action plans, and population reports at baseline. A time delay design during year one converts practices in Group B to group C after receiving the integrated approach to care intervention. Four practices within Group C will receive the shared decision making intervention (and become group D. Group E will receive a school based care intervention through case management within the schools. A centralized database will be created with the goal of facilitating comparative effectiveness research on asthma outcomes

Retrieval-Based Learning: Positive Effects of Retrieval Practice in Elementary School Children

Directory of Open Access Journals (Sweden)

Jeffrey D. Karpicke

2016-03-01

Full Text Available A wealth of research has demonstrated that practicing retrieval is a powerful way to enhance learning. However, nearly all prior research has examined retrieval practice with college students. Little is known about retrieval practice in children, and even less is known about possible individual differences in retrieval practice. In three experiments, 88 children (mean age 10 years studied a list of words and either restudied the items or practiced retrieving them. They then took a final free recall test (Experiments 1 and 2 or recognition test (Experiment 3. In all experiments, children showed robust retrieval practice effects. Although a range of individual differences in reading comprehension and processing speed were observed among these children, the benefits of retrieval practice were independent of these factors. The results contribute to the growing body of research supporting the mnemonic benefits of retrieval practice and provide preliminary evidence that practicing retrieval may be an effective learning strategy for children with varying levels of reading comprehension and processing speed.

Test-retest reliability and practice effects of the Wechsler Memory Scale-III.

Science.gov (United States)

Lo, Ada H Y; Humphreys, Michael; Byrne, Gerard J; Pachana, Nancy A

2012-09-01

Although serial administration of cognitive tests is increasingly common, there is a paucity of research on test-retest reliabilities and practice effects, both of which are important for evaluating changes in functioning. Reliability is generally conceptualized as involving short-lasting changes in performance. However, when repeated testing occurs over a period of years, there will be some longer lasting effects. The implications of these longer lasting effects and practice effects on reliability were examined in the context of repeated administrations of the Wechsler Memory Scale-III in 339 community-dwelling women aged 40-79 years over 2 to 7 years. The results showed that Logical Memory and Verbal Paired Associates subtests were consistently the most reliable subtests across the age cohorts. The magnitude of practice effects varied as a function of subtests and age. The largest practice effects were found in the youngest age cohort, especially on the Faces, Logical Memory, and Verbal Paired Associates subtests. ©2012 The British Psychological Society.

Effective Teamwork Practical Lessons from Organizational Research

CERN Document Server

West, Michael A

2012-01-01

Updated to reflect the latest research evidence, the third edition of Effective Teamwork provides business managers with the necessary guidance and tools to build and maintain effective teamwork strategies. A new edition of a bestselling book on teamwork from an acknowledged leader in the fieldOffers a unique integration of rigorous research with practical guidance to develop effective leadership teamsFeatures new chapters on virtual teams and top management teams, plus contemporary themes of ethics and valuesUtilizes research based on positive psychology techniques

The effects of information framing on the practices of physicians.

Science.gov (United States)

McGettigan, P; Sly, K; O'Connell, D; Hill, S; Henry, D

1999-10-01

The presentation format of clinical trial results, or the "frame," may influence perceptions about the worth of a treatment. The extent and consistency of that influence are unclear. We undertook a systematic review of the published literature on the effects of information framing on the practices of physicians. Relevant articles were retrieved using bibliographic and electronic searches. Information was extracted from each in relation to study design, frame type, parameter assessed, assessment scale, clinical setting, intervention, results, and factors modifying the frame effect. Twelve articles reported randomized trials investigating the effect of framing on doctors' opinions or intended practices. Methodological shortcomings were numerous. Seven papers investigated the effect of presenting clinical trial results in terms of relative risk reduction, or absolute risk reductions or the number needing to be treated; gain/loss (positive/negative) terms were used in four papers; verbal/numeric terms in one. In simple clinical scenarios, results expressed in relative risk reduction or gain terms were viewed most positively by doctors. Factors that reduced the impact of framing included the risk of causing harm, preexisting prejudices about treatments, the type of decision, the therapeutic yield, clinical experience, and costs. No study investigated the effect of framing on actual clinical practice. While a framing effect may exist, particularly when results are presented in terms of proportional or absolute measures of gain or loss, it appears highly susceptible to modification, and even neutralization, by other factors that influence doctors' decision making. Its effects on actual clinical practice are unknown.

Daily Mindful Responding Mediates the Effect of Meditation Practice on Stress and Mood: The Role of Practice Duration and Adherence.

Science.gov (United States)

Lacaille, Julien; Sadikaj, Gentiana; Nishioka, Midori; Carrière, Kimberly; Flanders, Joseph; Knäuper, Bärbel

2018-01-01

Although meditation practice is an important component of many mindfulness-based interventions (MBIs), empirical findings of its effects on psychological functioning are mixed and the mechanisms for the effects remain unclear. Responding with mindfulness (i.e., returning one's attention back to a nonjudgmental, present-oriented awareness) is a fundamental skill practiced in meditations. With repeated meditation practice, this skill is thought to become internalized and be applied to one's daily life. We thus hypothesized that the extent to which individuals responded to daily events with mindfulness would mediate the effects of meditation practice (instance, duration, and adherence to instructions) on psychological well-being. Using a daily diary methodology, we tracked the meditation practice, use of mindful responding during the day, and psychological outcomes (perceived stress, negative and positive affect) of 117 mindfulness-based stress reduction program participants. We found that on days when participants meditated, they responded with greater mindfulness to daily events, which accounted for the beneficial effects of meditating on psychological outcomes. Furthermore, findings suggest that on meditation days, longer and more closely adhered meditation practices were independently associated with increases in mindful responding, which in turn were associated with better psychological outcomes. These results suggest that regular, longer, and more closely adhered meditation practice is an important component of MBIs, in part because it leads to responding more mindfully in daily life, which promotes well-being. © 2017 Wiley Periodicals, Inc.

Effects and Dose-Response Relationships of Motor Imagery Practice on Strength Development in Healthy Adult Populations: a Systematic Review and Meta-analysis.

Science.gov (United States)

Paravlic, Armin H; Slimani, Maamer; Tod, David; Marusic, Uros; Milanovic, Zoran; Pisot, Rado

2018-05-01

Motor imagery (MI), a mental simulation of a movement without overt muscle contraction, has been largely used to improve general motor tasks. However, the effects of MI practice on maximal voluntary strength (MVS) remain equivocal. The aims of this meta-analysis were to (1) estimate whether MI practice intervention can meaningfully improve MVS in healthy adults; (2) compare the effects of MI practice on MVS with its combination with physical practice (MI-C), and with physical practice (PP) training alone; and (3) investigate the dose-response relationships of MI practice. Seven electronic databases were searched up to April 2017. Initially 717 studies were identified; however, after evaluation of the study characteristics, data from 13 articles involving 370 participants were extracted. The meta-analysis was completed on MVS as the primary parameter. In addition, parameters associated with training volume, training intensity, and time spent training were used to investigate dose-response relationships. MI practice moderately improved MVS. When compared to conventional PP, effects were of small benefit in favour of PP. MI-C when compared to PP showed unclear effects. MI practice produced moderate effects in both upper and lower extremities on MVS. The cortical representation area of the involved muscles did not modify the effects. Meta-regression analysis revealed that (a) a training period of 4 weeks, (b) a frequency of three times per week, (c) two to three sets per single session, (d) 25 repetitions per single set, and (e) single session duration of 15 min were associated with enhanced improvements in muscle strength following MI practice. Similar dose-response relationships were observed following MI and PP. The present meta-analysis demonstrates that compared to a no-exercise control group of healthy adults, MI practice increases MVS, but less than PP. These findings suggest that MI practice could be considered as a substitute or additional training tool to

Newly identified psychiatric illness in one general practice: 12-month outcome and the influence of patients' personality.

Science.gov (United States)

Wright, A F; Anderson, A J

1995-01-01

BACKGROUND. Relatively little is known about the natural history and outcome of psychological problems in patients who present to general practitioners. Only a small proportion of such patients are seen by specialists. Clinical experience suggests that patient personality is one of the factors influencing outcome in patients diagnosed as having psychiatric illness. AIM. This study set out to examine prospectively the progress and 12-month outcome of patients with newly identified psychiatric illness, and the association of patients' personality with outcome. METHOD. One hundred and seventy one patients with clinically significant psychiatric illness attending one practice in a Scottish new town were followed up prospectively (96 presented with psychological symptoms and 75 with somatic symptoms), and were compared with a group of 127 patients with chronic physical illness. Patients were assessed in terms of psychiatric state, social problems and personality using both computer-based and pencil and paper tests in addition to clinical assessments at each consultation during the follow-up year and structured interview one year after recruitment. RESULTS. Most of the improvement in psychiatric state scores on the 28-item general health questionnaire occurred in the first six months of the illness. Of the 171 patients with psychiatric illness 34% improved quickly and remained well, 54% had an intermittent course but had improved at 12-month follow up while 12% pursued a chronic course without improvement. The mean number of consultations in the follow-up year was 8.4 for patients presenting with psychological symptoms, 7.2 for those presenting with somatic symptoms and 6.6 for patients with chronic physical illness. The Eysenck N score proved a strong predictor of the outcome of new psychiatric illness. CONCLUSION. Only one in three patients with newly identified psychiatric illness improved quickly and and remained well, reflecting the importance of continuing care of

Parameter trajectory analysis to identify treatment effects of pharmacological interventions.

Directory of Open Access Journals (Sweden)

Christian A Tiemann

Full Text Available The field of medical systems biology aims to advance understanding of molecular mechanisms that drive disease progression and to translate this knowledge into therapies to effectively treat diseases. A challenging task is the investigation of long-term effects of a (pharmacological treatment, to establish its applicability and to identify potential side effects. We present a new modeling approach, called Analysis of Dynamic Adaptations in Parameter Trajectories (ADAPT, to analyze the long-term effects of a pharmacological intervention. A concept of time-dependent evolution of model parameters is introduced to study the dynamics of molecular adaptations. The progression of these adaptations is predicted by identifying necessary dynamic changes in the model parameters to describe the transition between experimental data obtained during different stages of the treatment. The trajectories provide insight in the affected underlying biological systems and identify the molecular events that should be studied in more detail to unravel the mechanistic basis of treatment outcome. Modulating effects caused by interactions with the proteome and transcriptome levels, which are often less well understood, can be captured by the time-dependent descriptions of the parameters. ADAPT was employed to identify metabolic adaptations induced upon pharmacological activation of the liver X receptor (LXR, a potential drug target to treat or prevent atherosclerosis. The trajectories were investigated to study the cascade of adaptations. This provided a counter-intuitive insight concerning the function of scavenger receptor class B1 (SR-B1, a receptor that facilitates the hepatic uptake of cholesterol. Although activation of LXR promotes cholesterol efflux and -excretion, our computational analysis showed that the hepatic capacity to clear cholesterol was reduced upon prolonged treatment. This prediction was confirmed experimentally by immunoblotting measurements of SR-B1

Basic practical skills teaching and learning in undergraduate medical education – a review on methodological evidence

Science.gov (United States)

Vogel, Daniela; Harendza, Sigrid

2016-01-01

Objective: Practical skills are an essential part of physicians’ daily routine. Nevertheless, medical graduates’ performance of basic skills is often below the expected level. This review aims to identify and summarize teaching approaches of basic practical skills in undergraduate medical education which provide evidence with respect to effective students’ learning of these skills. Methods: Basic practical skills were defined as basic physical examination skills, routine skills which get better with practice, and skills which are also performed by nurses. We searched PubMed with different terms describing these basic practical skills. In total, 3467 identified publications were screened and 205 articles were eventually reviewed for eligibility. Results: 43 studies that included at least one basic practical skill, a comparison of two groups of undergraduate medical students and effects on students’ performance were analyzed. Seven basic practical skills and 15 different teaching methods could be identified. The most consistent results with respect to effective teaching and acquisition of basic practical skills were found for structured skills training, feedback, and self-directed learning. Simulation was effective with specific teaching methods and in several studies no differences in teaching effects were detected between expert or peer instructors. Multimedia instruction, when used in the right setting, also showed beneficial effects for basic practical skills learning. Conclusion: A combination of voluntary or obligatory self-study with multimedia applications like video clips in combination with a structured program including the possibility for individual exercise with personal feedback by peers or teachers might provide a good learning opportunity for basic practical skills. PMID:27579364

Combining the Power of Statistical Analyses and Community Interviews to Identify Adoption Barriers for Stormwater Best-Management Practices

Science.gov (United States)

Hoover, F. A.; Bowling, L. C.; Prokopy, L. S.

2015-12-01

Urban stormwater is an on-going management concern in municipalities of all sizes. In both combined or separated sewer systems, pollutants from stormwater runoff enter the natural waterway system during heavy rain events. Urban flooding during frequent and more intense storms are also a growing concern. Therefore, stormwater best-management practices (BMPs) are being implemented in efforts to reduce and manage stormwater pollution and overflow. The majority of BMP water quality studies focus on the small-scale, individual effects of the BMP, and the change in water quality directly from the runoff of these infrastructures. At the watershed scale, it is difficult to establish statistically whether or not these BMPs are making a difference in water quality, given that watershed scale monitoring is often costly and time consuming, relying on significant sources of funds, which a city may not have. Hence, there is a need to quantify the level of sampling needed to detect the water quality impact of BMPs at the watershed scale. In this study, a power analysis was performed on data from an urban watershed in Lafayette, Indiana, to determine the frequency of sampling required to detect a significant change in water quality measurements. Using the R platform, results indicate that detecting a significant change in watershed level water quality would require hundreds of weekly measurements, even when improvement is present. The second part of this study investigates whether the difficulty in demonstrating water quality change represents a barrier to adoption of stormwater BMPs. Semi-structured interviews of community residents and organizations in Chicago, IL are being used to investigate residents understanding of water quality and best management practices and identify their attitudes and perceptions towards stormwater BMPs. Second round interviews will examine how information on uncertainty in water quality improvements influences their BMP attitudes and perceptions.

Optimizing Team Dynamics: An Assessment of Physician Trainees and Advanced Practice Providers Collaborative Practice.

Science.gov (United States)

Foster, Cortney B; Simone, Shari; Bagdure, Dayanand; Garber, Nan A; Bhutta, Adnan

2016-09-01

The presence of advanced practice providers has become increasingly common in many ICUs. The ideal staffing model for units that contain both advanced practice providers and physician trainees has not been described. The objectives of this study were to evaluate ICU staffing models that include physician trainees and advanced practice providers and their effects on patient outcomes, resident and fellow education, and training experience. A second aim was to assess strategies to promote collaboration between team members. PubMed, CINAHL, OVID MEDLINE, and Cochrane Review from 2002 to 2015. Experimental study designs conducted in an ICU setting. Two reviewers screened articles for eligibility and independently abstracted data using the identified search terms. We found 21 articles describing ICU team structure and outcomes. Four articles were found describing the impact of advanced practice providers on resident or fellow education. Two articles were found discussing strategies to promote collaboration between advanced practice providers and critical care fellows or residents. Several articles were identified describing the utilization of advanced practice providers in the ICU and the impact of models of care on patient outcomes. Limited data exist describing the impact of advanced practice providers on resident and fellow education and training experience. In addition, there are minimal data describing methods to enhance collaboration between providers. Future research should focus on determining the optimal ICU team structure to improve patient outcomes, education of trainees, and job satisfaction of team members and methods to promote collaboration between advanced practice providers and physicians in training.

An Efficient, Non-iterative Method of Identifying the Cost-Effectiveness Frontier

Science.gov (United States)

Suen, Sze-chuan; Goldhaber-Fiebert, Jeremy D.

2015-01-01

Cost-effectiveness analysis aims to identify treatments and policies that maximize benefits subject to resource constraints. However, the conventional process of identifying the efficient frontier (i.e., the set of potentially cost-effective options) can be algorithmically inefficient, especially when considering a policy problem with many alternative options or when performing an extensive suite of sensitivity analyses for which the efficient frontier must be found for each. Here, we describe an alternative one-pass algorithm that is conceptually simple, easier to implement, and potentially faster for situations that challenge the conventional approach. Our algorithm accomplishes this by exploiting the relationship between the net monetary benefit and the cost-effectiveness plane. To facilitate further evaluation and use of this approach, we additionally provide scripts in R and Matlab that implement our method and can be used to identify efficient frontiers for any decision problem. PMID:25926282

Effects of Different Practice Conditions on Advanced Instrumentalists' Performance Accuracy.

Science.gov (United States)

Rosenthal, Roseanne K.; And Others

1988-01-01

Examines the relative effects of the five practice conditions of modeling, singing, silent analysis, free practice, and control on instrumentalists' performance. Finds significant differences in subjects' performance of correct rhythms, phrasing or dynamics, and tempo, and insignificant differences among performances of correct notes and…

Market Orientation Practices and Effects on Organizational Performance

Directory of Open Access Journals (Sweden)

Haim Hilman

2014-09-01

Full Text Available Today’s organizations need market orientation practices to strive and generate superior performance and competitive advantage in the modern turbulent marketplace. Thus, this research inspects the respective links between the dimensions of (a competitor orientation and (b customer orientation and performance in the context of hotels in Malaysia. Data were gathered through self-administrated mail questionnaires directed to the top- and middle-level managers of three- to five-star-rated hotels in Malaysia. The findings indicated that hotels in Malaysia practiced competitor orientation and customer orientation as their core marketing strategy. Specifically, both competitor orientation and customer orientation positively linked to organizational performance. Few studies have investigated the practices and effects of market orientation on performance in the Malaysian hotel setting. Therefore, this study provided new insights into the understanding of market orientation practices in the hotel industry, particularly in Malaysia. In addition, the significance of this study, potential limitations, and future examination directions are highlighted.

Identifying Keys to Success in Innovative Teaching: Student Engagement and Instructional Practices as Predictors of Student Learning in a Course Using a Team-Based Learning Approach

Directory of Open Access Journals (Sweden)

Rosa M. Alvarez-Bell

2017-09-01

Full Text Available When implementing innovative teaching techniques, instructors often seek to gauge the success of their methods. Proposing one approach to assessing classroom innovation, this study examines the ability of students’ ratings of engagement and instructional practices to predict their learning in a cooperative (team-based framework. After identifying the factor structures underlying measures of student engagement and instructional practices, these factors were used as predictors of self-reported student learning in a general chemistry course delivered using a team-based learning approach. Exploratory factor analyses showed a four-factor structure of engagement: teamwork involvement, investment in the learning process, feelings about team-based learning, level of academic challenge; and a three-factor structure of instructional practices: instructional guidance, fostering self-directed learning skills, and cognitive level. Multiple linear regression revealed that feelings about team-based learning and perceptions of instructional guidance had significant effects on learning, beyond other predictors, while controlling gender, GPA, class level, number of credit hours, whether students began college at their current institution, expected highest level of education, racial or ethnic identification, and parental level of education. These results yield insight into student perceptions about team-based learning, and how to measure learning in a team-based learning framework, with implications for how to evaluate innovative instructional methods.

Between worst and best: developing criteria to identify promising practices in health promotion and disease prevention for the Canadian Best Practices Portal.

Science.gov (United States)

Fazal, Nadia; Jackson, Suzanne F; Wong, Katy; Yessis, Jennifer; Jetha, Nina

2017-11-01

In health promotion and chronic disease prevention, both best and promising practices can provide critical insights into what works for enhancing the healthrelated outcomes of individuals and communities, and how/why these practices work in different situations and contexts. The promising practices criteria were developed using the Public Health Agency of Canada's (PHAC's) existing best practices criteria as the foundation. They were modified and pilot tested (three rounds) using published interventions. Theoretical and methodological issues and challenges were resolved via consultation and in-depth discussions with a working group. The team established a set of promising practices criteria, which differentiated from the best practices criteria via six specific measures. While a number of complex challenges emerged in the development of these criteria, they were thoroughly discussed, debated and resolved. The Canadian Best Practices Portal's screening criteria allow one to screen for both best and promising practices in the fields of public health, health promotion, chronic disease prevention, and potentially beyond.

Practical Considerations in Creating School-Wide Positive Behavior Support in Public Schools

Science.gov (United States)

Handler, Marcie W.; Rey, Jannette; Connell, James; Thier, Kimberly; Feinberg, Adam; Putnam, Robert

2007-01-01

School-wide positive behavior support (SWPBS) has been identified as an effective and efficient method to teach students prosocial skills. It requires both effective behavior support practices and systems that will support these changes, including data-based decision making among the school leadership team. There are many practical and systemic…

Practical In-Depth Analysis of IDS Alerts for Tracing and Identifying Potential Attackers on Darknet

Directory of Open Access Journals (Sweden)

Jungsuk Song

2017-02-01

Full Text Available The darknet (i.e., a set of unused IP addresses is a very useful solution for observing the global trends of cyber threats and analyzing attack activities on the Internet. Since the darknet is not connected with real systems, in most cases, the incoming packets on the darknet (‘the darknet traffic’ do not contain a payload. This means that we are unable to get real malware from the darknet traffic. This situation makes it difficult for security experts (e.g., academic researchers, engineers, operators, etc. to identify whether the source hosts of the darknet traffic are infected by real malware or not. In this paper, we present the overall procedure of the in-depth analysis between the darknet traffic and IDS alerts using real data collected at the Science and Technology Cyber Security Center (S&T CSC in Korea and provide the detailed in-depth analysis results. The ultimate goal of this paper is to provide practical experience, insight and know-how to security experts so that they are able to identify and trace the root cause of the darknet traffic. The experimental results show that correlation analysis between the darknet traffic and IDS alerts is very useful to discover potential attack hosts, especially internal hosts, and to find out what kinds of malware infected them.

Effect of Professional Development on Classroom Practices in Some Selected Saudi Universities

Science.gov (United States)

Alghamdi, AbdulKhaliq Hajjad; Bin Sihes, Ahmad Johari

2016-01-01

"Scientific studies found the impact of professional development on effective classroom practices in Higher Education." This paper hypothesizes no statistically significant effect of lecturers' professional development on classroom practices in some selected Saudi Universities not as highlighted in the model. Hierarchical multiple…

Placebo Response and Practice Effects in Schizophrenia Cognition Trials.

Science.gov (United States)

Keefe, Richard S E; Davis, Vicki G; Harvey, Philip D; Atkins, Alexandra S; Haig, George M; Hagino, Owen; Marder, Stephen; Hilt, Dana C; Umbricht, Daniel

2017-08-01

Patients' previous experience with performance-based cognitive tests in clinical trials for cognitive impairment associated with schizophrenia can create practice-related improvements. Placebo-controlled trials for cognitive impairment associated with schizophrenia are at risk for these practice effects, which can be difficult to distinguish from placebo effects. To conduct a systematic evaluation of the magnitude of practice effects on the Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery (MCCB) in cognitive impairment associated with schizophrenia and to examine which demographic, clinical, and cognitive characteristics were associated with improvement in placebo conditions. A blinded review was conducted of data from 813 patients with schizophrenia who were treated with placebo in 12 randomized placebo-controlled clinical trials conducted mostly in outpatient clinics in North America, Europe, Asia, and Latin America from February 22, 2007, to March 1, 2014. A total of 779 patients provided data for the primary outcome measure at baseline and at least 1 follow-up. Seven trials had prebaseline assessments wherein the patients knew that they were not receiving treatment, allowing a comparison of practice and placebo effects in the same patients. Placebo compared with various experimental drug treatments. Composite score on the MCCB. Of the 813 patients in the study (260 women and 553 men; mean [SD] age, 41.2 [11.5] years), the mean MCCB composite score at baseline was 22.8 points below the normative mean, and the mean (SEM) total change in the MCCB during receipt of placebo was 1.8 (0.2) T-score points (95% CI, 1.40-2.18), equivalent to a change of 0.18 SD. Practice effects in the 7 studies in which there was a prebaseline assessment were essentially identical to the postbaseline placebo changes. Baseline factors associated with greater improvements in the MCCB during receipt of placebo included more depression

Practice And Perceived Effectiveness Of Non-Pharmacological ...

African Journals Online (AJOL)

Pain is one of the major leading symptoms of diseases and the most common cause of hospital visitation and hospitalization. Studies have shown that ineffective pain management has a deleterious effect on both patient and the care giver especially the nurse. This study determines the practice and perceived effectof ...

Therapist effects on dropout from a college counseling center practice research network.

Science.gov (United States)

Xiao, Henry; Castonguay, Louis G; Janis, Rebecca A; Youn, Soo Jeong; Hayes, Jeffrey A; Locke, Benjamin D

2017-07-01

Dropout has been a pervasive and costly problem in psychotherapy, particularly for college counseling centers. The present study examined potential predictors of dropout using a large data set (N = 10,147 clients, 481 therapists) that was gathered through a college counseling center practice research network as a replication and extension of recent findings regarding therapist effects on dropout. The final model resulted in a dropout rate of 15.9% and a therapist effect of 9.51% on dropout variance. Therapist demographic variables were investigated, though none were found to be significant. Variables found to be predictive of increased likelihood of dropping out included higher levels of general presenting concerns, alcohol-related distress, and current financial stress. Ultimately, this study showed that therapists may play an important role in the likelihood of client dropout, and that additional research should be conducted to identify additional predictors, particularly at the therapist and center level. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The Effect of Two Different Cooperative Approaches on Students' Learning and Practices within the Context of a WebQuest Science Investigation

Science.gov (United States)

Zacharia, Zacharias C.; Xenofontos, Nikoletta A.; Manoli, Constantinos C.

2011-01-01

The goal of this study was to investigate the effect of two different cooperative learning approaches, namely, the Jigsaw Cooperative Approach (JCA) and the Traditional Cooperative Approach (TCA), on students' learning and practices/actions within the context of a WebQuest science investigation. Another goal of this study was to identify possible…

Literature on theory and practice on unethical practices in the construction of projects: A case of an emerging economy

Directory of Open Access Journals (Sweden)

Chipo Mellania Maseko

2017-12-01

Full Text Available The construction of projects is mostly symbolised by the extraordinary levels of unethical practices and this has ruined the image of the industry. The delivery of good quality infrastructure projects in some emerging economies is continuously, disrupted because of unethical practices. This paper was, initiated to identify the most dominant unethical practices in the construction of projects, using most recent and comprehensive literature ranging from 2011 to 2017. Twenty unethical practices in the construction of projects were, identified. From this, the study observed that the most dominant unethical practices are corruption, bribery and collusive tendering. The least unethical practices revealed by this study are the lack of safety, overstatement of capacity and falsification of experience. Findings indicate that in order to redesign the future landscape of the industry, there is need to educate the workforce on the effects of unethical practices as well as the need to implement stronger policies. Based on these findings, further empirical studies are necessary. This article also presents recent challenges and trends of unethical behaviour that needs acknowledgement in order to assist the construction industry. In conclusion, this study proposes twelve possible solutions that could assist the construction community in the reduction of unethical practices

An inquiry into the concept of SEA effectiveness: Towards criteria for Chinese practice

International Nuclear Information System (INIS)

Bina, Olivia; Jing Wu; Brown, Lex; Partidario, Maria Rosario

2011-01-01

The importance of improving the effectiveness of Plan EIA and SEA-type evaluations in China cannot be overstated: at a time when the country's economy is being boosted by a stimulus package worth over RMB 400 trillion - largely for infrastructure - the pressure on China's already strained environment and resource base is bound to increase. The aim is to propose the criteria for plan EIA's effectiveness to raise the awareness of the need to strengthen the performance of the assessment and maximize its potential benefits. The authors first review critically the discourse on the effectiveness of the impact assessment, identifying three dimensions: substantive, procedural and incremental. The resulting conceptual framework allows them to interpret the weaknesses of the Chinese discourse on the effectiveness and of the practice of the Plan EIA to date. The result is the identification of a clear gap, both in terms of the breadth of the concept, and in terms of the quality of the existing criteria, which tend to be very generic to the point of inapplicability. The analysis also reveals a need for transitioning from formal models of the Plan EIA to more strategic approaches, in a gradual manner that is consistent with context-specificities. The proposal of a set of preliminary criteria for effectiveness is therefore structured on three levels. This framework is meant to input into the ongoing debate on how to improve the practice of PEIA and the SEA-type evaluations in China, and provide ideas for a government strategy aimed at maximizing the positive impact of PEIAs on planning, as well as on the context of application.

Effectiveness of multimedia-supported education in practical sports courses.

Science.gov (United States)

Leser, Roland; Baca, Arnold; Uhlig, Johannes

2011-01-01

Multimedia-assisted teaching and learning have become standard forms of education. In sports, multimedia material has been used to teach practical aspects of courses, such as motor skills. The main goal of this study is to examine if multimedia technology impacts learning in the field of sport motor skill acquisition. This question was investigated during a practical sports education course involving 35 students who participated in a university soccer class. The whole course was split into two groups: Group A was taught traditionally with no assistance of multimedia and Group B was prepared with multimedia-assisted instructional units. To quantify selected skills of soccer technique and tactic, the test subjects performed a specific passing test and a tactical assessment. Furthermore, a ques-tionnaire was used to assess the subjective impressions of the test subjects. All testing instruments were applied before and after a six-week-long teaching period. A comparison of the gathered data between the two groups resulted in no significant differences, neither concerning the results of the technique test nor concerning the tactic test. However, the results of the ques-tionnaire showed a positive agreement among the participants in the usability and assistance of multimedia for the sports practical course. Considering the reviewed conditions, it can be concluded that the use of multimedia content doesn't affect the learning effects. Key pointsMultimedia-assisted learning showed no positive learning effects on technical skills in soccer.Multimedia-assisted learning showed no positive learning effects on tactical skills in soccer.Students participating in practical sports courses have very good attitudes towards the use of multi-media learning material. This may be considered for motivational effects.

Effectiveness of Multimedia-Supported Education in Practical Sports Courses

Science.gov (United States)

Leser, Roland; Baca, Arnold; Uhlig, Johannes

2011-01-01

Multimedia-assisted teaching and learning have become standard forms of education. In sports, multimedia material has been used to teach practical aspects of courses, such as motor skills. The main goal of this study is to examine if multimedia technology impacts learning in the field of sport motor skill acquisition. This question was investigated during a practical sports education course involving 35 students who participated in a university soccer class. The whole course was split into two groups: Group A was taught traditionally with no assistance of multimedia and Group B was prepared with multimedia-assisted instructional units. To quantify selected skills of soccer technique and tactic, the test subjects performed a specific passing test and a tactical assessment. Furthermore, a ques-tionnaire was used to assess the subjective impressions of the test subjects. All testing instruments were applied before and after a six-week-long teaching period. A comparison of the gathered data between the two groups resulted in no significant differences, neither concerning the results of the technique test nor concerning the tactic test. However, the results of the ques-tionnaire showed a positive agreement among the participants in the usability and assistance of multimedia for the sports practical course. Considering the reviewed conditions, it can be concluded that the use of multimedia content doesn’t affect the learning effects. Key points Multimedia-assisted learning showed no positive learning effects on technical skills in soccer. Multimedia-assisted learning showed no positive learning effects on tactical skills in soccer. Students participating in practical sports courses have very good attitudes towards the use of multi-media learning material. This may be considered for motivational effects. PMID:24149313

A journal club is an effective tool for assisting librarians in the practice of evidence-based librarianship: a case study.

Science.gov (United States)

Pearce-Smith, Nicola

2006-03-01

To establish a journal club for librarians, which aimed to develop appraisal skills and assist in the application of research to practice. Fourteen health librarians were invited to attend a journal club. Each month a librarian was responsible for preparing a scenario, choosing a research paper, and selecting a checklist. The paper was appraised by the club, and a critically appraised topic (CAT) prepared. Six months later, a questionnaire was sent to all librarians. Six out of 14 librarians attended the journal club and five out of six returned the questionnaire. All five agreed that attending the journal club helped them develop appraisal skills, write a CAT and be more critical of research. Four agreed they always identified a research paper first, then formulated a question. One librarian agreed that applying results to their own practice was difficult, one disagreed and three were neutral. Journal clubs can be effective at developing appraisal skills and writing a CAT, as well as increasing the reading of library research. Librarians still need assistance in identifying and using questions directly from their own practice. The journal club has helped some librarians to apply evidence to practice, but others find the research is not always directly relevant.

Caring for people with dementia in hospital: findings from a survey to identify barriers and facilitators to implementing best practice dementia care.

Science.gov (United States)

Tropea, Joanne; LoGiudice, Dina; Liew, Danny; Roberts, Carol; Brand, Caroline

2017-03-01

Best practice dementia care is not always provided in the hospital setting. Knowledge, attitudes and motivation, practitioner behavior, and external factors can influence uptake of best practice and quality care. The aim of this study was to determine hospital staff perceived barriers and enablers to implementing best practice dementia care. A 17-item survey was administered at two Australian hospitals between July and September 2014. Multidisciplinary staff working in the emergency departments and general medical wards were invited to participate in the survey. The survey collected data about the respondents' current role, work area, and years of experience, their perceived level of confidence and knowledge in dementia care and common symptoms of dementia, barriers and enablers to implementing best practice dementia care, job satisfaction in caring for people with dementia, and to rate the hospital's capacity and available resources to support best practice dementia care. A total of 112 survey responses were received. The environment, inadequate staffing levels and workload, time, and staff knowledge and skills were identified as barriers to implementing best practice dementia care. Most respondents rated their knowledge of dementia care and common symptoms of dementia, and confidence in recognizing whether a person has dementia, as moderate or high dementia. Approximately, half the respondents rated access to training and equipment as low or very low. The survey findings highlighted hospital staff perceived barriers to implementing best practice dementia care that can be used to inform locally tailored improvement interventions.

Understanding Graduate School Aspirations: The Effect of Good Teaching Practices

Science.gov (United States)

Hanson, Jana M.; Paulsen, Michael B.; Pascarella, Ernest T.

2016-01-01

This study examined the effects of good teaching practices on post-baccalaureate degree aspirations using logistic regression techniques on a multi-institutional, longitudinal sample of students at 4-year colleges and universities in the USA. We examined whether eight good teaching practices (non-classroom interactions with faculty, prompt…

Between worst and best: developing criteria to identify promising practices in health promotion and disease prevention for the Canadian Best Practices Portal

Directory of Open Access Journals (Sweden)

Nadia Fazal

2017-11-01

Full Text Available Introduction: In health promotion and chronic disease prevention, both best and promising practices can provide critical insights into what works for enhancing the healthrelated outcomes of individuals and communities, and how/why these practices work in different situations and contexts. Methods: The promising practices criteria were developed using the Public Health Agency of Canada’s (PHAC’s existing best practices criteria as the foundation. They were modified and pilot tested (three rounds using published interventions. Theoretical and methodological issues and challenges were resolved via consultation and in-depth discussions with a working group. Results: The team established a set of promising practices criteria, which differentiated from the best practices criteria via six specific measures. Conclusion: While a number of complex challenges emerged in the development of these criteria, they were thoroughly discussed, debated and resolved. The Canadian Best Practices Portal’s screening criteria allow one to screen for both best and promising practices in the fields of public health, health promotion, chronic disease prevention, and potentially beyond.

The Influence of Human Resource Practices on Internal Customer Satisfaction and Organizational Effectiveness

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Irfan Ullah

2013-08-01

Full Text Available It is generally believed that the impact of Human Resource Practices on internal customer satisfaction can create comparative advantage for the organizational performance. The main objective of this study was to find out the impact of Human Resource Practices on internal customer satisfaction and organizational effectiveness. The impact of human resource practices on the overall performance of organizations has been a leading subject of research and the results have been encouraging, indicative of positive relationship between Human Resource practices and organizational effectiveness. Data was collected through personally administered questionnaire-based survey from 290 banking personnel of Pakistan. Structural equation modeling was used to examine the anticipated model. The results showed that some Human Resource Practices appear to be linked to internal customer satisfaction and organizational effectiveness. The implications for practitioners were to modify and emphasize certain human resource practices, and to emphasize the role of internal customers for organizational effectiveness enhancement. These findings revealed the importance of internal customers in enhancing employee morale, organizational commitment, employee productivity, turnover rate and the organization’s ability to attract talent.

Physician dual practice: A review of literature

DEFF Research Database (Denmark)

Socha, Karolina; Bech, Mickael

2010-01-01

Objectives A combination of public and private practice by physicians, referred to as physician dual practice, has been receiving attention in connection with arguments about its negative impact for the public health care. This paper aims to review and critically discuss findings on the subject...... of dual practice effects for the public health care. Methods A systematic literature review identified 23 positions on the subject consisting of journal articles, academic working papers, book chapter, and publications of the WHO. Results The subject is short on evidence. Theoretical analyses indicate...

Effectiveness of a step-by-step oral recount before a practical simulation of fracture fixation.

Science.gov (United States)

Abagge, Marcelo; Uliana, Christiano Saliba; Fischer, Sergei Taggesell; Kojima, Kodi Edson

2017-10-01

To evaluate the effectiveness of a step-by-step oral recount by residents before the final execution of a practical exercise simulating a surgical fixation of a radial diaphyseal fracture. The study included 10 residents of orthopaedics and traumatology (four second- year and six first-year residents) divided into two groups with five residents each. All participants initially gathered in a room in which a video was presented demonstrating the practical exercise to be performed. One group (Group A) was referred directly to the practical exercise room. The other group (Group B) attended an extra session before the practical exercise, in which they were invited by instructors to recount all the steps that they would perform during the practical exercise. During this session, the instructors corrected the residents if any errors in the step-by-step recount were identified, and clarified questions from them. After this session, both Groups A and B gathered in a room in which they proceeded to the practical exercise, while being video recorded and evaluated using a 20-point checklist. Group A achieved a 57% accuracy, with results in this group ranging from 7 to 15 points out of a total of a possible 20 points. Group B achieved an 89% accuracy, with results in this group ranging from 15 to 20 points out of 20. An oral step-by-step recount by the residents before the final execution of a practical simulation exercise of surgical fixation of a diaphyseal radial fracture improved the technique and reduced the execution time of the exercise. © 2017 Elsevier Ltd. All rights reserved.

An investigation into the effectiveness of public entities’ procurement practices

Directory of Open Access Journals (Sweden)

Moitswadi Mofokeng

2014-11-01

Full Text Available The delivery of services through the procurement of goods and services requires proper strategic leadership and management processes. Inappropriate planning, under-spending of budgets and ineffective procurement form part of the root causes of poor service delivery, as this restricts the movement of resources to the right places. This study identified the leading procurement practices as: procurement strategy and leadership, the procurement process, human resource management, procurement information systems, supplier management and procurement performance management. These practices were then tested in public entities, mainly in Gauteng Province, South Africa, to determine the extent to which they are applied. The study found that there is a major divide between the perception of the level of application of the leading practices and actual implementation. Processes, skills, performance management, information technology (IT systems and supplier management are applied inadequately or inappropriately. Most entities thus show a poor understanding of customer needs and there seems to be a general lack of customer focus. The study highlighted the best practice areas in which public entities are able to focus their efforts to better achieve excellent customer service and thus service delivery.

Effects of Various Early Writing Practices on Reading and Spelling

Science.gov (United States)

Rieben, Laurence; Ntamakiliro, Ladislas; Gonthier, Brana; Fayol, Michel

2005-01-01

The effects of different early word spelling practices on reading and spelling were studied in 145 five-year-old children. Three experimental treatments were designed to mimic different teaching activities by having children practice invented spelling (IS group), copied spelling (CS group), or invented spelling with feedback on correct orthography…

MYC Immunohistochemistry to Identify MYC-Driven B-Cell Lymphomas in Clinical Practice.

Science.gov (United States)

Kluk, Michael J; Ho, Caleb; Yu, Hongbo; Chen, Benjamin J; Neuberg, Donna S; Dal Cin, Paola; Woda, Bruce A; Pinkus, Geraldine S; Rodig, Scott J

2016-02-01

Immunohistochemistry with anti-MYC antibody (MYC IHC) detects MYC protein in fixed samples of aggressive B-cell lymphomas and, according to the number of positive staining tumor nuclei, facilitates tumor subclassification, predicts underlying MYC rearrangements, and stratifies patient outcome. We aimed to determine the performance of MYC IHC in clinical practice. We reviewed MYC IHC performed on control specimens and 256 aggressive B-cell lymphomas and compared clinically reported IHC scores with experts' review. Control tissues showed less than 5% variation in daily IHC staining. Reported and expert IHC scores were well correlated (r = 0.86) with an SD of 14.2%. Reported IHC scores 30% or less and 70% or more were accurate (94.5%) compared with experts in categorizing tumors as "MYC IHC-Low" and "MYC IHC-High," respectively, but scores 40% to 60% were not (60.3%). The mean IHC score among lymphomas with MYC rearrangements was 80%, but with a large range of scores (20%-100%). There was no statistically significant association between IHC score and MYC copy number. Under optimal conditions, clinically reported MYC IHC scores are concordant with expert scores within 15%. MYC IHC does not capture all B-cell lymphomas with MYC rearrangements, however. MYC IHC and MYC fluorescence in situ hybridization are both recommended to identify MYC-driven B-cell lymphomas. © American Society for Clinical Pathology, 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Production practices affecting worker task demands in concrete operations: A case study.

Science.gov (United States)

Memarian, Babak; Mitropoulos, Panagiotis

2015-01-01

Construction work involves significant physical, mental, and temporal task demands. Excessive task demands can have negative consequences for safety, errors and production. This exploratory study investigates the magnitude and sources of task demands on a concrete operation, and examines the effect of the production practices on the workers' task demands. The NASA Task Load Index was used to measure the perceived task demands of two work crews. The operation involved the construction of a cast-in-place concrete building under high schedule pressures. Interviews with each crew member were used to identify the main sources of the perceived demands. Extensive field observations and interviews with the supervisors and crews identified the production practices. The workers perceived different level of task demands depending on their role. The production practices influenced the task demands in two ways: (1) practices related to work organization, task design, resource management, and crew management mitigated the task demands; and (2) other practices related to work planning and crew management increased the crew's ability to cope with and adapt to high task demands. The findings identify production practices that regulate the workers' task demands. The effect of task demands on performance is mitigated by the ability to cope with high demands.

PEDAGOGICAL PRACTICE WAY OF CONNECTING PEDAGOGICAL THEORY AND PRACTICE

Directory of Open Access Journals (Sweden)

Božo Obradović

2013-12-01

Full Text Available The issue of linking educational theory to educational practice (educational work with young people is highly topical and important issue for the science of pedagogy. One way of achieving this task is a pedagogical practice (PP students. In paper we deal with identifying, comparing, and analyzing the curricula of vocational (Curriculum for Preschool Teacher (2007 and academic (Curriculum for Educators (2007. Studies Teacher Training in Serbia, as well as educational disciplines and areas of pedagogical science derived from them. The results showed many similarities, but also differences when it comes to educational disciplines that are taught, the name of pedagogical practice, the number of classes to implement, ECTS (European Credit Transfer System, which affect the quality and coherence of educational theory and educational practice. In order to identify similarities and overcome weaknesses that accompany the pedagogical practice analysis, we came to know about the specifics of each of the six pedagogical practice. For each pedagogical practice defined specific goals and tasks arising from the curriculum, and in particular pedagogical disciplines taught at university. Each of these pedagogical practices is the ability to connect educational theory and educational practice and direct way to increase the quality of training and competence of future teachers for direct work with children.

Mesoscale Biotransformations of Uranium: Identifying Sites and Strategies where Reductive Immobilization is Practical

International Nuclear Information System (INIS)

Tetsu K. Tokunaga; Jiamin Wan; Terry C. Hazen; Mary K. Firestone; Eoin Brodie; Yongman Kim; Rebecca Daly

2006-01-01

Bioreduction of U in contaminated sediments is an attractive strategy because of its low cost, and because of short-term studies supporting its feasibility. However, any in-situ immobilization approach for U will require assurance of either permanent fixation, or of very low release rates into the biosphere. Our previous long-term (2 years) laboratory experiments have shown that organic carbon (OC) based U(VI) bioreduction to UO2 can be transient even under sustained reducing (methanogenic) conditions. The biogeochemical processes underlying this finding urgently need to be understood. The current research is designed to identify mechanisms responsible for anaerobic U oxidation, and identify conditions that will support long-term stability of bioreduced U. We are investigating: (1) effects of OC concentration and supply rate on remobilization of bioreduced U, (2) the roles of Fe- and Mn-oxides as potential U oxidants in sediments, and (3) the role of microorganisms in U reoxidation, and (4) influences of pH on U(IV)/U(VI) redox equilibrium

Challenges in Identifying Effects and Determinants of Corporate Tax Avoidance

OpenAIRE

Hüsecken, Birgit

2017-01-01

Policymakers worldwide try to hinder tax avoidance. In order to implement effective tax regulations, it is essential to completely understand why corporations avoid taxes and why some appear to be more effective than others. However, various challenges in identifying effects and determinants of corporate tax avoidance cause knowledge gaps. This thesis consists of three essays highlighting the necessity of refined identification strategies. The first essay “The Undersheltering Puzzle and its P...

Effective and Innovative Practices for Stronger Facilities Management.

Science.gov (United States)

Banick, Sarah

2002-01-01

Describes the five winners of the APPA's Effective & Innovative Practices Award. These facilities management programs and processes were recognized for enhancing service delivery, lowering costs, increasing productivity, improving customer service, generating revenue, or otherwise benefiting the educational institution. (EV)

Studying motivation in classrooms : effects of teaching practices on early adolescents' motivation

NARCIS (Netherlands)

Stroet, Kim

2014-01-01

For many early adolescent students, motivation for school declines after the transition toward secondary education. Kim Stroet aimed to identify how these motivational developments are affected by teaching practices, thereby intending to—ultimately—help schools diminish or counter the declines. Next

Teacher Progress Monitoring of Instructional and Behavioral Management Practices: An Evidence-Based Approach to Improving Classroom Practices

Science.gov (United States)

Reddy, Linda A.; Dudek, Christopher M.

2014-01-01

In the era of teacher evaluation and effectiveness, assessment tools that identify and monitor educators' instruction and behavioral management practices are in high demand. The Classroom Strategies Scale (CSS) Observer Form is a multidimensional teacher progress monitoring tool designed to assess teachers' usage of instructional and behavioral…

The influence of deliberate practice on musical achievement: A meta-analysis

Directory of Open Access Journals (Sweden)

Friedrich ePlatz

2014-06-01

Full Text Available Deliberate practice (DP is a task-specific structured training activity that plays a key role in understanding skill acquisition and explaining individual differences in expert performance. Relevant activities that qualify as DP have to be identified in every domain. For example, for training in classical music, solitary practice is a typical training activity during skill acquisition. To date, no meta-analysis on the quantifiable effect size of deliberate practice on attained performance in music has been conducted. Yet the identification of a quantifiable effect size could be relevant for the current discussion on the role of various factors on individual difference in musical achievement. Furthermore, a research synthesis might enable new computational approaches to musical development. Here we present the first meta-analysis on the role of deliberate practice in the domain of musical performance. A final sample size of 13 studies (total N = 788 was carefully extracted to satisfy the following criteria: reported durations of task-specific accumulated practice as predictor variables and objectively assessed musical achievement as the target variable. We identified an aggregated effect size of rc = .61; 95% CI [.54, .67] for the relationship between task-relevant practice (which by definition includes DP and musical achievement. Our results corroborate the central role of long-term (deliberate practice for explaining expert performance in music.

The influence of deliberate practice on musical achievement: a meta-analysis.

Science.gov (United States)

Platz, Friedrich; Kopiez, Reinhard; Lehmann, Andreas C; Wolf, Anna

2014-01-01

Deliberate practice (DP) is a task-specific structured training activity that plays a key role in understanding skill acquisition and explaining individual differences in expert performance. Relevant activities that qualify as DP have to be identified in every domain. For example, for training in classical music, solitary practice is a typical training activity during skill acquisition. To date, no meta-analysis on the quantifiable effect size of deliberate practice on attained performance in music has been conducted. Yet the identification of a quantifiable effect size could be relevant for the current discussion on the role of various factors on individual difference in musical achievement. Furthermore, a research synthesis might enable new computational approaches to musical development. Here we present the first meta-analysis on the role of deliberate practice in the domain of musical performance. A final sample size of 13 studies (total N = 788) was carefully extracted to satisfy the following criteria: reported durations of task-specific accumulated practice as predictor variables and objectively assessed musical achievement as the target variable. We identified an aggregated effect size of r c = 0.61; 95% CI [0.54, 0.67] for the relationship between task-relevant practice (which by definition includes DP) and musical achievement. Our results corroborate the central role of long-term (deliberate) practice for explaining expert performance in music.

The sensitivity and specificity of four questions (HARK to identify intimate partner violence: a diagnostic accuracy study in general practice

Directory of Open Access Journals (Sweden)

Feder Gene

2007-08-01

Full Text Available Abstract Background Intimate partner violence (IPV including physical, sexual and emotional violence, causes short and long term ill-health. Brief questions that reliably identify women experiencing IPV who present in clinical settings are a pre-requisite for an appropriate response from health services to this substantial public health problem. We estimated the sensitivity and specificity of four questions (HARK developed from the Abuse Assessment screen, compared to a 30-item abuse questionnaire, the Composite Abuse Scale (CAS. Methods We administered the four HARK questions and the CAS to women approached by two researchers in general practice waiting rooms in Newham, east London. Inclusions: women aged more than 17 years waiting to see a doctor or nurse, who had been in an intimate relationship in the last year. Exclusions: women who were accompanied by children over four years of age or another adult, too unwell to complete the questionnaires, unable to understand English or unable to give informed consent. Results Two hundred and thirty two women were recruited. The response rate was 54%. The prevalence of current intimate partner violence, within the last 12 months, using the CAS cut off score of ≥3, was 23% (95% C.I. 17% to 28% with pre-test odds of 0.3 (95% C.I. 0.2 to 0.4. The receiver operator characteristic curve demonstrated that a HARK cut off score of ≥1 maximises the true positives whilst minimising the false positives. The sensitivity of the optimal HARK cut-off score of ≥1 was 81% (95% C.I. 69% to 90%, specificity 95% (95% C.I. 91% to 98%, positive predictive value 83% (95% C.I. 70% to 91%, negative predictive value 94% (95% C.I. 90% to 97%, likelihood ratio 16 (95% C.I. 8 to 31 and post-test odds 5. Conclusion The four HARK questions accurately identify women experiencing IPV in the past year and may help women disclose abuse in general practice. The HARK questions could be incorporated into the electronic medical record

Identifying potentially cost effective chronic care programs for people with COPD

NARCIS (Netherlands)

L.M.G. Steuten (Lotte); K.M.M. Lemmens (Karin); A.P. Nieboer (Anna); H.J.M. Vrijhoef (Hubertus)

2009-01-01

textabstractObjective: To review published evidence regarding the cost effectiveness of multi-component COPD programs and to illustrate how potentially cost effective programs can be identified. Methods: Systematic search of Medline and Cochrane databases for evaluations of multicomponent disease

Invited review: effect of udder health management practices on herd somatic cell count.

Science.gov (United States)

Dufour, S; Fréchette, A; Barkema, H W; Mussell, A; Scholl, D T

2011-02-01

A systematic review of the scientific literature on relationships between management practices used on dairy farms and herd somatic cell count (SCC) was undertaken to distinguish those management practices that have been consistently shown to be associated with herd SCC from those lacking evidence of association. Relevant literature was identified using a combination of database searches (PubMed, Medline, CAB, Agricola, and Web of Science) and iterative screening of references. To be included in the review, a manuscript had to be published after 1979 in French, English, or Dutch; study design had to be other than case report or case series; herds studied had to be composed of ≥ 40 milking cows producing on average ≥ 7,000kg of milk in 305 d; interventions studied had to be management practices applied at the herd level and used as udder health control strategies; and SCC had to be measured using electronic cell counting methods. The 36 manuscripts selected were mainly observational cross-sectional studies; 8 manuscripts dealt exclusively with automatic milking systems and 4 with management of calves and heifers and its effect on SCC in early lactation heifers. Most practices having consistent associations with SCC were related to milking procedures: wearing gloves during milking, using automatic take-offs, using postmilking teat dipping, milking problem cows last, yearly inspection of the milking system, and use of a technique to keep cows standing following milking; all were consistently associated with lower herd SCC. Other practices associated with lower SCC were the use of a freestall system, sand bedding, cleaning the calving pen after each calving, surveillance of dry-cow udders for mastitis, use of blanket dry-cow therapy, parenteral selenium supplementation, udder hair management, and frequent use of the California Mastitis Test. Regarding SCC of heifers, most of the consistent associations reported were related to interventions made during the

Neural underpinnings of the identifiable victim effect: affect shifts preferences for giving.

Science.gov (United States)

Genevsky, Alexander; Västfjäll, Daniel; Slovic, Paul; Knutson, Brian

2013-10-23

The "identifiable victim effect" refers to peoples' tendency to preferentially give to identified versus anonymous victims of misfortune, and has been proposed to partly depend on affect. By soliciting charitable donations from human subjects during behavioral and neural (i.e., functional magnetic resonance imaging) experiments, we sought to determine whether and how affect might promote the identifiable victim effect. Behaviorally, subjects gave more to orphans depicted by photographs versus silhouettes, and their shift in preferences was mediated by photograph-induced feelings of positive arousal, but not negative arousal. Neurally, while photographs versus silhouettes elicited activity in widespread circuits associated with facial and affective processing, only nucleus accumbens activity predicted and could statistically account for increased donations. Together, these findings suggest that presenting evaluable identifiable information can recruit positive arousal, which then promotes giving. We propose that affect elicited by identifiable stimuli can compel people to give more to strangers, even despite costs to the self.

Current nuclear industry practices with regard to the integration of surveillances

International Nuclear Information System (INIS)

Stewart, M.; Smith, C.

1992-04-01

Commercial nuclear industry practices regarding the integration of technical specification (TS) surveillance and maintenance activities are identified in this report. A questionnaire was developed and used to obtain current industry practices from NRC Regional personnel and INEL engineers with utility experience. Some of these practices indicate that the scheduling of TS surveillance and maintenance items could be more effectively coordinated. Also, must utilities do not formally consider risk implications when they are scheduling maintenance. Methodologies and approaches for proposing and evaluating changes to improve the integration of TS surveillance and maintenance activities have been identified for planned future work

Effects of Training and Feedback on Teachers' Use of Classroom Preventive Practices

Science.gov (United States)

Artman-Meeker, Kathleen M.; Hemmeter, Mary Louise

2013-01-01

This study examined the effects of in-service training with performance feedback on preschool teachers' use of classroom preventive practices. Three practices designed to prevent challenging behavior were selected: transition preparations, rule reminders, and social-emotional teaching strategies. Following a brief training on each practice,…

Awareness and practices on eye effects among people with ...

African Journals Online (AJOL)

Background: Recently eye effects of Diabetes Mellitus (DM) are an important concern due to increase in its trend especially in developing countries. Objectives: To assess the awareness related to eye effects of DM and its prevention practices among people with diabetes. Methods: This cross sectional study was conducted ...

Branding your medical practice with effective public relations.

Science.gov (United States)

Trent, Nancy

2009-01-01

Whether you think of it as your image, your standing in the community, or your reputation, your medical practice is also a brand. While many organizations, companies, products, and services are known for specific attributes that make them stand out from competitors, most use a combination of marketing disciplines to communicate who and what they are to their customers, consumers, and patients. Public relations is often considered the most powerful, cost-effective, and efficacious of the marketing disciplines, surpassing advertising, promotion, and direct mail in molding and developing brands. Your practice can benefit from a well-crafted branding public relations program.

Optimizing stormwater treatment practices a handbook of assessment and maintenance

CERN Document Server

Erickson, Andrew J; Gulliver, John S

2013-01-01

Optimizing Stormwater Treatment Practices: A Handbook of Assessment and Maintenance provides the information necessary for developing and operating an effective maintenance program for stormwater treatment. The book offers instructions on how to measure the level of performance of stormwater treatment practices directly and bases proposed maintenance schedules on actual performance and historical maintenance efforts and costs. The inspection methods, which are proven in the field and have been implemented successfully, are necessary as regulatory agencies are demanding evaluations of the performance of stormwater treatment practices. The authors have developed a three-tiered approach that offers readers a standard protocol for how to determine the effectiveness of stormwater treatment practices currently in place. This book also: Provides a standard protocol for how to determine the effectiveness of stormwater treatment practices Assists readers with identifying which assessment techniques to use for stormwa...

The ripple effect: personal scholarships and impact on practice development

Directory of Open Access Journals (Sweden)

Lesley Baillie

2015-05-01

Full Text Available Background: Practice development projects are often situated within a specific context and team, while scholarship awards focus more on the personal and professional development of individuals. Personal and professional development is an important component of practice development, however, and this paper reports on a survey of nurses and midwives who had been awarded personal scholarships and examines the scholars’ perceptions of the impact on practice development. Few studies of scholarships and their impact have been published previously. Aims: 1. To present the outcomes of a research project that evaluated scholarships awarded to nurses and midwives, within the context of practice development 2. To critique the role of personal scholarships as a means to support practice development and/ or service improvement Methods: An online cross-sectional survey of nurses and midwives who had been awarded scholarships by a UK charity was conducted; 82 scholars responded, a 59% response rate. Quantitative data were analysed using descriptive statistics and free text comments were analysed thematically. Results: Scholars overwhelmingly perceived a positive impact on their personal and professional development but most also believed there had been a positive impact on patient care, safety and experience, and on colleagues and their organisation; some referred to the latter as a ‘ripple’ effect of their scholarship. An analysis of these results indicated some synergy with practice development values. Conclusions: The award of scholarships to individuals appears to have a wider impact on scholars’ colleagues and their organisation with a resulting impact on practice development. This is important as few individuals are awarded personal scholarships. The explicit promotion of personal scholarships within a practice development framework could further develop the relationship between the two, affirming a wider impact of the awards. The sustainability

Cost-effective practices in the blood service sector.

Science.gov (United States)

Katsaliaki, Korina

2008-05-01

The objective of this study is to recommend alternative policies, which are tested on a computer simulation model, towards a more cost-effective management of the blood supply chain in the UK. With the use of primary and secondary data from the National Blood Service (NBS) and the supplied hospitals, statistical analysis is conducted and a detailed discrete event simulation model of a vertical part of the UK supply chain of blood products is developed to test and identify good ordering, inventory and distribution practices. Fewer outdates, group substitutions, shortages and deliveries could be achieved by blood banks: holding stock of rare blood groups of red blood cells (RBC), having a second routine delivery per weekday, exercising a more insensitive ordering point for RBC, reducing the total crossmatch release period to less than 1.5 days, increasing the transfusion-to-crossmatch ratio to 70%, adhering to an age-based issuing of orders, holding RBC stock of a weighted average of approximately 4 days. The blood supply simulation model can offer useful pieces of advice to the stakeholders of the examined system which leads to cost reductions and increased safety. Moreover, it provides a great range of experimental capabilities in a risk-free environment.

The Impact of Human Resource Management Practices on Employee Turnover

OpenAIRE

Ozoliņa-Ozola, I

2014-01-01

The aim of this research was to identify the human resource management practices that are effective for employee turnover reducing. For this purpose the methods of document analysis and expert survey were used. On the basis of analysis of the scientific literature retrieved from academic databases the human resource management practices, which were mentioned in connection with employee turnover, were detected and described its effect on employee turnover. By conducting two separate expert sur...

Effective Practices for Evaluating Education and Public Outreach Programs

Science.gov (United States)

Wilkerson, S.

2013-12-01

Stephanie Baird Wilkerson, PhD Carol Haden EdD Magnolia Consulting,LLC Education and public outreach (EPO) program developers and providers seeking insights regarding effective practices for evaluating EPO activities programs benefit from understanding why evaluation is critical to the success of EPO activities and programs, what data collection methods are appropriate, and how to effectively communicate and report findings. Based on our extensive experience evaluating EPO programs, we will share lessons learned and examples of how these practices play out in actual evaluation studies. EPO program developers, providers, and evaluators must consider several factors that influence which evaluation designs and data collection methods will be most appropriate, given the nature of EPO programs. Effective evaluation practices of EPO programs take into account a program's phase of development, duration, and budget as well as a program's intended outcomes. EPO programs that are just beginning development will have different evaluation needs and priorities than will well-established programs. Effective evaluation practices consider the 'life' of a program with an evaluation design that supports a program's growth through various phases including development, revision and refinement, and completion. It would be premature and inappropriate to expect the attainment of longer-term outcomes of activities during program development phases or early stages of implementation. During program development, EPO providers should clearly define program outcomes that are feasible and appropriate given a program's scope and expected reach. In many respects, this directly relates to the amount of time, or duration, intended audiences participate in EPO programs. As program duration increases so does the likelihood that the program can achieve longer-term outcomes. When choosing which outcomes are reasonable to impact and measure, program duration should be considered. Effective evaluation

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.

Effectiveness of Practicing Supply Chain Management in Construction Site

Directory of Open Access Journals (Sweden)

Mamter S.

2014-01-01

Full Text Available Construction Supply chain management comprised of the network of organization involved in the different processes and activities which produce the material, components and services that come together to design, procurement and deliver a building. It also consists of different organizations involved in the construction process including client/owner, designer, contractor, subcontractor and suppliers. This paper shall present on the implementation of supply chain management in construction and the effectiveness of practicing SCM in construction site. A field study is done from the viewpoint of contractor and consultant then analysed by using average index methods and presented in a statistical analysis. From the analysis, it reveals that effectiveness of practicing the SCM give a lot of good performances and granted benefits to contractor. The statistical analysis produced first ranking effectiveness of SCM is can minimize waste of material and labor for construction project.

EFFECT OF SOIL FERTILITY MANAGEMENT PRACTICES ON NEMATODE DESTROYING FUNGI IN TAITA, KENYA

Directory of Open Access Journals (Sweden)

Peter M Wachira

2010-10-01

Full Text Available The effect of soil fertility management practices on nematode destroying fungi was investigated for three seasons in Taita, Kenya. The study aimed at identifying soil fertility practice that promoted nematode destroying fungi in the soil. Field experiments were established in Taita district, the treatments comprised of Mavuno fertilizer, Triple super- phosphate and calcium ammonium nitrate (TSP+CAN, cow manure and a control where no amendments were applied. This experiment was replicated in ten farms and repeated in three planting seasons. Isolation of nematode destroying fungi carried out was using the soil sprinkle technique and the isolates were identified using the key described by Cooke and Godfrey (1964. There were significant difference (P= 1.705 x 10-06 in occurrence of the nematode destroying fungi between soil fertility treatments. The highest mean (1.6 occurrence of nematode destroying fungi was recorded in soils amended with cow manure and the least (0.7 was recorded in soils from the control plots. A mean of 0.78 was recorded in soils from both TSP+CAN and Mavuno fertilizers. Plots amended with cow manure presented the highest diversity of nematodes followed by the control, then TSP+CAN and least in Mavuno with shannon indices of 0.34, 0.15, 0.13 and 0.11 respectively. Sixty percent of all the isolated nematode destroying fungi genera were from plots treated with cow manure and only twenty percent were from plots amended with the inorganic fertilizer. The control plots recorded higher number of nematode destroying fungi compared to the soils that received inorganic fertilizers.

Lean practices for quality results: a case illustration.

Science.gov (United States)

Hwang, Pauline; Hwang, David; Hong, Paul

2014-01-01

Increasingly, healthcare providers are implementing lean practices to achieve quality results. Implementing lean healthcare practices is unique compared to manufacturing and other service industries. The purpose of this paper is to present a model that identifies and defines the lean implementation key success factors in healthcare organisations. The model is based on an extant literature review and a case illustration that explores actual lean implementation in a major USA hospital located in a Midwestern city (approximately 300,000 people). An exploratory/descriptive study using observation and follow-up interviews was conducted to identify lean practices in the hospital. Lean practice key drivers include growing elderly populations, rising medical expenses, decreasing insurance coverage and decreasing management support. Effectively implementing lean practices to increase bottom-line results and improve organisational integrity requires sharing goals and processes among healthcare managers and professionals. An illustration explains the model and the study provides a sound foundation for empirical work. Practical implications are included. Lean practices minimise waste and unnecessary hospital stays while simultaneously enhancing customer values and deploying resources in supply systems. Leadership requires clear project targets based on sound front-end planning because initial implementation steps involve uncertainty and ambiguity (i.e. fuzzy front-end planning). Since top management support is crucial for implementing lean practices successfully, a heavyweight manager, who communicates well both with top managers and project team members, is an important success factor when implementing lean practices. Increasingly, green orientation and sustainability initiatives are phrases that replaced lean practices. Effective results; e.g. waste reduction, employee satisfaction and customer values are applicable to bigger competitive challenges arising both in specific

Best practices in the organization, management and conduct of an effective investigation of events at nuclear power plants

International Nuclear Information System (INIS)

2008-09-01

IAEA Safety Standards Series No. SF-1 entitled Fundamental Safety Principles: Safety Fundamentals states the need for operating organizations to establish a programme for the feedback and analysis of operating experience in nuclear power plants. Such a programme ensures that operating experience is analysed, events important to safety are reviewed in depth, lessons learned are disseminated to the staff of the organization and to the relevant national and international organizations, and corrective actions are effectively implemented. This publication has been developed to provide advice and assistance to nuclear installations, and related institutions including contractors and support organizations to strengthen and enhance their own feedback process through the implementation of best practices in organization, management and conduct of an effective investigation of events. Conducting an effective investigation of events is essential in supporting a proactive safety management approach of preventing events from occurring. Event investigation is the heart of the operating experience feedback programme and in an operating organization it is essential to develop and maintain necessary expertise in this area. Experience has shown that it is not sufficient to identify only the direct causes of an event and the event is bound to recur unless all the root causes and casual factors for an event are identified and necessary corrective actions are developed and implemented. The present publication is the outcome of a coordinated effort involving the participation of experts of nuclear organizations in several Member States. It was developed to further elaborate on how to implement the event investigation requirements in the area of feedback of operating experience, as specified in the IAEA Safety Requirements publication NS-R-2 on Safety of Nuclear Power Plants: Operation. This document will also complement the publication IAEA Services Series No. 10 - PROSPER Guidelines

Testicular Biopsy for Fertility Preservation in Prepubertal Boys with Cancer: Identifying Preferences for Procedure and Reactions to Disclosure Practices.

Science.gov (United States)

Gupta, Abha A; Donen, Rachel M; Sung, Lillian; Boydell, Katherine M; Lo, Kirk C; Stephens, Derek; Pritchard, Sheila; Portwine, Carol; Maloney, Anne Marie; Lorenzo, Armando J

2016-07-01

Fertility preservation options are limited in prepubertal boys with cancer. Worldwide there has been growing interest in testicular tissue cryopreservation as a promising experimental strategy to address future infertility. We measured and compared parent, male cancer survivor and provider willingness to accept the risk of testicular biopsy among prepubertal boys with cancer, and identified reactions to disclosure practices. We conducted a multicenter study that included 153 parents of prepubertal boys with cancer, 77 male survivors of childhood cancer and 30 oncology providers. The threshold technique was used to measure subject relative willingness to accept risk of testicular biopsy under 4 different aspects of care, ie chance of infertility, complications from biopsy, development of technology to use tissue and tissue storage cost. A total of 47 in-depth interviews were conducted to identify reactions to disclosure practices. A total of 52 survivors (67%), 22 providers (73%) and 110 parents (72%) selected to have testicular biopsy (vs no biopsy). Median minimum infertility risk to make biopsy worthwhile varied from 25% to 30% among the 3 respondent groups. Interviews revealed that some providers would not offer biopsy in cases of greater perceived risk than benefit, that parents preferred having information regardless of risk of infertility and that nondisclosure elicited adverse feelings from some parents. Parents, survivors and providers were willing to accept risk of prepubertal testicular biopsy. Parental/survivor desire for information and provider decision not to disclose suggest that barriers to information delivery need to be addressed. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Best practices and recommendations on policy packaging

DEFF Research Database (Denmark)

Fearnley, Nils; Longva, Frode; Ramjerdi, Farideh

2011-01-01

. This report gives practical and general advice for each of these stages: 1. Define objectives and targets 2. Create an inventory of measures, identify potential primary measures and detect causal relationships 3. Assess policy package 4. Modify package 5. Package implementation 6. Evaluate effects, introduce...

Effective Teaching Practice Supervison: A Predictor of Teacher ...

African Journals Online (AJOL)

The quality of teachers prepared for basic education in Africa and othercontinents of the world is a consequence of the knowledge of contentacquired and the pedagogy. Effective teaching practice supervision coulddetermine the level of teacher trainees performance in the art of teaching. The study investigated the ...

Could yoga practice improve treatment-related side effects and quality of life for women with breast cancer? A systematic review and meta-analysis.

Science.gov (United States)

Pan, Yuanqing; Yang, Kehu; Wang, Yuliang; Zhang, Laiping; Liang, Haiqing

2017-04-01

To determine if yoga as a complementary and alternative therapy was associated with enhanced health and treatment-related side effects in patients with breast cancer. This systematic review examines whether yoga practice provides any measurable benefit, both physically and psychologically, for women with breast cancer. PubMed, EMBASE and the Cochrane Library for randomized controlled trials (RCTs) throughout June 2013. We evaluated the quality of the included studies by the Cochrane Handbook 5.2 standards and analyzed the data using the Stata software, version 10.0. Meta-regression and subgroup analysis were also performed to identify additional predictors of outcome and to assess heterogeneity. Sixteen RCTs with a total of 930 participants were included. Comparing yoga groups to control groups, there was a statistically significant difference in overall health-related quality of life, depression, anxiety and gastrointestinal symptoms. Meta-regression analyses revealed that the duration of yoga practice and type of control group partly explained the heterogeneity. Subgroup analyses revealed that yoga had a positive effect on anxiety only when it had been practiced for longer than 3 months. Only the wait-list control group showed an effect of yoga on physical well-being. The current evidence demonstrates that yoga practice could be effective in enhancing health and managing some treatment-related side effects for patients recovering from breast cancer. In future clinical studies, clinicians should consider the patient's wishes along with the current best evidence of the effects of yoga practice in their clinical decision-making. © 2015 Wiley Publishing Asia Pty Ltd.

Identifying Effective Spelling Interventions Using a Brief Experimental Analysis and Extended Analysis

Science.gov (United States)

McCurdy, Merilee; Clure, Lynne F.; Bleck, Amanda A.; Schmitz, Stephanie L.

2016-01-01

Spelling is an important skill that is crucial to effective written communication. In this study, brief experimental analysis procedures were used to examine spelling instruction strategies (e.g., whole word correction; word study strategy; positive practice; and cover, copy, and compare) for four students. In addition, an extended analysis was…

Communication: an ophthalmic practice issue.

Science.gov (United States)

Whitton, S J

1995-12-01

In the 1990's communication becomes an ophthalmic practice issue. The present ophthalmic climate of cost containment, downsizing, budget cuts, and lack of appreciation of contributions, results in a low staff morale. Recognition of the effects of job satisfaction and productivity led one group to seek solutions. A communication task force was formed to identify problems and the appropriate interventions.

Clinical Nurse Leader Integration Into Practice: Developing Theory To Guide Best Practice.

Science.gov (United States)

Bender, Miriam

2016-01-01

Numerous policy bodies have identified the clinical nurse leader (CNL) as an innovative new role for meeting higher health care quality standards. Although there is growing evidence of improved care environment and patient safety and quality outcomes after redesigning care delivery microsystems to integrate CNL practice, significant variation in CNL implementation has been noted across reports, making it difficult to causally link CNL practice to reported outcomes. This variability reflects the overall absence in the literature of a well-defined CNL theoretical framework to help guide standardized application in practice. To address this knowledge gap, an interpretive synthesis with a grounded theory analysis of CNL narratives was conducted to develop a theoretical model for CNL practice. The model clarifies CNL practice domains and proposes mechanisms by which CNL-integrated care delivery microsystems improve health care quality. The model highlights the need for a systematic approach to CNL implementation including a well-thought out strategy for care delivery redesign; a consistent, competency-based CNL workflow; and sustained macro-to-micro system leadership support. CNL practice can be considered an effective approach to organizing nursing care that maximizes the scope of nursing to influence the ways care is delivered by all professions within a clinical microsystem. Copyright © 2016 Elsevier Inc. All rights reserved.

Effectively identifying user profiles in network and host metrics

Science.gov (United States)

Murphy, John P.; Berk, Vincent H.; Gregorio-de Souza, Ian

2010-04-01

This work presents a collection of methods that is used to effectively identify users of computers systems based on their particular usage of the software and the network. Not only are we able to identify individual computer users by their behavioral patterns, we are also able to detect significant deviations in their typical computer usage over time, or compared to a group of their peers. For instance, most people have a small, and relatively unique selection of regularly visited websites, certain email services, daily work hours, and typical preferred applications for mandated tasks. We argue that these habitual patterns are sufficiently specific to identify fully anonymized network users. We demonstrate that with only a modest data collection capability, profiles of individual computer users can be constructed so as to uniquely identify a profiled user from among their peers. As time progresses and habits or circumstances change, the methods presented update each profile so that changes in user behavior can be reliably detected over both abrupt and gradual time frames, without losing the ability to identify the profiled user. The primary benefit of our methodology allows one to efficiently detect deviant behaviors, such as subverted user accounts, or organizational policy violations. Thanks to the relative robustness, these techniques can be used in scenarios with very diverse data collection capabilities, and data privacy requirements. In addition to behavioral change detection, the generated profiles can also be compared against pre-defined examples of known adversarial patterns.

Identifying strategies to improve the effectiveness of booster seat laws

Science.gov (United States)

2008-05-01

The objective of this project was to identify strategies to improve the effectiveness of booster seat laws. The project explored the possible factors that relate to the use and nonuse of booster seats, and examined the attitudes of law enforcement of...

Organisational development in general practice: lessons from practice and professional development plans (PPDPs

Directory of Open Access Journals (Sweden)

Hocking Paul

2000-12-01

Full Text Available Abstract Background Improving the quality and effectiveness of clinical practice is becoming a key task within all health services. Primary medical care, as organised in the UK is composed of clinicians who work in independent partnerships (general practices that collaborate with other health care professionals. Although many practices have successfully introduced innovations, there are no organisational development structures in place that support the evolution of primary medical care towards integrated care processes. Providing incentives for attendance at passive educational events and promoting 'teamwork' without first identifying organisational priorities are interventions that have proved to be ineffective at changing clinical processes. A practice and professional development plan feasibility study was evaluated in Wales and provided the experiential basis for a summary of the lessons learnt on how best to guide organisational development systems for primary medical care. Results Practice and professional development plans are hybrids produced by the combination of ideas from management (the applied behavioural science of organisational development and education (self-directed adult learning theories and, in conceptual terms, address the lack of effectiveness of passive educational strategies by making interventions relevant to identified system wide needs. In the intervention, each practice participated in a series of multidisciplinary workshops (minimum 4 where the process outcome was the production of a practice development plan and a set of personal portfolios, and the final outcome was a realised organisational change. It was apparent during the project that organisational admission to a process of developmental planning needed to be a stepwise process, where initial interest can lead to a fuller understanding, which subsequently develops into motivation and ownership, sufficient to complete the exercise. The advantages of

Role of scanning electron microscopy in identifying drugs used in medical practice.

Science.gov (United States)

Fazil Marickar, Y M; Sylaja, N; Koshy, Peter

2009-10-01

Several plant preparations are administered for treatment of stone disease without scientific basis. This paper presents the results of in vitro and animal experimental studies using scanning electron microscopy (SEM) in the identification of the therapeutic properties of trial drugs in medicine. In the first set of the study, urinary crystals namely calcium oxalate monohydrate and calcium oxalate dehydrate were grown in six sets of Hane's tubes in silica gel medium. Trial drugs namely scoparia dulcis Lynn, musa sapiens and dolicos biflorus were incorporated in the gel medium to identify the dopant effect of the trial drugs on the size and extent of crystal column growth. The changes in morphology of crystals were studied using SEM. In the second set, six male Wistar rats each were calculogenised by administering sodium oxalate and ethylene glycol and diabetised using streptozotocin. The SEM changes of calculogenisation were studied. The rats were administered trial drugs before calculogenisation or after. The kidneys of the rats studied under the scanning electron microscope showed changes in tissue morphology and crystal deposition produced by calculogenisation and alterations produced by addition of trial drugs. The trial drugs produced changes in the pattern of crystal growth and in the crystal morphology of both calcium oxalate monohydrate and calcium oxalate dihydrate grown in vitro. Elemental distribution analysis showed that the crystal purity was not altered by the trial drugs. Scoparia dulcis Lynn was found to be the most effective anticalculogenic agent. Musa sapiens and dolicos biflorus were found to have no significant effect in inhibiting crystal growth. The kidneys of rats on calculogenisation showed different grades of crystals in the glomerulus and interstitial tissues, extrusion of the crystals into the tubular lumen, collodisation and tissue inflammatory cell infiltration. Scoparia dulcis Lynn exhibited maximum protector effect against the

Marketing your medical practice with an effective web presence.

Science.gov (United States)

Finch, Tammy

2004-01-01

The proliferation of the World Wide Web has provided an opportunity for medical practices to sell themselves through low-cost marketing on the Internet. A Web site is a quick and effective way to provide patients with up-to-date treatment and procedure information. This article provides suggestions on what to include on a medical practice's Web site, how the Web can assist office staff and physicians, and cost options for your Web site. The article also discusses design tips, such as Web-site optimization.

European Educational Systems and Assessment Practice

DEFF Research Database (Denmark)

Evans, Robert Harry; Cross, David; Grangeat, Michel

2018-01-01

Abstract This chapter surveys the status of educational systems and assessment practices across eight European countries that are part of the ASSIST-ME project. First, variations in country educational systems are examined to identify possible connections between systems and educational practices....... Such associations are useful both for understanding different existing assessment conditions as well as for providing possible pathways for change. Next, the chapter takes a closer look at teacher practices in these educational systems in order to identify the actual assessment practices of teachers in each country....... With these understandings of the systems and current uses of assessment, it is possible to identify affordances and challenges for improving assessment practices....

Dissociable effects of practice variability on learning motor and timing skills.

Science.gov (United States)

Caramiaux, Baptiste; Bevilacqua, Frédéric; Wanderley, Marcelo M; Palmer, Caroline

2018-01-01

Motor skill acquisition inherently depends on the way one practices the motor task. The amount of motor task variability during practice has been shown to foster transfer of the learned skill to other similar motor tasks. In addition, variability in a learning schedule, in which a task and its variations are interweaved during practice, has been shown to help the transfer of learning in motor skill acquisition. However, there is little evidence on how motor task variations and variability schedules during practice act on the acquisition of complex motor skills such as music performance, in which a performer learns both the right movements (motor skill) and the right time to perform them (timing skill). This study investigated the impact of rate (tempo) variability and the schedule of tempo change during practice on timing and motor skill acquisition. Complete novices, with no musical training, practiced a simple musical sequence on a piano keyboard at different rates. Each novice was assigned to one of four learning conditions designed to manipulate the amount of tempo variability across trials (large or small tempo set) and the schedule of tempo change (randomized or non-randomized order) during practice. At test, the novices performed the same musical sequence at a familiar tempo and at novel tempi (testing tempo transfer), as well as two novel (but related) sequences at a familiar tempo (testing spatial transfer). We found that practice conditions had little effect on learning and transfer performance of timing skill. Interestingly, practice conditions influenced motor skill learning (reduction of movement variability): lower temporal variability during practice facilitated transfer to new tempi and new sequences; non-randomized learning schedule improved transfer to new tempi and new sequences. Tempo (rate) and the sequence difficulty (spatial manipulation) affected performance variability in both timing and movement. These findings suggest that there is a

Practical compassions: repertoires of practice and compassion talk in acute mental healthcare.

Science.gov (United States)

Brown, Brian; Crawford, Paul; Gilbert, Paul; Gilbert, Jean; Gale, Corinne

2014-03-01

This article reports an exploratory study of the concept of compassion in the work of 20 mental health practitioners in a UK Midlands facility. Using notions of practice derived from phenomenology and Bourdieusian sociology and notions of emotional labour we identify two contrasting interpretive repertoires in discussions of compassion. The first, the practical compassion repertoire, evokes the practical, physical and bodily aspects of compassion. It involves organising being with patients, playing games, anticipating disruption and taking them outside for cigarettes. Practitioners described being aware that these practical, bodily activities could lead to patients 'opening up', disclosing their interior concerns and enabling practical, compassionate mental health work to take place. In contrast, the second, organisational repertoire, concerns organisational constraints on compassionate practice. The shortage of staff, the record-keeping and internal processes of quality control were seen as time-greedy and apt to detract from contact with patients. The findings are discussed in relation to Bourdieu and Merleau-Ponty's phenomenological accounts of practice and habit and set in context in the growing interest in placing compassion centrally in healthcare. We also explore how the exercise of compassion in the way our participants describe it can afford the more effective exercise of medical power. © 2013 The Author. Sociology of Health & Illness © 2013 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

[Quality assurance and quality improvement in medical practice. Part 3: Clinical audit in medical practice].

Science.gov (United States)

Godény, Sándor

2012-02-05

The first two articles in the series were about the definition of quality in healthcare, the quality approach, the importance of quality assurance, the advantages of quality management systems and the basic concepts and necessity of evidence based medicine. In the third article the importance and basic steps of clinical audit are summarised. Clinical audit is an integral part of quality assurance and quality improvement in healthcare, that is the responsibility of any practitioner involved in medical practice. Clinical audit principally measures the clinical practice against clinical guidelines, protocols and other professional standards, and sometimes induces changes to ensure that all patients receive care according to principles of the best practice. The clinical audit can be defined also as a quality improvement process that seeks to identify areas for service improvement, develop and carry out plans and actions to improve medical activity and then by re-audit to ensure that these changes have an effect. Therefore, its aims are both to stimulate quality improvement interventions and to assess their impact in order to develop clinical effectiveness. At the end of the article key points of quality assurance and improvement in medical practice are summarised.

Traditional practices used by infertile women in Turkey.

Science.gov (United States)

Ayaz, S; Efe, S Yaman

2010-09-01

Numerous traditional methods are used in the treatment of infertility around the world. To identify the traditional practices of infertile women using one clinic in Ankara, Turkey. The population comprised all women (5700) who attended one infertility outpatient clinic in 2007. The sample was calculated using sample calculation formula and 410 women were included in the study. The survey method was used for data collection. Of the responding women, 27.3% had tried a traditional practice, and 67.8% who tried traditional practices used an herbal mixture. The reason for the women's use of a traditional practice was 'hope' (66.9%), and 15.2% of them had experienced an adverse effect related with traditional practice. Maternal education level, perceived economic status, duration of marriage all significantly affected the use of traditional practices (Pwomen who had received unsuccessful medical treatment for infertility and who had experienced side effects after medical treatment had a higher rate of use of traditional practice (Pwomen who responded to the questionnaire had tried traditional methods, and some experienced adverse effects related to the practice. For couples with infertility problems, educational programmes and consultation services should be organized with respect to their traditional culture. Women should be informed about the hazards of traditional practices and avoidance of harmful practices, and continuous emotional support must be provided for infertile couples. In the future, nursing staff should play a much larger role in these supportive services.

Identifying and Managing Risk.

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Abraham, Janice M.

1999-01-01

The role of the college or university chief financial officer in institutional risk management is (1) to identify risk (physical, casualty, fiscal, business, reputational, workplace safety, legal liability, employment practices, general liability), (2) to develop a campus plan to reduce and control risk, (3) to transfer risk, and (4) to track and…

Quality measures for nurse practitioner practice evaluation.

Science.gov (United States)

Kleinpell, Ruth; Kapu, April N

2017-08-01

Evaluating the impact of nurse practitioner (NP) practice has become a priority area of focus for demonstrating outcomes. A number of quality measures are available to enable practice-specific evaluation of NP roles and initiatives. This article reviews sources of quality measures that can be used to facilitate quantifying the outcomes of NP practice as part of an overall evaluation agenda. National resources and published literature on NP quality measures were reviewed. Various resources and toolkits exist to assist NPs in identifying outcomes of practice using quality measures. The need to demonstrate outcomes of NP practice remains an ongoing priority area regardless of the clinical practice setting. A variety of sources of quality measures exist that can be used to showcase the effect of NP care. The use of quality measures can be effectively integrated into evaluation of NP role and NP-directed initiatives to demonstrate impact, and enhance the conduct of an NP outcomes assessment. The use of organizational, NP-specific, and national-related quality measures can help to showcase how NP care improves the quality, safety, and costs of health care. ©2017 American Association of Nurse Practitioners.

Using Rituals to Strengthen Your Medical Practice Team.

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Hills, Laura

2015-01-01

Rituals can cement the identity of and strengthen the bonds between any people, including the members of the medical practice team. This article presents the idea that the medical practice manager is in the ideal position to create and use rituals for team building. It defines the term ritual, and explores how rituals differ from customs or traditions. As well, it describes six benefits of rituals and the hallmarks of the most effective team rituals; describes seven creative and interesting corporate rituals that medical practice managers can study for inspiration; suggests 20 excellent opportunities within the medical practice calendar year for medical practice team rituals; and identifies six kinds of rituals that are used in organizations. Finally, this article provides a four-step action plan for ritualizing your medical practice team's morning huddles.

Action to Support Practices Implement Research Evidence (ASPIRE): protocol for a cluster-randomised evaluation of adaptable implementation packages targeting 'high impact' clinical practice recommendations in general practice.

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Willis, Thomas A; Hartley, Suzanne; Glidewell, Liz; Farrin, Amanda J; Lawton, Rebecca; McEachan, Rosemary R C; Ingleson, Emma; Heudtlass, Peter; Collinson, Michelle; Clamp, Susan; Hunter, Cheryl; Ward, Vicky; Hulme, Claire; Meads, David; Bregantini, Daniele; Carder, Paul; Foy, Robbie

2016-02-29

There are recognised gaps between evidence and practice in general practice, a setting which provides particular challenges for implementation. We earlier screened clinical guideline recommendations to derive a set of 'high impact' indicators based upon criteria including potential for significant patient benefit, scope for improved practice and amenability to measurement using routinely collected data. We aim to evaluate the effectiveness and cost-effectiveness of a multifaceted, adaptable intervention package to implement four targeted, high impact recommendations in general practice. The research programme Action to Support Practice Implement Research Evidence (ASPIRE) includes a pair of pragmatic cluster-randomised trials which use a balanced incomplete block design. Clusters are general practices in West Yorkshire, United Kingdom (UK), recruited using an 'opt-out' recruitment process. The intervention package adapted to each recommendation includes combinations of audit and feedback, educational outreach visits and computerised prompts with embedded behaviour change techniques selected on the basis of identified needs and barriers to change. In trial 1, practices are randomised to adapted interventions targeting either diabetes control or risky prescribing and those in trial 2 to adapted interventions targeting either blood pressure control in patients at risk of cardiovascular events or anticoagulation in atrial fibrillation. The respective primary endpoints comprise achievement of all recommended target levels of haemoglobin A1c (HbA1c), blood pressure and cholesterol in patients with type 2 diabetes, a composite indicator of risky prescribing, achievement of recommended blood pressure targets for specific patient groups and anticoagulation prescribing in patients with atrial fibrillation. We are also randomising practices to a fifth, non-intervention control group to further assess Hawthorne effects. Outcomes will be assessed using routinely collected data

Practice effect in Symbol Digit Modalities Test in multiple sclerosis patients treated with natalizumab

DEFF Research Database (Denmark)

Roar Eriksen, Malte; Illes, Zsolt; Sejbaek, Tobias

2016-01-01

OBJECTIVES: How practice effect influences cognitive testing measured by monthly Symbol Digit Modalities Test (SDMT) during natalizumab treatment, and what factors confound such effect. METHODS: Eighty patients were examined monthly with SDMT for 26.2±8.4 months. After 26.0±8.1 months, SDMT...... and the rearranged key, respectively. We also explored if natalizumab applied before regular monthly SDMT may influence practice effect and cognition. RESULTS: SDMT performance improved by 1.2 points/test during the first six months and by 0.4 points/test thereafter. Rearranging the symbols of the key after 26.......0±8.1 months returned SDMT scores to baseline indicating a practice effect. Such practice effect was more significant after longer testing period, but was not influenced by gender, age, relapses, disability progression and prior natalizumab treatment. Although the change from baseline to 2.5 years...

Effect of intensive education on knowledge, attitudes, and practices regarding upper respiratory infections among urban Latinos.

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Larson, Elaine L; Ferng, Yu-Hui; McLoughlin, Jennifer Wong; Wang, Shuang; Morse, Stephen S

2009-01-01

Although upper respiratory infections (URIs) take a major social and economic toll, little research has been conducted to assess the impact of educational interventions on knowledge, attitudes, and practices of community members regarding prevention and treatment of URIs, particularly among recently immigrated urban Latinos who may not be reached by the mainstream healthcare system. The objective of this study was to assess the impact of a culturally appropriate, home-based educational intervention on the knowledge, attitudes, and practices regarding prevention and treatment of URIs among urban Latinos. Using a pretest-posttest design, Spanish-language educational materials available from sources such as the Centers for Disease Control and Prevention were adapted based on feedback from community focus groups and provided to households during an in-person home visit every 2 months (generally three to four visits). Outcome data regarding knowledge, attitudes, and practices were collected in home-based interviews using an 85-item instrument adapted and pilot tested from three other validated instruments. Nonparametric and multiple linear regression analyses were used to summarize data and identify predictors of knowledge scores. Four hundred twenty-two households had complete data at baseline and 6 months. Knowledge and attitude scores were improved significantly, and use of alcohol hand sanitizer and rates of influenza vaccine were increased significantly (all p effectiveness of such a person-intensive intervention, the long-term outcomes, and whether less intensive interventions might be equally effective.

Defending the solo and small practice neurologist.

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Jones, Elaine C; Evans, David A

2015-04-01

Changes in health care are having a dramatic effect on the practice of medicine. In 2005, a National Center for Health Statistics survey showed that 55%-70% of physicians are in small/solo practices. These data also demonstrated that 70% of physicians identified themselves as owners. Since passage of the Affordable Care Act (ACA) in 2010, neurologists report an 8% increase in academic practice settings, a 2% decrease in private practice settings, and a 5% decrease in solo practice settings. Surveys of family physicians showed that 60% are now employees of hospitals or larger groups. A survey by The Physicians Foundation showed that 89% of physicians believed that the traditional model of independent private practice is either "on shaky ground" or "a dinosaur soon to go extinct." With the changes expected from the ACA, solo/small practices will continue to face challenges and therefore must pay close attention to business and clinical metrics.

Personal Finance Education: Effective Practice Guide for Schools

Science.gov (United States)

Spielhofer, Thomas; Kerr, David; Gardiner, Clare

2010-01-01

This document provides guidance on effective practice in delivering personal finance education in secondary schools. It is based on the findings from research carried out by NFER (the National Foundation for Educational Research) on behalf of pfeg (Personal Finance Education Group) as part of an evaluation of Learning Money Matters (LMM). This…

Core Practices for Teaching History: The Results of a Delphi Panel Survey

Science.gov (United States)

Fogo, Bradley

2014-01-01

Recent education literature and research has focused on identifying effective core teaching practices to inform and help shape teacher education and professional development. Although a rich literature on the teaching and learning of history has continued to develop over the past decade, core practice research has largely overlooked…

The effect of misapplied religious practices in some alternative ...

African Journals Online (AJOL)

The effect of misapplied religious practices in some alternative religious groups. ... religion generally has on human beings has been suggested by different studies. ... emotions. Adherence to the tenets of the group then occurred as a result of ...

Role of Transformational Leadership in Effective Organizational Knowledge Creation Practices: Mediating Effects of Employees' Work Engagement

Science.gov (United States)

Song, Ji Hoon; Kolb, Judith A.; Lee, Ung Hee; Kim, Hye Kyoung

2012-01-01

Engagement as an area of increasing interest has been discussed in terms of a wide array of organizational policies, practices, and outcomes. This study focuses on a specific aspect of work engagement and its relationship with leadership practices and the outcome of knowledge creation. The mediating effect of employees' work engagement level was…

Under What Assumptions Do Site-by-Treatment Instruments Identify Average Causal Effects?

Science.gov (United States)

Reardon, Sean F.; Raudenbush, Stephen W.

2013-01-01

The increasing availability of data from multi-site randomized trials provides a potential opportunity to use instrumental variables methods to study the effects of multiple hypothesized mediators of the effect of a treatment. We derive nine assumptions needed to identify the effects of multiple mediators when using site-by-treatment interactions…

The effects of variable practice on locomotor adaptation to a novel asymmetric gait.

Science.gov (United States)

Hinkel-Lipsker, Jacob W; Hahn, Michael E

2017-09-01

Very little is known about the effects of specific practice on motor learning of predictive balance control during novel bipedal gait. This information could provide an insight into how the direction and magnitude of predictive errors during acquisition of a novel gait task influence transfer of balance control, as well as yield a practice protocol for the restoration of balance for those with locomotor impairments. This study examined the effect of a variable practice paradigm on transfer of a novel asymmetric gait pattern in able-bodied individuals. Using a split-belt treadmill, one limb was driven at a constant velocity (constant limb) and the other underwent specific changes in velocity (variable limb) during practice according to one of three prescribed practice paradigms: serial, where the variable limb velocity increased linearly; random blocked, where variable limb underwent random belt velocity changes every 20 strides; and random practice, where the variable limb underwent random step-to-step changes in velocity. Random practice showed the highest balance control variability during acquisition compared to serial and random blocked practice which demonstrated the best transfer of balance control on one transfer test. Both random and random blocked practices showed significantly less balance control variability during a second transfer test compared to serial practice. These results indicate that random blocked practice may be best for generalizability of balance control while learning a novel gait, perhaps, indicating that individuals who underwent this practice paradigm were able to find the most optimal balance control solution during practice.

Nursing professional practice environments: setting the stage for constructive conflict resolution and work effectiveness.

Science.gov (United States)

Siu, Heidi; Spence Laschinger, Heather K; Finegan, Joan

2008-05-01

The aim of this study was to examine the impact of nurses' perceived professional practice environment on their quality of nursing conflict management approaches and ultimately their perceptions of unit effectiveness from the perspective of Deutsch's theory of constructive conflict management. Rising reports of hostility and conflict among Canadian nurses are a concern to nurses' health and the viability of effective patient care delivery. However, research on the situational factors that influence nurses' ability to apply effective conflict resolution skills that lead to positive results in practice is limited. A nonexperimental, predictive design was used in a sample of 678 registered nurses working in community hospitals within a large metropolitan area in Ontario. The results supported a modified version of the hypothesized model [chi2(1) = 16.25, Goodness of Fit = 0.99, Comparative Fit Index = 0.98, Root-Mean-Square Error of Approximation = 0.15] linking professional practice environment and core self-evaluation to nurses' conflict management and, ultimately, unit effectiveness. Professional practice environment, conflict management, and core-self evaluation explained approximately 46.6% of the variance in unit effectiveness. Positive professional practice environments and high core self-evaluations predicted nurses' constructive conflict management and, in turn, greater unit effectiveness.

The effects of cumulative practice on mathematics problem solving.

Science.gov (United States)

Mayfield, Kristin H; Chase, Philip N

2002-01-01

This study compared three different methods of teaching five basic algebra rules to college students. All methods used the same procedures to teach the rules and included four 50-question review sessions interspersed among the training of the individual rules. The differences among methods involved the kinds of practice provided during the four review sessions. Participants who received cumulative practice answered 50 questions covering a mix of the rules learned prior to each review session. Participants who received a simple review answered 50 questions on one previously trained rule. Participants who received extra practice answered 50 extra questions on the rule they had just learned. Tests administered after each review included new questions for applying each rule (application items) and problems that required novel combinations of the rules (problem-solving items). On the final test, the cumulative group outscored the other groups on application and problem-solving items. In addition, the cumulative group solved the problem-solving items significantly faster than the other groups. These results suggest that cumulative practice of component skills is an effective method of training problem solving.

Mentoring overseas nurses: barriers to effective and non-discriminatory mentoring practices.

Science.gov (United States)

Allan, Helen

2010-09-01

In this article it is argued that there are barriers to effective and non-discriminatory practice when mentoring overseas nurses within the National Health Service (NHS) and the care home sector. These include a lack of awareness about how cultural differences affect mentoring and learning for overseas nurses during their period of supervised practice prior to registration with the UK Nursing and Midwifery Council. These barriers may demonstrate a lack of effective teaching of ethical practice in the context of cultural diversity in health care. This argument is supported by empirical data from a national study. Interviews were undertaken with 93 overseas nurses and 24 national and 13 local managers and mentors from six research sites involving UK health care employers in the NHS and independent sectors in different regions of the UK. The data collected showed that overseas nurses are discriminated against in their learning by poor mentoring practices; equally, from these data, it appears that mentors are ill-equipped by existing mentor preparation programmes to mentor overseas-trained nurses from culturally diverse backgrounds. Recommendations are made for improving mentoring programmes to address mentors' ability to facilitate learning in a culturally diverse workplace and thereby improve overseas nurses' experiences of their supervised practice.

How can placebo effects best be applied in clinical practice? A narrative review

Directory of Open Access Journals (Sweden)

Bystad M

2015-01-01

Full Text Available Martin Bystad,1,2 Camilla Bystad,3 Rolf Wynn1,3 1Division of Addictions and Specialized Psychiatric Services, University Hospital of North Norway, 2Institute of Psychology, 3Institute of Clinical Medicine, Faculty of Health Sciences, Arctic University of Norway, Tromsø, Norway Abstract: Placebo effects are documented in a number of clinical and experimental studies. It is possible to benefit from placebo effects in clinical practice by using them as effects additive to those of documented and effective treatments. The purpose of this paper is to discuss how doctors and other health workers may benefit from placebo effects within an ethical framework. A narrative review of the literature relating to placebo effects in clinical practice was performed. We searched PubMed and selected textbooks on placebo effects for articles and book chapters relating to placebo effects in clinical practice. By drawing on placebo effects, doctors may access patients’ self-healing potentials. In practice, doctors may best benefit from placebo effects by influencing the patient’s expectations through communication. An important principle is to give the patient information stating that a particular treatment is effective, as long as this is based on realistic optimism. A patient-centered style involving elements such as developing trust and respect, exploring the patient’s values, speaking positively about treatments, and providing reassurance and encouragement might aid in activating placebo effects. The total effect of a documented treatment will partly depend on how well the placebo effects have been activated. Thus, placebo effects can be understood as a form of supplemental treatment. Keywords: placebo effects, doctor-patient communication, expectations, biopsychosocial model

General Practice Clinical Data Help Identify Dementia Hotspots: A Novel Geospatial Analysis Approach.

Science.gov (United States)

Bagheri, Nasser; Wangdi, Kinley; Cherbuin, Nicolas; Anstey, Kaarin J

2018-01-01

We have a poor understanding of whether dementia clusters geographically, how this occurs, and how dementia may relate to socio-demographic factors. To shed light on these important questions, this study aimed to compute a dementia risk score for individuals to assess spatial variation of dementia risk, identify significant clusters (hotspots), and explore their association with socioeconomic status. We used clinical records from 16 general practices (468 Statistical Area level 1 s, N = 14,746) from the city of west Adelaide, Australia for the duration of 1 January 2012 to 31 December 2014. Dementia risk was estimated using The Australian National University-Alzheimer's Disease Risk Index. Hotspot analyses were applied to examine potential clusters in dementia risk at small area level. Significant hotspots were observed in eastern and southern areas while coldspots were observed in the western area within the study perimeter. Additionally, significant hotspots were observed in low socio-economic communities. We found dementia risk scores increased with age, sex (female), high cholesterol, no physical activity, living alone (widow, divorced, separated, or never married), and co-morbidities such as diabetes and depression. Similarly, smoking was associated with a lower dementia risk score. The identification of dementia risk clusters may provide insight into possible geographical variations in risk factors for dementia and quantify these risks at the community level. As such, this research may enable policy makers to tailor early prevention strategies to the correct individuals within their precise locations.

Identifying the Average Causal Mediation Effects with Multiple Mediators in the Presence of Treatment Non-Compliance

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Park, Soojin

2015-01-01

Identifying the causal mechanisms is becoming more essential in social and medical sciences. In the presence of treatment non-compliance, the Intent-To-Treated effect (hereafter, ITT effect) is identified as long as the treatment is randomized (Angrist et al., 1996). However, the mediated portion of effect is not identified without additional…

The influence of different error estimates in the detection of postoperative cognitive dysfunction using reliable change indices with correction for practice effects.

Science.gov (United States)

Lewis, Matthew S; Maruff, Paul; Silbert, Brendan S; Evered, Lis A; Scott, David A

2007-02-01

The reliable change index (RCI) expresses change relative to its associated error, and is useful in the identification of postoperative cognitive dysfunction (POCD). This paper examines four common RCIs that each account for error in different ways. Three rules incorporate a constant correction for practice effects and are contrasted with the standard RCI that had no correction for practice. These rules are applied to 160 patients undergoing coronary artery bypass graft (CABG) surgery who completed neuropsychological assessments preoperatively and 1 week postoperatively using error and reliability data from a comparable healthy nonsurgical control group. The rules all identify POCD in a similar proportion of patients, but the use of the within-subject standard deviation (WSD), expressing the effects of random error, as an error estimate is a theoretically appropriate denominator when a constant error correction, removing the effects of systematic error, is deducted from the numerator in a RCI.

Peer Review of Best Practices

Science.gov (United States)

Pearlman, J.; Buttigieg, P. L.; Simpson, P.; Munoz, C.; Dufois, F.; Heslop, E. E.

2017-12-01

To ensure the quality of oceanographic data, there is a clear need to employ best practices (BPs) for ocean observation and information management. However, effectively discovering these BPs is a challenge, hindering harmonized quality assurance across projects and programmes. To remedy this, we are prototyping a resource for the stable archiving and efficient discovery of BPs through a granular, semantically indexed, and consistently formatted web resource. While these technical advances have value, they cannot ensure improved oceanographic data quality without effective and inclusive peer review processes. Peer review of digitized best practices can take a number of forms from traditional (blind) peer review as practiced by journal publishers through to the evolving "open" approach where community reviews have both the authors and reviewers identified. This presentation will discuss the options for peer review mechanisms for best practices, including a hybrid approach where both expert panels and open community review are used to improve methodologies and thus downstream data quality. It is not yet clear if the ocean community prefers open versus blind reviews for best practices. It is also unclear the extent to which innovation versus solid technical base should have a higher priority in the reviews. Further, it is not clear whether the reviews should use an internal expert panel of the IODE OceanBestPractices Repository (http://www.oceanbestpractices.net/) or should be done as part of a journal publications process or both, as mentioned above. Thus, we will also describe our future approach to `field test' these review models on a multi-stakeholder compendium of digitized best practice documents.

Prevention of occupational injuries: Evidence for effective good practices in foundries.

Science.gov (United States)

Porru, Stefano; Calza, Stefano; Arici, Cecilia

2017-02-01

Occupational injuries are a relevant research and practical issue. However, intervention studies evaluating the effectiveness of workplace injury prevention programs are seldom performed. The effectiveness of a multifaceted intervention aimed at reducing occupational injury rates (incidence/employment-based=IR, frequency/hours-based=FR, severity=SR) was evaluated between 2008 and 2013 in 29 Italian foundries (22 ferrous; 7 non-ferrous; 3,460 male blue collar workers/year) of varying sizes. Each foundry established an internal multidisciplinary prevention team for risk assessment, monitoring and prevention of occupational injuries, involving employers, occupational physicians, safety personnel, workers' representatives, supervisors. Targets of intervention were workers, equipment, organization, workplace, job tasks. An interrupted time series (ITS) design was applied. 4,604 occupational injuries and 83,156 lost workdays were registered between 2003 and 2013. Statistical analysis showed, after intervention, a reduction of all injury rates (-26% IR, -15% FR, -18% SR) in ferrous foundries and of SR (-4%) in non-ferrous foundries. A significant (p=0.021) 'step-effect' was shown for IR in ferrous foundries, independent of secular trends (pgood external validity; promotion of effective good practices. Main limitations were the non-randomized nature and a medium length post-intervention period. In conclusion, a multifaceted, pragmatic and accountable intervention is effective in reducing the burden of occupational injuries in small-, medium- and large-sized foundries. Practical Applications: The study poses the basis for feasible good practice guidelines to be implemented to prevent occupational injuries, by means of sector-specific numerical benchmarks, with potentially relevant impacts on workers, companies, occupational health professionals and society at large. Copyright © 2016 National Safety Council and Elsevier Ltd. All rights reserved.

Effects of Practical Life Materials on Kindergartners' Fine Motor Skills.

Science.gov (United States)

Rule, Audrey C.; Stewart, Roger A.

2002-01-01

A pretest-posttest control group design was used to measure the effect of practical life materials (e.g., tweezers, tongs, spoons) on kindergarten children's fine motor skill development. Experimental and control group teachers reported equal amounts of fine motor activity in their classrooms; however, significant interaction effects were found…

Age and Practice Effects on Inter-manual Performance Asymmetry

Directory of Open Access Journals (Sweden)

Karen L Francis

2015-01-01

Full Text Available Manual dexterity declines with increasing age however, the way in which inter-manual asymmetry responds to aging is unclear. Our purpose was to determine the effect of age and practice on inter-manual performance asymmetry in an isometric force pinch line tracing task that varied in difficulty within segments. Thirty right handed participants, 5 males and 5 females in each of three age groups, young (Y20, young-old (O70, and old-old (O80, practiced an isometric force pinch task for 10 trials with each hand on each of five consecutive days. Inter-manual performance asymmetry of the right and left hands was analyzed with a repeated measures ANOVA of asymmetry with age groups, practice, task difficulty, and hand as factors. The within-individual magnitude of asymmetry was also analyzed with a repeated measures ANOVA of manual asymmetry calculated as an asymmetry index (AI. Post hoc pair-wise comparisons were performed when significance was found. We observed no inter-manual performance asymmetry on this isometric tracing task among any of the age groups, either in the hand performance differences or in the magnitude of the asymmetry index (AI. Age and practice interacted in terms of manual performance: the Y20 and O70 group improved accuracy and task time across the five days of practice but the O80 group did not. However, practice did not differentially affect the AI for accuracy or task time for any group. Accuracy of performance of the two hands was differentially affected by practice. All age groups exhibited poorer performance and larger AIs on the most difficult segments of the task (3 and 6 and this did not change with practice.

Teachers' instructional goals for science practice: Identifying knowledge gaps using cultural-historical activity theory (CHAT)

Science.gov (United States)

Farrar, Cynthia Hamen

In AP Biology, the course goal, with respect to scientific acts and reasoning, has recently shifted toward a reform goal of science practice, where the goal is for students to have a scientific perspective that views science as a practice of a community rather than a body of knowledge. Given this recent shift, this study is interested in the gaps that may exist between an individual teacher's instructional goal and the goals of the AP Biology course. A Cultural-Historical Activity Theory (CHAT) methodology and perspective is used to analyze four teachers' knowledge, practice, and learning. Teachers have content knowledge for teaching, a form of knowledge that is unique for teaching called specialized content knowledge. This specialized content knowledge (SCK) defines their instructional goals, the student outcomes they ultimately aim to achieve with their students. The study employs a cultural-historical continuum of scientific acts and reasoning, which represents the development of the AP Biology goal over time, to study gaps in their instructional goal. The study also analyzes the contradictions within their teaching practice and how teachers address those contradictions to shift their instructional practice and learn. The findings suggest that teachers have different interpretations of the AP Biology goals of science practice, placing their instructional goal at different points along the continuum. Based on the location of their instructional goal, different micro-communities of teachers exist along the continuum, comprised of teachers with a shared goal, language, and culture of their AP Biology teaching. The in-depth study of one teacher's AP Biology teaching, using a CHAT perspective, provides a means for studying the mechanisms that connect SCK to classroom actions and ultimately to instructional practice. CHAT also reveals the nature and importance of contradictions or cognitive dissonance in teacher learning and the types of support teachers need to

Adoption Level of IFAD Project Recommended Farming Practices ...

African Journals Online (AJOL)

E M IGBOKWE

the respondents respectively identified low counterpart funding, untimely disbursement of funds and inadequate mobility of extension staff as the major constraints to the effective implementation of the programme. Generally, there was a high level of adoption of the recommended farming practices among the participating.

Identifying Key Features of Effective Active Learning: The Effects of Writing and Peer Discussion

Science.gov (United States)

Pangle, Wiline M.; Wyatt, Kevin H.; Powell, Karli N.; Sherwood, Rachel E.

2014-01-01

We investigated some of the key features of effective active learning by comparing the outcomes of three different methods of implementing active-learning exercises in a majors introductory biology course. Students completed activities in one of three treatments: discussion, writing, and discussion + writing. Treatments were rotated weekly between three sections taught by three different instructors in a full factorial design. The data set was analyzed by generalized linear mixed-effect models with three independent variables: student aptitude, treatment, and instructor, and three dependent (assessment) variables: change in score on pre- and postactivity clicker questions, and coding scores on in-class writing and exam essays. All independent variables had significant effects on student performance for at least one of the dependent variables. Students with higher aptitude scored higher on all assessments. Student scores were higher on exam essay questions when the activity was implemented with a writing component compared with peer discussion only. There was a significant effect of instructor, with instructors showing different degrees of effectiveness with active-learning techniques. We suggest that individual writing should be implemented as part of active learning whenever possible and that instructors may need training and practice to become effective with active learning. PMID:25185230

The Effect of Personality Value Practice of Principals toward Attitude, Discipline, Qualities and Communications of Work

Directory of Open Access Journals (Sweden)

Muhammad Asri

2015-02-01

Full Text Available This study aims to identify the effect of personality value practice of principals toward work attitude, work discipline, work quality and work communication of teachers in senior high schools such as public senior high schools (SMA, vocational senior high schools (SMK, religion senior high schools (MAN in Makassar city, South Sulawesi province of Indonesia. The sample consisted of 295 teachers. It used random sampling method. The study used a questionnaire to collect data. Data were analyzed by the statistical inference of linear regression to test the hypotheses. Cronbach's alpha of the questionnaire is 0.879. The results showed a strong effect of personality values of principals toward work attitude, work quality and work communication of teachers at schools. While, personality value of principals have moderate influence on teachers’ work discipline.

Developing practical knowledge content of emergency nursing professionals.

Science.gov (United States)

Chu, Wen; Hsu, Li-Ling

2011-06-01

There is a paucity of published research on clinical or practical nursing knowledge. The ways that nurses acquire, develop, and maintain emergency room (ER) nursing care skills is a research area, in particular, that deserves further investigation. This study examined clinical setting learning processes to better understand the practical knowledge content of ER nurses. This study used a phenomenological approach and in-depth interviews of 10 nurses. Each participant had at least 3 years of ER experience. Researchers used Moustakas' method to analyze interview data. Findings were checked for credibility, transferability, dependability, and confirmability. The authors identified four major practical knowledge themes for ER professionals. These were (a) basic emergency treatment procedure routines and symptom management; (b) disease mechanisms, pharmacodynamics, and treatment responses; (c) newly identified diseases, updated emergency treatments and techniques, and medical treatment discussions; and (d) identifying nursing values including nursing attitudes and continuing patient care. Participants in this study had experience with the first three themes and successfully combined various types of nursing knowledge in their nursing care duties. Only few participants indicated experience with the fourth theme. Findings clarify that clinical or practical knowledge in ER nurses evolves first from declarative knowledge (e.g., basic emergency treatment routines and operating procedures) to procedural knowledge (e.g., instructions from supervisors, actual practice, and drills) to conditional knowledge (e.g., observation and treatment involving direct interactions with patients). Nurses should combine and apply the various knowledge types in their nursing practice to assess comprehensively each patient's condition and administer effective treatment and service.

Lean, green and resilient practices influence on supply chain performance

DEFF Research Database (Denmark)

Govindan, K.; Azevedo, S. G.; Carvalho, H.

2015-01-01

performance and to classify them according to their driving or dependence power. According to this research, the practices with the main driving power are just-in-time (lean practice), flexible transportation (resilient practice) and environmentally friendly packaging (green practice). Customer satisfaction...... of the lean, green and resilient practices is expected to be of great value for their effective implementation by the automotive companies. The interpretive structural modeling approach is used as a useful methodology to identify inter-relationships among lean, green and resilient practices and supply chain...... is the performance measure with strong dependence and weak driving power; that is, it is strongly influenced by the other researched variables but does not affect them....

A Clinical Nurse Leader (CNL) practice development model to support integration of the CNL role into microsystem care delivery.

Science.gov (United States)

Kaack, Lorraine; Bender, Miriam; Finch, Michael; Borns, Linda; Grasham, Katherine; Avolio, Alice; Clausen, Shawna; Terese, Nadine A; Johnstone, Diane; Williams, Marjory

The Veterans Health Administration (VHA) Office of Nursing Services (ONS) was an early adopter of Clinical Nurse Leader (CNL) practice, generating some of the earliest pilot data of CNL practice effectiveness. In 2011 the VHA ONS CNL Implementation & Evaluation Service (CNL I&E) piloted a curriculum to facilitate CNL transition to effective practice at local VHA settings. In 2015, the CNL I&E and local VHA setting stakeholders collaborated to refine the program, based on lessons learned at the national and local level. The workgroup reviewed the literature to identify theoretical frameworks for CNL practice and practice development. The workgroup selected Benner et al.'s Novice-to-Expert model as the defining framework for CNL practice development, and Bender et al.'s CNL Practice Model as the defining framework for CNL practice integration. The selected frameworks were cross-walked against existing curriculum elements to identify and clarify additional practice development needs. The work generated key insights into: core stages of transition to effective practice; CNL progress and expectations for each stage; and organizational support structures necessary for CNL success at each stage. The refined CNL development model is a robust tool that can be applied to support consistent and effective integration of CNL practice into care delivery. Published by Elsevier Inc.

Effect of Music Practice on Anxiety and Depression of Iranian Dental Students

Directory of Open Access Journals (Sweden)

Mahmood Ghasemi

2017-10-01

Full Text Available Objectives: The practice of dentistry has long been associated with high levels of occupational stress and anxiety and music has been shown as a method of reducing stress. Considering the reportedly high level of stress among dental students and its consequences and also considering the positive effect of music therapy, the aim of this study was to evaluate the relationship between music practice and level of stress in dental students.  Materials and Methods: In this analytical, cross-sectional study, 88 students, including 44 with a history of music practice and 44 matched controls without music practice who met the defined inclusion criteria, participated. Upon obtaining written informed consent, all volunteers filled the Beck anxiety inventory (BAI and Beck depression inventory (BDI questionnaires. Data were analyzed using the Kolmogorov-Smirnov test, and multiple linear regression test with backward method was used to evaluate the effect of demographic factors on anxiety and depression scores.Results: The level of anxiety was higher in students who did not have music practice and this difference was significant (P<0.001. The same was observed for depression (P=0.027. Other factors including age, gender, and being far from family had no significant effect on depression and anxiety (P>0.05. But level of anxiety and depression was higher in students of universities with tuition fee compared to free public institutes (P<0.05.Conclusions: It may be concluded that music practice can reduce anxiety and depression of dental students.

Regulatory Monitoring of Fortified Foods: Identifying Barriers and Good Practices

Science.gov (United States)

Rowe, Laura A; Vossenaar, Marieke; Garrett, Greg S

2015-01-01

While fortification of staple foods and condiments has gained enormous global traction, poor performance persists throughout many aspects of implementation, most notably around the critical element of regulatory monitoring, which is essential for ensuring foods meet national fortification standards. Where coverage of fortified foods is high, limited nutritional impact of fortification programs largely exists due to regulatory monitoring that insufficiently identifies and holds producers accountable for underfortified products. Based on quality assurance data from 20 national fortification programs in 12 countries, we estimate that less than half of the samples are adequately fortified against relevant national standards. In this paper, we outline key findings from a literature review, key informant interviews with 11 fortification experts, and semi-quantitative surveys with 39 individuals from regulatory agencies and the food fortification industry in 17 countries on the perceived effectiveness of regulatory monitoring systems and barriers to compliance against national fortification standards. Findings highlight that regulatory agencies and industry disagree on the value that enforcement mechanisms have in ensuring compliance against standards. Perceived political risk of enforcement and poorly resourced inspectorate capacity appear to adversely reinforce each other within an environment of unclear legislation to create a major hurdle for improving overall compliance of fortification programs against national standards. Budget constraints affect the ability of regulatory agencies to create a well-trained inspector cadre and improve the detection and enforcement of non-compliant and underfortified products. Recommendations to improve fortification compliance include improving technical capacity; ensuring sustained leadership, accountability, and funding in both the private and the public sectors; and removing political barriers to ensure consistent detection of

Classification of complementary and alternative medical practices: Family physicians' ratings of effectiveness.

Science.gov (United States)

Fries, Christopher J

2008-11-01

ABSTRACTOBJECTIVETo develop a classification of complementary and alternative medicine (CAM) practices widely available in Canada based on physicians' effectiveness ratings of the therapies.DESIGNA self-administered postal questionnaire asking family physicians to rate their "belief in the degree of therapeutic effectiveness" of 15 CAM therapies.SETTINGProvince of Alberta.PARTICIPANTSA total of 875 family physicians.MAIN OUTCOME MEASURESDescriptive statistics of physicians' awareness of and effectiveness ratings for each of the therapies; factor analysis was applied to the ratings of the 15 therapies in order to explore whether or not the data support the proposed classification of CAM practices into categories of accepted and rejected.RESULTSPhysicians believed that acupuncture, massage therapy, chiropractic care, relaxation therapy, biofeedback, and spiritual or religious healing were effective when used in conjunction with biomedicine to treat chronic or psychosomatic indications. Physicians attributed little effectiveness to homeopathy or naturopathy, Feldenkrais or Alexander technique, Rolfing, herbal medicine, traditional Chinese medicine, and reflexology. The factor analysis revealed an underlying dimensionality to physicians' effectiveness ratings of the CAM therapies that supports the classification of these practices as either accepted or rejected.CONCLUSIONThis study provides Canadian family physicians with information concerning which CAM therapies are generally accepted by their peers as effective and which are not.

Supporting Implementation of Evidence-Based Practices through Practice-Based Coaching

Science.gov (United States)

Snyder, Patricia A.; Hemmeter, Mary Louise; Fox, Lise

2015-01-01

In active implementation science frameworks, coaching has been described as an important competency "driver" to ensure evidence-based practices are implemented as intended. Empirical evidence also has identified coaching as a promising job-embedded professional development strategy to support implementation of quality teaching practices.…

Effect of green business practices on organizational performance of ...

African Journals Online (AJOL)

Effect of green business practices on organizational performance of selected manufacturing firms in Nigeria. ... AFRICAN JOURNALS ONLINE (AJOL) · Journals · Advanced Search · USING AJOL · RESOURCES. International Journal of Development and Management Review ... Journal Home > Vol 13, No 1 (2018) >.

Identifying challenges in project consultants engagement practices

Science.gov (United States)

Shariffuddin, Nadia Alina Amir; Abidin, Nazirah Zainul

2017-10-01

Construction projects, green or conventional, involve multi-faceted disciplines engaged with the goal of delivering products i.e. building, infrastructure etc. at the best quality within stipulated budgets. For green projects, additional attention is added for environmental quality. Due to the various responsibilities and liabilities involved as well as the complexity of the construction process itself, formal engagement of multi-disciplinary professionals i.e. project consultants is required in any construction project. Poor selection of project consultants will lead to a multitude of complications resulting in delay, cost escalation, conflicts and poor quality. This paper explores the challenges that occur during the engagement of project consultants in a green project. As the engagement decision involves developers and architects, these two groups of respondents with green project backgrounds were approached qualitatively using interview technique. The challenges identified are limited experience and knowledge, consultants' fee vs. quality, green complexity, conflicts of interest, clients' extended expectation and less demand in green projects. The construction shifts to green project demands engagement of project consultants with added skills. It is expected that through the identification of challenges, better management and administration can be created which would give impact to the overall process of engagement in green projects.

Effect of Music Practice on Anxiety and Depression of Iranian Dental Students.

Science.gov (United States)

Ghasemi, Mahmood; Lotfollahzadeh, Hana; Kermani-Ranjbar, Tahereh; Kharazifard, Mohammad Javad

2017-05-01

The practice of dentistry has long been associated with high levels of occupational stress and anxiety and music has been shown as a method of reducing stress. Considering the reportedly high level of stress among dental students and its consequences and also considering the positive effect of music therapy, the aim of this study was to evaluate the relationship between music practice and level of stress in dental students. In this analytical, cross-sectional study, 88 students, including 44 with a history of music practice and 44 matched controls without music practice who met the defined inclusion criteria, participated. Upon obtaining written informed consent, all volunteers filled the Beck anxiety inventory (BAI) and Beck depression inventory (BDI) questionnaires. Data were analyzed using the Kolmogorov-Smirnov test, and multiple linear regression test with backward method was used to evaluate the effect of demographic factors on anxiety and depression scores. The level of anxiety was higher in students who did not have music practice and this difference was significant (P0.05). But level of anxiety and depression was higher in students of universities with tuition fee compared to free public institutes (Pmusic practice can reduce anxiety and depression of dental students.

Benchmarking supply chain management practices in a South African confectionery manufacturing organisation

Directory of Open Access Journals (Sweden)

Orestes Peristeris

2015-08-01

Full Text Available Background: In an increasingly competitive business world, businesses need to be able to measure the effectiveness of their supply chain management process practices against proven best practice frameworks. A number of these frameworks exist internationally but have to be used within the context of knowing the relative strengths and weaknesses of potential benchmarking frameworks. Two such frameworks were identified in the research and a case was made to use one such framework, the Global Supply Chain Forum (GSCF framework, to measure the effectiveness of the supply chain practices of a leading confectionery manufacturing company in South Africa. Objective of the research: The purpose of the research was to identify an international best practice framework, which could be used by South African manufacturing organisations to benchmark their supply chain management (SCM practices. Methodology: The methodology followed was a literature review of the existing SCM frameworks to identify a framework, which would be the most suited to the objective of the study, followed by a case study of a leading manufacturing organisation’s SCM practices benchmarked against those found in the framework. Results and conclusions: The main finding of the case study was that there is a high degree of adherence between the case study organisation’s SCM practices and those found in the SCM framework. There was also generally a high level of importance ascribed by respondents to the best practices contained by the GSCF framework. It was therefore concluded that the GSCF framework proved to be a useful instrument for a comprehensive analysis of supply chain management processes and practices for a manufacturer in the fast moving consumer goods industry, with potential for applications by organisations in the supply chains of other industries.

Teaching Effectiveness: Preparing Occupational Therapy Students for Clinical Practice

Directory of Open Access Journals (Sweden)

Jane C. OBrien PhD, MS.MEdL, OTR/L

2013-06-01

Full Text Available Medical educators must examine the ability of teaching methodologies to prepare students for clinical practice. Two types of assessment methods commonly used in medical education include the Short Objective Structured Clinical Examination (OSCE and the Integrated Performance Procedural Instrument (IPPI. The use of these methods in occupational therapy (OT education is less understood. With the increasing number of students enrolled in programs, faculty face challenges to examine how clinical competence is established using data to determine teaching effectiveness. This study examines two educational methodologies used in OT curriculum: the long written case study (IPPI and short performance-based OSCE. The authors describe the effectiveness of each examination as it relates to student performance in clinical practice (as measured by the Fieldwork Performance Evaluation [FWPE]. The findings obtained from separate focus group sessions with faculty and students further provide insight into the advantages and disadvantages of the educational methodologies.

WITHDRAWN: Nursing record systems: effects on nursing practice and healthcare outcomes.

Science.gov (United States)

Urquhart, Christine; Currell, Rosemary; Grant, Maria J; Hardiker, Nicholas R

2018-05-15

A nursing record system is the record of care that was planned or given to individual patients and clients by qualified nurses or other caregivers under the direction of a qualified nurse. Nursing record systems may be an effective way of influencing nurse practice. To assess the effects of nursing record systems on nursing practice and patient outcomes. For the original version of this review in 2000, and updates in 2003 and 2008, we searched: the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register; MEDLINE, EMBASE, CINAHL, BNI, ISI Web of Knowledge, and ASLIB Index of Theses. We also handsearched: Computers, Informatics, Nursing (Computers in Nursing); Information Technology in Nursing; and the Journal of Nursing Administration. For this update, searches can be considered complete until the end of 2007. We checked reference lists of retrieved articles and other related reviews. Randomised controlled trials (RCTs), controlled before and after studies, and interrupted time series comparing one kind of nursing record system with another in hospital, community or primary care settings. The participants were qualified nurses, students or healthcare assistants working under the direction of a qualified nurse, and patients receiving care recorded or planned using nursing record systems. Two review authors (in two pairs) independently assessed trial quality and extracted data. We included nine trials (eight RCTs, one controlled before and after study) involving 1846 people. The studies that evaluated nursing record systems focusing on relatively discrete and focused problems, for example effective pain management in children, empowering pregnant women and parents, reducing loss of notes, reducing time spent on data entry of test results, reducing transcription errors, and reducing the number of pieces of paper in a record, all demonstrated some degree of success in achieving the desired results. Studies of nursing care planning

Genomics and infectious disease: a call to identify the ethical, legal and social implications for public health and clinical practice.

Science.gov (United States)

Geller, Gail; Dvoskin, Rachel; Thio, Chloe L; Duggal, Priya; Lewis, Michelle H; Bailey, Theodore C; Sutherland, Andrea; Salmon, Daniel A; Kahn, Jeffrey P

2014-01-01

Advances in genomics are contributing to the development of more effective, personalized approaches to the prevention and treatment of infectious diseases. Genetic sequencing technologies are furthering our understanding of how human and pathogen genomic factors - and their interactions - contribute to individual differences in immunologic responses to vaccines, infections and drug therapies. Such understanding will influence future policies and procedures for infectious disease management. With the potential for tailored interventions for particular individuals, populations or subpopulations, ethical, legal and social implications (ELSIs) may arise for public health and clinical practice. Potential considerations include balancing health-related benefits and harms between individuals and the larger community, minimizing threats to individual privacy and autonomy, and ensuring just distribution of scarce resources. In this Opinion, we consider the potential application of pathogen and host genomic information to particular viral infections that have large-scale public health consequences but differ in ELSI-relevant characteristics such as ease of transmission, chronicity, severity, preventability and treatability. We argue for the importance of anticipating these ELSI issues in advance of new scientific discoveries, and call for the development of strategies for identifying and exploring ethical questions that should be considered as clinical, public health and policy decisions are made.

Failure mode effects and criticality analysis: innovative risk assessment to identify critical areas for improvement in emergency department sepsis resuscitation.

Science.gov (United States)

Powell, Emilie S; O'Connor, Lanty M; Nannicelli, Anna P; Barker, Lisa T; Khare, Rahul K; Seivert, Nicholas P; Holl, Jane L; Vozenilek, John A

2014-06-01

Sepsis is an increasing problem in the practice of emergency medicine as the prevalence is increasing and optimal care to reduce mortality requires significant resources and time. Evidence-based septic shock resuscitation strategies exist, and rely on appropriate recognition and diagnosis, but variation in adherence to the recommendations and therefore outcomes remains. Our objective was to perform a multi-institutional prospective risk-assessment, using failure mode effects and criticality analysis (FMECA), to identify high-risk failures in ED sepsis resuscitation. We conducted a FMECA, which prospectively identifies critical areas for improvement in systems and processes of care, across three diverse hospitals. A multidisciplinary group of participants described the process of emergency department (ED) sepsis resuscitation to then create a comprehensive map and table listing all process steps and identified process failures. High-risk failures in sepsis resuscitation from each of the institutions were compiled to identify common high-risk failures. Common high-risk failures included limited availability of equipment to place the central venous catheter and conduct invasive monitoring, and cognitive overload leading to errors in decision-making. Additionally, we identified great variability in care processes across institutions. Several common high-risk failures in sepsis care exist: a disparity in resources available across hospitals, a lack of adherence to the invasive components of care, and cognitive barriers that affect expert clinicians' decision-making capabilities. Future work may concentrate on dissemination of non-invasive alternatives and overcoming cognitive barriers in diagnosis and knowledge translation.

Innovative Work Practices and Lessons Learned at the N Area Deactivation Project

International Nuclear Information System (INIS)

Day, R.S.

1999-01-01

This report identifies many of the lessons learned, innovations,and effective work practices that derived from activities supporting the N Area Deactivation Project at the U.S. Department of Energy's (DOE) Hanford Site. The work practices discussed in this report may be applicable and beneficial to similar projects throughout the DOE complex

Final Technical Report Power through Policy: "Best Practices" for Cost-Effective Distributed Wind

Energy Technology Data Exchange (ETDEWEB)

Rhoads-Weaver, Heather; Gagne, Matthew; Sahl, Kurt; Orrell, Alice; Banks, Jennifer

2012-02-28

Power through Policy: 'Best Practices' for Cost-Effective Distributed Wind is a U.S. Department of Energy (DOE)-funded project to identify distributed wind technology policy best practices and to help policymakers, utilities, advocates, and consumers examine their effectiveness using a pro forma model. Incorporating a customized feed from the Database of State Incentives for Renewables and Efficiency (DSIRE), the Web-based Distributed Wind Policy Comparison Tool (Policy Tool) is designed to assist state, local, and utility officials in understanding the financial impacts of different policy options to help reduce the cost of distributed wind technologies. The project's final products include the Distributed Wind Policy Comparison Tool, found at www.windpolicytool.org, and its accompanying documentation: Distributed Wind Policy Comparison Tool Guidebook: User Instructions, Assumptions, and Case Studies. With only two initial user inputs required, the Policy Tool allows users to adjust and test a wide range of policy-related variables through a user-friendly dashboard interface with slider bars. The Policy Tool is populated with a variety of financial variables, including turbine costs, electricity rates, policies, and financial incentives; economic variables including discount and escalation rates; as well as technical variables that impact electricity production, such as turbine power curves and wind speed. The Policy Tool allows users to change many of the variables, including the policies, to gauge the expected impacts that various policy combinations could have on the cost of energy (COE), net present value (NPV), internal rate of return (IRR), and the simple payback of distributed wind projects ranging in size from 2.4 kilowatts (kW) to 100 kW. The project conducted case studies to demonstrate how the Policy Tool can provide insights into 'what if' scenarios and also allow the current status of incentives to be examined or defended when

Use of globally unique identifiers (GUIDs) to link herbarium specimen records to physical specimens.

Science.gov (United States)

Nelson, Gil; Sweeney, Patrick; Gilbert, Edward

2018-02-01

With the advent of the U.S. National Science Foundation's Advancing Digitization of Biodiversity Collections program and related worldwide digitization initiatives, the rate of herbarium specimen digitization in the United States has expanded exponentially. As the number of electronic herbarium records proliferates, the importance of linking these records to the physical specimens they represent as well as to related records from other sources will intensify. Although a rich and diverse literature has developed over the past decade that addresses the use of specimen identifiers for facilitating linking across the internet, few implementable guidelines or recommended practices for herbaria have been advanced. Here we review this literature with the express purpose of distilling a specific set of recommendations especially tailored to herbarium specimen digitization, curation, and management. We argue that associating globally unique identifiers (GUIDs) with physical herbarium specimens and including these identifiers in all electronic records about those specimens is essential to effective digital data curation. We also address practical applications for ensuring these associations.

Pilot study on the use of data mining to identify cochlear implant candidates.

Science.gov (United States)

Grisel, Jedidiah J; Schafer, Erin; Lam, Anne; Griffin, Terry

2018-05-01

The goal of this pilot study was to determine the clinical utility of data-mining software that screens for cochlear implant (CI) candidacy. The Auditory Implant Initiative developed a software module that screens for CI candidates via integration with a software system (Noah 4) that serves as a depository for hearing test data. To identify candidates, patient audiograms from one practice were exported into the screening module. Candidates were tracked to determine if any eventually underwent implantation. After loading 4836 audiograms from the Noah 4 system, the screening module identified 558 potential CI candidates. After reviewing the data for the potential candidates, 117 were targeted and invited to an educational event. Following the event, a total of six candidates were evaluated, and two were implanted. This objective approach to identifying candidates has the potential to address the gross underutilization of CIs by removing any bias or lack of knowledge regarding the management of severe to profound sensorineural hearing loss with CIs. The screening module was an effective tool for identifying potential CI candidates at one ENT practice. On a larger scale, the screening module has the potential to impact thousands of CI candidates worldwide.

Unveiling the Effects of Citizen Journalism Practice on College Students' Social Capital

Science.gov (United States)

Nah, Seungahn; Namkoong, Kang; Van Stee, Stephanie K.; Record, Rachael A.

2014-01-01

This study examined the effects of citizen journalism practices on social capital concerning nonprofit and voluntary organizations (i.e., satisfaction, trust, and engagement). Through a quasi-experimental design, the analyses revealed that students in the treatment group, in which participants engaged in citizen journalism practice, had greater…

Developing a questionnaire to identify perceived barriers for implementing the Dutch physical therapy COPD clinical practice guideline.

Science.gov (United States)

van der Wees, Philip J; Zagers, Cor A M; de Die, Sara E; Hendriks, Erik J M; Nijhuis-van der Sanden, Maria W G; de Bie, Rob A

2013-05-01

Clinical practice guidelines have been developed to assist healthcare practitioners in clinical decision making. Publication of clinical practice guidelines does not automatically lead to their uptake and barrier identification has been recognized as an important step in implementation planning. This study aimed at developing a questionnaire to identify perceived barriers for implementing the Dutch COPD guideline for physical therapists and its recommended measurement instruments. An overall questionnaire, based on two existing questionnaires, was constructed to identify barriers and facilitators for implementing the COPD guideline. The construct of the questionnaire was assessed in a cross-sectional study among 246 chest physical therapists. Factor analysis was conducted to explore underlying dimensions. Psychometric properties were analyzed using Cronbach's alpha. Barriers and facilitators were assessed using descriptive statistics. Some 139 physical therapists (57%) responded. Factor analysis revealed 4-factor and 5-factor solutions with an explained variance of 36% and 39% respectively. Cronbach's alpha of the overall questionnaire was 0.90, and varied from 0.66 to 0.92 for the different factors. Underlying domains of the 5-factor solution were characterized as: attitude towards using measurement instruments, knowledge and skills of the physical therapist, applicability of the COPD guideline, required investment of time & money, and patient characteristics. Physical therapists showed a positive attitude toward using the COPD guideline. Main barriers for implementation were required time investment and financial constraints. The construct of the questionnaire revealed relevant underlying domains for the identification of barriers and facilitators for implementing the COPD guideline. The questionnaire allowed for tailoring to the target group and may be used across health care professionals as basis for in-depth analysis of barriers to specific recommendations in

Trends in publications regarding evidence-practice gaps: a literature review.

Science.gov (United States)

Evensen, Ann E; Sanson-Fisher, Rob; D'Este, Catherine; Fitzgerald, Michael

2010-02-03

Well-designed trials of strategies to improve adherence to clinical practice guidelines are needed to close persistent evidence-practice gaps. We studied how the number of these trials is changing with time, and to what extent physicians are participating in such trials. This is a literature-based study of trends in evidence-practice gap publications over 10 years and participation of clinicians in intervention trials to narrow evidence-practice gaps. We chose nine evidence-based guidelines and identified relevant publications in the PubMed database from January 1998 to December 2007. We coded these publications by study type (intervention versus non-intervention studies). We further subdivided intervention studies into those for clinicians and those for patients. Data were analyzed to determine if observed trends were statistically significant. We identified 1,151 publications that discussed evidence-practice gaps in nine topic areas. There were 169 intervention studies that were designed to improve adherence to well-established clinical guidelines, averaging 1.9 studies per year per topic area. Twenty-eight publications (34%; 95% CI: 24% - 45%) reported interventions intended for clinicians or health systems that met Effective Practice and Organization of Care (EPOC) criteria for adequate design. The median consent rate of physicians asked to participate in these well-designed studies was 60% (95% CI, 25% to 69%). We evaluated research publications for nine evidence-practice gaps, and identified small numbers of well-designed intervention trials and low rates of physician participation in these trials.

MATHEMATICS PRACTICES AND THEIR EFFECTS ON FIRST-TO-FOURTH-GRADE TEACHER EDUCATION

Directory of Open Access Journals (Sweden)

Marta Cristina Cezar Pozzobon

2012-12-01

Full Text Available Grounded on Foucauldian studies, we have attempted to understand how mathematics practices have produced effects on first-to-fourth-grade mathematics teachers. We have argued that such effects go beyond the borders of the pedagogical and the contents of this knowledge area, becoming part of a “general policy” of truth that comprehends the conceptions of scientific knowledge, mathematics and teaching of a particular time. The materials here considered were produced in a High School course in the 1990’s. We have realized that the practices of mathematics education in that period could be assessed from three emphases: a education to teach mathematics through the “concrete”, the “logical knowledge” and the “abstract”, showing mathematics teaching practices from a constructivist, science-oriented perspective, b “globalized teaching”, and c “emphasis on reality”. This has enabled us to problematize the mathematical education of first-to-fourth grade teachers produced in those practices.

Work Practice Characteristics

DEFF Research Database (Denmark)

Pors, Jens Kaaber; Simonsen, Jesper

2003-01-01

and work practice. To understand these issues a framework of characteristics is identified and termed work practice characteristics to describe important aspects of the hybrid configuration of groupware and situated work practices. Drawing on concepts and work practice studies in the field of computer...... investigation of how groupware is employed to support new ways of working in a large European financial organisation are analysed to illustrate situations with high and low integration of groupware. The framework of work practice characteristics is discussed in the light of these findings and implications...

Total quality management in orthodontic practice.

Science.gov (United States)

Atta, A E

1999-12-01

Quality is the buzz word for the new Millennium. Patients demand it, and we must serve it. Yet one must identify it. Quality is not imaging or public relations; it is a business process. This short article presents quality as a balance of three critical notions: core clinical competence, perceived values that our patients seek and want, and the cost of quality. Customer satisfaction is a variable that must be identified for each practice. In my practice, patients perceive quality as communication and time, be it treatment or waiting time. Time is a value and cost that must be managed effectively. Total quality management is a business function; it involves diagnosis, design, implementation, and measurement of the process, the people, and the service. Kazien is a function that reduces value services, eliminates waste, and manages time and cost in the process. Total quality management is a total commitment for continuous improvement.

Multi-criteria decision support framework for sustainable implementation of effective green supply chain management practices.

Science.gov (United States)

Boutkhoum, Omar; Hanine, Mohamed; Boukhriss, Hicham; Agouti, Tarik; Tikniouine, Abdessadek

2016-01-01

At present, environmental issues become real critical barriers for many supply chain corporations concerning the sustainability of their businesses. In this context, several studies have been proposed from both academia and industry trying to develop new measurements related to green supply chain management (GSCM) practices to overcome these barriers, which will help create new environmental strategies, implementing those practices in their manufacturing processes. The objective of this study is to present the technical and analytical contribution that multi-criteria decision making analysis (MCDA) can bring to environmental decision making problems, and especially to GSCM field. For this reason, a multi-criteria decision-making methodology, combining fuzzy analytical hierarchy process and fuzzy technique for order preference by similarity to ideal solution (fuzzy TOPSIS), is proposed to contribute to a better understanding of new sustainable strategies through the identification and evaluation of the most appropriate GSCM practices to be adopted by industrial organizations. The fuzzy AHP process is used to construct hierarchies of the influential criteria, and then identify the importance weights of the selected criteria, while the fuzzy TOPSIS process employs these weighted criteria as inputs to evaluate and measure the performance of each alternative. To illustrate the effectiveness and performance of our MCDA approach, we have applied it to a chemical industry corporation located in Safi, Morocco.

Effect of age, sex, area and management practices on cattle mortality in Rajshahi division, Bangladesh

Directory of Open Access Journals (Sweden)

Md. Reazul Islam

2016-03-01

Full Text Available Objective: The aim of the present study was to evaluate the effect of age, sex, location and management on cattle mortality rate in Rajshahi division of Bangladesh. Materials and methods: The study was conducted in 8 districts of Rajshahi division during July 2011 to June 2012. A total of 17,982 cattle heads were investigated based on age, sex, area. Data were collected from the cattle owners using a closed structured questionnaire. Tentative cause of cattle mortality was identified based on clinical signs, laboratory tests, history, ante-mortem and postmortem reports. Management practices of the cattle were also investigated. Results: Out of 17,982 cattle heads, 549 were found to be dead by various diseases, and an average mortality rate was 3.05%. Age-wise mortality rate of cattle revealed that the maximum mortality rate was found in the age group of 0.05 between the cattle mortality rate in Natore district (2.84% and Joypurhat districts (2.84%. Conclusion: The overall mortality rate of cattle in Rajshahi division was found comparatively low. This might be due to improved management practices, better veterinary services, and awareness among farmers. However, cattle mortality rate in the age group <2-year is alarming due to bad management practices and disease. [J Adv Vet Anim Res 2016; 3(1.000: 13-17

Criminal investigations of child abuse: the research behind "best practices".

Science.gov (United States)

Jones, Lisa M; Cross, Theodore P; Walsh, Wendy A; Simone, Monique

2005-07-01

This article reviews the research relevant to seven practices considered by many to be among the most progressive approaches to criminal child abuse investigations: multidisciplinary team investigations, trained child forensic interviewers, videotaped interviews, specialized forensic medical examiners, victim advocacy programs, improved access to mental health treatment for victims, and Children's Advocacy Centers (CACs). The review finds that despite the popularity of these practices, little outcome research is currently available documenting their success. However, preliminary research supports many of these practices or has influenced their development. Knowledge of this research can assist investigators and policy makers who want to improve the response to victims, understand the effectiveness of particular programs, or identify where assumptions about effectiveness are not empirically supported.

Value of wireless personal digital assistants for practice: perceptions of advanced practice nurses.

Science.gov (United States)

Garrett, Bernard; Klein, Gerri

2008-08-01

The aims were to explore advanced practice nurses' perceptions on wireless Personal Digital Assistant technologies, to establish the type and range of tools that would be useful to support their practice and to identify any requirements and limitations that may impact the implementation of wireless Personal Digital Assistants in practice. The wireless Personal Digital Assistant is becoming established as a hand-held computing tool for healthcare professionals. The reflections of advanced practice nurses' about the value of wireless Personal Digital Assistants and its potential to contribute to improved patient care has not been investigated. A qualitative interpretivist design was used to explore advanced practice nurses' perceptions on the value of wireless Personal Digital Assistant technologies to support their practice. The data were collected using survey questionnaires and individual and focus group interviews with nurse practitioners, clinical nurse specialists and information technology managers based in British Columbia, Canada. An open-coding content analysis was performed using qualitative data analysis software. Wireless Personal Digital Assistant's use supports the principles of pervasivity and is a technology rapidly being adopted by advanced practice nurses. Some nurses indicated a reluctance to integrate wireless Personal Digital Assistant technologies into their practices because of the cost and the short technological life cycle of these devices. Many of the barriers which precluded the use of wireless networks within facilities are being removed. Nurses demonstrated a complex understanding of wireless Personal Digital Assistant technologies and gave good rationales for its integration in their practice. Nurses identified improved client care as the major benefit of this technology in practice and the type and range of tools they identified included clinical reference tools such as drug and diagnostic/laboratory reference applications and wireless

Self-care practice of ostomy patients: contributions of the Orem’s theory

Directory of Open Access Journals (Sweden)

Luciana Catunda Gomes Menezes

2013-05-01

Full Text Available This study aimed to identify the conditioning factors to self-care practice of ostomy patients, and verify knowledge and practices on stoma care. Descriptive and qualitative study, referencing the Orem’s Self-Care Theory, carried out at the Ostomy Association of Fortaleza-CE, Brazil, in June and July 2007. We identified as the main conditioning factors for self-care: male, aged over 51 years, low education, from the capital city/metropolitan area, married, and with low family income. From the participants’ statements, emerged three categories: Learning to take care of stoma: education-support system; Stoma Care: knowledge and practices; and Difficulties found in the practice of self-care. It was concluded that ostomy patients require a multidimensional and individualized nursing care, which enables them to perform self-care effectively.

Practice effect in Symbol Digit Modalities Test in multiple sclerosis patients treated with natalizumab.

Science.gov (United States)

Roar, Malte; Illes, Zsolt; Sejbaek, Tobias

2016-11-01

How practice effect influences cognitive testing measured by monthly Symbol Digit Modalities Test (SDMT) during natalizumab treatment, and what factors confound such effect. Eighty patients were examined monthly with SDMT for 26.2±8.4 months. After 26.0±8.1 months, SDMT was also performed with a rearranged key in 59 cases. Results of SDMTs with the rearranged and previous regular key were compared. We examined if gender, age, Extended Disability Status Scale (EDSS), relapses, and disability progression/improvement influence SDMT performed with the regular and the rearranged key, respectively. We also explored if natalizumab applied before regular monthly SDMT may influence practice effect and cognition. SDMT performance improved by 1.2 points/test during the first six months and by 0.4 points/test thereafter. Rearranging the symbols of the key after 26.0±8.1 months returned SDMT scores to baseline indicating a practice effect. Such practice effect was more significant after longer testing period, but was not influenced by gender, age, relapses, disability progression and prior natalizumab treatment. Although the change from baseline to 2.5 years was significant in subgroups with EDSS 0-3, 3.5-5.5 and 6-7.5, this was higher in patients with EDSS 0-3 compared to 6-7.5. Practice effect significantly contributes to continuous improvement in SDMT performance during natalizumab treatment: to test cognition, a change in key is required. Practice effect is less pronounced in patients with advanced disease. Cognition remains stable even in patients with progressive disease during more than 2 years of natalizumab treatment indicated by scores corresponding to baseline after changing the key. Copyright © 2016 Elsevier B.V. All rights reserved.

Identifying biogeochemical processes beneath stormwater infiltration ponds in support of a new best management practice for groundwater protection

Science.gov (United States)

O'Reilly, Andrew M.; Chang, Ni-Bin; Wanielista, Martin P.; Xuan, Zhemin; Schirmer, Mario; Hoehn, Eduard; Vogt, Tobias

2011-01-01

 When applying a stormwater infiltration pond best management practice (BMP) for protecting the quality of underlying groundwater, a common constituent of concern is nitrate. Two stormwater infiltration ponds, the SO and HT ponds, in central Florida, USA, were monitored. A temporal succession of biogeochemical processes was identified beneath the SO pond, including oxygen reduction, denitrification, manganese and iron reduction, and methanogenesis. In contrast, aerobic conditions persisted beneath the HT pond, resulting in nitrate leaching into groundwater. Biogeochemical differences likely are related to soil textural and hydraulic properties that control surface/subsurface oxygen exchange. A new infiltration BMP was developed and a full-scale application was implemented for the HT pond. Preliminary results indicate reductions in nitrate concentration exceeding 50% in soil water and shallow groundwater beneath the HT pond.

Mathematics Reform Curricula and Special Education: Identifying Intersections and Implications for Practice

Science.gov (United States)

Sayeski, Kristin L.; Paulsen, Kim J.

2010-01-01

In many general education classrooms today, teachers are using "reform" mathematics curricula. These curricula emphasize the application of mathematics in real-life contexts and include such practices as collaborative, group problem solving and student-generated algorithms. Students with learning disabilities in the area of mathematics can…

A microteaching application on a teaching practice course

Directory of Open Access Journals (Sweden)

Vahide Can

2009-12-01

Full Text Available This study investigated effectivenes of a teaching practice course which realized using the microteaching methods. Theparticipants of the study were six student teachers who experienced teaching practices for two times in a real classroomenvironment. Each of the two teaching practices of the student teachers were videotaped. Having observed of the first videorecords the instructur gave the student teachers feedback about their effectiveness in teaching. Analysis of the video recordsrevealed that student teachers achieved a better performance in their second teachings in terms of explaining basic theoriesand principles, identifying and observing necessary teaching roles and behaviours, preparing lesson plans, and conducting moreeffective teaching practices. In light of the these findings, it is suggested that this method should be integrated into teachingpractice courses.

Performance improvement planning : developing effective billing and collection practices

OpenAIRE

anonymous

2008-01-01

Effective billing and collection systems are a critical component for ensuring the viability of a service provider. Improving billing and collection activities has an immediate impact on the revenue streams of a service provider that can, in turn, help the service provider in improving services. However, while effective billing and collection practices depend on many internal factors (including customer databases, the extent of metered and unmetered service provision, tariff and billing struc...

Infant Feeding Practices and the Effect of Early Complementary ...

African Journals Online (AJOL)

Objective: The objective of this study was to determine infant feeding practices and the effect of early complementary feeding on the nutritional status of children in Makada Community, Sabon Gari Local Government Area (LGA), Kaduna State, Nigeria. Materials and Methods: A cross-sectional survey was carried out.

Health education: Effect on knowledge and practice of workplace ...

African Journals Online (AJOL)

Background: There has been increasing incidence of occupational diseases among woodworkers due to exposure to preventable hazards in the workplace. The objective of this study was to determine the effects of health education on the knowledge and practice of workplace hygiene and protective measures among ...

Identifying professionals' needs in integrating electronic pain monitoring in community palliative care services: An interview study.

Science.gov (United States)

Taylor, Sally; Allsop, Matthew J; Bekker, Hilary L; Bennett, Michael I; Bewick, Bridgette M

2017-07-01

Poor pain assessment is a barrier to effective pain control. There is growing interest internationally in the development and implementation of remote monitoring technologies to enhance assessment in cancer and chronic disease contexts. Findings describe the development and testing of pain monitoring systems, but research identifying the needs of health professionals to implement routine monitoring systems within clinical practice is limited. To inform the development and implementation strategy of an electronic pain monitoring system, PainCheck, by understanding palliative care professionals' needs when integrating PainCheck into routine clinical practice. Qualitative study using face-to-face interviews. Data were analysed using framework analysis Setting/participants: Purposive sample of health professionals managing the palliative care of patients living in the community Results: A total of 15 interviews with health professionals took place. Three meta-themes emerged from the data: (1) uncertainties about integration of PainCheck and changes to current practice, (2) appraisal of current practice and (3) pain management is everybody's responsibility Conclusion: Even the most sceptical of health professionals could see the potential benefits of implementing an electronic patient-reported pain monitoring system. Health professionals have reservations about how PainCheck would work in practice. For optimal use, PainCheck needs embedding within existing electronic health records. Electronic pain monitoring systems have the potential to enable professionals to support patients' pain management more effectively but only when barriers to implementation are appropriately identified and addressed.

School practices to promote social distancing in K-12 schools: review of influenza pandemic policies and practices.

Science.gov (United States)

Uscher-Pines, Lori; Schwartz, Heather L; Ahmed, Faruque; Zheteyeva, Yenlik; Meza, Erika; Baker, Garrett; Uzicanin, Amra

2018-03-27

During an evolving influenza pandemic, community mitigation strategies, such as social distancing, can slow down virus transmission in schools and surrounding communities. To date, research on school practices to promote social distancing in primary and secondary schools has focused on prolonged school closure, with little attention paid to the identification and feasibility of other more sustainable interventions. To develop a list and typology of school practices that have been proposed and/or implemented in an influenza pandemic and to uncover any barriers identified, lessons learned from their use, and documented impacts. We conducted a review of the peer-reviewed and grey literature on social distancing interventions in schools other than school closure. We also collected state government guidance documents directed to local education agencies or schools to assess state policies regarding social distancing. We collected standardized information from each document using an abstraction form and generated descriptive statistics on common plan elements. The document review revealed limited literature on school practices to promote social distancing, as well as limited incorporation of school practices to promote social distancing into state government guidance documents. Among the 38 states that had guidance documents that met inclusion criteria, fewer than half (42%) mentioned a single school practice to promote social distancing, and none provided any substantive detail about the policies or practices needed to enact them. The most frequently identified school practices were cancelling or postponing after-school activities, canceling classes or activities with a high rate of mixing/contact that occur within the school day, and reducing mixing during transport. Little information is available to schools to develop policies and procedures on social distancing. Additional research and guidance are needed to assess the feasibility and effectiveness of school

The identifiable victim effect in charitable giving: evidence from a natural field experiment

DEFF Research Database (Denmark)

Lesner, Tine; Rasmussen, O. D.

2014-01-01

or a statistical victim. Unlike much previous research, which has used only laboratory experiments, we find that the campaign letter focusing on one identifiable victim did not result in significantly larger donations than the campaign letter focusing on the statistical victim. In addition to the role......We design a natural field experiment to enhance our understanding of the role of the identifiable victim effect in charitable giving. Using direct mail solicitations to 25797 prior donors of a nonprofit charity, we tested the responsiveness of donors to make a contribution to either an identifiable...... campaigns. We find some evidence of crowding out, indicating that charitable giving could be a zero-sum game; however, the treatment letters did not have different effects on other payments....

Providing services to trafficking survivors: Understanding practices across the globe.

Science.gov (United States)

Steiner, Jordan J; Kynn, Jamie; Stylianou, Amanda M; Postmus, Judy L

2018-01-01

Human trafficking is a global issue, with survivors representing all genders, ages, races, ethnicities, religions, and countries. However, little research exists that identifies effective practices in supporting survivors of human trafficking. The research that does exist is Western-centric. To fill this gap in the literature, the goal of this research was to understand practices used throughout the globe with adult human trafficking survivors. A qualitative approach was utilized. Providers from 26 countries, across six different continents, were interviewed to allow for a comprehensive and multi-faceted understanding of practices in working with survivors. Participants identified utilizing an empowerment-based, survivor, and human life-centered approach to working with survivors, emphasized the importance of engaging in community level interventions, and highlighted the importance of government recognition of human trafficking. Findings provide information from the perspective of advocates on best practices in the field that can be used by agencies to enhance human trafficking programming.

Age-related practice effects across longitudinal neuropsychological assessments in older people with schizophrenia.

Science.gov (United States)

Granholm, Eric; Link, Peter; Fish, Scott; Kraemer, Helena; Jeste, Dilip

2010-09-01

The relationship between aging and practice effects on longitudinal neuropsychological assessments was investigated in middle-aged and older people with schizophrenia and healthy controls. Older people with schizophrenia (n = 107; M age = 56.1) and age-comparable nonpsychiatric controls (n = 107; M age = 57.7) were scheduled to receive annual assessments on a comprehensive battery of neuropsychological tests for an average of 2.5 years (range 11 months to 4 years). Mixed-model analyses were used to separately examine the effects of practice and age on test performance. Number of prior assessments (practice) was associated with significant performance improvement across assessments, whereas older age was associated with significant decline in performance. The groups did not differ significantly in extent of age-related cognitive decline, but a three-way interaction among group, age, and practice was found, such that greater age-related decline in practice effects were found for older people with schizophrenia relative to nonpsychiatric participants. This study did not find any evidence of neurodegenerative age-related decline in neuropsychological abilities in middle-aged and older people with schizophrenia, but older age was associated with diminished ability to benefit from repeated exposure to cognitive tasks in people with schizophrenia. Cognitive impairment in schizophrenia may combine with cognitive decline associated with normal aging to reduce practice effects in older patients. These findings have important implications for the design of studies examining the longitudinal trajectory of cognitive functioning across the life span of people with schizophrenia, as well as clinical trials that attempt to demonstrate cognitive enhancement in these individuals. Copyright 2010 APA, all rights reserved.

Conceptualizing clinical nurse leader practice: an interpretive synthesis.

Science.gov (United States)

Bender, Miriam

2016-01-01

The Institute of Medicine's Future of Nursing report identifies the clinical nurse leader as an innovative new role for meeting higher health-care quality standards. However, specific clinical nurse leader practices influencing documented quality outcomes remain unclear. Lack of practice clarity limits the ability to articulate, implement and measure clinical nurse leader-specific practice and quality outcomes. Interpretive synthesis design and grounded theory analysis were used to develop a theoretical understanding of clinical nurse leader practice that can facilitate systematic and replicable implementation across health-care settings. The core phenomenon of clinical nurse leader practice is continuous clinical leadership, which involves four fundamental activities: facilitating effective ongoing communication; strengthening intra and interprofessional relationships; building and sustaining teams; and supporting staff engagement. Clinical nurse leaders continuously communicate and develop relationships within and across professions to promote and sustain information exchange, engagement, teamwork and effective care processes at the microsystem level. Clinical nurse leader-integrated care delivery systems highlight the benefits of nurse-led models of care for transforming health-care quality. Managers can use this study's findings to frame an implementation strategy that addresses theoretical domains of clinical nurse leader practice to help ensure practice success. © 2015 John Wiley & Sons Ltd.

Novel Harmful Recessive Haplotypes Identified for Fertility Traits in Nordic Holstein Cattle

Science.gov (United States)

Sahana, Goutam; Nielsen, Ulrik Sander; Aamand, Gert Pedersen; Lund, Mogens Sandø; Guldbrandtsen, Bernt

2013-01-01

Using genomic data, lethal recessives may be discovered from haplotypes that are common in the population but never occur in the homozygote state in live animals. This approach only requires genotype data from phenotypically normal (i.e. live) individuals and not from the affected embryos that die. A total of 7,937 Nordic Holstein animals were genotyped with BovineSNP50 BeadChip and haplotypes including 25 consecutive markers were constructed and tested for absence of homozygotes states. We have identified 17 homozygote deficient haplotypes which could be loosely clustered into eight genomic regions harboring possible recessive lethal alleles. Effects of the identified haplotypes were estimated on two fertility traits: non-return rates and calving interval. Out of the eight identified genomic regions, six regions were confirmed as having an effect on fertility. The information can be used to avoid carrier-by-carrier mattings in practical animal breeding. Further, identification of causative genes/polymorphisms responsible for lethal effects will lead to accurate testing of the individuals carrying a lethal allele. PMID:24376603

Recruitment of general practices

DEFF Research Database (Denmark)

Riis, Allan; Jensen, Cathrine Elgaard; Maindal, Helle Terkildsen

2016-01-01

-factors as determinants for successfully recruiting healthcare professionals: relationships, reputation, requirements, rewards, reciprocity, resolution, and respect. Method: This is a process evaluation of the seven R-factors. We applied these factors to guide the design of our recruitment strategy as well as to make......Introduction: Health service research often involves the active participation of healthcare professionals. However, their ability and commitment to research varies. This can cause recruitment difficulties and thereby prolong the study period and inflate budgets. Solberg has identified seven R...... adjustments when recruiting general practices in a guideline implementation study. In the guideline implementation study, we studied the effect of outreach visits, quality reports, and new patient stratification tools for low back pain patients. Results: During a period of 15 months, we recruited 60 practices...

How user-innovators can be identified? Evidence collected from the analysis of practices

Energy Technology Data Exchange (ETDEWEB)

Fursov, K.; Nefedova, A.; Thurner, T

2016-07-01

This paper studies how daily routines around media consumption, internet and technologyusage, product preferences or civic engagement mediate likehood of being a user-innovator. Based on the differences in demographic characteristics of consumers and assimilation by them of certain daily routines we conclude that a deeper analysis of day-to-day activities can help distinguishing user-innovators fron non-innovating peers. It is argued that innovationrelated actions are rooted in learned behaviour, can be observed through the daily routines and tell us more on user-innovation experience. We suggest that no individual practice, but instead sets of practices taken in different economic, social and cultural environments can explain how innovations grow and disseminate through the entire economy. (Author)

A network analysis of the Chinese medicine Lianhua-Qingwen formula to identify its main effective components.

Science.gov (United States)

Wang, Chun-Hua; Zhong, Yi; Zhang, Yan; Liu, Jin-Ping; Wang, Yue-Fei; Jia, Wei-Na; Wang, Guo-Cai; Li, Zheng; Zhu, Yan; Gao, Xiu-Mei

2016-02-01

Chinese medicine is known to treat complex diseases with multiple components and multiple targets. However, the main effective components and their related key targets and functions remain to be identified. Herein, a network analysis method was developed to identify the main effective components and key targets of a Chinese medicine, Lianhua-Qingwen Formula (LQF). The LQF is commonly used for the prevention and treatment of viral influenza in China. It is composed of 11 herbs, gypsum and menthol with 61 compounds being identified in our previous work. In this paper, these 61 candidate compounds were used to find their related targets and construct the predicted-target (PT) network. An influenza-related protein-protein interaction (PPI) network was constructed and integrated with the PT network. Then the compound-effective target (CET) network and compound-ineffective target network (CIT) were extracted, respectively. A novel approach was developed to identify effective components by comparing CET and CIT networks. As a result, 15 main effective components were identified along with 61 corresponding targets. 7 of these main effective components were further experimentally validated to have antivirus efficacy in vitro. The main effective component-target (MECT) network was further constructed with main effective components and their key targets. Gene Ontology (GO) analysis of the MECT network predicted key functions such as NO production being modulated by the LQF. Interestingly, five effective components were experimentally tested and exhibited inhibitory effects on NO production in the LPS induced RAW 264.7 cell. In summary, we have developed a novel approach to identify the main effective components in a Chinese medicine LQF and experimentally validated some of the predictions.

Identifying Strategies Programs Adopt to Meet Healthy Eating and Physical Activity Standards in Afterschool Programs.

Science.gov (United States)

Weaver, Robert G; Moore, Justin B; Turner-McGrievy, Brie; Saunders, Ruth; Beighle, Aaron; Khan, M Mahmud; Chandler, Jessica; Brazendale, Keith; Randell, Allison; Webster, Collin; Beets, Michael W

2017-08-01

The YMCA of USA has adopted Healthy Eating and Physical Activity (HEPA) Standards for its afterschool programs (ASPs). Little is known about strategies YMCA ASPs are implementing to achieve Standards and these strategies' effectiveness. (1) Identify strategies implemented in YMCA ASPs and (2) evaluate the relationship between strategy implementation and meeting Standards. HEPA was measured via accelerometer (moderate-to-vigorous-physical-activity [MVPA]) and direct observation (snacks served) in 20 ASPs. Strategies were identified and mapped onto a capacity building framework ( Strategies To Enhance Practice [STEPs]). Mixed-effects regression estimated increases in HEPA outcomes as implementation increased. Model-implied estimates were calculated for high (i.e., highest implementation score achieved), moderate (median implementation score across programs), and low (lowest implementation score achieved) implementation for both HEPA separately. Programs implemented a variety of strategies identified in STEPs. For every 1-point increase in implementation score 1.45% (95% confidence interval = 0.33% to 2.55%, p ≤ .001) more girls accumulated 30 min/day of MVPA and fruits and/or vegetables were served on 0.11 more days (95% confidence interval = 0.11-0.45, p ≤ .01). Relationships between implementation and other HEPA outcomes did not reach statistical significance. Still regression estimates indicated that desserts are served on 1.94 fewer days (i.e., 0.40 vs. 2.34) in the highest implementing program than the lowest implementing program and water is served 0.73 more days (i.e., 2.37 vs. 1.64). Adopting HEPA Standards at the national level does not lead to changes in routine practice in all programs. Practical strategies that programs could adopt to more fully comply with the HEPA Standards are identified.

Leadership theory in clinical practice

OpenAIRE

Jie-Hui Xu

2017-01-01

In current clinical settings, effective clinical leadership ensures a high-quality health care system that consistently provides safe and efficient care. It is useful, then, for health care professionals to be able to identify the leadership styles and theories relevant to their nursing practice. Being adept in recognizing these styles not only enables nurses to develop their skills to become better leaders but also improves relationships with colleagues and leaders who have previously been c...

The effects of biological soil conservation practices and community perception toward these practices in the Lemo District of Southern Ethiopia

Directory of Open Access Journals (Sweden)

Tamrat Sinore

2018-06-01

Full Text Available Land degradation is the critical ecological and agricultural challenges in Ethiopia. To combat this, the government and local farmers’ have undertaken soil and water conservation measures (physical, biological and integrated across the country since 1970's. This study investigate effect of elephant grass (P. purpureum and sesbania sesban (S. sesban used as biological land rehabilitation practices on soil properties and farmers’ perception on the practices. Composite soil samples (0–30 cm were randomly collected from lands treated with sesbania, elephant grass, and adjacent degraded grazing land, and a structured questionnaire was used to assess farmers’ perceptions. Statistical results showed that elephant grass and sesbania were significantly (P < .05 improves degraded land soil bulk density, pH, CEC, OC, TN, Av.P, K, Na, Ca, Mg and clay characteristics. Moreover, there was a significant (P < .05 difference between farmers’ perception of the effectiveness of physical, biological and integration of the two practices to control soil erosion. 48% of the farmers perceived that using both biological methods and the integration of biological with physical structures was more successful for controlling erosion and improving soil fertility. Logistic regression analysis revealed strong association (R2 = 0.84 between farmers’ perception on elephant grass and sesbanias' roles in soil conservation and groups of explanatory variables. Among the variables age, education and extension service significantly (P < .05 influenced farmers’ perception on the practices. Generally, elephant grass and sesbania are effective biological practices for rehabilitating lands and improving soil properties through minimizing erosion. Keywords: Soil erosion, Soil and water conservation, Biological soil conservation, Sesbania, Elephant grass

Exploring Gender Roles' Effects of Turkish Women Teachers on Their Teaching Practices

Science.gov (United States)

Sari, Mediha

2012-01-01

The purpose of this study is to investigate how gender roles of women teachers affect their practices in the classrooms. Participants in the study were 75 female teachers working in elementary schools in Adana, Turkey. Findings indicated that gender roles of women teachers have important effects on their educational practices. Women teachers…

A Regional Assessment of the Effects of Conservation Practices on In-stream Water Quality

Science.gov (United States)

Garcia, A. M.; Alexander, R. B.; Arnold, J.; Norfleet, L.; Robertson, D. M.; White, M.

2011-12-01

The Conservation Effects Assessment Program (CEAP), initiated by USDA Natural Resources Conservation Service (NRCS), has the goal of quantifying the environmental benefits of agricultural conservation practices. As part of this effort, detailed farmer surveys were compiled to document the adoption of conservation practices. Survey data showed that up to 38 percent of cropland in the Upper Mississippi River basin is managed to reduce sediment, nutrient and pesticide loads from agricultural activities. The broader effects of these practices on downstream water quality are challenging to quantify. The USDA-NRCS recently reported results of a study that combined farmer surveys with process-based models to deduce the effect of conservation practices on sediment and chemical loads in farm runoff and downstream waters. As a follow-up collaboration, USGS and USDA scientists conducted a semi-empirical assessment of the same suite of practices using the USGS SPARROW (SPAtially Referenced Regression On Watershed attributes) modeling framework. SPARROW is a hybrid statistical and mechanistic stream water quality model of annual conditions that has been used extensively in studies of nutrient sources and delivery. In this assessment, the USDA simulations of the effects of conservation practices on loads in farm runoff were used as an explanatory variable (i.e., change in farm loads per unit area) in a component of an existing a SPARROW model of the Upper Midwest. The model was then re-calibrated and tested to determine whether the USDA estimate of conservation adoption intensity explained a statistically significant proportion of the spatial variability in stream nutrient loads in the Upper Mississippi River basin. The results showed that the suite of conservation practices that NRCS has catalogued as complete nutrient and sediment management are a statistically significant feature in the Midwestern landscape associated with phosphorous runoff and delivery to downstream waters

Future Directions of Evidence-Based Practice in Athletic Training: Perceived Strategies to Enhance the Use of Evidence-Based Practice

Science.gov (United States)

Welch, Cailee E.; Hankemeier, Dorice A.; Wyant, Aimee L.; Hays, Danica G.; Pitney, William A.; Van Lunen, Bonnie L.

2014-01-01

Context: The shift to a culture of evidence-based practice (EBP) in athletic training is a necessary step in both the optimization of patient care and the advancement of athletic trainers (ATs) as health care professionals. Whereas individuals have gained knowledge in this area, most ATs still are not practicing in an evidence-based manner. Exploring perceived strategies to enhance the use of EBP will help to determine the best approaches to assist ATs in applying EBP concepts to practice to improve patient care. Objective: To explore beneficial strategies and techniques ATs perceived would promote successful implementation of EBP within athletic training education and clinical practice. Design: Qualitative study. Setting: Individual telephone interviews. Patients or Other Participants: Twenty-five ATs (12 educators, 13 clinicians; athletic training experience = 16.00 ± 9.41 years) were interviewed. Data Collection and Analysis: One phone interview was conducted with each participant. After the interview was transcribed, the data were analyzed and coded into common themes and categories. Triangulation of the data occurred via the use of multiple researchers and member checking to confirm the accuracy of the data. Results: Participants identified several components they perceived as essential for enhancing the use of EBP within the athletic training profession. These components included the need for more EBP resources, more processed information, focused workshops, peer discussion and mentorship, and continual repetition and exposure. Participants also indicated that ATs need to accept their professional responsibilities to foster EBP in their daily practices. Conclusions: The proper shift to a culture of EBP in athletic training will take both time and a persistent commitment by ATs to create strategies that will enhance the implementation of EBP across the profession. Researchers should focus on continuing to identify effective educational interventions for ATs

Knowledge, compliance with good clinical practices and barriers to effective control of postoperative pain among nurses from hospitals with and without a "Hospital without Pain" certificate.

Science.gov (United States)

Tomaszek, Lucyna; Dębska, Grażyna

2018-04-01

(i) To compare knowledge and compliance with good clinical practices regarding control of postoperative pain among nurses employed at hospitals with and without a "Hospital without Pain" certificate, (ii) to identify the determinants of nurses' knowledge and (iii) to define barriers to effective control of postoperative pain. Only a slight improvement in postoperative pain control has been observed recently, if any. Implementation of good clinical practices in the control of postoperative pain requires involvement of nurses. A cross-sectional study. The study included 257 nurses from hospitals with a "Hospital without Pain" certificate and 243 nurses from noncertified hospitals, with mean job seniority of 17.6 ± 9.6 years. All respondents answered 26 questions regarding postoperative pain control-related issues. Based on the answers, overall scores were calculated for (i) nurses' knowledge, (ii) compliance with good clinical practices and (iii) barriers to effective control of postoperative pain. Nurses from the certified hospitals presented with significantly higher levels of knowledge and compliance with good clinical practices and identified significantly more barriers to effective control of postoperative pain. Apart from certification of a hospital, better knowledge of postoperative pain control was determined by higher education, participation in postgraduate training programmes and other relevant courses, self-education from medical journals, employment at paediatric ward or intensive care unit. The most commonly reported barriers to effective control of pain included too low doses of painkillers prescribed by physicians and inability to modify the protocol of pain treatment by the nurse. Control of postoperative pain can be improved by enrolling nurses in various forms of continuous training and by providing them with greater autonomy in administering painkillers to surgical patients. Better quality of care offered to patients with postoperative pain

Use of clinical practice guidelines to promote best practice when managing clinical interventions for liver transplant candidates.

Science.gov (United States)

Jarrett, Maree

2009-06-01

Limited organ availability and an increasing demand for organ transplantation has extended transplant waiting times and thus increased morbidity and mortality for potential recipients on waiting lists. The Queensland Liver Transplant Service identified use of clinical practice guidelines developed from evidence-based practice as a strategic clinical management/workflow tool that could improve clinical outcomes for patients awaiting liver transplant. An extensive review of publications related to the management of advanced liver disease in potential transplant recipients was undertaken and the supporting evidence was identified. In all stages of development of the guidelines, the multidisciplinary collaborative team of clinicians used recommended principles from The Appraisal of Guidelines, Research and Evaluation collaboration. The liver transplant recipient coordinator acted as facilitator for the project, identifying positive factors and resolving obstacles. Key focus areas in optimizing medical management before liver transplant were identified with the aim of preventing disease progression and complications that would jeopardize patients' outcome. Clinical practice guidelines were developed for each key area to optimize care by promoting appropriate timing of clinical interventions. Practices that required change to comply with identified best practice were investigated, and clinical practice for the outpatient medical management of potential liver transplant recipients with chronic liver disease were developed collaboratively. These guidelines have been accepted and are being implemented within the gastroenterology and hepatology department at the Princess Alexandra Hospital.

Practice-level quality improvement interventions in primary care: a review of systematic reviews.

Science.gov (United States)

Irwin, Ryan; Stokes, Tim; Marshall, Tom

2015-11-01

To present an overview of effective interventions for quality improvement in primary care at the practice level utilising existing systematic reviews. Quality improvement in primary care involves a range of approaches from the system-level to patient-level improvement. One key setting in which quality improvement needs to occur is at the level of the basic unit of primary care--the individual general practice. Therefore, there is a need for practitioners to have access to an overview of the effectiveness of quality improvement interventions available in this setting. A tertiary evidence synthesis was conducted (a review of systematic reviews). A systematic approach was used to identify and summarise published literature relevant to understanding primary-care quality improvement at the practice level. Quality assessment was via the Critical Appraisal Skills Programme tool for systematic reviews, with data extraction identifying evidence of effect for the examined interventions. Included reviews had to be relevant to quality improvement at the practice level and relevant to the UK primary-care context. Reviews were excluded if describing system-level interventions. A range of measures across care structure, process and outcomes were defined and interpreted across the quality improvement interventions. Audit and feedback, computerised advice, point-of-care reminders, practice facilitation, educational outreach and processes for patient review and follow-up all demonstrated evidence of a quality improvement effect. Evidence of an improvement effect was higher where baseline performance was low and was particularly demonstrated across process measures and measures related to prescribing. Evidence was not sufficient to suggest that multifaceted approaches were more effective than single interventions. Evidence exists for a range of quality improvement interventions at the primary-care practice level. More research is required to determine the use and impact of quality

Identifying and applying psychological theory to setting and achieving rehabilitation goals.

Science.gov (United States)

Scobbie, Lesley; Wyke, Sally; Dixon, Diane

2009-04-01

Goal setting is considered to be a fundamental part of rehabilitation; however, theories of behaviour change relevant to goal-setting practice have not been comprehensively reviewed. (i) To identify and discuss specific theories of behaviour change relevant to goal-setting practice in the rehabilitation setting. (ii) To identify 'candidate' theories that that offer most potential to inform clinical practice. The rehabilitation and self-management literature was systematically searched to identify review papers or empirical studies that proposed a specific theory of behaviour change relevant to setting and/or achieving goals in a clinical context. Data from included papers were extracted under the headings of: key constructs, clinical application and empirical support. Twenty-four papers were included in the review which proposed a total of five theories: (i) social cognitive theory, (ii) goal setting theory, (iii) health action process approach, (iv) proactive coping theory, and (v) the self-regulatory model of illness behaviour. The first three of these theories demonstrated most potential to inform clinical practice, on the basis of their capacity to inform interventions that resulted in improved patient outcomes. Social cognitive theory, goal setting theory and the health action process approach are theories of behaviour change that can inform clinicians in the process of setting and achieving goals in the rehabilitation setting. Overlapping constructs within these theories have been identified, and can be applied in clinical practice through the development and evaluation of a goal-setting practice framework.

A methodology for practical implementation of ICRP recommendations for optimization

International Nuclear Information System (INIS)

Webb, G.A.M.; Clarke, R.H.

1979-01-01

The system of dose limitation recommended by the Commission has been restated in its most recent recommendations with the requirements implying cost benefit analysis elevated to pride of place. The main subject of this paper is discussion of the problems involved in carrying out differential cost benefit analysis (optimization) studies. The various quantities such as Effective Dose Equivalent and Collective Effective Dose Equivalent Commitment needed to carry out these studies are discussed, their strengths and weaknesses identified and suggestions made as to how they should be used in practice. In particular the implications underlying the use of the collective quantities as the independent variable in these studies are clarified and examined. The need for the maximum realism in calculational models and parameters used in the calculation of collective quantities for optimization studies is stressed, with the corollary of conservative calculations for comparison with dose limits. The methods for calculating costs are examined, both for the plant or equipment installed to reduce doses and for the cost associated with the consequent reduction in health detriment. Some practical problems are cited in both the theory and practice of optimization. It is concluded that optimization is not yet sufficiently developed in either basic formalism or practical application. Some areas are identified where further work is needed. (author)

A comparison of statistical methods for identifying out-of-date systematic reviews.

Directory of Open Access Journals (Sweden)

Porjai Pattanittum

Full Text Available BACKGROUND: Systematic reviews (SRs can provide accurate and reliable evidence, typically about the effectiveness of health interventions. Evidence is dynamic, and if SRs are out-of-date this information may not be useful; it may even be harmful. This study aimed to compare five statistical methods to identify out-of-date SRs. METHODS: A retrospective cohort of SRs registered in the Cochrane Pregnancy and Childbirth Group (CPCG, published between 2008 and 2010, were considered for inclusion. For each eligible CPCG review, data were extracted and "3-years previous" meta-analyses were assessed for the need to update, given the data from the most recent 3 years. Each of the five statistical methods was used, with random effects analyses throughout the study. RESULTS: Eighty reviews were included in this study; most were in the area of induction of labour. The numbers of reviews identified as being out-of-date using the Ottawa, recursive cumulative meta-analysis (CMA, and Barrowman methods were 34, 7, and 7 respectively. No reviews were identified as being out-of-date using the simulation-based power method, or the CMA for sufficiency and stability method. The overall agreement among the three discriminating statistical methods was slight (Kappa = 0.14; 95% CI 0.05 to 0.23. The recursive cumulative meta-analysis, Ottawa, and Barrowman methods were practical according to the study criteria. CONCLUSION: Our study shows that three practical statistical methods could be applied to examine the need to update SRs.

A simple method for identifying parameter correlations in partially observed linear dynamic models.

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Li, Pu; Vu, Quoc Dong

2015-12-14

Parameter estimation represents one of the most significant challenges in systems biology. This is because biological models commonly contain a large number of parameters among which there may be functional interrelationships, thus leading to the problem of non-identifiability. Although identifiability analysis has been extensively studied by analytical as well as numerical approaches, systematic methods for remedying practically non-identifiable models have rarely been investigated. We propose a simple method for identifying pairwise correlations and higher order interrelationships of parameters in partially observed linear dynamic models. This is made by derivation of the output sensitivity matrix and analysis of the linear dependencies of its columns. Consequently, analytical relations between the identifiability of the model parameters and the initial conditions as well as the input functions can be achieved. In the case of structural non-identifiability, identifiable combinations can be obtained by solving the resulting homogenous linear equations. In the case of practical non-identifiability, experiment conditions (i.e. initial condition and constant control signals) can be provided which are necessary for remedying the non-identifiability and unique parameter estimation. It is noted that the approach does not consider noisy data. In this way, the practical non-identifiability issue, which is popular for linear biological models, can be remedied. Several linear compartment models including an insulin receptor dynamics model are taken to illustrate the application of the proposed approach. Both structural and practical identifiability of partially observed linear dynamic models can be clarified by the proposed method. The result of this method provides important information for experimental design to remedy the practical non-identifiability if applicable. The derivation of the method is straightforward and thus the algorithm can be easily implemented into a

The Effect of Advanced Management Accounting Practices on the Competitive Strategies and Performance

OpenAIRE

Rahmi Yücel; Kayhan Ahmetoğulları

2015-01-01

This study is based on a sample of 300 managers from the production industry of West Marmara Region. The goal of this study is to examine the interaction among advanced management accounting practices, competitive strategies and company performance. As a result of study, it is found that advanced accounting management practices have a positive effect on the company performance and competitive strategies. In addition, competitive strategies have an effect on the company performance positively....

The effect of production system and management practices on the ...

African Journals Online (AJOL)

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The effect of production system and management practices on the quality of ... contains more yellow pigments, which may affect a consumer's choice to purchase. ... which is better utilized, and much more attention is given to animal ethics, ...

Effective Practices for Online Delivery of Quantitative Business Courses

Science.gov (United States)

Lam, Helen; Khare, Anshuman

2010-01-01

Online delivery of university-level courses has grown exponentially in the last decade and is increasingly being recognised as a viable and effective alternative to face-to-face classroom teaching. Many scholars have already written about the benefits and best practices of online teaching in general. However, not many studies have paid specific…

Process evaluation of a practice nurse-led smoking cessation trial in Australian general practice: views of general practitioners and practice nurses.

Science.gov (United States)

Halcomb, Elizabeth J; Furler, John S; Hermiz, Oshana S; Blackberry, Irene D; Smith, Julie P; Richmond, Robyn L; Zwar, Nicholas A

2015-08-01

Support in primary care can assist smokers to quit successfully, but there are barriers to general practitioners (GPs) providing this support routinely. Practice nurses (PNs) may be able to effectively take on this role. The aim of this study was to perform a process evaluation of a PN-led smoking cessation intervention being tested in a randomized controlled trial in Australian general practice. Process evaluation was conducted by means of semi-structured telephone interviews with GPs and PNs allocated in the intervention arm (Quit with PN) of the Quit in General Practice trial. Interviews focussed on nurse training, content and implementation of the intervention. Twenty-two PNs and 15 GPs participated in the interviews. The Quit with PN intervention was viewed positively. Most PNs were satisfied with the training and the materials provided. Some challenges in managing patient data and follow-up were identified. The Quit with PN intervention was acceptable to participating PNs and GPs. Issues to be addressed in the planning and wider implementation of future trials of nurse-led intervention in general practice include providing ongoing mentoring support, integration into practice management systems and strategies to promote greater collaboration in GPs and PN teams in general practice. The ongoing feasibility of the intervention was impacted by the funding model supporting PN employment and the competing demands on the PNs time. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Identifying Practical Solutions to Meet America’s Fiber Needs: Proceedings from the Food & Fiber Summit

Science.gov (United States)

Mobley, Amy R.; Jones, Julie Miller; Rodriguez, Judith; Slavin, Joanne; Zelman, Kathleen M.

2014-01-01

Fiber continues to be singled out as a nutrient of public health concern. Adequate intakes of fiber are associated with reduced risk for cardiovascular disease, cancer, diabetes, certain gastrointestinal disorders and obesity. Despite ongoing efforts to promote adequate fiber through increased vegetable, fruit and whole-grain intakes, average fiber consumption has remained flat at approximately half of the recommended daily amounts. Research indicates that consumers report increasingly attempting to add fiber-containing foods, but there is confusion around fiber in whole grains. The persistent and alarmingly low intakes of fiber prompted the “Food & Fiber Summit,” which assembled nutrition researchers, educators and communicators to explore fiber’s role in public health, current fiber consumption trends and consumer awareness data with the objective of generating opportunities and solutions to help close the fiber gap. The summit outcomes highlight the need to address consumer confusion and improve the understanding of sources of fiber, to recognize the benefits of various types of fibers and to influence future dietary guidance to provide prominence and clarity around meeting daily fiber recommendations through a variety of foods and fiber types. Potential opportunities to increase fiber intake were identified, with emphasis on meal occasions and food categories that offer practical solutions for closing the fiber gap. PMID:25006857

Identifying Practical Solutions to Meet America’s Fiber Needs: Proceedings from the Food & Fiber Summit

Directory of Open Access Journals (Sweden)

Amy R. Mobley

2014-07-01

Full Text Available Fiber continues to be singled out as a nutrient of public health concern. Adequate intakes of fiber are associated with reduced risk for cardiovascular disease, cancer, diabetes, certain gastrointestinal disorders and obesity. Despite ongoing efforts to promote adequate fiber through increased vegetable, fruit and whole-grain intakes, average fiber consumption has remained flat at approximately half of the recommended daily amounts. Research indicates that consumers report increasingly attempting to add fiber-containing foods, but there is confusion around fiber in whole grains. The persistent and alarmingly low intakes of fiber prompted the “Food & Fiber Summit,” which assembled nutrition researchers, educators and communicators to explore fiber’s role in public health, current fiber consumption trends and consumer awareness data with the objective of generating opportunities and solutions to help close the fiber gap. The summit outcomes highlight the need to address consumer confusion and improve the understanding of sources of fiber, to recognize the benefits of various types of fibers and to influence future dietary guidance to provide prominence and clarity around meeting daily fiber recommendations through a variety of foods and fiber types. Potential opportunities to increase fiber intake were identified, with emphasis on meal occasions and food categories that offer practical solutions for closing the fiber gap.

Identifying an outcome measure to assess the impact of Mobility Dogs.

Science.gov (United States)

Mudge, Suzie; Rewi, Dallas; Channon, Alexis

2017-01-01

Mobility Dogs® trains dogs to work with people with physical disabilities to increase independence, confidence, self-esteem and participation. Mobility Dogs® seeks to critically evaluate and improve its services as it grows. This study aimed to identify and implement a standardised outcome measure into practice at Mobility Dogs®. Based on the Consolidated Framework for Implementation Research and guided by a steering group of key stakeholders, a three-phase approach was developed to identify and assess an outcome measure. The steering group highlighted the organisation's specific needs, selected participation as the assessment domain and identified core utility requirements of the measure. A comprehensive review of evidence was undertaken to identify and rank potential measures according to the specified needs. Of the seven participation outcome measures that met inclusion criteria, the three highest ranked measures were critically evaluated by the steering group to determine suitability against the organisation's needs. The Impact on Participation and Autonomy (IPA) was selected for implementation into practice at Mobility Dogs®. Use of the IPA is an important first step for Mobility Dogs® to test the benefits of trained service dogs. This process could be replicated by other service dog organisations to identify outcome measures to assess their own services. Implications for Rehabilitation Service dogs (such as Mobility Dogs® in New Zealand) assist people living with physical impairments by performing tasks, however there is limited evidence on outcomes. The process for selecting an appropriate outcome measure for Mobility Dogs® involving partnership between Mobility Dogs® personnel and academics was an effective way to steer the project by determining important properties of the measure, before a search of the literature was undertaken. While the IPA was selected as the most appropriate outcome measure for use at Mobility Dogs®, it was the process that

Failure Mode and Effect Analysis (FMEA) may enhance implementation of clinical practice guidelines: An experience from the Middle East.

Science.gov (United States)

Babiker, Amir; Amer, Yasser S; Osman, Mohamed E; Al-Eyadhy, Ayman; Fatani, Solafa; Mohamed, Sarar; Alnemri, Abdulrahman; Titi, Maher A; Shaikh, Farheen; Alswat, Khalid A; Wahabi, Hayfaa A; Al-Ansary, Lubna A

2018-02-01

Implementation of clinical practice guidelines (CPGs) has been shown to reduce variation in practice and improve health care quality and patients' safety. There is a limited experience of CPG implementation (CPGI) in the Middle East. The CPG program in our institution was launched in 2009. The Quality Management department conducted a Failure Mode and Effect Analysis (FMEA) for further improvement of CPGI. This is a prospective study of a qualitative/quantitative design. Our FMEA included (1) process review and recording of the steps and activities of CPGI; (2) hazard analysis by recording activity-related failure modes and their effects, identification of actions required, assigned severity, occurrence, and detection scores for each failure mode and calculated the risk priority number (RPN) by using an online interactive FMEA tool; (3) planning: RPNs were prioritized, recommendations, and further planning for new interventions were identified; and (4) monitoring: after reduction or elimination of the failure mode. The calculated RPN will be compared with subsequent analysis in post-implementation phase. The data were scrutinized from a feedback of quality team members using a FMEA framework to enhance the implementation of 29 adapted CPGs. The identified potential common failure modes with the highest RPN (≥ 80) included awareness/training activities, accessibility of CPGs, fewer advocates from clinical champions, and CPGs auditing. Actions included (1) organizing regular awareness activities, (2) making CPGs printed and electronic copies accessible, (3) encouraging senior practitioners to get involved in CPGI, and (4) enhancing CPGs auditing as part of the quality sustainability plan. In our experience, FMEA could be a useful tool to enhance CPGI. It helped us to identify potential barriers and prepare relevant solutions. © 2017 John Wiley & Sons, Ltd.

Patient satisfaction with ambulatory care in Germany: effects of patient- and medical practice-related factors.

Science.gov (United States)

Auras, Silke; Ostermann, Thomas; de Cruppé, Werner; Bitzer, Eva-Maria; Diel, Franziska; Geraedts, Max

2016-12-01

The study aimed to illustrate the effect of the patients' sex, age, self-rated health and medical practice specialization on patient satisfaction. Secondary analysis of patient survey data using multilevel analysis (generalized linear mixed model, medical practice as random effect) using a sequential modelling strategy. We examined the effects of the patients' sex, age, self-rated health and medical practice specialization on four patient satisfaction dimensions: medical practice organization, information, interaction, professional competence. The study was performed in 92 German medical practices providing ambulatory care in general medicine, internal medicine or gynaecology. In total, 9888 adult patients participated in a patient survey using the validated 'questionnaire on satisfaction with ambulatory care-quality from the patient perspective [ZAP]'. We calculated four models for each satisfaction dimension, revealing regression coefficients with 95% confidence intervals (CIs) for all independent variables, and using Wald Chi-Square statistic for each modelling step (model validity) and LR-Tests to compare the models of each step with the previous model. The patients' sex and age had a weak effect (maximum regression coefficient 1.09, CI 0.39; 1.80), and the patients' self-rated health had the strongest positive effect (maximum regression coefficient 7.66, CI 6.69; 8.63) on satisfaction ratings. The effect of medical practice specialization was heterogeneous. All factors studied, specifically the patients' self-rated health, affected patient satisfaction. Adjustment should always be considered because it improves the comparability of patient satisfaction in medical practices with atypically varying patient populations and increases the acceptance of comparisons. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Traditional and Local Knowledge Practices for Disaster Risk Reduction in Northern Ghana

Directory of Open Access Journals (Sweden)

Nsioh Macnight Ngwese

2018-03-01

Full Text Available In order to deal with recurrent disasters, like floods and droughts coupled with the limited adaptive capacity, in the semiarid regions of Northern Ghana, local communities have no choice but to apply traditional and local knowledge practices. This study seeks to identify such practices employed in selected rural communities in Northern Ghana and to investigate their effectiveness. Data were collected through key informant interviews, household questionnaire surveys, focus group discussions, and participant observations. The findings indicated that although diverse practices were applied to predict and manage local disaster events, skepticism prevailed among locals toward these practices regarding their effectiveness. Due to the lack of science-based tools and systems for disaster prediction and management, local communities continually depended on these knowledge systems and practices. Integrating local and traditional disaster risk reduction (DRR efforts into modern scientific knowledge should be encouraged in order to reduce the vulnerability of local communities to disasters with thorough effectiveness evaluation protocols.

Practices That Promote English Reading for English Learners (Els)

Science.gov (United States)

Martínez, Rebecca S.; Harris, Bryn; McClain, Maryellen Brunson

2014-01-01

Schools are becoming increasingly diversified; however, training and professional development related to working with English language learners (ELs), especially in the area of English reading, is limited. In this article, we identify three "Big Ideas" of effective and collaborative practices that promote English reading achievement for…

Test-Retest Reliability and Practice Effects of the Stability Evaluation Test.

Science.gov (United States)

Williams, Richelle M; Corvo, Matthew A; Lam, Kenneth C; Williams, Travis A; Gilmer, Lesley K; McLeod, Tamara C Valovich

2017-01-17

Postural control plays an essential role in concussion evaluation. The Stability Evaluation Test (SET) aims to objectively analyze postural control by measuring sway velocity on the NeuroCom's VSR portable force platform (Natus, San Carlos, CA). To assess the test-retest reliability and practice effects of the SET protocol. Cohort. Research Laboratory. Fifty healthy adults (males=20, females=30, age=25.30±3.60 years, height=166.60±12.80 cm, mass=68.80±13.90 kg). All participants completed four trials of the SET. Each trial consisted of six 20-second balance tests with eyes closed, under the following conditions: double-leg firm (DFi), single-leg firm (SFi), tandem firm (TFi), double-leg foam (DFo), single-leg foam (SFo), and tandem foam (TFo). Each trial was separated by a 5-minute seated rest period. The dependent variable was sway velocity (deg/sec), with lower values indicating better balance. Sway velocity was recorded for each of the six conditions as well as a composite score for each trial. Test-retest reliability was analyzed across four trials with Intraclass Correlation Coefficients. Practice effects analyzed with repeated measures analysis of variance, followed by Tukey post-hoc comparisons for any significant main effects (preliability values were good to excellent: DFi (ICC=0.88;95%CI:0.81,0.92), SFi (ICC=0.75;95%CI:0.61,0.85), TFi (ICC=0.84;95%CI:0.75,0.90), DFo (ICC=0.83;95%CI:0.74,0.90), SFo (ICC=0.82;95%CI:0.72,0.89), TFo (ICC=0.81;95%CI:0.69,0.88), and composite score (ICC=0.93;95%CI:0.88,0.95). Significant practice effects (preliability for the assessment of postural control in healthy adults. Due to the practice effects noted, a familiarization session is recommended (i.e., all 6 conditions) prior to recording the data. Future studies should evaluate injured patients to determine meaningful change scores during various injuries.

Redesigning Health Care Practices to Address Childhood Poverty.

Science.gov (United States)

Fierman, Arthur H; Beck, Andrew F; Chung, Esther K; Tschudy, Megan M; Coker, Tumaini R; Mistry, Kamila B; Siegel, Benjamin; Chamberlain, Lisa J; Conroy, Kathleen; Federico, Steven G; Flanagan, Patricia J; Garg, Arvin; Gitterman, Benjamin A; Grace, Aimee M; Gross, Rachel S; Hole, Michael K; Klass, Perri; Kraft, Colleen; Kuo, Alice; Lewis, Gena; Lobach, Katherine S; Long, Dayna; Ma, Christine T; Messito, Mary; Navsaria, Dipesh; Northrip, Kimberley R; Osman, Cynthia; Sadof, Matthew D; Schickedanz, Adam B; Cox, Joanne

2016-04-01

Child poverty in the United States is widespread and has serious negative effects on the health and well-being of children throughout their life course. Child health providers are considering ways to redesign their practices in order to mitigate the negative effects of poverty on children and support the efforts of families to lift themselves out of poverty. To do so, practices need to adopt effective methods to identify poverty-related social determinants of health and provide effective interventions to address them. Identification of needs can be accomplished with a variety of established screening tools. Interventions may include resource directories, best maintained in collaboration with local/regional public health, community, and/or professional organizations; programs embedded in the practice (eg, Reach Out and Read, Healthy Steps for Young Children, Medical-Legal Partnership, Health Leads); and collaboration with home visiting programs. Changes to health care financing are needed to support the delivery of these enhanced services, and active advocacy by child health providers continues to be important in effecting change. We highlight the ongoing work of the Health Care Delivery Subcommittee of the Academic Pediatric Association Task Force on Child Poverty in defining the ways in which child health care practice can be adapted to improve the approach to addressing child poverty. Copyright © 2016 Academic Pediatric Association. All rights reserved.

The effect of production system and management practices on the ...

African Journals Online (AJOL)

The effect of production system and management practices on the environmental impact, quality and safety of milk and dairy products. ... that are important during the production of processed dairy foods such as cheese or yoghurt. There is no ...

Effect of practicing yoga on cervical vestibular evoked myogenic potential.

Science.gov (United States)

Shambhu, Tejaswini; Kumar, Shubhaganga Dhrruva; Prabhu, Prashanth

2017-10-01

The present study attempted to determine the effect of practicing yoga on functioning of sacculo-collic pathway using cervical vestibular evoked myogenic potential (cVEMP). cVEMP was recorded from 40 participants (20 who practice yoga regularly and 20 who do not practice yoga regularly). The differences in amplitude of P1, N1, P1-N1 complex, asymmetry ratio and latencies of P1 and N1 of cVEMP were compared between both the groups. The results of the study showed that there was a significant increase (p yoga was significantly lower (Mean = 6.73) compared to the control group (Mean = 19.13). Multivariate regression analyses suggested that the number of years of yoga practice significantly predicted the amplitude of P1-N1 complex (β = 0.70, p yoga improves postural control and strengthens the muscles and vestibular system leading to enhanced cVEMP responses. The plastic changes in the vestibular system and increased muscular strength because of constant practicing of yoga could have led to changes in cVEMP responses. However, further studies on a larger group of individuals are essential for better clinical applicability of the results.

Perspectives from practice: complexities of personal care workers.

Science.gov (United States)

Martyn, Julie-Anne; Zanella, Sally; Wilkinson, Adele

2017-11-14

Personal care workers (PCWs) make up the bulk of the workforce in residential and community care services. The knowledge and skill set needed for safe and effective practice in care settings is extensive. A diverse range of registered training organisations (RTOs) offering Certificate III and IV in Individual Support (aging, home and community) are tasked with producing job-ready PCWs. However, the curricula of these programs vary. Additionally, a national code of conduct for healthcare workers became effective in October 2015 as a governance framework for PCWs. The language of the code statements is ambiguous making it unclear how this framework should be translated by RTOs and applied in the preservice practice preparation of PCWs. Employers of PCWs need to feel confident that the content of the preservice education of PCWs satisfactorily prepares them for the diverse contexts of their practice. Likewise, the health professionals who supervise PCWs must be assured about the knowledge and skills of the PCW if they are to safely delegate care activities. The perspectives presented in this discussion make it clear that investigation into the nebulous nature of PCW education, regulation and practice is needed to identify the shortcomings and enable improved practice.

Are adverse effects incorporated in economic models? An initial review of current practice.

Science.gov (United States)

Craig, D; McDaid, C; Fonseca, T; Stock, C; Duffy, S; Woolacott, N

2009-12-01

To identify methodological research on the incorporation of adverse effects in economic models and to review current practice. Major electronic databases (Cochrane Methodology Register, Health Economic Evaluations Database, NHS Economic Evaluation Database, EconLit, EMBASE, Health Management Information Consortium, IDEAS, MEDLINE and Science Citation Index) were searched from inception to September 2007. Health technology assessment (HTA) reports commissioned by the National Institute for Health Research (NIHR) HTA programme and published between 2004 and 2007 were also reviewed. The reviews of methodological research on the inclusion of adverse effects in decision models and of current practice were carried out according to standard methods. Data were summarised in a narrative synthesis. Of the 719 potentially relevant references in the methodological research review, five met the inclusion criteria; however, they contained little information of direct relevance to the incorporation of adverse effects in models. Of the 194 HTA monographs published from 2004 to 2007, 80 were reviewed, covering a range of research and therapeutic areas. In total, 85% of the reports included adverse effects in the clinical effectiveness review and 54% of the decision models included adverse effects in the model; 49% included adverse effects in the clinical review and model. The link between adverse effects in the clinical review and model was generally weak; only 3/80 (manipulation. Of the models including adverse effects, 67% used a clinical adverse effects parameter, 79% used a cost of adverse effects parameter, 86% used one of these and 60% used both. Most models (83%) used utilities, but only two (2.5%) used solely utilities to incorporate adverse effects and were explicit that the utility captured relevant adverse effects; 53% of those models that included utilities derived them from patients on treatment and could therefore be interpreted as capturing adverse effects. In total

Defense programs business practices re-engineering QFD exercise

International Nuclear Information System (INIS)

Murray, C.; Halbleib, L.

1996-03-01

The end of the cold war has resulted in many changes for the Nuclear Weapons Complex (NWC). We now work in a smaller complex, with reduced resources, a smaller stockpile, and no new phase 3 weapons development programs. This new environment demands that we re-evaluate the way we design and produce nuclear weapons. The Defense Program (DP) Business Practices Re-engineering activity was initiated to improve the design and production efficiency of the DP Sector. The activity had six goals: (1) to identify DP business practices that are exercised by the Product Realization Process (PRP); (2) to determine the impact (positive, negative, or none) of these practices on defined, prioritized customer criteria; (3) to identify business practices that are candidates for elimination or re-engineering; (4) to select two or three business practices for re-engineering; (5) to re-engineer the selected business practices; and (6) to exercise the re-engineered practices on three pilot development projects. Business practices include technical and well as administrative procedures that are exercised by the PRP. A QFD exercise was performed to address (1)-(4). The customer that identified, defined, and prioritized the criteria to rate the business practices was the Block Change Advisory Group. Five criteria were identified: cycle time, flexibility, cost, product performance/quality, and best practices. Forty-nine business practices were identified and rated per the criteria. From this analysis, the group made preliminary recommendations as to which practices would be addressed in the re-engineering activity. Sixteen practices will be addressed in the re-engineering activity. These practices will then be piloted on three projects: (1) the Electronic Component Assembly (ECA)/Radar Project, (2) the B61 Mod 11, and (3) Warhead Protection Program (WPP)

Ex vivo analysis identifies effective HIV-1 latency–reversing drug combinations

Science.gov (United States)

Laird, Gregory M.; Bullen, C. Korin; Rosenbloom, Daniel I.S.; Martin, Alyssa R.; Hill, Alison L.; Durand, Christine M.; Siliciano, Janet D.; Siliciano, Robert F.

2015-01-01

Reversal of HIV-1 latency by small molecules is a potential cure strategy. This approach will likely require effective drug combinations to achieve high levels of latency reversal. Using resting CD4+ T cells (rCD4s) from infected individuals, we developed an experimental and theoretical framework to identify effective latency-reversing agent (LRA) combinations. Utilizing ex vivo assays for intracellular HIV-1 mRNA and virion production, we compared 2-drug combinations of leading candidate LRAs and identified multiple combinations that effectively reverse latency. We showed that protein kinase C agonists in combination with bromodomain inhibitor JQ1 or histone deacetylase inhibitors robustly induce HIV-1 transcription and virus production when directly compared with maximum reactivation by T cell activation. Using the Bliss independence model to quantitate combined drug effects, we demonstrated that these combinations synergize to induce HIV-1 transcription. This robust latency reversal occurred without release of proinflammatory cytokines by rCD4s. To extend the clinical utility of our findings, we applied a mathematical model that estimates in vivo changes in plasma HIV-1 RNA from ex vivo measurements of virus production. Our study reconciles diverse findings from previous studies, establishes a quantitative experimental approach to evaluate combinatorial LRA efficacy, and presents a model to predict in vivo responses to LRAs. PMID:25822022

Measuring treatment effects on dual-task performance: a framework for research and clinical practice

Directory of Open Access Journals (Sweden)

Prudence ePlummer

2015-04-01

Full Text Available The relevance of dual-task walking to everyday ambulation is widely acknowledged, and numerous studies have demonstrated that dual-task interference can significantly impact recovery of functional walking in people with neurological disorders. The magnitude and direction of dual-task interference is influenced by the interaction between the two tasks, including how individuals spontaneously prioritize their attention. Therefore, to accurately interpret and characterize dual-task interference and identify changes over time, it is imperative to evaluate single and dual-task performance in both tasks, as well as the tasks relative to each other. Yet, reciprocal dual-task effects are frequently ignored. The purpose of this perspective paper is to present a framework for measuring treatment effects on dual-task interference, specifically taking into account the interactions between the two tasks and how this can provide information on whether overall dual-task capacity has improved or a different attentional strategy has been adopted. In discussing the clinical implications of using this framework, we provide specific examples of using this method and provide some explicit recommendations for research and clinical practice.

TRACKING FARM MANAGEMENT PRACTICES WITH REMOTE SENSING

Directory of Open Access Journals (Sweden)

J. P. Stals

2017-11-01

Full Text Available Earth observation (EO data is effective in monitoring agricultural cropping activity over large areas. An example of such an application is the GeoTerraImage crop type classification for the South African Crop Estimates Committee (CEC. The satellite based classification of crop types in South Africa provides a large scale, spatial and historical record of agricultural practices in the main crop growing areas. The results from these classifications provides data for the analysis of trends over time, in order to extract valuable information that can aid decision making in the agricultural sector. Crop cultivation practices change over time as farmers adapt to demand, exchange rate and new technology. Through the use of remote sensing, grain crop types have been identified at field level since 2008, providing a historical data set of cropping activity for the three most important grain producing provinces of Mpumalanga, Freestate and North West province in South Africa. This historical information allows the analysis of farm management practices to identify changes and trends in crop rotation and irrigation practices. Analysis of crop type classification over time highlighted practices such as: frequency of cultivation of the same crop on a field, intensified cultivation on centre pivot irrigated fields with double cropping of a winter grain followed by a summer grain in the same year and increasing cultivation of certain types of crops over time such as soyabeans. All these practices can be analysed in a quantitative spatial and temporal manner through the use of the remote sensing based crop type classifications.

Patient education about cough: effect on the consulting behaviour of general practice patients.

Science.gov (United States)

Rutten, G; Van Eijk, J; Beek, M; Van der Velden, H

1991-07-01

The aim of this general practice study was to examine how the consulting behaviour of patients with a cough was affected when the tasks and responsibilities of patients, practice nurses and general practitioners were reorganized. In four 'average' single-handed general practices the effects on the consulting behaviour of patients of a rational practice policy on cough and the provision of systematic patient education on cough were compared with patient behaviour in four matched control practices. Changes of behaviour were measured in 548 patients who consulted for cough at least twice, in two successive autumn-winter periods. Significantly more patients in the experimental practice changed their behaviour to follow the practice guidelines than did patients in the control practices (56% versus 30%, P less than 0.001). The proportion of patients who continued to consult in the approved manner was greater among patients receiving intervention (66% versus 29%, P less than 0.001). This was equally true for patients who had suffered less than four episodes of cough or more than four episodes. The more often the patients received the education, the more effective it was. All patients who consulted the general practitioner for cough during the first autumn-winter period filled in a cough diary during the second period. From this it appeared that the intervention did not result in patients delaying consultation when they had a cough lasting longer than three weeks or one with 'serious' symptoms. It would appear that a rational practice policy and the provision of patient education can stimulate patients to modify their consulting behaviour. This could result in a reduction in the costs of health care.

Practice Location Characteristics of Non-Traditional Dental Practices.

Science.gov (United States)

Solomon, Eric S; Jones, Daniel L

2016-04-01

Current and future dental school graduates are increasingly likely to choose a non-traditional dental practice-a group practice managed by a dental service organization or a corporate practice with employed dentists-for their initial practice experience. In addition, the growth of non-traditional practices, which are located primarily in major urban areas, could accelerate the movement of dentists to those areas and contribute to geographic disparities in the distribution of dental services. To help the profession understand the implications of these developments, the aim of this study was to compare the location characteristics of non-traditional practices and traditional dental practices. After identifying non-traditional practices across the United States, the authors located those practices and traditional dental practices geographically by zip code. Non-traditional dental practices were found to represent about 3.1% of all dental practices, but they had a greater impact on the marketplace with almost twice the average number of staff and annual revenue. Virtually all non-traditional dental practices were located in zip codes that also had a traditional dental practice. Zip codes with non-traditional practices had significant differences from zip codes with only a traditional dental practice: the populations in areas with non-traditional practices had higher income levels and higher education and were slightly younger and proportionally more Hispanic; those practices also had a much higher likelihood of being located in a major metropolitan area. Dental educators and leaders need to understand the impact of these trends in the practice environment in order to both prepare graduates for practice and make decisions about planning for the workforce of the future.

Effects of RN Age and Experience on Transformational Leadership Practices.

Science.gov (United States)

Herman, Susan; Gish, Mary; Rosenblum, Ruth; Herman, Michael

2017-06-01

This study reported the evolution of transformational leadership (TL) practices and behaviors across years of age, management experience, and professional nursing practice within a professional nursing leadership organization. Recent studies of CNO TL found valuations peak near age 60 years. This study reported on a wider range of management positions, correlating years of RN practice and management experience and age to TL metrics. This study used Kouzes and Posner's Leadership Practices Inventory-Self-Assessment (LPI-S) to survey a nursing leadership organization, the Association of California Nurse Leaders (ACNL). Anonymous responses were analyzed to identify leadership trends in age and years of professional service. On average, LPI-S metrics of leadership skills advance through years of management, RN experience, and age. The TL scores are statistically higher in most LPI-S categories for those with more than 30 years of RN or management experience. Decade-averaged LPI-S TL metrics in the ACNL survey evolve linearly throughout age before peaking in the decade from age 60 to 69 years. A similar evolution of TL metrics is seen in decades of either years of management experience or years of RN experience. Transformational leadership increased with nursing maturity particularly for LPI-S categories of "inspire a shared vision," "challenge the process," and "enable others to act." In the ACNL population studied, decade-averaged leadership metrics advanced. Leadership evolution with age in the broader RN population peaked in age bracket 60 to 69 years. The LPI-S averages declined when older than 70 years, coinciding with a shift from full-time work toward retirement and part-time employment.

The Effects of Practice-Based Training on Graduate Teaching Assistants’ Classroom Practices

Science.gov (United States)

Becker, Erin A.; Easlon, Erin J.; Potter, Sarah C.; Guzman-Alvarez, Alberto; Spear, Jensen M.; Facciotti, Marc T.; Igo, Michele M.; Singer, Mitchell; Pagliarulo, Christopher

2017-01-01

Evidence-based teaching is a highly complex skill, requiring repeated cycles of deliberate practice and feedback to master. Despite existing well-characterized frameworks for practice-based training in K–12 teacher education, the major principles of these frameworks have not yet been transferred to instructor development in higher educational contexts, including training of graduate teaching assistants (GTAs). We sought to determine whether a practice-based training program could help GTAs learn and use evidence-based teaching methods in their classrooms. We implemented a weekly training program for introductory biology GTAs that included structured drills of techniques selected to enhance student practice, logic development, and accountability and reduce apprehension. These elements were selected based on their previous characterization as dimensions of active learning. GTAs received regular performance feedback based on classroom observations. To quantify use of target techniques and levels of student participation, we collected and coded 160 h of video footage. We investigated the relationship between frequency of GTA implementation of target techniques and student exam scores; however, we observed no significant relationship. Although GTAs adopted and used many of the target techniques with high frequency, techniques that enforced student participation were not stably adopted, and their use was unresponsive to formal feedback. We also found that techniques discussed in training, but not practiced, were not used at quantifiable frequencies, further supporting the importance of practice-based training for influencing instructional practices. PMID:29146664

International Good Practice on Practical Implementation of Characterisation in Decommissioning. Radiological Characterization in Decommissioning of Nuclear Facilities: International Good Practice on Practical Implementation

International Nuclear Information System (INIS)

Larsson, A.; Empdage, M.; Weber, I.; )

2017-01-01

Within the Nuclear Energy Agency (NEA), the Working Party on Decommissioning and Dismantling (WPDD) operates under the umbrella of the Radioactive Waste Management Committee (RWMC). The WPDD provides a focus for the analysis of decommissioning policy, strategy and regulation, including the related issues of waste management, release of buildings and sites from regulatory control and associated cost estimation and funding. WPDD also convenes task groups comprised of experts from the NEA member countries to review related topics such as characterisation techniques which support decommissioning and associated waste management. The Task Group on Radiological Characterisation and Decommissioning was established in 2011 to identify and present characterisation good practice at different stages of decommissioning and to identify areas that could, or should, be developed further through international cooperation and coordination. By the end of 2016 two phases of work will be complete. The first phase developed strategic guidance for decision makers on the selection and tailoring of strategies for radiological characterisation, which gives an overview of good practice for radiological characterisation at different phases of the life cycle of a nuclear installation. The second phase has focused on strategies for practical implementation of radiological characterisation from a waste and materials end-state perspective. This paper provides a summary of the phase 2 findings, covering: -) a major international survey (questionnaire) to elicit the views of characterisation experts regarding good practice; -) Learning drawn from recent international case studies; -) The collation and analysis of regulations, standards and guidance documents; -) Learning distilled from an international conference on characterisation co-organised by the task group; and -) Overall conclusions regarding characterisation good practice, recommendations and identified areas for further international

Measuring the Physical Activity Practices Used by Parents of Preschool Children

OpenAIRE

Vaughn, Amber; Hales, Derek; Ward, Dianne S.

2013-01-01

Parents play a critical role in shaping children’s attitudes, beliefs and behaviors, including those around physical activity and inactivity. Our ability to identify which practices effectively promote children’s physical activity and limit inactivity is limited by existing measurement instruments. This project will present a newly developed physical activity parenting practices survey, the psychometric properties of this survey’s scales, and their association with child physical activity and...

Sustainability in Health care by Allocating Resources Effectively (SHARE) 2: identifying opportunities for disinvestment in a local healthcare setting.

Science.gov (United States)

Harris, Claire; Allen, Kelly; King, Richard; Ramsey, Wayne; Kelly, Cate; Thiagarajan, Malar

2017-05-05

This is the second in a series of papers reporting a program of Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. Rising healthcare costs, continuing advances in health technologies and recognition of ineffective practices and systematic waste are driving disinvestment of health technologies and clinical practices that offer little or no benefit in order to maximise outcomes from existing resources. However there is little information to guide regional health services or individual facilities in how they might approach disinvestment locally. This paper outlines the investigation of potential settings and methods for decision-making about disinvestment in the context of an Australian health service. Methods include a literature review on the concepts and terminology relating to disinvestment, a survey of national and international researchers, and interviews and workshops with local informants. A conceptual framework was drafted and refined with stakeholder feedback. There is a lack of common terminology regarding definitions and concepts related to disinvestment and no guidance for an organisation-wide systematic approach to disinvestment in a local healthcare service. A summary of issues from the literature and respondents highlight the lack of theoretical knowledge and practical experience and provide a guide to the information required to develop future models or methods for disinvestment in the local context. A conceptual framework was developed. Three mechanisms that provide opportunities to introduce disinvestment decisions into health service systems and processes were identified. Presented in order of complexity, time to achieve outcomes and resources required they include 1) Explicit consideration of potential disinvestment in routine decision-making, 2) Proactive decision-making about disinvestment driven by available evidence from published research and local data, and 3) Specific exercises in

Using MIQUEST in General Practice

Directory of Open Access Journals (Sweden)

Victoria Hammersley

1998-11-01

Full Text Available This paper describes ten months' experience with MIQUEST software used for the collection of data from computerised databases in General Practice. We report on the following: the MIQUEST software in use, the time costs to the practice, the completeness of confidentiality barriers and the accuracy of data collected using MIQUEST compared with similar data collected by the practice system (EMIS. There were no problems encountered with installation of MIQUEST-related software. With experience, MIQUEST was equal to the practice system for speed and ease of use. The confidentiality safeguards were found to be in accordance with the GMSC/RCGP Guidelines - patients could not be directly, or indirectly, identified from the data extracted by external searches. Inaccuracies in the data collected using MIQUEST were identified, but these were largely attributable to problems with the EMIS-written interpreter available on the practice system at the time, or with the coding schemes used by the practice. In an individual practice, MIQUEST represents an alternative data collection method to the practice-based software. For data collection from multiple general practices it should prove an invaluable tool for Health Authorities and research organisations.

Web-based classroom data collection in ADHD: a best practices case study.

Science.gov (United States)

Bhatara, Vinod; Vogt, H Bruce; Ellis, Roland; Alshari, Ghyath; Patrick, Sarah

2003-09-01

Best practices research identifies and disseminates effective clinical strategies developed and refined by clinicians for their practices. As opposed to the content of health care, medical students and residents are typically not trained in the process of its provision. This paper illustrates a best practices approach to development of a Web-based classroom data collection method to improve medication management in attention deficit hyperactivity disorder (ADHD). 1) To increase Primary Care Physician (PCP) awareness of the process of best practices research, and; 2) to highlight the use of the World Wide Web as a tool for integration of care of children with ADHD. Based on the review of a large national study in ADHD, the key ingredients for the best pharmacotherapy practices were identified. The lessons from the literature were adapted for local practice using the framework and steps for best practices outlined by Mold and Gregory. A conceptual model of managing information provided by parents/caregivers and teachers to PCPs was developed. Several steps were identified, including Web-based classroom behavioral data collection by a care manager and feedback reports to PCPs from a child psychiatrist based on the data collected. This model is currently being tested. Our preliminary experience suggests that a best practices approach has potential applications to a variety of primary care settings in South Dakota. We encourage PCPs to consider best practice strategies for their own practices. The practice-based research network (Rush Net) being developed by the Center for Rural Health Improvement of the University of South Dakota School of Medicine's Department of Family Medicine can be helpful in this regard.

The Impact of Reason for Training on the Relationship between "Best Practices" and Sexual Harassment Training Effectiveness

Science.gov (United States)

Perry, Elissa L.; Kulik, Carol T.; Bustamante, Jennifer; Golom, Frank D.

2010-01-01

The current study explored the use of best training practices on human resources managers' perceptions of sexual harassment training success and frequency of sexual harassment complaints. Results revealed no main effects of best training practices on sexual harassment training success. However, effects of best training practices on sexual…

Annual Report, Fall 2016: Identifying Cost Effective Tank Waste Characterization Approaches

Energy Technology Data Exchange (ETDEWEB)

Reboul, S. H. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); DiPrete, D. P. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

2016-12-12

This report documents the activities that were performed during the second year of a project undertaken to improve the cost effectiveness and timeliness of SRNL’s tank closure characterization practices. The activities performed during the first year of the project were previously reported in SRNL-STI-2015-00144. The scope of the second year activities was divided into the following three primary tasks: 1) develop a technical basis and strategy for improving the cost effectiveness and schedule of SRNL’s tank closure characterization program; 2) initiate the design and assembly of a new waste removal system for improving the throughput and reducing the personnel dose associated with extraction chromatography radiochemical separations; and 3) develop and perform feasibility testing of three alternative radiochemical separation protocols holding promise for improving high resource demand/time consuming tank closure sample analysis methods.

Servant leadership: a phenomenological study of practices, Experiences, organizational effectiveness and barriers

Directory of Open Access Journals (Sweden)

Amy R. Savage-Austin, PhD

2013-07-01

Full Text Available The subject of leadership is complex, and one of the main issues facing organizational leaders today is how to motivate employees to actively participate in the efforts that lead to accomplishing organizational goals. This study gathered lived experiences of 15 organizational leaders who practice the servant leadership philosophy, and explored how business leaders link their servant leadership practices to their organization’s effectiveness. The qualitative responses obtained during this study indicated that the perceived organizational barriers that prevent the servant leadership practices are the organization’s culture, the fear of change, and the lack of knowledge regarding the servant leadership philosophy. This study also gained insight into the impact that these organizational barriers have on one’s ability to practice servant leadership

Effective knowledge translation approaches and practices in Indigenous health research: a systematic review protocol

Directory of Open Access Journals (Sweden)

Melody E. Morton Ninomiya

2017-02-01

Full Text Available Abstract Background Effective knowledge translation (KT is critical to implementing program and policy changes that require shared understandings of knowledge systems, assumptions, and practices. Within mainstream research institutions and funding agencies, systemic and insidious inequities, privileges, and power relationships inhibit Indigenous peoples’ control, input, and benefits over research. This systematic review will examine literature on KT initiatives in Indigenous health research to help identify wise and promising Indigenous KT practices and language in Canada and abroad. Methods Indexed databases including Aboriginal Health Abstract Database, Bibliography of Native North Americans, CINAHL, Circumpolar Health Bibliographic Database, Dissertation Abstracts, First Nations Periodical Index, Medline, National Indigenous Studies Portal, ProQuest Conference Papers Index, PsycInfo, Social Services Abstracts, Social Work Abstracts, and Web of Science will be searched. A comprehensive list of non-indexed and grey literature sources will also be searched. For inclusion, documents must be published in English; linked to Indigenous health and wellbeing; focused on Indigenous people; document KT goals, activities, and rationale; and include an evaluation of their KT strategy. Identified quantitative, qualitative, and mixed methods’ studies that meet the inclusion criteria will then be appraised using a quality appraisal tool for research with Indigenous people. Studies that score 6 or higher on the quality appraisal tool will be included for analysis. Discussion This unique systematic review involves robust Indigenous community engagement strategies throughout the life of the project, starting with the development of the review protocol. The review is being guided by senior Indigenous researchers who will purposefully include literature sources characterized by Indigenous authorship, community engagement, and representation; screen and

Effective Organisational Communication: Perspectives, principles and practices (4th edition)

OpenAIRE

Blundel, Richard; Ippolito, Kate; Donnarumma, David

2013-01-01

Effective Organisational Communication gives students from all backgrounds the tools to communicate both within and between organisations of all kinds. With thorough coverage of the theoretical background of organisational communication, as well as practical content that helps readers develop their own communication skills, this is the perfect resource for those who want to improve their ability to work effectively with others. \\ud \\ud This heavily revised fourth edition reflects the rapidly ...

Practice Alignment and intent as distinctions for understanding cross-boundary knowledge creation practices in knowledge ecosystems

DEFF Research Database (Denmark)

Aaen, Mathias

This paper explores how practice alignment and intent across organizational boundaries may serve as an explanation for collaborative knowledge creation in a knowledge ecosystem. The paper is based on a longitudinal case study of a large multinational knowledge ecosystem consisting of many...... communities of practices and organisations. By applying a practice theory approach to five data sets collected over a five-year period, the study investigates how two distinctions may serve as a potential gateway into understanding knowledge creation across boundaries. The two distinctions – practice...... are identified and discussed. Potential implications for organisational and knowledge ecosystem conceptions are identified and discussed for further research....

Cancer Screening Among Patients Who Self-Identify as Muslim: Combining Self-Reported Data with Medical Records in a Family Practice Setting.

Science.gov (United States)

Lofters, A K; Slater, M; Vahabi, M

2018-02-01

Cancer screening is a core component of family medicine but screening inequalities are well documented in Canada for foreign-born persons. Although people of Muslim faith and culture are the fastest growing immigrant population in Canada, there is little information in the literature about their cancer screening practices. Determining screening gaps could inform practice-based quality improvement initiatives. We conducted a retrospective chart review combining patient-level medical record data with self-reported religious affiliation to examine the relationship between religion and cancer screening in a large multi-site urban family practice. Religious affiliation was classified as Muslim, other affiliation, or atheist/no religious affiliation. 5311 patients were included in the study sample. Muslim patients were significantly less likely to prefer English for spoken communication than the other two groups, less likely to be Canadian-born, more likely to have a female family physician, and were over-represented in the lowest income quintile. Muslim women were most likely to be up-to-date on breast cancer screening (85.2 vs. 77.5 % for those with other religions vs. 69.5 % for those with no religious affiliation). There were no significant differences in cancer screening by physician sex. In this pilot study conducted within a primary care practice, we used self-reported data on religious affiliation to examine possible inequities in cancer screening and observed intriguing variations in screening by self-identified religious affiliation. Future efforts to collect and use similar patient-level data should incorporate non-official languages and intensively outreach to patients with less health system contact. Regardless, the family medicine context may be the ideal setting to collect and act on patient-level sociodemographic data such as religious affiliation.

Advanced practice nurses: starting an independent practice.

Science.gov (United States)

Lambert, V A; Lambert, C E

1996-01-01

Independent or private practice is the delivery of nursing services provided by nurses over which nurses have full control. With a changing healthcare system, nurses are in a prime position to negotiate the delivery of appropriate, acceptable, and cost-effective health care as independent practitioners. This article addresses the mission and goals of independent practice, community need, business structure of the practice, housing the practice, legal considerations, financing the practice, marketing issues, clientele, record keeping, and reimbursement.

Challenges in Australian policy processes for disinvestment from existing, ineffective health care practices.

Science.gov (United States)

Elshaug, Adam G; Hiller, Janet E; Tunis, Sean R; Moss, John R

2007-10-31

Internationally, many health care interventions were diffused prior to the standard use of assessments of safety, effectiveness and cost-effectiveness. Disinvestment from ineffective or inappropriately applied practices is a growing priority for health care systems for reasons of improved quality of care and sustainability of resource allocation. In this paper we examine key challenges for disinvestment from these interventions and explore potential policy-related avenues to advance a disinvestment agenda. We examine five key challenges in the area of policy driven disinvestment: 1) lack of resources to support disinvestment policy mechanisms; 2) lack of reliable administrative mechanisms to identify and prioritise technologies and/or practices with uncertain clinical and cost-effectiveness; 3) political, clinical and social challenges to removing an established technology or practice; 4) lack of published studies with evidence demonstrating that existing technologies/practices provide little or no benefit (highlighting complexity of design) and; 5) inadequate resources to support a research agenda to advance disinvestment methods. Partnerships are required to involve government, professional colleges and relevant stakeholder groups to put disinvestment on the agenda. Such partnerships could foster awareness raising, collaboration and improved health outcome data generation and reporting. Dedicated funds and distinct processes could be established within the Medical Services Advisory Committee and Pharmaceutical Benefits Advisory Committee to, a) identify technologies and practices for which there is relative uncertainty that could be the basis for disinvestment analysis, and b) conduct disinvestment assessments of selected item(s) to address existing practices in an analogous manner to the current focus on new and emerging technology. Finally, dedicated funding and cross-disciplinary collaboration is necessary to build health services and policy research capacity

Identifying key features of effective active learning: the effects of writing and peer discussion.

Science.gov (United States)

Linton, Debra L; Pangle, Wiline M; Wyatt, Kevin H; Powell, Karli N; Sherwood, Rachel E

2014-01-01

We investigated some of the key features of effective active learning by comparing the outcomes of three different methods of implementing active-learning exercises in a majors introductory biology course. Students completed activities in one of three treatments: discussion, writing, and discussion + writing. Treatments were rotated weekly between three sections taught by three different instructors in a full factorial design. The data set was analyzed by generalized linear mixed-effect models with three independent variables: student aptitude, treatment, and instructor, and three dependent (assessment) variables: change in score on pre- and postactivity clicker questions, and coding scores on in-class writing and exam essays. All independent variables had significant effects on student performance for at least one of the dependent variables. Students with higher aptitude scored higher on all assessments. Student scores were higher on exam essay questions when the activity was implemented with a writing component compared with peer discussion only. There was a significant effect of instructor, with instructors showing different degrees of effectiveness with active-learning techniques. We suggest that individual writing should be implemented as part of active learning whenever possible and that instructors may need training and practice to become effective with active learning. © 2014 D. L. Linton et al. CBE—Life Sciences Education © 2014 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

Best Practices for Sustainable WInd Energy Development in the Great Lakes Region and Beyond

Energy Technology Data Exchange (ETDEWEB)

Great Lakes Commission; Victoria Pebbles; John Hummer; Celia Haven

2011-07-19

This document offers a menu of 18 different, yet complimentary preferred practices and policies. The best practices cover all phases of the wind energy development process - from the policies that allow for wind development, to the sustainable operation of a wind project, to the best practices for decommissioning a spent turbine - including applications for offshore wind. The practices include those that have been previously tested and proven effective, as well as new practices that were identified by experts in the field as needed for future wind developments. Each best practice includes information about the opportunities and challenges (pros and cons), and offers a case example that illustrates how that best practice is being utilized by a particular jurisdiction or wind project. The practices described in this publication were selected by a diverse group of interests from the Great Lakes Wind Collaborative that included environmental groups, industry, and federal, state and local government regulators. They were identified through a year long process that included a literature review, online survey and interviews with individuals from the public, private and non-profit sectors.

Effects of the amount and schedule of varied practice after constant practice on the adaptive process of motor learning

Directory of Open Access Journals (Sweden)

Umberto Cesar Corrêa

2014-12-01

Full Text Available This study investigated the effects of different amounts and schedules of varied practice, after constant practice, on the adaptive process of motor learning. Participants were one hundred and seven children with a mean age of 11.1 ± 0.9 years. Three experiments were carried out using a complex anticipatory timing task manipulating the following components in the varied practice: visual stimulus speed (experiment 1; sequential response pattern (experiment 2; and visual stimulus speed plus sequential response pattern (experiment 3. In all experiments the design involved three amounts (18, 36, and 63 trials, and two schedules (random and blocked of varied practice. The experiments also involved two learning phases: stabilization and adaptation. The dependent variables were the absolute, variable, and constant errors related to the task goal, and the relative timing of the sequential response. Results showed that all groups worsened the performances in the adaptation phase, and no difference was observed between them. Altogether, the results of the three experiments allow the conclusion that the amounts of trials manipulated in the random and blocked practices did not promote the diversification of the skill since no adaptation was observed.

Hygiene and health: systematic review of handwashing practices worldwide and update of health effects.

Science.gov (United States)

Freeman, Matthew C; Stocks, Meredith E; Cumming, Oliver; Jeandron, Aurelie; Higgins, Julian P T; Wolf, Jennyfer; Prüss-Ustün, Annette; Bonjour, Sophie; Hunter, Paul R; Fewtrell, Lorna; Curtis, Valerie

2014-08-01

To estimate the global prevalence of handwashing with soap and derive a pooled estimate of the effect of hygiene on diarrhoeal diseases, based on a systematic search of the literature. Studies with data on observed rates of handwashing with soap published between 1990 and August 2013 were identified from a systematic search of PubMed, Embase and ISI Web of Knowledge. A separate search was conducted for studies on the effect of hygiene on diarrhoeal disease that included randomised controlled trials, quasi-randomised trials with control group, observational studies using matching techniques and observational studies with a control group where the intervention was well defined. The search used Cochrane Library, Global Health, BIOSIS, PubMed, and Embase databases supplemented with reference lists from previously published systematic reviews to identify studies published between 1970 and August 2013. Results were combined using multilevel modelling for handwashing prevalence and meta-regression for risk estimates. From the 42 studies reporting handwashing prevalence we estimate that approximately 19% of the world population washes hands with soap after contact with excreta (i.e. use of a sanitation facility or contact with children's excreta). Meta-regression of risk estimates suggests that handwashing reduces the risk of diarrhoeal disease by 40% (risk ratio 0.60, 95% CI 0.53-0.68); however, when we included an adjustment for unblinded studies, the effect estimate was reduced to 23% (risk ratio 0.77, 95% CI 0.32-1.86). Our results show that handwashing after contact with excreta is poorly practiced globally, despite the likely positive health benefits. © 2014 John Wiley & Sons Ltd.

Improving and ensuring best practice continence management in residential aged care.

Science.gov (United States)

Heckenberg, Gayle

2008-06-01

Background  Continence Management within residential aged care is an every day component of care that requires assessment, implementation of strategies, resource allocation and evaluation. At times the management of incontinence of aged residents can be challenging and unsuccessful. The project chosen through the Clinical Fellowship program was Continence Management with the aim of raising awareness of best practice to assist in improving and providing person-centred resident care. Aims/objectives •  Review the literature on best practice management of incontinence •  Evaluate current practice in continence management for elderly residents within residential aged care services •  Improve adherence to best practice strategies of care for incontinence •  Raise awareness within the nursing home of the best practice management of incontinence •  Promote appropriate and effective use of resources for continence management •  Deliver individualised person-centred care to residents. •  Ensure best practice in continence management Methods  The Joanna Briggs Institute (JBI) Practical Application of Clinical Evidence System clinical audit tool was utilised to measure current practice against best practice. The results identify gaps that require improvement. The Getting Research into Practice process then allowed analysis of the level of compliance with each of the audit criteria, which would identify any barriers in implementing a selected course of action and aim to improve compliance. The project team was consulted with additional stakeholder consultation to form an action plan and implement strategies to improve practice. Results  Although 100% compliance with all audit criteria in audit 1 and 2 was not achieved, there was improvement in the criteria concerning the documented fluid intake for residents. Further strategies have been identified and implemented and this continues to be a 'work in progress'. Staff now have an acute awareness

The effect of retrieval practice in primary school vocabulary learning

NARCIS (Netherlands)

Goossens, Nicole; Camp, Gino; Verkoeijen, Peter; Tabbers, Huib

2018-01-01

The testing effect refers to the finding that retrieval practice leads to better long-term retention than additional study of course material. In the present study, we examined whether this finding generalizes to primary school vocabulary learning. We also manipulated the word learning context.

Business intelligence: using insight to improve the value and performance of your practice.

Science.gov (United States)

Coan, Tim

2007-01-01

Using information to improve the value of your practice can be a great way to create leverage and improve the performance of your practice. Business intelligence (BI) is the result of a complete system that produces meaningful insights by providing the information necessary to make business decisions. Changes made from these insights improve both the performance and value of your practice. It is important to identify the key elements required of a good BI system and the areas within a practice that can directly benefit from an effective BI system.

Using the Systems-Practice Framework to Understand Food Allergen Management Practices at College Catering Operations: A Qualitative Study.

Science.gov (United States)

Verstappen, Jennie; Mirosa, Miranda; Thomson, Carla

2018-03-01

The number of individuals with food allergies or intolerances attending catered university residential colleges is increasing, and safe dining options are required to minimize the risk of allergic reactions and food-induced death. This qualitative research study sought to advance professional knowledge of the factors affecting allergen management practices, particularly pertaining to college foodservices. Three catered residential colleges affiliated with a major university in New Zealand were selected as research sites. The study used an ethnographic approach and systems-practice theory as a framework for data collection and organizing results. Data collection techniques included document analyses (3 hours per site), observations (6 to 8 hours per site), focus groups with foodservice workers (30 to 45 minutes per site, n=16), and interviews with foodservice managers (45 to 90 minutes per interview, n=5). Notes and transcripts were coded through the process of thematic analysis using NVivo for Mac software, version 11.1.1, to identify factors affecting allergen management practices. The main factors affecting allergen management practices at college foodservices included information provided by residents about dietary requirements; communication between residents and foodservice staff; systems for allergen management; attitude of foodservice staff; and college size. Detailed dietary information, effective communication with residents, sufficient resources, clarification of responsibilities, and thorough systems are required for staff to perform safe allergen management practices. Ultimately, successful implementation was predominantly determined by staff attitude. Foodservice managers are advised to identify motivators and address barriers of staff attitudes toward allergen management practices to promote successful implementation. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Benchmarking D and D procurement best practices at four commercial nuclear power plants

International Nuclear Information System (INIS)

Arflin, J.; Baker, G.; Bidwell, B.; Bugielski, D.; Cavanagh, J.; Sandlin, N.

1999-01-01

The Department of Energy (DOE) has as two of its strategic objectives to safely accomplish the world's largest environmental clean-up of contaminated sites and the adoption of the best management practices of the private sector to achieve business-like results efficiently and effectively. An integral part of the strategic response to the challenges facing the Department has been the use of benchmarking and best practice management to facilitate identifying and implementing leading-edge thinking, practices, approaches, and solutions

Practical guide to understanding Comparative Effectiveness Research (CER).

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Neely, J Gail; Sharon, Jeffrey D; Graboyes, Evan M; Paniello, Randal C; Nussenbaum, Brian; Grindler, David J; Dassopoulos, Themistocles

2013-12-01

"Comparative effectiveness research" (CER) is not a new concept; however, recently it has been popularized as a method to develop scientifically sound actionable data by which patients, physicians, payers, and policymakers may make informed health care decisions. Fundamental to CER is that the comparative data are derived from large diverse populations of patients assembled from point-of-care general primary care practices and that measured outcomes include patient value judgments. The challenge is to obtain scientifically valid data to be acted upon by decision-making stakeholders with potentially quite diversely different agenda. The process requires very thoughtful research designs modulated by complex statistical and analytic methods. This article is composed of a guiding narrative with an extensive set of tables outlining many of the details required in performing and understanding CER. It ends with short discussions of three example papers, limitations of the method, and how a practicing physician may view such reports.

Research-Based Strategies and Best Practices for Dropout Prevention

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Smink, Jay

2009-01-01

The National Dropout Prevention Center (NDPC) at Clemson University has been at the forefront of identifying model dropout prevention programs and promoting the use of best practices to increase the graduation rates in schools since 1986. The structure for these varied interventions and solutions takes the form of effective strategies, model…

Comparing the Ability of Anthropometric Indicators in Identifying Metabolic Syndrome in HIV Patients.

Directory of Open Access Journals (Sweden)

Rebeca Antunes Beraldo

Full Text Available Highly active antiretroviral therapy (HAART can cause side effects in HIV patients, as the metabolic syndrome. Early identification of risk for development of cardiovascular diseases using available reliable and practical methods is fundamental. On this basis, the aim of this study was to compare the effectiveness of anthropometric indicators to identify metabolic syndrome in HIV patients on HAART.It is a cross-sectional study. A number of 280 stable HIV patients were studied. It measured weight, height, waist circumference (WC, hip circumference (HP, thigh circumference (TC and calculated body mass index (BMI, body adiposity index (BAI, waist to hip ratio (WHR and waist to thigh ratio (WTR. There was also a performance of biochemical tests of lipid profile and fasting glucose. Systemic blood pressure was measured. The criteria proposed by the National Cholesterol Education Program III (NCEP-ATP III to metabolic syndrome classification was used. Individuals were divided in groups with or without metabolic alterations and their anthropometric indicators were compared. Receiver operating characteristic (ROC curves were designed for each anthropometric indicator using the metabolic syndrome classification to identify sensitivity and specificity.WC was a good tool to identify each metabolic disorder separately: total cholesterol (only females, p<0.05, triglycerides (only males, p<0.001, HDL cholesterol (p<0.05, LDL cholesterol (p<005 and fasting glycemic (p<005. WC also showed the best performance to identify metabolic syndrome in both genders (areas under the curve (AUCs: 0.79 and 0.76 for male and female, respectively, while BAI proved to be an inadequate indicator (AUCs: 0.63 and 0.67 for males and females, respectively, in this population.The central adiposity measure (WC had the best performance to identify metabolic syndrome, and it is a convenient, cheap and reliable tool that can be used in clinical practice routinely to prevent

The Effect of Monitoring: How Data Collection Type and Frequency Boosts Participation and the Adoption of Best Practices in a Coffee Agronomy Training Program in Rwanda.

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Gathani, Sachin; Gomez, Maria Paula; Sabates, Ricardo; Stoelinga, Dimitri

2015-12-01

The impact of surveying on individuals' behavior and decision making has been widely studied in academic literature on market research but not so much the impact of monitoring on economic development interventions. To estimate whether different monitoring strategies lead to improvement in participation levels and adoption of best practices for coffee production for farmer who participated in TechnoServe Agronomy Training Program in Rwanda. Farmers were identified randomly for monitoring purposes to belong to two different groups and then selected depending on the additional criterion of having productive coffee trees. We estimate treatment-on-the-treated and intention-to-treat effects on training attendance rates and farmers best-practice adoptions using difference-in-differences estimation techniques. Farmers were randomly identified to a high or low monitoring with different type and frequency of data collection and selected if they had productive coffee trees as part of the monitoring strategy. Attendance to training sessions by all farmers in the program and best-practice adoption data for improving coffee yield. We find that monitoring led to surprisingly large increases in farmer participation levels in the project and also improved best-practice adoption rates. We also find that higher frequency of data collection has long-lasting effects and are more pronounced for low-attendance farmers. Monitoring not only provides more data and a better understanding of project dynamics, which in turn can help improve design, but can also improve processes and outcomes, in particular for the least engaged. © The Author(s) 2016.

Organizational determinants of evaluation practice in Australian prevention agencies.

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Schwarzman, J; Bauman, A; Gabbe, B; Rissel, C; Shilton, T; Smith, B J

2018-06-01

Program evaluation is essential to inform decision making, contribute to the evidence base for strategies, and facilitate learning in health promotion and disease prevention organizations. Theoretical frameworks of organizational learning, and studies of evaluation capacity building describe the organization as central to evaluation capacity. Australian prevention organizations recognize limitations to current evaluation effectiveness and are seeking guidance to build evaluation capacity. This qualitative study identifies organizational facilitators and barriers to evaluation practice, and explores their interactions in Australian prevention organizations. We conducted semi-structured interviews with 40 experienced practitioners from government and non-government organizations. Using thematic analysis, we identified seven key themes that influence evaluation practice: leadership, organizational culture, organizational systems and structures, partnerships, resources, workforce development and training and recruitment and skills mix. We found organizational determinants of evaluation to have multi-level interactions. Leadership and organizational culture influenced organizational systems, resource allocation and support of staff. Partnerships were important to overcome resource deficits, and systems were critical to embed evaluation within the organization. Organizational factors also influenced the opportunities for staff to develop skills and confidence. We argue that investment to improve these factors would allow organizations to address evaluation capacity at multiple levels, and ultimately facilitate effective evaluation practice.

Analysis and effect of multi-fuel and practical constraints on economic load dispatch in the presence of Unified Power Flow Controller using UDTPSO

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Chintalapudi V. Suresh

2015-09-01

Full Text Available This paper presents an attempt to analyze the effect of multi-fuel and practical constraints on economic load dispatch problem using a novel uniform distributed two-stage particle swarm optimization (UDTPSO algorithm without and with unified power flow controller (UPFC while satisfying equality, inequality, practical constraints such as ramp-rate and prohibited operating zone (POZ limits and device operating limits. A Novel severity function is formulated based on the transmission line overloads and bus voltage violations to identify an optimal location to install UPFC. A multi-objective optimization problem is solved for multi-fuel non-convex cost and transmission power loss objectives. Obtained results for considered standard test functions and electrical systems indicate the effectiveness of the proposed algorithm and can obtain efficient solution when compared to existing methods. Hence, the proposed method is a promising method and can be easily applied to optimize the power system objectives.