Effective Strategy-Making in Multinational Subsidiaries

DEFF Research Database (Denmark)

Andersen, Torben Juul; Andersson, Ulf; Palmié, Maximilian

for global efficiencies and autonomy for effective local responses. Strategic guidance from headquarters frames subsidiary decisions in line with corporate priorities and distributed decision power coupled with informal exchange of information facilitates strategic responses in tune with local market......We outline commonalities between studies of subsidiary decentralization and autonomous strategy-making in the international business and strategic management fields. This suggests that corporate headquarters should engage in strategy-making processes that provide a combination of formal direction...... requirements. We identify some important nuances in the integration-responsiveness conundrum supported by an empirical study of 351 multinational subsidiaries. We discuss the implications for multinational strategy practice and suggest future research venues to investigate strategy-making in multinational...

Assessment of Current Knowledge about the Effectiveness of School Desegregation Strategies. Summary. Volume I: Strategies for Effective Desegregation: A Synthesis of Findings.

Science.gov (United States)

Hawley, Willis D.; And Others

This project report examines strategies for effective school desegregation based on case studies of individual schools, national school surveys, ethnographic studies of classrooms, trend analyses, opinion surveys and conference interviews, and court documents. The strategies identified in the report include the attainment of one or more of the…

Methodology to explore interactions between the water system and society in order to identify adaptation strategies

Science.gov (United States)

Offermans, A. G. E.; Haasnoot, M.

2009-04-01

Development of sustainable water management strategies involves analysing current and future vulnerability, identification of adaptation possibilities, effect analysis and evaluation of the strategies under different possible futures. Recent studies on water management often followed the pressure-effect chain and compared the state of social, economic and ecological functions of the water systems in one or two future situations with the current situation. The future is, however, more complex and dynamic. Water management faces major challenges to cope with future uncertainties in both the water system as well as the social system. Uncertainties in our water system relate to (changes in) drivers and pressures and their effects on the state, like the effects of climate change on discharges. Uncertainties in the social world relate to changing of perceptions, objectives and demands concerning water (management), which are often related with the aforementioned changes in the physical environment. The methodology presented here comprises the 'Perspectives method', derived from the Cultural Theory, a method on analyzing and classifying social response to social and natural states and pressures. The method will be used for scenario analysis and to identify social responses including changes in perspectives and management strategies. The scenarios and responses will be integrated within a rapid assessment tool. The purpose of the tool is to provide users with insight about the interaction of the social and physical system and to identify robust water management strategies by analysing the effectiveness under different possible futures on the physical, social and socio-economic system. This method allows for a mutual interaction between the physical and social system. We will present the theoretical background of the perspectives method as well as a historical overview of perspective changes in the Dutch Meuse area to show how social and physical systems interrelate. We

Identifying Multiple Levels of Discussion-Based Teaching Strategies for Constructing Scientific Models

Science.gov (United States)

Williams, Grant; Clement, John

2015-01-01

This study sought to identify specific types of discussion-based strategies that two successful high school physics teachers using a model-based approach utilized in attempting to foster students' construction of explanatory models for scientific concepts. We found evidence that, in addition to previously documented dialogical strategies that…

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...

The comparison of the performance of two screening strategies identifying newly-diagnosed HIV during pregnancy.

Science.gov (United States)

Boer, Kees; Smit, Colette; van der Flier, Michiel; de Wolf, Frank

2011-10-01

In the Netherlands, a non-selective opt-out instead of a selective opt-in antenatal HIV screening strategy was implemented in 2004. In case of infection, screening was followed by prevention of mother-to-child-transmission (PMTCT). We compared the performance of the two strategies in terms of detection of new cases of HIV and vertical transmission. HIV-infected pregnant women were identified retrospectively from the Dutch HIV cohort ATHENA January 2000 to January 2008. Apart from demographic, virological and immunological data, the date of HIV infection in relation to the index pregnancy was established. Separately, all infants diagnosed with HIV born following implementation of the screening program were identified by a questionnaire via the paediatric HIV centres. 162/481 (33.7%) HIV-positive pregnant women were diagnosed with HIV before 2004 and 172/214 (80.3%) after January 2004. Multivariate analysis showed an 8-fold (95% confidence interval 5.47-11.87) increase in the odds of HIV detection during pregnancy after the national introduction of the opt-out strategy. Still, three children born during a 5-year period after July 2004 were infected due to de novo infection in pregnancy. Implementation of a nation-wide screening strategy based upon non-selective opt-out screening followed by effective PMTCT appeared to detect more HIV-infected women for the first time in pregnancy and to reduce vertical transmission of HIV substantially. Nonetheless, still few children are infected because of maternal infection after the first trimester. We propose the introduction of partner screening on HIV as part of the antenatal screening strategy.

Validation of a search strategy to identify nutrition trials in PubMed using the relative recall method.

Science.gov (United States)

Durão, Solange; Kredo, Tamara; Volmink, Jimmy

2015-06-01

To develop, assess, and maximize the sensitivity of a search strategy to identify diet and nutrition trials in PubMed using relative recall. We developed a search strategy to identify diet and nutrition trials in PubMed. We then constructed a gold standard reference set to validate the identified trials using the relative recall method. Relative recall was calculated by dividing the number of references from the gold standard our search strategy identified by the total number of references in the gold standard. Our gold standard comprised 298 trials, derived from 16 included systematic reviews. The initial search strategy identified 242 of 298 references, with a relative recall of 81.2% [95% confidence interval (CI): 76.3%, 85.5%]. We analyzed titles and abstracts of the 56 missed references for possible additional terms. We then modified the search strategy accordingly. The relative recall of the final search strategy was 88.6% (95% CI: 84.4%, 91.9%). We developed a search strategy to identify diet and nutrition trials in PubMed with a high relative recall (sensitivity). This could be useful for establishing a nutrition trials register to support the conduct of future research, including systematic reviews. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Managerial strategies for creating an effective work environment.

Science.gov (United States)

Luse, Kimberly A

2013-01-01

To create a highly functioning medical imaging team, radiology managers must be able to analyze their departments and identify areas for improvement. This type of analysis means assessing front-line personnel who already work in the department, along with identifying staffing needs and recruiting talented new employees. In addition, managers must develop effective retention tools such as career ladders and mentorship programs to improve the overall working environment. This article discusses a variety of different strategies to help managers develop a more effective department.

Dominant Advertisement Strategies in Iranian TV Commercials and their Cognitive Effect

Directory of Open Access Journals (Sweden)

Parvaneh Khosravizadeh

2017-12-01

Full Text Available Advertising strategies are some factors in the content and form of advertisements which are intended to have certain effects on ad viewers or potential customers. These effects could be defined as the kind of cognitive responses they are expected to elicit in their audiences. This study examined 39 Iranian TV commercials in seven product categories to identify the most dominant strategies used by the advertisers and investigated the effect of product type on the selection and use of these strategies. The results showed that Iranian TV commercials used a mixture of analytic and effective cognitive strategies among which “elaborating on the reasons to buy”, “explaining the quality appeal” are the most favorite analytic based strategies and use of emotion and mood arising words is the most dominant affective based advertising method. The results also endorse significant effect of product type on types of strategies employed in the ads.

Personal coping strategies for managing the side effects of ...

African Journals Online (AJOL)

This study describes the burden of side effects from ARV treatment as experienced by a sample of HIV/AIDS patients and identifies the personal strategies they used to cope with ... The most common adverse effects reported were tiredness, nightmares, mood swings, nausea, poor appetite, insomnia, vomiting and dizziness.

Stakeholders' participatory diagnosis of climate change impacts on subsistence agriculture in Sikkim, India, for identifying adaptation strategies

Science.gov (United States)

Azhoni, A.; Goyal, M. K.

2017-12-01

Narrowing the gap between research, policy making and implementing adaptation remains a challenge in many parts of the world where climate change is likely to severely impact subsistence agriculture. This research aims to narrow this gap by matching the adaptation strategies being framed by policy makers and perspectives of consultants and researchers which are expected to be implemented by development agencies farmers in the state of Sikkim in India. Our case study examined the framing and implementation of State Action Plan on Climate Change through semi-structured interviews carried out with decision makers in the State Government, Scientific Organisations, consultants, local academia, implementing and development agencies, and farmers for whom the adaptation strategies are targeted. Using Social Network and Stakeholder Analysis approach, this research unravels the complexities of perceiving climate change impacts, identifying adaptation strategies, and implementing climate change adaptation strategies. While farmers are less aware about the global phenomenon of climate change impacts for their subsistence livelihood, their knowledge of the local conditions and their close interaction with the State Government Agriculture Department provides them an access to new and high value crops. Although important steps are initiated through the Sikkim State Action Plan on Climate Change it is yet to deliver effective means of adaptation implementation and identifying the networks of close coordination between the various implementing agencies will likely to pay rich dividends. While Sikkim being a small and hilly state with specific contextual challenges of climate change impacts, the results from this study highlights how the internal and external networks between various types of stakeholders informs decision makers in identifying local impacts of climate change and plan adaptation strategies.

Effective recruitment and retention strategies in community health programs.

Science.gov (United States)

McCann, Jennifer; Ridgers, Nicola D; Carver, Alison; Thornton, Lukar E; Teychenne, Megan

2013-08-01

The aim of this project was to identify effective recruitment and retention strategies used by health-promotion organisations that focus on increasing physical activity and improving nutrition within the local community. Semistructured telephone or face-to-face interviews with 25 key informants from stakeholder organisations were conducted. Key informants discussed strategies used by their organisation to effectively recruit and retain participants into community-based healthy eating and/or physical activity programs. Transcribed data were analysed with NVivo software. Effective recruitment strategies included word of mouth, links with organisations, dissemination of printed materials, media, referrals, cross-promotion of programs and face-to-face methods. Effective retention strategies included encouraging a sense of community ownership, social opportunities, recruiting a suitable leader and offering flexibility and support. Fees and support for recruiting and retaining participants was also identified. This study provides novel insights to a greatly under researched topic in the field of health promotion. There are two key take-home messages from the present study that are applicable to health practitioners as well as developers and deliverers of community health-promotion programs: (1) it is imperative that all community health organisations report on the effectiveness of their recruitment and retention, both successes and failures; and (2) there is a clear need to tailor the recruitment and retention approach to the target population and the setting the program is occurring in. SO WHAT? These findings provide important insights for the development of future community-based healthy eating and physical activity programs.

The effects of rhythm control strategies versus rate control strategies for atrial fibrillation and atrial flutter

DEFF Research Database (Denmark)

Sethi, Naqash; Safi, Sanam; Nielsen, Emil E

2017-01-01

by Jakobsen and colleagues. We plan to include all relevant randomised clinical trials assessing the effects of any rhythm control strategy versus any rate control strategy. We plan to search the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, LILACS, Science Citation Index Expanded...... on Web of Science, and BIOSIS to identify relevant trials. Any eligible trial will be assessed and classified as either high risk of bias or low risk of bias, and our conclusions will be based on trials with low risk of bias. The analyses of the extracted data will be performed using Review Manager 5....... This protocol for a systematic review aims at identifying the best overall treatment strategy for atrial fibrillation and atrial flutter. METHODS: This protocol for a systematic review was performed following the recommendations of the Cochrane Collaboration and the eight-step assessment procedure suggested...

CDC's DELTA FOCUS Program: Identifying Promising Primary Prevention Strategies for Intimate Partner Violence.

Science.gov (United States)

Armstead, Theresa L; Rambo, Kirsten; Kearns, Megan; Jones, Kathryn M; Dills, Jenny; Brown, Pamela

2017-01-01

According to 2011 data, nearly one in four women and one in seven men in the United States experience severe physical violence by an intimate partner, creating a public health burden requiring population-level solutions. To prevent intimate partner violence (IPV) before it occurs, the CDC developed Domestic Violence Prevention Enhancements and Leadership Through Alliances, Focusing on Outcomes for Communities United with States to identify promising community- and societal-level prevention strategies to prevent IPV. The program funds 10 state domestic violence coalitions for 5 years to implement and evaluate programs and policies to prevent IPV by influencing the environments and conditions in which people live, work, and play. The program evaluation goals are to promote IPV prevention by identifying promising prevention strategies and describing those strategies using case studies, thereby creating a foundation for building practice-based evidence with a health equity approach.

Identifying nurse staffing research in Medline: development and testing of empirically derived search strategies with the PubMed interface.

Science.gov (United States)

Simon, Michael; Hausner, Elke; Klaus, Susan F; Dunton, Nancy E

2010-08-23

The identification of health services research in databases such as PubMed/Medline is a cumbersome task. This task becomes even more difficult if the field of interest involves the use of diverse methods and data sources, as is the case with nurse staffing research. This type of research investigates the association between nurse staffing parameters and nursing and patient outcomes. A comprehensively developed search strategy may help identify nurse staffing research in PubMed/Medline. A set of relevant references in PubMed/Medline was identified by means of three systematic reviews. This development set was used to detect candidate free-text and MeSH terms. The frequency of these terms was compared to a random sample from PubMed/Medline in order to identify terms specific to nurse staffing research, which were then used to develop a sensitive, precise and balanced search strategy. To determine their precision, the newly developed search strategies were tested against a) the pool of relevant references extracted from the systematic reviews, b) a reference set identified from an electronic journal screening, and c) a sample from PubMed/Medline. Finally, all newly developed strategies were compared to PubMed's Health Services Research Queries (PubMed's HSR Queries). The sensitivities of the newly developed search strategies were almost 100% in all of the three test sets applied; precision ranged from 6.1% to 32.0%. PubMed's HSR queries were less sensitive (83.3% to 88.2%) than the new search strategies. Only minor differences in precision were found (5.0% to 32.0%). As with other literature on health services research, nurse staffing studies are difficult to identify in PubMed/Medline. Depending on the purpose of the search, researchers can choose between high sensitivity and retrieval of a large number of references or high precision, i.e. and an increased risk of missing relevant references, respectively. More standardized terminology (e.g. by consistent use of the

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

Effective training strategies for teaching communication skills to physicians: an overview of systematic reviews.

Science.gov (United States)

Berkhof, Marianne; van Rijssen, H Jolanda; Schellart, Antonius J M; Anema, Johannes R; van der Beek, Allard J

2011-08-01

Physicians need good communication skills to communicate effectively with patients. The objective of this review was to identify effective training strategies for teaching communication skills to qualified physicians. PubMED, PsycINFO, CINAHL, and COCHRANE were searched in October 2008 and in March 2009. Two authors independently selected relevant reviews and assessed their methodological quality with AMSTAR. Summary tables were constructed for data-synthesis, and results were linked to outcome measures. As a result, conclusions about the effectiveness of communication skills training strategies for physicians could be drawn. Twelve systematic reviews on communication skills training programmes for physicians were identified. Some focused on specific training strategies, whereas others emphasized a more general approach with mixed strategies. Training programmes were effective if they lasted for at least one day, were learner-centred, and focused on practising skills. The best training strategies within the programmes included role-play, feedback, and small group discussions. Training programmes should include active, practice-oriented strategies. Oral presentations on communication skills, modelling, and written information should only be used as supportive strategies. To be able to compare the effectiveness of training programmes more easily in the future, general agreement on outcome measures has to be established. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

A cost effective CO2 strategy

DEFF Research Database (Denmark)

, a scenario-part and a cost-benefit part. Air and sea modes are not analyzed. The model adopts a bottom-up approach to allow a detailed assessment of transport policy measures. Four generic areas of intervention were identified and the likely effect on CO2 emissions, socioeconomic efficiency and other...... are evaluated according to CO2 reduction potential and according to the ‘shadow price’ on a reduction of one ton CO2. The shadow price reflects the costs (and benefits) of the different measures. Comparing the measures it is possible to identify cost effective measures, but these measures are not necessarily...... by the Ministry of Transport, with the Technical University of Denmark as one of the main contributors. The CO2-strategy was to be based on the principle of cost-effectiveness. A model was set up to assist in the assessment. The model consists of a projection of CO2-emissions from road and rail modes from 2020...

Inclusive Branding Strategies for Domestic Violence Agencies: Embracing Opportunities to Reach and Better Serve Male-Identified Survivors.

Science.gov (United States)

Dewey, Morgan; Heiss, Sarah N

2018-05-01

Successful strategies for branding that are inclusive of male-identified survivors were identified in this qualitative study through semi-structured interviews with leaders from six domestic violence agencies across the United States: four represented traditional domestic violence agencies and two represented specialized agencies with expertise in providing services to nontraditional survivors. The strategic implementation of (a) inclusive language, (b) visual diversity, (c) community outreach, and (d) communication channels emerged as successful strategies in branding in an inclusive way for male-identified survivors. The implementation of these successful strategies provides the opportunity for domestic violence agencies to create an inclusive environment for male-identified survivors and would contribute to a paradigm shift in how domestic violence is viewed.

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.

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

Business Responses to Climate Change. Identifying Emergent Strategies

International Nuclear Information System (INIS)

Kolk, A.; Pinkse, J.

2005-01-01

Companies face much uncertainty about the competitive effects of the recently adopted Kyoto Protocol on global climate change and the current and future regulations that may emerge from it. Companies have considerable discretion to explore different market strategies to address global warming and reduce greenhouse gas emissions. This article examines these strategic options by reviewing the market-oriented actions that are currently being taken by 136 large companies that are part of the Global 500. There are six different market strategies that companies use to address climate change and that consist of different combinations of the market components available to managers. Managers can choose between more emphasis on improvements in their business activities through innovation or employ compensatory approaches such as emissions trading. They can either act by themselves or work with other companies, NGOs, or (local) governments

The effectiveness of knowledge translation strategies used in public health: a systematic review

Directory of Open Access Journals (Sweden)

LaRocca Rebecca

2012-09-01

Full Text Available Abstract Background Literature related to the effectiveness of knowledge translation (KT strategies used in public health is lacking. The capacity to seek, analyze, and synthesize evidence-based information in public health is linked to greater success in making policy choices that have the best potential to yield positive outcomes for populations. The purpose of this systematic review is to identify the effectiveness of KT strategies used to promote evidence-informed decision making (EIDM among public health decision makers. Methods A search strategy was developed to identify primary studies published between 2000–2010. Studies were obtained from multiple electronic databases (CINAHL, Medline, EMBASE, and the Cochrane Database of Systematic Reviews. Searches were supplemented by hand searching and checking the reference lists of included articles. Two independent review authors screened studies for relevance, assessed methodological quality of relevant studies, and extracted data from studies using standardized tools. Results After removal of duplicates, the search identified 64, 391 titles related to KT strategies. Following title and abstract review, 346 publications were deemed potentially relevant, of which 5 met all relevance criteria on full text screen. The included publications were of moderate quality and consisted of five primary studies (four randomized controlled trials and one interrupted time series analysis. Results were synthesized narratively. Simple or single KT strategies were shown in some circumstances to be as effective as complex, multifaceted ones when changing practice including tailored and targeted messaging. Multifaceted KT strategies led to changes in knowledge but not practice. Knowledge translation strategies shown to be less effective were passive and included access to registries of pre-processed research evidence or print materials. While knowledge brokering did not have a significant effect generally

Strategy Implementation Style and Public Service Effectiveness, Efficiency, and Equity

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Rhys Andrews

2017-02-01

Full Text Available Strategic decision-making theories suggest that organizations that combine rational and incremental strategy implementation styles are likely to perform better than those that emphasize a single style. To assess whether these arguments apply to the public sector; we explore the strategy implementation style and perceived service effectiveness, efficiency and equity of Turkish municipal government departments. Using fuzzy cluster analysis, we identify four distinctive though inter-related styles of strategy implementation in our sample organizations: logical-incremental; mostly rational; mostly incremental; and no clear approach. A logical-incremental and mostly rational style of implementation are associated with better effectiveness, efficiency and equity; with the absence of an implementation style associated with worse performance. Theoretical and practical implications are discussed.

Identifying tacit strategies in aircraft maneuvers

Science.gov (United States)

Lewis, Charles M.; Heidorn, P. B.

1991-01-01

Two machine-learning methods are presently used to characterize the avoidance strategies used by skilled pilots in simulated aircraft encounters, and a general framework for the characterization of the strategic components of skilled behavior via qualitative representation of situations and responses is presented. Descriptions of pilot maneuvers that were 'conceptually equivalent' were ascertained by a concept-learning algorithm in conjunction with a classifier system that employed a generic algorithm; satisficing and 'buggy' strategies were thereby revealed.

The effects of image transfer strategy achieved through cobranding and brand extension

Directory of Open Access Journals (Sweden)

Rakita Branko

2010-01-01

Full Text Available This paper investigates the strategic importance of brand extension and cobranding. These two strategies we identify as the most important and the most popular brand image transfer strategies. They are widely adopted strategies for firms entering new markets, so they can take advantage of an existing brand's equity. In this article, we investigate whether cobranding with partner and brand extension has positive effects on customers' responses toward a new product. We also analyzed prerequisites for successful implementation of mentioned brand strategies. .

Generating demand for pharmacist-provided medication therapy management: identifying patient-preferred marketing strategies.

Science.gov (United States)

Garcia, Gladys M; Snyder, Margie E; McGrath, Stephanie Harriman; Smith, Randall B; McGivney, Melissa Somma

2009-01-01

To identify effective strategies for marketing pharmacist-provided medication therapy management (MTM) services to patients in a self-insured employer setting. Qualitative study. University of Pittsburgh during March through May 2008. 26 university employees taking at least one chronic medication. Three focus group sessions were conducted using a semistructured topic guide to facilitate the discussion. Employees' perceived medication-related needs, perceived benefits of pharmacist-provided MTM, potential barriers for employee participation in MTM, and effective strategies for marketing MTM. Participants reported concerns with timing of doses, medication costs, access, and ensuring adherence. Participants generally felt positively toward pharmacists; however, the level of reported patient contact with pharmacists varied among participants. Some participants questioned pharmacists' education and qualifications for this enhanced role in patient care. Perceived benefits of MTM noted by participants included the opportunity to obtain personalized information about their medications and the potential for improved communication among their health providers. Barriers to patient participation were out-of-pocket costs and lack of time for MTM visits. Participants suggested use of alternative words to describe MTM and marketing approaches that involve personal contact. Pharmacists should emphasize parts of MTM that patients feel are most beneficial (i.e., provision of a personal medication record) and use patient-friendly language to describe MTM when marketing their practice. Patients will need greater exposure to the concept of MTM and the pharmacists' role in order to correctly describe and assign value to this type of pharmacist patient care practice.

Challenges and Strategies for Building and Maintaining Effective Preceptor-Preceptee Relationships among Nurses

Directory of Open Access Journals (Sweden)

Gerald A. Matua

2014-10-01

Full Text Available Objectives: This study aimed to determine the challenges encountered and strategies used by nurse preceptors to build effective professional relationships during the preceptorship of final year nursing students. Methods: This study was conducted in November 2012 at the College of Nursing in Sultan Qaboos University, Muscat, Oman. A qualitative research design consisting of focus group discussions was used to investigate the challenges that preceptors encounter and the strategies that they use to build effective relationships with preceptees. A total of 21 preceptors from Sultan Qaboos University Hospital participated in the study as part of a training workshop for nurse preceptors. The interviews were audio recorded, transcribed verbatim and thematically analysed. Results: The main challenges faced by preceptors included discrepancies in applying theory to practice; lack of trust; lack of time, and perceived lack of knowledge. The effective strategies identified by the preceptors to be used in building a healthy preceptor-preceptee relationship were proper orientation; effective communication; preparation for complex situations; appreciation and acknowledgment; positive feedback; assurance of support; spending time together; knowing preceptors personally; giving breaks, and encouraging self-commitment. Conclusion: Preceptors should be encouraged to identify challenges that hinder the building of effective relationships with preceptees early during their preceptorship. The incorporation of appropriate and evidenced-based strategies, such as those identified in this study, can transform the preceptorship experience into one that is fulfilling for both preceptors and preceptees. This may lead to greater job satisfaction, personal and professional growth as well as higher self-esteem levels for preceptors and the realisation of clinical objectives for preceptees.

Challenges and Strategies for Building and Maintaining Effective Preceptor-Preceptee Relationships among Nurses.

Science.gov (United States)

Matua, Gerald A; Seshan, Vidya; Savithri, Raman; Fronda, Dennis C

2014-11-01

This study aimed to determine the challenges encountered and strategies used by nurse preceptors to build effective professional relationships during the preceptorship of final year nursing students. This study was conducted in November 2012 at the College of Nursing in Sultan Qaboos University, Muscat, Oman. A qualitative research design consisting of focus group discussions was used to investigate the challenges that preceptors encounter and the strategies that they use to build effective relationships with preceptees. A total of 21 preceptors from Sultan Qaboos University Hospital participated in the study as part of a training workshop for nurse preceptors. The interviews were audio recorded, transcribed verbatim and thematically analysed. The main challenges faced by preceptors included discrepancies in applying theory to practice; lack of trust; lack of time, and perceived lack of knowledge. The effective strategies identified by the preceptors to be used in building a healthy preceptor-preceptee relationship were proper orientation; effective communication; preparation for complex situations; appreciation and acknowledgment; positive feedback; assurance of support; spending time together; knowing preceptors personally; giving breaks, and encouraging self-commitment. Preceptors should be encouraged to identify challenges that hinder the building of effective relationships with preceptees early during their preceptorship. The incorporation of appropriate and evidenced-based strategies, such as those identified in this study, can transform the preceptorship experience into one that is fulfilling for both preceptors and preceptees. This may lead to greater job satisfaction, personal and professional growth as well as higher self-esteem levels for preceptors and the realisation of clinical objectives for preceptees.

CONTEXTUAL STRATEGIES FOR CONDUCTING EFFECTIVE NEGOTIATION

Directory of Open Access Journals (Sweden)

Camelia\tBĂEȘU

2015-12-01

Full Text Available Within this paper we try to argue the development of contextual strategies for conducting effective negotiation. Throughout the paper we present that the first motivation which we manage to identify is that we negotiate to improve whatever situation we are involved in. It is of great relevance to identify a few reasons for what we negotiate. Another motivation is that negotiation is an opportunity for creativity and it does allow you to fashion a solution according to, usually different kinds of facts, different fact situation so you may get to express some creativity. Negotiation is perceived as an opportunity where we can also build relationship with the other person. We can also communicate better with the other side about where they are, what they want and where they want to go. Next, we try to identify what makes for successful negotiation during each stage of the negotiation process. According to this paper there are five things which are the essence of business negotiation.

Perceived stress among medical students: To identify its sources and coping strategies

Directory of Open Access Journals (Sweden)

Shubhada Gade

2014-01-01

Full Text Available Context: Stress in medical education is common and process-oriented. It often exerts a negative effect on their academic performance, physical health, and psychological well being. Aims: This study aims at identification of such susceptible students in the early stage i.e. first year of medical education, and to provide them essential support in the form of an intervention program to lessen the negative consequences of stress. Materials and Methods: A cross-sectional survey was carried out among the First MBBS students of NKP Salve Institute of Medical Sciences and Research Center, Nagpur, India. A 41-item questionnaire was designed to assess the sources of stress and their severity. Likert′s 5-point scale was used to quantify the extent of severity on each item. Coping strategies adopted by students were assessed by using a 22-item stress inventory, and a questionnaire based on 19 institutional stress-reducing factors was used to identify its role. Results: The survey resulted into an overall response rate of 87% (131 out of 150 students. Median stress level based on 41 items was evaluated for each student. About 29% (40 students had median stress level greater than 3. Female students were more stressed (17.19% than male students (14.93%. The study revealed that students generally adopt active coping strategies rather than avoidant strategies like alcohol and drug abuse. The study indicated that emotional support system is a major stress-relieving factor for students. Conclusion: Prevalence of perceived stress is high among medical students. It seems that academic-related problems are greater perceived stressors. Review of academics, exam schedules and patterns, better interaction with the faculty and proper guidance, intervention programs and counseling could certainly help a lot to reduce stress in medical students.

A Quantitative Study Identifying Political Strategies Used by Principals of Dual Language Programs

Science.gov (United States)

Girard, Guadalupe

2017-01-01

Purpose. The purpose of this quantitative study was to identify the external and internal political strategies used by principals that allow them to successfully navigate the political environment surrounding dual language programs. Methodology. This quantitative study used descriptive research to collect, analyze, and report data that identified…

The evolution of unconditional strategies via the 'multiplier effect'.

Science.gov (United States)

McNamara, John M; Dall, Sasha R X

2011-03-01

Ostensibly, it makes sense in a changeable world to condition behaviour and development on information when it is available. Nevertheless, unconditional behavioural and life history strategies are widespread. Here, we show how intergenerational effects can limit the evolutionary value of responding to reliable environmental cues, and thus favour the evolutionary persistence of otherwise paradoxical unconditional strategies. While cue-ignoring genotypes do poorly in the wrong environments, in the right environment they will leave many copies of themselves, which will themselves leave many copies, and so on, leading genotypes to accumulate in habitats in which they do well. We call this 'The Multiplier Effect'. We explore the consequences of the multiplier effect by focussing on the ecologically important phenomenon of natal philopatry. We model the environment as a large number of temporally varying breeding sites connected by natal dispersal between sites. Our aim is to identify which aspects of an environment promote the multiplier effect. We show, if sites remain connected through some background level of 'accidental' dispersal, unconditional natal philopatry can evolve even when there is density dependence (with its accompanying kin competition effects), and cues that are only mildly erroneous. Thus, the multiplier effect may underpin the evolution and maintenance of unconditional strategies such as natal philopatry in many biological systems. © 2011 Blackwell Publishing Ltd/CNRS.

A Strategy for Identifying Quantitative Trait Genes Using Gene Expression Analysis and Causal Analysis

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Akira Ishikawa

2017-11-01

Full Text Available Large numbers of quantitative trait loci (QTL affecting complex diseases and other quantitative traits have been reported in humans and model animals. However, the genetic architecture of these traits remains elusive due to the difficulty in identifying causal quantitative trait genes (QTGs for common QTL with relatively small phenotypic effects. A traditional strategy based on techniques such as positional cloning does not always enable identification of a single candidate gene for a QTL of interest because it is difficult to narrow down a target genomic interval of the QTL to a very small interval harboring only one gene. A combination of gene expression analysis and statistical causal analysis can greatly reduce the number of candidate genes. This integrated approach provides causal evidence that one of the candidate genes is a putative QTG for the QTL. Using this approach, I have recently succeeded in identifying a single putative QTG for resistance to obesity in mice. Here, I outline the integration approach and discuss its usefulness using my studies as an example.

A Strategy for Identifying Quantitative Trait Genes Using Gene Expression Analysis and Causal Analysis.

Science.gov (United States)

Ishikawa, Akira

2017-11-27

Large numbers of quantitative trait loci (QTL) affecting complex diseases and other quantitative traits have been reported in humans and model animals. However, the genetic architecture of these traits remains elusive due to the difficulty in identifying causal quantitative trait genes (QTGs) for common QTL with relatively small phenotypic effects. A traditional strategy based on techniques such as positional cloning does not always enable identification of a single candidate gene for a QTL of interest because it is difficult to narrow down a target genomic interval of the QTL to a very small interval harboring only one gene. A combination of gene expression analysis and statistical causal analysis can greatly reduce the number of candidate genes. This integrated approach provides causal evidence that one of the candidate genes is a putative QTG for the QTL. Using this approach, I have recently succeeded in identifying a single putative QTG for resistance to obesity in mice. Here, I outline the integration approach and discuss its usefulness using my studies as an example.

Effectiveness of communication strategies for deaf or hard of hearing workers in group settings.

Science.gov (United States)

Haynes, Scott

2014-01-01

In group settings, background noise and an obstructed view of the speaker are just a few of the issues that can make workplace communication difficult for an individual who is deaf or hard of hearing. Accommodation strategies such as amplification of the speaker's voice or the use of text-based alternatives exist to address these issues. However, recent studies have shown that there are still unmet needs related to workplace communication in group settings for individuals who are deaf or hard of hearing. Identify the most common strategies used by individuals who are deaf or hard of hearing to improve communication in group settings and gauge the perceived effectiveness of those strategies. An online survey was conducted with individuals who self-identified as deaf or hard of hearing. The survey presented specific communication strategies based on three functional approaches (aural/oral, text, visual). The strategies applied to both receptive and expressive communication in five different meeting types ranging in size and purpose. 161 adults (age 22-90 yrs.) with limited hearing ability completed the survey. Text-based strategies were typically the least frequently used strategies in group settings, yet they ranked high in perceived effectiveness for receptive and expressive communication. Those who used an interpreter demonstrated a strong preference for having a qualified interpreter present in the meeting rather than an interpreter acting remotely. For expressive communication, participants in general preferred to use their own voice or signing abilities and ranked those strategies as highly effective. A more accessible workplace for individuals who are deaf or hard of hearing would incorporate more ubiquitous text-based strategy options. Also, qualified interpreters, when used, should be present in the meeting for maximum effectiveness.

Evaluating the effect of organization culture on the successful execution of strategies: Case study of Payam-e-Noor university

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Babak Monzavi

2013-07-01

Full Text Available In this research, we use Hofstede method and Noble’s framework in strategy execution to evaluate the effect of organization culture on the successful implementation of strategies in a case study of Payam-e-Noor University of Iran. Data Collection is performed with the standard Hofstede survey, an evaluation tool for organization culture, and researchers’ survey tool to evaluate the effective implementation of strategies. The reliability coefficient was calculated as 0.846 using the Cronbach alpha. The target population includes 600 senior managers of Payam-e-Noor university of Iran at the time of data collection Cochran formula was used to calculate the required sample number of 120 individuals. The results show that according to the Hofstede dimensions, the dominant cultural aspects of high power distance, uncertainty avoidance, collectivism, and femininity were identified. The first two have a direct influence on effectiveness of strategies. While individualism is known to have an invert effect on effectiveness of strategies, no connection was identified between masculinity and effectiveness of strategies, and thus, this theory was not confirmed in this research.

Identifying and Prioritizing Cleaner Production Strategies in Raw Materials’ Warehouse of Yazdbaf Textile Company in 2015

Directory of Open Access Journals (Sweden)

Mohammad Taghi Ghaneian

2017-03-01

Full Text Available Introduction: Cleaner productions in textile industry is achieved by reducing water and chemicals’ consumption, saving energy, reducing production of air pollution and solid wastes, reducing toxicity and noise pollution through many solutions. The purpose of the present research was to apply Strengths, Weaknesses, Opportunities, Threats (SWOT and Quality Systems Planning Matrix (QSPM techniques in identifying and prioritizing production in raw materials’ warehouse of Yazdbaf Textile Factory. Materials and Methods: In this research, effective internal and external factors in cleaner production were identified by providing the required information through field visit and interview with industry managers and supervisors of raw materials’ warehouse. Finally, To form matrix of internal and external factors 17 important internal factors and 7 important external factors were identified and selected respectively.Then, QSPM matrix was formed to determine the attractiveness and priority of the selected strategies by using results of internal and external factors and SWOT matrixes. Results: According to the results, the total score of raw materials’ warehouse in Internal Factor Evaluation (IFE matrix is equal to 2.90 which shows the good situation of warehouse than the internal factors. However, the total score in External Factor Evaluation (EFE matrix is 2.14 and indicates the relative weak situation of warehouse than the external factors. Conclusion: Based on the obtained results, continuity, monitor, and improvement of the general plan of qualitative control (QC of raw materials and laboratory as well as more emphasis on quality indexes according to its importance in the production processes were selected as the most important strategies. 

Novel association strategy with copy number variation for identifying new risk Loci of human diseases.

Directory of Open Access Journals (Sweden)

Xianfeng Chen

2010-08-01

Full Text Available Copy number variations (CNV are important causal genetic variations for human disease; however, the lack of a statistical model has impeded the systematic testing of CNVs associated with disease in large-scale cohort.Here, we developed a novel integrated strategy to test CNV-association in genome-wide case-control studies. We converted the single-nucleotide polymorphism (SNP signal to copy number states using a well-trained hidden Markov model. We mapped the susceptible CNV-loci through SNP site-specific testing to cope with the physiological complexity of CNVs. We also ensured the credibility of the associated CNVs through further window-based CNV-pattern clustering. Genome-wide data with seven diseases were used to test our strategy and, in total, we identified 36 new susceptible loci that are associated with CNVs for the seven diseases: 5 with bipolar disorder, 4 with coronary artery disease, 1 with Crohn's disease, 7 with hypertension, 9 with rheumatoid arthritis, 7 with type 1 diabetes and 3 with type 2 diabetes. Fifteen of these identified loci were validated through genotype-association and physiological function from previous studies, which provide further confidence for our results. Notably, the genes associated with bipolar disorder converged in the phosphoinositide/calcium signaling, a well-known affected pathway in bipolar disorder, which further supports that CNVs have impact on bipolar disorder.Our results demonstrated the effectiveness and robustness of our CNV-association analysis and provided an alternative avenue for discovering new associated loci of human diseases.

Multiple strategies to identify HIV-positive black men who have sex with men and transgender women in New York City: a cross-sectional analysis of recruitment results.

Science.gov (United States)

Franks, Julie; Mannheimer, Sharon B; Hirsch-Moverman, Yael; Hayes-Larson, Eleanor; Colson, Paul W; Ortega, Hugo; El-Sadr, Wafaa M

2018-03-01

Black men who have sex with men and transgender women are at high risk for HIV infection, but are more likely to be unaware of their infection or not in care for diagnosed HIV compared to other races. Respondent driven sampling has been advanced as a method to reach stigmatized and hidden populations for HIV testing. We compared strategies to recruit black, substance-using men who have sex with men and transgender women to identify newly diagnosed HIV infection, or those previously diagnosed but not in care. The STAR (Seek, Test, and Retain) study (ClinicalTrials.gov NCT01790360) used several recruitment strategies to identify black, substance-using men who have sex with men and transgender women with undiagnosed HIV infection or with previously diagnosed HIV infection but who were not in HIV care. Respondent-driven sampling, community-based recruitment and online advertising were used to recruit participants. Incentivized peer referral was integrated into all recruitment strategies. Participants completed interviewer-administered questionnaires and HIV testing. Demographic and HIV risk-related characteristics and recruitment strategy were summarized and stratified by HIV status. Associations were tested using Pearson's chi-squared, Fisher's exact, and Wilcoxon rank sum tests. Factors associated with HIV-positive diagnosis at p recruitment strategies, respondent driven sampling was least effective in identifying HIV-positive participants. Integrating multiple recruitment strategies yielded a large sample of black men who have sex with men and transgender women at substantial risk for HIV. Respondent-driven sampling was less effective than other strategies at identifying men who have sex with men and transgender women with HIV. © 2018 The Authors. Journal of the International AIDS Society published by John Wiley & sons Ltd on behalf of the International AIDS Society.

The use of concept mapping to identify community-driven intervention strategies for physical and mental health.

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Vaughn, Lisa M; Jacquez, Farrah; McLinden, Daniel

2013-09-01

Research that partners with youth and community stakeholders increases contextual relevance and community buy-in and therefore maximizes the chance for intervention success. Concept mapping is a mixed-method participatory research process that accesses the input of the community in a collaborative manner. After a school-wide health needs assessment at a low-income, minority/immigrant K-8 school identified bullying and obesity as the most important health issues, concept mapping was used to identify and prioritize specific strategies to address these two areas. Stakeholders including 160 K-8 students, 33 college students working in the school, 35 parents, 20 academic partners, and 22 teachers/staff brainstormed strategies to reduce and prevent obesity and bullying. A smaller group of stakeholders worked individually to complete an unstructured sorting of these strategies into groups of similar ideas, once for obesity and again for bullying. Multidimensional scaling and cluster analysis was applied to the sorting data to produce a series of maps that illustrated the stakeholders' conceptual thinking about obesity and bullying prevention strategies. The maps for both obesity and bullying organized specific strategies into themes that included education, parental role, teacher/school supervision, youth role, expert/professional role, and school structure/support.

Cost-effectiveness of health research study participant recruitment strategies: a systematic review.

Science.gov (United States)

Huynh, Lynn; Johns, Benjamin; Liu, Su-Hsun; Vedula, S Swaroop; Li, Tianjing; Puhan, Milo A

2014-10-01

A large fraction of the cost of conducting clinical trials is allocated to recruitment of participants. A synthesis of findings from studies that evaluate the cost and effectiveness of different recruitment strategies will inform investigators in designing cost-efficient clinical trials. To systematically identify, assess, and synthesize evidence from published comparisons of the cost and yield of strategies for recruitment of participants to health research studies. We included randomized studies in which two or more strategies for recruitment of participants had been compared. We focused our economic evaluation on studies that randomized participants to different recruitment strategies. We identified 10 randomized studies that compared recruitment strategies, including monetary incentives (cash or prize), direct contact (letters or telephone call), and medical referral strategies. Only two of the 10 studies compared strategies for recruiting participants to clinical trials. We found that allocating additional resources to recruit participants using monetary incentives or direct contact yielded between 4% and 23% additional participants compared to using neither strategy. For medical referral, recruitment of prostate cancer patients by nurses was cost-saving compared to recruitment by consultant urologists. For all underlying study designs, monetary incentives cost more than direct contact with potential participants, with a median incremental cost per recruitment ratio of Int$72 (Int$-International dollar, a theoretical unit of currency) for monetary incentive strategy compared to Int$28 for direct contact strategy. Only monetary incentives and source of referral were evaluated for recruiting participants into clinical trials. We did not review studies that presented non-monetary cost or lost opportunity cost. We did not adjust for the number of study recruitment sites or the study duration in our economic evaluation analysis. Systematic and explicit reporting of

Organizational crisis-denial strategy: the effect of denial on public framing

NARCIS (Netherlands)

van der Meer, T.G.L.A.

2014-01-01

By applying a framing perspective, this study explores the effect of a crisis-denial strategy on public response. The online public framing of a specific crisis is compared with the crisis-denial frame provided by the organization. An automated semantic-network analysis is used to identify frames

An outline of a model-based expert system to identify optimal remedial strategies for restoring contaminated acquatic ecosystems: The project ``moira``

Energy Technology Data Exchange (ETDEWEB)

Appelgren, A.; Bergstrom, U. [Studsvik Eco and AB, Nykoping (Sweden); Brittain, J. [Oslo Univ. (Norway). LFI Zoological Museum; Gallego Diaz, E. [Madrid Universidad Politecnica (Spain). Dept. de Ingenieria Nuclear; Hakanson, L. [KEMA Nuclear, Arnhem (Niger); Monte, L. [ENEA, Centro Ricerche Casaccia, Rome (Italy). Dip. Ambiente

1996-10-01

The present report describes the fundamental principles of the research programme MOIRA (a model based computerized system for management support to Identify optimal remedial strategies for Restoring radionuclide contaminated Aquatic ecosystems and drainage areas) financed by the EC (European Community) (Contract N F14P-CT96-0036). The interventions to restore radionuclides contaminated aquatic systems may result in detrimental ecological, social and economical effects. Decision makers must carefully evaluate these impacts. The main aim of the MOIRA project is the development of an expert system based on validated models predicting the evolution of the radioactive contamination of fresh water systems following countermeasure applications and their relevant ecological, social and economical impacts. The expert system will help decision makers, that are not necessarily gifted with experience in environmental modeling, to identify optimal remedial strategies for restoring contaminated fresh water systems.

An outline of a model-based expert system to identify optimal remedial strategies for restoring contaminated aquatic ecosystems: the project MOIRA

International Nuclear Information System (INIS)

Appelgren, A.; Bergstrom, U.; Brittain, J.; Monte, L.

1996-10-01

The present report describes the fundamental principles of the research programme MOIRA (a model based computerized system for management support to Identify optimal remedial strategies for Restoring radionuclide contaminated Aquatic ecosystems and drainage areas) financed by the EC (European Community) (Contract N F14P-CT96-0036). The interventions to restore radionuclides contaminated aquatic systems may result in detrimental ecological, social and economical effects. Decision makers must carefully evaluate these impacts. The main aim of the MOIRA project is the development of an expert system based on validated models predicting the evolution of the radioactive contamination of fresh water systems following countermeasure applications and their relevant ecological, social and economical impacts. The expert system will help decision makers, that are not necessarily gifted with experience in environmental modeling, to identify optimal remedial strategies for restoring contaminated fresh water systems

A model-based assessment of the cost-utility of strategies to identify Lynch syndrome in early-onset colorectal cancer patients.

Science.gov (United States)

Snowsill, Tristan; Huxley, Nicola; Hoyle, Martin; Jones-Hughes, Tracey; Coelho, Helen; Cooper, Chris; Frayling, Ian; Hyde, Chris

2015-04-25

Lynch syndrome is an autosomal dominant cancer predisposition syndrome caused by mutations in the DNA mismatch repair genes MLH1, MSH2, MSH6 and PMS2. Individuals with Lynch syndrome have an increased risk of colorectal cancer, endometrial cancer, ovarian and other cancers. Lynch syndrome remains underdiagnosed in the UK. Reflex testing for Lynch syndrome in early-onset colorectal cancer patients is proposed as a method to identify more families affected by Lynch syndrome and offer surveillance to reduce cancer risks, although cost-effectiveness is viewed as a barrier to implementation. The objective of this project was to estimate the cost-utility of strategies to identify Lynch syndrome in individuals with early-onset colorectal cancer in the NHS. A decision analytic model was developed which simulated diagnostic and long-term outcomes over a lifetime horizon for colorectal cancer patients with and without Lynch syndrome and for relatives of those patients. Nine diagnostic strategies were modelled which included microsatellite instability (MSI) testing, immunohistochemistry (IHC), BRAF mutation testing (methylation testing in a scenario analysis), diagnostic mutation testing and Amsterdam II criteria. Biennial colonoscopic surveillance was included for individuals diagnosed with Lynch syndrome and accepting surveillance. Prophylactic hysterectomy with bilateral salpingo-oophorectomy (H-BSO) was similarly included for women diagnosed with Lynch syndrome. Costs from NHS and Personal Social Services perspective and quality-adjusted life years (QALYs) were estimated and discounted at 3.5% per annum. All strategies included for the identification of Lynch syndrome were cost-effective versus no testing. The strategy with the greatest net health benefit was MSI followed by BRAF followed by diagnostic genetic testing, costing £5,491 per QALY gained over no testing. The effect of prophylactic H-BSO on health-related quality of life (HRQoL) is uncertain and could outweigh

Identifying optimal agricultural countermeasure strategies for a hypothetical contamination scenario using the strategy model

International Nuclear Information System (INIS)

Cox, G.; Beresford, N.A.; Alvarez-Farizo, B.; Oughton, D.; Kis, Z.; Eged, K.; Thorring, H.; Hunt, J.; Wright, S.; Barnett, C.L.; Gil, J.M.; Howard, B.J.; Crout, N.M.J.

2005-01-01

A spatially implemented model designed to assist the identification of optimal countermeasure strategies for radioactively contaminated regions is described. Collective and individual ingestion doses for people within the affected area are estimated together with collective exported ingestion dose. A range of countermeasures are incorporated within the model, and environmental restrictions have been included as appropriate. The model evaluates the effectiveness of a given combination of countermeasures through a cost function which balances the benefit obtained through the reduction in dose with the cost of implementation. The optimal countermeasure strategy is the combination of individual countermeasures (and when and where they are implemented) which gives the lowest value of the cost function. The model outputs should not be considered as definitive solutions, rather as interactive inputs to the decision making process. As a demonstration the model has been applied to a hypothetical scenario in Cumbria (UK). This scenario considered a published nuclear power plant accident scenario with a total deposition of 1.7 x 10 14 , 1.2 x 10 13 , 2.8 x 10 10 and 5.3 x 10 9 Bq for Cs-137, Sr-90, Pu-239/240 and Am-241, respectively. The model predicts that if no remediation measures were implemented the resulting collective dose would be approximately 36 000 person-Sv (predominantly from 137 Cs) over a 10-year period post-deposition. The optimal countermeasure strategy is predicted to avert approximately 33 000 person-Sv at a cost of approximately pound 160 million. The optimal strategy comprises a mixture of ploughing, AFCF (ammonium-ferric hexacyano-ferrate) administration, potassium fertiliser application, clean feeding of livestock and food restrictions. The model recommends specific areas within the contaminated area and time periods where these measures should be implemented

An interdisciplinary approach to identify adaptation strategies that enhance flood resilience and urban liveability

DEFF Research Database (Denmark)

Rogers, B. C.; Bertram, N.; Gunn, Alex

This paper provides guidance on how to identify and design the most suitable climate adaptation strategies for enhancing the liveability and flood resilience of urban catchments. It presents findings from a case study of Elwood, a coastal Melbourne suburb regularly affected by flooding. The resea...

Barriers and Effective Educational Strategies to Develop Extension Agents' Professional Competencies

Science.gov (United States)

Lakai, Dona; Jayaratne, K. S. U.; Moore, Gary E.; Kistler, Mark J.

2012-01-01

The study reported here determined the barriers and effective educational strategies to develop Extension agents' professional competencies. This was a descriptive survey research conducted with a random sample of Extension agents. Increased workload and lack of time and funding were identified as the most constraining barriers of Extension agents…

Strategies to design clinical studies to identify predictive biomarkers in cancer research.

Science.gov (United States)

Perez-Gracia, Jose Luis; Sanmamed, Miguel F; Bosch, Ana; Patiño-Garcia, Ana; Schalper, Kurt A; Segura, Victor; Bellmunt, Joaquim; Tabernero, Josep; Sweeney, Christopher J; Choueiri, Toni K; Martín, Miguel; Fusco, Juan Pablo; Rodriguez-Ruiz, Maria Esperanza; Calvo, Alfonso; Prior, Celia; Paz-Ares, Luis; Pio, Ruben; Gonzalez-Billalabeitia, Enrique; Gonzalez Hernandez, Alvaro; Páez, David; Piulats, Jose María; Gurpide, Alfonso; Andueza, Mapi; de Velasco, Guillermo; Pazo, Roberto; Grande, Enrique; Nicolas, Pilar; Abad-Santos, Francisco; Garcia-Donas, Jesus; Castellano, Daniel; Pajares, María J; Suarez, Cristina; Colomer, Ramon; Montuenga, Luis M; Melero, Ignacio

2017-02-01

The discovery of reliable biomarkers to predict efficacy and toxicity of anticancer drugs remains one of the key challenges in cancer research. Despite its relevance, no efficient study designs to identify promising candidate biomarkers have been established. This has led to the proliferation of a myriad of exploratory studies using dissimilar strategies, most of which fail to identify any promising targets and are seldom validated. The lack of a proper methodology also determines that many anti-cancer drugs are developed below their potential, due to failure to identify predictive biomarkers. While some drugs will be systematically administered to many patients who will not benefit from them, leading to unnecessary toxicities and costs, others will never reach registration due to our inability to identify the specific patient population in which they are active. Despite these drawbacks, a limited number of outstanding predictive biomarkers have been successfully identified and validated, and have changed the standard practice of oncology. In this manuscript, a multidisciplinary panel reviews how those key biomarkers were identified and, based on those experiences, proposes a methodological framework-the DESIGN guidelines-to standardize the clinical design of biomarker identification studies and to develop future research in this pivotal field. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

A study on the implementation effect of accident management strategies on safety

International Nuclear Information System (INIS)

Jae, Moo Sung; Kim, Dong Ha; Jin, Young Ho

1996-01-01

This paper presents a new approach for assessing accident management strategies using containment event trees(CETs) developed during an individual plant examination (IPE) for a reference plant (CE type, 950 MWe PWR). Various accident management strategies to reduce risk have been proposed through IPE. Three strategies for the station blackout sequence are used as an example: 1) reactor cavity flooding only, 2) primary system depressurization only, and 3) doing both. These strategies are assumed to be initiated at about the time of core uncovery. The station blackout (SBO) sequence is selected in this paper since it is identified as one of the most threatening sequences to safety of the reference plant. The effectiveness and adverse effects of each accident management strategy are considered synthetically in the CETs. A best estimate assessment for the developed CETs using data obtained from NUREG-1150, other PRA results, and the MAAP code calculations is performed. The strategies are ranked with respect to minimizing the frequencies of various containment failure modes. The proposed approach is demonstrated to be very flexible in that it can be applied to any kind of accident management strategy for any sequence. 9 refs., 3 figs., 2 tabs. (author)

The effects of three concept mapping strategies on seventh-grade students' science achievement at an urban middle school

Science.gov (United States)

Dosanjh, Navdeep Kaur

2011-12-01

There is great concern over students' poor science achievement in the United States. Due to the lack of science achievement, students are not pursing science related careers resulting in an increase in outsourcing to other countries. Learning strategies such as concept mapping may ameliorate this situation by providing students with tools that encourage meaningful learning. The purpose of this quasi-experimental study was to measure the effects of three concept mapping learning strategies (concept identifying, proposition identifying, student generated) on urban middle school students' understanding of the circulatory system. Three intact classes of seventh-grade students were assigned to one of the three concept mapping strategies. The students were given a pretest on the circulatory system then learned and used their respective concept mapping strategies while learning about the circulatory system. At the conclusion of the study, students' science achievement was measured by performance on an achievement test and rubric scores of their respective concept identifying, proposition identifying, and student generated concept maps. The results of the study suggest that all three of the concept mapping strategies are effective in increasing students' science achievement. Additionally, the moderate significant correlations between the posttest and concept map scores of the current study established that concept maps are a useful measure of student knowledge. Lastly, the results of the current study also suggest that the concept identifying mapping strategy may be a useful scaffold in instructing students how to develop student generated concept maps.

A model-based assessment of the cost–utility of strategies to identify Lynch syndrome in early-onset colorectal cancer patients

International Nuclear Information System (INIS)

Snowsill, Tristan; Huxley, Nicola; Hoyle, Martin; Jones-Hughes, Tracey; Coelho, Helen; Cooper, Chris; Frayling, Ian; Hyde, Chris

2015-01-01

Lynch syndrome is an autosomal dominant cancer predisposition syndrome caused by mutations in the DNA mismatch repair genes MLH1, MSH2, MSH6 and PMS2. Individuals with Lynch syndrome have an increased risk of colorectal cancer, endometrial cancer, ovarian and other cancers. Lynch syndrome remains underdiagnosed in the UK. Reflex testing for Lynch syndrome in early-onset colorectal cancer patients is proposed as a method to identify more families affected by Lynch syndrome and offer surveillance to reduce cancer risks, although cost-effectiveness is viewed as a barrier to implementation. The objective of this project was to estimate the cost–utility of strategies to identify Lynch syndrome in individuals with early-onset colorectal cancer in the NHS. A decision analytic model was developed which simulated diagnostic and long-term outcomes over a lifetime horizon for colorectal cancer patients with and without Lynch syndrome and for relatives of those patients. Nine diagnostic strategies were modelled which included microsatellite instability (MSI) testing, immunohistochemistry (IHC), BRAF mutation testing (methylation testing in a scenario analysis), diagnostic mutation testing and Amsterdam II criteria. Biennial colonoscopic surveillance was included for individuals diagnosed with Lynch syndrome and accepting surveillance. Prophylactic hysterectomy with bilateral salpingo-oophorectomy (H-BSO) was similarly included for women diagnosed with Lynch syndrome. Costs from NHS and Personal Social Services perspective and quality-adjusted life years (QALYs) were estimated and discounted at 3.5% per annum. All strategies included for the identification of Lynch syndrome were cost-effective versus no testing. The strategy with the greatest net health benefit was MSI followed by BRAF followed by diagnostic genetic testing, costing £5,491 per QALY gained over no testing. The effect of prophylactic H-BSO on health-related quality of life (HRQoL) is uncertain and could

Effective recruitment of minority populations through community-led strategies.

Science.gov (United States)

Horowitz, Carol R; Brenner, Barbara L; Lachapelle, Susanne; Amara, Duna A; Arniella, Guedy

2009-12-01

Traditional research approaches frequently fail to yield representative numbers of people of color in research. Community-based participatory research (CBPR) may be an important strategy for partnering with and reaching populations that bear a greater burden of illness but have been historically difficult to engage. The Community Action Board, consisting of 20 East Harlem residents, leaders, and advocates, used CBPR to compare the effectiveness of various strategies in recruiting and enrolling adults with prediabetes into a peer-led, diabetes prevention intervention. The board created five recruitment strategies: recruiting through clinicians; recruiting at large public events such as farmers markets; organizing special local recruitment events; recruiting at local organizations; and recruiting through a partner-led approach, in which community partners developed and managed the recruitment efforts at their sites. In 3 months, 555 local adults were approached; 249 were appropriate candidates for further evaluation (overweight, nonpregnant, East Harlem residents without known diabetes); 179 consented and returned in a fasting state for 1/2 day of prediabetes testing; 99 had prediabetes and enrolled in a pilot randomized trial. The partner-led approach was highly successful, recruiting 68% of those enrolled. This strategy was also the most efficient; 34% of those approached through partners were ultimately enrolled, versus 0%-17% enrolled through the other four strategies. Participants were predominantly low-income, uninsured, undereducated, Spanish-speaking women. This CBPR approach highlights the value of partner-led recruitment to identify, reach out to, and motivate a vulnerable population into participation in research, using techniques that may be unfamiliar to researchers but are nevertheless rigorous and effective.

Stakeholders identify similar barriers but different strategies to facilitate return-to-work: A vignette of a worker with an upper extremity condition.

Science.gov (United States)

Peters, Susan E; Truong, Anthony P; Johnston, Venerina

2018-01-01

Stakeholders involved in the return-to-work (RTW) process have different roles and qualificationsOBJECTIVE:To explore the perspectives of Australian stakeholders of the RTW barriers and strategies for a worker with an upper extremity condition and a complex workers' compensation case. Using a case vignette, stakeholders were asked to identify barriers and recommend strategies to facilitate RTW. Content analysis was performed on the open-ended responses. The responses were categorised into RTW barriers and strategies using the biopsychosocial model. Pearson's Chi Square and ANOVA were performed to establish group differences. 621 participants (488 healthcare providers (HCPs), 62 employers, 55 insurers and 16 lawyers) identified 36 barriers (31 modifiable): 4 demographic; 8 biological; 15 psychological and 9 social barriers. 484 participants reported 16 RTW strategies: 4 biological; 6 psychological and 6 social strategies. 'Work relationship stressors' (83.4%) and 'Personal relationship stressors' (64.7%) were the most frequently nominated barriers. HCPs most frequently nominated 'Pain management' (49.6%), while employers, insurers and lawyers nominated 'RTW planning/Suitable duties programs' (40.5%; 42.9%; 80%). Stakeholders perceived similar barriers for RTW but recommended different strategies. Stakeholders appeared to be more proficient in identifying barriers than recommending strategies. Future research should focus on tools to both identify RTW barriers and direct intervention.

The quality of clinical maternal and neonatal healthcare - a strategy for identifying 'routine care signal functions'.

Directory of Open Access Journals (Sweden)

Stephan Brenner

Full Text Available A variety of clinical process indicators exists to measure the quality of care provided by maternal and neonatal health (MNH programs. To allow comparison across MNH programs in low- and middle-income countries (LMICs, a core set of essential process indicators is needed. Although such a core set is available for emergency obstetric care (EmOC, the 'EmOC signal functions', a similar approach is currently missing for MNH routine care evaluation. We describe a strategy for identifying core process indicators for routine care and illustrate their usefulness in a field example.We first developed an indicator selection strategy by combining epidemiological and programmatic aspects relevant to MNH in LMICs. We then identified routine care process indicators meeting our selection criteria by reviewing existing quality of care assessment protocols. We grouped these indicators into three categories based on their main function in addressing risk factors of maternal or neonatal complications. We then tested this indicator set in a study assessing MNH quality of clinical care in 33 health facilities in Malawi.Our strategy identified 51 routine care processes: 23 related to initial patient risk assessment, 17 to risk monitoring, 11 to risk prevention. During the clinical performance assessment a total of 82 cases were observed. Birth attendants' adherence to clinical standards was lowest in relation to risk monitoring processes. In relation to major complications, routine care processes addressing fetal and newborn distress were performed relatively consistently, but there were major gaps in the performance of routine care processes addressing bleeding, infection, and pre-eclampsia risks.The identified set of process indicators could identify major gaps in the quality of obstetric and neonatal care provided during the intra- and immediate postpartum period. We hope our suggested indicators for essential routine care processes will contribute to streamlining

The quality of clinical maternal and neonatal healthcare - a strategy for identifying 'routine care signal functions'.

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Brenner, Stephan; De Allegri, Manuela; Gabrysch, Sabine; Chinkhumba, Jobiba; Sarker, Malabika; Muula, Adamson S

2015-01-01

A variety of clinical process indicators exists to measure the quality of care provided by maternal and neonatal health (MNH) programs. To allow comparison across MNH programs in low- and middle-income countries (LMICs), a core set of essential process indicators is needed. Although such a core set is available for emergency obstetric care (EmOC), the 'EmOC signal functions', a similar approach is currently missing for MNH routine care evaluation. We describe a strategy for identifying core process indicators for routine care and illustrate their usefulness in a field example. We first developed an indicator selection strategy by combining epidemiological and programmatic aspects relevant to MNH in LMICs. We then identified routine care process indicators meeting our selection criteria by reviewing existing quality of care assessment protocols. We grouped these indicators into three categories based on their main function in addressing risk factors of maternal or neonatal complications. We then tested this indicator set in a study assessing MNH quality of clinical care in 33 health facilities in Malawi. Our strategy identified 51 routine care processes: 23 related to initial patient risk assessment, 17 to risk monitoring, 11 to risk prevention. During the clinical performance assessment a total of 82 cases were observed. Birth attendants' adherence to clinical standards was lowest in relation to risk monitoring processes. In relation to major complications, routine care processes addressing fetal and newborn distress were performed relatively consistently, but there were major gaps in the performance of routine care processes addressing bleeding, infection, and pre-eclampsia risks. The identified set of process indicators could identify major gaps in the quality of obstetric and neonatal care provided during the intra- and immediate postpartum period. We hope our suggested indicators for essential routine care processes will contribute to streamlining MNH program

Nursing students' perspectives on clinical instructors' effective teaching strategies: A descriptive study.

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Valiee, Sina; Moridi, Glorokh; Khaledi, Shahnaz; Garibi, Fardin

2016-01-01

An important factor contributing to the quality of clinical education is instructors' teaching performance. The aim of this study was to identify clinical instructors' most effective teaching strategies from nursing and midwifery students' perspectives. This was a descriptive cross-sectional study. All third- and fourth-year bachelor's nursing and midwifery students studying at the Nursing and Midwifery Faculty of Kurdistan University of Medical Sciences were recruited to the study by using the census method. The study instrument consisted of a demographic questionnaire and the self-report 30-item Clinical Instructors' Effective Teaching Strategies Inventory. The SPSS v.16.0 was used for data analysis. The most effective teaching strategies of clinical instructors from nursing and midwifery students' perspectives were respectively 'treating students, clients, and colleagues with respect' and 'being eager for guiding students and manage their problems'. Clinical instructors need to be eager for education and also be able to establish effective communication with students. Empowering clinical instructors in specialized and technical aspects of clinical education seems necessary. Copyright © 2015 Elsevier Ltd. All rights reserved.

Effective recruitment strategies in primary care research: a systematic review.

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Ngune, Irene; Jiwa, Moyez; Dadich, Ann; Lotriet, Jaco; Sriram, Deepa

2012-01-01

Patient recruitment in primary care research is often a protracted and frustrating process, affecting project timeframes, budget and the dissemination of research findings. Yet, clear guidance on patient recruitment strategies in primary care research is limited. This paper addresses this issue through a systematic review. Articles were sourced from five academic databases - AustHealth, CINAHL, the Cochrane Methodology Group, EMBASE and PubMed/Medline; grey literature was also sourced from an academic library and the Primary Healthcare Research & Information Service (PHCRIS) website. Two reviewers independently screened the articles using the following criteria: (1) published in English, (2) reported empirical research, (3) focused on interventions designed to increase patient recruitment in primary care settings, and (4) reported patient recruitment in primary care settings. Sixty-six articles met the inclusion criteria. Of these, 23 specifically focused on recruitment strategies and included randomised trials (n = 7), systematic reviews (n = 8) and qualitative studies (n = 8). Of the remaining articles, 30 evaluated recruitment strategies, while 13 addressed the value of recruitment strategies using descriptive statistics and/or qualitative data. Among the 66 articles, primary care chiefly included general practice (n = 30); nursing and allied health services, multiple settings, as well as other community settings (n = 30); and pharmacy (n = 6). Effective recruitment strategies included the involvement of a discipline champion, simple patient eligibility criteria, patient incentives and organisational strategies that reduce practitioner workload. The most effective recruitment in primary care research requires practitioner involvement. The active participation of primary care practitioners in both the design and conduct of research helps to identify strategies that are congruent with the context in which patient care is delivered. This is reported to be the

Integrated Model to Assess Cloud Deployment Effectiveness When Developing an IT-strategy

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Razumnikov, S.; Prankevich, D.

2016-04-01

Developing an IT-strategy of cloud deployment is a complex issue since even the stage of its formation necessitates revealing what applications will be the best possible to meet the requirements of a company business-strategy, evaluate reliability and safety of cloud providers and analyze staff satisfaction. A system of criteria, as well an integrated model to assess cloud deployment effectiveness is offered. The model makes it possible to identify what applications being at the disposal of a company, as well as new tools to be deployed are reliable and safe enough for implementation in the cloud environment. The data on practical use of the procedure to assess cloud deployment effectiveness by a provider of telecommunication services is presented. The model was used to calculate values of integral indexes of services to be assessed, then, ones, meeting the criteria and answering the business-strategy of a company, were selected.

Root Cause Analyses of Suicides of Mental Health Clients: Identifying Systematic Processes and Service-Level Prevention Strategies.

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Gillies, Donna; Chicop, David; O'Halloran, Paul

2015-01-01

The ability to predict imminent risk of suicide is limited, particularly among mental health clients. Root cause analysis (RCA) can be used by health services to identify service-wide approaches to suicide prevention. To (a) develop a standardized taxonomy for RCAs; (b) to quantitate service-related factors associated with suicides; and (c) to identify service-related suicide prevention strategies. The RCAs of all people who died by suicide within 1 week of contact with the mental health service over 5 years were thematically analyzed using a data collection tool. Data were derived from RCAs of all 64 people who died by suicide between 2008 and 2012. Major themes were categorized as individual, situational, and care-related factors. The most common factor was that clients had recently denied suicidality. Reliance on carers, recent changes in medication, communication problems, and problems in follow-through were also commonly identified. Given the difficulty in predicting suicide in people whose expressions of suicidal ideation change so rapidly, services may consider the use of strategies aimed at improving the individual, stressor, support, and care factors identified in this study.

Workplace-Based Assessment: A Review of User Perceptions and Strategies to Address the Identified Shortcomings

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Massie, Jonathan; Ali, Jason M.

2016-01-01

Workplace based assessments (WBAs) are now commonplace in postgraduate medical training. User acceptability and engagement is essential to the success of any medical education innovation. To this end, possessing an insight into trainee and trainer perceptions towards WBAs will help identify the major problems, permitting strategies to be…

Evaluation of testing strategies to identify infected animals at a single round of testing within dairy herds known to be infected with Mycobacterium avium ssp. paratuberculosis.

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More, S J; Cameron, A R; Strain, S; Cashman, W; Ezanno, P; Kenny, K; Fourichon, C; Graham, D

2015-08-01

As part of a broader control strategy within herds known to be infected with Mycobacterium avium ssp. paratuberculosis (MAP), individual animal testing is generally conducted to identify infected animals for action, usually culling. Opportunities are now available to quantitatively compare different testing strategies (combinations of tests) in known infected herds. This study evaluates the effectiveness, cost, and cost-effectiveness of different testing strategies to identify infected animals at a single round of testing within dairy herds known to be MAP infected. A model was developed, taking account of both within-herd infection dynamics and test performance, to simulate the use of different tests at a single round of testing in a known infected herd. Model inputs included the number of animals at different stages of infection, the sensitivity and specificity of each test, and the costs of testing and culling. Testing strategies included either milk or serum ELISA alone or with fecal culture in series. Model outputs included effectiveness (detection fraction, the proportion of truly infected animals in the herd that are successfully detected by the testing strategy), cost, and cost-effectiveness (testing cost per true positive detected, total cost per true positive detected). Several assumptions were made: MAP was introduced with a single animal and no management interventions were implemented to limit within-herd transmission of MAP before this test. In medium herds, between 7 and 26% of infected animals are detected at a single round of testing, the former using the milk ELISA and fecal culture in series 5 yr after MAP introduction and the latter using fecal culture alone 15 yr after MAP introduction. The combined costs of testing and culling at a single round of testing increases with time since introduction of MAP infection, with culling costs being much greater than testing costs. The cost-effectiveness of testing varied by testing strategy. It was also

Implementation of a cost-effective strategy to prevent neonatal early-onset group B haemolytic streptococcus disease in the Netherlands.

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Kolkman, Diny G E; Rijnders, Marlies E B; Wouters, Maurice G A J; van den Akker-van Marle, M Elske; van der Ploeg, Cpb Kitty; de Groot, Christianne J M; Fleuren, Margot A H

2013-07-30

Early-onset Group B haemolytic streptococcus infection (EOGBS) is an important cause of neonatal morbidity and mortality in the first week of life. Primary prevention of EOGBS is possible with intra-partum antibiotic prophylaxis (IAP.) Different prevention strategies are used internationally based on identifying pregnant women at risk, either by screening for GBS colonisation and/or by identifying risk factors for EOGBS in pregnancy or labour. A theoretical cost-effectiveness study has shown that a strategy with IAP based on five risk factors (risk-based strategy) or based on a positive screening test in combination with one or more risk factors (combination strategy) was the most cost-effective approach in the Netherlands. IAP for all pregnant women with a positive culture in pregnancy (screening strategy) and treatment in line with the current Dutch guideline (IAP after establishing a positive culture in case of pre-labour rupture of membranes or preterm birth and immediate IAP in case of intra-partum fever, previous sibling with EOGBS or GBS bacteriuria), were not cost-effective. Cost-effectiveness was based on the assumption of 100% adherence to each strategy. However, adherence in daily practice will be lower and therefore have an effect on cost-effectiveness. The aims are to: a.) implement the current Dutch guideline, the risk-based strategy and the combination strategy in three pilot regions and b.) study the effects of these strategies in daily practice. Regions where all the care providers in maternity care implement the allocated strategy will be randomised. Before the introduction of the strategy, there will be a pre-test (use of the current guideline) involving 105 pregnant women per region. This will be followed by a post-test (use of the allocated strategy) involving 315 women per region. The outcome measures are: 1.) adherence to the specific prevention strategy and the determinants of adherence among care providers and pregnant women, 2.) outcomes

Strategies for effective collaborative manuscript development in interdisciplinary science teams

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Oliver, Samantha K.; Fergus, C. Emi; Skaff, Nicholas K.; Wagner, Tyler; Tan, Pang-Ning; Cheruvelil, Kendra Spence; Soranno, Patricia A.

2018-01-01

Science is increasingly being conducted in large, interdisciplinary teams. As team size increases, challenges can arise during manuscript development, where achieving one team goal (e.g., inclusivity) may be in direct conflict with other goals (e.g., efficiency). Here, we present strategies for effective collaborative manuscript development that draw from our experiences in an interdisciplinary science team writing collaborative manuscripts for six years. These strategies are rooted in six guiding principles that were important to our team: to create a transparent, inclusive, and accountable research team that promotes and protects team members who have less power to influence decision‐making while fostering creativity and productivity. To help alleviate the conflicts that can arise in collaborative manuscript development, we present the following strategies: understand your team composition, create an authorship policy and discuss authorship early and often, openly announce manuscript ideas, identify and communicate the type of manuscript and lead author management style, and document and describe authorship contributions. These strategies can help reduce the probability of group conflict, uphold individual and team values, achieve fair authorship practices, and increase science productivity.

New cochlear implant research coding strategy based on the MP3(000™) strategy to reintroduce the virtual channel effect.

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Neben, Nicole; Lenarz, Thomas; Schuessler, Mark; Harpel, Theo; Buechner, Andreas

2013-05-01

Results for speech recognition in noise tests when using a new research coding strategy designed to introduce the virtual channel effect provided no advantage over MP3(000™). Although statistically significant smaller just noticeable differences (JNDs) were obtained, the findings for pitch ranking proved to have little clinical impact. The aim of this study was to explore whether modifications to MP3000 by including sequential virtual channel stimulation would lead to further improvements in hearing, particularly for speech recognition in background noise and in competing-talker conditions, and to compare results for pitch perception and melody recognition, as well as informally collect subjective impressions on strategy preference. Nine experienced cochlear implant subjects were recruited for the prospective study. Two variants of the experimental strategy were compared to MP3000. The study design was a single-blinded ABCCBA cross-over trial paradigm with 3 weeks of take-home experience for each user condition. Comparing results of pitch-ranking, a significantly reduced JND was identified. No significant effect of coding strategy on speech understanding in noise or competing-talker materials was found. Melody recognition skills were the same under all user conditions.

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

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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

Inverse targeting —An effective immunization strategy

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Schneider, C. M.; Mihaljev, T.; Herrmann, H. J.

2012-05-01

We propose a new method to immunize populations or computer networks against epidemics which is more efficient than any continuous immunization method considered before. The novelty of our method resides in the way of determining the immunization targets. First we identify those individuals or computers that contribute the least to the disease spreading measured through their contribution to the size of the largest connected cluster in the social or a computer network. The immunization process follows the list of identified individuals or computers in inverse order, immunizing first those which are most relevant for the epidemic spreading. We have applied our immunization strategy to several model networks and two real networks, the Internet and the collaboration network of high-energy physicists. We find that our new immunization strategy is in the case of model networks up to 14%, and for real networks up to 33% more efficient than immunizing dynamically the most connected nodes in a network. Our strategy is also numerically efficient and can therefore be applied to large systems.

The Effect of Summarizing and Presentation Strategies

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Hooshang Khoshsima

2014-07-01

Full Text Available The present study aimed to find out the effect of summarizing and presentation strategies on Iranian intermediate EFL learners’ reading comprehension. 61 students were selected and divided into two experimental and control groups. The homogeneity of their proficiency level was established using a TOEFL proficiency test. The experimental group used the two strategies three sessions each week for twenty weeks, while the control group was not trained on the strategies. After every two-week instruction, an immediate posttest was administered. At the end of the study, a post-test was administered to both groups. Paired-sample t-test and Independent sample t-test were used for analysis. The results of the study revealed that summarizing and presentation strategies had significant effect on promoting reading comprehension of intermediate EFL learners. It also indicated that the presentation strategy was significantly more effective on students’ reading comprehension.

Cost-Effectiveness Analysis of Different Genetic Testing Strategies for Lynch Syndrome in Taiwan.

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Ying-Erh Chen

Full Text Available Patients with Lynch syndrome (LS have a significantly increased risk of developing colorectal cancer (CRC and other cancers. Genetic screening for LS among patients with newly diagnosed CRC aims to identify mutations in the disease-causing genes (i.e., the DNA mismatch repair genes in the patients, to offer genetic testing for relatives of the patients with the mutations, and then to provide early prevention for the relatives with the mutations. Several genetic tests are available for LS, such as DNA sequencing for MMR genes and tumor testing using microsatellite instability and immunohistochemical analyses. Cost-effectiveness analyses of different genetic testing strategies for LS have been performed in several studies from different countries such as the US and Germany. However, a cost-effectiveness analysis for the testing has not yet been performed in Taiwan. In this study, we evaluated the cost-effectiveness of four genetic testing strategies for LS described in previous studies, while population-specific parameters, such as the mutation rates of the DNA mismatch repair genes and treatment costs for CRC in Taiwan, were used. The incremental cost-effectiveness ratios based on discounted life years gained due to genetic screening were calculated for the strategies relative to no screening and to the previous strategy. Using the World Health Organization standard, which was defined based on Taiwan's Gross Domestic Product per capita, the strategy based on immunohistochemistry as a genetic test followed by BRAF mutation testing was considered to be highly cost-effective relative to no screening. Our probabilistic sensitivity analysis results also suggest that the strategy has a probability of 0.939 of being cost-effective relative to no screening based on the commonly used threshold of $50,000 to determine cost-effectiveness. To the best of our knowledge, this is the first cost-effectiveness analysis for evaluating different genetic testing

Identifying and assessing strategies for evaluating the impact of mobile eye health units on health outcomes.

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Fu, Shiwan; Turner, Angus; Tan, Irene; Muir, Josephine

2017-12-01

To identify and assess strategies for evaluating the impact of mobile eye health units on health outcomes. Systematic literature review. Worldwide. Peer-reviewed journal articles that included the use of a mobile eye health unit. Journal articles were included if outcome measures reflected an assessment of the impact of a mobile eye health unit on health outcomes. Six studies were identified with mobile services offering diabetic retinopathy screening (three studies), optometric services (two studies) and orthoptic services (one study). This review identified and assessed strategies in existing literature used to evaluate the impact of mobile eye health units on health outcomes. Studies included in this review used patient outcomes (i.e. disease detection, vision impairment, treatment compliance) and/or service delivery outcomes (i.e. cost per attendance, hospital transport use, inappropriate referrals, time from diabetic retinopathy photography to treatment) to evaluate the impact of mobile eye health units. Limitations include difficulty proving causation of specific outcome measures and the overall shortage of impact evaluation studies. Variation in geographical location, service population and nature of eye care providers limits broad application. © 2017 National Rural Health Alliance Inc.

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

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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

Identifying Multi-Level Culturally Appropriate Smoking Cessation Strategies for Aboriginal Health Staff: A Concept Mapping Approach

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Dawson, Anna P.; Cargo, Margaret; Stewart, Harold; Chong, Alwin; Daniel, Mark

2013-01-01

Aboriginal Australians, including Aboriginal Health Workers (AHWs), smoke at rates double the non-Aboriginal population. This study utilized concept mapping methodology to identify and prioritize culturally relevant strategies to promote smoking cessation in AHWs. Stakeholder participants included AHWs, other health service employees and tobacco…

Multi-level Strategy for Identifying Proteasome-Catalyzed Spliced Epitopes Targeted by CD8+ T Cells during Bacterial Infection

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Anouk C.M. Platteel

2017-08-01

Full Text Available Proteasome-catalyzed peptide splicing (PCPS generates peptides that are presented by MHC class I molecules, but because their identification is challenging, the immunological relevance of spliced peptides remains unclear. Here, we developed a reverse immunology-based multi-level approach to identify proteasome-generated spliced epitopes. Applying this strategy to a murine Listeria monocytogenes infection model, we identified two spliced epitopes within the secreted bacterial phospholipase PlcB that primed antigen-specific CD8+ T cells in L. monocytogenes-infected mice. While reacting to the spliced epitopes, these CD8+ T cells failed to recognize the non-spliced peptide parts in the context of their natural flanking sequences. Thus, we here show that PCPS expands the CD8+ T cell response against L. monocytogenes by exposing spliced epitopes on the cell surface. Moreover, our multi-level strategy opens up opportunities to systematically investigate proteins for spliced epitope candidates and thus strategies for immunotherapies or vaccine design.

Uncovering effective strategies for hearing loss prevention

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Morata, Thais C.; Meinke, Deanna

2016-01-01

Occupational health agencies, researchers and policy makers have recognized the need for evidence on the effectiveness of interventions designed to reduce or prevent workplace injuries and illnesses. While many workplaces comply with legal or obligatory requirements and implement recommended interventions, few publications exist documenting the effectiveness of these actions. Additionally, some workplaces have discovered through their own processes, novel ways to reduce the risk of injury. Peer-reviewed information on the effectiveness of the many strategies and approaches currently in use could help correct weaknesses, or further encourage their adoption and expansion. The evaluation of intervention effectiveness would certainly contribute to improved worker health and safety. This need is particularly relevant regarding noise exposure in the workplace and hearing loss prevention interventions. In a 2006 review of the U.S. National Institute for Occupational Safety and Health (NIOSH) Hearing Loss Research Program, the independent National Academies of Sciences recommended that NIOSH place greater emphasis on identifying the effectiveness of hearing loss prevention measures on the basis of outcomes that are as closely related as possible to reducing noise exposure and work related hearing loss (http://www.nap.edu/openbook.php?record_id=11721). NIOSH used two different approaches to address that recommendation: the first one was to conduct research, including broad systematic reviews on the effectiveness of interventions to prevent occupational noise-induced hearing loss. The second was to create an award program, the Safe-In-Sound Excellence in Hearing Loss Prevention Award™, to identify and honor excellent real-world examples of noise control and other hearing loss prevention practices and innovations. PMID:27397968

Codemeshing in Academic Writing: Identifying Teachable Strategies of Translanguaging

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Canagarajah, Suresh

2011-01-01

Studies on translanguaging of multilingual students have turned their attention to teachable strategies in classrooms. This study is based on the assumption that it is possible to learn from students' translanguaging strategies while developing their proficiency through a dialogical pedagogy. Based on a classroom ethnography, this article…

Chromatographic fingerprinting as a strategy to identify regulated plants in illegal herbal supplements.

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Custers, D; Van Praag, N; Courselle, P; Apers, S; Deconinck, E

2017-03-01

Erectile dysfunction (ED) is a sexual disorder characterized by the inability to achieve or maintain a sufficiently rigid erection. Despite the availability of non-invasive oral treatment options, many patients turn to herbal alternatives. Furthermore, herbal supplements are increasingly gaining popularity in industrialized countries and, as a consequence, quality control is a highly important issue. Unfortunately, this is not a simple task since plants are often crushed and mixed with other plants, which complicates their identification by usage of classical approaches such as microscopy. The aim of this study was to explore the potential use of chromatographic fingerprinting to identify plants present in herbal preparations intended for the treatment of ED. To achieve this goal, a HPLC-PDA and a HPLC-MS method were developed, using a full factorial experimental design in order to acquire characteristic fingerprints of three plants which are potentially beneficial for treating ED: Epimedium spp., Pausinystalia yohimbe and Tribulus terrestris. The full factorial design demonstrated that for all three plant references a C8 column (250mm×4.6mm; 5µm particle size) is best suited; methanol and an ammonium formate buffer (pH 3) were found to be the best constituents for the mobile phase. The suitability of this strategy was demonstrated by analysing several self-made triturations in three different botanical matrices, which mimic the influential effects that could be expected when analysing herbal supplements. To conclude, this study demonstrates that chromatographic fingerprinting could provide a useful means to identify plants in a complex herbal mixture. Copyright © 2016 Elsevier B.V. All rights reserved.

Effectiveness of Integration and Re-Integration into Work Strategies for Persons with Chronic Conditions: A Systematic Review of European Strategies

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Carla Sabariego

2018-03-01

Full Text Available Due to low employment rates associated to chronic conditions in Europe, it is essential to foster effective integration and re-integration into work strategies. The objective of this systematic review is to summarize the evidence on the effectiveness of strategies for integration and re-integration to work for persons with chronic diseases or with musculoskeletal disorders, implemented in Europe in the past five years. A systematic search was conducted in MedLine, PsycINFO, CDR-HTA, CDR-DARE and Cochrane Systematic Reviews. Overall, 32 relevant publications were identified. Of these, 21 were considered eligible after a methodological assessment and included. Positive changes in employment status, return to work and sick leave outcomes were achieved with graded sickness-absence certificates, part-time sick leave, early ergonomic interventions for back pain, disability evaluation followed by information and advice, and with multidisciplinary, coordinated and tailored return to work interventions. Additionally, a positive association between the co-existence of active labour market policies to promote employment and passive support measures (e.g., pensions or benefits and the probability of finding a job was observed. Research on the evaluation of the effectiveness of strategies targeting integration and re-integration into work for persons with chronic health conditions needs, however, to be improved and strengthened.

Effectiveness of Integration and Re-Integration into Work Strategies for Persons with Chronic Conditions: A Systematic Review of European Strategies.

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Sabariego, Carla; Coenen, Michaela; Ito, Elizabeth; Fheodoroff, Klemens; Scaratti, Chiara; Leonardi, Matilde; Vlachou, Anastasia; Stavroussi, Panayiota; Brecelj, Valentina; Kovačič, Dare S; Esteban, Eva

2018-03-19

Due to low employment rates associated to chronic conditions in Europe, it is essential to foster effective integration and re-integration into work strategies. The objective of this systematic review is to summarize the evidence on the effectiveness of strategies for integration and re-integration to work for persons with chronic diseases or with musculoskeletal disorders, implemented in Europe in the past five years. A systematic search was conducted in MedLine, PsycINFO, CDR-HTA, CDR-DARE and Cochrane Systematic Reviews. Overall, 32 relevant publications were identified. Of these, 21 were considered eligible after a methodological assessment and included. Positive changes in employment status, return to work and sick leave outcomes were achieved with graded sickness-absence certificates, part-time sick leave, early ergonomic interventions for back pain, disability evaluation followed by information and advice, and with multidisciplinary, coordinated and tailored return to work interventions. Additionally, a positive association between the co-existence of active labour market policies to promote employment and passive support measures (e.g., pensions or benefits) and the probability of finding a job was observed. Research on the evaluation of the effectiveness of strategies targeting integration and re-integration into work for persons with chronic health conditions needs, however, to be improved and strengthened.

Identifying mismatches between institutional perceptions of water-related risk drivers and water management strategies in three river basin areas

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Räsänen, Aleksi; Juhola, Sirkku; Monge Monge, Adrián; Käkönen, Mira; Kanninen, Markku; Nygren, Anja

2017-07-01

Water-related risks and vulnerabilities are driven by variety of stressors, including climate and land use change, as well as changes in socio-economic positions and political landscapes. Hence, water governance, which addresses risks and vulnerabilities, should target multiple stressors. We analyze the institutional perceptions of the drivers and strategies for managing water-related risks and vulnerabilities in three regionally important river basin areas located in Finland, Mexico, and Laos. Our analysis is based on data gathered through participatory workshops and complemented by qualitative content analysis of relevant policy documents. The identified drivers and proposed risk reduction strategies showed the multidimensionality and context-specificity of water-related risks and vulnerabilities across study areas. Most of the identified drivers were seen to increase risks, but some of the drivers were positive trends, and drivers also included also policy instruments that can both increase or decrease risks. Nevertheless, all perceived drivers were not addressed with suggested risk reduction strategies. In particular, most of the risk reduction strategies were incremental adjustments, although many of the drivers classified as most important were large-scale trends, such as climate change, land use changes and increase in foreign investments. We argue that there is a scale mismatch between the identified drivers and suggested strategies, which questions the opportunity to manage the drivers by single-scale incremental adjustments. Our study suggests that for more sustainable risk and vulnerability reduction, the root causes of water-related risks and vulnerabilities should be addressed through adaptive multi-scale governance that carefully considers the context-specificity and the multidimensionality of the associated drivers and stressors.

THE EFFECT OF INTIMACY AND STATUS DISCREPANCY ON SALIENT AND NON-SALIENT CONFLICT STRATEGIES OF JAPANESE.

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Nakatsugawa, Satomi; Takai, Jiro

2015-10-01

It has been claimed that Japanese people prefer passive forms of conflict strategies to preserve interpersonal harmony. This study aimed to identify some conditions in which such passive strategies are used. The effects of target intimacy and status discrepancy on the intent and use of salient and non-salient conflict strategies were examined, along with respondent sex differences. Questionnaires were collected from 205 Japanese university students. Results indicated that women were more likely to have non-salient intents than men and that intimacy affected considerateness intent but not avoidance intent. Active non-salient strategy was affected by status while passive non-salient strategy was affected by intimacy. Overall, target characteristics proved to be a strong factor in the intents and strategies employed in conflict situations of Japanese.

Antibiotic discovery throughout the Small World Initiative: A molecular strategy to identify biosynthetic gene clusters involved in antagonistic activity.

Science.gov (United States)

Davis, Elizabeth; Sloan, Tyler; Aurelius, Krista; Barbour, Angela; Bodey, Elijah; Clark, Brigette; Dennis, Celeste; Drown, Rachel; Fleming, Megan; Humbert, Allison; Glasgo, Elizabeth; Kerns, Trent; Lingro, Kelly; McMillin, MacKenzie; Meyer, Aaron; Pope, Breanna; Stalevicz, April; Steffen, Brittney; Steindl, Austin; Williams, Carolyn; Wimberley, Carmen; Zenas, Robert; Butela, Kristen; Wildschutte, Hans

2017-06-01

The emergence of bacterial pathogens resistant to all known antibiotics is a global health crisis. Adding to this problem is that major pharmaceutical companies have shifted away from antibiotic discovery due to low profitability. As a result, the pipeline of new antibiotics is essentially dry and many bacteria now resist the effects of most commonly used drugs. To address this global health concern, citizen science through the Small World Initiative (SWI) was formed in 2012. As part of SWI, students isolate bacteria from their local environments, characterize the strains, and assay for antibiotic production. During the 2015 fall semester at Bowling Green State University, students isolated 77 soil-derived bacteria and genetically characterized strains using the 16S rRNA gene, identified strains exhibiting antagonistic activity, and performed an expanded SWI workflow using transposon mutagenesis to identify a biosynthetic gene cluster involved in toxigenic compound production. We identified one mutant with loss of antagonistic activity and through subsequent whole-genome sequencing and linker-mediated PCR identified a 24.9 kb biosynthetic gene locus likely involved in inhibitory activity in that mutant. Further assessment against human pathogens demonstrated the inhibition of Bacillus cereus, Listeria monocytogenes, and methicillin-resistant Staphylococcus aureus in the presence of this compound, thus supporting our molecular strategy as an effective research pipeline for SWI antibiotic discovery and genetic characterization. © 2017 The Authors. MicrobiologyOpen published by John Wiley & Sons Ltd.

Identifying optimal postmarket surveillance strategies for medical and surgical devices: implications for policy, practice and research.

Science.gov (United States)

Gagliardi, Anna R; Umoquit, Muriah; Lehoux, Pascale; Ross, Sue; Ducey, Ariel; Urbach, David R

2013-03-01

Non-drug technologies offer many benefits, but have been associated with adverse events, prompting calls for improved postmarket surveillance. There is little empirical research to guide the development of such a system. The purpose of this study was to identify optimal postmarket surveillance strategies for medical and surgical devices. Qualitative methods were used for sampling, data collection and analysis. Stakeholders from Canada and the USA representing different roles and perspectives were first interviewed to identify examples and characteristics of different surveillance strategies. These stakeholders and others they recommended were then assembled at a 1-day nominal group meeting to discuss and prioritise the components of a postmarket device surveillance system, and research needed to achieve such a system. Consultations were held with 37 participants, and 47 participants attended the 1-day meeting. They recommended a multicomponent system including reporting by facilities, clinicians and patients, supported with some external surveillance for validation and real-time trials for high-risk devices. Many considerations were identified that constitute desirable characteristics of, and means by which to implement such a system. An overarching network was envisioned to broker linkages, establish a shared minimum dataset, and support communication and decision making. Numerous research questions were identified, which could be pursued in tandem with phased implementation of the system. These findings provide unique guidance for establishing a device safety network that is based on existing initiatives, and could be expanded and evaluated in a prospective, phased fashion as it was developed.

Characterizing the effects of intermittent faults on a processor for dependability enhancement strategy.

Science.gov (United States)

Wang, Chao Saul; Fu, Zhong-Chuan; Chen, Hong-Song; Wang, Dong-Sheng

2014-01-01

As semiconductor technology scales into the nanometer regime, intermittent faults have become an increasing threat. This paper focuses on the effects of intermittent faults on NET versus REG on one hand and the implications for dependability strategy on the other. First, the vulnerability characteristics of representative units in OpenSPARC T2 are revealed, and in particular, the highly sensitive modules are identified. Second, an arch-level dependability enhancement strategy is proposed, showing that events such as core/strand running status and core-memory interface events can be candidates of detectable symptoms. A simple watchdog can be deployed to detect application running status (IEXE event). Then SDC (silent data corruption) rate is evaluated demonstrating its potential. Third and last, the effects of traditional protection schemes in the target CMT to intermittent faults are quantitatively studied on behalf of the contribution of each trap type, demonstrating the necessity of taking this factor into account for the strategy.

Characterizing the Effects of Intermittent Faults on a Processor for Dependability Enhancement Strategy

Directory of Open Access Journals (Sweden)

Chao(Saul Wang

2014-01-01

Full Text Available As semiconductor technology scales into the nanometer regime, intermittent faults have become an increasing threat. This paper focuses on the effects of intermittent faults on NET versus REG on one hand and the implications for dependability strategy on the other. First, the vulnerability characteristics of representative units in OpenSPARC T2 are revealed, and in particular, the highly sensitive modules are identified. Second, an arch-level dependability enhancement strategy is proposed, showing that events such as core/strand running status and core-memory interface events can be candidates of detectable symptoms. A simple watchdog can be deployed to detect application running status (IEXE event. Then SDC (silent data corruption rate is evaluated demonstrating its potential. Third and last, the effects of traditional protection schemes in the target CMT to intermittent faults are quantitatively studied on behalf of the contribution of each trap type, demonstrating the necessity of taking this factor into account for the strategy.

Organisational change stressors and nursing job satisfaction: the mediating effect of coping strategies.

Science.gov (United States)

Teo, Stephen T T; Pick, David; Newton, Cameron J; Yeung, Melissa E; Chang, Esther

2013-09-01

To examine the mediating effect of coping strategies on the consequences of nursing and non-nursing (administrative) stressors on the job satisfaction of nurses during change management. Organisational change can result in an increase in nursing and non-nursing-related stressors, which can have a negative impact on the job satisfaction of nurses employed in health-care organisations. Matched data were collected in 2009 via an online survey at two time-points (six months apart). Partial least squares path analysis revealed a significant causal relationship between Time 1 administrative and role stressors and an increase in nursing-specific stressors in Time 2. A significant relationship was also identified between job-specific nursing stressors and the adoption of effective coping strategies to deal with increased levels of change-induced stress and strain and the likelihood of reporting higher levels of job satisfaction in Time 2. The effectiveness of coping strategies is critical in helping nurses to deal with the negative consequences of organisational change. This study shows that there is a causal relationship between change, non-nursing stressors and job satisfaction. Senior management should implement strategies aimed at reducing nursing and non-nursing stress during change in order to enhance the job satisfaction of nurses. © 2013 John Wiley & Sons Ltd.

Clinicians' preventive strategies for children and adolescents identified as at high risk of developing caries.

Science.gov (United States)

Sarmadi, Roxana; Gahnberg, Lars; Gabre, Pia

2011-05-01

Clinicians handle diagnosis and treatment planning of caries in different ways, and the underlying factors leading to management of risk and choice of treatment strategies are poorly understood. The aim of this study was to investigate dentists' and dental hygienists' choices of preventive strategies for children and adolescents identified as at high risk of developing caries. A sample of dental records from 432 of a total of 3372 children in a Swedish county identified as at high risk of developing caries, aged 3-19 years, was randomly selected for analysis in the study. Information of importance for the therapists' choice of caries management strategies were obtained from the dental records. The results showed that therapists considered tooth brushing instruction and fluoride treatment at the clinic to be of primary importance as treatment given in 60% of the cases, respectively. Fluoride treatment at home and diet counselling were both chosen in half of the cases. Fissure sealant therapy was used in 21% of the cases, and 15% of the patients did not receive any preventive treatment at all. The results also showed that girls more often received fluoride treatment, tooth brushing instruction and oral hygiene information than boys. In the majority of the children and adolescents, several preventive measures were given. The more background factors included in the risk assessment, the more preventive measures were given. The differences between the treatments given to girls and the boys need to be further investigated. © 2010 The Authors. International Journal of Paediatric Dentistry © 2010 BSPD, IAPD and Blackwell Publishing Ltd.

Effective strategies for weight loss in post-partum women

DEFF Research Database (Denmark)

Lim, S.; O'Reilly, S.; Behrens, H.

2015-01-01

Post-partum weight loss is critical to preventing and managing obesity in women, but the results from lifestyle interventions are variable and the components associated with successful outcomes are not yet clearly identified. This study aimed to identify lifestyle intervention strategies associated...

Interactive Strategy-Making

DEFF Research Database (Denmark)

Andersen, Torben Juul

2015-01-01

This article outlines an interactive strategy-making model that combines central reasoning with ongoing learning from decentralised responses. The management literature often presents strategy as implementing an optimal plan identified through rational analysis and ascribes potential shortcomings...... to failed communication and execution of the planned actions. However, effective strategy-making comprises both central reasoning from forward-looking planning considerations and decentralised responses to emerging events as interacting elements in a dynamic adaptive system. The interaction between...

The effectiveness of strategies to change organisational culture to improve healthcare performance.

Science.gov (United States)

Parmelli, Elena; Flodgren, Gerd; Schaafsma, Mary Ellen; Baillie, Nick; Beyer, Fiona R; Eccles, Martin P

2011-01-19

Organisational culture is an anthropological metaphor used to inform research and consultancy and to explain organisational environments. Great emphasis has been placed during the last years on the need to change organisational culture in order to pursue effective improvement of healthcare performance. However, the precise nature of organisational culture in healthcare policy often remains underspecified and the desirability and feasibility of strategies to be adopted has been called into question. To determine the effectiveness of strategies to change organisational culture in order to improve healthcare performance.To examine the effectiveness of these strategies according to different patterns of organisational culture. We searched the following electronic databases for primary studies: The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, Sociological Abstracts, Web of Knowledge, PsycINFO, Business and Management, EThOS, Index to Theses, Intute, HMIC, SIGLE, and Scopus until October 2009. The Database of Abstracts of Reviews of Effectiveness (DARE) was searched for related reviews. We also searched the reference lists of all papers and relevant reviews identified, and we contacted experts in the field for advice on further potential studies. We considered randomised controlled trials (RCTs) or well designed quasi-experimental studies, controlled clinical trials (CCTs), controlled before and after studies (CBAs) and interrupted time series analyses (ITS) meeting the quality criteria used by the Cochrane Effective Practice and Organisation of Care Group (EPOC). Studies should be set in any type of healthcare organisation in which strategies to change organisational culture in order to improve healthcare performance were applied. Our main outcomes were objective measures of professional performance and patient outcome. At least two review authors independently applied the criteria for inclusion and exclusion criteria to scan titles and

Effects of Brand Extension Strategies on University Students’ Purchase Intent

Directory of Open Access Journals (Sweden)

Şükran KARACA

2015-06-01

Full Text Available The brand extension strategy today preferred by many companies is an application that companies want to transfer the existing certain brand image and reputation in consumers value to new products as they existing brand name to the new products and in this way marketing. In this study, they apply business expansion strategy for the brand and consumer attitudes to identify the variables that influence these attitudes by means of brand extension strategies on consumer purchase intent was to determine the effects. Within this research, 445 students studying at the Cumhuriyet University of face to face interviews were conducted. Results were evaluated using SPSS 20.0 program, students’ frequencies and percentages of the responses received; the responses were analyzed using t-test and ANOVA. In this study, students Adidas company's brand for the expansion of applications imaginary product categories with jeans products against the positive attitude that the other imaginary product categories such as cell phones and laptop computers in terms of some factors other than a positive attitude that has emerged.

Waste Management Strategy in The Netherlands. Part 2. Strategy Principles and Influencing Issues

International Nuclear Information System (INIS)

Haverkate, B.R.W.

2002-01-01

This report reflects the Dutch input prepared in the framework of work package 2 of the EU thematic network COMPAS, which deals with the identification of alternative waste management strategies and issues influencing strategy selection in EU member states and their applicant countries. All elements that could have an effect in identifying alternative policies to manage (long-lived) radioactive wastes are addressed in this report. After a short introduction, in chapter 1, about some general issues influencing decision-making such as public acceptance, involvement, perception and (European) legislation, the considered disposal methods and disposal requirements are given in chapter 2. Chapter 3 of this report deals with the background topics of the current waste management strategy in The Netherlands. A detailed overview of (basic) strategy principles and their influencing issues is the subject of chapter 4. Issues considered include: safety and environmental impact; technical limitations; nuclear materials safeguards; monitoring and retrievability; ethical issues; public acceptance; (timing of) strategy development and implementation; and economical considerations. Relevant additional issues that could have an effect in identifying alternative waste management strategy are provided in appendices, including signed treaties (appendix B) and nuclear statutory regulations (appendix C)

The Quality of Clinical Maternal and Neonatal Healthcare – A Strategy for Identifying ‘Routine Care Signal Functions’

Science.gov (United States)

Brenner, Stephan; De Allegri, Manuela; Gabrysch, Sabine; Chinkhumba, Jobiba; Sarker, Malabika; Muula, Adamson S.

2015-01-01

Background A variety of clinical process indicators exists to measure the quality of care provided by maternal and neonatal health (MNH) programs. To allow comparison across MNH programs in low- and middle-income countries (LMICs), a core set of essential process indicators is needed. Although such a core set is available for emergency obstetric care (EmOC), the ‘EmOC signal functions’, a similar approach is currently missing for MNH routine care evaluation. We describe a strategy for identifying core process indicators for routine care and illustrate their usefulness in a field example. Methods We first developed an indicator selection strategy by combining epidemiological and programmatic aspects relevant to MNH in LMICs. We then identified routine care process indicators meeting our selection criteria by reviewing existing quality of care assessment protocols. We grouped these indicators into three categories based on their main function in addressing risk factors of maternal or neonatal complications. We then tested this indicator set in a study assessing MNH quality of clinical care in 33 health facilities in Malawi. Results Our strategy identified 51 routine care processes: 23 related to initial patient risk assessment, 17 to risk monitoring, 11 to risk prevention. During the clinical performance assessment a total of 82 cases were observed. Birth attendants’ adherence to clinical standards was lowest in relation to risk monitoring processes. In relation to major complications, routine care processes addressing fetal and newborn distress were performed relatively consistently, but there were major gaps in the performance of routine care processes addressing bleeding, infection, and pre-eclampsia risks. Conclusion The identified set of process indicators could identify major gaps in the quality of obstetric and neonatal care provided during the intra- and immediate postpartum period. We hope our suggested indicators for essential routine care processes

Israel's Counter-Terrorism Strategy and its Effectiveness

National Research Council Canada - National Science Library

Smith, Jerry D

2005-01-01

This thesis analyzes Israeli counter-terrorism strategy and its effectiveness. Because of ongoing suicide attacks from Palestinian and other terrorist organizations, Israel will continue to have an aggressive counter-terrorism strategy...

Saltelli Global Sensitivity Analysis and Simulation Modelling to Identify Intervention Strategies to Reduce the Prevalence of Escherichia coli O157 Contaminated Beef Carcasses.

Directory of Open Access Journals (Sweden)

Victoria J Brookes

Full Text Available Strains of Shiga-toxin producing Escherichia coli O157 (STEC O157 are important foodborne pathogens in humans, and outbreaks of illness have been associated with consumption of undercooked beef. Here, we determine the most effective intervention strategies to reduce the prevalence of STEC O157 contaminated beef carcasses using a modelling approach.A computational model simulated events and processes in the beef harvest chain. Information from empirical studies was used to parameterise the model. Variance-based global sensitivity analysis (GSA using the Saltelli method identified variables with the greatest influence on the prevalence of STEC O157 contaminated carcasses. Following a baseline scenario (no interventions, a series of simulations systematically introduced and tested interventions based on influential variables identified by repeated Saltelli GSA, to determine the most effective intervention strategy.Transfer of STEC O157 from hide or gastro-intestinal tract to carcass (improved abattoir hygiene had the greatest influence on the prevalence of contaminated carcases. Due to interactions between inputs (identified by Saltelli GSA, combinations of interventions based on improved abattoir hygiene achieved a greater reduction in maximum prevalence than would be expected from an additive effect of single interventions. The most effective combination was improved abattoir hygiene with vaccination, which achieved a greater than ten-fold decrease in maximum prevalence compared to the baseline scenario.Study results suggest that effective interventions to reduce the prevalence of STEC O157 contaminated carcasses should initially be based on improved abattoir hygiene. However, the effect of improved abattoir hygiene on the distribution of STEC O157 concentration on carcasses is an important information gap-further empirical research is required to determine whether reduced prevalence of contaminated carcasses is likely to result in reduced

Relationship between incivility experiences and nursing professional values among nursing students: Moderating effects of coping strategies.

Science.gov (United States)

Kim, Ji-Soo

2018-06-01

During clinical practice, nursing students develop their professional role and internalize the values of the nursing profession. Unfortunately, it also often exposes them uncivil behaviors from nurses. To identify the relationship between incivility experiences and nursing professional values, and investigate the potential moderating effects of coping strategies in this relationship. This was a descriptive, cross-sectional study. Data were collected from 203 nursing students using questionnaires. The questionnaire comprised sections assessing participant characteristics, incivility experiences, coping strategies, and nursing professional values. Multiple regression analysis was used to identify the relationship between incivility experiences and nursing professional values, as well as the interaction effect of incivility experiences and coping strategies on nursing professional values. Incivility experiences were negatively related to nursing professional values. Furthermore, seeking support moderated the relationship between incivility experiences and nursing professional values. In other words, as incivility experiences increased, nursing students who used more seeking social support tended to have stronger nursing professional values than did those who used this coping strategy less. To improve the nursing professional values of nursing students, educators must inform nursing managers when nurses direct uncivil behaviors towards students. Educators should also listen to students' experiences, support them emotionally, and encourage students to engage in seeking social support. Copyright © 2018 Elsevier Ltd. All rights reserved.

Novel HTS strategy identifies TRAIL-sensitizing compounds acting specifically through the caspase-8 apoptotic axis.

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Darren Finlay

Full Text Available Tumor Necrosis Factor-Related Apoptosis-Inducing Ligand (TRAIL is potentially a very important therapeutic as it shows selectivity for inducing apoptosis in cancer cells whilst normal cells are refractory. TRAIL binding to its cognate receptors, Death Receptors-4 and -5, leads to recruitment of caspase-8 and classical activation of downstream effector caspases, leading to apoptosis. As with many drugs however, TRAIL's usefulness is limited by resistance, either innate or acquired. We describe here the development of a novel 384-well high-throughput screening (HTS strategy for identifying potential TRAIL-sensitizing agents that act solely in a caspase-8 dependent manner. By utilizing a TRAIL resistant cell line lacking caspase-8 (NB7 compared to the same cells reconstituted with the wild-type protein, or with a catalytically inactive point mutant of caspase-8, we are able to identify compounds that act specifically through the caspase-8 axis, rather than through general toxicity. In addition, false positive hits can easily be "weeded out" in this assay due to their activity in cells lacking caspase-8-inducible activity. Screening of the library of pharmacologically active compounds (LOPAC was performed as both proof-of-concept and to discover potential unknown TRAIL sensitizers whose mechanism is caspase-8 mediated. We identified known TRAIL sensitizers from the library and identified new compounds that appear to sensitize specifically through caspase-8. In sum, we demonstrate proof-of-concept and discovery of novel compounds with a screening strategy optimized for the detection of caspase-8 pathway-specific TRAIL sensitizers. This screen was performed in the 384-well format, but could easily be further miniaturized, allows easy identification of artifactual false positives, and is highly scalable to accommodate diverse libraries.

Strategies for effective management of health and safety in confined site construction

Directory of Open Access Journals (Sweden)

John Spillane

2013-12-01

Full Text Available Purpose: The overall aim of this research is to identify and catalogue the numerous managerial strategies for effective management of health and safety on a confined, urban, construction site. Design/Methodology/Approach: This is achieved by utilising individual interviews, focus groups discussion on selected case studies of confined construction sites, coupled with a questionnaire survey. Findings: The top five key strategies include (1 Employ safe system of work plans to mitigate personnel health and safety issues; (2 Inform personnel, before starting on-site, of the potential issues using site inductions; (3 Effective communication among site personnel; (4 Draft and implement an effective design site layout prior to starting on-site; and (5 Use of banksman (traffic co-ordinator to segregate personnel from vehicular traffic. Practical Implication: The construction sector is one of the leading industries in accident causation and with the continued development and regeneration of our urban centres, confined site construction is quickly becoming the norm - an environment which only fuels accident creation within the construction sector. Originality/Value: This research aids on-site management that requires direction and assistance in the identification and implementation of key strategies for the management of health and safety, particularly in confined construction site environments.

Effective Behaviour Management Strategies for Australian Aboriginal and Torres Strait Islander Students: A Literature Review

Science.gov (United States)

Llewellyn, Linda L.; Boon, Helen J.; Lewthwaite, Brian E.

2018-01-01

This paper reports findings from a systematic literature review conducted to identify effective behaviour management strategies which create a positive learning environment for Aboriginal and Torres Strait Islander students. The search criteria employed resulted in 103 documents which were analysed in response to this focus. Results identified…

Diagnosing climate change impacts and identifying adaptation strategies by involving key stakeholder organisations and farmers in Sikkim, India: Challenges and opportunities.

Science.gov (United States)

Azhoni, Adani; Goyal, Manish Kumar

2018-06-01

Narrowing the gap between research, policy making and implementing adaptation remains a challenge in many parts of the world where climate change is likely to severely impact water security. This research aims to narrow this gap by matching the adaptation strategies being framed by policy makers to that of the perspectives of development agencies, researchers and farmers in the Himalayan state of Sikkim in India. Our case study examined the perspectives of various stakeholders for climate change impacts, current adaptation strategies, knowledge gaps and adaptation barriers, particularly in the context of implementing the Sikkim State Action Plan on Climate Change through semi-structured interviews carried out with decision makers in the Sikkim State Government, researchers, consultants, local academia, development agencies and farmers. Using Stakeholders Network Analysis tools, this research unravels the complexities of perceiving climate change impacts, identifying strategies, and implementing adaptation. While farmers are less aware about the global phenomenon of climate change impacts for water security, their knowledge of the local conditions and their close interaction with the State Government Agriculture Department provides them opportunities. Although important steps are being initiated through the Sikkim State Action Plan on Climate Change it is yet to deliver effective means of adaptation implementation and hence, strengthening the networks of close coordination between the various implementing agencies will pay dividends. Knowledge gaps and the need for capacity building identified in this research, based on the understandings of key stakeholders are highly relevant to both the research community and for informing policy. Copyright © 2018 Elsevier B.V. All rights reserved.

Comparison of genome-wide selection strategies to identify furfural tolerance genes in Escherichia coli.

Science.gov (United States)

Glebes, Tirzah Y; Sandoval, Nicholas R; Gillis, Jacob H; Gill, Ryan T

2015-01-01

Engineering both feedstock and product tolerance is important for transitioning towards next-generation biofuels derived from renewable sources. Tolerance to chemical inhibitors typically results in complex phenotypes, for which multiple genetic changes must often be made to confer tolerance. Here, we performed a genome-wide search for furfural-tolerant alleles using the TRackable Multiplex Recombineering (TRMR) method (Warner et al. (2010), Nature Biotechnology), which uses chromosomally integrated mutations directed towards increased or decreased expression of virtually every gene in Escherichia coli. We employed various growth selection strategies to assess the role of selection design towards growth enrichments. We also compared genes with increased fitness from our TRMR selection to those from a previously reported genome-wide identification study of furfural tolerance genes using a plasmid-based genomic library approach (Glebes et al. (2014) PLOS ONE). In several cases, growth improvements were observed for the chromosomally integrated promoter/RBS mutations but not for the plasmid-based overexpression constructs. Through this assessment, four novel tolerance genes, ahpC, yhjH, rna, and dicA, were identified and confirmed for their effect on improving growth in the presence of furfural. © 2014 Wiley Periodicals, Inc.

Cognitive and Other Strategies to Mitigate the Effects of Fatigue. Lessons from Staff Physicians Working in Intensive Care Units.

Science.gov (United States)

Henrich, Natalie; Ayas, Najib T; Stelfox, Henry T; Peets, Adam D

2016-09-01

Fatigue is common among physicians and adversely affects their performance. To identify strategies that attending physicians use when fatigued to maintain clinical performance in the intensive care unit (ICU). We conducted a qualitative study using focus groups and structured interviews of attending ICU physicians working in academic centers in Canada. In three focus group meetings, we engaged a total of 11 physicians to identify strategies used to prevent and cope with fatigue. In the focus groups, 21 cognitive strategies were identified and classified into 9 categories (minimizing number of tasks, using techniques to improve retention of details, using a structured approach to patient care, asking for help, improving opportunities for focusing, planning ahead, double-checking, adjusting expectations, and modulating alertness). In addition, various lifestyle strategies were mentioned as important in preventing fatigue (e.g., protecting sleep before call, adequate exercise, and limiting alcohol). Telephone interviews were then conducted (n = 15 physicians) with another group of intensivists. Structured questions were asked about the strategies identified in the focus groups that were most useful during ICU activities. In the interviews, the most useful and frequently used strategies were prioritizing tasks that need to be done immediately and postponing tasks that can wait, working systematically, using a structured approach, and avoiding distractions. ICU physicians reported using a variety of deliberate cognitive and lifestyle strategies to prevent and cope with fatigue. Given the low cost and intuitive nature of the majority of these strategies, further investigations should be done to better characterize their effectiveness in improving performance.

Effective instructional strategies in physics classrooms

Science.gov (United States)

Tosa, Sachiko

2011-04-01

Instructional strategies such as Think-Pair-Share and Socratic questioning are powerful ways to get students engaged in thinking processes. In this talk, tips and techniques that help students make sense of physics concepts in lecture-based classes are presented with specific examples. The participants will see the effectiveness of the instructional strategies by actually experiencing the process as learners with the use of clickers.

A cost-effective approach to the development of printed materials: a randomized controlled trial of three strategies.

Science.gov (United States)

Paul, C L; Redman, S; Sanson-Fisher, R W

2004-12-01

Printed materials have been a primary mode of communication in public health education. Three major approaches to the development of these materials--the application of characteristics identified in the literature, behavioral strategies and marketing strategies--have major implications for both the effectiveness and cost of materials. However, little attention has been directed towards the cost-effectiveness of such approaches. In the present study, three pamphlets were developed using successive addition of each approach: first literature characteristics only ('C' pamphlet), then behavioral strategies ('C + B' pamphlet) and then marketing strategies ('C + B + M' pamphlet). Each pamphlet encouraged women to join a Pap Test Reminder Service (PTRS). Each pamphlet was mailed to a randomly selected sample of 2700 women aged 50-69 years. Registrations with the PTRS were monitored and 420 women in each pamphlet group were surveyed by telephone. It was reported that the 'C + B' and 'C + B + M' pamphlets were significantly more effective than the 'C' pamphlet. The 'C + B' pamphlet was the most cost-effective of the three pamphlets. There were no significant differences between any of the pamphlet groups on acceptability, knowledge or attitudes. It was suggested that the inclusion of behavioral strategies is likely to be a cost-effective approach to the development of printed health education materials.

Using Learning Strategies to Inhibit the Nocebo Effect.

Science.gov (United States)

Quinn, Veronica F; Colagiuri, Ben

2018-01-01

Learning is a key mechanism underpinning the development of the nocebo effect. The learning literature has cataloged and explored numerous ways in which the environment can be manipulated to prevent, reduce, or eradicate learning. Knowledge of these processes could be used to both inhibit the development of nocebo effects and reduce already established nocebo learning. This review describes the available evidence on how such learning strategies have, or could be, applied to reduce the nocebo effect in both healthy participants and patients to date. These learning strategies include overshadowing, latent inhibition, extinction, and contingency degradation. These strategies represent important new avenues for investigation and should be used by researchers to design and test interventions to reduce nocebo effects. © 2018 Elsevier Inc. All rights reserved.

Optimal combinations of control strategies and cost-effective analysis for visceral leishmaniasis disease transmission.

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Santanu Biswas

Full Text Available Visceral leishmaniasis (VL is a deadly neglected tropical disease that poses a serious problem in various countries all over the world. Implementation of various intervention strategies fail in controlling the spread of this disease due to issues of parasite drug resistance and resistance of sandfly vectors to insecticide sprays. Due to this, policy makers need to develop novel strategies or resort to a combination of multiple intervention strategies to control the spread of the disease. To address this issue, we propose an extensive SIR-type model for anthroponotic visceral leishmaniasis transmission with seasonal fluctuations modeled in the form of periodic sandfly biting rate. Fitting the model for real data reported in South Sudan, we estimate the model parameters and compare the model predictions with known VL cases. Using optimal control theory, we study the effects of popular control strategies namely, drug-based treatment of symptomatic and PKDL-infected individuals, insecticide treated bednets and spray of insecticides on the dynamics of infected human and vector populations. We propose that the strategies remain ineffective in curbing the disease individually, as opposed to the use of optimal combinations of the mentioned strategies. Testing the model for different optimal combinations while considering periodic seasonal fluctuations, we find that the optimal combination of treatment of individuals and insecticide sprays perform well in controlling the disease for the time period of intervention introduced. Performing a cost-effective analysis we identify that the same strategy also proves to be efficacious and cost-effective. Finally, we suggest that our model would be helpful for policy makers to predict the best intervention strategies for specific time periods and their appropriate implementation for elimination of visceral leishmaniasis.

Shifting the Focus to Student Learning: Characteristics of Effective Teaching Practice As Identified by Experienced Pre-service Faculty Advisors

Directory of Open Access Journals (Sweden)

Nancy Maynes

2012-11-01

Full Text Available Cochrane-Smith and Power identify trends in teacher education programs with some relating to heightened teacher accountability for students’ learning. In this paper we provide a model that identifies characteristics believed to be critical elements related to a teacher’s conceptual focus shifting from an emphasis on their teaching to their students’ learning and we have grounded these characteristics in current educational research. Through focus group inquiry, we have identified those teacher characteristics thought to account for effective teaching practice. These characteristics include: a professional growth perspective, passion and enthusiasm for the  content, pedagogical content knowledge, a rich instructional repertoire of strategies, awareness of assessment for, as, and of learning, ability to read the body language  of the learner, caring classroom management strategies, and instructional efforts (e.g., social justice. Our research data provide a conceptual framework for further study.

The Effect of Using Metacognitive Strategies for Solving Geometry Problems on Students' Achievement and Attitude

Science.gov (United States)

Mandaci Sahin, Seher; Kendir, Fatma

2013-01-01

The purpose of this study is to identify the effect of using metacognitive strategies for problem solving in "geometry" on fifth grade students' achievement, metacognitive skills and attitude. Experimental method was used with a pretest/posttest control group design. Firstly, both groups were subject to a pretest that was comprised of…

Life-history strategies as a tool to identify conservation constraints: A case-study on ants in chalk grasslands

NARCIS (Netherlands)

Noordwijk, C.G.E.; Boer, P.; Mabelis, A.A.; Verberk, W.C.E.P.; Siepel, H.

2012-01-01

Species’ life-history traits underlie species–environment relationships. Therefore, analysis of species traits, combined into life-history strategies, can be used to identify key factors shaping the local species composition. This is demonstrated in a case-study on ants in chalk grasslands. We

Comparison of search strategies in systematic reviews of adverse effects to other systematic reviews.

Science.gov (United States)

Golder, Su; Loke, Yoon K; Zorzela, Liliane

2014-06-01

Research indicates that the methods used to identify data for systematic reviews of adverse effects may need to differ from other systematic reviews. To compare search methods in systematic reviews of adverse effects with other reviews. The search methodologies in 849 systematic reviews of adverse effects were compared with other reviews. Poor reporting of search strategies is apparent in both systematic reviews of adverse effects and other types of systematic reviews. Systematic reviews of adverse effects are less likely to restrict their searches to MEDLINE or include only randomised controlled trials (RCTs). The use of other databases is largely dependent on the topic area and the year the review was conducted, with more databases searched in more recent reviews. Adverse effects search terms are used by 72% of reviews and despite recommendations only two reviews report using floating subheadings. The poor reporting of search strategies in systematic reviews is universal, as is the dominance of searching MEDLINE. However, reviews of adverse effects are more likely to include a range of study designs (not just RCTs) and search beyond MEDLINE. © 2014 Crown Copyright.

Investigating strategies used by hospital pharmacists to effectively communicate with patients during medication counselling.

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Chevalier, Bernadette A M; Watson, Bernadette M; Barras, Michael A; Cottrell, William Neil

2017-10-01

Medication counselling opportunities are key times for pharmacists and patients to discuss medications and patients' concerns about their therapy. Communication Accommodation Theory (CAT) describes behavioural, motivational and emotional processes underlying communication exchanges. Five CAT strategies (approximation, interpretability, discourse management, emotional expression and interpersonal control) permit identification of effective communication. To invoke CAT to investigate communication strategies used by hospital pharmacists during patient medication counselling. This was a theory-based, qualitative study using transcribed audiorecordings of patients and hospital pharmacists engaged in medication counselling. Recruited pharmacists practised in inpatient or outpatient settings. Eligible patients within participating pharmacists' practice sites were prescribed at least three medications to manage chronic disease(s). The extent to which pharmacists accommodate, or not, to patients' conversational needs based on accommodative behaviour described within CAT strategies. Twelve pharmacists engaged four patients (48 total interactions). Exemplars provided robust examples of pharmacists effectively accommodating or meeting patients' conversational needs. Non-accommodation mainly occurred when pharmacists spoke too quickly, used terms not understood by patients and did not include patients in the agenda-setting phase. Multiple strategy use resulted in communication patterns such as "information-reassurance-rationale" sandwiches. Most pharmacists effectively employed all five CAT strategies to engage patients in discussions. Pharmacists' communication could be improved at the initial agenda-setting phase by asking open-ended questions to invite patients' input and allow patients to identify any medication-related concerns or issues. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Dental and dental hygiene students' diagnostic accuracy in oral radiology: effect of diagnostic strategy and instructional method.

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Baghdady, Mariam T; Carnahan, Heather; Lam, Ernest W N; Woods, Nicole N

2014-09-01

There has been much debate surrounding diagnostic strategies and the most appropriate training models for novices in oral radiology. It has been argued that an analytic approach, using a step-by-step analysis of the radiographic features of an abnormality, is ideal. Alternative research suggests that novices can successfully employ non-analytic reasoning. Many of these studies do not take instructional methodology into account. This study evaluated the effectiveness of non-analytic and analytic strategies in radiographic interpretation and explored the relationship between instructional methodology and diagnostic strategy. Second-year dental and dental hygiene students were taught four radiographic abnormalities using basic science instructions or a step-by-step algorithm. The students were tested on diagnostic accuracy and memory immediately after learning and one week later. A total of seventy-three students completed both immediate and delayed sessions and were included in the analysis. Students were randomly divided into two instructional conditions: one group provided a diagnostic hypothesis for the image and then identified specific features to support it, while the other group first identified features and then provided a diagnosis. Participants in the diagnosis-first condition (non-analytic reasoning) had higher diagnostic accuracy then those in the features-first condition (analytic reasoning), regardless of their learning condition. No main effect of learning condition or interaction with diagnostic strategy was observed. Educators should be mindful of the potential influence of analytic and non-analytic approaches on the effectiveness of the instructional method.

Identifying and ranking of strategies to implement green supply chain management in Indian manufacturing industry using Analytical Hierarchy Process

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Sunil Luthra

2013-09-01

Full Text Available Purpose – The study aims to identify and rank the major strategies that help achieve successful implementation of Green Supply Chain Management (GSCM in Indian manufacturing industry.Design/methodology/approach – Strategies to implement GSCM have been identified thorough extensive literature review and then experts’ opinion is sought for categorizing them into four representative dimensions which are then ranked using Analytic Hierarchy Process (AHP.Findings – The study categorizes the GSCM implementation strategies into four dimensions - Non members of supply chain, downward stream supply chain Members, Organizational members of supply chain and upward stream supply chain members. These dimensions are found to play an important role in greening the supply chains enabling the practicing firms achieve enhanced operational performances.Research limitations/implications- AHP is used for ranking the GSCM implementation strategies in Indian manufacturing scenario. The pair-wise comparisons are made on the basis of the opinion of the experts drawn from academia and industry. As is natural, opinions of experts may not always be free from bias or prejudices. Moreover, the study relied more on the GSCM practices literature in developed nations as only limited literature related to the undertaken work in the Indian context was available.Practical implications – This paper may play important role in understanding various strategies and ranking them in order of importance. This facilitates firms prioritize different actions for achieving high GSCM performances in Indian manufacturing industry. Strategic implementation of green supply chain management will help Indian manufacturing enterprises enjoy cost and efficiency benefits.Originality/value – GSCM is a relatively new topic for majority of Indian manufacturing industries. This work is likely to help GSCM practitioners select suitable strategies in consonance with the government regulations

Increased vocal intensity due to the Lombard effect in speakers with Parkinson's disease: simultaneous laryngeal and respiratory strategies.

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Stathopoulos, Elaine T; Huber, Jessica E; Richardson, Kelly; Kamphaus, Jennifer; DeCicco, Devan; Darling, Meghan; Fulcher, Katrina; Sussman, Joan E

2014-01-01

The objective of the present study was to investigate whether speakers with hypophonia, secondary to Parkinson's disease (PD), would increases their vocal intensity when speaking in a noisy environment (Lombard effect). The other objective was to examine the underlying laryngeal and respiratory strategies used to increase vocal intensity. Thirty-three participants with PD were included for study. Each participant was fitted with the SpeechVive™ device that played multi-talker babble noise into one ear during speech. Using acoustic, aerodynamic and respiratory kinematic techniques, the simultaneous laryngeal and respiratory mechanisms used to regulate vocal intensity were examined. Significant group results showed that most speakers with PD (26/33) were successful at increasing their vocal intensity when speaking in the condition of multi-talker babble noise. They were able to support their increased vocal intensity and subglottal pressure with combined strategies from both the laryngeal and respiratory mechanisms. Individual speaker analysis indicated that the particular laryngeal and respiratory interactions differed among speakers. The SpeechVive™ device elicited higher vocal intensities from patients with PD. Speakers used different combinations of laryngeal and respiratory physiologic mechanisms to increase vocal intensity, thus suggesting that disease process does not uniformly affect the speech subsystems. Readers will be able to: (1) identify speech characteristics of people with Parkinson's disease (PD), (2) identify typical respiratory strategies for increasing sound pressure level (SPL), (3) identify typical laryngeal strategies for increasing SPL, (4) define the Lombard effect. Copyright © 2014 Elsevier Inc. All rights reserved.

An innovative strategy for the molecular diagnosis of Usher syndrome identifies causal biallelic mutations in 93% of European patients.

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Bonnet, Crystel; Riahi, Zied; Chantot-Bastaraud, Sandra; Smagghe, Luce; Letexier, Mélanie; Marcaillou, Charles; Lefèvre, Gaëlle M; Hardelin, Jean-Pierre; El-Amraoui, Aziz; Singh-Estivalet, Amrit; Mohand-Saïd, Saddek; Kohl, Susanne; Kurtenbach, Anne; Sliesoraityte, Ieva; Zobor, Ditta; Gherbi, Souad; Testa, Francesco; Simonelli, Francesca; Banfi, Sandro; Fakin, Ana; Glavač, Damjan; Jarc-Vidmar, Martina; Zupan, Andrej; Battelino, Saba; Martorell Sampol, Loreto; Claveria, Maria Antonia; Catala Mora, Jaume; Dad, Shzeena; Møller, Lisbeth B; Rodriguez Jorge, Jesus; Hawlina, Marko; Auricchio, Alberto; Sahel, José-Alain; Marlin, Sandrine; Zrenner, Eberhart; Audo, Isabelle; Petit, Christine

2016-12-01

Usher syndrome (USH), the most prevalent cause of hereditary deafness-blindness, is an autosomal recessive and genetically heterogeneous disorder. Three clinical subtypes (USH1-3) are distinguishable based on the severity of the sensorineural hearing impairment, the presence or absence of vestibular dysfunction, and the age of onset of the retinitis pigmentosa. A total of 10 causal genes, 6 for USH1, 3 for USH2, and 1 for USH3, and an USH2 modifier gene, have been identified. A robust molecular diagnosis is required not only to improve genetic counseling, but also to advance gene therapy in USH patients. Here, we present an improved diagnostic strategy that is both cost- and time-effective. It relies on the sequential use of three different techniques to analyze selected genomic regions: targeted exome sequencing, comparative genome hybridization, and quantitative exon amplification. We screened a large cohort of 427 patients (139 USH1, 282 USH2, and six of undefined clinical subtype) from various European medical centers for mutations in all USH genes and the modifier gene. We identified a total of 421 different sequence variants predicted to be pathogenic, about half of which had not been previously reported. Remarkably, we detected large genomic rearrangements, most of which were novel and unique, in 9% of the patients. Thus, our strategy led to the identification of biallelic and monoallelic mutations in 92.7% and 5.8% of the USH patients, respectively. With an overall 98.5% mutation characterization rate, the diagnosis efficiency was substantially improved compared with previously reported methods.

Effect of four teaching strategies on senior secondary students ...

African Journals Online (AJOL)

This study investigated the effect of four teaching strategies; peer-tutoring, demonstration, project-based and lecture teaching strategies on students' achievement in pasture and forage crops which is an aspect of agricultural science. Lecture strategy served both as a teaching strategy as well as control since it is assumed to ...

Effective teaching strategies and methods of delivery for patient education: a systematic review and practice guideline recommendations.

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Friedman, Audrey Jusko; Cosby, Roxanne; Boyko, Susan; Hatton-Bauer, Jane; Turnbull, Gale

2011-03-01

The objective of this study was to determine effective teaching strategies and methods of delivery for patient education (PE). A systematic review was conducted and reviews with or without meta-analyses, which examined teaching strategies and methods of delivery for PE, were included. Teaching strategies identified are traditional lectures, discussions, simulated games, computer technology, written material, audiovisual sources, verbal recall, demonstration, and role playing. Methods of delivery focused on how to deliver the teaching strategies. Teaching strategies that increased knowledge, decreased anxiety, and increased satisfaction included computer technology, audio and videotapes, written materials, and demonstrations. Various teaching strategies used in combination were similarly successful. Moreover, structured-, culturally appropriate- and patient-specific teachings were found to be better than ad hoc teaching or generalized teaching. Findings provide guidance for establishing provincial standards for the delivery of PE. Recommendations concerning the efficacy of the teaching strategies and delivery methods are provided.

The effectiveness of research implementation strategies for promoting evidence-informed policy and management decisions in healthcare: a systematic review.

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Sarkies, Mitchell N; Bowles, Kelly-Ann; Skinner, Elizabeth H; Haas, Romi; Lane, Haylee; Haines, Terry P

2017-11-14

It is widely acknowledged that health policy and management decisions rarely reflect research evidence. Therefore, it is important to determine how to improve evidence-informed decision-making. The primary aim of this systematic review was to evaluate the effectiveness of research implementation strategies for promoting evidence-informed policy and management decisions in healthcare. The secondary aim of the review was to describe factors perceived to be associated with effective strategies and the inter-relationship between these factors. An electronic search was developed to identify studies published between January 01, 2000, and February 02, 2016. This was supplemented by checking the reference list of included articles, systematic reviews, and hand-searching publication lists from prominent authors. Two reviewers independently screened studies for inclusion, assessed methodological quality, and extracted data. After duplicate removal, the search strategy identified 3830 titles. Following title and abstract screening, 96 full-text articles were reviewed, of which 19 studies (21 articles) met all inclusion criteria. Three studies were included in the narrative synthesis, finding policy briefs including expert opinion might affect intended actions, and intentions persisting to actions for public health policy in developing nations. Workshops, ongoing technical assistance, and distribution of instructional digital materials may improve knowledge and skills around evidence-informed decision-making in US public health departments. Tailored, targeted messages were more effective in increasing public health policies and programs in Canadian public health departments compared to messages and a knowledge broker. Sixteen studies (18 articles) were included in the thematic synthesis, leading to a conceptualisation of inter-relating factors perceived to be associated with effective research implementation strategies. A unidirectional, hierarchal flow was described from (1

A Framework to Determine the Effectiveness of Maintenance Strategies Lean Thinking Approach

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Alireza Irajpour

2014-01-01

Full Text Available The purpose of this paper is to provide a framework that can identify and evaluate the effectiveness of a given maintenance strategy and to rank components of maintenance system. The framework is developed using DEMATEL method on maintenance strategy as a guideline. To gain a richer understanding of the framework, a questionnaire is constructed and answered by experts. Then the DEMATEL method is applied to analyze the importance of criteria and the casual relations among the criteria are constructed. The scope of the paper is limited to performance measurement of maintenance strategies. It is found that the framework is applicable and useful for the strategic management of the maintenance function. It is observed that the influencing and preferred infrastructures for designing Learning and Training are three components, that is, optimal maintenance, CMMS, and RCM which are interdependent on each other and are the fundamental components to realize the designed goals of maintenance process. This paper provides an overview of research and developments in the measurement of maintenance performance. Many tools and techniques have been developed in other fields. However, the applicability of those tools to maintenance function has never been tried. In that respect this topic is novel. It helps in managing maintenance more effectively.

Effective strategies for behavior change.

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Coleman, Mary Thoesen; Pasternak, Ryan H

2012-06-01

Strategies that are most effective in both prevention and management of chronic disease consider factors such as age, ethnicity, community, and technology. Most behavioral change strategies derive their components from application of the health belief model, the theory of reasoned action/theory of planned behavior, transtheoretical model, and social cognitive theory. Many tools such as the readiness ruler and personalized action plan form are available to assist health care teams to facilitate healthy behavior change. Primary care providers can support behavior changes by providing venues for peer interventions and family meetings and by making new partnerships with community organizations. Copyright © 2012 Elsevier Inc. All rights reserved.

Systematic review of cost-effectiveness analyses for combinations of prevention strategies against human papillomavirus (HPV infection: a general trend

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Frédéric Gervais

2017-03-01

Full Text Available Abstract Background Due to the arrival of multi-valent HPV vaccines, it is more and more important to have a better understanding of the relationship between vaccination and screening programmes. This review aimed to: (1 collect published evidence on the cost-effectiveness profile of different HPV prevention strategies and, in particular, those combining vaccination with changes in screening practices; (2 explore the cost-effectiveness of alternative preventive strategies based on screening and vaccination. Methods A systematic literature review was conducted in order to identify the relevant studies regarding the cost-effectiveness of prevention strategies against HPV infection. Analysis comparing the modelling approaches between studies was made along with an assessment of the magnitude of impact of several factors on the cost-effectiveness of different screening strategies. Results A total of 18 papers were quantitatively summarised within the narrative. A high degree of heterogeneity was found in terms of how HPV prevention strategies have been assessed in terms of their economic and epidemiological impact, with variation in screening practice and valence of HPV vaccination found to have large implications in terms of cost-effectiveness. Conclusions This review demonstrated synergies between screening and vaccination. New prevention strategies involving multi-valence vaccination, HPV DNA test screening, delayed commencement and frequency of screening could be implemented in the future. Strategies implemented in the future should be chosen with care, and informed knowledge of the potential impact of all possible prevention strategies. Highlighted in this review is the difficulty in assessing multiple strategies. Appropriate modelling techniques will need to be utilised to assess the most cost-effective strategies.

A hybrid life cycle and multi-criteria decision analysis approach for identifying sustainable development strategies of Beijing's taxi fleet

International Nuclear Information System (INIS)

Cai, Yanpeng; Applegate, Scott; Yue, Wencong; Cai, Jianying; Wang, Xuan; Liu, Gengyuan; Li, Chunhui

2017-01-01

To identify and evaluate sustainable strategies of taxi fleet in Beijing in terms of economic, policy, and environmental implications, a hybrid approach was developed through incorporating multi-criteria decision analysis (MCDA) methods within a general life-cycle analysis (LCA) framework. The approach can (a) help comprehensive evaluate environmental impacts of multiple types of vehicles, (b) facilitate analysis of environmental, economic and policy features of such vehicles, and (c) identify desirable taxi fleet development strategies for the city. The developed approach represented an improvement of the decision-making capability for taxi implementation based on multiple available technologies and their performance that can be specifically tailored to Beijing. The results demonstrated that the proposed approach could comprehensively reflect multiple implications of strategies for the taxi fleet in Beijing to reduce air pollution in the city. The results also indicated that the electric vehicle powered with the year 2020 electricity projections would be the ideal solution, outranking the other alternatives. The conventional vehicle ranked the lowest among the alternatives. The plug-in hybrid vehicle powered by 2020 electricity projects ranked the third, followed by the plug-in hybrid vehicle ranking the fourth, and the hybrid vehicle ranking the fifth. - Highlights: • An hybrid approach was proposed for evaluating sustainable strategies of Beijing's taxi fleet. • This approach was based on the combination of multi-criteria decision analysis methods and life-cycle assessment. • Environmental, economic and policy performances of multiple strategies were compared. • Detailed responses of taxi drivers and local residents were interviewed. • The electric vehicle would be the ideal solution for Beijing Taxi fleet.

Cost-effectiveness of different strategies to manage patients with sciatica.

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Fitzsimmons, Deborah; Phillips, Ceri J; Bennett, Hayley; Jones, Mari; Williams, Nefyn; Lewis, Ruth; Sutton, Alex; Matar, Hosam E; Din, Nafees; Burton, Kim; Nafees, Sadia; Hendry, Maggie; Rickard, Ian; Wilkinson, Claire

2014-07-01

The aim of this paper is to estimate the relative cost-effectiveness of treatment regimens for managing patients with sciatica. A deterministic model structure was constructed based on information from the findings from a systematic review of clinical effectiveness and cost-effectiveness, published sources of unit costs, and expert opinion. The assumption was that patients presenting with sciatica would be managed through one of 3 pathways (primary care, stepped approach, immediate referral to surgery). Results were expressed as incremental cost per patient with symptoms successfully resolved. Analysis also included incremental cost per utility gained over a 12-month period. One-way sensitivity analyses were used to address uncertainty. The model demonstrated that none of the strategies resulted in 100% success. For initial treatments, the most successful regime in the first pathway was nonopioids, with a probability of success of 0.613. In the second pathway, the most successful strategy was nonopioids, followed by biological agents, followed by epidural/nerve block and disk surgery, with a probability of success of 0.996. Pathway 3 (immediate surgery) was not cost-effective. Sensitivity analyses identified that the use of the highest cost estimates results in a similar overall picture. While the estimates of cost per quality-adjusted life year are higher, the economic model demonstrated that stepped approaches based on initial treatment with nonopioids are likely to represent the most cost-effective regimens for the treatment of sciatica. However, development of alternative economic modelling approaches is required. Copyright © 2014 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

The effectiveness of strategies to change organisational culture to improve healthcare performance: a systematic review.

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Parmelli, Elena; Flodgren, Gerd; Beyer, Fiona; Baillie, Nick; Schaafsma, Mary Ellen; Eccles, Martin P

2011-04-03

Organisational culture is an anthropological metaphor used to inform research and consultancy and to explain organisational environments. In recent years, increasing emphasis has been placed on the need to change organisational culture in order to improve healthcare performance. However, the precise function of organisational culture in healthcare policy often remains underspecified and the desirability and feasibility of strategies to be adopted have been called into question. The objective of this review was to determine the effectiveness of strategies to change organisational culture in order to improve healthcare performance. We searched the following electronic databases: The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, Sociological Abstracts, Web of Knowledge, PsycINFO, Business and Management, EThOS, Index to Theses, Intute, HMIC, SIGLE, and Scopus until October 2009. The Database of Abstracts of Reviews of Effectiveness (DARE) was searched for related reviews. We also searched the reference lists of all papers and relevant reviews identified, and we contacted experts in the field for advice on further potential studies. We considered randomised controlled trials (RCTs) or well designed quasi-experimental studies (controlled clinical trials (CCTs), controlled before and after studies (CBAs), and interrupted time series (ITS) analyses). Studies could be set in any type of healthcare organisation in which strategies to change organisational culture in order to improve healthcare performance were applied. Our main outcomes were objective measures of professional performance and patient outcome. The search strategy yielded 4,239 records. After the full text assessment, two CBA studies were included in the review. They both assessed the impact of interventions aimed at changing organisational culture, but one evaluated the impact on work-related and personal outcomes while the other measured clinical outcomes. Both were at high risk of

A proteomic strategy to identify novel serum biomarkers for liver cirrhosis and hepatocellular cancer in individuals with fatty liver disease

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Stewart Stephen

2009-08-01

Full Text Available Abstract Background Non-alcoholic fatty liver disease (NAFLD has a prevalence of over 20% in Western societies. Affected individuals are at risk of developing both cirrhosis and hepatocellular cancer (HCC. Presently there is no cost effective population based means of identifying cirrhotic individuals and even if there were, our ability to perform HCC surveillance in the at risk group is inadequate. We have performed a pilot proteomic study to assess this as a strategy for serum biomarker detection. Methods 2D Gel electrophoresis was performed on immune depleted sera from 3 groups of patients, namely those with (1 pre-cirrhotic NAFLD (2 cirrhotic NAFLD and (3 cirrhotic NAFLD with co-existing HCC. Five spots differentiating at least one of these three groups were characterised by mass spectroscopy. An ELISA assay was optimised and a cross sectional study assessing one of these serum spots was performed on serum from 45 patients with steatohepatitis related cirrhosis and HCC and compared to 77 patients with histologically staged steatohepatitis. Results Four of the spots identified were apolipoprotein isoforms, the pattern of which was able to differentiate the three groups. The 5th spot, seen in the serum of cirrhotic individuals and more markedly in those with HCC, was identified as CD5 antigen like (CD5L. By ELISA assay, although CD5L was markedly elevated in a number of cirrhotic individuals with HCC, its overall ability to distinguish non-cancer from cancer individuals as determined by AUC ROC analysis was poor. However, serum CD5L was dramatically increased, independently of age, sex, and the presence of necroinflammation, in the serum of individuals with NAFLD cirrhosis relative to those with pre-cirrhotic disease. Conclusion This novel proteomic strategy has identified a number of candidate biomarkers which may have benefit in the surveillance and diagnosis of individuals with chronic liver disease and/or HCC.

Effects of a Self-Monitoring Strategy on Independent Work Behavior of Students with Mild Intellectual Disability

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Coughlin, Jennifer; McCoy, Kathleen M.; Kenzer, Amy; Mathur, Sarup R.; Zucker, Stanley H.

2012-01-01

This study evaluated the effectiveness of a self-monitoring strategy on independent work behavior. The three subjects were in first grade, seven years old, identified with mild intellectual disability (MID), and had an Individualized Education Plan (IEP) with targeted functional academic and behavior goals. The purpose of this study was to…

A comprehensive strategy for identifying long-distance mobile peptides in xylem sap.

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Okamoto, Satoru; Suzuki, Takamasa; Kawaguchi, Masayoshi; Higashiyama, Tetsuya; Matsubayashi, Yoshikatsu

2015-11-01

There is a growing awareness that secreted pemediate organ-to-organ communication in higher plants. Xylem sap peptidomics is an effective but challenging approach for identifying long-distance mobile peptides. In this study we developed a simple, gel-free purification system that combines o-chlorophenol extraction with HPLC separation. Using this system, we successfully identified seven oligopeptides from soybean xylem sap exudate that had one or more post-transcriptional modifications: glycosylation, sulfation and/or hydroxylation. RNA sequencing and quantitative PCR analyses showed that the peptide-encoding genes are expressed in multiple tissues. We further analyzed the long-distance translocation of four of the seven peptides using gene-encoding peptides with single amino acid substitutions, and identified these four peptides as potential root-to-shoot mobile oligopeptides. Promoter-GUS analysis showed that all four peptide-encoding genes were expressed in the inner tissues of the root endodermis. Moreover, we found that some of these peptide-encoding genes responded to biotic and/or abiotic factors. These results indicate that our purification system provides a comprehensive approach for effectively identifying endogenous small peptides and reinforce the concept that higher plants employ various peptides in root-to-shoot signaling. © 2015 The Authors The Plant Journal © 2015 John Wiley & Sons Ltd.

Age differences in perceptions of memory strategy effectiveness for recent and remote memory.

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Lineweaver, Tara T; Horhota, Michelle; Crumley, Jessica; Geanon, Catherine T; Juett, Jacqueline J

2018-03-01

We examined whether young and older adults hold different beliefs about the effectiveness of memory strategies for specific types of memory tasks and whether memory strategies are perceived to be differentially effective for young, middle-aged, and older targets. Participants rated the effectiveness of five memory strategies for 10 memory tasks at three target ages (20, 50, and 80 years old). Older adults did not strongly differentiate strategy effectiveness, viewing most strategies as similarly effective across memory tasks. Young adults held strategy-specific beliefs, endorsing external aids and physical health as more effective than a positive attitude or internal strategies, without substantial differentiation based on task. We also found differences in anticipated strategy effectiveness for targets of different ages. Older adults described cognitive and physical health strategies as more effective for older than middle-aged targets, whereas young adults expected these strategies to be equally effective for middle-aged and older target adults.

Matched and mismatched appraisals of the effectiveness of communication strategies by family caregivers of persons with Alzheimer's disease.

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Savundranayagam, Marie Y; Orange, J B

2014-01-01

Communication problems stemming from Alzheimer's disease (AD) often result in misunderstandings that can be linked with problem behaviours and increased caregiver stress. Moreover, these communication breakdowns also can result either from caregivers' use of ineffective communication strategies, which paradoxically are perceived as helpful, or can occur as a result of not using effective communication strategies that are perceived as unhelpful. The two primary aims were to determine the effectiveness of strategies used to resolve communication breakdowns and to examine whether caregivers' ratings of strategy effectiveness were consistent with evidence from video-recorded conversations and with effective communication strategies documented in the literature. Twenty-eight mealtime conversations were recorded using a sample of 15 dyads consisting of individuals with early, middle and late clinical-stage AD and their family caregivers. Conversations were analysed using the trouble-source repair paradigm to identify the communication strategies used by caregivers to resolve breakdowns. Family caregivers also rated the helpfulness of communication strategies used to resolve breakdowns. Analyses were conducted to assess the overlap or match between the use and appraisals of the helpfulness of communication strategies. Matched and mismatched appraisals of communication strategies varied across stages of AD. Matched appraisals by caregivers of persons with early-stage AD were observed for 68% of 22 communication strategies, whereas caregivers of persons with middle- and late-stage AD had matched appraisals for 45% and 55% of the strategies, respectively. Moreover, caregivers of persons with early-stage AD had matched appraisals over and above making matched appraisals by chance alone, compared with caregivers of persons in middle- and late-stage AD. Mismatches illustrate the need for communication education and training, particularly to establish empirically derived

Developing a strategy to promote the generation and effective use of population health research for NSW Health: 2011-2015.

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Biggs, Janice S; Stickney, Beth

2011-04-01

The Population Health Division of the NSW Department of Health has developed a 5-year strategy to improve the effectiveness of its resource investment in population health research. This paper describes the development of the strategy, Promoting the generation and effective use of population health research in NSW: a Strategy for NSW Health 2011-2015. A review of Australian and international strategic research documents and stakeholder interviews was conducted to support the development of the strategy. The findings from these two processes influenced the structure of the document and supported the inclusion of strategies and actions to assist with identifying research priorities, improving communication, enhancing networks and partnerships, supporting workforce development initiatives, providing research infrastructure, enhancing research and the use of research evidence and streamlining research governance and ethics processes. Small group discussions and a detailed review of literature were conducted to refine the thinking around four of the more complex aspects of the strategy. Finally, a broad consultation process was used to test the face validity of the proposed strategy content.

The Effectiveness of Time Management Strategies Instruction on Students' Academic Time Management and Academic Self Efficacy

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Kader, Fathi Abdul Hamid Abdul; Eissa, Mourad Ali

2015-01-01

This study investigated the effect of using time management strategies instruction on improving first year learning disabled students' academic time management and academic self efficacy. A total of 60 students identified with LD participated. The sample was divided into two groups; experimental (n = 30 boys) and control (n = 30 boys). ANCOVA and…

Classroom Management Strategies of Highly Effective Teachers in Diverse Middle Schools: Be Strict and Calm, Not Mean

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McGregor, Katheryne L.

2012-01-01

This qualitative research study investigated and identified the classroom management strategies of 12 highly effective middle school teachers who served diverse student populations at two different school sites. In addition, this research explored the beliefs and experiences of 305 diverse middle school students regarding their experiences with…

Hemodialysis: stressors and coping strategies.

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Ahmad, Muayyad M; Al Nazly, Eman K

2015-01-01

End-stage renal disease (ESRD) is an irreversible and life-threatening condition. In Jordan, the number of ESRD patients treated with hemodialysis is on the rise. Identifying stressors and coping strategies used by patients with ESRD may help nurses and health care providers to gain a clearer understanding of the condition of these patients and thus institute effective care planning. The purpose of this study was to identify stressors perceived by Jordanian patients on hemodialysis, and the coping strategies used by them. A convenience sample of 131 Jordanian men and women was recruited from outpatients' dialysis units in four hospitals. Stressors perceived by participants on hemodialysis and the coping strategies were measured using Hemodialysis Stressor Scale, and Ways of Coping Scale-Revised. Findings showed that patients on hemodialysis psychosocial stressors scores mean was higher than the physiological stressors mean. Positive reappraisal coping strategy had the highest mean among the coping strategies and the lowest mean was accepting responsibility. Attention should be focused towards the psychosocial stressors of patients on hemodialysis and also helping patients utilize the coping strategies that help to alleviate the stressors. The most used coping strategy was positive reappraisal strategy which includes faith and prayer.

A Way to More Effective Marketing Strategies

Directory of Open Access Journals (Sweden)

Carola Grebitus

2011-09-01

Full Text Available To create successful marketing strategies, it is essential to be familiar with consumers’ cognitive structures. In this article, the qualitative method of concept mapping is applied in a consumer survey (N = 132 to elicit cognitive structures and dimensionality of cognitive structures. The authors present methods to analyze dimensionality of cognitive structures descriptively and microeconometrically. An indicator for measuring cognitive structure dimensionality including weighted links is applied. To test the methodology, effects of sociodemographics on dimensionality are analyzed regarding a chosen food product. Results show that consumers’ age and education determine whether cognitive structures are more or less complex, whereas gender has no effect on the dimensionality of cognitive structures. To offer tailored marketing strategies based on dimensionality, emotional marketing strategies should be applied to reach customers with less complex cognitive structures. For consumers with more complex cognitive structures, marketers might focus on providing more detailed, information-based promotion.

Screening strategies for atrial fibrillation: a systematic review and cost-effectiveness analysis.

Science.gov (United States)

Welton, Nicky J; McAleenan, Alexandra; Thom, Howard Hz; Davies, Philippa; Hollingworth, Will; Higgins, Julian Pt; Okoli, George; Sterne, Jonathan Ac; Feder, Gene; Eaton, Diane; Hingorani, Aroon; Fawsitt, Christopher; Lobban, Trudie; Bryden, Peter; Richards, Alison; Sofat, Reecha

2017-05-01

Atrial fibrillation (AF) is a common cardiac arrhythmia that increases the risk of thromboembolic events. Anticoagulation therapy to prevent AF-related stroke has been shown to be cost-effective. A national screening programme for AF may prevent AF-related events, but would involve a substantial investment of NHS resources. To conduct a systematic review of the diagnostic test accuracy (DTA) of screening tests for AF, update a systematic review of comparative studies evaluating screening strategies for AF, develop an economic model to compare the cost-effectiveness of different screening strategies and review observational studies of AF screening to provide inputs to the model. Systematic review, meta-analysis and cost-effectiveness analysis. Primary care. Adults. Screening strategies, defined by screening test, age at initial and final screens, screening interval and format of screening {systematic opportunistic screening [individuals offered screening if they consult with their general practitioner (GP)] or systematic population screening (when all eligible individuals are invited to screening)}. Sensitivity, specificity and diagnostic odds ratios; the odds ratio of detecting new AF cases compared with no screening; and the mean incremental net benefit compared with no screening. Two reviewers screened the search results, extracted data and assessed the risk of bias. A DTA meta-analysis was perfomed, and a decision tree and Markov model was used to evaluate the cost-effectiveness of the screening strategies. Diagnostic test accuracy depended on the screening test and how it was interpreted. In general, the screening tests identified in our review had high sensitivity (> 0.9). Systematic population and systematic opportunistic screening strategies were found to be similarly effective, with an estimated 170 individuals needed to be screened to detect one additional AF case compared with no screening. Systematic opportunistic screening was more likely to be cost-effective

Cost-effective strategy to mitigate transportation disruptions in supply chain

Science.gov (United States)

Albertzeth, G.; Pujawan, I. N.

2018-04-01

Supply chain disruptions have gained significant attention by scholars. But, even though transportation plays a central role in supply chain, only few studies address transportation disruptions. This research demonstrates a real case of an order delivery process from a focal company (FC) to a single distributor, where transportation disruptions stochastically occurs. Considering the possibility of sales loss during the disruption duration, we proposed a redundant stock, flexible route, and combined flexibility-redundancy (ReFlex) as mitigation strategies and a base case as a risk acceptance strategy. The objective is to find out the best strategy that promotes cost-effectiveness against transportation disruptions. To fulfill this objective, we use simulation modeling and cost-effectiveness analysis (CEA) as our research method. We simulate the delivery process of 5 brands using each strategy to produce two different responses: loss of sales percentage and the incurred costs. Next, using these responses, we evaluate and compare the cost-effectiveness ratio of each strategy using CEA. We found that redundant stock gave the best effectiveness on all brands, ReFlex as the second best, while flexible route gave the least effectiveness. Finally, we recommend which strategy should be applied based on the decision maker willingness to pay.

Protocol: a systematic review of studies developing and/or evaluating search strategies to identify prognosis studies.

Science.gov (United States)

Corp, Nadia; Jordan, Joanne L; Hayden, Jill A; Irvin, Emma; Parker, Robin; Smith, Andrea; van der Windt, Danielle A

2017-04-20

Prognosis research is on the rise, its importance recognised because chronic health conditions and diseases are increasingly common and costly. Prognosis systematic reviews are needed to collate and synthesise these research findings, especially to help inform effective clinical decision-making and healthcare policy. A detailed, comprehensive search strategy is central to any systematic review. However, within prognosis research, this is challenging due to poor reporting and inconsistent use of available indexing terms in electronic databases. Whilst many published search filters exist for finding clinical trials, this is not the case for prognosis studies. This systematic review aims to identify and compare existing methodological filters developed and evaluated to identify prognosis studies of any of the three main types: overall prognosis, prognostic factors, and prognostic [risk prediction] models. Primary studies reporting the development and/or evaluation of methodological search filters to retrieve any type of prognosis study will be included in this systematic review. Multiple electronic bibliographic databases will be searched, grey literature will be sought from relevant organisations and websites, experts will be contacted, and citation tracking of key papers and reference list checking of all included papers will be undertaken. Titles will be screened by one person, and abstracts and full articles will be reviewed for inclusion independently by two reviewers. Data extraction and quality assessment will also be undertaken independently by two reviewers with disagreements resolved by discussion or by a third reviewer if necessary. Filters' characteristics and performance metrics reported in the included studies will be extracted and tabulated. To enable comparisons, filters will be grouped according to database, platform, type of prognosis study, and type of filter for which it was intended. This systematic review will identify all existing validated

A cost effective degradation-based maintenance strategy under imperfect repair

International Nuclear Information System (INIS)

Wu, Fan; Niknam, Seyed A.; Kobza, John E.

2015-01-01

An optimization model is developed to minimize the total cost of imperfect degradation-based maintenance by determining an optimal interval of condition monitoring and the degradation level after imperfect preventive repairs. The decision model is based on a novel cost model that considers functional relationship between the expected degradation reduction and the cost of preventive repairs. The decision model is applied to simulated vibration signals with a variety of specifications of cost values and degradation model parameters. This study has initiated a new area for the research of cost effective maintenance strategies. The results clearly indicate the significance of the proposed model and the decision variables under the objective of minimal cost. For instance, the results indicate direct relationship between the optimal length of monitoring interval and the monitoring cost. However, longer monitoring interval increases the risk of failure, and therefore, more degradation reduction is needed. By increasing the slope of cumulative degradation, the cost effective strategy advocates taking more frequent monitoring. The optimal degradation level after each preventive repair is not so sensitive to the change in the degradation slope due to the uncertainty associated with degradation patterns. - Highlights: • Discuss the relationship of degradation reduction and maintenance cost. • Determine the optimal interval of condition monitoring with minimal cost. • Identify the optimal degradation level after imperfect preventive repairs. • Discuss the effects of change in the slope of cumulative degradation.

Comparative clinical effectiveness of management strategies for sciatica: systematic review and network meta-analyses.

Science.gov (United States)

Lewis, Ruth A; Williams, Nefyn H; Sutton, Alex J; Burton, Kim; Din, Nafees Ud; Matar, Hosam E; Hendry, Maggie; Phillips, Ceri J; Nafees, Sadia; Fitzsimmons, Deborah; Rickard, Ian; Wilkinson, Clare

2015-06-01

There are numerous treatment approaches for sciatica. Previous systematic reviews have not compared all these strategies together. To compare the clinical effectiveness of different treatment strategies for sciatica simultaneously. Systematic review and network meta-analysis. We searched 28 electronic databases and online trial registries, along with bibliographies of previous reviews for comparative studies evaluating any intervention to treat sciatica in adults, with outcome data on global effect or pain intensity. Network meta-analysis methods were used to simultaneously compare all treatment strategies and allow indirect comparisons of treatments between studies. The study was funded by the UK National Institute for Health Research Health Technology Assessment program; there are no potential conflict of interests. We identified 122 relevant studies; 90 were randomized controlled trials (RCTs) or quasi-RCTs. Interventions were grouped into 21 treatment strategies. Internal and external validity of included studies was very low. For overall recovery as the outcome, compared with inactive control or conventional care, there was a statistically significant improvement following disc surgery, epidural injections, nonopioid analgesia, manipulation, and acupuncture. Traction, percutaneous discectomy, and exercise therapy were significantly inferior to epidural injections or surgery. For pain as the outcome, epidural injections and biological agents were significantly better than inactive control, but similar findings for disc surgery were not statistically significant. Biological agents were significantly better for pain reduction than bed rest, nonopioids, and opioids. Opioids, education/advice alone, bed rest, and percutaneous discectomy were inferior to most other treatment strategies; although these findings represented large effects, they were statistically equivocal. For the first time, many different treatment strategies for sciatica have been compared in the

Effect Of Constructivist-Based Teaching Strategy On Academic ...

African Journals Online (AJOL)

Research reports indicate that this negative attitude was caused, majorly, by teachers' conventional (lecture) method of teaching integrated science. Research reports on the effectiveness of constructivist-based teaching strategy revealed that the strategy enhanced students' academic performance. In view of this, this study ...

Identifying health facilities outside the enterprise: challenges and strategies for supporting health reform and meaningful use.

Science.gov (United States)

Dixon, Brian E; Colvard, Cyril; Tierney, William M

2014-06-24

Objective: To support collation of data for disability determination, we sought to accurately identify facilities where care was delivered across multiple, independent hospitals and clinics. Methods: Data from various institutions' electronic health records were merged and delivered as continuity of care documents to the United States Social Security Administration (SSA). Results: Electronic records for nearly 8000 disability claimants were exchanged with SSA. Due to the lack of standard nomenclature for identifying the facilities in which patients received the care documented in the electronic records, SSA could not match the information received with information provided by disability claimants. Facility identifiers were generated arbitrarily by health care systems and therefore could not be mapped to the existing international standards. Discussion: We propose strategies for improving facility identification in electronic health records to support improved tracking of a patient's care between providers to better serve clinical care delivery, disability determination, health reform and meaningful use. Conclusion: Accurately identifying the facilities where health care is delivered to patients is important to a number of major health reform and improvement efforts underway in many nations. A standardized nomenclature for identifying health care facilities is needed to improve tracking of care and linking of electronic health records.

Cost Effectiveness Analysis of Optimal Malaria Control Strategies in Kenya

Directory of Open Access Journals (Sweden)

Gabriel Otieno

2016-03-01

Full Text Available Malaria remains a leading cause of mortality and morbidity among the children under five and pregnant women in sub-Saharan Africa, but it is preventable and controllable provided current recommended interventions are properly implemented. Better utilization of malaria intervention strategies will ensure the gain for the value for money and producing health improvements in the most cost effective way. The purpose of the value for money drive is to develop a better understanding (and better articulation of costs and results so that more informed, evidence-based choices could be made. Cost effectiveness analysis is carried out to inform decision makers on how to determine where to allocate resources for malaria interventions. This study carries out cost effective analysis of one or all possible combinations of the optimal malaria control strategies (Insecticide Treated Bednets—ITNs, Treatment, Indoor Residual Spray—IRS and Intermittent Preventive Treatment for Pregnant Women—IPTp for the four different transmission settings in order to assess the extent to which the intervention strategies are beneficial and cost effective. For the four different transmission settings in Kenya the optimal solution for the 15 strategies and their associated effectiveness are computed. Cost-effective analysis using Incremental Cost Effectiveness Ratio (ICER was done after ranking the strategies in order of the increasing effectiveness (total infections averted. The findings shows that for the endemic regions the combination of ITNs, IRS, and IPTp was the most cost-effective of all the combined strategies developed in this study for malaria disease control and prevention; for the epidemic prone areas is the combination of the treatment and IRS; for seasonal areas is the use of ITNs plus treatment; and for the low risk areas is the use of treatment only. Malaria transmission in Kenya can be minimized through tailor-made intervention strategies for malaria control

Effectiveness of alternative management strategies in meeting conservation objectives

Science.gov (United States)

Richards S. Holthausen; Carolyn Hull Sieg

2007-01-01

This chapter evaluates how well various management strategies meet a variety of conservation objectives, summarizes their effectiveness in meeting objectives for rare or little-known (RLK) species, and proposes ways to combine strategies to meet overall conservation objectives. We address two broad categories of management strategies. Species approaches result in...

The effects of rhythm control strategies versus rate control strategies for atrial fibrillation and atrial flutter: a protocol for a systematic review with meta-analysis and Trial Sequential Analysis.

Science.gov (United States)

Sethi, Naqash J; Safi, Sanam; Nielsen, Emil E; Feinberg, Joshua; Gluud, Christian; Jakobsen, Janus C

2017-03-06

Atrial fibrillation is the most common arrhythmia of the heart with a prevalence of approximately 2% in the western world. Atrial flutter, another arrhythmia, occurs less often with an incidence of approximately 200,000 new patients per year in the USA. Patients with atrial fibrillation and atrial flutter have an increased risk of death and morbidities. The management of atrial fibrillation and atrial flutter is often based on interventions aiming at either a rhythm control strategy or a rate control strategy. The evidence on the comparable effects of these strategies is unclear. This protocol for a systematic review aims at identifying the best overall treatment strategy for atrial fibrillation and atrial flutter. This protocol for a systematic review was performed following the recommendations of the Cochrane Collaboration and the eight-step assessment procedure suggested by Jakobsen and colleagues. We plan to include all relevant randomised clinical trials assessing the effects of any rhythm control strategy versus any rate control strategy. We plan to search the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, LILACS, Science Citation Index Expanded on Web of Science, and BIOSIS to identify relevant trials. Any eligible trial will be assessed and classified as either high risk of bias or low risk of bias, and our conclusions will be based on trials with low risk of bias. The analyses of the extracted data will be performed using Review Manager 5 and Trial Sequential Analysis. For both our primary and secondary outcomes, we will create a 'Summary of Findings' table and use GRADE assessment to assess the quality of the evidence. The results of this systematic review have the potential to benefit thousands of patients worldwide as well as healthcare systems and healthcare economy. PROSPERO CRD42016051433.

Effects of strategy on visual working memory capacity.

Science.gov (United States)

Bengson, Jesse J; Luck, Steven J

2016-02-01

Substantial evidence suggests that individual differences in estimates of working memory capacity reflect differences in how effectively people use their intrinsic storage capacity. This suggests that estimated capacity could be increased by instructions that encourage more effective encoding strategies. The present study tested this by giving different participants explicit strategy instructions in a change detection task. Compared to a condition in which participants were simply told to do their best, we found that estimated capacity was increased for participants who were instructed to remember the entire visual display, even at set sizes beyond their capacity. However, no increase in estimated capacity was found for a group that was told to focus on a subset of the items in supracapacity arrays. This finding confirms the hypothesis that encoding strategies may influence visual working memory performance, and it is contrary to the hypothesis that the optimal strategy is to filter out any items beyond the storage capacity.

Maximizing cost-effectiveness by adjusting treatment strategy according to glaucoma severity

Science.gov (United States)

Guedes, Ricardo Augusto Paletta; Guedes, Vanessa Maria Paletta; Gomes, Carlos Eduardo de Mello; Chaoubah, Alfredo

2016-01-01

Abstract Background: The aim of this study is to determine the most cost-effective strategy for the treatment of primary open-angle glaucoma (POAG) in Brazil, from the payer's perspective (Brazilian Public Health System) in the setting of the Glaucoma Referral Centers. Methods: Study design was a cost-effectiveness analysis of different treatment strategies for POAG. We developed 3 Markov models (one for each glaucoma stage: early, moderate and advanced), using a hypothetical cohort of POAG patients, from the perspective of the Brazilian Public Health System (SUS) and a horizon of the average life expectancy of the Brazilian population. Different strategies were tested according to disease severity. For early glaucoma, we compared observation, laser and medications. For moderate glaucoma, medications, laser and surgery. For advanced glaucoma, medications and surgery. Main outcome measures were ICER (incremental cost-effectiveness ratio), medical direct costs and QALY (quality-adjusted life year). Results: In early glaucoma, both laser and medical treatment were cost-effective (ICERs of initial laser and initial medical treatment over observation only, were R$ 2,811.39/QALY and R$ 3,450.47/QALY). Compared to observation strategy, the two alternatives have provided significant gains in quality of life. In moderate glaucoma population, medical treatment presented the highest costs among treatment strategies. Both laser and surgery were highly cost-effective in this group. For advanced glaucoma, both tested strategies were cost-effective. Starting age had a great impact on results in all studied groups. Initiating glaucoma therapy using laser or surgery were more cost-effective, the younger the patient. Conclusion: All tested treatment strategies for glaucoma provided real gains in quality of life and were cost-effective. However, according to the disease severity, not all strategies provided the same cost-effectiveness profile. Based on our findings, there should be a

Quasi-Experiment Study on Effectiveness Evaluation of Health Communication Strategies

Science.gov (United States)

2016-01-01

This experimental study examined differences in doctor-patient relationships according to the health communication strategies during cases of medical malpractices occurred at primary medical institution. A total of 116 subjects aged in their 20s-50s was sampled. The first medical malpractice scenario chosen was the medical malpractice case most frequently registered at the Korean Medical Association Mutual Aid and the second scenario was associated with materials and devices as the cause of malpractice. Four types of crisis communication strategy messages were utilized, consisting of denial, denial + ingratiation, apology, and apology + ingratiation. Subjects were classified into four research groups by crisis communication strategy to measure levels of trust, control mutuality, commitment, and satisfaction, before and after the occurrence of medical malpractice and application of communication strategies. The findings of this study revealed that the apology strategy, compared with the denial strategy, showed a smaller difference before and after the application of communication strategies in all variables of trust (F = 8.080, F = 5.768), control mutuality (F = 8.824, F = 9.081), commitment (F = 9.815, F = 8.301), and satisfaction (F = 8.723, F = 5.638). Further, a significant interaction effect was shown between variables. The apology strategy, compared with the denial strategy, was effective in the improvement of doctor-patient relationships in both Scenarios I and II. For Scenario I, the apology strategy without ingratiation boosted commitment and satisfaction, but for Scenario II, utilizing the apology strategy with ingratiation boosted the effectiveness of trust and commitment. PMID:27365998

Quasi-Experiment Study on Effectiveness Evaluation of Health Communication Strategies.

Science.gov (United States)

Song, Dae Jong; Choi, Jae Wook; Kim, Kyunghee; Kim, Min Soo; Moon, Jiwon Monica

2016-07-01

This experimental study examined differences in doctor-patient relationships according to the health communication strategies during cases of medical malpractices occurred at primary medical institution. A total of 116 subjects aged in their 20s-50s was sampled. The first medical malpractice scenario chosen was the medical malpractice case most frequently registered at the Korean Medical Association Mutual Aid and the second scenario was associated with materials and devices as the cause of malpractice. Four types of crisis communication strategy messages were utilized, consisting of denial, denial + ingratiation, apology, and apology + ingratiation. Subjects were classified into four research groups by crisis communication strategy to measure levels of trust, control mutuality, commitment, and satisfaction, before and after the occurrence of medical malpractice and application of communication strategies. The findings of this study revealed that the apology strategy, compared with the denial strategy, showed a smaller difference before and after the application of communication strategies in all variables of trust (F = 8.080, F = 5.768), control mutuality (F = 8.824, F = 9.081), commitment (F = 9.815, F = 8.301), and satisfaction (F = 8.723, F = 5.638). Further, a significant interaction effect was shown between variables. The apology strategy, compared with the denial strategy, was effective in the improvement of doctor-patient relationships in both Scenarios I and II. For Scenario I, the apology strategy without ingratiation boosted commitment and satisfaction, but for Scenario II, utilizing the apology strategy with ingratiation boosted the effectiveness of trust and commitment.

The Effects of Cost Leadership Strategy and Product Differentiation Strategy on the Performance of Firms

OpenAIRE

Hashem Valipour; Hamid Birjandi; Samira Honarbakhsh

2012-01-01

This study empirically investigates the effects of business strategies on the relationship between financial leverage and the performance of firms. The research data is collected from 45 firms in the Tehran Security Exchange (TSE) during 2003-2010.The statistical technique is used to examine the assumption of multiple regressions. To test the assumptions, firms were divided into 2 groups: firms with cost leadership strategy and firms with product differentiation strategy. The results indicate...

Comparative effectiveness of correction strategies in connected discourse tracking.

Science.gov (United States)

Lunato, K E; Weisenberger, J M

1994-10-01

The effectiveness of four correction strategies commonly used in connected discourse tracking was investigated in the present study. The strategies were 1) verbatim repetition of a word or phrase; 2) use of antonyms or synonyms as cues; 3) use of phonemic cues, with no whole word repetition; and 4) going back or ahead in the text, with no repetition of the missed segment. Four normal-hearing adults served as listeners. Live-voice presentation of text by two female talkers was employed for all conditions. Listeners were tested in two stimulus presentation modes, speechreading alone and speechreading plus a multichannel tactile aid. Results indicated that strategy 1, repetition of the missed segment, produced the highest tracking rates, significantly higher than any of the other strategies. Strategy 2 produced the lowest tracking rates. Strategies 1 and 3 yielded the lowest percentage of initially missed words, or blockages, and strategy 4 the highest percentage. Significantly higher tracking rates were found under the speechreading plus tactile aid presentation mode, compared with speechreading alone. Further, tracking rates increased significantly from the beginning to the end of training. Data were compared with a more typical CDT task, in which all correction strategies were operative, and results showed little difference in tracking rates between this task and the constrained CDT employing only strategy 1. Overall, results suggest that simple repetition of missed segments is an effective correction strategy for CDT and argue for its inclusion in computer-assisted tracking implementations.

Costs, equity, efficiency and feasibility of identifying the poor in Ghana's National Health Insurance Scheme: empirical analysis of various strategies.

NARCIS (Netherlands)

Aryeetey, G.C.N.O.; Jehu-Appiah, C.; Spaan, E.; Agyepong, I.; Baltussen, R.M.

2012-01-01

Objectives To analyse the costs and evaluate the equity, efficiency and feasibility of four strategies to identify poor households for premium exemptions in Ghana's National Health Insurance Scheme (NHIS): means testing (MT), proxy means testing (PMT), participatory wealth ranking (PWR) and

Effective strategy making: Co-designing scenarios as a tool for effective strategic planning

Directory of Open Access Journals (Sweden)

Jan Vogelij

2015-08-01

-producing, as making together a product and collaboration towards a strategy, defined as a common exploration of possibilities. The interactions of the participants in the strategy making process, potentially creating trust and enhancing social cohesion, may be more important than the resulting concept for a development strategy. Therefore our attention focused on the way strategies are made in the black box of specific processes. The interactions aiming at co-ownership and collaboration are central in this novel ’interactions approach’. The resulting strategy does not necessarily contain (infra structural projects; a spatial strategy concerns a selected localised policy and argumentative framework for future development. Societal relevance Being a planning consultant with over forty years of experience in practice, the author highly values practical applicability in society. Understanding of practice-related factors for effectiveness of strategy making is important because effective public management saves costs for society; a framework expressing the aimed-for direction of development provides clarity for private initiatives; an agreed strategy helps to coordinate sector policies; several EU and national subsidies for projects require a locally agreed structural frame. Because a development vision concerns the direction of an envisaged development, its effectiveness is defined in terms of performance of the argumentative framework based on the story lines developed in the discussions during the strategy making process. Our search aims at identifying recommendations for enhanced chances for performing strategies in praxis. Approach A theoretical frame was composed based on literature in the fields of planning theory, policy analysis and design. Research questions were formulated concerning the importance of the process related variables: open process management, coownership, co-design, the application of scenarios and visualizations. Concerning the importance of the place

IDENTIFYING PRODUCT AND PRICE STRATEGIES FOR DESIGNING TRANSACTIONAL BANKING PACKAGES ADDRESSED TO SMES (CONSIDERATIONS

Directory of Open Access Journals (Sweden)

Giuca Simona-Mihaela

2014-07-01

Full Text Available The current paper has the aim to provide guidelines for designing efficient product and price strategies, through proposed business cases which could be used especially for banking products addressed to SMEs. While identifying the optimal product and price strategy and designing the product catalogue structure, the marketing specialist should definitely consider existing portfolio behaviour and estimate the growing potential (if possible, overall portfolio, with focus on accurately defining the additional impact of the newly proposed product/ products. A business case contains estimations for results to be generated by products to be launched or optimized. This paper presents complex schemes for business case scenarios for migration of existing portfolio to the new products, but also considers new clients acquisition based on important features of the products. The pricing strategy is not a simple task to manage. Especially when speaking about transactional packages (for which the price is lower than separate services included, some segments or clusters may generate loss to the bank if they already used the services at a higher price than the one of the package. Therefore, the decision of setting up specific prices needs to be based on an accurate and complex analysis, as presented in current paper. The assumptions used in a business case need to be relevant for the entire process of designing and launching a product, therefore they can always be adjusted for better calculation of the impact. No matter if the assumptions and prices remain as in the initial proposal or not, the steps to be followed are the same. Segmentation also plays an important role in designing the product strategy, since the target for a product or product catalogue can be represented by a segment, a sub segment or a cluster of many segments. Not always the initial segmentation represents the clustering for the product strategy. Sometimes, behaviour of existing clients

Multiple strategies of oxygen supply in Drosophila malignancies identify tracheogenesis as a novel cancer hallmark.

Science.gov (United States)

Grifoni, Daniela; Sollazzo, Manuela; Fontana, Elisabetta; Froldi, Francesca; Pession, Annalisa

2015-03-12

Angiogenesis is the term used to describe all the alterations in blood vessel growth induced by a tumour mass following hypoxic stress. The occurrence of multiple strategies of vessel recruitment favours drug resistance, greatly complicating the treatment of certain tumours. In Drosophila, oxygen is conveyed to the internal organs by the tracheal system, a closed tubular network whose role in cancer growth is so far unexplored. We found that, as observed in human cancers, Drosophila malignant cells suffer from oxygen shortage, release pro-tracheogenic factors, co-opt nearby vessels and get incorporated into the tracheal walls. We also found that the parallelisms observed in cellular behaviours are supported by genetic and molecular conservation. Finally, we identified a molecular circuitry associated with the differentiation of cancer cells into tracheal cells. In summary, our findings identify tracheogenesis as a novel cancer hallmark in Drosophila, further expanding the power of the fly model in cancer research.

Effects of Two Listening Strategies for Melodic Dictation

Science.gov (United States)

Buonviri, Nathan O.

2017-01-01

The purpose of this research was to examine effects of two listening strategies on melodic dictation scores. Fifty-four undergraduate music majors completed short tonal melodic dictations in a within-subjects design with three conditions: (a) no specified strategy in the instructions, (b) required listening before writing, and (c) required writing…

PROMOTION STRATEGIES IN WINE MARKETING

Directory of Open Access Journals (Sweden)

Ştefan MATEI

2014-06-01

Full Text Available Marketing has proven to be very useful instrument in the wine industry, in fostering comprehensive, cohesive and effective strategies which wineries require to effectively compete in today’s almost saturated wine market. But within wine marketing, the promotion strategy, from our point of view, is the most important component of the winery that can ensure the success in the market or can shorten the life cycle of the product. This being said, the aim of the paper is twofold. Firstly, to determine and analyze the steps that are required to create a promotion strategy in the wine industry, by comparing different approaches. Secondly, to identify the instruments of the promotional mix that helps a winery to implement its promotional strategy. Bearing that in mind, the paper starts with some theoretical aspects regarding the promotion strategy and ends by providing a brief overview of the main findings.

Recruitment Strategies and Activities Used by Agriculture Teachers.

Science.gov (United States)

Myers, Brian E.; Dyer, James E.; Breja, Lisa M.

2003-01-01

The most frequent student recruitment strategies reported by 275 secondary agriculture teachers were (in order of effectiveness) feeder schools, personal contacts, FFA, publications, strong curriculum, support groups, and special events. Specific activities for each strategy were identified. (Contains 34 references.) (SK)

Effective intervention strategies to improve health outcomes for cardiovascular disease patients with low health literacy skills: a systematic review.

Science.gov (United States)

Lee, Tae Wha; Lee, Seon Heui; Kim, Hye Hyun; Kang, Soo Jin

2012-12-01

Systematic studies on the relationship between health literacy and health outcomes demonstrate that as health literacy declines, patients engage in fewer preventive health and self-care behaviors and have worse disease-related knowledge. The purpose of this study was to identify effective intervention strategies to improve health outcomes in patients with cardiovascular disease and low literacy skills. This study employs the following criteria recommended by Khan Kunz, Keijnen, and Antes (2003) for systematic review: framing question, identifying relevant literature, assessing quality of the literature, summarizing the evidence, and interpreting the finding. A total of 235 articles were reviewed by the research team, and 9 articles met inclusion criteria. Although nine studies were reviewed for their health outcomes, only six studies, which had a positive quality grade evaluation were used to recommend effective intervention strategies. Interventions were categorized into three groups: tailored counseling, self-monitoring, and periodic reminder. The main strategies used to improve health outcomes of low literacy patients included tailored counseling, improved provider-patient interactions, organizing information by patient preference, self-care algorithms, and self-directed learning. Specific strategies included written materials tailored to appropriate reading levels, materials using plain language, emphasizing key points with large font size, and using visual items such as icons or color codes. With evidence-driven strategies, health care professionals can use tailored interventions to provide better health education and counseling that meets patient needs and improves health outcomes. Copyright © 2012. Published by Elsevier B.V.

Asthma management simulation for children: translating theory, methods, and strategies to effect behavior change.

Science.gov (United States)

Shegog, Ross; Bartholomew, L Kay; Gold, Robert S; Pierrel, Elaine; Parcel, Guy S; Sockrider, Marianna M; Czyzewski, Danita I; Fernandez, Maria E; Berlin, Nina J; Abramson, Stuart

2006-01-01

Translating behavioral theories, models, and strategies to guide the development and structure of computer-based health applications is well recognized, although a continued challenge for program developers. A stepped approach to translate behavioral theory in the design of simulations to teach chronic disease management to children is described. This includes the translation steps to: 1) define target behaviors and their determinants, 2) identify theoretical methods to optimize behavioral change, and 3) choose educational strategies to effectively apply these methods and combine these into a cohesive computer-based simulation for health education. Asthma is used to exemplify a chronic health management problem and a computer-based asthma management simulation (Watch, Discover, Think and Act) that has been evaluated and shown to effect asthma self-management in children is used to exemplify the application of theory to practice. Impact and outcome evaluation studies have indicated the effectiveness of these steps in providing increased rigor and accountability, suggesting their utility for educators and developers seeking to apply simulations to enhance self-management behaviors in patients.

Identifying demand effects in a large network of product categories

NARCIS (Netherlands)

Gelper, S.E.C.; Wilms, I.; Croux, C.

2016-01-01

Planning marketing mix strategies requires retailers to understand within- as well as cross-category demand effects. Most retailers carry products in a large variety of categories, leading to a high number of such demand effects to be estimated. At the same time, we do not expect cross-category

Identifying the Structure and Effect of Drinking-Related Self-Schemas.

Science.gov (United States)

Domenico, Lisa H; Strobbe, Stephen; Stein, Karen Farchaus; Giordani, Bruno J; Hagerty, Bonnie M; Pressler, Susan J

2017-07-01

Self-schemas have received increased attention as favorable targets for therapeutic intervention because of their central role in self-perception and behavior. The purpose of this integrative review was to identify, evaluate, and synthesize existing research pertaining to drinking-related self-schemas. Russell's integrative review strategy guided the search. Sixteen published works were identified, meeting criteria for evaluation ( n = 12 data-based publications and n = 4 models). The retrieved data-based publications rated fair-good using Polit and Beck's criteria; the overall body of literature rated "B" using Grimes and Schulz criteria. Retrieved models rated 4 to 7 using Fitzpatrick and Whall's criteria. The existing literature strongly supports the availability of a drinking-related self-schema among moderate-to-heavy drinking samples, and suggests a positive relationship between elaboration and drinking behavior. The relationship between valenced content of the schema and drinking behavior remains unexplored. Identifying variation in the structural properties of drinking-related self-schemas could lay the foundation for future interventions.

Strategies to Address Identified Education Gaps in the Preparation of a National Security Workforce

Energy Technology Data Exchange (ETDEWEB)

None

2008-06-30

This report will discuss strategies available to address identified gaps and weaknesses in education efforts aimed at the preparation of a skilled and properly trained national security workforce.The need to adequately train and educate a national security workforce is at a critical juncture. Even though there are an increasing number of college graduates in the appropriate fields, many of these graduates choose to work in the private sector because of more desirable salary and benefit packages. This is contributing to an inability to fill vacant positions at NNSA resulting from high personnel turnover from the large number of retirements. Further, many of the retirees are practically irreplaceable because they are Cold War scientists that have experience and expertise with nuclear weapons.

The Effect of Teaching Search Strategies on Perceptual Performance.

Science.gov (United States)

van der Gijp, Anouk; Vincken, Koen L; Boscardin, Christy; Webb, Emily M; Ten Cate, Olle Th J; Naeger, David M

2017-06-01

Radiology expertise is dependent on the use of efficient search strategies. The aim of this study is to investigate the effect of teaching search strategies on trainee's accuracy in detecting lung nodules at computed tomography. Two search strategies, "scanning" and "drilling," were tested with a randomized crossover design. Nineteen junior radiology residents were randomized into two groups. Both groups first completed a baseline lung nodule detection test allowing a free search strategy, followed by a test after scanning instruction and drilling instruction or vice versa. True positive (TP) and false positive (FP) scores and scroll behavior were registered. A mixed-design analysis of variance was applied to compare the three search conditions. Search strategy instruction had a significant effect on scroll behavior, F(1.3) = 54.2, P search (M = 15.3, SD = 4.6), t(18) = 4.44, P search. FP scores for drilling (M = 7.3, SD = 5.6) were significantly lower than for free search (M = 12.5, SD = 7.8), t(18) = 4.86, P < 0.001. Teaching a drilling strategy is preferable to teaching a scanning strategy for finding lung nodules. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Evaluating the effectiveness of brand-positioning strategies from a consumer perspective

DEFF Research Database (Denmark)

Fuchs, Christoph; Diamantopoulos, Adamantios

2010-01-01

- The findings should guide brand managers in selecting the most appropriate positioning strategies for their brands in high-involvement markets such as the automobile market. Originality/value - The study sheds initial light on the overall relative effectiveness of major positioning strategies. The study......Purpose - The purpose of the paper is to explore empirically the overall relative effectiveness of alternative positioning strategies from a consumer perspective. Design/methodology/approach - Two studies (within- and between-subjects design) are conducted aimed at evaluating the positioning...... of positioning strategy used affects the positioning success of a brand. More specifically, the study confirms normative arguments about the overall relative effectiveness of main positioning strategies by revealing that benefit-based positioning and surrogate (user) positioning generally outperform feature...

Effective Strategies for Enhancing Waste Management at University Campuses

Science.gov (United States)

Ebrahimi, Kianoosh; North, Leslie A.

2017-01-01

Purpose: The purpose of this study is to identify and assess the waste management strategies that should be priorities for higher education institutions. The role of policy instruments (i.e. purchasing policies and recycling initiatives) in implementing sustainable zero-waste management programs at higher education institutions was investigated…

Emergency management: Concepts and strategies for effective programs

OpenAIRE

Lucus, Valerie

2007-01-01

Review of Emergency Management: Concepts and Strategies for Effective Programs By Lucien G. Canton, CEM. By taking a different perspective on local government emergency management programs, this book presents the vision for a very different model--one that includes an independent emergency manager leading an enterprise-wide program focused on strategies that promote disaster resilient communities.

Identifying Strategies to Decrease Overtime, Absenteeism and Agency Use: Insights from Healthcare Leaders.

Science.gov (United States)

Jeffs, Lianne; Grinspun, Doris; Closson, Tom; Mainville, Marie-Claude

2015-09-01

Working overtime, absenteeism and agency use can negatively impact working environments, the health of staff and patient outcomes, and increase healthcare costs. The purpose of this study was to explore how healthcare leaders in Ontario hospitals implement and sustain best practices that advance workforce stability within their organization. Qualitative study design using semi-structured interviews and thematic analysis. Participants included 23 healthcare leaders from 16 hospital sites. Two main themes emerged: (1) enacting proactive human resource practices and (2) having strong, caring and strategic leaders that create learning and supportive work environments. A number of sub-themes identified were reported through narratives stratified according to size (small/large) and performance (low/high) of each site. Insights gained from this study may offer healthcare leaders strategies to maximize the nursing workforce and minimize overtime, absenteeism and agency use to ensure safe, efficient and quality healthcare. Copyright © 2015 Longwoods Publishing.

The Effect of Language Learning Strategies on Proficiency, Attitudes and School Achievement

Directory of Open Access Journals (Sweden)

Anita Habók

2018-01-01

Full Text Available This study examines language learning strategy (LLS use in connexion with foreign language attitude, proficiency and general school achievement among lower secondary students in Years 5 and 8 (n = 868 in Hungary. An adapted version of the Strategies Inventory for Language Learning questionnaire was used for data collection. The results showed that Hungarian students mainly engage in metacognitive strategies in both years. Differences between more and less proficient language learners’ strategy use have also been found. With regard to the effect of LLS on foreign language attitude, the foreign language mark and school achievement, path analysis indicated a good fit in both years. The metacognitive, social and memory strategies primarily influenced foreign language attitudes and marks in Year 5. The metacognitive strategies had a slight impact on school achievement as well as on foreign language marks. We demonstrated the dominant effect of metacognitive strategies and the low effect of memory strategies in Year 8. In addition, metacognitive strategies also influenced foreign language marks. The effect of foreign language marks on school achievement was also remarkable. There was a strong impact on the children’s attitudes through these variables.

The Effect of Language Learning Strategies on Proficiency, Attitudes and School Achievement.

Science.gov (United States)

Habók, Anita; Magyar, Andrea

2017-01-01

This study examines language learning strategy (LLS) use in connexion with foreign language attitude, proficiency and general school achievement among lower secondary students in Years 5 and 8 ( n = 868) in Hungary. An adapted version of the Strategies Inventory for Language Learning questionnaire was used for data collection. The results showed that Hungarian students mainly engage in metacognitive strategies in both years. Differences between more and less proficient language learners' strategy use have also been found. With regard to the effect of LLS on foreign language attitude, the foreign language mark and school achievement, path analysis indicated a good fit in both years. The metacognitive, social and memory strategies primarily influenced foreign language attitudes and marks in Year 5. The metacognitive strategies had a slight impact on school achievement as well as on foreign language marks. We demonstrated the dominant effect of metacognitive strategies and the low effect of memory strategies in Year 8. In addition, metacognitive strategies also influenced foreign language marks. The effect of foreign language marks on school achievement was also remarkable. There was a strong impact on the children's attitudes through these variables.

Adaptation and translation of mental health interventions in Middle Eastern Arab countries: a systematic review of barriers to and strategies for effective treatment implementation.

Science.gov (United States)

Gearing, Robin E; Schwalbe, Craig S; MacKenzie, Michael J; Brewer, Kathryne B; Ibrahim, Rawan W; Olimat, Hmoud S; Al-Makhamreh, Sahar S; Mian, Irfan; Al-Krenawi, Alean

2013-11-01

All too often, efficacious psychosocial evidence-based interventions fail when adapted from one culture to another. International translation requires a deep understanding of the local culture, nuanced differences within a culture, established service practices, and knowledge of obstacles and promoters to treatment implementation. This research investigated the following objectives to better facilitate cultural adaptation and translation of psychosocial and mental health treatments in Arab countries: (1) identify barriers or obstacles; (2) identify promoting strategies; and (3) provide clinical and research recommendations. This systematic review of 22 psychosocial or mental health studies in Middle East Arab countries identified more barriers (68%) than promoters (32%) to effective translation and adaptation of empirically supported psychosocial interventions. Identified barriers include obstacles related to acceptability of the intervention within the cultural context, community and system difficulties, and problems with clinical engagement processes. Whereas identified promoter strategies centre on the importance of partnering and working within the local and cultural context, the need to engage with acceptable and traditional intervention characteristics, and the development of culturally appropriate treatment strategies and techniques. Although Arab cultures across the Middle East are unique, this article provides a series of core clinical and research recommendations to assist effective treatment adaptation and translation within Arab communities in the Middle East.

Dealing with Feeling: A Meta-Analysis of the Effectiveness of Strategies Derived from the Process Model of Emotion Regulation

Science.gov (United States)

Webb, Thomas L.; Miles, Eleanor; Sheeran, Paschal

2012-01-01

The present meta-analysis investigated the effectiveness of strategies derived from the process model of emotion regulation in modifying emotional outcomes as indexed by experiential, behavioral, and physiological measures. A systematic search of the literature identified 306 experimental comparisons of different emotion regulation (ER)…

Suppressor Effects of Coping Strategies on Resilience

Science.gov (United States)

Yoon, Jae ho; Lee, Ji hae; Lee, Chae Yeon; Cho, Minhee; Lee, Sang Min

2014-01-01

The purpose of the current study is to demonstrate a significant suppressor effect among coping strategies on resilience. Two different samples were used to replicate the suppressor effect. Participants in the first example were 391 adolescents (middle school students) in Korea, and participants in the second example were 282 young adults…

Beyond "implementation strategies": classifying the full range of strategies used in implementation science and practice.

Science.gov (United States)

Leeman, Jennifer; Birken, Sarah A; Powell, Byron J; Rohweder, Catherine; Shea, Christopher M

2017-11-03

Strategies are central to the National Institutes of Health's definition of implementation research as "the study of strategies to integrate evidence-based interventions into specific settings." Multiple scholars have proposed lists of the strategies used in implementation research and practice, which they increasingly are classifying under the single term "implementation strategies." We contend that classifying all strategies under a single term leads to confusion, impedes synthesis across studies, and limits advancement of the full range of strategies of importance to implementation. To address this concern, we offer a system for classifying implementation strategies that builds on Proctor and colleagues' (2013) reporting guidelines, which recommend that authors not only name and define their implementation strategies but also specify who enacted the strategy (i.e., the actor) and the level and determinants that were targeted (i.e., the action targets). We build on Wandersman and colleagues' Interactive Systems Framework to distinguish strategies based on whether they are enacted by actors functioning as part of a Delivery, Support, or Synthesis and Translation System. We build on Damschroder and colleague's Consolidated Framework for Implementation Research to distinguish the levels that strategies target (intervention, inner setting, outer setting, individual, and process). We then draw on numerous resources to identify determinants, which are conceptualized as modifiable factors that prevent or enable the adoption and implementation of evidence-based interventions. Identifying actors and targets resulted in five conceptually distinct classes of implementation strategies: dissemination, implementation process, integration, capacity-building, and scale-up. In our descriptions of each class, we identify the level of the Interactive System Framework at which the strategy is enacted (actors), level and determinants targeted (action targets), and outcomes used to

Effect of perestroika on disarmament strategy

International Nuclear Information System (INIS)

Kalyadine, A.N.

1990-01-01

The article discusses the effect perestroika has had on the strategy for disarmament, on the assessment of the possibilities, ways and means of implementing it and on the approaches to solving specific problems in the field, and particularly in the area of nuclear disarmament. 10 notes

A strategy to identify opportunities for innovation in Romanian healthcare services.

Science.gov (United States)

Coculescu, B I; Purcărea, V L; Coculescu, E C

2015-01-01

In principle, the development of medicine (including the Romanian health system) is primarily dependent on the level of funding and the efficiency with which this funding is used, the structure of the population and socio-economic development of the geographical area concerned, and not least, the attitudes and expectations of patients, which in turn translate into care taking policies system. Unlike the other services, health services are accessed by a large number of people, which results into high health. As an economic principle, the fewer resources are used to achieve the expected results, the more effective the supplier. However, the introduction of new medical technologies, many of them more reliable yet more expensive, required a reassessment of the way resources are used at the suppliers' level to produce the expected results, an evaluation based on cost-effectiveness per analysis (or per patient) criteria. Finally, medical services are the tools of the marketing strategy of any medical organizations without which the needs and motivations of the beneficiaries (patients) could not be satisfied. In essence, the entire marketing philosophy is based on the needs and wishes of the people and on concrete solutions to solve them.

A cost-effectiveness analysis of two different repositioning strategies for the prevention of pressure ulcers.

Science.gov (United States)

Marsden, Grace; Jones, Katie; Neilson, Julie; Avital, Liz; Collier, Mark; Stansby, Gerard

2015-12-01

To assess the cost effectiveness of two repositioning strategies and inform the 2014 National Institute for Health and Care Excellence clinical guideline recommendations on pressure ulcer prevention. Pressure ulcers are distressing events, caused when skin and underlying tissues are placed under pressure sufficient to impair blood supply. They can have a substantial impact on quality of life and have significant resource implications. Repositioning is a key prevention strategy, but can be resource intensive, leading to variation in practice. This economic analysis was conducted to identify the most cost-effective repositioning strategy for the prevention of pressure ulcers. The economic analysis took the form of a cost-utility model. The clinical inputs to the model were taken from a systematic review of clinical data. The population in the model was older people in a nursing home. The economic model was developed with members of the guideline development group and included costs borne by the UK National Health Service. Outcomes were expressed as costs and quality adjusted life years. Despite being marginally more clinically effective, alternating 2 and 4 hourly repositioning is not a cost-effective use of UK National Health Service resources (compared with 4 hourly repositioning) for this high risk group of patients at a cost-effectiveness threshold of £20,000 per quality adjusted life years. These results were used to inform the clinical guideline recommendations for those who are at high risk of developing pressure ulcers. © 2015 John Wiley & Sons Ltd.

A study to identify winning strategies for the business community during the next pandemic.

Science.gov (United States)

Spriggs, Martin

2013-01-01

This study examines the relationship between the healthcare system and the corporate sector to answer the following research question: how does the healthcare system best prepare small to medium-sized businesses for the next pandemic influenza? Data were collected and collated through a literature review, electronic survey and semi-structured follow-up telephone interviews. The participants were businesses with membership in the Alberta Chambers of Commerce, a provincial lobby group in Alberta, Canada. The findings indicate strategies that were effective in minimising impact to the business community during the H1N1 pandemic and suggest areas for the business community to improve in preparation for the next pandemic influenza. Recommendations focus on establishing new links for communication between the business community and the healthcare sector and improving strategies to increase the resilience of small to medium-sized businesses for the next pandemic influenza.

[Cost-effectiveness analysis and diet quality index applied to the WHO Global Strategy].

Science.gov (United States)

Machado, Flávia Mori Sarti; Simões, Arlete Naresse

2008-02-01

To test the use of cost-effectiveness analysis as a decision making tool in the production of meals for the inclusion of the recommendations published in the World Health Organization's Global Strategy. Five alternative options for breakfast menu were assessed previously to their adoption in a food service at a university in the state of Sao Paulo, Southeastern Brazil, in 2006. Costs of the different options were based on market prices of food items (direct cost). Health benefits were estimated based on adaptation of the Diet Quality Index (DQI). Cost-effectiveness ratios were estimated by dividing benefits by costs and incremental cost-effectiveness ratios were estimated as cost differential per unit of additional benefit. The meal choice was based on health benefit units associated to direct production cost as well as incremental effectiveness per unit of differential cost. The analysis showed the most simple option with the addition of a fruit (DQI = 64 / cost = R$ 1.58) as the best alternative. Higher effectiveness was seen in the options with a fruit portion (DQI1=64 / DQI3=58 / DQI5=72) compared to the others (DQI2=48 / DQI4=58). The estimate of cost-effectiveness ratio allowed to identifying the best breakfast option based on cost-effectiveness analysis and Diet Quality Index. These instruments allow easy application easiness and objective evaluation which are key to the process of inclusion of public or private institutions under the Global Strategy directives.

The Effect of Three Kinds of Reading Strategies on EFL Learners’ Reading Comprehension and Gender Difference Using Think-aloud Protocol

Directory of Open Access Journals (Sweden)

Ali Fathi Karizak

2016-09-01

Full Text Available Reading comprehension strategy instruction is a powerful tool in teaching context. The present study examines the effect of teaching three kinds of reading strategies on L2 learners’ reading comprehension ability as well as identifying the gender role in this intervention. This quasi experimental study was carried out on 100 Iranian EFL students who were chosen on the basis of a convenient sampling procedure. These participants were divided into two groups of experimental and control.  50 students (experimental group were taught to use three reading comprehension strategies while reading English texts over 16 sessions, whereas the other 50 students (control group were taught reading comprehension traditionally. The results of the study revealed significant effect of reading strategies application on L2 learners’ reading comprehension ability. It also showed that not only male learners employ reading strategies more than their female counterparts, but also male learners had higher reading comprehension performance in comparison to their female counterparts. Thus, it seems that training of reading strategy raised students' awareness towards these strategies and could encourage some learners to use them; which in turn could improve the students' reading comprehension skill.

Effects of Downsizing Strategies on Survivors' Organizational ...

African Journals Online (AJOL)

Journal of Business and Administrative Studies ... Effects of Downsizing Strategies on Survivors' Organizational Commitment: The Case of Ethio Telecom ... do human resource planning industriously, set clear selection criteria, make the ...

Effective and cost-effective clinical trial recruitment strategies for postmenopausal women in a community-based, primary care setting.

Science.gov (United States)

Butt, Debra A; Lock, Michael; Harvey, Bart J

2010-09-01

Little evidence exists to guide investigators on the effectiveness and cost-effectiveness of various recruitment strategies in primary care research. The purpose of this study is to describe the effectiveness and cost-effectiveness of eight clinical trial recruitment methods for postmenopausal women in a community-based setting. A retrospective analysis of the yield and cost of eight different recruitment methods: 1) family physician (FP) recruiters, 2) FP referrals, 3) community presentations, 4) community events, 5) newsletters, 6) direct mailings, 7) posters, and 8) newspaper advertisements that were used to recruit postmenopausal women to a randomized clinical trial (RCT) evaluating the effectiveness of gabapentin in treating hot flashes. We recruited 197 postmenopausal women from a total of 904 screened, with 291 of the remainder being ineligible and 416 declining to participate. Of the 904 women screened, 34 (3.8%) were from FP recruiters and 35 (3.9%) were from other FP referrals while 612 (67.7%) resulted from newspaper advertisements. Of the 197 women enrolled, 141 (72%) were from newspaper advertisements, with 26 (13%) following next from posters. Word of mouth was identified as an additional unanticipated study recruitment strategy. Metropolitan newspaper advertising at $112.73 (Canadian) per enrolled participant and posters at $119.98 were found to be cost-effective recruitment methods. Newspaper advertisements were the most successful method to recruit postmenopausal women into a community-based, primary care RCT. Copyright 2010 Elsevier Inc. All rights reserved.

Mold prevention strategies and possible health effects in the aftermath of hurricanes and major floods.

Science.gov (United States)

Brandt, Mary; Brown, Clive; Burkhart, Joe; Burton, Nancy; Cox-Ganser, Jean; Damon, Scott; Falk, Henry; Fridkin, Scott; Garbe, Paul; McGeehin, Mike; Morgan, Juliette; Page, Elena; Rao, Carol; Redd, Stephen; Sinks, Tom; Trout, Douglas; Wallingford, Kenneth; Warnock, David; Weissman, David

2006-06-09

Extensive water damage after major hurricanes and floods increases the likelihood of mold contamination in buildings. This report provides information on how to limit exposure to mold and how to identify and prevent mold-related health effects. Where uncertainties in scientific knowledge exist, practical applications designed to be protective of a person's health are presented. Evidence is included about assessing exposure, clean-up and prevention, personal protective equipment, health effects, and public health strategies and recommendations. The recommendations assume that, in the aftermath of major hurricanes or floods, buildings wet for health effects in susceptible persons regardless of the type of mold or the extent of contamination. For the majority of persons, undisturbed mold is not a substantial health hazard. Mold is a greater hazard for persons with conditions such as impaired host defenses or mold allergies. To prevent exposure that could result in adverse health effects from disturbed mold, persons should 1) avoid areas where mold contamination is obvious; 2) use environmental controls; 3) use personal protective equipment; and 4) keep hands, skin, and clothing clean and free from mold-contaminated dust. Clinical evaluation of suspected mold-related illness should follow conventional clinical guidelines. In addition, in the aftermath of extensive flooding, health-care providers should be watchful for unusual mold-related diseases. The development of a public health surveillance strategy among persons repopulating areas after extensive flooding is recommended to assess potential health effects and the effectiveness of prevention efforts. Such a surveillance program will help CDC and state and local public health officials refine the guidelines for exposure avoidance, personal protection, and clean-up and assist health departments to identify unrecognized hazards.

Integrative Strategy for Effective Teaching of Density and Pressure in ...

African Journals Online (AJOL)

Integrative Strategy for Effective Teaching of Density and Pressure in Senior Secondary Schools: A Guide to Physics teachers. U Stephen, J T Mkpanang. Abstract. The problem of many teachers throughout the world is not what to teach but how to teach what. In this paper, integrative strategy for effective teaching of density ...

The Effect of a Course Management System (CMS)-Supported Strategy Instruction on EFL Reading Comprehension and Strategy Use

Science.gov (United States)

Tsai, Yea-Ru; Talley, Paul C.

2014-01-01

This paper reports on the effect of a Moodle-supported strategy instruction on both reading comprehension and strategy use among EFL (English as a Foreign Language) students. Specific reading strategy training was first integrated into a Moodle system, which included reading exercises on problem identification, monitoring comprehension,…

Identifying optimal vaccination strategies for serogroup A Neisseria meningitidis conjugate vaccine in the African meningitis belt.

Directory of Open Access Journals (Sweden)

Sara Tartof

Full Text Available The optimal long-term vaccination strategies to provide population-level protection against serogroup A Neisseria meningitidis (MenA are unknown. We developed an age-structured mathematical model of MenA transmission, colonization, and disease in the African meningitis belt, and used this model to explore the impact of various vaccination strategies.The model stratifies the simulated population into groups based on age, infection status, and MenA antibody levels. We defined the model parameters (such as birth and death rates, age-specific incidence rates, and age-specific duration of protection using published data and maximum likelihood estimation. We assessed the validity of the model by comparing simulated incidence of invasive MenA and prevalence of MenA carriage to observed incidence and carriage data.The model fit well to observed age- and season-specific prevalence of carriage (mean pseudo-R2 0.84 and incidence of invasive disease (mean R2 0.89. The model is able to reproduce the observed dynamics of MenA epidemics in the African meningitis belt, including seasonal increases in incidence, with large epidemics occurring every eight to twelve years. Following a mass vaccination campaign of all persons 1-29 years of age, the most effective modeled vaccination strategy is to conduct mass vaccination campaigns every 5 years for children 1-5 years of age. Less frequent campaigns covering broader age groups would also be effective, although somewhat less so. Introducing conjugate MenA vaccine into the EPI vaccination schedule at 9 months of age results in higher predicted incidence than periodic mass campaigns.We have developed the first mathematical model of MenA in Africa to incorporate age structures and progressively waning protection over time. Our model accurately reproduces key features of MenA epidemiology in the African meningitis belt. This model can help policy makers consider vaccine program effectiveness when determining the

Occupational Stress and Mental Health Symptoms: Examining the Moderating Effect of Work Recovery Strategies in Firefighters.

Science.gov (United States)

Sawhney, Gargi; Jennings, Kristen S; Britt, Thomas W; Sliter, Michael T

2017-06-12

The goal of this research was to examine the moderating effect of work recovery strategies on the relationship between occupational stress experienced by firefighters and mental health symptoms. Work recovery strategies were identified through semistructured interviews with 20 firefighters and a literature search on recovery strategies. A total of 7 work recovery strategies emerged using the 2 methods: work-related talks, stress-related talks, time with coworkers/supervisor, exercise, recreational activities, relaxation, and mastery experiences. Using a prospective study design with a 1-month time interval in a sample of 268 firefighters, experienced occupational stress at Time 1 was positively related to mental health symptoms at Time 2. In addition, with the exception of spending time with coworkers/supervisor, exercise and mastery experiences, recovery strategies at Time 1 were negatively related to mental health symptoms at Time 2. Lastly, all work recovery strategies, except stress-related talks and relaxation, moderated the relationship between experienced occupational stress at Time 1 and mental health symptoms at Time 2. Specifically, the positive relationship between experienced occupational stress and mental health symptoms was stronger when firefighters engaged in low, rather than high, work recovery strategies. Implications for research and practice are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Strategy and space

DEFF Research Database (Denmark)

Jensen, Per Anker

2011-01-01

in different periods and how these strategies can be related to the general conditions of the corporation. The strategic uncertainty of the corporation is investigated as a main determining factor for changes in space strategy based on theories of the relations between strategy and place. These theories......The article is based on results from a research project on space strategies and building values, which included a major case study of the development of facilities for the Danish Broadcasting Corporation over time. The focus is to identify, how different space strategies have been implemented...... include that corporations follows one of the three generic space strategies: Incrementalism, standardization, and value-based strategy. Among the conclusion are, that the space strategies mostly changes between incremental and value-based strategies, but one period of standardization was identified...

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…

Developing a conservation strategy to maximize persistence of an endangered freshwater mussel species while considering management effectiveness and cost

Science.gov (United States)

Smith, David R.; McRae, Sarah E.; Augspurger, Tom; Ratcliffe, Judith A.; Nichols, Robert B.; Eads, Chris B.; Savidge, Tim; Bogan, Arthur E.

2015-01-01

We used a structured decision-making process to develop conservation strategies to increase persistence of Dwarf Wedgemussel (Alasmidonta heterodon) in North Carolina, USA, while accounting for uncertainty in management effectiveness and considering costs. Alternative conservation strategies were portfolios of management actions that differed by location of management actions on the landscape. Objectives of the conservation strategy were to maximize species persistence, maintain genetic diversity, maximize public support, and minimize management costs. We compared 4 conservation strategies: 1) the ‘status quo’ strategy represented current management, 2) the ‘protect the best’ strategy focused on protecting the best populations in the Tar River basin, 3) the ‘expand the distribution’ strategy focused on management of extant populations and establishment of new populations in the Neuse River basin, and 4) the ‘hybrid’ strategy combined elements of each strategy to balance conservation in the Tar and Neuse River basins. A population model informed requirements for population management, and experts projected performance of alternative strategies over a 20-y period. The optimal strategy depended on the relative value placed on competing objectives, which can vary among stakeholders. The protect the best and hybrid strategies were optimal across a wide range of relative values with 2 exceptions: 1) if minimizing management cost was of overriding concern, then status quo was optimal, or 2) if maximizing population persistence in the Neuse River basin was emphasized, then expand the distribution strategy was optimal. The optimal strategy was robust to uncertainty in management effectiveness. Overall, the structured decision process can help identify the most promising strategies for endangered species conservation that maximize conservation benefit given the constraint of limited funding.

STRATEGIES OF MAINTAINING PROFICIENCY BY TEACHERS OF ENGLISH IN INDONESIA

Directory of Open Access Journals (Sweden)

Junaidi Mistar, Alfan Zuhairini

2011-10-01

Full Text Available The objectives of the present study are four-fold: (1 to identify the types of strategies to maintain proficiency used by teachers of English in Indonesia, (2 to know the intensity of use of the obtained strategy types, (3 to measure the inter-correlation in the use of the obtained strategy types, and (4 to investigate the effect of proficiency level on the use of maintaining strategies. The subjects were 93 teachers applying for S2 degree in 2010/2011 at the postgraduate program of the Islamic University of Malang. They were given two sets of instrument, a Likert-scale questionnaire of English proficiency maintaining strategies and a TOEFL test. Then, a factor analysis identified nine strategy categories, including language focusing, metacognitive and affective developing, reading and writing activating, language resource utilizing, cognitive processing, culture learning, social communicating, text analyzing, and radio listening strategies. These strategy types explained 63.84% of variances of maintaining strategies and they were used at high level of intensity. Moreover, the use of the nine strategy types were found to be inter-correlated with one another. Finally, no significant effect of proficiency level on strategy use was found, indicating that teachers with different level of proficiency reported using the same strategies of maintaining their proficiency.

Evaluating the combined effectiveness of influenza control strategies and human preventive behavior.

Directory of Open Access Journals (Sweden)

Liang Mao

Full Text Available Control strategies enforced by health agencies are a major type of practice to contain influenza outbreaks. Another type of practice is the voluntary preventive behavior of individuals, such as receiving vaccination, taking antiviral drugs, and wearing face masks. These two types of practices take effects concurrently in influenza containment, but little attention has been paid to their combined effectiveness. This article estimates this combined effectiveness using established simulation models in the urbanized area of Buffalo, NY, USA. Three control strategies are investigated, including: Targeted Antiviral Prophylaxis (TAP, workplace/school closure, community travel restriction, as well as the combination of the three. All control strategies are simulated with and without regard to individual preventive behavior, and the resulting effectiveness are compared. The simulation outcomes suggest that weaker control strategies could suffice to contain influenza epidemics, because individuals voluntarily adopt preventive behavior, rendering these weaker strategies more effective than would otherwise have been expected. The preventive behavior of individuals could save medical resources for control strategies and avoid unnecessary socio-economic interruptions. This research adds a human behavioral dimension into the simulation of control strategies and offers new insights into disease containment. Health policy makers are recommended to review current control strategies and comprehend preventive behavior patterns of local populations before making decisions on influenza containment.

Identifying Instructional Strategies Used to Design Mobile Learning in a Corporate Setting

Science.gov (United States)

Jackson-Butler, Uletta

2016-01-01

The purpose of this qualitative embedded multiple case study was to describe what instructional strategies corporate instructional designers were using to design mobile learning and to understand from their experiences which instructional strategies they believed enhance learning. Participants were five instructional designers who were actively…

The effective eradication and control strategies for tsetse and ...

African Journals Online (AJOL)

I conducted an extensive literature review on the effective tsetse and trypanosomiasis eradication method strategies in Africa in 2010 as i embarked on my research that coincided with the formulation of the Tsetse and Trypanosomiasis Eradication Strategy for Kenya spearheaded by Pan African Tsetse and Trypanosomiasis ...

The closure of Trawsfynydd power station - effects on staff and the local community and identifying a strategy for decommissioning

International Nuclear Information System (INIS)

Kay, J.M.; Ellis, A.T.; Williams, T.W.

1995-01-01

The decision to close Trawsfynydd power station had implications for staff and the local community. It was necessary to take immediate steps to prepare for decommissioning the station and to devise an appropriate staff structure. At the same time, there was also a need for Nuclear Electric to adopt a clear and well defined decommissioning strategy. As the station is located within a National Park, as local employment opportunities are very limited and as the nuclear industry was approaching a Government Review, Nuclear Electric took steps to consult the staff and the local public on the options for decommissioning the station. This consultation influenced the decommissioning strategy chosen for Trawsfynydd. (Author)

Possible Effects of Strategy Instruction on L1 and L2 Reading.

Science.gov (United States)

Salataci, Reyhan; Akyel, Ayse

2002-01-01

Investigates the reading strategies of Turkish English-as-a-Foreign-Language (EFL) students in Turkish and English and the possible effects of reading instruction on reading in Turkish and English. Addresses whether strategy instruction in EFL reading effects EFL reading strategies and reading comprehension in English , and whether strategy…

Modeling strategy to identify patients with primary immunodeficiency utilizing risk management and outcome measurement.

Science.gov (United States)

Modell, Vicki; Quinn, Jessica; Ginsberg, Grant; Gladue, Ron; Orange, Jordan; Modell, Fred

2017-06-01

This study seeks to generate analytic insights into risk management and probability of an identifiable primary immunodeficiency defect. The Jeffrey Modell Centers Network database, Jeffrey Modell Foundation's 10 Warning Signs, the 4 Stages of Testing Algorithm, physician-reported clinical outcomes, programs of physician education and public awareness, the SPIRIT® Analyzer, and newborn screening, taken together, generates P values of less than 0.05%. This indicates that the data results do not occur by chance, and that there is a better than 95% probability that the data are valid. The objectives are to improve patients' quality of life, while generating significant reduction of costs. The advances of the world's experts aligned with these JMF programs can generate analytic insights as to risk management and probability of an identifiable primary immunodeficiency defect. This strategy reduces the uncertainties related to primary immunodeficiency risks, as we can screen, test, identify, and treat undiagnosed patients. We can also address regional differences and prevalence, age, gender, treatment modalities, and sites of care, as well as economic benefits. These tools support high net benefits, substantial financial savings, and significant reduction of costs. All stakeholders, including patients, clinicians, pharmaceutical companies, third party payers, and government healthcare agencies, must address the earliest possible precise diagnosis, appropriate intervention and treatment, as well as stringent control of healthcare costs through risk assessment and outcome measurement. An affected patient is entitled to nothing less, and stakeholders are responsible to utilize tools currently available. Implementation offers a significant challenge to the entire primary immunodeficiency community.

The effectiveness of a learning strategies program for university students.

Science.gov (United States)

Roces Montero, Cristina; Sierra Y Arizmendiarrieta, Beatriz

2017-11-01

University lecturers often complain about their students’ lack of learning strategies, but not many universities in Spain offer specific courses in this area. Studies on their effectiveness are also rare. This study presents the results of a Learning Strategies Course implemented at the School of Teacher Training and Education, University of Oviedo, Spain. A quasi-experimental design was used with an experi-mental (n = 60) and a control group (n = 57) of students on the Educational Psychology course. A Spanish adaptation of the Motivated Strategies for Learning Questionnaire (MSLQ): the CEAMR2 was used as a pre and post-test measure. Group A (EG) received training in learning strategies, while group B (CG) received no training. Post-test measures showed significant differences in five out of the ten learning strategies assessed: elaboration, organization, repetition, self-questioning and study space, and also an improvement in one out of the six motivational scales: control of learning beliefs. The results suggest that learning strategies courses with proven effectiveness should be offered to university students.

Sampling strategies for estimating brook trout effective population size

Science.gov (United States)

Andrew R. Whiteley; Jason A. Coombs; Mark Hudy; Zachary Robinson; Keith H. Nislow; Benjamin H. Letcher

2012-01-01

The influence of sampling strategy on estimates of effective population size (Ne) from single-sample genetic methods has not been rigorously examined, though these methods are increasingly used. For headwater salmonids, spatially close kin association among age-0 individuals suggests that sampling strategy (number of individuals and location from...

Problems and Preconditions of Ensuring Effectiveness of the Accounting and Control of Implementation of the Enterprise Development Strategy

OpenAIRE

Burlan Svitlana A.; Katkova Natalia V.

2017-01-01

The main problem aspects of building an effective system of accounting and control at the strategic level of the enterprise are considered. The guidelines for the formation and management of this system in the modern business environment are outlined. The principles of ensuring effectiveness of the accounting and control of implementation of the enterprise development strategy are defined. Taking into account the identified problems of formation of accounting and control support for the imple...

Nice or effective? Social problem solving strategies in patients with major depressive disorder.

Science.gov (United States)

Thoma, Patrizia; Schmidt, Tobias; Juckel, Georg; Norra, Christine; Suchan, Boris

2015-08-30

Our study addressed distinct aspects of social problem solving in 28 hospitalized patients with Major Depressive Disorder (MDD) and 28 matched healthy controls. Three scenario-based tests assessed the ability to infer the mental states of story characters in difficult interpersonal situations, the capacity to freely generate good strategies for dealing with such situations and the ability to identify the best solutions among less optimal alternatives. Also, standard tests assessing attention, memory, executive function and trait empathy were administered. Compared to controls, MDD patients showed impaired interpretation of other peoples' sarcastic remarks but not of the mental states underlying other peoples' actions. Furthermore, MDD patients generated fewer strategies that were socially sensitive and practically effective at the same time or at least only socially sensitive. Overall, while the free generation of adequate strategies for difficult social situations was impaired, recognition of optimal solutions among alternatives was spared in MDD patients. Higher generation scores were associated with higher trait empathy and cognitive flexibility scores. We suggest that this specific pattern of impairments ought to be considered in the development of therapies addressing impaired social skills in MDD. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Barriers and strategies for identifying and managing risk factors of cardiovascular diseases in levels of preventing, screening, and treating

Directory of Open Access Journals (Sweden)

Saber Azami Aghdash

2015-11-01

Full Text Available Introduction: Cardiovascular diseases (CVD are of the main causes of mortality in the world and impose a heavy economic, social, and health burden on society. Therefore, the objective of this study was to determine the barriers and strategies for identifying and managing risk factors of CVD in levels of preventing, screening, and treating. Methods: During present qualitative study with phenomenological approach, 60 subjects of cardiologists, nurses, patients, and their relatives were selected based on purposive sampling from educational-medical cardiothoracic subspecialty centers. Data were collected using an open-ended questionnaire and was extracted and analyzed with content analysis method. Results: Barriers were divided into three groups of individual barriers (low awareness, delay in referring for treatment and screening, incorrect beliefs, and not caring about health, socio-economic barriers (high costs, lack of resources, mental and psychological pressures, and health care barriers (non-alignment of doctors, being therapy-oriented, managerial and planning weaknesses, and lack of health care facilities. The most important presenting strategies are: providing public educations, improving family physician program, reduction of costs, cooperation of patients, and using functional indices to evaluate and improve the quality of services. Conclusion: Low awareness of people, high costs of services, lack of health care facilities, socio-cultural problems of people, and delay in referring of people, for treatment and screening are of the most important barriers of proper identifying and managing risk factors of CVD. Strategies provided in this study to overcome these barriers could be used.

A strategy for evaluating pathway analysis methods.

Science.gov (United States)

Yu, Chenggang; Woo, Hyung Jun; Yu, Xueping; Oyama, Tatsuya; Wallqvist, Anders; Reifman, Jaques

2017-10-13

Researchers have previously developed a multitude of methods designed to identify biological pathways associated with specific clinical or experimental conditions of interest, with the aim of facilitating biological interpretation of high-throughput data. Before practically applying such pathway analysis (PA) methods, we must first evaluate their performance and reliability, using datasets where the pathways perturbed by the conditions of interest have been well characterized in advance. However, such 'ground truths' (or gold standards) are often unavailable. Furthermore, previous evaluation strategies that have focused on defining 'true answers' are unable to systematically and objectively assess PA methods under a wide range of conditions. In this work, we propose a novel strategy for evaluating PA methods independently of any gold standard, either established or assumed. The strategy involves the use of two mutually complementary metrics, recall and discrimination. Recall measures the consistency of the perturbed pathways identified by applying a particular analysis method to an original large dataset and those identified by the same method to a sub-dataset of the original dataset. In contrast, discrimination measures specificity-the degree to which the perturbed pathways identified by a particular method to a dataset from one experiment differ from those identifying by the same method to a dataset from a different experiment. We used these metrics and 24 datasets to evaluate six widely used PA methods. The results highlighted the common challenge in reliably identifying significant pathways from small datasets. Importantly, we confirmed the effectiveness of our proposed dual-metric strategy by showing that previous comparative studies corroborate the performance evaluations of the six methods obtained by our strategy. Unlike any previously proposed strategy for evaluating the performance of PA methods, our dual-metric strategy does not rely on any ground truth

Clinical multi-omics strategies for the effective cancer management.

Science.gov (United States)

Yoo, Byong Chul; Kim, Kyung-Hee; Woo, Sang Myung; Myung, Jae Kyung

2017-08-15

Cancer is a global health issue as a multi-factorial complex disease, and early detection and novel therapeutic strategies are required for more effective cancer management. With the development of systemic analytical -omics strategies, the therapeutic approach and study of the molecular mechanisms of carcinogenesis and cancer progression have moved from hypothesis-driven targeted investigations to data-driven untargeted investigations focusing on the integrated diagnosis, treatment, and prevention of cancer in individual patients. Predictive, preventive, and personalized medicine (PPPM) is a promising new approach to reduce the burden of cancer and facilitate more accurate prognosis, diagnosis, as well as effective treatment. Here we review the fundamentals of, and new developments in, -omics technologies, together with the key role of a variety of practical -omics strategies in PPPM for cancer treatment and diagnosis. In this review, a comprehensive and critical overview of the systematic strategy for predictive, preventive, and personalized medicine (PPPM) for cancer disease was described in a view of cancer prognostic prediction, diagnostics, and prevention as well as cancer therapy and drug responses. We have discussed multi-dimensional data obtained from various resources and integration of multisciplinary -omics strategies with computational method which could contribute the more effective PPPM for cancer. This review has provided the novel insights of the current applications of each and combined -omics technologies, which showed their powerful potential for the establishment of PPPM for cancer. Copyright © 2017 Elsevier B.V. All rights reserved.

Integrative Strategy for Effective Teaching of Alternating Circuits in ...

African Journals Online (AJOL)

One of the reasons advanced for the low enrolment and achievement of students in Physics at both secondary and post-secondary schools is poor teaching strategies used by teachers of Physics particularly in teaching Physics concepts classified by students as being difficult. In this paper, integrative strategy for effective ...

Tenant Placement Strategies within Multi-Level Large-Scale Shopping Centers

OpenAIRE

Tony Shun-Te Yuo; Colin Lizieri

2013-01-01

This paper argues that tenant placement strategies for large-scale multi-unit shopping centers differ depending on the number of floor levels. Two core strategies are identified: dispersion and departmentalization. There exists a trade-off between three income effects: basic footfall effects, spillover effects, and an effective floor area effect, which varies by the number of floor levels. Departmentalization is favored for centers with more than four floors. Greater spatial complexity also p...

ASSESSMENT OF THE EFFECTIVENESS OF THE BLUE OCEAN STRATEGY FOR UKRAINIAN WINE INDUSTRY

Directory of Open Access Journals (Sweden)

N. Kochkina

2015-08-01

Full Text Available The study addresses the problem of assessment the effectiveness of company’s strategy. It gives an overview of theoretical and practical foundations for development of company’s strategy. It examines the principles of innovative Blue Ocean Strategy. The Blue Ocean Strategy for Ukrainian companies on wine market is developed. It is proposed to use DPM (Direct Policy Matrix for assessment the effectiveness of company’s strategy. The paper puts forward an algorithm for evaluating the effectiveness of strategies using DPM (Direct Policy Matrix. A structured interviews with experts by personal interview using a formalized table were conducted to build DPM. DPM is drawn to demonstrate results of the research method. Expenses for implementation the Blue Ocean Strategy for Ukrainian companies is evaluated. The efficiency of the developed Blue Ocean Strategy for Ukrainian companies on wine market is calculated.

Getting men in the room: perceptions of effective strategies to initiate men's involvement in gender-based violence prevention in a global sample.

Science.gov (United States)

Casey, Erin A; Leek, Cliff; Tolman, Richard M; Allen, Christopher T; Carlson, Juliana M

2017-09-01

As engaging men in gender-based violence prevention efforts becomes an increasingly institutionalised component of gender equity work globally, clarity is needed about the strategies that best initiate male-identified individuals' involvement in these efforts. The purpose of this study was to examine the perceived relevance and effectiveness of men's engagement strategies from the perspective of men around the world who have organised or attended gender-based violence prevention events. Participants responded to an online survey (available in English, French and Spanish) and rated the effectiveness of 15 discrete engagement strategies derived from earlier qualitative work. Participants also provided suggestions regarding strategies in open-ended comments. Listed strategies cut across the social ecological spectrum and represented both venues in which to reach men, and the content of violence prevention messaging. Results suggest that all strategies, on average, were perceived as effective across regions of the world, with strategies that tailor messaging to topics of particular concern to men (such as fatherhood and healthy relationships) rated most highly. Open-ended comments also surfaced tensions, particularly related to the role of a gender analysis in initial men's engagement efforts. Findings suggest the promise of cross-regional adaptation and information sharing regarding successful approaches to initiating men's anti-violence involvement.

The Effects of Physical Manipulatives on Children's Numerical Strategies

Science.gov (United States)

Manches, Andrew; O'Malley, Claire

2016-01-01

This article focuses on how the representational properties of manipulatives affect the strategies children employ in problem solving. Two studies examined the effect of physical materials on 4-7-year-old children's problem solving strategies in a numerical (i.e., additive composition) task. The first study showed how children not only identified…

Effective sourcing strategies for perishable product supply chains

NARCIS (Netherlands)

Rijpkema, W.A.; Rossi, R.; Vorst, van der J.G.A.J.

2014-01-01

Purpose – The purpose of this paper is to assess whether an existing sourcing strategy can effectively supply products of appropriate quality with acceptable levels of product waste if applied to an international perishable product supply chain. The authors also analyse whether the effectiveness of

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

The Effect of Using a Proposed Teaching Strategy Based on the Selective Thinking on Students' Acquisition Concepts in Mathematics

Science.gov (United States)

Qudah, Ahmad Hassan

2016-01-01

This study aimed at identify the effect of using a proposed teaching strategy based on the selective thinking in acquire mathematical concepts by Classroom Teacher Students at Al- al- Bayt University, The sample of the study consisted of (74) students, equally distributed into a control group and an experimental group. The selective thinking…

ADHD in the Classroom: Effective Intervention Strategies

Science.gov (United States)

DuPaul, George J.; Weyandt, Lisa L.; Janusis, Grace M.

2011-01-01

School-related difficulties are commonly associated with attention deficit hyperactivity disorder (ADHD). This article describes effective school-based intervention strategies including behavioral interventions, modifications to academic instruction, and home-school communication programs. One overlooked aspect of treatment of children with ADHD…

Testing the effectiveness of simplified search strategies for updating systematic reviews.

Science.gov (United States)

Rice, Maureen; Ali, Muhammad Usman; Fitzpatrick-Lewis, Donna; Kenny, Meghan; Raina, Parminder; Sherifali, Diana

2017-08-01

The objective of the study was to test the overall effectiveness of a simplified search strategy (SSS) for updating systematic reviews. We identified nine systematic reviews undertaken by our research group for which both comprehensive and SSS updates were performed. Three relevant performance measures were estimated, that is, sensitivity, precision, and number needed to read (NNR). The update reference searches for all nine included systematic reviews identified a total of 55,099 citations that were screened resulting in final inclusion of 163 randomized controlled trials. As compared with reference search, the SSS resulted in 8,239 hits and had a median sensitivity of 83.3%, while precision and NNR were 4.5 times better. During analysis, we found that the SSS performed better for clinically focused topics, with a median sensitivity of 100% and precision and NNR 6 times better than for the reference searches. For broader topics, the sensitivity of the SSS was 80% while precision and NNR were 5.4 times better compared with reference search. SSS performed well for clinically focused topics and, with a median sensitivity of 100%, could be a viable alternative to a conventional comprehensive search strategy for updating this type of systematic reviews particularly considering the budget constraints and the volume of new literature being published. For broader topics, 80% sensitivity is likely to be considered too low for a systematic review update in most cases, although it might be acceptable if updating a scoping or rapid review. Copyright © 2017 Elsevier Inc. All rights reserved.

Task-selective memory effects for successfully implemented encoding strategies.

Science.gov (United States)

Leshikar, Eric D; Duarte, Audrey; Hertzog, Christopher

2012-01-01

Previous behavioral evidence suggests that instructed strategy use benefits associative memory formation in paired associate tasks. Two such effective encoding strategies--visual imagery and sentence generation--facilitate memory through the production of different types of mediators (e.g., mental images and sentences). Neuroimaging evidence suggests that regions of the brain support memory reflecting the mental operations engaged at the time of study. That work, however, has not taken into account self-reported encoding task success (i.e., whether participants successfully generated a mediator). It is unknown, therefore, whether task-selective memory effects specific to each strategy might be found when encoding strategies are successfully implemented. In this experiment, participants studied pairs of abstract nouns under either visual imagery or sentence generation encoding instructions. At the time of study, participants reported their success at generating a mediator. Outside of the scanner, participants further reported the quality of the generated mediator (e.g., images, sentences) for each word pair. We observed task-selective memory effects for visual imagery in the left middle occipital gyrus, the left precuneus, and the lingual gyrus. No such task-selective effects were observed for sentence generation. Intriguingly, activity at the time of study in the left precuneus was modulated by the self-reported quality (vividness) of the generated mental images with greater activity for trials given higher ratings of quality. These data suggest that regions of the brain support memory in accord with the encoding operations engaged at the time of study.

A dynamic model for assessing the effects of management strategies on the reduction of construction and demolition waste

International Nuclear Information System (INIS)

Yuan Hongping; Chini, Abdol R.; Lu Yujie; Shen Liyin

2012-01-01

Highlights: ► We proposes a model for projecting C and D waste reduction of construction projects. ► The model can simulate effects of various management strategies on waste reduction. ► The model integrates all essential variables that affect C and D waste reduction. ► By using the model, best strategies could be identified before being implemented. - Abstract: During the past few decades, construction and demolition (C and D) waste has received increasing attention from construction practitioners and researchers worldwide. A plethora of research regarding C and D waste management has been published in various academic journals. However, it has been determined that existing studies with respect to C and D waste reduction are mainly carried out from a static perspective, without considering the dynamic and interdependent nature of the whole waste reduction system. This might lead to misunderstanding about the actual effect of implementing any waste reduction strategies. Therefore, this research proposes a model that can serve as a decision support tool for projecting C and D waste reduction in line with the waste management situation of a given construction project, and more importantly, as a platform for simulating effects of various management strategies on C and D waste reduction. The research is conducted using system dynamics methodology, which is a systematic approach that deals with the complexity – interrelationships and dynamics – of any social, economic and managerial system. The dynamic model integrates major variables that affect C and D waste reduction. In this paper, seven causal loop diagrams that can deepen understanding about the feedback relationships underlying C and D waste reduction system are firstly presented. Then a stock-flow diagram is formulated by using software for system dynamics modeling. Finally, a case study is used to illustrate the validation and application of the proposed model. Results of the case study not only

Reducing disaster risk in rural Arctic communities through effective communication strategies

Science.gov (United States)

Kontar, Y. Y.

2015-12-01

Communication is the process of exchanging and relaying vital information that has bearing on the effectiveness of all phases of emergency management: mitigation, preparedness, response, and recovery, making it one of the most important activities in disasters. Lack of communication between emergency managers, policy makers, and communities at risk may result in an inability to accurately identify disaster risk, and failure to determine priorities during a hazard event. Specific goals of communication change during the four phases of emergency management. Consequently, the communication strategy changes as well. Communication strategy also depends on a variety of attitudinal and motivational characteristics of the population at risk, as well as socioeconomic, cultural, and geographical features of the disaster-prone region. In May 2013, insufficient communication patterns between federal, state, tribal agencies, and affected communities significantly contributed to delays in the flood response and recovery in several rural villages along the Yukon River in central Alaska. This case study finds that long term dialogue is critical for managing disaster risk and increasing disaster resilience in rural Northern communities. It introduces new ideas and highlights best practices in disaster communication.

Discrete strategies to reduce intake of discretionary food choices: a scoping review.

Science.gov (United States)

Grieger, Jessica A; Wycherley, Thomas P; Johnson, Brittany J; Golley, Rebecca K

2016-05-06

On a population level, dietary improvement strategies have had limited success in preventing the surge in overweight and obesity or reducing risk factors for chronic disease. While numerous multi-component studies have examined whole-of-diet strategies, and single component (i.e. discrete) dietary intervention strategies have targeted an increase in core foods (e.g. fruits, vegetables, dairy), there is a paucity of evidence on the effectiveness of dietary intervention strategies targeting a decrease in discretionary choices. The aim of this review was to identify dietary intervention strategies that are potentially relevant to reducing intake of discretionary choices in 2-65 year olds. A scoping review was carried out to map the literature on key discrete dietary intervention strategies that are potentially applicable to reducing discretionary choices, and to identify the targeted health/nutrition effects (e.g. improve nutrient intake, decrease sugar intake, and reduce body weight) of these strategies. Studies conducted in participants aged 2-65 years and published in English by July 20, 2015, were located through electronic searches including the Cochrane Library, Medline, Embase, CINAHL, and Scopus. Three thousand two hundred and eighty three studies were identified from the search, of which 44 met the selection criteria. The dietary intervention strategies included reformulation (n = 13), substitution (n = 5), restriction/elimination (n = 9), supplementation (n = 13), and nutrition education/messages (n = 4). The key findings of the review were: restricting portion size was consistently beneficial for reducing energy intake in the acute setting; reformulating foods from higher fat to lower fat could be useful to reduce saturated fat intake; substituting discretionary choices for high fibre snacks, fruit, or low/no-calorie beverages may be an effective strategy for reducing energy intake; supplementing nutrient dense foods such as nuts and

Using Visual Metaphors in Health Messages: A Strategy to Increase Effectiveness for Mental Illness Communication.

Science.gov (United States)

Lazard, Allison J; Bamgbade, Benita A; Sontag, Jennah M; Brown, Carolyn

2016-12-01

Depression is highly prevalent among college students. Although treatment is often available on university campuses, many stigma-based barriers prevent students from seeking help. Communication strategies, such as the use of metaphors, are needed to reduce barriers. Specially, the use of visual metaphors, as a strategic message design tactic, may be an effective communication strategy to increase message appeal and engagement. Using a 2-phase approach, this study first identified common metaphors students use to conceptualize mental illness. Messages incorporating conceptual and visual metaphors were then designed and tested to determine their potential in reducing stigma. Participants (n = 256) were randomly assigned to 1 of 4 conditions in a between-subjects experiment: messages with visual and textual metaphors, messages with straightforward visuals and textual metaphors, text-based metaphor messages, or a control group. Overall, metaphorical messages are appealing, the use of visual metaphors leads to greater message engagement, and messages based on conceptual metaphors have the potential to reduce stigma. The use of conceptual and visual metaphors in campaign design is an effective strategy to communicate about a complex health topic, such as mental illness, and should be considered for use in campaigns to reduce barriers for help-seeking behavior.

Effective behavioural strategies for reducing disgust in contamination-related OCD: A review.

Science.gov (United States)

Ludvik, Dominika; Boschen, Mark J; Neumann, David L

2015-12-01

Disgust is an understudied but important emotion in various psychological disorders. Over the last decade, increasing evidence suggests that disgust is also present in various subtypes of obsessive-compulsive disorder (OCD), especially in contamination-related OCD (C-OCD). The treatment of choice for C-OCD is exposure with response prevention, originally designed to reduce fear-associated emotions thought to be acquired through Pavlovian conditioning (PC). However, disgust has been proposed to be acquired through evaluative conditioning (EC) and according to the referential model of this form of learning, there are functional differences between PC and EC that need to be considered in the treatment of disgust-related responses. Alternative strategies suggested by EC-based models include counterconditioning (contingent presentation of the CS with a US of opposite valence) and US revaluation (contingent presentation of the US with US of opposite valence). Drawing on the referential model, this paper reviews evidence for the effectiveness of each strategy to identify the most theoretically sound and empirically valid intervention to reduce disgust in C-OCD. Copyright © 2015 Elsevier Ltd. All rights reserved.

Effective Strategies for Sustaining Professional Learning Communities

Science.gov (United States)

Bennett, Patricia R.

2010-01-01

Professional Learning Communities (PLCs), in which educators work collaboratively to improve learning for students, need effective strategies to sustain them. PLCs promote continuous improvement in student learning and build academic success with increased teacher expertise. Grounded in organizational systems theory, participative leadership…

Societal costs in displaced transverse olecranon fractures: using decision analysis tools to find the most cost-effective strategy between tension band wiring and locked plating.

Science.gov (United States)

Francis, Tittu; Washington, Travis; Srivastava, Karan; Moutzouros, Vasilios; Makhni, Eric C; Hakeos, William

2017-11-01

Tension band wiring (TBW) and locked plating are common treatment options for Mayo IIA olecranon fractures. Clinical trials have shown excellent functional outcomes with both techniques. Although TBW implants are significantly less expensive than a locked olecranon plate, TBW often requires an additional operation for implant removal. To choose the most cost-effective treatment strategy, surgeons must understand how implant costs and return to the operating room influence the most cost-effective strategy. This cost-effective analysis study explored the optimal treatment strategies by using decision analysis tools. An expected-value decision tree was constructed to estimate costs based on the 2 implant choices. Values for critical variables, such as implant removal rate, were obtained from the literature. A Monte Carlo simulation consisting of 100,000 trials was used to incorporate variability in medical costs and implant removal rates. Sensitivity analysis and strategy tables were used to show how different variables influence the most cost-effective strategy. TBW was the most cost-effective strategy, with a cost savings of approximately $1300. TBW was also the dominant strategy by being the most cost-effective solution in 63% of the Monte Carlo trials. Sensitivity analysis identified implant costs for plate fixation and surgical costs for implant removal as the most sensitive parameters influencing the cost-effective strategy. Strategy tables showed the most cost-effective solution as 2 parameters vary simultaneously. TBW is the most cost-effective strategy in treating Mayo IIA olecranon fractures despite a higher rate of return to the operating room. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

THE BANDWAGON EFFECT OF LEADERS' ENTRY STRATEGIES ON FOLLOWERS' ENTRY STRATEGIES

OpenAIRE

Kaplan, Tugba

2017-01-01

Firms, whichhave to compete with global firms in domestic market, try to internationalizefor gaining competitive advantage. The aim of this study is to recommend a conceptual framework to explain thedynamics of internationalization process of leader and follower firms thatinternationalize from an emerging country. In this study, author tries tofigure out the determinants of entrymode decisions of follower firms. In addition, bandwagon effect of leaders'entry mode strategies on followers&...

Strategies, Protections and Mitigations for Electric Grid from Electromagnetic Pulse Effects

Energy Technology Data Exchange (ETDEWEB)

Foster, Rita Ann [Idaho National Lab. (INL), Idaho Falls, ID (United States); Frickey, Steven Jay [Idaho National Lab. (INL), Idaho Falls, ID (United States)

2016-01-01

The mission of DOE’s Office of Electricity Delivery and Energy Reliability (OE) is to lead national efforts to modernize the electricity delivery system, enhance the security and reliability of America’s energy infrastructure and facilitate recovery from disruptions to the energy supply. One of the threats OE is concerned about is a high-altitude electro-magnetic pulse (HEMP) from a nuclear explosion and eletro-magnetic pulse (EMP) or E1 pulse can be generated by EMP weapons. DOE-OE provides federal leadership and technical guidance in addressing electric grid issues. The Idaho National Laboratory (INL) was chosen to conduct the EMP study for DOE-OE due to its capabilities and experience in setting up EMP experiments on the electric grid and conducting vulnerability assessments and developing innovative technology to increase infrastructure resiliency. This report identifies known impacts to EMP threats, known mitigations and effectiveness of mitigations, potential cost of mitigation, areas for government and private partnerships in protecting the electric grid to EMP, and identifying gaps in our knowledge and protection strategies.

Intervention Strategies Used in Sport Injury Prevention Studies: A Systematic Review Identifying Studies Applying the Haddon Matrix

NARCIS (Netherlands)

Vriend, Ingrid; Gouttebarge, Vincent; Finch, Caroline F.; van Mechelen, Willem; Verhagen, Evert A. L. M.

2017-01-01

Prevention of sport injuries is crucial to maximise the health and societal benefits of a physically active lifestyle. To strengthen the translation and implementation of the available evidence base on effective preventive measures, a range of potentially relevant strategies should be considered.

The psychological effects of empowerment strategies on consumers' product demand

DEFF Research Database (Denmark)

Fuchs, Christoph; Prandelli, Emanuela; Schreier, Martin

2010-01-01

. In such scenarios, it is no longer the company but its customers who decide democratically which products should be produced. This article discusses the first set of empirical studies which highlight the important psychological consequences of this power shift. The results indicate that customers who are empowered...... of psychological ownership of the products selected. The studies also identify two boundary conditions for this "empowerment - product demand" effect: It diminishes if the outcome of the joint decision-making process does not reflect consumers' preferences and if consumers do not feel that they have the relevant......Companies have recently begun to use the Internet in order to integrate their customers more actively into various phases of the new product development (NPD) process. One such strategy involves empowering customers to cooperate in selecting the product concepts to be marketed by the firm...

The effect of information types on diagnostic strategies in the information aid

International Nuclear Information System (INIS)

Kim, Jong Hyun; Seong, Poong Hyun

2007-01-01

Through experiments, this paper investigates the compatibility of information types with the diagnostic strategy in information aid. Compatibility with operator strategies is an important requirement for information aiding systems in nuclear power plants (NPPs). This paper used three typical types of information aids for MCR operators to investigate the effect of the aids on diagnostic strategies: 'alarm (A),' 'hypothesis on faults (H),' and 'hypothesis on faults and expected symptoms (HS).' The experimental results indicate that the effectiveness of information aid types can vary, dependent on the strategies subjects employ. The results also show that the HS aid improved the diagnosis performance in the hypothesis-and-test strategy

Evaluation Methods Basis of Strategy Development Effectiveness of the Enterprise

Science.gov (United States)

Zotova, Anna S.; Kandrashina, Elena A.; Ivliev, Andrey D.; Charaeva, Marina V.

2016-01-01

The urgency to study the problem is caused by the necessity to make management decisions in terms of reducing goods life cycle, reducing profitability of production, increasing speed of technological progress. In this context, this article aims to identify and elaborate the tools for integrated diagnostic of strategy efficiency, taking into…

Effective Spelling Strategies for Students with Dyslexia in Hong Kong Secondary Schools

Science.gov (United States)

Wai, Nicole; Chan, Ying; Zhang, Kaili Chen

2014-01-01

This study examines the effectiveness of five spelling strategies used to teach junior secondary school students with dyslexia. Participants were 30 secondary school teachers in Hong Kong. The teachers commented on five spelling strategies: the phonological strategy, an integration of phonological and orthographical strategies, the rule-based…

Cost-Effectiveness of HBV and HCV Screening Strategies – A Systematic Review of Existing Modelling Techniques

Science.gov (United States)

Geue, Claudia; Wu, Olivia; Xin, Yiqiao; Heggie, Robert; Hutchinson, Sharon; Martin, Natasha K.; Fenwick, Elisabeth; Goldberg, David

2015-01-01

Introduction Studies evaluating the cost-effectiveness of screening for Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) are generally heterogeneous in terms of risk groups, settings, screening intervention, outcomes and the economic modelling framework. It is therefore difficult to compare cost-effectiveness results between studies. This systematic review aims to summarise and critically assess existing economic models for HBV and HCV in order to identify the main methodological differences in modelling approaches. Methods A structured search strategy was developed and a systematic review carried out. A critical assessment of the decision-analytic models was carried out according to the guidelines and framework developed for assessment of decision-analytic models in Health Technology Assessment of health care interventions. Results The overall approach to analysing the cost-effectiveness of screening strategies was found to be broadly consistent for HBV and HCV. However, modelling parameters and related structure differed between models, producing different results. More recent publications performed better against a performance matrix, evaluating model components and methodology. Conclusion When assessing screening strategies for HBV and HCV infection, the focus should be on more recent studies, which applied the latest treatment regimes, test methods and had better and more complete data on which to base their models. In addition to parameter selection and associated assumptions, careful consideration of dynamic versus static modelling is recommended. Future research may want to focus on these methodological issues. In addition, the ability to evaluate screening strategies for multiple infectious diseases, (HCV and HIV at the same time) might prove important for decision makers. PMID:26689908

Scales, strategies and actions for effective energy planning: A review

International Nuclear Information System (INIS)

Pasimeni, Maria Rita; Petrosillo, Irene; Aretano, Roberta; Semeraro, Teodoro; De Marco, Antonella; Zaccarelli, Nicola; Zurlini, Giovanni

2014-01-01

This paper is a review of the most recent literature on the interaction between climate change, land-use and energy, based on the analysis of papers collected through the most relevant scientific literature databases. A total of 114 papers published between 2000 and 2011 were reviewed. The aims of this review are: in general (1) to identify the different research topics that have been developed related to the interaction between climate change, land-use and energy; more specifically, (2) to analyze what are the most suitable spatial and temporal scales of investigation to focus on for actions and strategies to reduce critical issues in the field of energy and environment; (3) to identify which actions and strategies are deemed as the most appropriate to mitigate critical issues in energy and environment; and given the research gaps found in the review, (4) to propose research recommendations in the context of effective climate-energy planning. We argue that there are certain gaps and needs for a “nested” environmental governance. It is necessary to understand how different environmental policies overlap and how they can be integrated in order to verify whether there are conflicting targets that may negate each other in the long term. - Highlights: • Energy production and consumption can directly or indirectly affect climate change. • Energy sector is influenced directly and indirectly by changes in climate conditions. • Energy sector and climate change affect and limit alternative uses of land, causing land-use changes. • The most suitable spatial scale for energy planning is the municipal level requiring short-term perspectives. • Several research recommendations to deal with the complexity of energy-land-use-climate change issue are proposed

Utilization of genomic signatures to identify phenotype-specific drugs.

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Seiichi Mori

2009-08-01

Full Text Available Genetic and genomic studies highlight the substantial complexity and heterogeneity of human cancers and emphasize the general lack of therapeutics that can match this complexity. With the goal of expanding opportunities for drug discovery, we describe an approach that makes use of a phenotype-based screen combined with the use of multiple cancer cell lines. In particular, we have used the NCI-60 cancer cell line panel that includes drug sensitivity measures for over 40,000 compounds assayed on 59 independent cells lines. Targets are cancer-relevant phenotypes represented as gene expression signatures that are used to identify cells within the NCI-60 panel reflecting the signature phenotype and then connect to compounds that are selectively active against those cells. As a proof-of-concept, we show that this strategy effectively identifies compounds with selectivity to the RAS or PI3K pathways. We have then extended this strategy to identify compounds that have activity towards cells exhibiting the basal phenotype of breast cancer, a clinically-important breast cancer characterized as ER-, PR-, and Her2- that lacks viable therapeutic options. One of these compounds, Simvastatin, has previously been shown to inhibit breast cancer cell growth in vitro and importantly, has been associated with a reduction in ER-, PR- breast cancer in a clinical study. We suggest that this approach provides a novel strategy towards identification of therapeutic agents based on clinically relevant phenotypes that can augment the conventional strategies of target-based screens.

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…

Identifying strategies to assist final semester nursing students to develop numeracy skills: a mixed methods study.

Science.gov (United States)

Ramjan, Lucie M; Stewart, Lyn; Salamonson, Yenna; Morris, Maureen M; Armstrong, Lyn; Sanchez, Paula; Flannery, Liz

2014-03-01

It remains a grave concern that many nursing students within tertiary institutions continue to experience difficulties with achieving medication calculation competency. In addition, universities have a moral responsibility to prepare proficient clinicians for graduate practice. This requires risk management strategies to reduce adverse medication errors post registration. To identify strategies and potential predictors that may assist nurse academics to tailor their drug calculation teaching and assessment methods. This project builds on previous experience and explores students' perceptions of newly implemented interventions designed to increase confidence and competence in medication calculation. This mixed method study surveyed students (n=405) enrolled in their final semester of study at a large, metropolitan university in Sydney, Australia. Tailored, contextualised interventions included online practice quizzes, simulated medication calculation scenarios developed for clinical practice classes, contextualised 'pen and paper' tests, visually enhanced didactic remediation and 'hands-on' contextualised workshops. Surveys were administered to students to determine their perceptions of interventions and to identify whether these interventions assisted with calculation competence. Test scores were analysed using SPSS v. 20 for correlations between students' perceptions and actual performance. Qualitative open-ended survey questions were analysed manually and thematically. The study reinforced that nursing students preferred a 'hands-on,' contextualised approach to learning that was 'authentic' and aligned with clinical practice. Our interventions assisted with supporting students' learning and improvement of calculation confidence. Qualitative data provided further insight into students' awareness of their calculation errors and preferred learning styles. Some of the strongest predictors for numeracy skill performance included (1) being an international student, (2

A novel strategy to identify the critical conditions for growth-induced instabilities.

Science.gov (United States)

Javili, A; Steinmann, P; Kuhl, E

2014-01-01

Geometric instabilities in living structures can be critical for healthy biological function, and abnormal buckling, folding, or wrinkling patterns are often important indicators of disease. Mathematical models typically attribute these instabilities to differential growth, and characterize them using the concept of fictitious configurations. This kinematic approach toward growth-induced instabilities is based on the multiplicative decomposition of the total deformation gradient into a reversible elastic part and an irreversible growth part. While this generic concept is generally accepted and well established today, the critical conditions for the formation of growth-induced instabilities remain elusive and poorly understood. Here we propose a novel strategy for the stability analysis of growing structures motivated by the idea of replacing growth by prestress. Conceptually speaking, we kinematically map the stress-free grown configuration onto a prestressed initial configuration. This allows us to adopt a classical infinitesimal stability analysis to identify critical material parameter ranges beyond which growth-induced instabilities may occur. We illustrate the proposed concept by a series of numerical examples using the finite element method. Understanding the critical conditions for growth-induced instabilities may have immediate applications in plastic and reconstructive surgery, asthma, obstructive sleep apnoea, and brain development. © 2013 Elsevier Ltd. All rights reserved.

The Effect of Using Flipped Classroom Strategy on the Academic Achievement of Fourth Grade Students in Jordan

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Shereen Mazen Elian

2018-02-01

Full Text Available This study aimed at investigating the effect of flipped classroom strategy on the academic achievement in the subject of science among fourth grade students in Jordan. The study population consists of all fourth grade students in the Directorate of Private Education in Amman area, totaling 2134 students during the second semester of the academic year 2015-2016. The study sample consists of 44 male and female students who were chosen purposely from the study population. The study sample was distributed into two groups: the experimental group that consisted of 22 students, who has studied according to flipped classroom strategy, and the control group that consisted of 22 students, who has studied in the ordinary method. To achieve the objectives of the study, an achievement test was prepared and its validity and reliability were checked. ANCOVA, Means, and Standard Deviations were used to analyze the collected research data. The study deduced the following results: 1 There are statistically significant differences in the Means on the educational achievement test attributed to the teaching strategy, in favor of the members of the experimental group, and 2 there are no statistically significant differences in the Means on the academic achievement test attributed to gender. In light of the findings, the study recommended encouraging science teachers to teach students using teaching strategies emanated from the use of modern technologies, particularly the flipped classroom strategy. In addition, the study suggested that colleges of education should train prospective teachers on the use of teaching strategies stemming from modern educational theories and strategies such as the flipped classroom strategy during the period of preparing them to teach. Furthermore, the study recommended re-applying this experience and identifying its effectiveness at other schools stages and other subjects in other content areas.

Extending existing structural identifiability analysis methods to mixed-effects models.

Science.gov (United States)

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

2018-01-01

The concept of structural identifiability for state-space models is expanded to cover mixed-effects state-space models. Two methods applicable for the analytical study of the structural identifiability of mixed-effects models are presented. The two methods are based on previously established techniques for non-mixed-effects models; namely the Taylor series expansion and the input-output form approach. By generating an exhaustive summary, and by assuming an infinite number of subjects, functions of random variables can be derived which in turn determine the distribution of the system's observation function(s). By considering the uniqueness of the analytical statistical moments of the derived functions of the random variables, the structural identifiability of the corresponding mixed-effects model can be determined. The two methods are applied to a set of examples of mixed-effects models to illustrate how they work in practice. Copyright © 2017 Elsevier Inc. All rights reserved.

Task-selective memory effects for successfully implemented encoding strategies.

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Eric D Leshikar

Full Text Available Previous behavioral evidence suggests that instructed strategy use benefits associative memory formation in paired associate tasks. Two such effective encoding strategies--visual imagery and sentence generation--facilitate memory through the production of different types of mediators (e.g., mental images and sentences. Neuroimaging evidence suggests that regions of the brain support memory reflecting the mental operations engaged at the time of study. That work, however, has not taken into account self-reported encoding task success (i.e., whether participants successfully generated a mediator. It is unknown, therefore, whether task-selective memory effects specific to each strategy might be found when encoding strategies are successfully implemented. In this experiment, participants studied pairs of abstract nouns under either visual imagery or sentence generation encoding instructions. At the time of study, participants reported their success at generating a mediator. Outside of the scanner, participants further reported the quality of the generated mediator (e.g., images, sentences for each word pair. We observed task-selective memory effects for visual imagery in the left middle occipital gyrus, the left precuneus, and the lingual gyrus. No such task-selective effects were observed for sentence generation. Intriguingly, activity at the time of study in the left precuneus was modulated by the self-reported quality (vividness of the generated mental images with greater activity for trials given higher ratings of quality. These data suggest that regions of the brain support memory in accord with the encoding operations engaged at the time of study.

Effective strategies for recruiting of Asian cancer patients in internet research.

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Lim, Hyun Ju; Lin, Chia-Ju; Liu, Yi; Chee, Wonshik; Im, Eun-Ok

2006-01-01

This poster is aims to provide directions for effective strategies for recruiting Asian cancer patients in Internet study among Asian American cancer patients. In the study, we used four different strategies to recruit Asian cancer participants: (a) general and ethnic specific Internet cancer support groups; (b) Asian Internet communities/groups; (c) Asian physician clinics, Asian community and culture center; and (d) community consultants. The most effective recruitment strategy among them was the recruitment through community consultant. The findings support the importance of using key persons in ethnic minority communities to recruit ethnic minority participants.

Cost-Effectiveness Analysis of Six Strategies to Treat Recurrent Clostridium difficile Infection.

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Lauren Lapointe-Shaw

Full Text Available To assess the cost-effectiveness of six treatment strategies for patients diagnosed with recurrent Clostridium difficile infection (CDI in Canada: 1. oral metronidazole; 2. oral vancomycin; 3.oral fidaxomicin; 4. fecal transplantation by enema; 5. fecal transplantation by nasogastric tube; and 6. fecal transplantation by colonoscopy.Public insurer for all hospital and physician services.Ontario, Canada.A decision analytic model was used to model costs and lifetime health effects of each strategy for a typical patient experiencing up to three recurrences, over 18 weeks. Recurrence data and utilities were obtained from published sources. Cost data was obtained from published sources and hospitals in Toronto, Canada. The willingness-to-pay threshold was $50,000/QALY gained.Fecal transplantation by colonoscopy dominated all other strategies in the base case, as it was less costly and more effective than all alternatives. After accounting for uncertainty in all model parameters, there was an 87% probability that fecal transplantation by colonoscopy was the most beneficial strategy. If colonoscopy was not available, fecal transplantation by enema was cost-effective at $1,708 per QALY gained, compared to metronidazole. In addition, fecal transplantation by enema was the preferred strategy if the probability of recurrence following this strategy was below 8.7%. If fecal transplantation by any means was unavailable, fidaxomicin was cost-effective at an additional cost of $25,968 per QALY gained, compared to metronidazole.Fecal transplantation by colonoscopy (or enema, if colonoscopy is unavailable is cost-effective for treating recurrent CDI in Canada. Where fecal transplantation is not available, fidaxomicin is also cost-effective.

Cost-Effectiveness Analysis of Six Strategies to Treat Recurrent Clostridium difficile Infection.

Science.gov (United States)

Lapointe-Shaw, Lauren; Tran, Kim L; Coyte, Peter C; Hancock-Howard, Rebecca L; Powis, Jeff; Poutanen, Susan M; Hota, Susy

2016-01-01

To assess the cost-effectiveness of six treatment strategies for patients diagnosed with recurrent Clostridium difficile infection (CDI) in Canada: 1. oral metronidazole; 2. oral vancomycin; 3.oral fidaxomicin; 4. fecal transplantation by enema; 5. fecal transplantation by nasogastric tube; and 6. fecal transplantation by colonoscopy. Public insurer for all hospital and physician services. Ontario, Canada. A decision analytic model was used to model costs and lifetime health effects of each strategy for a typical patient experiencing up to three recurrences, over 18 weeks. Recurrence data and utilities were obtained from published sources. Cost data was obtained from published sources and hospitals in Toronto, Canada. The willingness-to-pay threshold was $50,000/QALY gained. Fecal transplantation by colonoscopy dominated all other strategies in the base case, as it was less costly and more effective than all alternatives. After accounting for uncertainty in all model parameters, there was an 87% probability that fecal transplantation by colonoscopy was the most beneficial strategy. If colonoscopy was not available, fecal transplantation by enema was cost-effective at $1,708 per QALY gained, compared to metronidazole. In addition, fecal transplantation by enema was the preferred strategy if the probability of recurrence following this strategy was below 8.7%. If fecal transplantation by any means was unavailable, fidaxomicin was cost-effective at an additional cost of $25,968 per QALY gained, compared to metronidazole. Fecal transplantation by colonoscopy (or enema, if colonoscopy is unavailable) is cost-effective for treating recurrent CDI in Canada. Where fecal transplantation is not available, fidaxomicin is also cost-effective.

Towards effective extension delivery approach and strategies for ...

African Journals Online (AJOL)

Towards effective extension delivery approach and strategies for food security poverty ... Journal Home > Vol 6, No 1 (2010) > ... groups, promotion of best practices and environment friendly initiatives among others were recommended.

Identifying potential environmental impacts of waste handling strategies in textile industry.

Science.gov (United States)

Yacout, Dalia M M; Hassouna, M S

2016-08-01

Waste management is a successful instrument to minimize generated waste and improve environmental conditions. In spite of the large share of developing countries in the textile industry, limited information is available concerning the waste management strategies implemented for textiles on those countries and their environmental impacts. In the current study, two waste management approaches for hazardous solid waste treatment of acrylic fibers (landfill and incineration) were investigated. The main research questions were: What are the different impacts of each waste management strategy? Which waste management strategy is more ecofriendly? Life cycle assessment was employed in order to model the environmental impacts of each waste streaming approach separately then compare them together. Results revealed that incineration was the more ecofriendly approach. Highest impacts of both approaches were on ecotoxicity and carcinogenic potentials due to release of metals from pigment wastes. Landfill had an impact of 46.8 % on human health as compared to 28 % by incineration. Incineration impact on ecosystem quality was higher than landfill impact (68.4 and 51.3 %, respectively). As for resources category, incineration had a higher impact than landfill (3.5 and 2.0 %, respectively). Those impacts could be mitigated if state-of-the-art landfill or incinerator were used and could be reduced by applying waste to energy approaches for both management systems In conclusion, shifting waste treatment from landfill to incineration would decrease the overall environmental impacts and allow energy recovery. The potential of waste to energy approach by incineration with heat recovery could be considered in further studies. Future research is needed in order to assess the implementation of waste management systems and the preferable waste management strategies in the textile industry on developing countries.

Faculty ratings of retention strategies for minority nursing students.

Science.gov (United States)

Baker, Barbara H

2010-01-01

The purpose of this study was to investigate a) the types of retention strategies used by undergraduate nursing programs for the purpose of retaining minority students, b) the rated effectiveness of the strategies, as identified by faculty in those programs, and c) whether there is a relationship between strategies rated as effective and the type of nursing program, baccalaureate (BSN) or associate (AD) degree. Administrator-selected faculty from randomly sampled BSN and AD nursing programs within a 16-state area of the southeastern United States were asked to respond to an online survey regarding the use and effectiveness of retention strategies selected from the literature. Descriptive statistics and chi-square tests for association were used to analyze the data. Of the 14 strategies included in this analysis, faculty availability and timely feedback on tests and clinical performances were used by all undergraduate programs. Organized study groups and peer mentoring were the least used strategies. Faculty from both BSN and AD programs reported using many of the strategies and rated their use as effective overall for minority nursing student retention. The highest rated strategies were those that involved direct interaction of nurse faculty and students.

An investigation on the effect of cognitive emotion regulation strategies on job satisfaction

Directory of Open Access Journals (Sweden)

Somayeh Shahba

2014-06-01

Full Text Available This paper examined the effects of cognitive emotion regulation on employees’ job satisfaction. In this survey, Questionnaire and the questions were divided into two categories of cognitive emotion regulation and job satisfaction. To measure cognitive emotion regulation, including unadjusted emotion regulation strategies and adjusted strategies, 36 items questionnaire was used originally developed by Garnefski et al. (2001 [Garnefski, N., Kraaij, V., & Spinhoven, P. (2001. Negative life events, cognitive emotion regulation, and emotional problems. Personality and Individual Differences, 30, 1311–1327.]. The questionnaires were distributed among 340 staff employee of the Islamic Republic of Iran Customs Administration. The results revealed that the adjusted cognitive emotion regulation strategies increase job satisfaction of employees. However, unadjusted cognitive emotion regulation strategies reduce employees' job satisfaction. Moreover, among adjusted emotion regulation strategies, put in perspective strategy did not have significant effect on job satisfaction and rumination, had no significant effect on job satisfaction, which was one of the unadjusted strategies of cognitive emotion regulation.

Facebook or Twitter?: Effective recruitment strategies for family caregivers.

Science.gov (United States)

Herbell, Kayla; Zauszniewski, Jaclene A

2018-06-01

This brief details recent recruitment insights from a large all-online study of family caregivers that aimed to develop a measure to assess how family caregivers manage daily stresses. Online recruitment strategies included the use of Twitter and Facebook. Overall, 800 individuals responded to the recruitment strategy; 230 completed all study procedures. The most effective online recruitment strategy for targeting family caregivers was Facebook, yielding 86% of the sample. Future researchers may find the use of social media recruitment methods appealing because they are inexpensive, simple, and efficient methods for obtaining National samples. Copyright © 2018 Elsevier Inc. All rights reserved.

Indirect effects of recovery strategies

DEFF Research Database (Denmark)

Andersen, Ken Haste; Rice, Jake

-based models of fish communities indicate that theserelationships have lawful dynamics that continue to be expressed, even when individualspecies become rarer - as predators or as prey. An ecosystem based management recoverystrategies of a given species or group of species should therefore not be seen...... in isolation,but the expected consequences for the rest of the ecosystem must be analyzed. We use ageneral size- and trait-based model to calculate the ecosystem effects of fishing andrecovery. We present a general analysis of a recovery strategies targeting either large fishes(consumer fishery), small fishes...

MARKETING STRATEGY OF THE UNIVERSITY: FORMATION AND ITS EFFECTIVENESS EVALUATION REALIZATION

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Natalia К. Shemetova

2015-01-01

Full Text Available The study is aimed at developing an algorithm of formation of university’s marketing strategy and the development of evaluating methods of its effectiveness realization. Despite the competitive expansion of the educational services market and the transition to a system of university self-financing, researchers have not paid due attention to the process of developing the marketing strategy of the university and the evaluation of its effectiveness yet. Methods. The applied methods include the method of general systems theory, and the complex of specialized marketing tools (PEST-, SNWand SWOT-analysis. Results. The algorithm of university’s marketing strategy formation and methodology for its effectiveness assessing is given in five fields: economic, informational, social, integration, and demand stage. The set of criteria is worked out for every field listed above. The author has developed a formula for determining the total indicator or general index of the effectiveness of university’s marketing strategy. Scientific novelty. The prospects of using the algorithm of formation of university’s marketing strategy and the system of monitoring and evaluating the effectiveness of marketing in higher vocational education was proved and evaluated by the author in the Ural Institute of Management of RANEPA. Practical significance. The research results can be used by the experts in the field of management of the higher educational institutions, and also as teaching materials while preparing the experts in marketing. 

Vasa previa screening strategies: a decision and cost-effectiveness analysis.

Science.gov (United States)

Sinkey, R G; Odibo, A O

2018-05-22

The aim of this study is to perform a decision and cost-effectiveness analysis comparing four screening strategies for the antenatal diagnosis of vasa previa among singleton pregnancies. A decision-analytic model was constructed comparing vasa previa screening strategies. Published probabilities and costs were applied to four transvaginal screening scenarios which occurred at the time of mid-trimester ultrasound: no screening, ultrasound-indicated screening, screening pregnancies conceived by in vitro fertilization (IVF), and universal screening. Ultrasound-indicated screening was defined as performing a transvaginal ultrasound at the time of routine anatomy ultrasound in response to one of the following sonographic findings associated with an increased risk of vasa previa: low-lying placenta, marginal or velamentous cord insertion, or bilobed or succenturiate lobed placenta. The primary outcome was cost per quality adjusted life years (QALY) in U.S. dollars. The analysis was from a healthcare system perspective with a willingness to pay (WTP) threshold of $100,000 per QALY selected. One-way and multivariate sensitivity analyses (Monte-Carlo simulation) were performed. This decision-analytic model demonstrated that screening pregnancies conceived by IVF was the most cost-effective strategy with an incremental cost effectiveness ratio (ICER) of $29,186.50 / QALY. Ultrasound-indicated screening was the second most cost-effective with an ICER of $56,096.77 / QALY. These data were robust to all one-way and multivariate sensitivity analyses performed. Within our baseline assumptions, transvaginal ultrasound screening for vasa previa appears to be most cost-effective when performed among IVF pregnancies. However, both IVF and ultrasound-indicated screening strategies fall within contemporary willingness-to-pay thresholds, suggesting that both strategies may be appropriate to apply in clinical practice. This article is protected by copyright. All rights reserved. This

Assessing urban potential flooding risk and identifying effective risk-reduction measures.

Science.gov (United States)

Cherqui, Frédéric; Belmeziti, Ali; Granger, Damien; Sourdril, Antoine; Le Gauffre, Pascal

2015-05-01

Flood protection is one of the traditional functions of any drainage system, and it remains a major issue in many cities because of economic and health impact. Heavy rain flooding has been well studied and existing simulation software can be used to predict and improve level of protection. However, simulating minor flooding remains highly complex, due to the numerous possible causes related to operational deficiencies or negligent behaviour. According to the literature, causes of blockages vary widely from one case to another: it is impossible to provide utility managers with effective recommendations on how to improve the level of protection. It is therefore vital to analyse each context in order to define an appropriate strategy. Here we propose a method to represent and assess the flooding risk, using GIS and data gathered during operation and maintenance. Our method also identifies potential management responses. The approach proposed aims to provide decision makers with clear and comprehensible information. Our method has been successfully applied to the Urban Community of Bordeaux (France) on 4895 interventions related to flooding recorded during the 2009-2011 period. Results have shown the relative importance of different issues, such as human behaviour (grease, etc.) or operational deficiencies (roots, etc.), and lead to identify corrective and proactive. This study also confirms that blockages are not always directly due to the network itself and its deterioration. Many causes depend on environmental and operating conditions on the network and often require collaboration between municipal departments in charge of roads, green spaces, etc. Copyright © 2015 Elsevier B.V. All rights reserved.

Effectiveness Of Communication Outreach Strategies Of Extension ...

African Journals Online (AJOL)

Communication is a major component of agricultural extension and extension agents utilize various methods to deliver messages to their clienteles. The paper focused on the effectiveness of communication outreach strategies of extension agents in Imo State, Nigeria. Data for the study was collected with the aid of ...

Strategies for improved French-language health services

Science.gov (United States)

Gauthier, Alain P.; Timony, Patrick E.; Serresse, Suzanne; Goodale, Natalie; Prpic, Jason

2015-01-01

Abstract Objective To identify strategies to improve the quality of health services for Francophone patients. Design A series of semistructured key informant interviews. Setting Northeastern Ontario. Participants A total of 18 physicians were interviewed. Ten physicians were interviewed in French, 7 physicians were women, and 10 physicians were located in urban communities. Methods Purposive and snowball sampling strategies were used to conduct a series of semistructured key informant interviews with family physicians practising in communities with a large Francophone population. Principles of grounded theory were applied, guided by a framework for patient-professional communication. Results were inductively derived following an iterative data collection–data analysis process and were analyzed using a detailed thematic approach. Main findings Respondents identified several strategies for providing high-quality French-language health services. Some were unique to non–French-speaking physicians (eg, using appropriate interpreter services), some were unique to French-speaking physicians (eg, using a flexible dialect), and some strategies were common to all physicians serving French populations (eg, hiring bilingual staff or having pamphlets and posters in both French and English). Conclusion Physicians interviewed for this study provided high-quality health care by attributing substantial importance to effective communication. While linguistic patient-to-physician concordance is ideal, it might not always be possible. Thus, conscious efforts to attenuate communication barriers are necessary, and several effective strategies exist. PMID:26505060

POEM: Identifying joint additive effects on regulatory circuits

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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/.

Costs, health effects and cost-effectiveness of alcohol and tobacco control strategies in Estonia.

NARCIS (Netherlands)

Lai, T.; Habicht, J.; Reinap, M.; Chisholm, D.; Baltussen, R.M.P.M.

2007-01-01

OBJECTIVE: To assess the population-level costs, effects and cost-effectiveness of different alcohol and tobacco control strategies in Estonia. DESIGN: A WHO cost-effectiveness modelling framework was used to estimate the total costs and effects of interventions. Costs were assessed in Estonian

Systematic review and cost-effectiveness evaluation of 'pill-in-the-pocket' strategy for paroxysmal atrial fibrillation compared to episodic in-hospital treatment or continuous antiarrhythmic drug therapy.

Science.gov (United States)

Saborido, C Martin; Hockenhull, J; Bagust, A; Boland, A; Dickson, R; Todd, D

2010-06-01

Atrial fibrillation (AF) is a tachyarrhythmia characterised by uncoordinated atrial activation with consequent deterioration of impairment of atrial function and a rapid, irregular heartbeat. The annual incidence rate of paroxysmal AF (PAF) has been estimated at 1.0 per 1000 person-years (95% confidence interval 0.9 to 1.1), and reported prevalence rates show wide variations depending on age and country. Conventional treatment strategies for PAF focus on the suppression of paroxysms of AF and return to normal sinus rhythm. To summarise the results of the rapid reviews of the clinical effectiveness and cost-effectiveness literature describing the pill-in-the-pocket (PiP) approach for the treatment of patients with PAF; and to develop an economic model to assess the cost-effectiveness of PiP compared with in-hospital treatment (IHT) or continuous antiarrhythmic drugs (AADs) for the treatment of patients with PAF. Ovid MEDLINE and Ovid OLDMEDLINE 1950 to present with Daily Update were searched. The following electronic databases were searched for ongoing trials: Health Services Research Projects in Progress, ClinicalTrials.gov, metaRegister of Current Controlled Trials, BioMed Central, World Health Organization International Clinical Trials Registry Platform, ClinicalStudyResults.org and the National Library of Medicine Gateway. Inclusion criteria, which included patients suffering from PAF, were independently applied to all identified references by two reviewers (JH and CMS). Electronic searches were conducted to identify clinical effectiveness and cost-effectiveness evidence describing the use of a PiP strategy for the treatment of PAF, published since the release of the Royal College of Physicians' national guidelines on AF in June 2006. A Markov model was constructed to examine differences between three PAF strategies (PiP, AAD and IHT) in terms of cost per quality-adjusted life-year (QALY). A Markov model structure was chosen because it is assumed that PAF is a

Time management strategies for research productivity.

Science.gov (United States)

Chase, Jo-Ana D; Topp, Robert; Smith, Carol E; Cohen, Marlene Z; Fahrenwald, Nancy; Zerwic, Julie J; Benefield, Lazelle E; Anderson, Cindy M; Conn, Vicki S

2013-02-01

Researchers function in a complex environment and carry multiple role responsibilities. This environment is prone to various distractions that can derail productivity and decrease efficiency. Effective time management allows researchers to maintain focus on their work, contributing to research productivity. Thus, improving time management skills is essential to developing and sustaining a successful program of research. This article presents time management strategies addressing behaviors surrounding time assessment, planning, and monitoring. Herein, the Western Journal of Nursing Research editorial board recommends strategies to enhance time management, including setting realistic goals, prioritizing, and optimizing planning. Involving a team, problem-solving barriers, and early management of potential distractions can facilitate maintaining focus on a research program. Continually evaluating the effectiveness of time management strategies allows researchers to identify areas of improvement and recognize progress.

Cost-effective strategies for rural community outreach, Hawaii, 2010-2011.

Science.gov (United States)

Pellegrin, Karen L; Barbato, Anna; Holuby, R Scott; Ciarleglio, Anita E; Taniguchi, Ronald

2014-12-11

Three strategies designed to maximize attendance at educational sessions on chronic disease medication safety in older adults in rural areas were implemented sequentially and compared for cost-effectiveness: 1) existing community groups and events, 2) formal advertisement, and 3) employer-based outreach. Cost-effectiveness was measured by comparing overall cost per attendee recruited and number of attendees per event. The overall cost per attendee was substantially higher for the formal advertising strategy, which produced the lowest number of attendees per event. Leveraging existing community events and employers in rural areas was more cost-effective than formal advertisement for recruiting rural community members.

Sensemaking Strategies for Ethical Decision-making.

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Caughron, Jay J; Antes, Alison L; Stenmark, Cheryl K; Thiel, Chaise E; Wang, Xiaoqian; Mumford, Michael D

2011-01-01

The current study uses a sensemaking model and thinking strategies identified in earlier research to examine ethical decision-making. Using a sample of 163 undergraduates, a low fidelity simulation approach is used to study the effects personal involvement (in causing the problem and personal involvement in experiencing the outcomes of the problem) could have on the use of cognitive reasoning strategies that have been shown to promote ethical decision-making. A mediated model is presented which suggests that environmental factors influence reasoning strategies, reasoning strategies influence sensemaking, and sensemaking in turn influences ethical decision-making. Findings were mixed but generally supported the hypothesized model. Interestingly, framing the outcomes of ethically charged situations in terms of more global organizational outcomes rather than personal outcomes was found to promote the use of pro-ethical cognitive reasoning strategies.

Cost-Effectiveness Analysis of Six Strategies to Treat Recurrent Clostridium difficile Infection

Science.gov (United States)

Lapointe-Shaw, Lauren; Tran, Kim L.; Coyte, Peter C.; Hancock-Howard, Rebecca L.; Powis, Jeff; Poutanen, Susan M.; Hota, Susy

2016-01-01

Objective To assess the cost-effectiveness of six treatment strategies for patients diagnosed with recurrent Clostridium difficile infection (CDI) in Canada: 1. oral metronidazole; 2. oral vancomycin; 3.oral fidaxomicin; 4. fecal transplantation by enema; 5. fecal transplantation by nasogastric tube; and 6. fecal transplantation by colonoscopy. Perspective Public insurer for all hospital and physician services. Setting Ontario, Canada. Methods A decision analytic model was used to model costs and lifetime health effects of each strategy for a typical patient experiencing up to three recurrences, over 18 weeks. Recurrence data and utilities were obtained from published sources. Cost data was obtained from published sources and hospitals in Toronto, Canada. The willingness-to-pay threshold was $50,000/QALY gained. Results Fecal transplantation by colonoscopy dominated all other strategies in the base case, as it was less costly and more effective than all alternatives. After accounting for uncertainty in all model parameters, there was an 87% probability that fecal transplantation by colonoscopy was the most beneficial strategy. If colonoscopy was not available, fecal transplantation by enema was cost-effective at $1,708 per QALY gained, compared to metronidazole. In addition, fecal transplantation by enema was the preferred strategy if the probability of recurrence following this strategy was below 8.7%. If fecal transplantation by any means was unavailable, fidaxomicin was cost-effective at an additional cost of $25,968 per QALY gained, compared to metronidazole. Conclusion Fecal transplantation by colonoscopy (or enema, if colonoscopy is unavailable) is cost-effective for treating recurrent CDI in Canada. Where fecal transplantation is not available, fidaxomicin is also cost-effective. PMID:26901316

Effects of Reading Strategy Instruction on Attitude toward Strategies and Performance in Reading Texts of Different Difficulty Levels

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Shorkaee, Hossein Zabihi; Talebi, Seyed Hassan

2018-01-01

This study investigated the effects of Reading Strategy Instruction (RSI) on reading performance and attitude toward reading strategies while reading texts of different difficulty levels. Fifty-five university students studying Political and Basic Sciences took part in this study. After homogenizing the participants, 24 students were in the…

A systems biology strategy to identify molecular mechanisms of action and protein indicators of traumatic brain injury.

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Yu, Chenggang; Boutté, Angela; Yu, Xueping; Dutta, Bhaskar; Feala, Jacob D; Schmid, Kara; Dave, Jitendra; Tawa, Gregory J; Wallqvist, Anders; Reifman, Jaques

2015-02-01

The multifactorial nature of traumatic brain injury (TBI), especially the complex secondary tissue injury involving intertwined networks of molecular pathways that mediate cellular behavior, has confounded attempts to elucidate the pathology underlying the progression of TBI. Here, systems biology strategies are exploited to identify novel molecular mechanisms and protein indicators of brain injury. To this end, we performed a meta-analysis of four distinct high-throughput gene expression studies involving different animal models of TBI. By using canonical pathways and a large human protein-interaction network as a scaffold, we separately overlaid the gene expression data from each study to identify molecular signatures that were conserved across the different studies. At 24 hr after injury, the significantly activated molecular signatures were nonspecific to TBI, whereas the significantly suppressed molecular signatures were specific to the nervous system. In particular, we identified a suppressed subnetwork consisting of 58 highly interacting, coregulated proteins associated with synaptic function. We selected three proteins from this subnetwork, postsynaptic density protein 95, nitric oxide synthase 1, and disrupted in schizophrenia 1, and hypothesized that their abundance would be significantly reduced after TBI. In a penetrating ballistic-like brain injury rat model of severe TBI, Western blot analysis confirmed our hypothesis. In addition, our analysis recovered 12 previously identified protein biomarkers of TBI. The results suggest that systems biology may provide an efficient, high-yield approach to generate testable hypotheses that can be experimentally validated to identify novel mechanisms of action and molecular indicators of TBI. © 2014 The Authors. Journal of Neuroscience Research Published by Wiley Periodicals, Inc.

Identifying Strategic Scientific Opportunities

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As NCI's central scientific strategy office, CRS collaborates with the institute's divisions, offices, and centers to identify research opportunities to advance NCI's vision for the future of cancer research.

The Concept of Sustainable Strategy Implementation

Directory of Open Access Journals (Sweden)

Joanna Radomska

2015-11-01

Full Text Available The idea of sustainable development has been present in the field of management for many years, yet the challenges and rules of contemporary business mean that it remains topical. At the same time, the results of much research indicates an unsatisfactory level of execution of development concepts. Due to this, the subject of the study encompasses the implementation of the idea of sustainability in the strategy execution process, lending it a holistic and balanced nature. The purpose of the paper is an examination of the relationship between strategy implementation and the effectiveness of the strategy execution process. The relationships between the perspectives defined and results obtained by organizations were investigated. The research demonstrated the existence of a positive correlation of varied intensity. It is thus possible to identify a positive influence of the integration of the idea of sustainability with strategy execution, which is reflected in the effectiveness of activities undertaken.

Effective Dissemination - Building an 'Evidence to Impact' Strategy

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Dan O'Neill

2017-02-01

Full Text Available When a piece of ‘evidence’ is generated in the research environment and almost nobody hears about it, then can we really still call it a piece of ‘evidence’? Does evidence only become evidence once it is used; and until then, is it just a piece of insignificant information? As we inexorably travel through the EBVM era, we must increasingly prioritise effective dissemination of evidence. This paper will use the VetCompass Programme at the Royal Veterinary College as a case study to explore a strategic dissemination plan and examine routes for effective dissemination.Although EBVM traditionally assumes an audience of academics or practicing veterinarians, the authors contend that substantial welfare gains can be additionally achieved by targeting current and future pet owners, the non-owner general public, industry, welfare bodies, scientific groups, breeders and kennel clubs. Effective dissemination should be strategic and give a priori consideration to identifying target audiences, appropriate formatting of the messages and open access routes for dissemination. Scientists who generate EBVM may not always be best placed to also disseminate these messages and therefore research teams should consider widening their combined skill-base to also incorporate marketing and media savvy.The VetCompass Programme is a new and hugely exciting project that shares de-identified primary-practice clinical data for research to support effective evidence based veterinary medicine and welfare reforms. VetCompass data collection commenced in 2009 and the current 470 collaborating primary-care practices have shared data on 4 million small animals and 45 million unique episodes of care. VetCompass has 15 peer-reviewed publications to date.In order to maximise the welfare gains from an array of evidence silos generated within VetCompass, a dissemination strategy was designed based on a Systems Thinking approach. The outcomes from a range of dissemination trials

Effects of Levodopa on Postural Strategies in Parkinson's disease.

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Baston, Chiara; Mancini, Martina; Rocchi, Laura; Horak, Fay

2016-05-01

Altered postural control and balance are major disabling issues of Parkinson's disease (PD). Static and dynamic posturography have provided insight into PD's postural deficits; however, little is known about impairments in postural coordination. We hypothesized that subjects with PD would show more ankle strategy during quiet stance than healthy control subjects, who would include some hip strategy, and this stiffer postural strategy would increase with disease progression. We quantified postural strategy and sway dispersion with inertial sensors (one placed on the shank and one on the posterior trunk at L5 level) while subjects were standing still with their eyes open. A total of 70 subjects with PD, including a mild group (H&Y≤2, N=33) and a more severe group (H&Y≥3, N=37), were assessed while OFF and while ON levodopa medication. We also included a healthy control group (N=21). Results showed an overall preference of ankle strategy in all groups while maintaining balance. Postural strategy was significantly lower ON compared to OFF medication (indicating more hip strategy), but no effect of disease stage was found. Instead, sway dispersion was significantly larger in ON compared to OFF medication, and significantly larger in the more severe PD group compared to the mild. In addition, increased hip strategy during stance was associated with poorer self-perception of balance. Copyright © 2016 Elsevier B.V. All rights reserved.

Opioid adjuvant strategy: improving opioid effectiveness.

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Bihel, Frédéric

2016-01-01

Opioid analgesics continue to be the mainstay of pharmacologic treatment of moderate to severe pain. Many patients, particularly those suffering from chronic pain, require chronic high-dose analgesic therapy. Achieving clinical efficacy and tolerability of such treatment regimens is hampered by the appearance of opioid-induced side effects such as tolerance, hyperalgesia and withdrawal syndrome. Among the therapeutic options to improve the opioid effectiveness, this current review focuses on strategies combining opioids to other drugs that can modulate opioid-mediated effects. We will discuss about experimental evidences reported for several potential opioid adjuvants, including N-methyl-D-aspartate receptor antagonists, 5-HT7 agonists, sigma-1 antagonists, I2-R ligands, cholecystokinin antagonists, neuropeptide FF-R antagonists and toll-like receptor 4 antagonists.

Coping Work Strategies and Job Satisfaction Among Iranian Nurses

OpenAIRE

Ghiyasvandian, Shahrzad; Adera Gebra, Addis

2014-01-01

Context: Nursing is a stressful job that could create physical and psychological disorders. Many studies presented information on stress, effects of coping strategies, and job satisfaction of nurses within health setting. We aimed to identify and describe nursing stresses, coping strategies and job satisfaction of Iranian nurses who are working or worked in different wards. Evidence Acquisition: In this review, we studied peer-reviewed journal articles on the field of stress, coping strategie...

Exploring the effects of spatial autocorrelation when identifying key drivers of wildlife crop-raiding.

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Songhurst, Anna; Coulson, Tim

2014-03-01

Few universal trends in spatial patterns of wildlife crop-raiding have been found. Variations in wildlife ecology and movements, and human spatial use have been identified as causes of this apparent unpredictability. However, varying spatial patterns of spatial autocorrelation (SA) in human-wildlife conflict (HWC) data could also contribute. We explicitly explore the effects of SA on wildlife crop-raiding data in order to facilitate the design of future HWC studies. We conducted a comparative survey of raided and nonraided fields to determine key drivers of crop-raiding. Data were subsampled at different spatial scales to select independent raiding data points. The model derived from all data was fitted to subsample data sets. Model parameters from these models were compared to determine the effect of SA. Most methods used to account for SA in data attempt to correct for the change in P-values; yet, by subsampling data at broader spatial scales, we identified changes in regression estimates. We consequently advocate reporting both model parameters across a range of spatial scales to help biological interpretation. Patterns of SA vary spatially in our crop-raiding data. Spatial distribution of fields should therefore be considered when choosing the spatial scale for analyses of HWC studies. Robust key drivers of elephant crop-raiding included raiding history of a field and distance of field to a main elephant pathway. Understanding spatial patterns and determining reliable socio-ecological drivers of wildlife crop-raiding is paramount for designing mitigation and land-use planning strategies to reduce HWC. Spatial patterns of HWC are complex, determined by multiple factors acting at more than one scale; therefore, studies need to be designed with an understanding of the effects of SA. Our methods are accessible to a variety of practitioners to assess the effects of SA, thereby improving the reliability of conservation management actions.

Effects of age on navigation strategy.

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Rodgers, M Kirk; Sindone, Joseph A; Moffat, Scott D

2012-01-01

Age differences in navigation strategies have been demonstrated in animals, with aged animals more likely to prefer an egocentric (route) strategy and younger animals more likely to prefer an allocentric (place) strategy. Using a novel virtual Y-maze strategy assessment (vYSA), the present study demonstrated substantial age differences in strategy preference in humans. Older adults overwhelmingly preferred an egocentric strategy, while younger adults were equally distributed between egocentric and allocentric preference. A preference for allocentric strategy on the Y-maze strategy assessment was found to benefit performance on an independent assessment (virtual Morris water task) only in younger adults. These results establish baseline age differences in spatial strategies and suggest this may impact performance on other spatial navigation assessments. The results are interpreted within the framework of age differences in hippocampal structure and function. Copyright © 2012 Elsevier Inc. All rights reserved.

Employer retention strategies and their effect on nurses' job satisfaction and intent to stay.

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Ellenbecker, Carol Hall; Samia, Linda; Cushman, Margaret J; Porell, Frank W

2007-01-01

Faced with a nursing shortage and anticipated increase in demand, home care agencies are implementing retention strategies with little knowledge of their effectiveness. The purpose of this study is to describe the strategies implemented and their effect on nurse job satisfaction and intention to leave. Data were collected from a random sample of 123 New England agencies during in-person interviews. Most agencies reported implementing multiple recruitment and retention strategies. Regression results suggest that the effects of employer retention strategy on nurses' intent to stay are the indirect result of its effects on job satisfaction. The only retention intervention that made a statistically significant difference in job satisfaction was shared governance, and no retention strategy directly affected nurses' intention to stay in their jobs.

Cost-effectiveness analysis of mammography and clinical breast examination strategies

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Ahern, Charlotte Hsieh; Shen, Yu

2009-01-01

Purpose Breast cancer screening by mammography and clinical breast exam are commonly used for early tumor detection. Previous cost-effectiveness studies considered mammography alone or did not account for all relevant costs. In this study, we assessed the cost-effectiveness of screening schedules recommended by three major cancer organizations and compared them with alternative strategies. We considered costs of screening examinations, subsequent work-up, biopsy, and treatment interventions after diagnosis. Methods We used a microsimulation model to generate women’s life histories, and assessed screening and treatment impacts on survival. Using statistical models, we accounted for age-specific incidence, preclinical disease duration, and age-specific sensitivity and specificity for each screening modality. The outcomes of interest were quality-adjusted life years (QALYs) saved and total costs with a 3% annual discount rate. Incremental cost-effectiveness ratios were used to compare strategies. Sensitivity analyses were performed by varying some of the assumptions. Results Compared to guidelines from the National Cancer Institute and the U.S. Preventive Services Task Force, alternative strategies were more efficient. Mammography and clinical breast exam in alternating years from ages 40 to 79 was a cost-effective alternative compared to the guidelines, costing $35,500 per QALY saved compared with no screening. The American Cancer Society guideline was the most effective and the most expensive, costing over $680,000 for an added QALY compared to the above alternative. Conclusion Screening strategies with lower costs and benefits comparable to those currently recommended should be considered for implementation in practice and for future guidelines. PMID:19258473

Human capital strategy: talent management.

Science.gov (United States)

Nagra, Michael

2011-01-01

Large organizations, including the US Army Medical Department and the Army Nurse Corps, are people-based organizations. Consequently, effective and efficient management of the human capital within these organizations is a strategic goal for the leadership. Over time, the Department of Defense has used many different systems and strategies to manage people throughout their service life-cycle. The current system in use is called Human Capital Management. In the near future, the Army's human capital will be managed based on skills, knowledge, and behaviors through various measurement tools. This article elaborates the human capital management strategy within the Army Nurse Corps, which identifies, develops, and implements key talent management strategies under the umbrella of the Corps' human capital goals. The talent management strategy solutions are aligned under the Nurse Corps business strategy captured by the 2008 Army Nurse Corps Campaign Plan, and are implemented within the context of the culture and core values of the organization.

Understanding MBA Consumer Needs and the Development of Marketing Strategy

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Dailey, Lynn; Anderson, Murphy; Ingenito, Cristina; Duffy, David; Krimm, Paul; Thomson, Scott

2006-01-01

The need to develop marketing strategies in higher education is evident. In order to develop effective strategies, marketers must understand the basic needs that their product fulfills. Exploratory research was utilized to identify and better understand the needs that motivate consumers to pursue an MBA degree. This paper emphasizes the importance…

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

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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.

The Effect of Exit Strategy on Optimal Portfolio Selection with Birandom Returns

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Guohua Cao

2013-01-01

Full Text Available The aims of this paper are to use a birandom variable to denote the stock return selected by some recurring technical patterns and to study the effect of exit strategy on optimal portfolio selection with birandom returns. Firstly, we propose a new method to estimate the stock return and use birandom distribution to denote the final stock return which can reflect the features of technical patterns and investors' heterogeneity simultaneously; secondly, we build a birandom safety-first model and design a hybrid intelligent algorithm to help investors make decisions; finally, we innovatively study the effect of exit strategy on the given birandom safety-first model. The results indicate that (1 the exit strategy affects the proportion of portfolio, (2 the performance of taking the exit strategy is better than when the exit strategy is not taken, if the stop-loss point and the stop-profit point are appropriately set, and (3 the investor using the exit strategy become conservative.

Comparison of Strategies and Incidence Thresholds for Vi Conjugate Vaccines Against Typhoid Fever: A Cost-effectiveness Modeling Study.

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Lo, Nathan C; Gupta, Ribhav; Stanaway, Jeffrey D; Garrett, Denise O; Bogoch, Isaac I; Luby, Stephen P; Andrews, Jason R

2018-02-12

Typhoid fever remains a major public health problem globally. While new Vi conjugate vaccines hold promise for averting disease, the optimal programmatic delivery remains unclear. We aimed to identify the strategies and associated epidemiologic conditions under which Vi conjugate vaccines would be cost-effective. We developed a dynamic, age-structured transmission and cost-effectiveness model that simulated multiple vaccination strategies with a typhoid Vi conjugate vaccine from a societal perspective. We simulated 10-year vaccination programs with (1) routine immunization of infants (aged typhoid fever and defined strategies as highly cost-effective by using the definition of a low-income country (defined as a country with a gross domestic product of $1045 per capita). We defined incidence as the true number of clinically symptomatic people in the population per year. Vi conjugate typhoid vaccines were highly cost-effective when administered by routine immunization activities through the EPI in settings with an annual incidence of >50 cases/100000 (95% uncertainty interval, 40-75 cases) and when administered through the EPI plus a catch-up campaign in settings with an annual incidence of >130 cases/100000 (95% uncertainty interval, 50-395 cases). The incidence threshold was sensitive to the typhoid-related case-fatality rate, carrier contribution to transmission, vaccine characteristics, and country-specific economic threshold for cost-effectiveness. Typhoid Vi conjugate vaccines would be highly cost-effective in low-income countries in settings of moderate typhoid incidence (50 cases/100000 annually). These results were sensitive to case-fatality rates, underscoring the need to consider factors contributing to typhoid mortality (eg, healthcare access and antimicrobial resistance) in the global vaccination strategy. © The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America.

A Comparison of Alternative Strategies for Cost-Effective Water Quality Management in Lakes

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Kramer, Daniel Boyd; Polasky, Stephen; Starfield, Anthony; Palik, Brian; Westphal, Lynne; Snyder, Stephanie; Jakes, Pamela; Hudson, Rachel; Gustafson, Eric

2006-09-01

Roughly 45% of the assessed lakes in the United States are impaired for one or more reasons. Eutrophication due to excess phosphorus loading is common in many impaired lakes. Various strategies are available to lake residents for addressing declining lake water quality, including septic system upgrades and establishing riparian buffers. This study examines 25 lakes to determine whether septic upgrades or riparian buffers are a more cost-effective strategy to meet a phosphorus reduction target. We find that riparian buffers are the more cost-effective strategy in every case but one. Large transaction costs associated with the negotiation and monitoring of riparian buffers, however, may be prohibiting lake residents from implementing the most cost-effective strategy.

Effect of the Holy Month of Ramadan on Coping Strategies

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S Akuchekian

2004-04-01

Full Text Available Background: Stress is one of the risk factors for the development of so many physical and especially psychological disorders. Now, the impression is focused on coping strategies versus previous emphasis on nature and severity of stress. The present study was performed to evaluate if fasting, not only as a religious behavior but also as a coping strategy can influence the way of coping with stress in humans. Methods: In a pre-test / post-test survey, 100 medical students were evaluated for stress coping strategies before and after the holy month of Ramadan using CS-R scale. Results: The results revealed that the use of ineffective coping strategies was significantly decreased after the holy month with no alterations in other strategies. In details, uses of superstitiousness, wishful thinking and self-medication coping strategies were statistically lower after Ramadan compared to values before it (P < 0.05. Conclusion: The present study showed that Ramadan fasting (a religious behavior or belief as a coping strategy has beneficial effect on the way of coping with stress in humans. Keywords: Stress, Coping Strategies, Religion, Ramadan, Medical Student

Cost-effectiveness analysis of infant feeding strategies to prevent ...

African Journals Online (AJOL)

Changing feeding practices is beneficial, depending on context. Breastfeeding is dominant (less costly, more effective) in rural settings, whilst formula feeding is a dominant strategy in urban settings. Cost-effectiveness was most sensitive to proportion of women on lifelong antiretroviral therapy (ART) and infant mortality rate ...

Alternative Strategies to Reduce Maternal Mortality in India: A Cost-Effectiveness Analysis

Science.gov (United States)

Goldie, Sue J.; Sweet, Steve; Carvalho, Natalie; Natchu, Uma Chandra Mouli; Hu, Delphine

2010-01-01

Background Approximately one-quarter of all pregnancy- and delivery-related maternal deaths worldwide occur in India. Taking into account the costs, feasibility, and operational complexity of alternative interventions, we estimate the clinical and population-level benefits associated with strategies to improve the safety of pregnancy and childbirth in India. Methods and Findings Country- and region-specific data were synthesized using a computer-based model that simulates the natural history of pregnancy (both planned and unintended) and pregnancy- and childbirth-associated complications in individual women; and considers delivery location, attendant, and facility level. Model outcomes included clinical events, population measures, costs, and cost-effectiveness ratios. Separate models were adapted to urban and rural India using survey-based data (e.g., unmet need for birth spacing/limiting, facility births, skilled birth attendants). Model validation compared projected maternal indicators with empiric data. Strategies consisted of improving coverage of effective interventions that could be provided individually or packaged as integrated services, could reduce the incidence of a complication or its case fatality rate, and could include improved logistics such as reliable transport to an appropriate referral facility as well as recognition of referral need and quality of care. Increasing family planning was the most effective individual intervention to reduce pregnancy-related mortality. If over the next 5 y the unmet need for spacing and limiting births was met, more than 150,000 maternal deaths would be prevented; more than US$1 billion saved; and at least one of every two abortion-related deaths averted. Still, reductions in maternal mortality reached a threshold (∼23%–35%) without including strategies that ensured reliable access to intrapartum and emergency obstetrical care (EmOC). An integrated and stepwise approach was identified that would ultimately

Alternative strategies to reduce maternal mortality in India: a cost-effectiveness analysis.

Directory of Open Access Journals (Sweden)

Sue J Goldie

2010-04-01

identified that would ultimately prevent four of five maternal deaths; this approach coupled stepwise improvements in family planning and safe abortion with consecutively implemented strategies that incrementally increased skilled attendants, improved antenatal/postpartum care, shifted births away from home, and improved recognition of referral need, transport, and availability/quality of EmOC. The strategies in this approach ranged from being cost-saving to having incremental cost-effectiveness ratios less than US$500 per year of life saved (YLS, well below India's per capita gross domestic product (GDP, a common benchmark for cost-effectiveness. CONCLUSIONS: Early intensive efforts to improve family planning and control of fertility choices and to provide safe abortion, accompanied by a paced systematic and stepwise effort to scale up capacity for integrated maternal health services over several years, is as cost-effective as childhood immunization or treatment of malaria, tuberculosis, or HIV. In just 5 y, more than 150,000 maternal deaths would be averted through increasing contraception rates to meet women's needs for spacing and limiting births; nearly US$1.5 billion would be saved by coupling safe abortion to aggressive family planning efforts; and with stepwise investments to improve access to pregnancy-related health services and to high-quality facility-based intrapartum care, more than 75% of maternal deaths could be prevented. If accomplished over the next decade, the lives of more than one million women would be saved.

Alternative strategies to reduce maternal mortality in India: a cost-effectiveness analysis.

Science.gov (United States)

Goldie, Sue J; Sweet, Steve; Carvalho, Natalie; Natchu, Uma Chandra Mouli; Hu, Delphine

2010-04-20

Approximately one-quarter of all pregnancy- and delivery-related maternal deaths worldwide occur in India. Taking into account the costs, feasibility, and operational complexity of alternative interventions, we estimate the clinical and population-level benefits associated with strategies to improve the safety of pregnancy and childbirth in India. Country- and region-specific data were synthesized using a computer-based model that simulates the natural history of pregnancy (both planned and unintended) and pregnancy- and childbirth-associated complications in individual women; and considers delivery location, attendant, and facility level. Model outcomes included clinical events, population measures, costs, and cost-effectiveness ratios. Separate models were adapted to urban and rural India using survey-based data (e.g., unmet need for birth spacing/limiting, facility births, skilled birth attendants). Model validation compared projected maternal indicators with empiric data. Strategies consisted of improving coverage of effective interventions that could be provided individually or packaged as integrated services, could reduce the incidence of a complication or its case fatality rate, and could include improved logistics such as reliable transport to an appropriate referral facility as well as recognition of referral need and quality of care. Increasing family planning was the most effective individual intervention to reduce pregnancy-related mortality. If over the next 5 y the unmet need for spacing and limiting births was met, more than 150,000 maternal deaths would be prevented; more than US$1 billion saved; and at least one of every two abortion-related deaths averted. Still, reductions in maternal mortality reached a threshold ( approximately 23%-35%) without including strategies that ensured reliable access to intrapartum and emergency obstetrical care (EmOC). An integrated and stepwise approach was identified that would ultimately prevent four of five

Cost-effectiveness analysis of optimal strategy for tumor treatment

International Nuclear Information System (INIS)

Pang, Liuyong; Zhao, Zhong; Song, Xinyu

2016-01-01

We propose and analyze an antitumor model with combined immunotherapy and chemotherapy. Firstly, we explore the treatment effects of single immunotherapy and single chemotherapy, respectively. Results indicate that neither immunotherapy nor chemotherapy alone are adequate to cure a tumor. Hence, we apply optimal theory to investigate how the combination of immunotherapy and chemotherapy should be implemented, for a certain time period, in order to reduce the number of tumor cells, while minimizing the implementation cost of the treatment strategy. Secondly, we establish the existence of the optimality system and use Pontryagin’s Maximum Principle to characterize the optimal levels of the two treatment measures. Furthermore, we calculate the incremental cost-effectiveness ratios to analyze the cost-effectiveness of all possible combinations of the two treatment measures. Finally, numerical results show that the combination of immunotherapy and chemotherapy is the most cost-effective strategy for tumor treatment, and able to eliminate the entire tumor with size 4.470 × 10"8 in a year.

Evaluating the effectiveness of a training program that builds teachers' capability to identify and appropriately refer middle and high school students with mental health problems in Brazil: an exploratory study.

Science.gov (United States)

Vieira, Marlene A; Gadelha, Ary A; Moriyama, Taís S; Bressan, Rodrigo A; Bordin, Isabel A

2014-02-28

In Brazil, like many countries, there has been a failure to identify mental health problems (MHP) in young people and refer them to appropriate care and support. The school environment provides an ideal setting to do this. Therefore, effective programs need to be developed to train teachers to identify and appropriately refer children with possible MHP. We aimed to evaluate teachers' ability to identify and appropriately refer students with possible MHP, and the effectiveness of a psychoeducational strategy to build teachers' capability in this area. To meet the first objective, we conducted a case-control study using a student sample. To meet the second, we employed longitudinal design with repeated measures before and after introducing the psychoeducational strategy using a teacher sample. In the case control study, the Youth Self-Report was used to investigate internalizing and externalizing problems. Before training, teachers selected 26 students who they thought were likely to have MHP. Twenty-six non-selected students acted as controls and were matched by gender, age and grade. The underlying principle was that if teachers could identify abnormal behaviors among their actual students, those with some MHP would likely be among the case group and those without among the control group. In the longitudinal study, 32 teachers were asked to evaluate six vignettes that highlighted behaviors indicating a high risk for psychosis, depression, conduct disorder, hyperactivity, mania, and normal adolescent behavior. We calculated the rates of correct answers for identifying the existence of some MHP and the need for referral before and after training; teachers were not asked to identify the individual conditions. Teachers were already able to identify the most symptomatic students, who had both internalizing and externalizing problems, as possibly having MHP, but teachers had difficulty in identifying students with internalizing problems alone. At least 50.0% of teachers

Effects of cooperative learning strategy on undergraduate kinesiology students' learning styles.

Science.gov (United States)

Meeuwsen, Harry J; King, George A; Pederson, Rockie

2005-10-01

A growing body of research supports cooperative learning as an effective teaching strategy. A specific cooperative learning strategy, Team-based Learning, was applied to a convenience sample of four undergraduate sophomore-level motor behavior courses over four semesters from Fall 2002 to Spring 2004 to examine whether this strategy would affect students' learning styles. The data from the Grasha-Reichmann Student Learning Style Scales indicated that this teaching strategy was associated with a significant decrease in the negative Avoidant and Dependent learning styles and an improvement in the positive Participant learning style.

Introduction strategies raise key questions.

Science.gov (United States)

Finger, W R; Keller, S

1995-09-01

Key issues that must be considered before a new contraceptive is introduced center on the need for a trained provider to begin or terminate the method, its side effects, duration of use, method's ability to meet users' needs and preferences, and extra training or staff requirements. Logistics and economic issues to consider are identifying a dependable way of effectively supplying commodities, planning extra services needed for the method, and cost of providing the method. Each contraceptive method presents a different side effect pattern and burdens the service delivery setting differently. The strategy developed to introduce or expand the 3-month injectable Depo-Provera (DMPA) can be used for any method. It includes a needs assessment and addresses regulatory issues, service delivery policies and procedures, information and training, evaluation, and other concerns. Viet Nam's needs assessment showed that Norplant should not be introduced until the service delivery system becomes stronger. Any needs assessment for expansion of contraceptive services should cover sexually transmitted disease/HIV issues. A World Health Organization strategy helps officials identify the best method mix for local situations. Introductory strategies must aim to improve the quality of family planning programs and expand choices. Many begin by examining existing data and conducting interviews with policymakers, users, providers, and women's health advocates. Introductory programs for Norplant focus on provider training, adequate counseling and informed consent for users, and ready access to removal. They need a well-prepared service delivery infrastructure. The first phase of the DMPA introductory strategy for the Philippines comprised a social marketing campaign and DMPA introduction at public clinics in 10 pilot areas with strong service delivery. Successful AIDS prevention programs show that people tend to use barrier methods when they are available. USAID is currently studying

Coal and the greenhouse effect: strategies for the future

Energy Technology Data Exchange (ETDEWEB)

Sullivan, K M [Australian Coal Association, Sydney, NSW (Australia)

1991-07-01

A number of gases, including carbon dioxide, methane, water vapour, nitrous oxide, ozone and chlorofluorocarbons are transparent to incoming short-wave radiation, but are relatively opaque to outgoing longwave radiation. Variations in the concentration of these gases in the troposphere can alter the thermal balance of the earth's atmosphere. Outgoing terrestrial radiation which would otherwise escape to space, is trapped within the inner layer of the atmosphere, resulting in a potential warming and the greenhouse effect. It is estimated that at present greenhouse gases other than carbon dioxide, contribute about 50% to the greenhouse effect. However, in the future, the contribution made by gases other than CO{sub 2} will be become greater. Greenhouse gases arise from a wide range of sources and their escalating increase is largely related to an increase in the world's population, and the standard of living of many areas as well as changes in lifestyle. The effect of increasing man-made greenhouse gases in the troposphere is unknown, but it is proposed that it may increase temperature and may modify climate, agricultural response and land use. The facts and uncertainties relating to potential greenhouse warming are examined. Man-generated emissions are quantified and their source identified. Coal's contribution worldwide is examined in detail and is shown to be small, being about 10% of man-made greenhouse gases. Strategies for minimising emissions, having maximum potential for reduction, with minimum impact on man are suggested. 16 refs., 1 fig., 3 tabs.

Cost-effectiveness analysis of different embryo transfer strategies in England.

Science.gov (United States)

Dixon, S; Faghih Nasiri, F; Ledger, W L; Lenton, E A; Duenas, A; Sutcliffe, P; Chilcott, J B

2008-05-01

The objective of this study was to assess the cost-effectiveness of different embryo transfer strategies for a single cycle when two embryos are available, and taking the NHS cost perspective. Cost-effectiveness model. Five in vitro fertilisation (IVF) centres in England between 2003/04 and 2004/05. Women with two embryos available for transfer in three age groups (Costs and adverse outcomes are estimated up to 5 years after the birth. Incremental cost per live birth was calculated for different embryo transfer strategies and for three separate age groups: less than 30, 30-35 and 36-39 years. Premature birth, neonatal intensive care unit admissions and days, cerebral palsy and incremental cost-effectiveness ratios. Single fresh embryo transfer (SET) plus frozen single embryo transfer (fzSET) is the more costly in terms of IVF costs, but the lower rates of multiple births mean that in terms of total costs, it is less costly than double embryo transfer (DET). Adverse events increase when moving from SET to SET+fzSET to DET. The probability of SET+fzSET being cost-effective decreases with age. When SET is included in the analysis, SET+fzSET no longer becomes a cost-effective option at any threshold value for all age groups studied. The analyses show that the choice of embryo transfer strategy is a function of four factors: the age of the mother, the relevance of the SET option, the value placed on a live birth and the relative importance placed on adverse outcomes. For each patient group, the choice of strategy is a trade-off between the value placed on a live birth and cost.

Age differences in everyday problem-solving effectiveness: older adults select more effective strategies for interpersonal problems.

Science.gov (United States)

Blanchard-Fields, Fredda; Mienaltowski, Andrew; Seay, Renee Baldi

2007-01-01

Using the Everyday Problem Solving Inventory of Cornelius and Caspi, we examined differences in problem-solving strategy endorsement and effectiveness in two domains of everyday functioning (instrumental or interpersonal, and a mixture of the two domains) and for four strategies (avoidance-denial, passive dependence, planful problem solving, and cognitive analysis). Consistent with past research, our research showed that older adults were more problem focused than young adults in their approach to solving instrumental problems, whereas older adults selected more avoidant-denial strategies than young adults when solving interpersonal problems. Overall, older adults were also more effective than young adults when solving everyday problems, in particular for interpersonal problems.

Strategies for time of culling in control of paratuberculosis in dairy herds

DEFF Research Database (Denmark)

Kudahl, Anne Margrethe Braad; Nielsen, Søren Saxmose; Østergaard, Søren

2011-01-01

Effect of time for culling cows infected with Mycobacterium avium ssp. paratuberculosis on prevalence and profitability was identified through simulations. Seven test-and-cull strategies with different culling criteria and no attempts to close infection routes were compared with strategies with (1...... would be the most effective culling strategy to reduce prevalence. However, closing transmission routes was even more effective in reducing the prevalence. In the first 3 to 6 yr, all test-and-cull strategies reduced gross margin by US$5 to 55/stall per year. These losses were fully compensated...... the ranking between the different culling strategies. Increased market price (20%) of replacement heifers made all culling strategies less profitable and made culling based on a milk yield criterion the most profitable culling strategy for a longer period (11 to 13 yr). A 20% reduction in heifer price made...

The Effect of Vocabulary Self-Selection Strategy and Input Enhancement Strategy on the Vocabulary Knowledge of Iranian EFL Learners

Science.gov (United States)

Masoudi, Golfam

2017-01-01

The present study was designed to investigate empirically the effect of Vocabulary Self-Selection strategy and Input Enhancement strategy on the vocabulary knowledge of Iranian EFL Learners. After taking a diagnostic pretest, both experimental groups enrolled in two classes. Learners who practiced Vocabulary Self-Selection were allowed to…

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.

Effective Fragmentation and Flyrock Control Strategies at Quarries

Directory of Open Access Journals (Sweden)

Sedat Esen

2017-01-01

Full Text Available This paper presents the effective fragmentation and flyrock control strategies that could be applied at quarries to improve the productivity and safety. Fragmentation measurement and modelling as well as a comprehensive drill and blast audit are essential for improving the fragmentation. Face profiling and bore tracking are good tools to manage the ―as-designed‖ and ―as-drilled‖ conditions to get reasonable fragmentation from face burden zone and minimise the flyrock risk. In general, a large scatter in fragmentation data was observed at sites and the causes should be analysed by a detailed root-cause analysis technique. Two case studies were presented in this paper showing some of the effective fragmentation strategies. Finally, a flyrock model was shown to determine the safe blast exclusion zone for the mining equipment and personnel. Some key guidelines were suggested to minimise the occurrence of the flyrock.

A systematic review and economic evaluation of diagnostic strategies for Lynch syndrome.

Science.gov (United States)

Snowsill, Tristan; Huxley, Nicola; Hoyle, Martin; Jones-Hughes, Tracey; Coelho, Helen; Cooper, Chris; Frayling, Ian; Hyde, Chris

2014-09-01

Lynch syndrome (LS) is an inherited autosomal dominant disorder characterised by an increased risk of colorectal cancer (CRC) and other cancers, and caused by mutations in the deoxyribonucleic acid (DNA) mismatch repair genes. To evaluate the accuracy and cost-effectiveness of strategies to identify LS in newly diagnosed early-onset CRC patients (aged strategies for individuals in whom LS is identified. Systematic reviews were conducted of the test accuracy of microsatellite instability (MSI) testing or immunohistochemistry (IHC) in individuals with CRC at risk of LS, and of economic evidence relating to diagnostic strategies for LS. Reviews were carried out in April 2012 (test accuracy); and in February 2012, repeated in February 2013 (economic evaluations). Databases searched included MEDLINE (1946 to April week 3, 2012), EMBASE (1980 to week 17, 2012) and Web of Science (inception to 30 April 2012), and risk of bias for test accuracy was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) quality appraisal tool. A de novo economic model of diagnostic strategies for LS was developed. Inconsistencies in study designs precluded pooling of diagnostic test accuracy results from a previous systematic review and nine subsequent primary studies. These were of mixed quality, with significant methodological concerns identified for most. IHC and MSI can both play a part in diagnosing LS but neither is gold standard. No UK studies evaluated the cost-effectiveness of diagnosing and managing LS, although studies from other countries generally found some strategies to be cost-effective compared with no testing. The de novo model demonstrated that all strategies were cost-effective compared with no testing at a threshold of £20,000 per quality-adjusted life-year (QALY), with the most cost-effective strategy utilising MSI and BRAF testing [incremental cost-effectiveness ratio (ICER) = £5491 per QALY]. The maximum health benefit to the

Does reading strategy instruction improve students’ comprehension?

Directory of Open Access Journals (Sweden)

Oyetunji, Christianah Oluwatoyin

2013-12-01

Full Text Available This paper describes the effect of reading strategy instruction on Second Language (L2 students’ reading comprehension in a Botswana College of Education. The intervention programme was implemented based on the observation that some trainee teachers failed to improve on their L2 proficiency after spending a year in the L2 classroom. Prior to the intervention, difficulty in reading and comprehending had been identified as one of the contributing factors to their failure to improve on their proficiency level. A reading comprehension test was used to collect data from participants who were trainee teachers at a College of Education in Botswana before and after the intervention. The six-week intervention programme focused on seven reading strategies, namely the use of background knowledge, self-questioning, inferencing, rereading, drawing conclusions, identifying main ideas and summarising. The findings suggest that strategy training can increase L2 students’ reading comprehension. Based on the findings, it is recommended that strategy training be introduced into the L2 syllabus of the primary school teacher trainees in all Botswana Colleges of Education.

Cost-effectiveness of alternative management strategies for patients with solitary pulmonary nodules.

Science.gov (United States)

Gould, Michael K; Sanders, Gillian D; Barnett, Paul G; Rydzak, Chara E; Maclean, Courtney C; McClellan, Mark B; Owens, Douglas K

2003-05-06

Positron emission tomography (PET) with 18-fluorodeoxyglucose (FDG) is a potentially useful but expensive test to diagnose solitary pulmonary nodules. To evaluate the cost-effectiveness of strategies for pulmonary nodule diagnosis and to specifically compare strategies that did and did not include FDG-PET. Decision model. Accuracy and complications of diagnostic tests were estimated by using meta-analysis and literature review. Modeled survival was based on data from a large tumor registry. Cost estimates were derived from Medicare reimbursement and other sources. All adult patients with a new, noncalcified pulmonary nodule seen on chest radiograph. Patient lifetime. Societal. 40 clinically plausible combinations of 5 diagnostic interventions, including computed tomography, FDG-PET, transthoracic needle biopsy, surgery, and watchful waiting. Costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios. The cost-effectiveness of strategies depended critically on the pretest probability of malignancy. For patients with low pretest probability (26%), strategies that used FDG-PET selectively when computed tomography results were possibly malignant cost as little as 20 000 dollars per QALY gained. For patients with high pretest probability (79%), strategies that used FDG-PET selectively when computed tomography results were benign cost as little as 16 000 dollars per QALY gained. For patients with intermediate pretest probability (55%), FDG-PET strategies cost more than 220 000 dollars per QALY gained because they were more costly but only marginally more effective than computed tomography-based strategies. The choice of strategy also depended on the risk for surgical complications, the probability of nondiagnostic needle biopsy, the sensitivity of computed tomography, and patient preferences for time spent in watchful waiting. In probabilistic sensitivity analysis, FDG-PET strategies were cost saving or cost less than 100 000 dollars per QALY

Collaborative Search Strategies for Green Innovation

DEFF Research Database (Denmark)

Ørding Olsen, Anders; Sofka, Wolfgang; Grimpe, Christoph

Recent innovation and strategy research emphasizes the importance of firm’s search for external knowledge to improve innovation performance. We focus on such search strategies within the domain of sustainable innovation in which problems are inherently complex and the relevant knowledge is widely...... dispersed. Hence, firms need to collaborate. We shed new light on collaborative search strategies led by firms in general and for solving environmental problems in particular. Both topics are largely absent in the extant open innovation literature. Using data from the European Seventh Framework Program...... for Research and Technological Development (FP7), our results indicate that the problem-solving potential of a search strategy increases with the diversity of existing knowledge of the partners in a consortium and with the experience of the partners involved. Moreover, we identify a substantial negative effect...

Effectiveness and Retention of Teaching Memory Strategy Use to Children with Autism Spectrum Disorder

Science.gov (United States)

Bebko, James M.; Rhee, Thomas; Ncube, Busisiwe L.; Dahary, Hadas

2017-01-01

Although low levels of memory strategy use have been found in children with autism spectrum disorders (ASDs), few studies have explored the effectiveness of interventions for improving strategy use with this population. In two studies, we examined the short- and longer term effectiveness of rehearsal strategy training. In Study 1, children with…

The Effects of Metacognitive Learning Strategy in Writing Enhancement of English Studen

Directory of Open Access Journals (Sweden)

Nazli Tyfekci

2017-12-01

Full Text Available This study investigates the effectiveness of metacognitive learning strategy in writing enhancement of English language and literature students in Kosovo. The research examined students’ metacognitive knowledge and regulation about their priorities regarding drafting, planning, organizing, summarizing, composing, reviewing and later on evaluation. Divided into two phases to first measure their awareness towards metacognition, and then to evaluate their capability in composition through learning strategies, the results of the research suggest that, contrary to the traditional view, in Kosovo, that places its importance on the teacher and not the student, the experimental participants proved that by utilizing metacognitive learning strategy enhances their writing efficiency and effectiveness. Findings also suggest that students’ attitude towards new and modern learning strategies is potently positive and welcoming.

Effects of Explicit Instruction in Cognitive and Metacognitive Reading Strategies on Iranian EFL Students' Reading Performance and Strategy Transfer

Science.gov (United States)

Aghaie, Reza; Zhang, Lawrence Jun

2012-01-01

This study explored the impact of explicit teaching of reading strategies on English-as-a-foreign-language (EFL) students' reading performance in Iran. The study employed a questionnaire adapted from Chamot and O'Malley's (1994) cognitive and metacognitive strategies framework. To test the effects of explicit teaching of cognitive and…

Effective seeding strategy in evolutionary prisoner's dilemma games on online social networks

Science.gov (United States)

Xu, Bo; Shi, Huibin; Wang, Jianwei; Huang, Yun

2015-04-01

This paper explores effective seeding strategies in prisoner's dilemma game (PDG) on online social networks, i.e. the optimal strategy to obtain global cooperation with minimum cost. Three distinct seeding strategies are compared by performing computer simulations on real online social network datasets. Our finding suggests that degree centrality seeding outperforms other strategies regardless of the initial payoff setting or network size. Celebrities of online social networks play key roles in preserving cooperation.

strategies for improving supervisory skills for effective primary ...

African Journals Online (AJOL)

Elizabeth

certain basic concepts such as inspection and supervision, the responsibility of supervisors, relevant areas in ... Strategies For Improving Supervisory Skills For Effective Primary Education In Nigeria. Enaigbe A. P. 236 ... book, attendance book etc. 6) Managerial Skills: These are skills on time management, good use.

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....

MARKETING STRATEGY OF THE UNIVERSITY: FORMATION AND ITS EFFECTIVENESS EVALUATION REALIZATION

OpenAIRE

Natalia К. Shemetova

2015-01-01

The study is aimed at developing an algorithm of formation of university’s marketing strategy and the development of evaluating methods of its effectiveness realization. Despite the competitive expansion of the educational services market and the transition to a system of university self-financing, researchers have not paid due attention to the process of developing the marketing strategy of the university and the evaluation of its effectiveness yet. Methods. The applied methods include the m...

Cost-effectiveness of seven IVF strategies: results of a Markov decision-analytic model.

Science.gov (United States)

Fiddelers, Audrey A A; Dirksen, Carmen D; Dumoulin, John C M; van Montfoort, Aafke P A; Land, Jolande A; Janssen, J Marij; Evers, Johannes L H; Severens, Johan L

2009-07-01

A selective switch to elective single embryo transfer (eSET) in IVF has been suggested to prevent complications of fertility treatment for both mother and infants. We compared seven IVF strategies concerning their cost-effectiveness using a Markov model. The model was based on a three IVF-attempts time horizon and a societal perspective using real world strategies and data, comparing seven IVF strategies, concerning costs, live births and incremental cost-effectiveness ratios (ICERs). In order to increase pregnancy probability, one cycle of eSET + one cycle of standard treatment policy [STP, i.e. eSET in patients IVF treatment, combining several transfer policies was not cost-effective. A choice has to be made between three cycles of eSET, STP or DET. It depends, however, on society's willingness to pay which strategy is to be preferred from a cost-effectiveness point of view.

Do personality traits of nurses have an effect on conflict management strategies?

Science.gov (United States)

Erdenk, Nigar; Altuntaş, Serap

2017-07-01

This research was conducted in a descriptive, correlational and cross-sectional design to determine whether personality traits of nurses have an effect on conflict management strategies. It is known that integration, avoidance and compromise conflict management strategies are the most frequent strategies used among nurses and obligation and domination are the least frequent. However, the reasons behind their strategy choice are not known. It is predicted that one of the reasons is the personality characteristics of the nurses. The study was conducted with the participation of 237 nurses working in three different hospitals. Research data were collected by using the 'Personal Information Form', 'Rahim Organisational Conflict Inventory-II' and 'Five Factor Personality Inventory' between December 2013 and February 2014. Ethical approval and the organisations' approvals were obtained before data collection. The collected data were analysed using frequency and percentage distributions, descriptive statistics, Pearson product-moment correlation analysis, t-test, Cronbach's alpha coefficient and simple linear regression analysis tests. The majority of nurses had conflict especially with patients' relatives several times a month. It was found that the personality traits of nurses were mostly 'conscientiousness' and 'openness' and when they had a conflict, they tended to use 'integration' strategy. It was also found that the personality traits of nurses had an effect on some of the conflict management strategies adopted by them. It was found that the personality traits of nurses had an effect on some conflict management strategies adopted by them. Nurse managers should support nurses who adopt appropriate conflict management strategies and there should be conflict management programmes that can teach appropriate skills to other nurses. © 2017 John Wiley & Sons Ltd.

The power of strategy metaphors

DEFF Research Database (Denmark)

Lystbæk, Christian Tang; Holmgren, Jens

2016-01-01

and post-structuralism. The paper reports on an action research study of a strategy workshop with the strategic team of a Human Resource Management Department in a Danish Municipality. It identifies two structural dimensions and four generic spatial metaphors were identified. Thus, the paper shows......This paper explores the power of spatial metaphors in strategy making. I seek to unfold a conception of the power of spatial metaphors in strategy making that stresses their creative and critical capacity as well as their constraints on strategic thinking. In order to identify the power of spatial...

The Effect of Queueing Strategy on Network Traffic

International Nuclear Information System (INIS)

Zhang Xue-Jun; Guan Xiang-Min; Sun Deng-Feng; Tang Shao-Ting

2013-01-01

In recent years, the transportation system has been faced by increasing challenge in congestion and inefficiency, and research in traffic network has become a significant area of interest. In this paper, we introduce a dynamic-information-based (DIB) queueing strategy into network traffic model under the efficient routing strategy. DIB makes a packet with higher priority to be delivered if there are less packets travelling along its path from the current node to the destination. It is found that, compared with the traditional first-in-first-out (FIFO) queueing strategy, DIB can effectively balance the traffic load of the system via delaying packets to be delivered to congested nodes. Although the network capacity has no obvious changes, some other indexes which reflect transportation efficiency are efficiently improved in the congestion state. Besides, extensive simulation results and discussions are provided to explain the phenomena. The results may provide novel insights for research on traffic systems. (condensed matter: structural, mechanical, and thermal properties)

Cost-effectiveness of alternative conservation strategies with application to the Pacific leatherback turtle.

Science.gov (United States)

Gjertsen, Heidi; Squires, Dale; Dutton, Peter H; Eguchi, Tomoharu

2014-02-01

Although holistic conservation addressing all sources of mortality for endangered species or stocks is the preferred conservation strategy, limited budgets require a criterion to prioritize conservation investments. We compared the cost-effectiveness of nesting site and at-sea conservation strategies for Pacific leatherback turtles (Dermochelys coriacea). We sought to determine which conservation strategy or mix of strategies would produce the largest increase in population growth rate per dollar. Alternative strategies included protection of nesters and their eggs at nesting beaches in Indonesia, gear changes, effort restrictions, and caps on turtle takes in the Hawaiian (U.S.A.) longline swordfish fishery, and temporal and area closures in the California (U.S.A.) drift gill net fishery. We used a population model with a biological metric to measure the effects of conservation alternatives. We normalized all effects by cost to prioritize those strategies with the greatest biological effect relative to its economic cost. We used Monte Carlo simulation to address uncertainty in the main variables and to calculate probability distributions for cost-effectiveness measures. Nesting beach protection was the most cost-effective means of achieving increases in leatherback populations. This result creates the possibility of noncompensatory bycatch mitigation, where high-bycatch fisheries invest in protecting nesting beaches. An example of this practice is U.S. processors of longline tuna and California drift gill net fishers that tax themselves to finance low-cost nesting site protection. Under certain conditions, fisheries interventions, such as technologies that reduce leatherback bycatch without substantially decreasing target species catch, can be cost-effective. Reducing bycatch in coastal areas where bycatch is high, particularly adjacent to nesting beaches, may be cost-effective, particularly, if fisheries in the area are small and of little commercial value. �

Effect of differentiated instructional strategies on students' retention ...

African Journals Online (AJOL)

The effect of differentiated instructional strategies on students' retention in geometry in senior secondary schools was examined. The study employed experimental research design of pretest, posttest control group. The area of this study is Abuja Municipal Area Council, the Federal Capital Territory. The target population ...

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.

Stress Management and Coping Strategies among Nurses : A Literature Review

OpenAIRE

Iyi, Obiora

2015-01-01

There is obvious need to have the safest working environments and the best quality of health care delivery to patients by nurses working in the hospitals. Effective stress management and coping strategies is one very important step towards this goal. This research aims to identify the major stressors for nurses and the most effective management and coping strategies as contained in literature. This involved excellent review of relevant articles in addition to deductive content analysis of the...

Interpersonal success factors for strategy implementation: a case study using group model building

OpenAIRE

Rodney J Scott; Robert Y Cavana; Donald Cameron

2015-01-01

Strategy implementation has been identified as an area of system dynamics literature requiring greater attention. Most strategies fail to be implemented successfully, and processes for effectively implementing strategy are yet to be fully explained and explored. The reported interpersonal success factors for strategy implementation are reported outcomes for group model building, suggesting potential applicability. A case study using validated survey methods yielded promising results, and sugg...

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.

Implementation of multidimensional knowledge translation strategies to improve procedural pain in hospitalized children.

Science.gov (United States)

Stevens, Bonnie J; Yamada, Janet; Promislow, Sara; Stinson, Jennifer; Harrison, Denise; Victor, J Charles

2014-11-25

Despite extensive research, institutional policies, and practice guidelines, procedural pain remains undertreated in hospitalized children. Knowledge translation (KT) strategies have been employed to bridge the research to practice gap with varying success. The most effective single or combination of KT strategies has not been found. A multifaceted KT intervention, Evidence-based Practice for Improving Quality (EPIQ), that included tailored KT strategies was effective in improving pain practices and clinical outcomes at the unit level in a prospective comparative cohort study in 32 hospital units (16 EPIQ intervention and 16 Standard Care), in eight pediatric hospitals in Canada. In a study of the 16 EPIQ units (two at each hospital) only, the objectives were to: determine the effectiveness of evidence-based KT strategies implemented to achieve unit aims; describe the KT strategies implemented and their influence on pain assessment and management across unit types; and identify facilitators and barriers to their implementation. Data were collected from each EPIQ intervention unit on targeted pain practices and KT strategies implemented, through chart review and a process evaluation checklist, following four intervention cycles over a 15-month period. Following the completion of the four cycle intervention, 78% of 23 targeted pain practice aims across units were achieved within 80% of the stated aims. A statistically significant improvement was found in the proportion of children receiving pain assessment and management, regardless of pre-determined aims (p strategies implemented was 35 and included reminders, educational outreach and materials, and audit and feedback. Units successful in achieving their aims implemented more KT strategies than units that did not. No specific type of single or combination of KT strategies was more effective in improving pain assessment and management outcomes. Tailoring KT strategies to unit context, support from unit leadership

Strategies to address transition costs in the electricity industry

Energy Technology Data Exchange (ETDEWEB)

Baxter, L.; Hadley, S.; Hirst, E.

1996-07-01

Transition costs are the potential monetary losses that electric- utility shareholders, ratepayers, or other parties might experience because of structural changes in the electricity industry. Regulators, policy analysts, utilities, and consumer groups have proposed a number of strategies to address transition costs, such as immediately opening retail electricity markets or delaying retail competition. This report has 3 objectives: identify a wide range of strategies available to regulators and utilities; systematically examine effects of strategies; and identify potentially promising strategies that may provide benefits to more than one set of stakeholders. The many individual strategies are grouped into 6 major categories: market actions, depreciation options, rate-making actions, utility cost reductions, tax measures, and other options. Of the 34 individual strategies, retail ratepayers have primary or secondary responsibility for paying transition costs in 19 of the strategies, shareholders in 12, wheeling customers in 11, taxpayers in 8, and nonutility suppliers in 4. Most of the strategies shift costs among different segments of the economy, although utility cost reductions can be used to offset transition costs. Most of the strategies require cooperation of other parties, including regulators, to be implemented successfully; financial stakeholders must be engages in negotiations that hold the promise of shared benefits. Only by rejecting ``winner-take-all`` strategies will the transition-cost issue be expeditiously resolved.

Comprehension of Relations among Controversial Texts: Effects of External Strategy Use

Science.gov (United States)

Kobayashi, Keiichi

2009-01-01

This study examined the effects of external strategy use on the comprehension of relations among controversial texts. About 80 undergraduates read six controversial texts for the purpose of either finding intertextual relations or forming their opinion about the controversial issue. Half of them were permitted to use external strategies, the other…

Identifying patients at risk of intraoperative and postoperative transfusion in isolated CABG: toward selective conservation strategies.

Science.gov (United States)

Arora, Rakesh C; Légaré, Jean-Francois; Buth, Karen J; Sullivan, John A; Hirsch, Gregory M

2004-11-01

Allogeneic blood product use during cardiac operation is often reported to exceed 40% despite published guidelines and costly blood conservation strategies. We developed a predictive model, based on eight preoperative risk factors, of allogeneic blood product transfusion rates in patients undergoing a cardiac procedure. All 3,046 consecutive, isolated coronary artery bypass graft (CABG) procedures at a university hospital from 1995 to 1998 were included. A logistic regression model was created to identify independent predictors of allogeneic blood product transfusion. This model was validated using a prospective patient sample. Overall use of allogeneic blood products was 23% with a crude operative mortality of 2.1%. In isolated, elective, first-time CABG cases, 16.9% received allogeneic blood products. Independent predictors of blood product usage in CABG patients were preoperative hemoglobin 12.0 or less, emergent operation, renal failure, female sex, age 70 years or older, left ventricular ejection fraction 0.40 or less, redo procedure, and low body surface area. Prospective validation of this model on 2,117 consecutive isolated CABG patients demonstrated an observed-to-expected allogeneic blood product transfusion rate ratio of 1.06. This internally validated logistic regression risk model is a sensitive and specific predictor of allogeneic blood product use in patients undergoing isolated CABG. Utilization of this model allows for preoperative risk stratification and may allow for more rational resource allocation of costly blood conservation strategies and blood bank resources.

Assessment of the effectiveness of flood adaptation strategies for HCMC

Science.gov (United States)

Lasage, R.; Veldkamp, T. I. E.; de Moel, H.; Van, T. C.; Phi, H. L.; Vellinga, P.; Aerts, J. C. J. H.

2014-06-01

Coastal cities are vulnerable to flooding, and flood risk to coastal cities will increase due to sea-level rise. Moreover, Asian cities in particular are subject to considerable population growth and associated urban developments, increasing this risk even more. Empirical data on vulnerability and the cost and benefits of flood risk reduction measures are therefore paramount for sustainable development of these cities. This paper presents an approach to explore the impacts of sea-level rise and socio-economic developments on flood risk for the flood-prone District 4 in Ho Chi Minh City, Vietnam, and to develop and evaluate the effects of different adaptation strategies (new levees, dry- and wet proofing of buildings and elevating roads and buildings). A flood damage model was developed to simulate current and future flood risk using the results from a household survey to establish stage-damage curves for residential buildings. The model has been used to assess the effects of several participatory developed adaptation strategies to reduce flood risk, expressed in expected annual damage (EAD). Adaptation strategies were evaluated assuming combinations of both sea-level scenarios and land-use scenarios. Together with information on costs of these strategies, we calculated the benefit-cost ratio and net present value for the adaptation strategies until 2100, taking into account depreciation rates of 2.5% and 5%. The results of this modelling study indicate that the current flood risk in District 4 is USD 0.31 million per year, increasing up to USD 0.78 million per year in 2100. The net present value and benefit-cost ratios using a discount rate of 5 % range from USD -107 to -1.5 million, and from 0.086 to 0.796 for the different strategies. Using a discount rate of 2.5% leads to an increase in both net present value and benefit-cost ratio. The adaptation strategies wet-proofing and dry-proofing generate the best results using these economic indicators. The information

Effectiveness of counteraggression strategies in reducing interactive aggression by males.

Science.gov (United States)

Kimble, C E; Fitz, D; Onorad, J R

1977-04-01

Studies on techniques of reducing aggression have typically examined passive, matching, and punitive strategies of counteraggression and have been remarkably inconsistent in their findings. This research was designed to resolve the contradictory results by reconceptuallzing the strategies in terms of counteraggression/aggression (cA/A) ratios. We predicted that the norm of reciprocity and the tendency to exploit weakness would make a cA/A ratio of less than but close to 1.0 (matching) most effective in reducing aggression. Ten cA/A ratios were used. One hundred male subjects set punishment level set by their opponent (a confederate) on 25 trials, and, on 13 losing trials, received punishment. The most effective cA/A ratios for reducing aggression were the lowest ones. Lower cA/A ratios reduced aggression and ratios greater than 1.0 increased aggresion. Contrary to the results of previous studies, the matching strategy was ineffective in reducing aggresion.

Identifying the effects of parameter uncertainty on the reliability of riverbank stability modelling

Science.gov (United States)

Samadi, A.; Amiri-Tokaldany, E.; Darby, S. E.

2009-05-01

Bank retreat is a key process in fluvial dynamics affecting a wide range of physical, ecological and socioeconomic issues in the fluvial environment. To predict the undesirable effects of bank retreat and to inform effective measures to prevent it, a wide range of bank stability models have been presented in the literature. These models typically express bank stability by defining a factor of safety as the ratio of driving and resisting forces acting on the incipient failure block. These forces are affected by a range of controlling factors that include such aspects as the bank profile (bank height and angle), the geotechnical properties of the bank materials, as well as the hydrological status of the riverbanks. In this paper we evaluate the extent to which uncertainties in the parameterization of these controlling factors feed through to influence the reliability of the resulting bank stability estimate. This is achieved by employing a simple model of riverbank stability with respect to planar failure (which is the most common type of bank stability model) in a series of sensitivity tests and Monte Carlo analyses to identify, for each model parameter, the range of values that induce significant changes in the simulated factor of safety. These identified parameter value ranges are compared to empirically derived parameter uncertainties to determine whether they are likely to confound the reliability of the resulting bank stability calculations. Our results show that parameter uncertainties are typically high enough that the likelihood of generating unreliable predictions is typically very high (> ˜ 80% for predictions requiring a precision of < ± 15%). Because parameter uncertainties are derived primarily from the natural variability of the parameters, rather than measurement errors, much more careful attention should be paid to field sampling strategies, such that the parameter uncertainties and consequent prediction unreliabilities can be quantified more

CREATIVE MARKETING STRATEGY AND EFFECTIVE EXECUTION ON PERFORMANCE IN PAKISTAN

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Muhammad Ishtiaq Ishaq

2016-11-01

Full Text Available The purpose of the current research is to determine the influence of creative marketing strategies and effective execution on business unit performance. Moreover, strategic orientation and environmental uncertainty are used as moderating variables. Data are collected from 368 key informants working in Fast-Moving Consumer Goods (FMCG, banking, pharmaceutical, chemical, insurance, and engineering industries using a multi-stage random sampling technique. Factor analysis and multiple hierarchal regressions are used to test the study hypotheses. The results indicate that creative marketing strategy and effective execution are positively associated with business performance. Moreover, environmental uncertainty and strategic orientation play a moderating role in the above relationships.

Community-identified strategies to increase physical activity during elementary school recess on an American Indian reservation: A pilot study

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Vernon Grant

2015-01-01

Simple and low-cost strategies were effective at increasing recess physical activity in females. The findings also suggest that providing children games that are led by a facilitator is not necessary to increase physical activity as long as proper equipment is provided.

Effective Teaching Strategies for Predicting Reading Growth in English Language Learners

Science.gov (United States)

Melgarejo, Melina

2017-01-01

The goal of the present study was to examine how effective use of teaching strategies predict reading growth among a sample of English Language Learners. The study specifically examined whether the types of teaching strategies that predict growth in decoding skills also predict growth in comprehension skills. The sample consisted of students in…

Factors Affecting Competitive Strategies in International Construction Companies

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Tuğçe ERCAN

2013-02-01

Full Text Available Due to rising competition in the international construction market, competitive strategies are becoming ever more important. This study aims to identify the level of importance of a variety of competitive strategies in construction companies to create a theoretical framework for competitive strategies in international construction business. In the questionnaire titled: ‘Identifying the Parameters of Strategic Performance Comparison Tool in International Construction Companies’, professionals were asked the level of importance of parameters in acquiring a competitive edge in international markets for construction companies. 82 people who currently work for international construction companies responded the questionnaire. The Relative Importance Index (RII of competitive strategies in construction companies was calculated using the survey results. The construct was redesigned through the Pearson Correlation and principal components analysis (PCA. The results of the PCA denoted that the construct of competitive strategies in construction companies can be explained by three main factors in sync with Porter’s three generic competitive strategy types: F1 Cost Leadership in Construction, F2 Specialization and Focus and F3 Differentiation in Construction and Company Resources. The analysis results show that the competitive strategies related to “Differentiation in Construction and Company Resources” have a greater importance level, while the diversification strategies have a lower importance level. Which means specialization in some type of construction activity and focus on a specific group of customers is more effective than diversification strategies in gaining a competitive advantage in the market.

Cost-Effective Strategies for Rural Community Outreach, Hawaii, 2010–2011

Science.gov (United States)

Barbato, Anna; Holuby, R. Scott; Ciarleglio, Anita E.; Taniguchi, Ronald

2014-01-01

Three strategies designed to maximize attendance at educational sessions on chronic disease medication safety in older adults in rural areas were implemented sequentially and compared for cost-effectiveness: 1) existing community groups and events, 2) formal advertisement, and 3) employer-based outreach. Cost-effectiveness was measured by comparing overall cost per attendee recruited and number of attendees per event. The overall cost per attendee was substantially higher for the formal advertising strategy, which produced the lowest number of attendees per event. Leveraging existing community events and employers in rural areas was more cost-effective than formal advertisement for recruiting rural community members. PMID:25496555

STRATEGIES TO REDUCE EXPOSURE TO TRAFFIC-RELATED AIR POLLUTION AT THE LOCAL LEVEL

Science.gov (United States)

As public health concerns for populations living, working and going to school near high-traffic roadways have increased, so have the need to identify and implement air pollution control strategies effective at the local level. While strategies implemented at the federal and stat...

Effects of Strategies Marketing of Collective Buying about Impulsive Behavior

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Suzi Elen Ferreira Dias

2014-08-01

Full Text Available Brazil has the second largest e-commerce market in the world. One model used in this sector is "collective buying", a feature of which is impulse sales. Consumer behavior can be influenced by several factors, two of which are addressed in this article: the individual impulsivity of consumers and strategies of mix marketing. Impulsive buying is characterized by an unplanned purchase, i.e. the need to acquire the product arises just before the purchase. Consumers respond differently to mixed strategies depending on their degree of impulsivity. Thus, this article aims to analyze the efficacy of different marketing mix strategies for impulsive and non-impulsive consumer purchasing behavior. 137 participants were given a questionnaire containing the Buying Impulsiveness scale from Rook and Fisher (1995, and statements about the marketing strategies used by collective buying sites. Through a regression analysis, three strategies were found to relate more to impulsivity: search for products from well-known brands, search for deals with big discounts and confidence in receiving the product. For e-commerce and researchers, this study elucidates which strategies, from the consumer's perspective, effectively persuade purchasing behavior.

Cost-effectiveness of using a gene expression profiling test to aid in identifying the primary tumour in patients with cancer of unknown primary.

Science.gov (United States)

Hannouf, M B; Winquist, E; Mahmud, S M; Brackstone, M; Sarma, S; Rodrigues, G; Rogan, P; Hoch, J S; Zaric, G S

2017-06-01

We aimed to investigate the cost-effectiveness of a 2000-gene-expression profiling (GEP) test to help identify the primary tumor site when clinicopathological diagnostic evaluation was inconclusive in patients with cancer of unknown primary (CUP). We built a decision-analytic-model to project the lifetime clinical and economic consequences of different clinical management strategies for CUP. The model was parameterized using follow-up data from the Manitoba Cancer Registry, cost data from Manitoba Health administrative databases and secondary sources. The 2000-GEP-based strategy compared to current clinical practice resulted in an incremental cost-effectiveness ratio (ICER) of $44,151 per quality-adjusted life years (QALY) gained. The total annual-budget impact was $36.2 million per year. A value-of-information analysis revealed that the expected value of perfect information about the test's clinical impact was $4.2 million per year. The 2000-GEP test should be considered for adoption in CUP. Field evaluations of the test are associated with a large societal benefit.

Modelling heavy metals build-up on urban road surfaces for effective stormwater reuse strategy implementation

International Nuclear Information System (INIS)

Hong, Nian; Zhu, Panfeng; Liu, An

2017-01-01

Urban road stormwater is an alternative water resource to mitigate water shortage issues in the worldwide. Heavy metals deposited (build-up) on urban road surface can enter road stormwater runoff, undermining stormwater reuse safety. As heavy metal build-up loads perform high variabilities in terms of spatial distribution and is strongly influenced by surrounding land uses, it is essential to develop an approach to identify hot-spots where stormwater runoff could include high heavy metal concentrations and hence cannot be reused if it is not properly treated. This study developed a robust modelling approach to estimating heavy metal build-up loads on urban roads using land use fractions (representing percentages of land uses within a given area) by an artificial neural network (ANN) model technique. Based on the modelling results, a series of heavy metal load spatial distribution maps and a comprehensive ecological risk map were generated. These maps provided a visualization platform to identify priority areas where the stormwater can be safely reused. Additionally, these maps can be utilized as an urban land use planning tool in the context of effective stormwater reuse strategy implementation. - Highlights: • A model was developed to simulate heavy metal build-up loads on urban roads. • This model is based on artificial neural networks. • Land use fractions was used to model build-up loads on different particle sizes. • The maps of heavy metal spatial distribution and ecological risk were generated. • This model can be used for effective stormwater reuse strategy implementation. - Development of a robust modelling approach to mapping heavy metals build-up and their ecological risks for stormwater reuse safety.

Strategies to address management challenges in larger intensive care units.

Science.gov (United States)

Matlakala, M C; Bezuidenhout, M C; Botha, A D H

2015-10-01

To illustrate the need for and suggest strategies that will enhance sustainable management of a large intensive care unit (ICU). The challenges faced by intensive care nursing in South Africa are well documented. However, there appear to be no strategies available to assist nurses to manage large ICUs or for ICU managers to deal with problems as they arise. Data sources to illustrate the need for strategies were challenges described by ICU managers in the management of large ICUs. A purposive sample of managers was included in individual interviews during compilation of evidence regarding the challenges experienced in the management of large ICUs. The challenges were presented at the Critical Care Society of Southern Africa Congress held on 28 August to 2 September 2012 in Sun City North-West province, South Africa. Five strategies are suggested for the challenges identified: divide the units into sections; develop a highly skilled and effective nursing workforce to ensure delivery of quality nursing care; create a culture to retain an effective ICU nursing team; manage assets; and determine the needs of ICU nurses. ICUs need measures to drive the desired strategies into actions to continuously improve the management of the unit. Future research should be aimed at investigating the effectiveness of the strategies identified. This research highlights issues relating to large ICUs and the strategies will assist ICU managers to deal with problems related to large unit sizes, shortage of trained ICU nurses, use of agency nurses, shortage of equipment and supplies and stressors in the ICU. The article will make a contribution to the body of nursing literature on management of ICUs. © 2014 John Wiley & Sons Ltd.

A cost-effectiveness analysis of the diagnostic strategies for differentiating focal nodular hyperplasia from hepatocellular adenoma

Energy Technology Data Exchange (ETDEWEB)

Suh, Chong Hyun [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Liver Center, Asan Medical Center, Seoul (Korea, Republic of); Namwon Medical Center, Department of Radiology, Namwon-si (Korea, Republic of); Kim, Kyung Won [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Liver Center, Asan Medical Center, Seoul (Korea, Republic of); Harvard Medical School, Department of Imaging, Dana-Farber Cancer Institute, Brigham and Women' s Hospital, Boston, MA (United States); Park, Seong Ho [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Liver Center, Asan Medical Center, Seoul (Korea, Republic of); Shin, Sangjin; Ahn, Jeonghoon [National Evidence-based Healthcare Collaborating Agency, Division of Healthcare Technology Assessment Research, Department of Economic Evaluation, Seoul (Korea, Republic of); Pyo, Junhee [Utrecht University, Collaborating Center for Pharmaceutical Policy and Regulation, Department of Pharmaceutical Science, Utrecht (Netherlands); Shinagare, Atul B.; Krajewski, Katherine M.; Ramaiya, Nikhil H. [Harvard Medical School, Department of Imaging, Dana-Farber Cancer Institute, Brigham and Women' s Hospital, Boston, MA (United States)

2018-01-15

We evaluated the cost-effectiveness of a gadoxetic acid-enhanced MRI (EOB-MRI) strategy compared with conventional MRI strategy and biopsy to differentiate focal nodular hyperplasia (FNH) from hepatocellular adenoma (HCA). A decision tree model was constructed to compare the cost-effectiveness of EOB-MRI, conventional MRI with extracellular contrast agents, and biopsy as the initial diagnostic modality in patients with incidentally detected focal liver lesions suspected of being FNH or HCA. We analysed the cost and effectiveness, i.e. probability of successful diagnosis of each strategy. Costs were based on utilisation rates and Medicare reimbursements in the USA and South Korea. In the base case analysis of our decision tree model, the effectiveness of the three strategies was similar. The cost of the EOB-MRI strategy ($1283 in USA, $813 in South Korea) was lowest compared with the biopsy strategy ($1725 in USA, $847 in South Korea) and the conventional MRI strategy ($1750 in USA, $962 in South Korea). One-way, two-way and probabilistic sensitivity analysis showed unchanged results over an acceptable range. EOB-MRI strategy is the most cost-effective strategy for differentiating FNH from HCA in patients with incidentally detected focal liver lesions in a non-cirrhotic liver. (orig.)

A cost-effectiveness analysis of the diagnostic strategies for differentiating focal nodular hyperplasia from hepatocellular adenoma

International Nuclear Information System (INIS)

Suh, Chong Hyun; Kim, Kyung Won; Park, Seong Ho; Shin, Sangjin; Ahn, Jeonghoon; Pyo, Junhee; Shinagare, Atul B.; Krajewski, Katherine M.; Ramaiya, Nikhil H.

2018-01-01

We evaluated the cost-effectiveness of a gadoxetic acid-enhanced MRI (EOB-MRI) strategy compared with conventional MRI strategy and biopsy to differentiate focal nodular hyperplasia (FNH) from hepatocellular adenoma (HCA). A decision tree model was constructed to compare the cost-effectiveness of EOB-MRI, conventional MRI with extracellular contrast agents, and biopsy as the initial diagnostic modality in patients with incidentally detected focal liver lesions suspected of being FNH or HCA. We analysed the cost and effectiveness, i.e. probability of successful diagnosis of each strategy. Costs were based on utilisation rates and Medicare reimbursements in the USA and South Korea. In the base case analysis of our decision tree model, the effectiveness of the three strategies was similar. The cost of the EOB-MRI strategy ($1283 in USA, $813 in South Korea) was lowest compared with the biopsy strategy ($1725 in USA, $847 in South Korea) and the conventional MRI strategy ($1750 in USA, $962 in South Korea). One-way, two-way and probabilistic sensitivity analysis showed unchanged results over an acceptable range. EOB-MRI strategy is the most cost-effective strategy for differentiating FNH from HCA in patients with incidentally detected focal liver lesions in a non-cirrhotic liver. (orig.)

Effective strategies for scaling up evidence-based practices in primary care: a systematic review.

Science.gov (United States)

Ben Charif, Ali; Zomahoun, Hervé Tchala Vignon; LeBlanc, Annie; Langlois, Léa; Wolfenden, Luke; Yoong, Sze Lin; Williams, Christopher M; Lépine, Roxanne; Légaré, France

2017-11-22

While an extensive array of existing evidence-based practices (EBPs) have the potential to improve patient outcomes, little is known about how to implement EBPs on a larger scale. Therefore, we sought to identify effective strategies for scaling up EBPs in primary care. We conducted a systematic review with the following inclusion criteria: (i) study design: randomized and non-randomized controlled trials, before-and-after (with/without control), and interrupted time series; (ii) participants: primary care-related units (e.g., clinical sites, patients); (iii) intervention: any strategy used to scale up an EBP; (iv) comparator: no restrictions; and (v) outcomes: no restrictions. We searched MEDLINE, Embase, PsycINFO, Web of Science, CINAHL, and the Cochrane Library from database inception to August 2016 and consulted clinical trial registries and gray literature. Two reviewers independently selected eligible studies, then extracted and analyzed data following the Cochrane methodology. We extracted components of scaling-up strategies and classified them into five categories: infrastructure, policy/regulation, financial, human resources-related, and patient involvement. We extracted scaling-up process outcomes, such as coverage, and provider/patient outcomes. We validated data extraction with study authors. We included 14 studies. They were published since 2003 and primarily conducted in low-/middle-income countries (n = 11). Most were funded by governmental organizations (n = 8). The clinical area most represented was infectious diseases (HIV, tuberculosis, and malaria, n = 8), followed by newborn/child care (n = 4), depression (n = 1), and preventing seniors' falls (n = 1). Study designs were mostly before-and-after (without control, n = 8). The most frequently targeted unit of scaling up was the clinical site (n = 11). The component of a scaling-up strategy most frequently mentioned was human resource-related (n = 12). All

Effective strategies for scaling up evidence-based practices in primary care: a systematic review

Directory of Open Access Journals (Sweden)

Ali Ben Charif

2017-11-01

Full Text Available Abstract Background While an extensive array of existing evidence-based practices (EBPs have the potential to improve patient outcomes, little is known about how to implement EBPs on a larger scale. Therefore, we sought to identify effective strategies for scaling up EBPs in primary care. Methods We conducted a systematic review with the following inclusion criteria: (i study design: randomized and non-randomized controlled trials, before-and-after (with/without control, and interrupted time series; (ii participants: primary care-related units (e.g., clinical sites, patients; (iii intervention: any strategy used to scale up an EBP; (iv comparator: no restrictions; and (v outcomes: no restrictions. We searched MEDLINE, Embase, PsycINFO, Web of Science, CINAHL, and the Cochrane Library from database inception to August 2016 and consulted clinical trial registries and gray literature. Two reviewers independently selected eligible studies, then extracted and analyzed data following the Cochrane methodology. We extracted components of scaling-up strategies and classified them into five categories: infrastructure, policy/regulation, financial, human resources-related, and patient involvement. We extracted scaling-up process outcomes, such as coverage, and provider/patient outcomes. We validated data extraction with study authors. Results We included 14 studies. They were published since 2003 and primarily conducted in low-/middle-income countries (n = 11. Most were funded by governmental organizations (n = 8. The clinical area most represented was infectious diseases (HIV, tuberculosis, and malaria, n = 8, followed by newborn/child care (n = 4, depression (n = 1, and preventing seniors’ falls (n = 1. Study designs were mostly before-and-after (without control, n = 8. The most frequently targeted unit of scaling up was the clinical site (n = 11. The component of a scaling-up strategy most frequently mentioned was

Effects of selected coping strategies on impediment oriented ...

African Journals Online (AJOL)

The study was carried out to determine the effects of selected coping strategies on the impediment oriented academic stress of the visually impaired pupils in Oji- River School for the Blind, Enugu State. The study is a quasi-Experimental design involving two treatment groups and one control group. Twenty visually impaired ...

The Effect of Presentation Strategy on Reading Comprehension of Iranian Intermediate EFL Learners

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Hooshang Khoshsima

2014-06-01

Full Text Available The present experimental study primarily aimed at examining the effect of presentation strategy on reading comprehension of Iranian intermediate EFL learners. To determine the effect of this strategy, 61 students who enrolled in English Language Center of Chabahar Maritime University were initially selected and then divided randomly into two classes one as an experimental group and the other one as the control group. The homogeneity of their proficiency level was established via the administration of a TOEFL (the PBT proficiency test. A reading comprehension test as pre-test administered to the subjects of both groups one week before the initiation of the study. The experimental group used the strategy three sessions each week for ten weeks, while the control group was trained based on the ordinary approaches of teaching reading comprehension. Presentation strategy was worked for every two weeks during the experiment and then at the end of each two-week instruction, an immediate posttest was administered according to the strategy worked. At the end of the study, a post-test was administered to both groups. The statistical techniques being applied were Paired Sample t-test and Independent Sample t-test. The results of the study revealed that presentation strategy had significant effect on promoting reading comprehension of intermediate EFL learners.

Different Imaging Strategies in Patients With Possible Basilar Artery Occlusion: Cost-Effectiveness Analysis.

Science.gov (United States)

Beyer, Sebastian E; Hunink, Myriam G; Schöberl, Florian; von Baumgarten, Louisa; Petersen, Steffen E; Dichgans, Martin; Janssen, Hendrik; Ertl-Wagner, Birgit; Reiser, Maximilian F; Sommer, Wieland H

2015-07-01

This study evaluated the cost-effectiveness of different noninvasive imaging strategies in patients with possible basilar artery occlusion. A Markov decision analytic model was used to evaluate long-term outcomes resulting from strategies using computed tomographic angiography (CTA), magnetic resonance imaging, nonenhanced CT, or duplex ultrasound with intravenous (IV) thrombolysis being administered after positive findings. The analysis was performed from the societal perspective based on US recommendations. Input parameters were derived from the literature. Costs were obtained from United States costing sources and published literature. Outcomes were lifetime costs, quality-adjusted life-years (QALYs), incremental cost-effectiveness ratios, and net monetary benefits, with a willingness-to-pay threshold of $80,000 per QALY. The strategy with the highest net monetary benefit was considered the most cost-effective. Extensive deterministic and probabilistic sensitivity analyses were performed to explore the effect of varying parameter values. In the reference case analysis, CTA dominated all other imaging strategies. CTA yielded 0.02 QALYs more than magnetic resonance imaging and 0.04 QALYs more than duplex ultrasound followed by CTA. At a willingness-to-pay threshold of $80,000 per QALY, CTA yielded the highest net monetary benefits. The probability that CTA is cost-effective was 96% at a willingness-to-pay threshold of $80,000/QALY. Sensitivity analyses showed that duplex ultrasound was cost-effective only for a prior probability of ≤0.02 and that these results were only minimally influenced by duplex ultrasound sensitivity and specificity. Nonenhanced CT and magnetic resonance imaging never became the most cost-effective strategy. Our results suggest that CTA in patients with possible basilar artery occlusion is cost-effective. © 2015 The Authors.

Proactive sustainability strategy and corporate sustainability performance: The mediating effect of sustainability control systems.

Science.gov (United States)

Wijethilake, Chaminda

2017-07-01

This study examines to what extent corporations use sustainability control systems (SCS) to translate proactive sustainability strategy into corporate sustainability performance. The study investigates the mediating effect of SCS on the relationship between proactive sustainability strategy and corporate sustainability performance. Survey data were collected from top managers in 175 multinational and local corporations operating in Sri Lanka and analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM). SCS were observed to only partially mediate the relationship between proactive sustainability strategy and corporate sustainability performance. The mediating effect of SCS is further examined under three sustainability strategies; environmental and social strategies reveal a partial mediation, while the economic strategy exhibits no mediation. The study also finds that (i) a proactive sustainability strategy is positively associated with SCS and corporate sustainability performance and (ii) SCS are positively associated with corporate sustainability performance. Copyright © 2017 Elsevier Ltd. All rights reserved.

Revealing the Effectivenesses of Communication Strategies

Science.gov (United States)

Lin, Grace Hui Chin

2013-01-01

The purpose of this study is to report the history of communication strategy and highlight the importance of strategic competence. It provides the histories and characterizations of communication strategy. Besides, it presents from which perspectives these definitions of communication strategies were developed. Various earlier and latter…

Clinical handover as an interactive event: informational and interactional communication strategies in effective shift-change handovers.

Science.gov (United States)

Eggins, Suzanne; Slade, Diana

2012-01-01

Clinical handover -- the transfer between clinicians of responsibility and accountability for patients and their care (AMA 2006) -- is a pivotal and high-risk communicative event in hospital practice. Studies focusing on critical incidents, mortality, risk and patient harm in hospitals have highlighted ineffective communication -- including incomplete and unstructured clinical handovers -- as a major contributing factor (NSW Health 2005; ACSQHC 2010). In Australia, as internationally, Health Departments and hospital management have responded by introducing standardised handover communication protocols. This paper problematises one such protocol - the ISBAR tool - and argues that the narrow understanding of communication on which such protocols are based may seriously constrain their ability to shape effective handovers. Based on analysis of audio-recorded shift-change clinical handovers between medical staff we argue that handover communication must be conceptualised as inherently interactive and that attempts to describe, model and teach handover practice must recognise both informational and interactive communication strategies. By comparing the communicative performance of participants in authentic handover events we identify communication strategies that are more and less likely to lead to an effective handover and demonstrate the importance of focusing close up on communication to improve the quality and safety of healthcare interactions.

Evaluation of an effective multifaceted implementation strategy for elective single-embryo transfer after in vitro fertilization.

Science.gov (United States)

Kreuwel, I A M; van Peperstraten, A M; Hulscher, M E J L; Kremer, J A M; Grol, R P T M; Nelen, W L D M; Hermens, R P M G

2013-02-01

What is the relationship between the rate of elective single-embryo transfer (eSET) and couples' exposure to different elements of a multifaceted implementation strategy? Additional elements in a multifaceted implementation strategy do not result in an increased eSET rate. A multifaceted eSET implementation strategy with four different elements is effective in increasing the eSET rate by 11%. It is unclear whether every strategy element contributes equally to the strategy's effectiveness. An observational study was performed among 222 subfertile couples included in a previously performed randomized controlled trial. Of the 222 subfertile couples included, 109 couples received the implementation strategy and 113 couples received standard IVF care. A multivariate regression analysis assessed the effectiveness of four different strategy elements on the decision about the number embryos to be transferred. Questionnaires evaluated the experiences of couples with the different elements. Of the couples who received the implementation strategy, almost 50% (52/109) were exposed to all the four elements of the strategy. The remaining 57 couples who received two or three elements of the strategy could be divided into two further classes of exposure. Our analysis demonstrated that additional elements do not result in an increased eSET rate. In addition to the physician's advice, couples rated a decision aid and a counselling session as more important for their decision to transfer one or two embryos, compared with a phone call and a reimbursement offer (P implementation strategy does not always result in an increased effectiveness, which is in concordance with recent literature. This in-depth evaluation of a multifaceted intervention strategy could therefore help to modify strategies, by making them more effective and less expensive.

Target and identify: triazene linker helps identify azidation sites of labelled proteins via click and cleave strategy.

Science.gov (United States)

Lohse, Jonas; Schindl, Alexandra; Danda, Natasha; Williams, Chris P; Kramer, Karl; Kuster, Bernhard; Witte, Martin D; Médard, Guillaume

2017-10-31

A method for identifying probe modification of proteins via tandem mass spectrometry was developed. Azide bearing molecules are immobilized on functionalised sepharose beads via copper catalysed Huisgen-type click chemistry and selectively released under acidic conditions by chemical cleavage of the triazene linkage. We applied this method to identify the modification site of targeted-diazotransfer on BirA.

  A Cost-Effectiveness Analysis of Two Management Strategies for Dyspepsia

DEFF Research Database (Denmark)

Kjeldsen, Hans Chr; Bech, Mickael; Christensen, Bo

2007-01-01

Objectives: To compare the cost-effectiveness of endoscopy and empirical proton pump inhibition (PPI) therapy for management of dyspepsia in primary care. Methods: A randomized controlled trial (RCT) including prospective collection of economic resource data was conducted in general practice from...... of dyspeptic symptoms and proportion of patients with dyspepsia after one year based on patients' and general practitioners' (GPs') assessment. Costs were estimated from patient and GP questionnaires and from medical records. Results: The incremental cost-effectiveness (CE) ratio for one day free of dyspeptic...... symptoms using the endoscopy strategy was €/day 154 compared with the PPI strategy. The incremental CE ratio for one person free of dyspeptic symptoms after one year using the endoscopy strategy was € 13,905 based on the patients' evaluation and the incremental CE ratio for one person free of predominant...

Effect of Appropriate Marketing Mix Strategies on Iranian Protein Products Export Performance

OpenAIRE

Hossein Rezaie Dolatabadi; Mohammad Hossein Forghani; Seyed Mehdi Tabatabaee; Fatemeh Faghani

2013-01-01

The purpose of the present paper is to examine effect of effect of appropriate marketing mix strategies on Iranian protein products export performance. 4P (Price, Product, Place, Promotion) were selected as marketing strategies. The data used to test the hypotheses were collected through an online standard questionnaire. The respondents were asked to rate on the scale between strongly agree and strongly Disagree. Reliability of questionnaire was measured using Cronbach Coefficient Alpha. The ...

Exome-wide rare variant analysis identifies TUBA4A mutations associated with familial ALS

NARCIS (Netherlands)

Smith, Bradley N.; Ticozzi, Nicola; Fallini, Claudia; Gkazi, Athina Soragia; Topp, Simon; Kenna, Kevin P.; Scotter, Emma L.; Kost, Jason; Keagle, Pamela; Miller, Jack W.; Calini, Daniela; Vance, Caroline; Danielson, Eric W.; Troakes, Claire; Tiloca, Cinzia; Al-Sarraj, Safa; Lewis, Elizabeth A.; King, Andrew; Colombrita, Claudia; Pensato, Viviana; Castellotti, Barbara; de Belleroche, Jacqueline; Baas, Frank; ten Asbroek, Anneloor L. M. A.; Sapp, Peter C.; McKenna-Yasek, Diane; McLaughlin, Russell L.; Polak, Meraida; Asress, Seneshaw; Esteban-Pérez, Jesús; Muñoz-Blanco, José Luis; Simpson, Michael; van Rheenen, Wouter; Diekstra, Frank P.; Lauria, Giuseppe; Duga, Stefano; Corti, Stefania; Cereda, Cristina; Corrado, Lucia; Sorarù, Gianni; Morrison, Karen E.; Williams, Kelly L.; Nicholson, Garth A.; Blair, Ian P.; Dion, Patrick A.; Leblond, Claire S.; Rouleau, Guy A.; Hardiman, Orla; Veldink, Jan H.; van den Berg, Leonard H.

2014-01-01

Exome sequencing is an effective strategy for identifying human disease genes. However, this methodology is difficult in late-onset diseases where limited availability of DNA from informative family members prohibits comprehensive segregation analysis. To overcome this limitation, we performed an

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

Vertical integration strategies: revenue effects in hospital and Medicare markets.

Science.gov (United States)

Cody, M

1996-01-01

The purpose of this study was to evaluate the revenue effects of seven vertically integrated strategies on California hospitals. The strategies investigated were managed care contracts, physician affiliations, ambulatory care, ambulatory surgery, home health services, inpatient rehabilitation, and skilled nursing care. The study population included 242 not-for-profit hospitals in continuous operation from 1983 to 1990. Many hospitals developed vertically integrated programs in the 1980s as inpatient utilization fell in response to the Medicare Prospective Payment program. Net revenue rose on average by $2,080 from 1983 to 1990, but fell by $2,421 from the Medicare program. On the whole, the more physicians affiliated with a hospital, the higher the net revenue. However, in the Medicare population, the number of managed care contracts was significant. The pre-hospital strategies generated significant revenue, while the post-hospital strategies did not. In the Medicare program, inpatient rehabilitation significantly reduced revenue.

Cost-effectiveness of competing strategies for management of recurrent Clostridium difficile infection: a decision analysis.

Science.gov (United States)

Konijeti, Gauree G; Sauk, Jenny; Shrime, Mark G; Gupta, Meera; Ananthakrishnan, Ashwin N

2014-06-01

Clostridium difficile infection (CDI) is an important cause of morbidity and healthcare costs, and is characterized by high rates of disease recurrence. The cost-effectiveness of newer treatments for recurrent CDI has not been examined, yet would be important to inform clinical practice. The aim of this study was to analyze the cost effectiveness of competing strategies for recurrent CDI. We constructed a decision-analytic model comparing 4 treatment strategies for first-line treatment of recurrent CDI in a population with a median age of 65 years: metronidazole, vancomycin, fidaxomicin, and fecal microbiota transplant (FMT). We modeled up to 2 additional recurrences following the initial recurrence. We assumed FMT delivery via colonoscopy as our base case, but conducted sensitivity analyses based on different modes of delivery. Willingness-to-pay threshold was set at $50 000 per quality-adjusted life-year. At our base case estimates, initial treatment of recurrent CDI using FMT colonoscopy was the most cost-effective strategy, with an incremental cost-effectiveness ratio of $17 016 relative to oral vancomycin. Fidaxomicin and metronidazole were both dominated by FMT colonoscopy. On sensitivity analysis, FMT colonoscopy remained the most cost-effective strategy at cure rates >88.4% and CDI recurrence rates cost cost-effectiveness threshold. In clinical settings where FMT is not available or applicable, the preferred strategy appears to be initial treatment with oral vancomycin. In this decision analysis examining treatment strategies for recurrent CDI, we demonstrate that FMT colonoscopy is the most cost-effective initial strategy for management of recurrent CDI.

Forest Strategy in Republic of Macedonia: Barriers to Effective Implementation

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Jana Baumgartner

2014-06-01

Full Text Available Background and Purpose: In recent years, implementation of forest strategies and programs has been acknowledged as an important phase of the forest policy process. Forest policies such as conflict management concepts between deferent interests of stakeholders, are a dynamic route that needs to be managed carefully to achieve its goals. Creation of the forest policy document entitled “Strategy for sustainable development of forestry in Republic of Macedonia” was introduced for the first time in 2005 as cooperation between the Government and United Nations Food and Agriculture Organization (FAO. Action Plan was brought in the same year including the strategy and validity until the end of the year 2009 now is out of date for undetermined reasons, due to lack of analysis of the level of implementation, monitoring and evaluation. Materials and Methods: Through exploratory qualitative method using a case study, this paper attempts to explore different stakeholders perception of the most common barriers for implementation of the Strategy for sustainable development of forests in Republic of Macedonia and ascertain if implementation variables are identified as barriers in the implementation stage. Results: The research showed that environmental and organisational barriers such as legal restrictions, political willingness, social change, control, leadership and clear responsibility are the most common barriers impeding forest strategy implementation in Macedonia. Conclusions: The paper concluded that the three year action plan was too ambitious, given the existing human and technical capacities in the forestry sector, recommending participation of all included stakeholders in the implementation as an important fact in overcoming the current barriers and moving forward the process.

Parental perspectives regarding primary-care weight-management strategies for school-age children.

Science.gov (United States)

Turer, Christy Boling; Mehta, Megha; Durante, Richard; Wazni, Fatima; Flores, Glenn

2016-04-01

To identify parental perspectives regarding weight-management strategies for school-age children, focus groups were conducted of parents of overweight and obese (body mass index ≥ 85th percentile) 6-12-year-old children recruited from primary-care clinics. Questions focused on the role of the primary-care provider, effective components of weight-management strategies and feasibility of specific dietary strategies. Focus groups were recorded, transcribed and analysed using margin coding and grounded theory. Six focus groups were held. The mean age (in years) for parents was 32, and for children, eight; 44% of participants were Latino, 33%, African-American and 23%, white. Parents' recommendations on the primary-care provider's role in weight management included monitoring weight, providing guidance regarding health risks and lifestyle changes, consistent follow-up and using discretion during weight discussions. Weight-management components identified as key included emphasising healthy lifestyles and enjoyment, small changes to routines and parental role modelling. Parents prefer guidance regarding healthy dietary practices rather than specific weight-loss diets, but identified principles that could enhance the acceptability of these diets. For dietary guidance to be feasible, parents recommended easy-to-follow instructions and emphasising servings over counting calories. Effective weight-management strategies identified by parents include primary-care provider engagement in weight management, simple instructions regarding healthy lifestyle changes, parental involvement and deemphasising specific weight-loss diets. These findings may prove useful in developing primary-care weight-management strategies for children that maximise parental acceptance. © 2014 John Wiley & Sons Ltd.

Consolidating Social Media Strategies

DEFF Research Database (Denmark)

Gyimóthy, Szilvia; Munar, Ana Maria; Larson, Mia

2014-01-01

This study revisits and integrates the insights of recent studies on emergent social media strategies deployed by destination and event management organisations. In a comparative analysis Munar (2012) identified four generic approaches pursued by national tourism boards in the Nordic region, while...... Gyimóthy & Larson (2014) portrayed three digital value co-creation strategies deployed by festival social media. Both frameworks provided novel analytical typologies which identified a series of categories (mimetic, analytic, immersion, advertising and insourcing, crowdsourcing and community consolidation......). This paper discusses the complementary nature of these conceptual proposals and advances an integrated conceptual framework of social media strategies. Based on the empirical findings of a case study that revisits evolving digital and social media strategies of European DMOs this paper maps the dynamics...

Target marketing strategies for occupational therapy entrepreneurs.

Science.gov (United States)

Kautzmann, L N; Kautzmann, F N; Navarro, F H

1989-01-01

Understanding marketing techniques is one of the skills needed by successful entre renews. Target marketing is an effective method for occupational therapy entrepreneurs to use in determining when and where to enter the marketplace. The two components of target marketing, market segmentation and the development of marketing mix strategies for each identified market segment, are described. The Profife of Attitudes Toward Health Care (PATH) method of psychographic market segmentation of health care consumers is presented. Occupational therapy marketing mix strategies for each PATH consumer group are delineated and compatible groupings of market segments are suggested.

Transfer effects of a cognitive strategy training for stroke patients with apraxia

NARCIS (Netherlands)

Geusgens, C. A. V.; van Heugten, C. M.; Cooijmans, J. P. J.; Jolles, J.; van den Heuvel, W. J. A.

2007-01-01

The objective of this study was to evaluate transfer effects of cognitive strategy training for stroke patients with apraxia. During 8 weeks, 29 apraxic patients received cognitive strategy training to teach them how to perform activities of daily living (ADL) as independently as possible. ADL

The hepatitis C cascade of care: identifying priorities to improve clinical outcomes.

Science.gov (United States)

Linas, Benjamin P; Barter, Devra M; Leff, Jared A; Assoumou, Sabrina A; Salomon, Joshua A; Weinstein, Milton C; Kim, Arthur Y; Schackman, Bruce R

2014-01-01

As highly effective hepatitis C virus (HCV) therapies emerge, data are needed to inform the development of interventions to improve HCV treatment rates. We used simulation modeling to estimate the impact of loss to follow-up on HCV treatment outcomes and to identify intervention strategies likely to provide good value for the resources invested in them. We used a Monte Carlo state-transition model to simulate a hypothetical cohort of chronically HCV-infected individuals recently screened positive for serum HCV antibody. We simulated four hypothetical intervention strategies (linkage to care; treatment initiation; integrated case management; peer navigator) to improve HCV treatment rates, varying efficacies and costs, and identified strategies that would most likely result in the best value for the resources required for implementation. Sustained virologic responses (SVRs), life expectancy, quality-adjusted life expectancy (QALE), costs from health system and program implementation perspectives, and incremental cost-effectiveness ratios (ICERs). We estimate that imperfect follow-up reduces the real-world effectiveness of HCV therapies by approximately 75%. In the base case, a modestly effective hypothetical peer navigator program maximized the number of SVRs and QALE, with an ICER compared to the next best intervention of $48,700/quality-adjusted life year. Hypothetical interventions that simultaneously addressed multiple points along the cascade provided better outcomes and more value for money than less costly interventions targeting single steps. The 5-year program cost of the hypothetical peer navigator intervention was $14.5 million per 10,000 newly diagnosed individuals. We estimate that imperfect follow-up during the HCV cascade of care greatly reduces the real-world effectiveness of HCV therapy. Our mathematical model shows that modestly effective interventions to improve follow-up would likely be cost-effective. Priority should be given to developing and

The hepatitis C cascade of care: identifying priorities to improve clinical outcomes.

Directory of Open Access Journals (Sweden)

Benjamin P Linas

Full Text Available As highly effective hepatitis C virus (HCV therapies emerge, data are needed to inform the development of interventions to improve HCV treatment rates. We used simulation modeling to estimate the impact of loss to follow-up on HCV treatment outcomes and to identify intervention strategies likely to provide good value for the resources invested in them.We used a Monte Carlo state-transition model to simulate a hypothetical cohort of chronically HCV-infected individuals recently screened positive for serum HCV antibody. We simulated four hypothetical intervention strategies (linkage to care; treatment initiation; integrated case management; peer navigator to improve HCV treatment rates, varying efficacies and costs, and identified strategies that would most likely result in the best value for the resources required for implementation.Sustained virologic responses (SVRs, life expectancy, quality-adjusted life expectancy (QALE, costs from health system and program implementation perspectives, and incremental cost-effectiveness ratios (ICERs.We estimate that imperfect follow-up reduces the real-world effectiveness of HCV therapies by approximately 75%. In the base case, a modestly effective hypothetical peer navigator program maximized the number of SVRs and QALE, with an ICER compared to the next best intervention of $48,700/quality-adjusted life year. Hypothetical interventions that simultaneously addressed multiple points along the cascade provided better outcomes and more value for money than less costly interventions targeting single steps. The 5-year program cost of the hypothetical peer navigator intervention was $14.5 million per 10,000 newly diagnosed individuals.We estimate that imperfect follow-up during the HCV cascade of care greatly reduces the real-world effectiveness of HCV therapy. Our mathematical model shows that modestly effective interventions to improve follow-up would likely be cost-effective. Priority should be given to

Analysis of IFE, EFE and QSPM matrix on business development strategy

Science.gov (United States)

Zulkarnain, A.; Wahyuningtias, D.; Putranto, T. S.

2018-03-01

IFE matrix, EFE matrix, and QSPM matrix are business strategy tools that can be used to identify the threat, opportunity, weakness, strength as internal, external business factors. The goal of Danti’s Deli Bakery is to provide pastry product and distribute to other food and beverage outlet all around Jakarta. Thus, Danti’s Deli Bakery requires development strategy in order to win the tight competition. Applied descriptive research and data collected from focus group discussion, questionnaire, interview, observation and literature review. The objectives of this paper are (1) to identify and evaluate internal and external factors, (2) to formulate alternative strategy toward business development program, and (3) to give effective recommendation. The result shows that Danti’s Deli Bakery should apply product differentiation strategy. Implementation of this study is providing the recommendation for pastry and bakery industry to establish a successful business.

Marketing Strategy : Company X Entering the Australian Wine Market

OpenAIRE

Tsukrejev, Jaan

2014-01-01

The main objective of this thesis was to identify which marketing strategy is most effective for wine producing companies to enter and compete on the Australian wine market with excessive supply and diminishing demand. The purpose of the thesis was to create a marketing strategy for the commissioner, a case company, referred to as Company X for confidential reasons. Secondary research, predominantly based on marketing literature and governmental statistics, was conducted to create the th...

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

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

Effective treatment strategies against Ebola virus

Directory of Open Access Journals (Sweden)

Amina Yaqoob

2015-08-01

Full Text Available Ebola virus (EBOV, a member of order Mononegavirales is most famous for causing the endemics of hemorrhagic fever in different countries of the world. Various effective treatment for EBOV are available presently but different clinical trials and experimental studies on animal models are ongoing for this purpose. Results from different studies showed that selective vaccines and therapeutic drugs have potential to interfere the viral life events within host cell in order to inhibit its replication. Various pre-clinical trials in this regard are proved successful on non-human primates (NHPs and found to be significant in inhibiting EBOV infections. It is the need of hour to develop effective vaccines against Ebola virus to combat this problem as soon as possible. The present article is a brief review on potential treatment strategies against Ebola virus.

Work-Related Stress and Coping Strategies of Professional Women.

Science.gov (United States)

Long, Bonita C.

1988-01-01

Interviewed 20 professional women on their work-related stress and coping processes to identify those who were good and poor at coping. Found that more effective copers seemed to have used problem-focused coping such as seeking information or advice or taking problem-solving action, whereas less effective copers seemed to have used strategies such…

Ethnopharmacological survey: a selection strategy to identify medicinal plants for a local phytotherapy program

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Flávia Liparini Pereira

2012-06-01

Full Text Available Ethnopharmacological studies are important for documenting and protecting cultural and traditional knowledge associated with the medical use of biodiversity. In this paper, we present a survey on medicinal plants used by locals in a community of Nova Viçosa, Viçosa, MG, Brazil, as a strategy to select medicinal plants for a phytotherapy-based local healthcare program. Eleven knowledgeable local informants were chosen by snowball sampling and interviewed about the use of medicinal plants. Plant samples were collected, herborised and then identified using traditional techniques and specialised literature. We sampled 107 medicinal plant species belonging to 86 genera and 39 families, predominantly Asteraceae with 16 species. Costus spicatus (Jacq. Sw, M. pulegium L., Rosmarinus officinalis L. and Ruta graveolens L. were found to have Consensus of Main Use corrected (CMUc values above 50%, which were in agreement with the traditional uses described by the informants. However, species with CMUc values equal to or above 20%, combined with the scientific information survey, were also used to select medicinal plants for the phytotherapy-based local healthcare program. The selection of medicinal plants based on the CMUc index from this particular community, in combination with the scientific survey, appears to be an effective strategy for the implementation of phytotherapy programs.Estudos etnofarmacológicos são importantes no registro e na preservação de conhecimentos de uma cultura tradicional associada ao uso medicinal da biodiversidade. No presente trabalho, foi realizado o levantamento das plantas medicinais utilizadas por conhecedores populares na comunidade de Nova Viçosa, Viçosa, Minas Gerais, Brasil, como ferramenta para auxiliar na seleção de espécies vegetais visando à implantação de um programa de fitoterapia local na comunidade estudada. Participaram 11 conhecedores escolhidos por amostragem Bola de Neve e submetidos a

Commercial secret as an instrument of company competitive strategy effectiveness increase

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Peskova Dinara

2017-01-01

Full Text Available Modern companies are very much diversified in scale, sectoral affiliation, marketing behavior. There are many theoretical and applied studies in effective competitiveness strategies (see Porter, M. (2002, 1998, Kramer, M. (1998, Fatkhutdinov, R. A. (2000, Feigelson, V. M. (1996 and others.They present famous approaches and probably there is no need to repeat them in this article. We would like to feature a different concept (suggested by Yudanov A. and followers with terminology adopted from natural sciences and show the way the commercial secret can increase effectiveness of competitiveness strategy. We also perform valid methods of commercial secret protection.

An effective approach to reducing strategy space for maintenance optimisation of multistate series–parallel systems

International Nuclear Information System (INIS)

Zhou, Yifan; Lin, Tian Ran; Sun, Yong; Bian, Yangqing; Ma, Lin

2015-01-01

Maintenance optimisation of series–parallel systems is a research topic of practical significance. Nevertheless, a cost-effective maintenance strategy is difficult to obtain due to the large strategy space for maintenance optimisation of such systems. The heuristic algorithm is often employed to deal with this problem. However, the solution obtained by the heuristic algorithm is not always the global optimum and the algorithm itself can be very time consuming. An alternative method based on linear programming is thus developed in this paper to overcome such difficulties by reducing strategy space of maintenance optimisation. A theoretical proof is provided in the paper to verify that the proposed method is at least as effective as the existing methods for strategy space reduction. Numerical examples for maintenance optimisation of series–parallel systems having multistate components and considering both economic dependence among components and multiple-level imperfect maintenance are also presented. The simulation results confirm that the proposed method is more effective than the existing methods in removing inappropriate maintenance strategies of multistate series–parallel systems. - Highlights: • A new method using linear programming is developed to reduce the strategy space. • The effectiveness of the new method for strategy reduction is theoretically proved. • Imperfect maintenance and economic dependence are considered during optimisation

Administrative Strategies of School Management Effectiveness, Buriram Office of Primary Educational Service Area 4

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Khanintipparat Prommaraj

2017-09-01

Full Text Available The objectives of this research were 1 to study the current and the expected Conditions of school management effectiveness, Buriram Office of Primary Educational Service Area 4 and 2 to construct administrative strategies of such schools. Eighty of directors, board chairpersons, teachers and parents were sampled. The instruments for data collection were 5-level rating scale questionnaires with the IOC value between 0.60–1.00 and the reliability value of 0.88 and in-depth interview forms. Quantitative data were analyzed by computer and qualitative data were inductively analyzed. The findings were as follows: 1. The current conditions school management effectiveness, Buriram Office of Primary Educational Service Area 4 was moderate while the expected conditions was high. By means of expected condition can be listed from high to low were atmosphere and environment management, administration, learning management and participation. 2. Strategies for effective management of schools under the Office of Educational Service Area 4 consists of four elementary Bachelor’s strategy is the first strategic development, management efficiency. 2 learners develop strategies to meet educational standards. Strategy 3: create an atmosphere and environment conducive to development. Strategy 4 and the joint cooperation of network.

Identifying Strategies that Facilitate EFL Learners' Oral Communication: A Classroom Study Using Multiple Data Collection Procedures

Science.gov (United States)

Nakatani, Yasuo

2010-01-01

This article considers whether the use of specific communication strategies can improve learners' English proficiency in communicative tasks. Japanese college students (n= 62) participated in a 12-week course of English lessons using a communicative approach with strategy training. To investigate the influence of specific strategy use, their…

Strategy to Identify and Test Putative Light-Sensitive Non-Opsin G-Protein-Coupled Receptors: A Case Study.

Science.gov (United States)

Faggionato, Davide; Serb, Jeanne M

2017-08-01

The rise of high-throughput RNA sequencing (RNA-seq) and de novo transcriptome assembly has had a transformative impact on how we identify and study genes in the phototransduction cascade of non-model organisms. But the advantage provided by the nearly automated annotation of RNA-seq transcriptomes may at the same time hinder the possibility for gene discovery and the discovery of new gene functions. For example, standard functional annotation based on domain homology to known protein families can only confirm group membership, not identify the emergence of new biochemical function. In this study, we show the importance of developing a strategy that circumvents the limitations of semiautomated annotation and apply this workflow to photosensitivity as a means to discover non-opsin photoreceptors. We hypothesize that non-opsin G-protein-coupled receptor (GPCR) proteins may have chromophore-binding lysines in locations that differ from opsin. Here, we provide the first case study describing non-opsin light-sensitive GPCRs based on tissue-specific RNA-seq data of the common bay scallop Argopecten irradians (Lamarck, 1819). Using a combination of sequence analysis and three-dimensional protein modeling, we identified two candidate proteins. We tested their photochemical properties and provide evidence showing that these two proteins incorporate 11-cis and/or all-trans retinal and react to light photochemically. Based on this case study, we demonstrate that there is potential for the discovery of new light-sensitive GPCRs, and we have developed a workflow that starts from RNA-seq assemblies to the discovery of new non-opsin, GPCR-based photopigments.

Understanding consumer acceptance of intervention strategies for healthy food choices: a qualitative study.

Science.gov (United States)

Bos, Colin; Van der Lans, Ivo A; Van Rijnsoever, Frank J; Van Trijp, Hans C M

2013-11-13

The increasing prevalence of overweight and obesity poses a major threat to public health. Intervention strategies for healthy food choices potentially reduce obesity rates. Reviews of the effectiveness of interventions, however, show mixed results. To maximise effectiveness, interventions need to be accepted by consumers. The aim of the present study is to explore consumer acceptance of intervention strategies for low-calorie food choices. Beliefs that are associated with consumer acceptance are identified. Data was collected in the Netherlands in 8 semi-structured interviews and 4 focus group discussions (N = 39). Nine archetypical strategies representing educational, marketing and legal interventions served as reference points. Verbatim transcriptions were coded both inductively and deductively with the framework approach. We found that three beliefs are related to consumer acceptance: 1) general beliefs regarding obesity, such as who is responsible for food choice; 2) the perceived effectiveness of interventions; and 3) the perceived fairness of interventions. Furthermore, the different aspects underlying these general and intervention-specific beliefs were identified. General and intervention-specific beliefs are associated with consumer acceptance of interventions for low-calorie food choices. Policymakers in the food domain can use the findings to negotiate the development of interventions and to assess the feasibility of interventions. With respect to future research, we recommend that segments of consumers based on perceptions of intervention strategies are identified.

Understanding consumer acceptance of intervention strategies for healthy food choices: a qualitative study

Science.gov (United States)

2013-01-01

Background The increasing prevalence of overweight and obesity poses a major threat to public health. Intervention strategies for healthy food choices potentially reduce obesity rates. Reviews of the effectiveness of interventions, however, show mixed results. To maximise effectiveness, interventions need to be accepted by consumers. The aim of the present study is to explore consumer acceptance of intervention strategies for low-calorie food choices. Beliefs that are associated with consumer acceptance are identified. Methods Data was collected in the Netherlands in 8 semi-structured interviews and 4 focus group discussions (N = 39). Nine archetypical strategies representing educational, marketing and legal interventions served as reference points. Verbatim transcriptions were coded both inductively and deductively with the framework approach. Results We found that three beliefs are related to consumer acceptance: 1) general beliefs regarding obesity, such as who is responsible for food choice; 2) the perceived effectiveness of interventions; and 3) the perceived fairness of interventions. Furthermore, the different aspects underlying these general and intervention-specific beliefs were identified. Conclusions General and intervention-specific beliefs are associated with consumer acceptance of interventions for low-calorie food choices. Policymakers in the food domain can use the findings to negotiate the development of interventions and to assess the feasibility of interventions. With respect to future research, we recommend that segments of consumers based on perceptions of intervention strategies are identified. PMID:24225034

Effect of stigma reduction intervention strategies on HIV test uptake in low- and middle-income countries

DEFF Research Database (Denmark)

Thapa, Subash; Hannes, Karin; Cargo, Margaret

2015-01-01

BACKGROUND: Several stigma reduction intervention strategies have been developed and tested for effectiveness in terms of increasing human immunodeficiency virus (HIV) test uptake. These strategies have been more effective in some contexts and less effective in others. Individual factors......, such as lack of knowledge and fear of disclosure, and social-contextual factors, such as poverty and illiteracy, might influence the effect of stigma reduction intervention strategies on HIV test uptake in low- and middle-income countries. So far, it is not clearly known how the stigma reduction intervention...... strategies interact with these contextual factors to increase HIV test uptake. Therefore, we will conduct a review that will synthesize existing studies on stigma reduction intervention strategies to increase HIV test uptake to better understand the mechanisms underlying this process in low- and middle...

Predicting intraindividual changes in learning strategies: The effects of previous achievement

OpenAIRE

Buško, Vesna; Mujagić, Amela

2013-01-01

Socio-cognitive models of self-regulated learning (e.g., Pintrich, 2000) emphasize contextualized nature oflearning process, and within-person variation in learning processes, along with between-person variability in selfregulation.Previous studies about contextual nature of learning strategies have mostly focused on the effects ofdifferent contextual factors on interindividual differences in learning strategies utilization. However, less attentionwas given to the question about contextual ef...

Coping work strategies and job satisfaction among Iranian nurses.

Science.gov (United States)

Ghiyasvandian, Shahrzad; Adera Gebra, Addis

2014-06-01

Nursing is a stressful job that could create physical and psychological disorders. Many studies presented information on stress, effects of coping strategies, and job satisfaction of nurses within health setting. We aimed to identify and describe nursing stresses, coping strategies and job satisfaction of Iranian nurses who are working or worked in different wards. In this review, we studied peer-reviewed journal articles on the field of stress, coping strategies and job satisfaction in nursing practice, especially Iranian nurses, which were published between 2000 and 2013. In this regard, we searched databases of PubMed, Elsevier, Google, BMJ, PMC, and MEDLINE. The majority of the studies (60%) had analyzed the effect of coping strategies, experiences and perception of job-related stresses in Iranian nurses working in hospitals. In some of the reviewed studies (60%), the majority of the samples enrolled Iranian nurses. Forty percent of studies selected a maximum sample size of 565 (44%) participants in 2011. Nursing stress scale employed at 30% of the studies was the most commonly used strategy. This reviewed studies also revealed a combined measurement (60% of studies), based on categorical stress measurement, effects of coping strategies, and job satisfaction methods. Three studies explored the relationship between job stress and job satisfaction. For instance, the majority (74.4%) of nurses reported job satisfaction. Effect of coping strategies and job satisfaction on Iranian nurses is a well-accepted issue and has important positive outcomes on several areas of health discipline.

Provoking "Eureka" moments for effective infection control strategies.

Science.gov (United States)

Pittet, Didier

2014-01-01

Safety is now a fundamental principle of patient care and a critical component of quality management. Health care-associated infection prevention strategies need to be constantly revisited and updated to be effective. The "Geneva hand hygiene model" is a typical example of a breakthrough innovatory campaign that caught fire and went viral worldwide, thanks to its adoption by the World Health Organization (WHO) as the First Global Patient Safety Challenge. The campaign remains an inspiration for further innovation. To encourage new and disruptive technologies with the potential to improve patient safety through the successful implementation of the WHO multimodal strategy, the University of Geneva Hospitals/WHO Collaborating Centre on Patient Safety, together with the Aesculap Academy, have created a series of "Hand Hygiene Excellence Awards" and "Hand Hygiene Innovation Awards" worldwide.

Influence of the large-small split effect on strategy choice in complex subtraction.

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Xiang, Yan Hui; Wu, Hao; Shang, Rui Hong; Chao, Xiaomei; Ren, Ting Ting; Zheng, Li Ling; Mo, Lei

2018-04-01

Two main theories have been used to explain the arithmetic split effect: decision-making process theory and strategy choice theory. Using the inequality paradigm, previous studies have confirmed that individuals tend to adopt a plausibility-checking strategy and a whole-calculation strategy to solve large and small split problems in complex addition arithmetic, respectively. This supports strategy choice theory, but it is unknown whether this theory also explains performance in solving different split problems in complex subtraction arithmetic. This study used small, intermediate and large split sizes, with each split condition being further divided into problems requiring and not requiring borrowing. The reaction times (RTs) for large and intermediate splits were significantly shorter than those for small splits, while accuracy was significantly higher for large and middle splits than for small splits, reflecting no speed-accuracy trade-off. Further, RTs and accuracy differed significantly between the borrow and no-borrow conditions only for small splits. This study indicates that strategy choice theory is suitable to explain the split effect in complex subtraction arithmetic. That is, individuals tend to choose the plausibility-checking strategy or the whole-calculation strategy according to the split size. © 2016 International Union of Psychological Science.

Identifying key factors and strategies for reducing industrial CO2 emissions from a non-Kyoto protocol member's (Taiwan) perspective

International Nuclear Information System (INIS)

Lin, Sue J.; Lu, I.J.; Lewis, Charles

2006-01-01

In this study we use Divisia index approach to identify key factors affecting CO 2 emission changes of industrial sectors in Taiwan. The changes of CO 2 emission are decomposed into emission coefficient, energy intensity, industrial structure and economic growth. Furthermore, comparisons with USA, Japan, Germany, the Netherlands and South Korea are made to have a better understanding of emission tendency in these countries and to help formulate our CO 2 reduction strategies for responding to the international calls for CO 2 cuts. The results show that economic growth and high energy intensity were two key factors for the rapid increase of industrial CO 2 emission in Taiwan, while adjustment of industrial structure was the main component for the decrease. Although economic development is important, Taiwan must keep pace with the international trends for CO 2 reduction. Among the most important strategies are continuous efforts to improve energy intensity, fuel mix toward lower carbon, setting targets for industrial CO 2 cuts, and advancing green technology through technology transfer. Also, the clean development mechanism (CDM) is expected to play an important role in the future

[Factors influencing research activity of Andalusian nurses and improvement strategies].

Science.gov (United States)

López Alonso, Sergio R; Gálvez González, María; Amezcua, Manuel

2013-04-01

To identify factors influencing research activity of Andalusian nurses and to find improvement strategies. Qualitative research using SWOT analysis (weaknesses, threats, strengths, opportunities). Nurses were selected deliberately in eight groups according to predetermined criteria. Analysis included categorization and relationship of factors and strategies. 81 participants were included in groups of 7-12 range. 45 categories were identified with 212 factors: 12 weaknesses (50 factors), 10 strengths (44 factors), 12 threats (68 factors) and 11 opportunities (50 factors). In addition, 32 categories were identified with 53 strategies: 14 categories of W-T strategies (42 strategies), 3 categories of S-T strategies (11 strategies), 5 categories of W-O strategies (13 strategies) and 10 categories of S-O strategies (41 strategies). Nurses identified numerous factors, mainly threats. The strategies are focused on W-T but they also suggest many but weak 5-0 strategies due to the low potential of the opportunities and strengths perceived.

Looking Ahead Toward Community-Level Strategies to Prevent Sexual Violence

Science.gov (United States)

DeGue, Sarah; Holt, Melissa K.; Massetti, Greta M.; Matjasko, Jennifer L.; Tharp, Andra Teten; Valle, Linda Anne

2018-01-01

The Division of Violence Prevention within CDC’s National Center for Injury Prevention and Control recently undertook a systematic review of primary prevention strategies for sexual violence (SV) perpetration. This review identified the lack of community-level strategies to prevent SV as a critical gap in the literature. Community-level strategies function by modifying the characteristics of settings (e.g., schools, workplaces, neighborhoods) that increase the risk for violence victimization and perpetration. Identification of evidence-based strategies at the community level would allow implementation of ecologic approaches to SV prevention with a greater potential for reducing the prevalence of SV perpetration. The field will face several challenges in identifying and evaluating the effectiveness of promising community-level strategies to prevent SV. These challenges include limited knowledge of community-level and societal-level risk factors for SV, a lack of theoretical or empirical guidance in the SV literature for identification of promising community-level approaches, and challenges in evaluating SV outcomes at the community level. Recognition of these challenges should guide future research and foster dialogue within the SV prevention field. The development and evaluation of community-level approaches to SV prevention represent a vital and logical next step toward the implementation of effective, multilevel prevention efforts and a population-level reduction in the prevalence of SV. PMID:22185587

The impact of familiarization strategies on the missing-letter effect.

Science.gov (United States)

Plamondon, Andréanne; Roy-Charland, Annie; Chamberland, Justin; Quenneville, Joannie; Laforge, Christian

2017-08-01

When reading a text and searching for a target letter, readers make more omissions of the target letter if it is embedded in frequent function words than if it is in rare content words. While word frequency effects are consistently found, few studies have examined the impacts of passage familiarity on the missing-letter effect and studies that have present conflicting evidence. The present study examines the effects of passage familiarity, as well as the impacts of passage familiarization strategy promoting surface or deep encoding, on the missing-letter effect. Participants were familiarized with a passage by retyping a text, replacing all common nouns with synonyms, or generating a text on the same topic as that of the original text, and then completed a letter search task on the familiar passage as well as an unfamiliar passage. In Experiment 1, when both familiar and unfamiliar passages use the same words, results revealed fewer omissions for the retyping and synonyms conditions. However, in Experiment 2, when different words are used in both types of texts, no effect of familiarization strategy was observed. Furthermore, the missing-letter effect is maintained in all conditions, adding support to the robustness of the effect regardless of familiarity with the text.