Magee, S K; Ellis, J
Functional analyses produced inconclusive results regarding variables that maintained problem behavior for 2 students with developmental disabilities. Procedures were modified to include a contingent physical restraint condition based on in-class observations. Results indicated that tinder conditions in which physical restraint (i.e., basket-hold timeout) was applied contingent on problem behavior, rates of these behaviors increased across sessions for both subjects. Implications for the use of physical restraint in the classroom are discussed.
Snell, Martha E.; Voorhees, Mary D.; Walker, Virginia L.; Berlin, Rebecca A.; Jamison, Kristen Roorbach; Stanton-Chapman, Tina L.
The purpose of this demonstration was to evaluate a universal intervention during teacher-identified routines that were characterized by significant classwide problem behavior. Six Head Start classrooms (seven groups of children, with one classroom divided into two groups) received two workshops and two coaching sessions on universal Positive…
Hernan, Colleen J; Collins, Tai A; Morrison, Julie Q; Kroeger, Stephen D
As the capabilities of portable technology continue to advance and become more accessible, educators express concern about the impact of the inappropriate use of mobile devices on academic engagement and learning. An alternating treatments design was used to compare the effectiveness of an antecedent (Clear Box) intervention and an interdependent group contingency (Clear Box + Good Behavior Game [GBG]) intervention to typical classroom management techniques (Control) in increasing the academic engagement and decreasing mobile device use of high school students during instruction. The results indicate an increase in academic engagement and a decrease in the inappropriate presence of mobile devices in both classrooms with the implementation of the Clear Box + GBG, as compared with the Clear Box and Control conditions. In addition, teacher and student social validity data suggested that teachers and students viewed the Clear Box + GBG intervention favorably. Discussion focuses on contributions to the current literature, implications for practice, and suggestions for future areas of research.
Al-Shammari, Zaid; Daniel, Cathy; Faulkner, Paula; Yawkey, Thomas D.
A case study was conducted on the development of the LISTEN intervention strategy for use with autistic students to improve inappropriate social behaviors. The study was conducted in a special education classroom in an autism school in Kuwait. Examination of LISTEN Intervention Strategy applications included: duration of targeted behavior; methods…
Full Text Available This research investigated the inappropriate behavior of preschool children with autism in a classroom and examined the effectiveness of the use of social stories to decrease inappropriate autistic behavior. An A-B-A-B single subject design was used across the five participants selected for the study. Investigating the problematic social skills and developing a social story intervention for the preschool autistic children was completed, followed by an examination of the effectiveness of the social story intervention. Ten common problematic social skills among the autistic children in preschool were identified—walking around, making loud noises, not sharing their toys with others, showing frustration when feeling unsatisfied, having no patience, not putting toys away when finished, taking other people's belongings without permission, not knowing how to greet others, destroying things when feeling frustrated, and giving a hug to other people at inappropriate times. It was found that the social story intervention helped to decrease inappropriate behavior in children with autism. The social story intervention consisted of five social story books and five e-books (one story per child using a single subject design with an A-B-A-B pattern. The autistic children preferred social stories from the hardcopy books compared with stories from the e-books. A fourth stage time trial was used over 6 weeks, five times per week, for a total of 30 times. The findings suggested that the use of properly constructed social stories can be effective in decreasing the inappropriate behavior of children with autism. However, each story intervention should be applied with caution because of individual differences between children. The social story intervention should be designed only for autistic children who exhibit specific inappropriate social behavior. Keywords: autistic child, inappropriate behavior, social skills, social story
Oliver, Regina M.; Wehby, Joseph H.; Reschly, Daniel J.
Despite the large research base grounded in behavioral theory for strategies to increase appropriate behavior and prevent or decrease inappropriate behavior in the classroom, a systematic review of multi-component universal classroom management research is necessary to establish the effects of teachers' universal classroom management approaches.…
Leonardo de Sousa Fortes
Full Text Available Objective: To evaluate the inappropriate eating behaviors (IEB of female adolescents over a one-year period. Methods: 290 adolescents aged between 11 and 14 years old participated in the three research stages (T1: first four months, T2: second four months and T3: third four months. The Eating Attitudes Test (EAT-26 was applied to assess the IEB. Weight and height were measured to calculate body mass index (BMI in the three study periods. Analysis of variance for repeated measures was used to analyze the data, adjusted for the scores of the Body Shape Questionnaire and the Brazil Economic Classification Criteria. Results: Girls at T1 showed a higher frequency of IEB compared to T2 (p=0.001 and T3 (p=0.001. The findings also indicated higher values for BMI in T3 in relation to T1 (p=0.04. The other comparisons did not show statistically significant differences. Conclusions: IEB scores of female adolescents declined over one year.
Whitman, Mryon; Whitman, Joan
This article presents the theoretical rationale for behavior modification, principally through its comparison with traditional psychotherapies, and suggests some behavior modification techniques for the classroom management of maladaptive behavior. (Author)
Burba, Fengjiao Ji; Petrosko, Joseph M.; Boyle, Mike A.
Teacher behaviors were rated by 102 students from the United States, 142 from Asian cultures, and 73 from Western cultures (Canada, Europe). U.S. students rated clarity, enthusiasm, interaction, and spatial-behavioral communication more highly than Eastern students did. Western students rated all but spatial-behavioral communication more highly…
Lee, Sang Ah; Jang, Suk Yong; Shin, Jaeyong; Ju, Yeong Jun; Nam, Jin Young; Park, Eun Cheol
Suicide is a leading cause of death among adolescents globally, and body weight is also a recognized reason for adolescent suicide. Therefore, we investigated the association between weight control behaviors (WCB) and suicide ideation and attempt, focusing on inappropriate weight control measures. We used data from the 2014 Korea Youth Risk Behavior Web-based Survey, representing a total of 35,224 boys and 34,361 girls aged 12 to 18 years. Adolescents were classified into groups based on WCB: appropriate WCB, inappropriate WCB, and no WCB. We performed logistic regression models to examine associations between WCB and suicide ideation and attempt, controlling for covariates. Both boys and girls with inappropriate WCB were more likely to report suicide ideation and attempt. Underweight and normal weight boys with inappropriate WCB were more likely to think or attempt suicide, and underweight girls with inappropriate WCB were also more likely to attempt suicide. Among five common WCB combinations, the combination of "regular exercise, fasting, eating less" was highly associated with suicide ideation and attempt. We confirmed that inappropriate WCB is associated with suicide ideation and attempt among Korean adolescents. Given the high incidence rate of suicide among adolescents and the adverse effect of inappropriate WCB, encouraging adolescents to control their weight in healthy ways is imperative.
Luper, Elizabeth P. S.; Lockley, Jeannie
This study focused on a population of 36 female patients, aged 25 to 65, who were diagnosed with intellectual disabilities, all of whom had long-standing patterns of inappropriate behaviors. In an attempt to increase more appropriate behaviors in these patients, a set of standardized contingency rules were established. These rules were implemented…
Full Text Available Traditionally, there has been no place for sexuality in older age. However, research has shown that sexuality plays an important role in older people’s life, even in situations such as dementia. The goal of the article is to review the scientific literature regarding the inappropriate sexual behavior that these kind of patients might present. In order to do so, we will firstly address the definition of inappropriate sexual behavior or, more precisely, its multiple definitions. After that, we will deal with other issues such as its prevalence, factors that can cause its appearance, its consequences and some of the available therapeutic options. Finally, in the last section some recommendations for future research will be provided, such as the need to clarify the concept of inappropriate sexual behavior, to find more efficient ways to address this problem, and the desirability of considering sexuality as a human dimension with a high potential for adaptation in old age.
Emotion tunes cognition, such that approach-motivated positive states promote verbal cognition, whereas withdrawal-motivated negative states promote spatial cognition (Gray, 2001). The current research examined whether self-control resources become depleted and influence subsequent behavior when emotion tunes an inappropriate cognitive tendency.…
Blunden, Dale; And Others
Factor-analytic methods were used toassess contruct validity of the Classroom Behavior Inventory, a scale for rating behaviors associated with hyperactivity. The Classroom Behavior Inventory measures three dimensions of behavior: Hyperactivity, Hostility, and Sociability. Significant concurrent validity was obtained for only one Classroom Behavior…
Stanley, Jennifer Tehan; Lohani, Monika; Isaacowitz, Derek M.
Identifying social gaffes is important for maintaining relationships. Older adults are less able than young to discriminate between socially appropriate and inappropriate behavior in video clips. One open question is how these social appropriateness ratings relate to potential age differences in the perception of what is actually funny or not. In the present study, young, middle-aged, and older adults were equally able to discriminate between appropriate and inappropriate social behavior in a diverse set of clips relevant to both age groups. However, young and middle-aged adults rated the gaffe clips as funnier than control clips and young adults smiled more during the inappropriate clips than the control clips. Older adults did not show this pattern, suggesting that they did not find the inappropriate clips funny. Additionally, young adults endorsed a more aggressive humor style than middle-aged and older adults and aggressive humor style endorsement mediated age differences in social appropriateness ratings. Results are discussed in terms of possible mechanisms such as cohort differences in humor and developmental prioritization of certain humor styles, as well as the importance of investigating age differences in both abilities and preferences. PMID:25244473
The purpose of the exploratory study reported here was to investigate the nature of children's behavior in unstreamed, informal, junior classrooms where the children sit in small groups and the incidence of private teacher talk to small groups and individual children is high. (Author)
Swanson, Ronald G.; Smith, William S.
Described are two instruments used in a workshop designed to help teachers clarify their own beliefs about education and to shape their classroom behavior accordingly. The Student-Content Inventory concerns styles of student-teacher interaction and the Educational Theory Inventory correlates the respondent's beliefs to major educational theories.…
Prakash, Ravi; Pathak, Amit; Munda, Sanjay; Bagati, Dhruv
Dementia of Lewy body disease is the second most common degenerative cause of dementia after Alzheimer's disease, among all the dementias. The core features are a progressive dementia, fluctuations in cognitive functions, visual hallucinations, and spontaneous parkinsonism. Rapid eye movement sleep behavior disorder, severe neuroleptic sensitivity, and low dopamine transporter uptake in basal ganglia are other suggestive features. Behavioral abnormalities are commonly present in the form of aggressive behavior, irritability, and uninhibited behaviors. These are mostly seen in the advanced stages of dementia. However, inappropriate sexual behavior is uncommonly seen in such cases. Three types of inappropriate sexual behaviors commonly found in cases of dementia are sex talks, sexual acts, and implied sexual acts. Such inappropriate sexual behaviors have not been described adequately in dementia of Lewy body disease. We report inappropriate sexual behaviors in a case of dementia of Lewy body disease, which improved rapidly after treatment with quetiapine.
Emotion tunes cognition, such that approach-motivated positive states promote verbal cognition, whereas withdrawal-motivated negative states promote spatial cognition (Gray, 2001). The current research examined whether self-control resources become depleted and influence subsequent behavior when emotion tunes an inappropriate cognitive tendency. In 2 experiments, either an approach-motivated positive state or a withdrawal-motivated negative state was induced, and then participants completed a verbal or a spatial working memory task creating conditions of emotion-cognition alignment (e.g., approach/verbal) or misalignment (e.g., approach/spatial). A control condition was also included. To examine behavioral costs due to depleted self-control resources, participants completed either a Stroop task (Stroop, 1935; Experiment 1) or a Black/White implicit association test (IAT; Greenwald, McGhee, & Schwartz, 1998; Experiment 2). Participants in the misalignment conditions performed worse on the Stroop task, and they were worse at controlling their implicit attitude biases on the IAT. Thus, when emotion tunes inappropriate cognitive tendencies for one's current environment, self-control resources become depleted, impairing behavioral control. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
Pas, Elise T; Cash, Anne H; O'Brennan, Lindsey; Debnam, Katrina J; Bradshaw, Catherine P
Although there has been considerable attention to the issue of classroom management and processes in educational reform models, there has been relatively limited research on these factors in high schools. The current study utilized observational data from 1262 classrooms in 52 high schools to examine teacher classroom management strategies and ratings of student compliance, engagement, and social disruption. Latent profile analysis (LPA) was conducted to examine specific patterns of classroom-wide student behavior in relation to teachers' use of classroom management strategies and classroom composition. The LPA revealed three distinct classroom behavioral profiles where students consistently met behavioral expectations (71%), inconsistently met expectations (23%), and were noncompliant (6%). Analyses indicated a functional association between patterns of student behavior and teachers' classroom management. In classrooms where students consistently met expectations, teachers provided more opportunities to respond and less disapproval and reactive behavioral management. Classrooms with noncompliant students had teachers who used the most disapproval and reactive behavior management. In addition, classrooms characterized as consistent had fewer males and more White students than classrooms characterized by inconsistent and noncompliant behaviors. These findings highlight the link between student patterns of behavior and teacher classroom management and have important implications for screening and professional development. Copyright © 2014 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.
Flynt, Cynthia J.
PREDICTING ACADEMIC ACHIEVEMENT FROM CLASSROOM BEHAVIORS by Cynthia J. Flynt Nancy Bodenhorn & Kusum Singh, Co-Chairs Counselor Education (ABSTRACT) This study examined the influence of behaviors exhibited in the classroom on reading and math achievement in the first, third and eighth grades; and the influence of teacher perceptions on reading and math achievement of African-Americans versus White students and male versus female students. Lastly, the study examined te...
Corder, Gregory W.
This paper discusses the use of behavior contracts for students with behavior problems in martial arts classrooms. Highlighted is the experience of one marital arts teacher with a preteen student who constantly disrupts the class. The behavior contract let the student continue participating while outlining specific expectations for him, his…
Gagnon, Jean; Henry, Anne; Decoste, François-Pierre; Ouellette, Michel; McDuff, Pierre; Daelman, Sacha
Very little research thus far has examined the decision making that underlies inappropriate social behavior (ISB) post-TBI (traumatic brain injury). To verify the usefulness of a new instrument, the Social Responding Task, for investigating whether, in social decision making, individuals with TBI, who present inappropriate social behavior (ISB), have difficulty anticipating their own feelings of embarrassment and others' angry reactions following an ISB. Seven subjects with TBI presenting with inappropriate social behavior (TBI-ISB), 10 presenting with appropriate social behavior (TBI-ASB), and 15 healthy controls were given 12 hypothetical scenarios three times, each time ending with a different behavioral response. Subjects were asked to gauge the likelihood of their displaying the behavior in that situation (part A) and of it being followed by an angry reaction from the other or by feelings of embarrassment in themselves (part B). TBI-ISB subjects scored higher than TBI-ASB and healthy controls on a scale of likelihood of displaying an ISB. RESULTS regarding expectations of angry reactions from others and feelings of embarrassment after an ISB were similar among groups. Negative correlations between endorsement of an inappropriate behavior and anticipation of negative emotional consequences were significant for both TBI-ASB and control subjects, but not for TBI-ISB subjects. RESULTS suggest that the TBI-ISB participants were likely to endorse an ISB despite being able to anticipate a negative emotional response in themselves or others, suggesting that there were other explanations for their poor behavior. A self-reported likely response to hypothetical social scenarios can be a useful approach for studying the neurocognitive processes behind the poor choices of individuals with TBI-ISB, but the task needs further validation studies. A comprehensive discussion follows on the underlying mechanisms affecting social behaviors after a TBI.
Full Text Available Background: Very little research thus far has examined the decision making that underlies inappropriate social behavior (ISB post-TBI (traumatic brain injury. Objectives: To verify the usefulness of a new instrument, the Social Responding Task, for investigating whether, in social decision making, individuals with TBI, who present inappropriate social behavior (ISB, have difficulty anticipating their own feelings of embarrassment and others’ angry reactions following an ISB. Methods: Seven subjects with TBI presenting with inappropriate social behavior (TBI-ISB, 10 presenting with appropriate social behavior (TBI-ASB, and 15 healthy controls were given 12 hypothetical scenarios three times, each time ending with a different behavioral response. Subjects were asked to gauge the likelihood of their displaying the behavior in that situation (part A and of it being followed by an angry reaction from the other or by feelings of embarrassment in themselves (part B. Results: TBI-ISB subjects scored higher than TBI-ASB and healthy controls on a scale of likelihood of displaying an ISB. Results regarding expectations of angry reactions from others and feelings of embarrassment after an ISB were similar among groups. Negative correlations between endorsement of an inappropriate behavior and anticipation of negative emotional consequences were significant for both TBI-ASB and control subjects, but not for TBI-ISB subjects. Conclusions: Results suggest that the TBI-ISB participants were likely to endorse an ISB despite being able to anticipate a negative emotional response in themselves or others, suggesting that there were other explanations for their poor behavior. A self-reported likely response to hypothetical social scenarios can be a useful approach for studying the neurocognitive processes behind the poor choices of individuals with TBI-ISB, but the task needs further validation studies. A comprehensive discussion follows on the underlying
Katt, James; Miller, Ann Neville; Brown, Tim
This study investigated the reliability and validity of Myers and colleagues' Classroom Citizenship Behavior scale, as well as the relationship between student personality traits (extraversion, neuroticism, agreeableness, conscientiousness, openness, and communication apprehension) and CCBs. Two hundred and thirteen students completed…
Boissonnault, Jill S; Cambier, Ziádee; Hetzel, Scott J; Plack, Margaret M
For health care providers in the United States, the risk for nonfatal violence in the workplace is 16 times greater than that for other workers. Inappropriate patient sexual behavior (IPSB) is directed at clinicians, staff, or other patients and may include leering, sexual remarks, deliberate touching, indecent exposure, and sexual assault. Inappropriate patient sexual behavior may adversely affect clinicians, the organization, or patients themselves. Few IPSB risk factors for physical therapists have been confirmed. The US prevalence was last assessed in the 1990s. The objectives of this study were to determine career and 12-month exposure to IPSB among US physical therapists, physical therapist assistants, physical therapist students, and physical therapist assistant students and to identify IPSB risk factors. This was a retrospective and observational study. An electronic survey was developed; content validity and test-retest reliability were established. Participants were recruited through physical therapist and physical therapist assistant academic programs and sections of the American Physical Therapy Association. Inappropriate patient sexual behavior risk models were constructed individually for any, mild, moderate, and severe IPSB events reported over the past 12 months. Open-ended comments were analyzed using qualitative methods. Eight hundred ninety-two physical therapist professionals and students completed the survey. The career prevalence among respondents was 84%, and the 12-month prevalence was 47%. Statistical risk modeling for any IPSB over the past 12 months indicated the following risks: having fewer years of direct patient care, routinely working with patients with cognitive impairments, being a female practitioner, and treating male patients. Qualitative analysis of 187 open-ended comments revealed patient-related characteristics, provider-related characteristics, and abusive actions. Self-report, clinician memory, and convenience sampling are
McKinney, James D.; Forman, Susan G.
Investigated whether classroom teachers could differentiate among educable mentally handicapped (EMH), learning disabled (LD), and emotionally handicapped (EH) students based on perceptions of classroom behavior patterns. Ratings from classroom behavior inventory scales revealed that EMH students were distinguished by low intelligence, creativity,…
Van Houten, R; Rolider, A
A mediated punishment procedure that involved recreating a behavioral sequence by guiding the subject through the behavior in the situation in which it occurred was used to suppress several severe problem behaviors in two developmentally delayed children. The mediational procedure was first used with a 4-year-old autistic boy for biting and then for foot stomping. Next the procedure was used for stealing and hoarding behavior with a multiply handicapped 17-year-old girl. Results indicated tha...
Van Houten, Ron; Rolider, Ahmos
A mediated punishment procedure that involved recreating a behavioral sequence by guiding the subject through the behavior in the situation in which it occurred was used to suppress several severe behavior problems in two severely handicapped children (ages 4 and 17). (Author/DB)
Holloway, Susan D.
A study examined the relationship between change in daycare children's classroom behavior and the teacher's socialization behavior. Various behaviors of 69 children in 24 classrooms were observed and coded in the fall and spring of the school year. Observers coded teacher behavior according to the Caregiver Interaction Scale, which assesses…
Parrish, Mark S.; Stanard, Rebecca P.; Cobia, Debra C.
Adolescent sexual acting out behaviors frequently occur in the context of comorbid issues, such as depression, trauma, behavioral disorders, and developmental deficits, thus rendering any single treatment modality less effective. Augmenting traditional treatment with an existential-humanistic (E-H) perspective enables counselors to more…
Leander, N. Pontus; Chartrand, Tanya L.; Bargh, John A.
In the research reported here, we investigated how suspicious nonverbal cues from other people can trigger feelings of physical coldness. There exist implicit standards for how much nonverbal behavioral mimicry is appropriate in various types of social interactions, and individuals may react
Myers, Scott A.; Goldman, Zachary W.; Atkinson, Jordan; Ball, Hannah; Carton, Shannon T.; Tindage, Melissa F.; Anderson, Amena O.
The purpose of this investigation was to identify the types of citizenship behavior students use in the college classroom, and to examine the link between their use of citizenship behavior and their perceptions of classroom climate, interest, and self-reports of learning outcomes. Participants were 416 undergraduate students enrolled at a large…
Dakanalis, Antonios; Clerici, Massimo; Caslini, Manuela; Gaudio, Santino; Serino, Silvia; Riva, Giuseppe; Carrà, Giuseppe
The transition to college is considered as a risk period for the development of behavioral symptoms of eating disorders (BSEDs) and some evidence suggests that, amongst men, these symptoms occurring on a regular basis remain relatively stable over the college period. Nevertheless, little is known about factors associated with persistent engagement in and initiation of recurrent (or regular) binge eating and inappropriate weight compensatory behaviors in this population. The objective of this report was to address these research gaps. Data were examined from 2,555 male first-year college students who completed an assessment of potential vulnerability factors and BSEDs at the beginning of the autumn semester (baseline) and nine months later (end of the spring semester; follow-up). Elevated negative affectivity, body dissatisfaction, self-objectification, and lower self-esteem at baseline were predictive of persistent engagement in regular binge eating and four compensatory behaviors (self-induced vomiting, laxative/diuretic abuse, fasting, exercise) at follow-up, as well as initiation of all these behaviors occurring regularly (i.e., at least weekly for 3 months). Self-objectification (thinking and monitoring the body's outward appearance from a third-person perspective) emerged as the largest contributor of both the initiation and persistence of all behavioral symptoms. Data emphasize that the same psychological factors underlie initiation and persistence of recurrent BSEDs and should shape the focus of future interventions for college men. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:581-590). © 2016 Wiley Periodicals, Inc.
This article discusses an innovative technique to teach strategic behavior in oligopoly markets. In the classroom exercise, students play the role of a firm that maximizes its profit given the behavior of other firms in the industry. Using classroom clickers to communicate pricing decisions, students explore first-hand the strategic nature of…
Leaf, Justin B.; Leaf, Ronald; McCray, Cynthia; Lamkins, Carol; Taubman, Mitchell; McEachin, John; Cihon, Joseph H.
Today many special education classrooms implement procedures based upon the principles of Applied Behavior Analysis (ABA) to establish educationally relevant skills and decrease aberrant behaviors. However, it is difficult for school staff and consultants to evaluate the implementation of various components of ABA and general classroom set up. In…
Breeman, L D; Wubbels, T; van Lier, P A C; Verhulst, F C; van der Ende, J; Maras, A; Hopman, J A B; Tick, N T
The goal of this study was to explore relations between teacher characteristics (i.e., competence and wellbeing); social classroom relationships (i.e., teacher-child and peer interactions); and children's social, emotional, and behavioral classroom adjustment. These relations were explored at both the individual and classroom levels among 414 children with emotional and behavioral disorders placed in special education. Two models were specified. In the first model, children's classroom adjustment was regressed on social relationships and teacher characteristics. In the second model, reversed links were examined by regressing teacher characteristics on social relationships and children's adjustment. Results of model 1 showed that, at the individual level, better social and emotional adjustment of children was predicted by higher levels of teacher-child closeness and better behavioral adjustment was predicted by both positive teacher-child and peer interactions. At the classroom level, positive social relationships were predicted by higher levels of teacher competence, which in turn were associated with lower classroom levels of social problems. Higher levels of teacher wellbeing were directly associated with classroom adaptive and maladaptive child outcomes. Results of model 2 showed that, at the individual and classroom levels, only the emotional and behavioral problems of children predicted social classroom relationships. At the classroom level, teacher competence was best predicted by positive teacher-child relationships and teacher wellbeing was best predicted by classroom levels of prosocial behavior. We discuss the importance of positive teacher-child and peer interactions for children placed in special education and suggest ways of improving classroom processes by targeting teacher competence. Copyright © 2014 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.
Thomas, Duane E; Bierman, Karen L; Powers, C J
Research suggests that early classroom experiences influence the socialization of aggression. Tracking changes in the aggressive behavior of 4,179 children from kindergarten to second-grade (ages 5-8), this study examined the impact of 2 important features of the classroom context--aggregate peer aggression and climates characterized by supportive teacher-student interactions. The aggregate aggression scores of children assigned to first-grade classrooms predicted the level of classroom aggression (assessed by teacher ratings) and quality of classroom climate (assessed by observers) that emerged by the end of Grade 1. Hierarchical linear model analyses revealed that first-grade classroom aggression and quality of classroom climate made independent contributions to changes in student aggression, as students moved from kindergarten to second grade. Implications for policy and practice are discussed. © 2011 The Authors. Child Development © 2011 Society for Research in Child Development, Inc.
Breeman, L.D.; Wubbels, T.; van Lier, P.A.C.; Verhulst, F.C.; van der Ende, J.; Maras, A.; Hopman, J.A.B.; Tick, N.T.
The goal of this study was to explore relations between teacher characteristics (i.e., competence and wellbeing); social classroom relationships (i.e., teacher-child and peer interactions); and children's social, emotional, and behavioral classroom adjustment. These relations were explored at both
Breeman, L.D.|info:eu-repo/dai/nl/390776114; Wubbels, T.|info:eu-repo/dai/nl/070651361; van Lier, P.A.C.; Verhulst, F.C.; van der Ende, J.; Maras, A.; Hopman, J.A.B.; Tick, Nouchka|info:eu-repo/dai/nl/298678012
The goal of this study was to explore relations between teacher characteristics (i.e., competence and wellbeing); social classroom relationships (i.e., teacher–child and peer interactions); and children's social, emotional, and behavioral classroom adjustment. These relations were explored at both
In today's heterogeneous classrooms, one-method-fits-all-students behavior management approaches are ineffective and often harmful. To succeed with all of their students, teachers should determine whether students have emotional disorders, conduct/behavior disorders, robust male-typical behavior patterns, culturally influenced behavior, learning…
Kowalewicz, Eva A.; Coffee, Gina
This study is an examination of the effectiveness of the Mystery Motivator--an interdependent group contingency, variable-ratio, classwide intervention--as a tool for reducing disruptive classroom behavior in eight diverse general-education elementary school classrooms across seven different schools. The study was conducted using an ABAB, changing…
Erb, Cathy Smeltzer; Erb, Peyton
Enticed by developing skills that would empower students to solve problems, take responsibility for their own actions within the classroom community, and model real-life processes for resolving conflict, a team of third-grade teachers responsible for nearly 100 students embarked on creating a classroom behavior system titled "Making…
Nolan, Julene D.; Houlihan, Daniel; Wanzek, Megan; Jenson, William R.
Few classroom behavioral interventions have been thoroughly studied using culturally and linguistically diverse populations, international student populations, or those from diverse socio-economic backgrounds. Yet, having such tools for school psychologists and teachers is critical for behavior management in the classroom. One important exception…
E.G. Balcik; S. Gulec
The present study aims to determine how often elementary school teachers encounter undesirable behaviors in the classroom and what their thoughts regarding possible reasons of these behaviors are. The teachers’ opininon about the prevalence of these behaviors and their possible reasons were evaluated according to gender, marital status, level of class being taught, size of class being taught and it was tried to be determined if there were significant differences between variables. The measure...
Kroshus, Emily; Paskus, Tom; Bell, Lydia
The objective of the present study was to assess whether there is a positive association between expectations about off-field conduct set by the team coach and the likelihood that college football players intend to engage as prosocial bystanders in the prevention of what they consider to be inappropriate sexual behavior. In a sample of U.S. collegiate football players (N = 3,281), a path analysis model tested the association between coach expectations, perceived likelihood of discipline for off-field transgressions, and likelihood of intending to intervene to prevent inappropriate sexual behavior. Mediation of these relationships by the athlete's sense of exploitative entitlement and their attitudes about intervening were also assessed. Findings supported the hypothesized relationships, with expectations and discipline associated with bystander intentions both directly and indirectly through the mediating pathways of entitlement and attitudes about intervening. These findings provide evidence about the important role that sports team coaches can play in encouraging bystander intervention by clarifying expectations and consequences for conduct off the field of play. Athletic departments can provide a framework within which coaches are informed about the importance of setting and enforcing standards for off-field behavior, and are appropriately incentivized to do so. © The Author(s) 2015.
Full Text Available This article describes students’ disruptive behaviors in language classroom that may greatly affect language teaching and learning process, especially in ESL or EFL classes. Teachers should know what disruptive behavior is to enable them to deal with problems occurred in their classroom or to take preventive actions to keep their students well-behaved during the class. This can reduce the occurrence of misbehavior of students in their classroom. To prevent disruption in the classroom, teachers should establish behavioral expectations in the first day of the semester and the expectations can be based on students attendance, arrivals and departures, class participation, full English speaking, and other appropriate conducts in the syllabus and discuss them at the outset of the term. The agreement is then assigned as a learning contract or a code of conducts with which bounds the whole class. Consequently, whenever students are misbehaved, teachers and other students will directly know and recognize that the behaviors are out of the code. There are factors reasoning students to behave badly, so teachers as trouble solvers have to find appropriate strategies that are effective in helping students keep the code. Otherwise, the disruptions will escalate quickly and the problems will increase in numbers rapidly and finally, teachers will have to work very hard to avoid teaching failure and “losing face” when they cannot manage the disruption as listed in the expectation.
Jackson, Lori A.
This study used qualitative methods to determine whether kindergarten children exhibited stress behaviors during the academic work period of the day. Sixteen children (8 male, 8 female) ages 5-6 years were observed. The data consisted of classroom observations by the researcher, open-ended interviews with teachers, artifacts collected from the…
Shinoda, Kevin Seiji
This paper presents research on the influence of divorce on the classroom behavior of school-aged children. It attempts to uncover some contributing factors that may play a role in how a child deals with divorce. It explores the role of the teacher and school in the intervention and discusses what teachers have observed in working with children of…
The article discusses types of teratogenic agents, (behavioral defects caused by toxic agents) behavioral targets, organismic vulnerability during growth spurts, teratogenic "routing" (path to the brain), exposure, and duration of effects. Lead is used as a paradigm of chemical neurotoxins known to affect cognitive and noncognitive…
Full Text Available The present study aims to determine how often elementary school teachers encounter undesirable behaviors in the classroom and what their thoughts regarding possible reasons of these behaviors are. The teachers’ opininon about the prevalence of these behaviors and their possible reasons were evaluated according to gender, marital status, level of class being taught, size of class being taught and it was tried to be determined if there were significant differences between variables. The measurement tool was applied to a total of 54 teachers at 5 schools in Gölcük district of the Kocaeli province. The data collection tool is composed of three sections. The first section is for establishing teachers’ personal information. In this study, as a data collection tool, a questionnaire was used. When preparing questions for the questionnaire, following the examination of resources available, the questionnaire prepared by Aksoy (1999 and used in the thesis study entitled “Classroom Management and Student Discipline in Elementary Schools of Ankara” and also used in the thesis study by Boyraz (2007 entitled “Discipline Problems that Candidate Teachers Servicing at Elementary Schools Encounter in the Classroom” was employed. Although the validity and reliability of the questionnaire was tested by Aksoy (1999 and Boyraz (2007, the reliability study for the questionnaire was retested and found to be 0,9. The questionnaire include 42 items. 19 of them are related to the reasons of undesirable behaviors observed in the classroom and 23 of them are related to undesirable behaviors observed in the classroom.
Hartman, Kelsey; Gresham, Frank
Disruptive behavior in the classroom negatively affects all students' academic engagement, achievement, and behavior. Group contingencies have been proven effective in reducing disruptive behavior as part of behavior interventions in the classroom. The Good Behavior Game is a Tier 1 classwide intervention that utilizes an interdependent group…
Kimmel, Allan J.
Describes five in-class exercises for use in consumer behavior classes that encourage student involvement in group and class discussions, promote student interest in course material, and stimulate critical thinking. Explains that the exercises can be adapted for other related courses and are equally successful with students of varying abilities.…
Garwood, Justin D.; Vernon-Feagans, Lynne
Many children with behavior problems perform poorly academically and can disrupt regular classroom instruction. Although good classroom management strategies can benefit children with behavior problems, it is not clear whether these students need consistently good classroom management across the early elementary school years to improve their…
Marlowe, Mike; Disney, Gayle
Torey Hayden's portrayal of classroom behavior management in her teacher lore, autobiographical writings about teaching children with emotional and behavioral disorders, is examined. Five of her books were sampled: "One child", "Somebody else's kids", "Just another kid", "Ghost girl" and "Beautiful child". Each of these books unfolds within the…
Sutherland, Kevin S.; Singh, Nirbhay N.
Students with emotional or behavioral disorders (E/BD) are characterized by academic deficits and classroom behavioral problems. The relationship between problem behavior and academic difficulties is complex, and some researchers have hypothesized that the classroom behavior problems of students with E/BD are responses to aversive stimuli, namely…
Bohn, Mariko T.
This article examines the influence of Japanese cultural values, beliefs, and educational style on Japanese students learning English as a second language in an American classroom. In contrast to the Japanese students' high motivation to learn English, their classroom behavior and roles reflect their own cultural perspectives rather than the…
Sturm, Dieter W. F.
Determines the relationship of student teachers' commitment to values, attitudes, and behaviors characteristically fostered by bureaucratic organizations and their verbal classroom behavior while teaching. Findings reveal no difference in verbal classroom behavior of student teachers high and low in bureaucratic orientation, and no difference in…
Alexander, Melody W.; Mundrake, George A.; Brown, Betty J.
The focus of this study was 1) to identify pre business college freshman observed classroom behavior (personal, technical, and collaborative behaviors) in high school versus college, and to compare by gender (male to male; female to female), and 2) to identify pre business college freshman perceptions of classroom behavior in college, and to…
Boss, Roberta S.
A study examined the influence of cultural values on classroom behaviors of adult Vietnamese refugees. More specifically, the study was designed to determine the effect of culturally acquired attitudes and personality traits on the refugees' classroom behaviors, the relationship between these behaviors and the cognitive learning styles favored by…
Lane, J; Muller, D
This research examined the impact of operant reinforcement of positive self-descriptive behavior on the self-concepts and classroom behavior of 60 fifth-grade students. Three groups of 10 male and 10 female low self-concept students wrote a series of eight essays describing their school performance. The first group (P) received written reinforcement for positive self-descriptions of their school performance. The second group (G) received an equal number of reinforcements for general statements. The third group (C) received no reinforcement for written statements. Three areas of self-concept were measured with the Primary Self-Concept Inventory: personal-self, social-self, and intellectual-self. A frequency count was also made of nine classroom behaviors thought to be influenced by self-concept. The P group displayed increases in the frequency of positive self-descriptive statement and in intellectual self-concept but no changes in personal self-concept, social self-concept, or the nine classroom behaviors. The G and C groups showed no change in self-description, self-concept, or the nine classroom behaviors.
Galler, Janina R.; And Others
The classroom behaviors of 129 Barbadian children (77 boys and 52 girls) ages 5 to 11 years, who had suffered from moderate to severe protein-energy malnutrition in the first year of life were compared with children with no history of malnutrition. Data were gathered from questionnaires administered to teachers who were unaware of the children's…
Moore Partin, Tara C.; Robertson, Rachel E.; Maggin, Daniel M.; Oliver, Regina M.; Wehby, Joseph H.
Teachers' successful provision of levels of support to prevent and reduce problem classroom behaviors requires skillful application of research-based classroom and behavior management strategies. Among others, 2 teacher-centered strategies have been shown to decrease students' inappropriate behaviors and increase their appropriate behaviors: the…
Jun 8, 1974 ... with Addison's disease, diarrhoea or salt-losing nephritis. (asymptomatic hyponatraemia).~ Schwartz et al.3 stud;ed two patients with anaplastic bronchus carcinoma and hyponatraemia in 1957, and they suggested that there was an inappropriate secretion of antidiuretic hormone (ADH). It is now well ...
Margalit, M; Almougy, K
The present study aimed to identify subtypes of the learning disabilities (LD) syndrome by examining classroom behavior and family climate among four groups of Israeli students ranging in age from 7 to 10 years: 22 students with LD and hyperactive behavior (HB), 22 nonhyperactive students with LD, 20 nondisabled students with HB, and 20 nondisabled nonhyperactive students. Schaefer's Classroom Behavior Inventory and Moos's Family Environmental Scale were administered to teachers and mothers, respectively. The results revealed that higher distractibility and hostility among both groups with HB differentiated between the two groups with LD. Families of children with HB were reported as less supportive and as emphasizing control less. The academic competence and temperament of the nondisabled students with HB were rated as similar to those of the two groups of students with LD. Both groups with LD were characterized by dependent interpersonal relations and by more conflictual families who fostered more achievement but less personal growth.
Student engagement and appropriate behaviors are essential for effective instruction in secondary special education classrooms. Research suggests that proactive engagement strategies and interventions can have a greater effect on overall classroom behaviors than negative consequences. A single case experiment measured the effects of…
Moore, Tara C.; Wehby, Joseph H.; Oliver, Regina M.; Chow, Jason C.; Gordon, Jason R.; Mahany, Laura A.
Teachers' reported knowledge about and implementation of research-based classroom and behavior management strategies were examined. A total of 160 elementary teachers from two districts in different regions of the same state completed the researcher-developed "Survey of Classroom and Behavior Management." On average, teachers reported to…
Davis, Tonya N.; Durand, Shannon; Fuentes, Lisa; Dacus, Sharon; Blenden, Kara
In this study we analyzed the effects of conducting a school-based functional analysis on subsequent classroom behavior. Each participant was observed in the classroom during activities that were reported by teachers to result in high levels of challenging behavior. Participants were observed during (a) baseline, prior to the administration of a…
Cappella, Elise; Kim, Ha Yeon; Neal, Jennifer W; Jackson, Daisy R
Applying social capital and systems theories of social processes, we examine the role of the classroom peer context in the behavioral engagement of low-income students (N = 80) in urban elementary school classrooms (N = 22). Systematic child observations were conducted to assess behavioral engagement among second to fifth graders in the fall and spring of the same school year. Classroom observations, teacher and child questionnaires, and social network data were collected in the fall. Confirming prior research, results from multilevel models indicate that students with more behavioral difficulties or less academic motivation in the fall were less behaviorally engaged in the spring. Extending prior research, classrooms with more equitably distributed and interconnected social ties-social network equity-had more behaviorally engaged students in the spring, especially in classrooms with higher levels of observed organization (i.e., effective management of behavior, time, and attention). Moreover, social network equity attenuated the negative relation between student behavioral difficulties and behavioral engagement, suggesting that students with behavioral difficulties were less disengaged in classrooms with more equitably distributed and interconnected social ties. Findings illuminate the need to consider classroom peer contexts in future research and intervention focused on the behavioral engagement of students in urban elementary schools.
Mohamad Mahdi Yaghooti Khorasani
Full Text Available Background and Objective: Inappropriate behaviors in academic environments can strongly disturb both teaching and learning processes and make conflict and anxiety between instructor and student. The main objective of this study was to investigate students' attitude on inappropriate behaviors in academic environments. Materials and Methods: This research was a cross-sectional descriptive study conducted in 2012. A questionnaire was designed by the researcher and all students of Faculty of Dentistry voluntarily participated. Data was analyzed using SPSS18 software, descriptive, independent T, ANOVA, and Spearman’s correlation coefficient; P ≤ 0.05 was considered significant. Results: Results of this study indicated that the majority of students considered sleeping in class as an inappropriate behavior, while checking the time at the end of class was the most common behavior which was reported by them. A significant relationship was observed between students’ perspective on inappropriate behaviors and the manner they did them; as Spearman statistical test indicated a high correlation between their perspective and frequency of inappropriate behaviors (R = 0.55 and P = 0.0001. Conclusion: Findings indicated that the majority of students had a negative attitude towards inappropriate behaviors. Besides, the frequency of doing these behaviors cannot be justified by this research team. Regarding the negative effects of inappropriate behaviors on education process, it is recommended to take some actions for cherishing instructors and students in academic environments.
Bloh, Christopher; Axelrod, Saul
With the passage of the Individuals with Disabilities Education Improvement Act, classrooms are now mandated to employ behavioral methods to address target behaviors. These relevant behavioral strategies have long been advanced and disseminated by the field of Applied Behavior Analysis (ABA). Notwithstanding this capability, proponents of the…
Classroom. In this section of Resonance, we in'Vite readers to pose questions likely to be raised in a classroom situation. We may suggest strategies for dealing with them, or in'Vite responses, or ... "Classroom" is equally a forum for raising broader issues and .... Now we can approach the question from a different viewpoint.
This paper addresses classroom design trends and the key issues schools should consider for better classroom space flexibility and adaptability. Classroom space design issues when schools embrace technology are discussed, as are design considerations when rooms must accommodate different grade levels, the importance of lighting, furniture…
Sueoka, Sarah; And Others
This case study of a kindergarten boy in the Kamehameha Early Education Program (KEEP) suggests that specific operant training in school-relevant behaviors can facilitate classroom adjustment if the training is coordinated with the regular classroom teacher. The subject, considered unmanageable, hyperactive, and aggressive by the staff at his…
Cappella, Elise; Hwang, Sophia H. J.; Kieffer, Michael J.; Yates, Miranda
Given the potential of afterschool programs to support youth in urban, low-income communities, we examined the role of afterschool classroom ecology in the academic outcomes of Latino and African American youth with and without social-behavioral risk. Using multireporter methods and multilevel analysis, we find that positive classroom ecology…
Karakaya, Esra G.; Tufan, Mumin
This study aimed to determine preschool teachers' classroom management skills and investigate the relationships between teachers' classroom management skills and inclusion students' social skills and problem behaviors. Relational screening model was used as the research method. Study group consisted of 42 pre-school teachers working in Kocaeli…
Marlowe, Mike; Disney, Gayle; Wilson, Kayce Jo
Torey Hayden's style of classroom management in her nonfiction book "One Child" was examined. "One Child" unfolds within the space of a special education classroom for children with severe behavioral impairments and focuses on Sheila, a troubled 6-year-old, who has tied a 3-year-old boy to a tree and critically burned him. Each technique Hayden…
Broekhuizen, Martine L.; Mokrova, Irina L.; Burchinal, Margaret R.; Garrett-Peters, Patricia T.
Focusing on the continuity in the quality of classroom environments as children transition from preschool into elementary school, this study examined the associations between classroom quality in pre-kindergarten and kindergarten and children's social skills and behavior problems in kindergarten and
This study explored Korean and American children's play behaviors during board games in a kindergarten classroom using an ethnographic approach. The Korean participants were 20 children and one teacher of one classroom at attached kindergarten of public elementary school. The American participants were 11 kindergarten children and one teacher from…
Full Text Available Students’ capabilities to use symbolic information in classroom setting could be expected to influence their possibilities to be active and participating. The development of strategies for teachers to compensate for reduced capability need specific operational definition of symbolic behavior. Fifty-three students, aged 11 to 13 years old, 29 boys and 24 girls, from three classes in the same Swedish compulsory regular school participated in the current study. After a short training sequence 25 students (47% were defined as showing symbolic behavior (symbolic, and 28 students (53% were not (non-symbolic, based on their follow-up test performances. Symbolic and non-symbolic differed significantly on post test performances (p. < .05. Surprisingly, non-symbolic behavior deteriorated their performance, while symbolic enhanced their performance (p. < .05. The results indicate that the operational definition used in the present study may be useful in further studies relating the capability to show symbolic behavior and students’ activity and participation in classroom settings.
Davis, Tonya N.; Dacus, Sharon; Bankhead, Jenna; Haupert, Megan; Fuentes, Lisa; Zoch, Tamara; Kang, Soyeon; Attai, Shanna; Lang, Russell
In this study we analyzed the effects of a self-monitoring and self-monitoring plus reinforcement intervention on classroom behavior. A typically-developing high school student demonstrating difficulty staying on-task during classroom instruction was observed in three classroom settings associated with high levels of off-task behavior. During…
Kurki, Anja; Wang, Wei; Li, Yibing; Poduska, Jeanne
The Good Behavior Game (GBG) is a classroom-based behavior management strategy aimed at reducing aggressive/disruptive behavior and socializing children into the role of student. GBG, delivered in first and second grades, has been shown to reduce rates of substance abuse and other deleterious outcomes into young adulthood (Brown, C.H. et al 2007,…
Carter, Stacy L.; Wheeler, John J.
Functional analysis was used to determine the possible function of inappropriate spitting behavior of an adult woman who had been diagnosed with profound mental retardation. Results of an initial descriptive assessment indicated a possible attention function and led to an attention-based intervention, which was deemed ineffective at reducing the…
McKinney, James D.
Four second-grade teachers completed the Classroom Behavior Inventory for every student in their class (N=101). Subjects were classified as either reflective (N=32) or impulsive (N=32) by using the Matching Familiar Figures Test (MFF). (Author)
Day, Stephanie L; Connor, Carol McDonald; McClelland, Megan M
Classroom learning environments are an important source of influence on children's development, particularly with regard to literacy achievement and behavioral regulation, both of which require the coordination of task inhibition, attention, and working memory. Classroom observations were conducted in 18 schools and 51 first grade classrooms for 500 children. The non-instructional activities were recorded for each student in the classroom. Hierarchical linear modeling revealed that children with weaker fall behavioral regulation were more likely to attend classrooms where more time was spent in disruptions and wasted instructional time over the course of the school year, such as waiting for the teacher to gather materials before beginning instruction. For literacy outcomes, children who were in classrooms where more time in disruptions, transitions, and waiting was observed showed weaker literacy skill gains in the spring compared to children in classrooms with lesser amounts of such unproductive non-instructional time and this effect was generally greater for students with initial weaker skills. These results also reveal that the classroom environment and the incoming characteristics of the students themselves influence students' development of behavioral regulation and literacy. Copyright © 2015. Published by Elsevier Ltd.
Skiba, Russ; Ormiston, Heather; Martinez, Sylvia; Cummings, Jack
Psychological science has identified positive classroom management and climate building strategies as a key element in developing and maintaining effective learning environments. In this article, we review the literature that has identified effective strategies that build classroom climates to maximize student learning and minimize disruption. In…
Every day in K-12 classrooms across the country, teachers are struggling to keep their students focused and on task during instructional time. There are hundreds of theories floating around about how to manage a classroom effectively, but nothing is as simple or as effective in engaging students as the physical presence of the teacher (Brophy,…
Joseph, Laurice M.; Alber-Morgan, Sheila; Neef, Nancy
The purpose of this article is to discuss the application of behavior analytic procedures for advancing and evaluating methods for teaching literacy skills in the classroom. Particularly, applied behavior analysis has contributed substantially to examining the relationship between teacher behavior and student literacy performance. Teacher…
Bayar, Adem; Kerns, James H.
The aim of this study is to define undesired behaviors in the classroom, to better understand the reasons of these undesired behaviors, and to offer strategies to overcome these behaviors. The researchers have used a qualitative research approach in this study. For this aim, the researchers have purposefully selected 12 physics teachers who work…
The impact of the instruction of a six-step problem solving negotiation procedure on the conflict resolution strategies and classroom behavior of six elementary students with challenging behaviors was examined. Moderately positive effects were found for the following negotiation strategies used by students: independent problem solving, problem…
Kim, Ha Yeon; Cappella, Elise
Understanding the social context of classrooms has been a central goal of research focused on the promotion of academic development. Building on the current literature on classroom social settings and guided by a risk and protection framework, this study examines the unique and combined contribution of individual relationships and quality of classroom interactions on behavioral engagement among low-income Latino students in kindergarten to fifth grade (N = 111). Findings indicate that individual relationships with teachers and peers and classroom quality, each independently predicted behavioral engagement. Moreover, high-quality classrooms buffered the negative influence of students' difficulties in individual relationships on behavioral engagement. Findings illuminate the need to consider multiple layers of social classroom relationships and interactions and suggest the potential benefit of targeting classroom quality as a mechanism for improving behavioral engagement in urban elementary schools. © Society for Community Research and Action 2016.
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Full Text Available We discuss traditional classroom, e-learning, behavioral engagement and difference between behavioral engagements in two kind of instruction environment. Results from variance analyses suggest that there is no significant difference between engagements of active learning in different classroom conditions, and there exist significant differences on higher-level learning of innovative and critical thinking. Our findings highlight students' behavioral engagements in two environments have no significant advantage over each other, but e-learning facilitates higher-level learning better.
Faculty in higher education are experiencing a new generation of college students referred to as Generation X (Gen-Xers) and Millennials. The characteristics and behaviors of Gen-Xers and Millennials have created a more challenging classroom learning environment. Some educators may choose to ignore disruptive behaviors or may simply not know which…
Belfiore, Phillip J.; Basile, Sarah Pulley; Lee, David L.
One of the most problematic behaviors in children with developmental disabilities is noncompliance. Although behavioral research has provided strategies to impact noncompliance, oftentimes the methodologies are consequent techniques, which may not be conducive to implementation by the classroom teacher. In this teacher-designed and implemented…
Elliott, Stephen N.
In this retrospective commentary on "Acceptability of Behavioral Interventions Used in Classrooms: The Influence of Amount of Teacher Time, Severity of Behavior Problem, and Type of Intervention," I first examine the concept of social validity and related measurement challenges per Wolf's concerns about consumers' subjective reactions to…
Baer, Ruth A.
The investigation of the effect of normative amounts of caffeine on the behavior of six normal kindergarten children found that caffeine exerted only small and inconsistent effects on such classroom behaviors as time off-task and gross motor activity. (Author/DB)
Kravetz, S; Faust, M; Lipshitz, S; Shalhav, S
This study used Baron and Kenny's (1986) criteria for mediation to investigate the extent to which interpersonal understanding mediates the relation between learning disabilities (LD) and social adaptation in the classroom. Twenty-two children with and 22 children without a diagnosis of LD completed a semistructured developmental clinical interview measure of interpersonal understanding. They were also rated by their fourth- and fifth-grade teachers on a measure of social adaptation in the classroom. Interpersonal understanding and social adaptation in the classroom were found to be positively correlated. Children with LD exhibited less interpersonal understanding and social adaptation. Although this group difference on social adaptation was greatly reduced when interpersonal understanding was statistically controlled, it remained statistically significant. These results suggest that reduced social adaptation in the classroom and lower interpersonal understanding are both associated with a diagnosis of LD. However, they do not conclusively support the claim that interpersonal understanding mediates the relation between LD and social adaptation. Thus, whether the social difficulties of people with LD stem from the same complex phenomena that produce these people's learning problems remains an open question.
Swift, J. Nathan; And Others
The effects of instructional guides and wait-time feedback upon the classroom interaction of 40 middle school science teachers were investigated in a prior study. The experimental nature of that study produced an artificial situation involving little personal contact between teacher-participants and the research staff. Therefore, a subsample of 10…
Gregas, Amanda J.
The principles of psychology are an effective, yet underutilized resource within American schools. Teachers can take advantage of established interventions from the field of psychology and apply them to their classrooms in a realistic, straightforward manner, while still remaining in the role of the educator. A large part of cognitive-behavioral…
Geraldina F Gaastra
Full Text Available Children with attention-deficit/hyperactivity disorder (ADHD often exhibit problem behavior in class, which teachers often struggle to manage due to a lack of knowledge and skills to use classroom management strategies. The aim of this meta-analytic review was to determine the effectiveness of several types of classroom interventions (antecedent-based, consequence-based, self-regulation, combined that can be applied by teachers in order to decrease off-task and disruptive classroom behavior in children with symptoms of ADHD. A second aim was to identify potential moderators (classroom setting, type of measure, students' age, gender, intelligence, and medication use. Finally, it was qualitatively explored whether the identified classroom interventions also directly or indirectly affected behavioral and academic outcomes of classmates. Separate meta-analyses were performed on standardized mean differences (SMDs for 24 within-subjects design (WSD and 76 single-subject design (SSD studies. Results showed that classroom interventions reduce off-task and disruptive classroom behavior in children with symptoms of ADHD (WSDs: MSMD = 0.92; SSDs: MSMD = 3.08, with largest effects for consequence-based (WSDs: MSMD = 1.82 and self-regulation interventions (SSDs: MSMD = 3.61. Larger effects were obtained in general education classrooms than in other classroom settings. No reliable conclusions could be formulated about moderating effects of type of measure and students' age, gender, intelligence, and medication use, mainly because of power problems. Finally, classroom interventions appeared to also benefit classmates' behavioral and academic outcomes.
Korpershoek, Hanke; Harms, Truus; de Boer, Hester; van Kuijk, Mechteld; Doolaard, Simone
This meta-analysis examined which classroom management strategies and programs enhanced students’ academic, behavioral, social-emotional, and motivational outcomes in primary education. The analysis included 54 random and nonrandom controlled intervention studies published in the past decade
CLASSROOM. Figure 1. An antibubble photographed with a white backdrop. contrast to the case of soap bubbles,. Soap bubbles float in air and descend due to gravity on account of higher density of the soap solution, while antibubbles rise due to buoyancy of the air film and float just below the surface of the soap solution.
BACKGROUND AND OBJECTIVE: Drug therapy is necessary to treat acute illness, maintain current health and prevent further decline. However, optimizing drug therapy for older patients is challenging and sometimes, drug therapy can do more harm than good. Drug utilization review tools can highlight instances of potentially inappropriate prescribing to those involved in elderly pharmacotherapy, i.e. doctors, nurses and pharmacists. We aim to provide a review of the literature on potentially inappropriate prescribing in the elderly and also to review the explicit criteria that have been designed to detect potentially inappropriate prescribing in the elderly. METHODS: We performed an electronic search of the PUBMED database for articles published between 1991 and 2006 and a manual search through major journals for articles referenced in those located through PUBMED. Search terms were elderly, inappropriate prescribing, prescriptions, prevalence, Beers criteria, health outcomes and Europe. RESULTS AND DISCUSSION: Prescription of potentially inappropriate medications to older people is highly prevalent in the United States and Europe, ranging from 12% in community-dwelling elderly to 40% in nursing home residents. Inappropriate prescribing is associated with adverse drug events. Limited data exists on health outcomes from use of inappropriate medications. There are no prospective randomized controlled studies that test the tangible clinical benefit to patients of using drug utilization review tools. Existing drug utilization review tools have been designed on the basis of North American and Canadian drug formularies and may not be appropriate for use in European countries because of the differences in national drug formularies and prescribing attitudes. CONCLUSION: Given the high prevalence of inappropriate prescribing despite the widespread use of drug-utilization review tools, prospective randomized controlled trials are necessary to identify useful interventions. Drug
Schaefer, Earl S.; Edgerton, Marianna D.
A preschool version of the Classroom Behavior Inventory which provides a method for collecting valid data on a child's classroom behavior from day care and preschool teachers, was developed to complement the earlier form which was developed and validated for elementary school populations. The new version was tested with a pilot group of twenty-two…
Tyler, Kenneth M.; Burris, Jennifer L.; Coleman, Sean T.
Disruptive classroom behaviors are a major schooling dilemma in urban schools. While several contextual and motivational factors have been statistically associated with disruptive classroom behaviors, one overlooked factor has been home-school dissonance. The current study examined the relationship between 260 middle school students' reports of…
Breeman, L.D.; van Lier, P.A.C.; Wubbels, T.; Verhulst, F.C.; van der Ende, J.; Maras, A.; Hopman, J.A.B.; Tick, N.T.
In mainstream education, positive relationships with teachers and peers have been found to positively influence children’s behavioral development. However, high levels of classroom behavior problems may hinder the formation of such positive relationships. Therefore, findings from mainstream
L.D. Breeman; P.A.C. van Lier (Pol); T. Wubbels; F.C. Verhulst (Frank); J. van der Ende (Jan); A. Maras (Athanasios); J.A.B. Hopman; N.T. Tick (Nouchka Tamar)
textabstractIn mainstream education, positive relationships with teachers and peers have been found to positively influence children’s behavioral development. However, high levels of classroom behavior problems may hinder the formation of such positive relationships. Therefore, findings from
Breeman, L.D.; Van Lier, Pol; Wubbels, T.; Verhulst, Frank C.; van der Ende, Jan; Maras, Athanasios; Hopman, J.A.B.; Tick, Nouchka
In mainstream education, positive relationships with teachers and peers have been found to positively influence children’s behavioral development. However, high levels of classroom behavior problems may hinder the formation of such positive relationships. Therefore, findings from mainstream
Assuah, Charles K.
Oral communication in mathematics classroom plays an essential role in the mathematics learning process, because it allows students to share ideas, refine their thoughts, reflect on their methods, and clarify their understanding (NCTM, 2000). Knowledge about teacher oral communication behaviors allows researchers and policy makers to identify and…
Guy, Barbara; And Others
This study examined whether teacher-implemented classroom measurement procedures of short duration are as reliable as methods used in research studies to determine behavior state (e.g., awake active, awake inactive, asleep, drowsed) of six students with profound mental disabilities. Results indicated that more frequent but briefer measurements…
Amato-Zech, Natalie A.; Hoff, Kathryn E.; Doepke, Karla J.
We examined the effectiveness of a tactile self-monitoring prompt to increase on-task behaviors among 3 elementary-aged students in a special education classroom. Students were taught to self-monitor their attention by using the MotivAider (MotivAider, 2000), an electronic beeper that vibrates to provide a tactile cue to self-monitor. An ABAB…
Cheng, Hong-Yu; Zhang, Shu-Qiang
The purpose of this study was to investigate whether and how high school students' cognitive tendencies in holistic/analytic style relate to their active or passive behavioral patterns observed in the classroom. It was speculated that academic intrinsic motivation might play the role as a moderator and learning approach (the structure-oriented…
Zijlstra, H.; Wubbels, T.; Brekelmans, M.; Koomen, H.M.Y.
This study analyzed children's generalized perceptions of teacher interpersonal behavior in terms of two dimensions, control and affiliation, referring to the degree of teacher leadership/management and teacher friendliness/cooperation in the classroom, respectively. An adapted version of the
Girard, Beverly Lawler
This study determined attitudes of kindergarten through fifth grade teachers about school nutrition environments, their perceived influence on school nutrition environments, and self-reported classroom behaviors. Specific objectives were to: (a) identify perceived factors that influence the school nutrition environment, according to teachers…
Funk, Kristin M.
The American Psychological Association (APA) conducted the online 2005-2006 Teacher Needs Survey wherein 52% of first year teachers, 28% of teachers with two to five years of experience, and 26% of teachers with 6 to 10 years experience ranked classroom management as their greatest need. Difficulty managing student behaviors leads to higher stress…
Shumate, Emily D.; Wills, Howard P.
Although there is a growing body of literature on the use of functional analysis in schools, there is a need for more demonstrations of this technology being used during the course of typical instruction. In this study, we conducted functional analyses of disruptive and off-task behavior in a reading classroom setting for 3 participants of typical…
Tucker, Thurman D.
This research examined attitudes to determine factors influencing teachers' attitudes toward including students with behavior intervention plans in inclusive high-school classrooms. For Research Question 1 one-way ANOVAs analyzed quantitative data with no significant differences found and qualitative data discovered common patterns that BIPs are…
Ahles, Paula M.; Contento, Jann M.
This recently completed study examined whether attribution theory can explain helping behavior in an interdependent classroom environment that utilized a cooperative-learning model. The study focused on student participants enrolled in 6 community college communication classes taught by the same instructor. Three levels of cooperative-learning…
Williams, Mia Kim; Foulger, Teresa S.; Wetzel, Keith
Keeping-up with progressing technology tools has been a troublesome issue for educational technology instructors for over ten years as they endeavor to prepare beginning teachers to integrate technology in their future classrooms. This paper promotes instructors' ideas about behaviors of 21st century teachers, and explores efforts to support their…
Greer, Brian D.; Neidert, Pamela L.; Dozier, Claudia L.; Payne, Steven W.; Zonneveld, Kimberley L. M.; Harper, Amy M.
We conducted functional analyses (FA) with 4 typically developing preschool children during ongoing classroom activities and evaluated treatments that were based on FA results. Results of each child's FA suggested social-positive reinforcement functions, and differential reinforcement of alternative behavior plus time-out was effective in…
Nie, Youyan; Lau, Shun
This study examined how classroom management practices--care and behavioral control--were differentially associated with students' engagement, misbehavior, and satisfaction with school, using a large representative sample of 3196 Grade 9 students from 117 classes in Singapore. Results of hierarchical linear modeling showed differential relations.…
Wagner, Lisa; Ruch, Willibald
Character strengths have been found to be substantially related to children's and adolescents' well-being. Initial evidence suggests that they also matter for school success (e.g., Weber and Ruch, 2012). The present set of two studies aimed at replicating and extending these findings in two different age groups, primary school students (N = 179; mean age = 11.6 years) and secondary school students (N = 199; mean age = 14.4 years). The students completed the VIA-Youth (Values in Action Inventory of Strengths for Youth), a self-report measure of the 24 character strengths in the VIA classification. Their teachers rated the students' positive behavior in the classroom. Additionally, school achievement was assessed: For the primary school students (Study 1), teachers rated the students' overall school achievement and for the secondary school students (Study 2), we used their grades as a measure of school achievement. We found that several character strengths were associated with both positive classroom behavior and school achievement. Across both samples, school achievement was correlated with love of learning, perseverance, zest, gratitude, hope, and perspective. The strongest correlations with positive classroom behavior were found for perseverance, self-regulation, prudence, social intelligence, and hope. For both samples, there were indirect effects of some of the character strengths on school achievement through teacher-rated positive classroom behavior. The converging findings from the two samples support the notion that character strengths contribute to positive classroom behavior, which in turn enhances school achievement. Results are discussed in terms of their implications for future research and for school interventions based on character strengths.
Full Text Available Character strengths have been found to be substantially related to children’s and adolescents’ well-being. Initial evidence suggests that they also matter for school success (e.g., Weber and Ruch, 2012. The present set of two studies aimed at replicating and extending these findings in two different age groups, primary school students (N = 179; mean age = 11.6 years and secondary school students (N = 199; mean age = 14.4 years. The students completed the VIA-Youth, a self-report measure of the 24 character strengths in the VIA classification. Their teachers rated the students’ positive behavior in the classroom. Additionally, school achievement was assessed: For the primary school students (Study 1, teachers rated the students’ overall school achievement and for the secondary school students (Study 2, we used their grades as a measure of school achievement. We found that several character strengths were associated with both positive classroom behavior and school achievement. Across both samples school achievement was correlated with love of learning, perseverance, zest, gratitude, hope, and perspective. The strongest correlations with positive classroom behavior were found for perseverance, self-regulation, prudence, social intelligence, and hope. For both samples, there were indirect effects of most of the character strengths on school achievement through teacher-rated positive classroom behavior. The converging findings from the two samples support the notion that character strengths contribute to positive classroom behavior, which in turn enhances school achievement. Results are discussed in terms of their implications for future research and for school interventions based on character strengths.
Sittarame, Frédéric; Golay, Alain
Physical inactivity or sedentary behavior is more and more widespread, a fairly recent worldwide health phenomenon. It currently takes the shape of a chronic illness with dire consequences. Its factors are influenced by personal motivation and the social and physical environments in which people live. Screening for physical inactivity or sedentary behavior enables patients and caregivers to become fully aware of its risks. The health benefits of simply adding walking to our everyday activities or adding low-impact movement in oureveryday lives would improve the health, the quality of life and longevity for most adults. Caregivers can successfully assist patients in changing their behavior. For certain patients suffering from diseases or complex cases, interdisciplinary specialized surveillance care is useful. There is a need to put this issue at the forefront of public health and adopt a positive stance towards strategies in our places of work, our schools, our means of transportation and overall urban planning and development.
Full Text Available Introduction: Students and faculty members in the health professions classroom are expected to exhibit professional behaviors that are conducive to maintaining a positive learning environment. Aim: To assess the perception of uncivil classroom behavior among the students and the faculty members in a private dental institute in Hyderabad city, India. Materials and Methods: A cross-sectional questionnaire study was conducted among the dental students and the faculty members. The mean perceptions of uncivil classroom behavior were assessed using a self-administered questionnaire of Rowland and Srisukho containing 18 items. Results: A statistically significant difference was noted between the students and the faculty members for mean perception of uncivil classroom behavior (P = 0.002. When based on gender, no significant difference was observed among the students and the staff, but when individual items were considered, most of the male students and the faculty members perceived uncivil behaviors. Among all students, the mean perception of uncivil classroom behavior was significantly high among the undergraduates (68.17 ± 14.5 and least in postgraduates (62.67 ± 22.7, and among the faculty members, it was more among the professors (82.63 ± 4.0. Conclusion: Overall, the issue of uncivil classroom behavior remains a major concern, because 88.6% of the students agreed that they were involved in uncivil classroom behavior previously.
McDaniel, Sara C.; Bruhn, Allison L.; Troughton, Leonard
Social skills instruction has been recommended as a way of improving behavioral and social outcomes for students with emotional and behavioral disorders (EBD). A brief social skills intervention ("Stop and Think" (Knoff in "The stop & think social skills program," Sopris West, Longmont, CO, 2001) was used to extend the…
Gumbiner, Jann; And Others
Two social trends are affecting the way in which children--particularly those of different ethnic groups--become socialized: children are spending less time with parents and more in day care centers and schools, and desegregation alters normal patterns of peer relationships. Since classroom behavior is affected by antecedent social behaviors, a…
Gao, Zan; Lee, Jung Eun; Pope, Zachary; Zhang, Dachao
The purpose of this study was to examine the effect of active videogames (AVGs) on underserved minority children's on-task classroom behavior, academic effort, and fitness. A one group pre- and posttest repeated measures design was used. In Fall 2013, 95 fourth grade children (57 boys, 38 girls; 96% of minority) from three classes at an underserved urban elementary school participated in teacher-supervised AVG activities (e.g., Wii Sports, Xbox Just Dance). Specifically, students participated in a 50-minute weekly AVG program at school for 6 weeks. Children's academic effort was evaluated by classroom teachers using a validated scale that assessed activity, attention, conduct, and social/emotional behavior. Moreover, children's classroom behavior was observed immediately before and after each AVG session by trained researchers. Finally, cardiovascular fitness was also measured. A paired t-test was used to assess teacher-rated student effort, while one-way (gender) analysis of variance (ANOVA) with repeated measures was performed to analyze children's on-task classroom behavior. There was a significant effect on children's effort between the first (mean = 3.24, SD = 0.75) and last week (mean = 3.41, SD = 0.73) assessments, t = 2.42, P = 0.02. In addition, there was a significant effect on classroom behavior, F = 33.103, P < 0.01. In detail, children scored significantly higher on on-task behavior during the post-AVG observation (mean = 81.4, SD = 12.3) than seen during the pre-AVG observation (mean = 69.8, SD = 14.9). However, no main effect was indicated for gender, F = 0.39, P = 0.54. No significant improvement in cardiovascular fitness was observed, although slight improvements were seen. Offering an AVG program at school could improve underserved minority children's classroom on-task behavior and academic effort. Future studies may include a control group to further confirm the effectiveness of AVG
Tiger, Jeffrey H; Miller, Sarah J; Mevers, Joanna Lomas; Mintz, Joslyn Cynkus; Scheithauer, Mindy C; Alvarez, Jessica
School consultants who rely on direct observation typically conduct observational samples (e.g., 1 30-min observation per day) with the hopes that the sample is representative of performance during the remainder of the day, but the representativeness of these samples is unclear. In the current study, we recorded the problem behavior of 3 referred students for 4 consecutive school days between 9:30 a.m. and 2:30 p.m. using duration recording in consecutive 10-min sessions. We then culled 10-min, 20-min, 30-min, and 60-min observations from the complete record and compared these observations to the true daily mean to assess their accuracy (i.e., how well individual observations represented the daily occurrence of target behaviors). The results indicated that when behavior occurred with low variability, the majority of brief observations were representative of the overall levels; however, when behavior occurred with greater variability, even 60-min observations did not accurately capture the true levels of behavior. © Society for the Experimental Analysis of Behavior.
Broekhuizen, Martine L.; Mokrova, Irina L.; Burchinal, Margaret R.; Garrett-Peters, Patricia T.
Focusing on the continuity in the quality of classroom environments as children transition from preschool into elementary school, this study examined the associations between classroom quality in pre-kindergarten and kindergarten and children’s social skills and behavior problems in kindergarten and first grade. Participants included 1175 ethnically-diverse children (43% African American) living in low-wealth rural communities of the US. Results indicated that children who experienced higher levels of emotional and organizational classroom quality in both pre-kindergarten and kindergarten demonstrated better social skills and fewer behavior problems in both kindergarten and first grade comparing to children who did not experience higher classroom quality. The examination of the first grade results indicated that the emotional and organizational quality of pre-kindergarten classrooms was the strongest predictor of children’s first grade social skills and behavior problems. The study results are discussed from theoretical, practical, and policy perspectives. PMID:26949286
Sheffield, Kim; Waller, Raymond J.
Trying to manage the problem behaviors of one or two students in the classroom can take teachers away from valuable instructional time with all students. However, these problem behaviors can be reduced and student engagement increased by teachers implementing effective behavior management strategies. 2008). Because behavior management is only one…
Hollingshead, Aleksandra; Kroeger, Stephen D.; Altus, Jillian; Trytten, Joyce Brubaker
Struggling with frequent off-task behavior, a teacher in a midwestern inner-city high school requested assistance in her social studies classroom. A study was designed to investigate if a combination of positive behavior supports-based interventions such as behavior-specific praise and reduced teacher reprimands might improve on-task behavior. A…
Stephen D. Luft
Full Text Available While several studies have investigated the role of risk-taking in language learning, the findings of these studies may not be generalizable to language learning where the performed culture approach (PCA is used. This study describes the relationship between language learning and risk-taking in PCA, and the relationship between risk-taking and personal study habits, teaching style, daily grading, and classroom dynamics. Data were collected by means of a questionnaire. This study finds that risk-taking behavior has a moderate positive relationship with student performance in PCA. While questionnaire items related to teaching style and classroom dynamics are not found to significantly correlate with students’ risk-taking behavior, some items related to daily grading and personal study habits are found to have a moderate positive relationship with risk-taking behavior. Based on these findings, it is recommended that further research investigate the relationship between assessment and risktaking in language learning. As second language acquisition researchers have investigated the role of affective variables in language learning, risk-taking has frequently been identified as a variable linked with success (Beebe, 1983; Ely, 1986; Naiman, Frolich, Stern, & Todesco, 1978; Rubin, 1975; Samimy & Pardin, 1994; Samimy & Tabuse, 1992. However, it is difficult to apply these findings to language classrooms that use the performed culture approach (PCA, an approach to the teaching of East Asian languages, for two reasons: (a PCA’s focus on the learning of a foreign culture could mean that greater risk is involved in 106 Luft language learning than in a typical language classroom; (b PCA creates a language learning experience for which the risks involved are different than those in language classrooms where other approaches are used.
Friedman-Krauss, Allison Hope; Raver, C. Cybele; Morris, Pamela A.; Jones, Stephanie M.
Research Findings: Despite the abundance of research suggesting that preschool classroom quality influences children's social-emotional development, the equally important and related question of how characteristics of children enrolled in a classroom influence classroom quality has rarely been addressed. The current article focuses on this…
Miller, Jon S.
These activities allow students to investigate behavioral responses of the large Milkweed bug, "Oncopeltus fasciatus," and the mealworm, "Tenebrio molitor" or "Tenebrio obscurus," to external stimuli of light, color, and temperature. During the activities, students formulate hypotheses to research questions presented. They also observe insects for…
Melahat Akgun Kostak
CONCLUSIONS: In this study, students\\ gender, health status, level of success, taking courses related to health promotion, smoking and their participation in sports activities influenced the behavior of healthy lifestyle. [TAF Prev Med Bull 2014; 13(3.000: 189-196
Buchanan, Helen Hamlet; McDermott, Paul A.; Schaefer, Barbara A.
Investigates the interobserver agreement of the Learning Behavior Scale (LBS) by educators (n=16) observing students in special-education classes (n=72). No significant observer effect was found. Moreover, the LBS produced comparable levels of differential learning styles for assessments of individual children. (Author/MKA)
Anderson, Lorin W.; Mandeville, Garrett K.
The purpose of this study was to examine the influence of several instructional formats (e.g., lecture, discourse, seatwork) on the generalizability of teacher behaviors. Two structured observation instruments were used to observe two samples of teachers: 42 fifth grade science teachers on eight occasions, and 87 fifth grade mathematics teachers…
Brown-Wright, Lynda; Tyler, Kenneth M; Graves, Scott L; Thomas, Deneia; Stevens-Watkins, Danelle; Mulder, Shambra
The current study examined the association among home-school dissonance, amotivation, and classroom disruptive behavior among 309 high school juniors and seniors at two urban high schools in the Southern region of the country. Students completed two subscales of the Patterns of Learning Activities Scales (PALS) and one subscale of the Academic Motivation Scale (AMS). ANCOVA analyses revealed significant differences in classroom disruptive behaviors for the gender independent variable. Controlling for gender in the multiple hierarchical regression analyses, it was revealed that home-school dissonance significantly predicted both amotivation and classroom disruptive behavior. In addition, a Sobel mediation analysis showed that amotivation was a significant mediator of the association between home-school dissonance and classroom disruptive behavior. Findings and limitations are discussed.
Brown-Wright, Lynda; Tyler, Kenneth M.; Graves, Scott L.; Thomas, Deneia; Stevens-Watkins, Danelle; Mulder, Shambra
The current study examined the association among home–school dissonance, amotivation, and classroom disruptive behavior among 309 high school juniors and seniors at two urban high schools in the Southern region of the country. Students completed two subscales of the Patterns of Learning Activities Scales (PALS) and one subscale of the Academic Motivation Scale (AMS). ANCOVA analyses revealed significant differences in classroom disruptive behaviors for the gender independent variable. Controlling for gender in the multiple hierarchical regression analyses, it was revealed that home–school dissonance significantly predicted both amotivation and classroom disruptive behavior. In addition, a Sobel mediation analysis showed that amotivation was a significant mediator of the association between home–school dissonance and classroom disruptive behavior. Findings and limitations are discussed. PMID:27081213
Friedman-Krauss, Allison H; Raver, C Cybele; Neuspiel, Juliana M; Kinsel, John
The current article explores the relationship between teachers' perceptions of child behavior problems and preschool teacher job stress, as well as the possibility that teachers' executive functions moderate this relationship. Data came from 69 preschool teachers in 31 early childhood classrooms in 4 Head Start centers and were collected using Web-based surveys and Web-based direct assessment tasks. Multilevel models revealed that higher levels of teachers' perceptions of child behavior problems were associated with higher levels of teacher job stress and that higher teacher executive function skills were related to lower job stress. However, findings did not yield evidence for teacher executive functions as a statistical moderator. Many early childhood teachers do not receive sufficient training for handling children's challenging behaviors. Child behavior problems increase a teacher's workload and consequently may contribute to feelings of stress. However, teachers' executive function abilities may enable them to use effective, cognitive-based behavior management and instructional strategies during interactions with students, which may reduce stress. Providing teachers with training on managing challenging behaviors and enhancing executive functions may reduce their stress and facilitate their use of effective classroom practices, which is important for children's school readiness skills and teachers' health.
Friedman-Krauss, Allison H.; Raver, C. Cybele; Neuspiel, Juliana M.; Kinsel, John
Research Findings The current article explores the relationship between teachers’ perceptions of child behavior problems and preschool teacher job stress, as well as the possibility that teachers’ executive functions moderate this relationship. Data came from 69 preschool teachers in 31 early childhood classrooms in 4 Head Start centers and were collected using Web-based surveys and Web-based direct assessment tasks. Multilevel models revealed that higher levels of teachers’ perceptions of child behavior problems were associated with higher levels of teacher job stress and that higher teacher executive function skills were related to lower job stress. However, findings did not yield evidence for teacher executive functions as a statistical moderator. Practice or Policy Many early childhood teachers do not receive sufficient training for handling children’s challenging behaviors. Child behavior problems increase a teacher’s workload and consequently may contribute to feelings of stress. However, teachers’ executive function abilities may enable them to use effective, cognitive-based behavior management and instructional strategies during interactions with students, which may reduce stress. Providing teachers with training on managing challenging behaviors and enhancing executive functions may reduce their stress and facilitate their use of effective classroom practices, which is important for children’s school readiness skills and teachers’ health. PMID:28596698
Ballard, Richard W; Hagan, Joseph L; Fournier, Suzanne E; Townsend, Janice A; Ballard, Mary B; Armbruster, Paul C
Uncivil behavior by a faculty member or student can threaten a classroom environment and make it less conducive to learning. The aim of this study was to explore faculty behaviors that dental faculty and students perceive to be uncivil when exhibited in the classroom and clinic. In 2015, all faculty, administrators, and students at a single academic dental institution were invited to participate in an electronic survey that used a five-point Likert scale for respondents to indicate their agreement that 33 faculty behaviors were uncivil. Response rates were 49% for faculty and 59% for students. Significant differences were found between student and faculty responses on 22 of the 33 behavioral items. None of the three category composite scores differed significantly for students compared to faculty respondents. The category composite scores were not significantly associated with gender, ethnicity, or age for faculty or students. Overall, this study found significant differences between students and faculty about perceived uncivil faculty behaviors, though not for categories of behaviors.
Brown-Wright, Lynda; Tyler, Kenneth M.; Graves, Scott L.; Thomas, Deneia; Stevens-Watkins, Danelle; Mulder, Shambra
The current study examined the association among home–school dissonance, amotivation, and classroom disruptive behavior among 309 high school juniors and seniors at two urban high schools in the Southern region of the country. Students completed two subscales of the Patterns of Learning Activities Scales (PALS) and one subscale of the Academic Motivation Scale (AMS). ANCOVA analyses revealed significant differences in classroom disruptive behaviors for the gender independent variable. Control...
Kim, Mi-Seon; Blair, Kwang-Sun Cho; Lim, Kyoung-Won
The present study examined the use of tablet assisted Social Stories™ intervention for three high school students with severe intellectual disabilities whose problem behavior interfered with their learning and caused classroom disruptions. A multiple probe design across participants was employed to test the impact of the tablet assisted SS on the participants' target behaviors. During intervention, the participants read the Social Stories that were created on Prezi and accessed via Quick Response (QR) codes using a Galaxy Tap smart tablet before participating in an academic period. Data indicated that the SS intervention decreased disruptive behavior and increased academic engagement in all three participants. All three demonstrated generalization of behaviors to a nontargeted academic period and maintenance of improved behaviors at the 2-week follow-up. Copyright © 2014 Elsevier Ltd. All rights reserved.
Burns, G L; Owen, S M
This study presents initial standardization data on the Sutter-Eyberg Student Behavior Inventory (SESBI), a teacher-completed measure of disruptive classroom behaviors. SESBIs were completed on 1116 children in kingergarten through fifth grade in a rural eastern Washington school district. Various analyses (Cronbach's alpha, corrected item-total correlations, average interitem correlations, principal components analyses) indicated that the SESBI provides a homogeneous measure of disruptive behaviors. Support was also found for three factors within the scale (e.g., overt aggression, oppositional behavior, and attentional difficulties). While the child's age did not have a significant effect on the SESBI, the child's gender did have a significant effect on scale scores as well as on most of the items, with males being rated more problematic than females. The SESBI was also able to discriminate between children in treatment for behavioral problems or learning disabilities and children not in treatment.
Flower, Andrea; McKenna, John; Muething, Colin S; Bryant, Diane Pedrotty; Bryant, Brian R
This study investigated the effects of the Good Behavior Game (GBG) on classwide off-task behavior in two ninth-grade basic algebra resource classes. Ten students with a variety of disabilities, in two classrooms, and their special education resource teacher participated in this study. A reversal design was employed, in which the special education teacher implemented GBG compared to typical practice-algebra readiness instruction. Results showed that classwide off-task behavior decreased in the GBG conditions compared to the baseline and reversal conditions. Fidelity measures indicated that the teacher implemented GBG with fidelity. Students and the teacher rated GBG favorably. Overall findings support the use of GBG for reducing classwide off-task behavior. Implications for practice and future research directions are presented.
Sadaf, Ayesha; Johnson, Barbara L.
This study explored teachers' behavioral, normative, and control beliefs related to digital literacy integration into their classrooms. Ajzen's Theory of Planned Behavior (TPB) was used as a theoretical framework to collect and analyze data. Findings revealed that teachers' integration of digital literacy were related to their behavioral beliefs…
Caldarella, Paul; Williams, Leslie; Jolstead, Krystine A.; Wills, Howard P.
Classroom management is a common concern for teachers. Music teachers in particular experience unique behavior challenges because of large class sizes, uncommon pacing requirements, and performance-based outcomes. Positive behavior support (PBS) is an evidence-based framework for preventing or eliminating challenging behaviors by teaching and…
Shapiro, E S; DuPaul, G J; Bradley-Klug, K L
This article reports on the application of a self-management strategy for improving the classroom behavior of students with attention-deficit/hyperactivity disorder (ADHD). Based on the work of Rhode, Morgan, and Young (1983), the intervention focuses on teaching students to systematically rate their own behavior according to the rating of their teacher. Although, historically, self-management strategies based on cognitive control have not been found to be effective for students with ADHD, strategies based on contingency management have not been widely reported in the literature. A description of the intervention and two case study illustrations are provided. Potential limitations and implications for research in using this strategy are discussed.
Korpershoek, Hanke; Harms, Truus; de Boer, Hester; van Kuijk, Mechteld; Doolaard, Simone
This meta-analysis examined which classroom management strategies and programs enhanced students' academic, behavioral, social-emotional, and motivational outcomes in primary education. The analysis included 54 random and nonrandom controlled intervention studies published in the past decade (2003-2013). Results showed small but significant…
Homer, Ryan; Hew, Khe Foon; Tan, Cheng Yong
This paper reports the findings of a field experiment that gamified the classroom experience of elementary school ESL students by implementing digital badges-and-points which students could earn by achieving specific behavioral and learning goals. Altogether, 120 children in eight different classes participated in this study. Four of the classes…
Gaastra, Geraldina F; Groen, Yvonne; Tucha, Lara; Tucha, Oliver
Children with attention-deficit/hyperactivity disorder (ADHD) often exhibit problem behavior in class, which teachers often struggle to manage due to a lack of knowledge and skills to use classroom management strategies. The aim of this meta-analytic review was to determine the effectiveness of
Hansen, Blake D; Caldarella, Paul; Williams, Leslie; Wills, Howard P
Classroom management in dual immersion classrooms includes unique challenges. The teacher must instruct and correct in the L2 language, in which students are beginning learners, and effective classroom management strategies appropriate to the L2 context. Class-Wide Function-Related Intervention Teams (CW-FIT) is a positive classroom management program that teaches social skills and uses group contingencies to improve behavior. The present study examined the ability of French immersion teachers to implement CW-FIT in the L2, including the effects of CW-FIT on teacher praise and reprimand rates and as well as on students' classroom behavior. Social validity was also assessed. A single-subject multiple baseline design with embedded reversals was used to evaluate impact in second-, third-, and fourth-grade dual immersion classrooms. Results indicated that dual immersion teachers were able to implement CW-FIT in L2 with fidelity. The intervention significantly increased teacher praise and improved classroom on-task behavior. Changes in teacher reprimand rates were inconsistent. Students and teachers reported CW-FIT to be socially valid.
Roantree, Christina F.; Kennedy, Craig H.
We analyzed the inappropriate social interactions of 3 students with Asperger's syndrome whose behavior was maintained by social positive reinforcement. We tested whether inappropriate social behavior was sensitive to social positive reinforcement contingencies and whether such contingencies could be reversed to increase the probability of…
Krull, Johanna; Wilbert, Jürgen; Hennemann, Thomas
The inclusion of children with special educational needs (SEN) in general education classrooms in Europe due to education policy and social developments is currently up for debate, especially in Germany. This paper addresses whether or not co-education of students with and without classroom problems and/or disabilities has negative consequences…
Barry, Patrick J
Inappropriate prescribing in older people is a common condition associated with significant morbidity, mortality, and financial costs. Medication use increases with age, and this, in conjunction with an increasing disease burden, is associated with adverse drug reactions. This review outlines why older people are more likely to develop adverse drug reactions and how common the problem is. The use of different tools to identify and measure the problem is reviewed. Common syndromes seen in older adults (eg, falling, cognitive impairment, sleep disturbance) are considered, and recent evidence in relation to medication use for these conditions is reviewed. Finally, we present a brief summary of significant developments in the recent literature for those caring for older people.
The primary purpose of this short-term study was to examine pre-service classroom teachers' intentions to integrate music in their future classrooms. Using the theory of planned behavior (Fishbein & Ajzen, 2010) as a framework, and embedded, multiple-case study design, I developed case studies of six pre-service classroom teachers enrolled in…
Shin, Sunwoo; Koh, Myung-sook
The purpose of this cross-cultural study is to investigate comparative students' problem behaviors and classroom behavior management strategies for students in urban public schools between teachers in the United States and Korea. This study incorporated data collected from two different teacher self-reported survey questionnaires, the Student…
Boor-Klip, Henrike J.; Segers, Eliane; Hendrickx, Marloes M. H. G.; Cillessen, Antonius H. N.
This study addressed the moderating role of classroom descriptive norms for overt and relational aggression, social withdrawal, prosocial behavior, and academic reputation in the association of behavior with social preference and popularity in early adolescence. Participants were 1,492 fifth-grade students ([x-bar][subscript age] = 10.6 years,…
Khan, Khalid; Factor-Litvak, Pam; Wasserman, Gail A.; Liu, Xinhua; Ahmed, Ershad; Parvez, Faruque; Slavkovich, Vesna; Levy, Diane; Mey, Jacob; van Geen, Alexander
Background: Evidence of neurological, cognitive, and neuropsychological effects of manganese (Mn) exposure from drinking water (WMn) in children has generated widespread public health concern. At elevated exposures, Mn has been associated with increased levels of externalizing behaviors, including irritability, aggression, and impulsivity. Little is known about potential effects at lower exposures, especially in children. Moreover, little is known regarding potential interactions between exposure to Mn and other metals, especially arsenic (As). Objectives: We conducted a cross-sectional study of 201 children to investigate associations of Mn and As in tube well water with classroom behavior among elementary school children, 8–11 years of age, in Araihazar, Bangladesh. Methods: Data on exposures and behavioral outcomes were collected from the participants at the baseline of an ongoing longitudinal study of child intelligence. Study children were rated by their school teachers on externalizing and internalizing items of classroom behavior using the standardized Child Behavior Checklist-Teacher’s Report Form (CBCL-TRF). Results: Log-transformed WMn was positively and significantly associated with TRF internalizing [estimated β = 0.82; 95% confidence interval (CI), 0.08–1.56; p = 0.03], TRF externalizing (estimated β = 2.59; 95% CI, 0.81–4.37; p =0.004), and TRF total scores (estimated β = 3.35; 95% CI, 0.86–5.83; p = 0.008) in models that adjusted for log-transformed water arsenic (WAs) and sociodemographic covariates. We also observed a positive monotonic dose–response relationship between WMn and TRF externalizing and TRF total scores among the participants of the study. We did not find any significant associations between WAs and various scales of TRF scores. Conclusion: These observations reinforce the growing concern regarding the neurotoxicologic effects of WMn in children. PMID:21493178
Bregnhøj, Lisbeth; Thirstrup, Steffen; Kristensen, Mogens Brandt
to the patients. Topical, dermatological medications and medications not used regularly were excluded. RESULTS: 212 patients were prescribed 1621 medications by their GPs at baseline. In all, 640 (39.5%) of the medications had one or more inappropriate ratings in the 10 criteria making up the MAI. The main part...... is good. However, the majority of patients used one or more medications with inappropriate ratings. The inappropriate prescribing relates to specific therapeutic groups and criteria, which should be targeted in future interventions....
Full Text Available The aim of the study was to investigate the effect of perceived motivational structure of classroom on achievement behaviors (the choice of problem, effort, persistence in solving algorithm and flowchart problems. There were 45 high school male students (Mean age = 17 years old in the third grade of computer field in three classes. Classes were divided into two experimental and one control group. Instructional content was given in 10 sessions for 180 minutes. The variables of choice, effort, and persistence were collected by direct as-sessment method. A pre-test and post-test design was used. The Data were analyzed by using multivariate analysis of variance. Results indicated that mastery structure had positive effect on the amount of effort and persistence in solving algorithm and flowchart problems in comparison with control group. Mastery structure in comparison with performance structure increased the amount of effort in solving problems significantly. In addition, an interactive effect between previous achieve-ment and perceived structure of classroom was achieved in a mastery level. The amount of persistence in that of students with very weak previous achievement was more than students with average previous achievement. The find-ing of this study is compatible with the theory of achievement goal and illustrates that the mastery structure plays an effective role in forming achievement behaviors.
Olde Nordkamp, Louise R A; Brouwer, Tom F; Barr, Craig
shocks have been reported. METHODS: We analyzed the incidence, predictors and management of inappropriate shocks in the EFFORTLESS S-ICD Registry, which collects S-ICD implantation information and follow-up data from clinical centers in Europe and New Zealand. RESULTS: During a follow-up of 21 ± 13...... xyphoid to V6) reduced the risk. Reprogramming or optimization of SVT treatment after the first clinical event of inappropriate shock was successful in preventing further inappropriate shocks for cardiac oversensing and SVT events. CONCLUSIONS: Inappropriate shocks, mainly due to cardiac oversensing...
Kleine-Tebbe, J; Herold, D A
Inappropriate test methods are increasingly utilized to diagnose allergy. They fall into two categories: I. Tests with obscure theoretical basis, missing validity and lacking reproducibility, such as bioresonance, electroacupuncture, applied kinesiology and the ALCAT-test. These methods lack both the technical and clinical validation needed to justify their use. II. Tests with real data, but misleading interpretation: Detection of IgG or IgG4-antibodies or lymphocyte proliferation tests to foods do not allow to separate healthy from diseased subjects, neither in case of food intolerance, allergy or other diagnoses. The absence of diagnostic specificity induces many false positive findings in healthy subjects. As a result unjustified diets might limit quality of life and lead to malnutrition. Proliferation of lymphocytes in response to foods can show elevated rates in patients with allergies. These values do not allow individual diagnosis of hypersensitivity due to their broad variation. Successful internet marketing, infiltration of academic programs and superficial reporting by the media promote the popularity of unqualified diagnostic tests; also in allergy. Therefore, critical observation and quick analysis of and clear comments to unqualified methods by the scientific medical societies are more important than ever.
Espelage, Dorothy L
This commentary reviews research findings of the five papers in the special entitled "School-related Factors in the Development of Bullying Perpetration and Victimization", which represent critical areas that are often overlooked in the literature. First, one paper points to the complex interaction between a genetic disposition for aggression and classroom norms toward aggression. Second, an intervention paper unpacks the underlying mechanisms of an efficacious school-wide bully prevention program by opening the "black box" and testing for mediators. Third, the remaining studies employ a wide range of rigorous designs to identify how teachers' attitudes, behaviors, and classroom practices play a critical role in the prevalence of victimization and bullying in the classroom. Further, teachers' attitudes and behaviors are shown to be predictive of youth's willingness to intervene to assist a peer who is being victimized. Results are situated in what is known about bullying prevention, and how the findings from these studies could maximize the sensitivity of future prevention efforts.
Wilson, H Kent; Scult, Matthew; Wilcher, Marilyn; Chudnofsky, Rana; Malloy, Laura; Drewel, Emily; Riklin, Eric; Saul, Southey; Fricchione, Gregory L; Benson, Herbert; Denninger, John W
Recent data suggest that severe stress during the adolescent period is becoming a problem of epidemic proportions. Elicitation of the relaxation response (RR) has been shown to be effective in treating anxiety, reducing stress, and increasing positive health behaviors. The research team's objective was to assess the impact of an RR-based curriculum, led by teachers, on the psychological status and health management behaviors of high-school students and to determine whether a train-the-trainer model would be feasible in a high-school setting. The research team designed a pilot study. The setting was a Horace Mann charter school within Boston's public school system. Participants were teachers and students at the charter school. The team taught teachers a curriculum that included (1) relaxation strategies, such as breathing and imagery; (2) psychoeducation regarding mind-body pathways; and (3) positive psychology. Teachers implemented this curriculum with students. The research team assessed changes in student outcomes (eg, stress, anxiety, and stress management behaviors) using preintervention/postintervention surveys, including the Perceived Stress Scale (PSS), the State-Trait Anxiety Inventory-Form Y (STAI-Y), the stress management subscale of the Health-promoting Lifestyle Profile II (HPLP-II), the Rosenberg Self-Esteem Scale (RSES), the Locus of Control (LOC) questionnaire, and the Life Orientation Test-Revised (LOTR). Classroom observations using the Classroom Assessment Scoring System (CLASS)-Secondary were also completed to assess changes in classroom environment. Using a Bonferroni correction (P management behaviors at that point. Using a Bonferroni correction (P management behaviors (P classroom productivity (eg, increased time spent on activities and instruction from pre- to postintervention). This study showed that teachers can lead an RR curriculum with fidelity and suggests that such a curriculum has positive benefits on student emotional and behavioral
Veenman, Betty; Luman, Marjolein; Oosterlaan, Jaap
Objective: The Positivity and Rules program (PR program), a low-level behavioral teacher program targeting symptoms of attention-deficit/hyperactivity disorder (ADHD), has shown positive effects on teacher-rated ADHD symptoms and social functioning. This study aimed to assess whether program effects could be confirmed by instruments assessing classroom behavior other than teacher-ratings, given teachers' involvement with the training. Methods: Participants were 114 primary school children (age = 6-13) displaying ADHD symptoms in the classroom, who were randomly assigned to the treatment ( n = 58) or control group ( n = 65). ADHD symptoms were measured using classroom observations and actigraphy, and peer acceptance was measured using peer ratings. Intention-to-treat multilevel analyses were conducted to assess program effects. Results: No beneficial program effects were found for any of the measures. Conclusion: The earlier beneficial program effects on both ADHD symptoms and social functioning reported by teachers, may be explained by a change in the perception of teachers rather than changes in the child's behavior. Other methodological explanations are also discussed, such as differences between instruments in the sensitivity to program-related changes. The current study underlines the importance of using different measures of classroom behavior to study program effects. ClinicalTrials.gov registration number: NCT02518711.
Garner, Pamela W.; Waajid, Badiyyah
The development of children's cognitive and social skills is a topic of considerable importance and interest in education and educational psychology. The current study examines whether emotion knowledge and self-regulation predict cognitive competence, social competence, and classroom behavior problems among a sample of 74 preschoolers (40 boys).…
Useche, Ana Carolina; Sullivan, Amanda L.; Merk, Welmoet; Orobio de Castro, Bram
This study examines the concurrent and longitudinal relationships between reactive and proactive aggression and children's peer status. Participants were 94 Dutch elementary school-aged boys in self-contained special education classrooms for students with emotional/behavioral disorders (EBD) and 47 boys with no disabilities in general education…
Useche, Ana Carolina; Sullivan, Amanda L.; Merk, Welmoet; Orobio de Castro, Bram
This study examines the concurrent and longitudinal relationships between reactive and proactive aggression and children's peer status. Participants were 94 Dutch elementary school-aged boys in self-contained special education classrooms for students with emotional/behavioral disorders (EBD) and 47
Hill, Heather D.; Morris, Pamela A.; Castells, Nina; Walker, Jessica Thornton
This study uses data from an experimental employment program and instrumental variables (IV) estimation to examine the effects of maternal job loss on child classroom behavior. Random assignment to the treatment at one of three program sites is an exogenous predictor of employment patterns. Cross-site variation in treatment-control differences is…
Wodrich, David L.
In an analog study, 122 continuing education and preservice teachers rated potential sources of one of two students' classroom problems. One student's behavior, described in a cumulative folder and a videotaped teacher/school psychologist conference, matched the symptoms of epilepsy, the other matched the symptoms of type 1 diabetes mellitus.…
Reddy, Linda A.; Dudek, Christopher M.
In the era of teacher evaluation and effectiveness, assessment tools that identify and monitor educators' instruction and behavioral management practices are in high demand. The Classroom Strategies Scale (CSS) Observer Form is a multidimensional teacher progress monitoring tool designed to assess teachers' usage of instructional and behavioral…
McNaughton-Cassill, Mary E.
Rising rates of incivility in the college classroom can generate stress for both faculty and students. However, incivility can take multiple forms, have different causes and require different management techniques. In some cases disruptive behavior is the result of student faculty interactions, and can be ameliorated by improved communication or…
Talib, Tasneem L.
Under federal law, students with disabilities have the right to be educated in classrooms with students without disabilities. For students with autism, social, communication, and behavioral deficits make inclusion difficult. The severity of deficits change over time, and therefore, so too do the effects of these deficits upon inclusion. Although…
Lopes, Paulo N.; Mestre, Jose M.; Guil, Rocio; Kremenitzer, Janet Pickard; Salovey, Peter
Students' ability to evaluate emotionally challenging situations and identify effective strategies for managing emotions in themselves and others was negatively related to poor classroom social behavior across three studies. These studies, involving 463 students from two Spanish high schools and one American university, examined indicators of…
Renee Michelle Goertzen
Full Text Available As part of a long-term program to develop effective, research-based professional development programs for physics graduate student teaching assistants (TAs, we first identify their current classroom practices and why they engage in these practices. In this paper, we identify a set of teaching practices we call “focusing on indicators,” which occurs when TAs use signs such as key words or diagrams as evidence that students understand the target idea; these indicators are more superficial than a detailed explanation. Our primary finding is that although the three TAs discussed here share a common behavior, the beliefs and motivations that underlie this behavior vary. We argue that TA professional development focused on changing these TAs’ focus-on-indicator behavior is unlikely to be effective. Instead, responsive TA professional development will need to address the TAs’ beliefs that guide the observed classroom behavior.
McClowry, Sandra Graham; Snow, David L.; Tamis-LeMonda, Catherine S.; Rodriguez, Eileen T.
A prevention trial tested the efficacy of INSIGHTS into Children?s Temperament as compared to a Read Aloud attention control condition in reducing student disruptive behavior and enhancing student competence and teacher classroom management. Participants included 116 first and second grade students, their parents, and their 42 teachers in six inner city schools. Teachers completed the Sutter-Eyberg Student Behavior Inventory (SESBI) and the Teacher?s Rating Scale of Child?s Actual Competence ...
Bellmore, Amy D.; Witkow, Melissa R.; Graham, Sandra; Juvonen, Jaana
With a sample of 1,630 sixth-grade students from 77 classrooms, the authors used hierarchical linear modeling to examine how ethnicity within context and classroom social disorder influenced the association between peer victimization and social-psychological adjustment (loneliness and social anxiety). Victimized students in classrooms where many…
Gulcan, Murat Gurkan
Teachers' classroom management approach varies depending on several factors such as the social, psychological, cultural and educational status of the student, classroom level, the physical conditions of the school, organization structure. There are different approaches in classroom management. These approaches are gathered under three headings in…
Anderson, Lorin W.
More information is necessary about constraints placed on teachers before sound classroom performance evaluations can be conducted. Results of an observational instrument utilized in South Carolina, "Describing Practices and Intentions of Classroom Teachers," isolates classroom factors associated with appropriateness of teachers'…
Nader Matin Sadr
Conclusion In the present study, therapy balls and or cushioned chairs for ASD students facilitated in-seat and on-task behaviors and improved classroom performance. It seems that using these alternative seating chairs can satisfy the subjects’ needs to sensory stimuli, and therefore, decreases their sensory seeking behaviors which interferes with their academic achievements. While, using therapy ball chairs for these students may facilitate in-seat behavior and decrease autistic behavior in class, the student’s response to dynamic seating is different individually. Therefore, chair selection must be based on vestibular reaction of the students.
A patient in whom primary Sjogren's syndrome and inappropriate antiduretic hormone secretion were associated is reported. This is the first report of such an association. The possible pathophysiological mechanisms are discussed and vasculitis proposed as the underlying pathogenetic mechanism.
O'Connor, Marie N
Inappropriate prescribing is highly prevalent in older people and is a major healthcare concern because of its association with negative healthcare outcomes including adverse drug events, related morbidity and hospitalization. With changing population demographics resulting in increasing proportions of older people worldwide, improving the quality and safety of prescribing in older people poses a global challenge. To date a number of different strategies have been used to identify potentially inappropriate prescribing in older people. Over the last two decades, a number of criteria have been published to assist prescribers in detecting inappropriate prescribing, the majority of which have been explicit sets of criteria, though some are implicit. The majority of these prescribing indicators pertain to overprescribing and misprescribing, with only a minority focussing on the underprescribing of indicated medicines. Additional interventions to optimize prescribing in older people include comprehensive geriatric assessment, clinical pharmacist review, and education of prescribers as well as computerized prescribing with clinical decision support systems. In this review, we describe the inappropriate prescribing detection tools or criteria most frequently cited in the literature and examine their role in preventing inappropriate prescribing and other related healthcare outcomes. We also discuss other measures commonly used in the detection and prevention of inappropriate prescribing in older people and the evidence supporting their use and their application in everyday clinical practice.
Nader Matin Sadr
Full Text Available Background: Classroom behaviorsare disturbed in autistic students because of their repetitive, restlessness, and disruptive behaviors. This study aimed to examine the impacts of sitting on a ball, cushion, and/or common chair on classroom behavior of four students with Autism Spectrum Disorder (ASD. Methods: Four children with Autism participated in this single-subject study. Students’ behaviors were video recorded in three phases: Sitting on their common chairs during phase A, air-sit cushioned in phase B, and ball chairs in phase C. Sitting times and on-task/off-task behaviors were quantified by momentary time sampling (every 10 seconds and compared during different phases for important changes. Social validity was taken by the teacher at the end of the research as well. Results: The findings demonstrated increases in on-task and in-seat behaviors in four students when seated on air sit cushioned chairs. Despite rises of ontask behaviors for all students, only two of the students showed enhanced inseat behaviors when seated on therapy balls. Social validity findings indicated that the teacher preferred the use of the balls and air-cushioned chairs for her students. Conclusion: Therapy balls/cushioned chairs for students with ASD may facilitate in-seat and on-task behavior.
Mautone, Jennifer A; DuPaul, George J; Jitendra, Asha K
The present study examines the effects of computer-assisted instruction (CAI) on the mathematics performance and classroom behavior of three second-through fourth-grade students with ADHD. A controlled case study is used to evaluate the effects of the computer software on participants' mathematics performance and on-task behavior. Participants' mathematics achievement improve and their on-task behavior increase during the CAI sessions relative to independent seatwork conditions. In addition, students and teachers consider CAI to be an acceptable intervention for some students with ADHD who are having difficulty with mathematics. Implications of these results for practice and research are discussed.
Moore, Dennis W.; Anderson, Angelika; Glassenbury, Michele; Lang, Russell; Didden, Robert
Self-management strategies have been shown to be widely effective. However, limited classroom-based research exists involving low performing but developmentally normal high school-aged participants. This study examined the effectiveness of a self-management strategy aimed at increasing on-task behavior in general education classrooms with students…
Fabiano, Gregory A.; Pelham, William E., Jr.; Gnagy, Elizabeth M.; Burrows-MacLean, Lisa; Coles, Erika K.; Chacko, Anil; Wymbs, Brian T.; Walker, Kathryn S.; Arnold, Fran; Garefino, Allison; Keenan, Jenna K.; Onyango, Adia N.; Hoffman, Martin T.; Massetti, Greta M.; Robb, Jessica A.
Currently behavior modification, stimulant medication, and combined treatments are supported as evidence-based interventions for attention deficit hyperactivity disorder in classroom settings. However, there has been little study of the relative effects of these two modalities and their combination in classrooms. Using a within-subject design, the…
Shogren, Karrie A.; Lang, Russell; Machalicek, Wendy; Rispoli, Mandy J.; O'Reilly, Mark
The purpose of this study was to evaluate and compare the effectiveness of a token economy and a self-management intervention in an inclusive kindergarten classroom. Two 5-year-old children with Asperger syndrome who were struggling to follow classroom rules participated in the study. An ABACABAC (A = baseline, B = token economy, C =…
METİN, Şermin; AYDOĞAN, Yasemin; KAVAK, Şule; MERCAN, Zerrin
Thisresearch was conducted to determine the classroom management profile ofpreschool teachers and to examine the influence of teachers' classroommanagement profiles on children's social skills and problem behaviors. Theresearch was carried out in 2015-2016 educational year with teachers workinginkindergartens affiliated to Provincial Directorate of National Education inGaziantep province center and children in their classes. The study groupconsists of 485 children and 45 teachers wh...
The impact of the Good Behavior Game, a universal classroom-based preventive intervention in first and second grades, on high-risk sexual behaviors and drug abuse and dependence disorders into young adulthood.
Kellam, Sheppard G; Wang, Wei; Mackenzie, Amelia C L; Brown, C Hendricks; Ompad, Danielle C; Or, Flora; Ialongo, Nicholas S; Poduska, Jeanne M; Windham, Amy
The Good Behavior Game (GBG), a method of teacher classroom behavior management, was tested in first- and second-grade classrooms in 19 Baltimore City Public Schools beginning in the 1985-1986 school year. The intervention was directed at the classroom as a whole to socialize children to the student role and reduce aggressive, disruptive behaviors, confirmed antecedents of a profile of externalizing problem outcomes. This article reports on the GBG impact on the courses and interrelationships among aggressive, disruptive behavior through middle school, risky sexual behaviors, and drug abuse and dependence disorders through ages 19-21. In five poor to lower-middle class, mainly African American urban areas, classrooms within matched schools were assigned randomly to either the GBG intervention or the control condition. Balanced assignment of children to classrooms was made, and teachers were randomly assigned to intervention or control. Analyses involved multilevel growth mixture modeling. By young adulthood, significant GBG impact was found in terms of reduced high-risk sexual behaviors and drug abuse and dependence disorders among males who in first grade and through middle school were more aggressive, disruptive. A replication with the next cohort of first-grade children with the same teachers occurred during the following school year, but with minimal teacher mentoring and monitoring. Findings were not significant but generally in the predicted direction. A universal classroom-based prevention intervention in first- and second-grade classrooms can reduce drug abuse and dependence disorders and risky sexual behaviors.
Cleary, Anne M.
College instructors are increasingly relying on wireless clicker systems as instructional tools in the classroom. Instructors commonly use clicker systems for such classroom activities as taking attendance, giving quizzes, and taking opinion polls. However, these systems are uniquely well suited for the teaching of psychology and other courses…
Though laws relating to including children on the autism spectrum and general education in public school settings are in place, inclusion of students is still not a widespread practice in all elementary classrooms. This study examines the social needs of children with autism and in an inclusive classroom. Children with autism are often placed in…
Okoro, Ephraim; Washington, Melvin
Economic and market globalization in the United States has engendered a multicultural learning environment that challenges both faculty and students. Diversity in the classroom is further complicated by nonverbal communication, which impacts on students' attitudes toward faculty members. Because today's classrooms are changing and undergoing rapid…
Eskey, Michael T.; Taylor, Cathy L.; Eskey, Michael T., Jr.
The advent of online learning has created the medium for cyber-bullying in the virtual classroom and also by e-mail. Bullying is usually expected in the workplace and between students in the classroom. Most recently, however, faculty members have become surprising targets of online bullying. For many, there are no established policies nor is…
Kilian, Britta; Hofer, Manfred; Kuhnle, Claudia
Students in class are sometimes torn between following the lesson and engaging in off-task behavior. In this paper, instead of classifying it as a form of deviant behavior, off-task behavior is reconstructed as a manifestation of students multiple motivations in the classroom. The study examines whether parental monitoring, peer value…
Data analysis involved use of World Health Organization (WHO) prescribing indicators, Updated 2002 Beer's criteria and DRUG-REAX® system software package of MICROMEDEX (R) Healthcare Series to assess the prescribing pattern, identify potentially inappropriate medications and potential drug-drug interactions, ...
Locke, Robin L.; Davidson, Richard J.; Kalin, Ned H.; Goldsmith, H. Hill
Some children show emotion that is not consistent with normative appraisal of the context and can therefore be defined as context inappropriate (CI). The authors used individual growth curve modeling and hierarchical multiple regression analyses to examine whether CI anger predicts differences in hypothalamic-pituitary-adrenal axis activity, as…
Objectives: To quantify missed opportunities for immunisation, document reasons for their occurrence and evaluate the extent of inappropriately given vaccine doses. Design: A cross sectional study of children under two years of age attending health facilities. Setting: Six health facilities predominantly serving the slums of ...
Breeman, L D; van Lier, P A C; Wubbels, T; Verhulst, F C; van der Ende, J; Maras, A; Hopman, J A B; Tick, N T
In mainstream education, positive relationships with teachers and peers have been found to positively influence children's behavioral development. However, high levels of classroom behavior problems may hinder the formation of such positive relationships. Therefore, findings from mainstream education cannot be generalized to special education. The present study investigated the developmental links between disobedience and positive as well as negative relationships with teachers and peers among boys in restrictive special educational settings. At three assessment waves across one school year, teacher-reports of teacher-child closeness and conflict, and peer-reports of peer acceptance, rejection and disobedience were collected among 340 boys (mean age = 10.1 years, SD = 1.58, range = 5-13) with psychiatric disorders receiving special education. Autoregressive cross-lagged models were fitted to explore the nature of these developmental links. The impact of boys' age was examined using multiple group analyses. Findings supported the importance of teacher-child conflict, but not closeness, and positive and negative peer relationships for the development of boys' disobedience, with a stronger effect of negative than positive relationships. However, teacher-child and peer relationships were not longitudinally related and the effect of boys' age was minimal. This study extends prior research by suggesting that, despite differences in educational setting and severity of behavior problems between children in mainstream and special education, reducing negative classroom interactional patterns is most important in preventing the development of problematic classroom behavior in boys with severe social-emotional and behavioral difficulties.
McClowry, Sandra Graham; Snow, David L; Tamis-Lemonda, Catherine S; Rodriguez, Eileen T
A prevention trial tested the efficacy of INSIGHTS into Children's Temperament as compared to a Read Aloud attention control condition in reducing student disruptive behavior and enhancing student competence and teacher classroom management. Participants included 116 first and second grade students, their parents, and their 42 teachers in six inner city schools. Teachers completed the Sutter-Eyberg Student Behavior Inventory (SESBI) and the Teacher's Rating Scale of Child's Actual Competence and Social Acceptance (TRS) at baseline and again upon completion of the intervention. Boys participating in INSIGHTS, compared with those in the Read Aloud program, showed a significant decline in attentional difficulties and overt aggression toward others. Teachers in INSIGHTS, compared to those in the attention control condition, reported significantly fewer problems managing the emotional-oppositional behavior, attentional difficulties, and covert disruptive behavior of their male students. They also perceived the boys as significantly more cognitively and physically competent.
Full Text Available While self-medication is common, inappropriate self-medication has potential risks. This study assesses inappropriate self-medication among adolescents and examines the relationships among medication literacy, substance use, and inappropriate self-medication.In 2016, a national representative sample of 6,226 students from 99 primary, middle, and high schools completed an online self-administered questionnaire. Multiple logistic regression analysis was used to examine factors related to inappropriate self-medication.The prevalence of self-medication in the past year among the adolescents surveyed was 45.8%, and the most frequently reported drugs for self-medication included nonsteroidal anti-inflammatory drugs or pain relievers (prevalence = 31.1%, cold or cough medicines (prevalence = 21.6%, analgesics (prevalence = 19.3%, and antacids (prevalence = 17.3%. Of the participants who practiced self-medication, the prevalence of inappropriate self-medication behaviors included not reading drug labels or instructions (10.1%, using excessive dosages (21.6%, and using prescription and nonprescription medicine simultaneously without advice from a health provider (polypharmacy (30.3%. The results of multiple logistic regression analysis showed that after controlling for school level, gender, and chronic diseases, the participants with lower medication knowledge, lower self-efficacy, lower medication literacy, and who consumed tobacco or alcohol were more likely to engage in inappropriate self-medication.Lower medication literacy and substance use were associated with inappropriate self-medication among adolescents.
Full Text Available Prescribing inappropriate pill splitting is not rare in clinical practice. To reduce inappropriate pill splitting, we developed an automatic warning system linked to a computerized physician order entry (CPOE system for special oral formulation drugs in outpatient settings. We examined the impact of the warning system on inappropriate prescribing of pill splitting and assess prescribers' responses to the warnings.Drugs with extended-release or enteric-coated formulations that were not originally intended to be split were recognized as "special oral formulations". A hard-stop system which could examine non-integer doses of drugs with special oral formulations, provide warnings to interrupt inappropriate prescriptions was integrated in CPOE in a medical center since June 2010. We designed an intervention study to compare the inappropriate splitting before and after the implementation of the warning system (baseline period 2010 January to May vs. intervention period 2010 June to 2011 August. During the intervention period, prescription changes in response to a warning were logged and analyzed.A total of 470,611 prescribed drug items with 34 different drugs with special oral formulations were prescribed in the study period. During the 15-month intervention period, 909 warnings for 26 different drugs were triggered among 354,523 prescribed drug items with special oral formulations. The warning rate of inappropriate splitting in the late intervention period was lower than those in baseline period (0.16% vs. 0.61%, incidence rate ratio 0.27, 95% CI 0.23-0.31, P<0.001. In respond to warnings, physicians had to make adjustments, of which the majority was changing to an unsplit pill (72.9%.The interruptive warning system could avoid the prescriptions with inappropriate pill splitting. Accordingly, physicians changed their behavior of prescribing special oral formulations regarding inappropriate pill splitting. We suggest the establishment of such system
Fudge, Daniel L.; Skinner, Christopher H.; Williams, Jacqueline L.; Cowden, Dan; Clark, Janice; Bliss, Stacy L.
A single-case (B-C-B-C) experimental design was used to evaluate the effects of the Color Wheel classroom management system (CWS) on on-task (OT) behavior in an intact, general-education, 2nd-grade classroom during transitions. The CWS included three sets of rules, posted cues to indicate the rules students are expected to be following at that…
Stephens, Keri K.; Pantoja, Gabriel E.
This study provides a first look into how learning motivations are associated with different ways that students use mobile devices to carry on multiple conversations--multicommunicate--while in class. We use self-determination theory to make predictions linking intrinsic motivation, extrinsic motivation, and amotivation, to classroom mobile device…
Zhou, Ning; Lam, Shui-Fong; Chan, Kam Chi
Chinese classrooms present an intriguing paradox to the claim of self-determination theory that autonomy facilitates learning. Chinese teachers appear to be controlling, but Chinese students do not have poor academic performance in international comparisons. The present study addressed this paradox by examining the cultural differences in…
Federal mandates require teachers to implement evidence-based strategies in their classrooms; however, due to gaps between research and practice, these evidence-based practices are inconsistently implemented across educational settings. Although intended to address this, teacher professional developments are most commonly delivered in a…
Positive teacher-student relationships promote growth in students both academically and socially, but in today's ever-changing classrooms creating such positive relationships can be a challenge. This study attempts to look at the influences on teacher thinking and judgment when creating and maintaining relationships. This is done by examining the…
J.A. Benfield; G.N. Rainbolt; P.A. Bell; G.H. Donovan
Viewing peaceful natural environments has been shown to restore cognitive abilities and reduce physiological arousal. As such, visual access to the natural environment is becoming more commonplace in built environments. One exception to that trend is in educational settings where windowless classrooms are used to reduce outside distractions. The current study examines...
Horan, Sean M.; Myers, Scott A.
A growing body of research indicates that classroom justice concerns are important to students. When students perceive their instructors are not concerned about justice, they report a host of negative outcomes. Due to the importance of justice assigned to students, the present study sought to understand how instructors view justice. Results…
Rongen, S.; Kramers, C.; O'Mahony, D.; Feuth, T.; Olde Rikkert, M.G.M.; Ahmed, A.I.A.
OBJECTIVES: The objectives of this study are to determine the prevalence of potentially inappropriate prescribing including potentially inappropriate medications (PIMs) and potential prescription omissions (PPOs) and to assess related risk factors in older people with major psychiatric illness.
Locke, Robin L; Lang, Nichole J
Some children show anger inappropriate for the situation based on the predominant incentives, which is called context-inappropriate anger. Children need to attend to and interpret situational incentives for appropriate emotional responses. We examined associations of context-inappropriate anger with emotion recognition and attention problems in 43 preschoolers (42% male; M age = 55.1 months, SD = 4.1). Parents rated context-inappropriate anger across situations. Teachers rated attention problems using the Child Behavior Checklist-Teacher Report Form. Emotion recognition was ability to recognize emotional faces using the Emotion Matching Test. Anger perception bias was indicated by anger to non-anger situations using an adapted Affect Knowledge Test. 28% of children showed context-inappropriate anger, which correlated with lower emotion recognition (β = -.28) and higher attention problems (β = .36). Higher attention problems correlated with more anger perception bias (β = .32). This cross-sectional, correlational study provides preliminary findings that children with context-inappropriate anger showed more attention problems, which suggests that both "problems" tend to covary and associate with deficits or biases in emotion knowledge. © The Author(s) 2016.
Full Text Available The Postgraduate Year (PGY Program allows doctors-in-training to learn about the diagnosis, treatment and nursing of various common, general diseases. These items form the core curriculum and are mostly learned through caring for patients and clinical teaching. Doctors-in-training are evaluated for their knowledge through written tests or assignments, based on which the effectiveness of their training is also assessed; however, this generally produces a negative learning attitude among them. So we introduced the flipped classroom into PGY training program to change PGY students' learning behavior. Although the flipped classroom is highly valued and has been practiced by teachers in schools of various levels, very few attempts have been made until now to report the learning outcomes achieved through the flipped classroom by means of rigorous research methods. Therefore we tried to employed Ajzen and Fishbein's (1980 theory of reasoned action and Bandura's self-efficacy to predict and explain the participants' behavioral intention when participating in the core curriculum learning of the flipped classroom and to assess the change in students' learning behavior and learning effectiveness. From August 2013 to July 2014, 39 PGY students from the General Surgery of the Tri-Service General Hospital were selected as the participants of this study. The control group included 43 students of the previous year, that is, the year before the intervention of the flipped classroom. A comparative analysis was performed. The questionnaire's related matrices indicated highest correlation between self-efficacy and behavioral intention (r = 0.491, P < 0.01, followed by attitude (r = 0.365, P < 0.01 and subjective norms (r = 0.360, P < 0.01. All three showed positive correlations with behavioral intention; among attitude, subjective norms, and self-efficacy, the pairwise correlations also reached significance level. The flipped classroom can indeed change PGY
Durber, Chelsea M; Yeates, Keith Owen; Taylor, H Gerry; Walz, Nicolay Chertkoff; Stancin, Terry; Wade, Shari L
This study examined how the family environment predicts long-term academic and behavioral functioning in school following traumatic brain injury (TBI) in early childhood. Using a concurrent cohort, prospective design, 15 children with severe TBI, 39 with moderate TBI, and 70 with orthopedic injury (OI) who were injured when they were 3-7 years of age were compared on tests of academic achievement and parent and teacher ratings of school performance and behavior on average 6.83 years postinjury. Soon after injury and at the longer term follow-up, families completed measures of parental psychological distress, family functioning, and quality of the home environment. Hierarchical linear regression analyses examined group differences in academic outcomes and their associations with measures of the early and later family environment. The severe TBI group, but not the moderate TBI group, performed worse than did the OI group on all achievement tests, parent ratings of academic performance, and teacher ratings of internalizing problems. Higher quality early and late home environments predicted stronger academic skills and better classroom behavior for children with both TBI and OI. The early family environment more consistently predicted academic achievement, whereas the later family environment more consistently predicted classroom functioning. The quality of the home environment predicted academic outcomes more strongly than did parental psychological distress or family functioning. TBI in early childhood has long-term consequences for academic achievement and school performance and behavior. Higher quality early and later home environments predict better school outcomes for both children with TBI and children with OI. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Heebøll, Anna; Wargocki, Pawel; Toftum, Jørn
of Copenhagen, Denmark, were retrofitted either with a decentralized, balanced supply and exhaust mechanical ventilation unit with heat recovery; automatically operable windows with an exhaust fan; automatically operable windows with alternating counter-flow heat recovery through slots in the outside wall......; or a visual feedback display unit showing the current classroom carbon dioxide concentration, thus advising when the windows should be opened. For comparison, one classroom retained the original approach for achieving ventilation by manual opening of windows. One year after retrofitting the classrooms carbon...... dioxide concentrations, temperatures, energy use, and window and door opening behavior were recorded during a four week period in the heating season in January. The measured carbon dioxide concentrations were significantly lower in the classrooms with the mechanical ventilation system and the system...
Mikkelsen, Thomas Raundahl
with teacher-produced learning material, typically videos. This frees up time in class, which can instead be spent on various student-centered, active-learning activities. Only very few studies on the use of flipped classroom in nursing education have been published. Methods: Videos and active......-learning activities were developed and used in a course with forty-eight first-year, first-semester nursing students at the School of Nursing, Campus Holstebro, VIA University College, Denmark. After completing the course, students were invited to participate in a survey. In addition, students’ use of videos...... believed that the videos were better than face-to-face lectures with regard to learning outcome, 56% felt they were of equal benefit, and only 18% benefited most from face-to-face lectures. Only a small minority (18%) preferred traditional teaching over flipped classroom teaching, 41% preferred flipped...
Stephen D. Luft
While several studies have investigated the role of risk-taking in language learning, the findings of these studies may not be generalizable to language learning where the performed culture approach (PCA) is used. This study describes the relationship between language learning and risk-taking in PCA, and the relationship between risk-taking and personal study habits, teaching style, daily grading, and classroom dynamics. Data were collected by means of a questionnaire. Th...
Machalicek, W.A.; O'Reilly, M.F.; Chan, J.M.; Lang, R.B.; Rispoli, M.; Davis, T.; Shogren, K.; Sigafoos, J.; Lancioni, G.E.; Antonuzzi, M.; Langthorne, P.; Andrews, A.; Didden, H.C.M.
We conducted a functional analysis of challenging behavior for two students with autism using widely available videoconferencing equipment (laptop computers equipped with web cameras). Observers used the videoconferencing facilities to collect data on challenging behavior and to instruct the
The Undesirable Behaviors of Students in Academic Classrooms, and the Discipline Strategies Used by Faculty Members to Control Such Behaviors from the Perspective of the College of Education Students in King Saud University
Al Qahtani, Norah Saad Sultan
This study aimed to identify the undesirable students' behaviors in academic classrooms, and the disciplinary, preventive and therapeutic strategies that will be used by faculty members to control those behaviors from the perspective of the College of Education's students in King Saud University. The results of the study has shown that the…
Hsu, Sheng-Der; Chen, Cheng-Jueng; Chang, Wei-Kuo; Hu, Yih-Jin
The Postgraduate Year (PGY) Program allows doctors-in-training to learn about the diagnosis, treatment and nursing of various common, general diseases. These items form the core curriculum and are mostly learned through caring for patients and clinical teaching. Doctors-in-training are evaluated for their knowledge through written tests or assignments, based on which the effectiveness of their training is also assessed; however, this generally produces a negative learning attitude among them. So we introduced the flipped classroom into PGY training program to change PGY students' learning behavior. Although the flipped classroom is highly valued and has been practiced by teachers in schools of various levels, very few attempts have been made until now to report the learning outcomes achieved through the flipped classroom by means of rigorous research methods. Therefore we tried to employed Ajzen and Fishbein's (1980) theory of reasoned action and Bandura's self-efficacy to predict and explain the participants' behavioral intention when participating in the core curriculum learning of the flipped classroom and to assess the change in students' learning behavior and learning effectiveness. From August 2013 to July 2014, 39 PGY students from the General Surgery of the Tri-Service General Hospital were selected as the participants of this study. The control group included 43 students of the previous year, that is, the year before the intervention of the flipped classroom. A comparative analysis was performed. The questionnaire's related matrices indicated highest correlation between self-efficacy and behavioral intention (r = 0.491, P flipped classroom can indeed change PGY students' the learning behavior from "passive learning" to "active learning."
Hsu, Sheng-Der; Chen, Cheng-Jueng; Chang, Wei-Kuo; Hu, Yih-Jin
The Postgraduate Year (PGY) Program allows doctors-in-training to learn about the diagnosis, treatment and nursing of various common, general diseases. These items form the core curriculum and are mostly learned through caring for patients and clinical teaching. Doctors-in-training are evaluated for their knowledge through written tests or assignments, based on which the effectiveness of their training is also assessed; however, this generally produces a negative learning attitude among them. So we introduced the flipped classroom into PGY training program to change PGY students’ learning behavior. Although the flipped classroom is highly valued and has been practiced by teachers in schools of various levels, very few attempts have been made until now to report the learning outcomes achieved through the flipped classroom by means of rigorous research methods. Therefore we tried to employed Ajzen and Fishbein’s (1980) theory of reasoned action and Bandura’s self-efficacy to predict and explain the participants’ behavioral intention when participating in the core curriculum learning of the flipped classroom and to assess the change in students’ learning behavior and learning effectiveness. From August 2013 to July 2014, 39 PGY students from the General Surgery of the Tri-Service General Hospital were selected as the participants of this study. The control group included 43 students of the previous year, that is, the year before the intervention of the flipped classroom. A comparative analysis was performed. The questionnaire’s related matrices indicated highest correlation between self-efficacy and behavioral intention (r = 0.491, P flipped classroom can indeed change PGY students’ the learning behavior from “passive learning” to “active learning.” PMID:27911937
Froiland, John Mark; Smith, Liana
Applied child psychologists and behavioral consultants often use systematic behavioral observations to inform the psychological assessment and intervention development process for children referred for attention and hyperactivity problems. This article provides a review of the 2010 version of the eCOVE classroom observation software in terms of its utility in tracking the progress of children with attention and hyperactive behaviors and its use in evaluating teacher behaviors that may impede or promote children's attention and positive behavior. The eCOVE shows promise as an efficient tool for psychologists and behavioral consultants who want to evaluate the effects of interventions for children with symptoms of ADHD, ODD, mood disorders and learning disorders; however, some research-based improvements for future models are suggested. The reviewers also share their firsthand experience in using eCOVE to evaluate teacher and student behavior exhibited on a television show about teaching urban high school students and during a movie about an eccentric new kindergarten teacher. Rich examples are provided of using strategic behavioral observations to reveal how to improve the classroom environment so as to facilitate attention, motivation and positive behavior among youth. Broader implications for enhancing the use of systematic behavioral observations in the assessment of children and adolescents with attention disorders and related behavioral problems are discussed. Key issues are examined such as the use of behavioral observations during psychological consultation to prevent the previously found gender bias in referrals for ADHD. Using behavioral observations to enhance differential diagnosis is also discussed.
Keane, R A
Colonoscopic surveillance of hyperplastic polyps alone is controversial and may be inappropriate. The colonoscopy surveillance register at a university teaching hospital was audited to determine the extent of such hyperplastic polyp surveillance. The surveillance endoscopy records were reviewed, those patients with hyperplastic polyps were identified, their clinical records were examined and contact was made with each patient. Of the 483 patients undergoing surveillance for colonic polyps 113 (23%) had hyperplastic polyps alone on last colonoscopy. 104 patients remained after exclusion of those under appropriate surveillance. 87 of the 104 patients (84%) were successfully contacted. 37 patients (8%) were under appropriate colonoscopic surveillance for a significant family history of colorectal carcinoma. 50 (10%) patients with hyperplastic polyps alone and no other clinical indication for colonoscopic surveillance were booked for follow up colonoscopy. This represents not only a budgetary but more importantly a clinical opportunity cost the removal of which could liberate valuable colonoscopy time for more appropriate indications.
Bollman, Jessica R.; Davis, Paula K.
This study examined the effectiveness of behavioral skills training in teaching 2 adult women with mild intellectual disabilities to report inappropriate staff-to-resident interactions. The reporting skill included making a self-advocacy response, walking away, and reporting the interaction. Participants' performance was measured during baseline,…
Schuck, Sabrina; Emmerson, Natasha; Ziv, Hadar; Collins, Penelope; Arastoo, Sara; Warschauer, Mark; Crinella, Francis; Lakes, Kimberley
Children with Attention Deficit/Hyperactivity Disorder (ADHD) receive approximately 80% of instruction in the general education classroom, where individualized behavioral management strategies may be difficult for teachers to consistently deliver. Mobile device apps provide promising platforms to manage behavior. This pilot study evaluated the utility of a web-based application (iSelfControl) designed to support classroom behavior management. iSelfControl prompted students every 'Center' (30-minutes) to self-evaluate using a universal token-economy classroom management system focused on compliance, productivity, and positive relationships. Simultaneously, the teacher evaluated each student on a separate iPad. Using Multi Level Modeling, we examined 13 days of data gathered from implementation with 5th grade students (N = 12) at a school for children with ADHD and related executive function difficulties. First, an unconditional growth model evaluated the overall amount of change in aggregated scores over time as well as the degree of systematic variation in scores within and across teacher-student dyads. Second, separate intercepts and slopes were estimated for teacher and student to estimate degree of congruency between trajectories. Finally, differences between teacher and student scores were tested at each time-point in separate models to examine unique 'Center' effects. 51% of the total variance in scores was attributed to differences between dyads. Trajectories of student and teacher scores remained relatively stable across seven time-points each day and did not statistically differ from each other. On any given day, students tended to evaluate their behaviors more positively (entered higher scores for themselves) compared to corresponding teacher scores. In summary, iSelfControl provides a platform for self and teacher evaluation that is an important adjunct to conventional classroom management strategies. The application captured teacher/student discrepancies
Full Text Available Children with Attention Deficit/Hyperactivity Disorder (ADHD receive approximately 80% of instruction in the general education classroom, where individualized behavioral management strategies may be difficult for teachers to consistently deliver. Mobile device apps provide promising platforms to manage behavior. This pilot study evaluated the utility of a web-based application (iSelfControl designed to support classroom behavior management. iSelfControl prompted students every 'Center' (30-minutes to self-evaluate using a universal token-economy classroom management system focused on compliance, productivity, and positive relationships. Simultaneously, the teacher evaluated each student on a separate iPad. Using Multi Level Modeling, we examined 13 days of data gathered from implementation with 5th grade students (N = 12 at a school for children with ADHD and related executive function difficulties. First, an unconditional growth model evaluated the overall amount of change in aggregated scores over time as well as the degree of systematic variation in scores within and across teacher-student dyads. Second, separate intercepts and slopes were estimated for teacher and student to estimate degree of congruency between trajectories. Finally, differences between teacher and student scores were tested at each time-point in separate models to examine unique 'Center' effects. 51% of the total variance in scores was attributed to differences between dyads. Trajectories of student and teacher scores remained relatively stable across seven time-points each day and did not statistically differ from each other. On any given day, students tended to evaluate their behaviors more positively (entered higher scores for themselves compared to corresponding teacher scores. In summary, iSelfControl provides a platform for self and teacher evaluation that is an important adjunct to conventional classroom management strategies. The application captured teacher
Emmerson, Natasha; Ziv, Hadar; Collins, Penelope; Arastoo, Sara; Warschauer, Mark; Crinella, Francis; Lakes, Kimberley
Children with Attention Deficit/Hyperactivity Disorder (ADHD) receive approximately 80% of instruction in the general education classroom, where individualized behavioral management strategies may be difficult for teachers to consistently deliver. Mobile device apps provide promising platforms to manage behavior. This pilot study evaluated the utility of a web-based application (iSelfControl) designed to support classroom behavior management. iSelfControl prompted students every ‘Center’ (30-minutes) to self-evaluate using a universal token-economy classroom management system focused on compliance, productivity, and positive relationships. Simultaneously, the teacher evaluated each student on a separate iPad. Using Multi Level Modeling, we examined 13 days of data gathered from implementation with 5th grade students (N = 12) at a school for children with ADHD and related executive function difficulties. First, an unconditional growth model evaluated the overall amount of change in aggregated scores over time as well as the degree of systematic variation in scores within and across teacher-student dyads. Second, separate intercepts and slopes were estimated for teacher and student to estimate degree of congruency between trajectories. Finally, differences between teacher and student scores were tested at each time-point in separate models to examine unique ‘Center’ effects. 51% of the total variance in scores was attributed to differences between dyads. Trajectories of student and teacher scores remained relatively stable across seven time-points each day and did not statistically differ from each other. On any given day, students tended to evaluate their behaviors more positively (entered higher scores for themselves) compared to corresponding teacher scores. In summary, iSelfControl provides a platform for self and teacher evaluation that is an important adjunct to conventional classroom management strategies. The application captured teacher
Children with communication disorders may express frustrations through challenging behaviors such as aggressive behaviors and social withdrawal. Challenging behaviors may lead to difficulties with building social competencies including emotional regulation and peer engagement. Individualized planning of functional goals for children with…
Sigee, Alicia D.
This qualitative phenomenological research study investigated the experiences of teachers' in the general education classroom with students with emotional behavior disorders. The five questions that guided the research examined teacher's use of strategies, administration support, and need the training to educate students with emotional behavioral…
Shin, Sunwoo; Koh, Myung-Sook
The purpose of this study is to investigate teachers' beliefs on classroom behavior management strategies for students in urban public high schools between teachers in the United States and the Republic of Korea. This study incorporates data collected from teacher self-reported survey questionnaire, which is the Attitudes and Beliefs on Classroom…
Koh, Myung-sook; Shin, Sunwoo
The purpose of this cross-cultural study is to investigate elementary teachers' beliefs and inter-cultural perspectives in classroom management (instructional environment and behavior management) for students in public schools of the U.S. and Korea. The results supported that the two groups of teachers showed similar beliefs in instructional…
Steed, Elizabeth A.; Noh, Jina; Heo, Kay H.
This study examined the implementation of critical features associated with positive behavioral interventions and supports (PBIS) in early childhood classrooms in the United States and South Korea. Each country has a distinct approach to providing early education for young children. There is some evidence that preschool teachers' approaches to…
Butzer, Bethany; Day, Danielle; Potts, Adam; Ryan, Connor; Coulombe, Sarah; Davies, Brandie; Weidknecht, Kimberly; Ebert, Marina; Flynn, Lisa; Khalsa, Sat Bir S.
This uncontrolled pilot study examined the effects of a classroom-based yoga intervention on cortisol concentrations and perceived behavior in children. A 10-week Yoga 4 Classrooms® intervention was implemented in one second- and one third-grade classroom. Students’ salivary cortisol responses were assessed at three time points. Classroom teachers also documented their perceptions of the effects of the intervention on students’ cognitive, social and emotional skills. Second, but not third, graders showed a significant decrease in baseline cortisol from before to after the intervention. Second and third graders both showed significant decreases in cortisol from before to after a cognitive task, but neither grade showed additional decreases from before to after a single yoga class. The second-grade teacher perceived significant improvements in several aspects his/her students’ behavior. The third-grade teacher perceived some, but fewer, improvements in his/her students’ behavior. Results suggest that school-based yoga may be advantageous for stress management and behavior. PMID:25412616
Machalicek, Wendy; O'Reilly, Mark; Chan, Jeffrey M.; Lang, Russell; Rispoli, Mandy; Davis, Tonya; Shogren, Karrie; Sigafoos, Jeff; Lancioni, Giulio; Antonucci, Massimo; Langthorne, Paul; Andrews, Alonzo; Didden, Robert
We conducted a functional analysis of challenging behavior for two students with autism using widely available videoconferencing equipment (laptop computers equipped with web cameras). Observers used the videoconferencing facilities to collect data on challenging behavior and to instruct the therapist conducting the assessment. Results of the…
Franco, Clemente; Amutio, Alberto; López-González, Luís; Oriol, Xavier; Martínez-Taboada, Cristina
Objective: The aim of the present study was to analyze the effects of a mindfulness training psycho-educative program on impulsivity and aggression levels in a sample of high school students. Methods: A randomized controlled trial with pre-test-post-test measurements was applied to an experimental group and a control group (waiting list). The Barratt Impulsivity Scale (BIS-11) Patton et al. (1995) and the Aggression Questionnaire (Buss and Perry, 1992) were used. Results: Statistical analyses showed a significant decrease in the levels of impulsivity and aggressiveness in the experimental group compared with the control group. These results have important implications for improving the level of academic engagement and self-efficacy of students and for reducing school failure. Conclusion: This is one of the first studies showing the effectiveness of mindfulness training at reducing impulsive and aggressive behaviors in the classroom. The efficacy of mindfulness-based programs is emphasized.
Allison, Barbara J.; Voss, Richard Steven; Dryer, Sean
Business students (n=211) rated their organizational citizenship behavior (altruism, courtesy, civic virtue, sportsmanship, conscientiousness). A majority had moderately high levels, but a significant percentage had relatively low levels. Organizational citizenship behavior was significantly and positively related to academic performance. (SK)
Lane, Kathleen Lynne; Pierson, Melinda R.; Stang, Kristin K.; Carter, Erik W.
Understanding the social behaviors teachers believe is critical for school success and can contribute to the development of effective behavioral supports and assist teachers in better preparing students for successful school transitions across the K-12 grade span. We explored 1303 elementary, middle, and high school teachers' expectations of…
Frayer, Dorothy A.; Klausmeier, Herbert J.
Research has shown that a behavior may be acquired through observing and imitating a model. A behavior which has already been acquired may be inhibited, disinhibited, or elicited by observing and imitating. A definition of imitation is given, and the effects of imitation on learning and performance are summarized. Research on factors which affect…
Burns, Michael E.; Houser, Marian L.; Farris, Kristen LeBlanc
The current study utilizes the theory of planned behavior (Ajzen "Organizational Behavior and Human Decision Processes," 50, 179-211 Ajzen 1991) to examine an instructor confirmation-interaction model in the instructional communication context to discover a means by which instructors might cultivate positive student attitudes and…
Rusby, Julie C.; Crowley, Ryann; Sprague, Jeffrey; Biglan, Anthony
This article describes the use of an observation system to measure middle school staff practices, environment characteristics, and student behavior in the school common areas. Data were collected at baseline from 18 middle schools participating in a randomized controlled trial of school-wide Positive Behavior Support. The observations were…
This article discusses how to work with a child who uses inappropriate language. The words inappropriately used by young children are grouped into five categories: (1) names of body parts considered as private, and their nicknames; (2) bathroom words and body products; (3) religion-related words; (4) sexually charged words overheard when adults…
Frieder, Jessica E; Peterson, Stephanie M; Woodward, Judy; Crane, Jaelee; Garner, Marlane
This paper describes a technically driven, collaborative approach to assessing the function of problem behavior using web-based technology. A case example is provided to illustrate the process used in this pilot project. A school team conducted a functional analysis with a child who demonstrated challenging behaviors in a preschool setting. Behavior analysts at a university setting provided the school team with initial workshop trainings, on-site visits, e-mail and phone communication, as well as live web-based feedback on functional analysis sessions. The school personnel implemented the functional analysis with high fidelity and scored the data reliably. Outcomes of the project suggest that there is great potential for collaboration via the use of web-based technologies for ongoing assessment and development of effective interventions. However, an empirical evaluation of this model should be conducted before wide-scale adoption is recommended.
Deborah J. Rhea
Full Text Available Unstructured, outdoor play combined with character development instruction has shown preliminary associations with improved cognitive functioning and classroom behaviors. The purpose of this study was to further evaluate these components of the LiiNK Project (Let’s inspire innovation ’N Kids when including intervention and comparison school children. The intervention consists of four 15-min recesses, scheduled throughout the day in combination with four 15-min character development lessons taught weekly to improve the elementary classroom learning environment. The second year of this longitudinal study included grades kindergarten through second grade students (N = 405 from two demographically comparable private schools in the southwest region of the United States. One school implemented the intervention, while the other school maintained current protocols. The intervention teachers adhered to the four play breaks at a rate of 92% over the course of the intervention. Transitions from classroom to playground and back dropped from 4 min each way to less than 1 min each way. The results of comparing the two schools showed classroom off-task behaviors such as fidgeting and moving around the room decreased significantly, while attentional focus improved significantly as a result of the intervention. LiiNK Project results from grades kindergarten and 1 in the same schools last year are congruent with the results of this study. Next steps will include public school expansion to explore student diversity among rural, urban, and suburban environments with the play and character intervention.
Dunlap, Glen; Kern, Lee; dePerczel, Maria; Clarke, Shelley; Wilson, Diane; Childs, Karen E.; White, Ronnie; Falk, George D.
Functional assessment and functional analysis are processes that have been applied successfully in work with people who have developmental disabilities, but they have been used rarely with students who experience emotional or behavioral disorders. In the present study, five students in elementary school programs for severe emotional disturbance…
Bruer, John T.
Implicit in recent Evidence Speaks postings is the need to develop evidence-based interventions for improving student achievement. Comparative analysis of the education research literature versus the educational neuroscience literature suggests that education research, grounded in the behavioral and cognitive sciences, is currently the better…
Tomul, Ekber; Çelik, Kazim; Tas, Ali
Problem Statement: In Turkey, students' perceptions about teachers' discrimination and justice behaviors and their effects on teacher-student relations have not been extensively studied. Within educational contexts, especially in justice literature, there is a lack of research about the perceptions of teacher candidates, as well as about teachers'…
Van Buskirk, William; London, Michael
In this article, the authors argue that poetry provides a valuable if overlooked resource to the organizational behavior professor. The authors describe a workshop designed to evoke students' innate poetic metaphors to enable a more lively engagement with course material. Because many of students' personal, private, and emotionally charged…
Black, Melanie R.
This study addressed the extent to which coaching, as a specific type of professional development, impacted teacher behavior and instructional quality. Specifically, this study sought to determine the extent to which teachers understood and used Marzano's nine high-yield strategies as a result of their participation in six weeks of on-site…
Buttner, E. Holly
Attributes of relational theory, based on women's development, include preventive connecting, mutual empowering, achieving, and team building. These attributes are compatible with the practices of high performance work organizations. Relational practices should be integrated into management and organizational behavior courses. (Contains 53…
Concurrent to the present reduction of arts education in mainstream American schools, many evolutionary-minded scholars are asserting that artistic behavior contributes significantly to cognition, has been advantageous for our survival, and satisfies psychological needs that are biologically embedded. Supported by long-term and wide-spread art…
Chiang, Tosti Hsu-Cheng
Programing is difficult for beginners because they need to learn the new language of computers. Developing software, especially complex software, is bound to result in problems, frustration, and the need to think in new ways. Identifying the learning behavior behind programing by way of empirical studies can help beginners learn more easily. In…
The role of context in preschool learning: a multilevel examination of the contribution of context-specific problem behaviors and classroom process quality to low-income children's approaches to learning.
Domínguez, Ximena; Vitiello, Virginia E; Fuccillo, Janna M; Greenfield, Daryl B; Bulotsky-Shearer, Rebecca J
Research suggests that promoting adaptive approaches to learning early in childhood may help close the gap between advantaged and disadvantaged children. Recent research has identified specific child-level and classroom-level variables that are significantly associated with preschoolers' approaches to learning. However, further research is needed to understand the interactive effects of these variables and determine whether classroom-level variables buffer the detrimental effects of child-level risk variables. Using a largely urban and minority sample (N=275) of preschool children, the present study examined the additive and interactive effects of children's context-specific problem behaviors and classroom process quality dimensions on children's approaches to learning. Teachers rated children's problem behavior and approaches to learning and independent assessors conducted classroom observations to assess process quality. Problem behaviors in structured learning situations and in peer and teacher interactions were found to negatively predict variance in approaches to learning. Classroom process quality domains did not independently predict variance in approaches to learning. Nonetheless, classroom process quality played an important role in these associations; high emotional support buffered the detrimental effects of problem behavior, whereas high instructional support exacerbated them. The findings of this study have important implications for classroom practices aimed at helping children who exhibit problem behaviors. Copyright © 2010 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.
Kramer, David C.
Provides basic information on the anatomy, physiology, behaviors, and distribution patterns of the box turtle. Offers suggestions for the turtle's care and maintenance in a classroom environment. (ML)
Hodgson, Theodore R.; Cunningham, Abby; McGee, Daniel; Kinne, Lenore J.; Murphy, Teri J.
There is a growing evidence that flipped classrooms are associated with increased levels of student engagement, as compared to engagement in "traditional" settings. Much of this research, however, occurs in post-secondary classrooms and is based upon self-reported engagement data. This study seeks to extend existing flipped classroom…
Gage, Nicholas A.; Scott, Terrance; Hirn, Regina; MacSuga-Gage, Ashley S.
Teachers' classroom management practices have a direct impact on their students' probability of success. Evidence-based classroom management practices include (a) active instruction and supervision of students (i.e., teaching), (b) opportunities for students to respond, and (c) feedback to students. In this study, we examined the degree to which…
Parastou Gholami Pasand
Full Text Available Considering the tenets of Sociocultural Theory with its emphasis on co-construction of knowledge, L2 writing can be regarded as a co-writing practice whereby assistance is provided to struggling writers. To date, most studies have dealt with peer scaffolding in the revision phase of writing, as such planning and drafting are remained untouched. The present study examines the impact of peer scaffolding on writing accuracy of a group of intermediate EFL learners, and explores scaffolding behaviors employed by them in planning and drafting phases of writing. To these ends, 40 freshmen majoring in English Language and Literature in the University of Guilan were randomly divided into a control group and an experimental group consisting of dyads in which a competent writer provided scaffolding to a less competent one using the process approach to writing. Results of independent samples t-tests revealed that learners in the experimental group produced more accurate essays. Microgenetic analysis of one dyad’s talks showed that scaffolding behaviors used in planning and drafting phases of writing were more or less the same as those identified in the revision phase. These findings can be used to inform peer intervention in L2 writing classes, and assist L2 learners in conducting successful peer scaffolding in the planning and drafting phases of writing.
Schmidt, Maria Christina Secher
This article investigates possible links between inclusion, students, for whom mathematics is extensively difficult, and classroom leadership through a case study on teaching strategies and student participation in four classrooms at two different primary schools in Denmark. Three sets of results...... are presented: 1) descriptions of the teachers’ classroom leadership to include all their students in the learning community, 2) the learning community produced by stated and practiced rules for teaching and learning behavior, 3) the classroom behavior of students who experience difficulties with mathematics....... The findings suggest that the teachers’ pedagogical choices and actions support an active learning environment for students in diverse learning needs, and that the teachers practise dimensions of inclusive classroom leadership that are known to be successful for teaching mathematics to all students. Despite...
Hmelo-Silver, C.; Gray, S.; Jordan, R.
the levels of ecosystems. A big part of this is making phenomena accessible to their experience. We accomplished through the use of physical models and computers simulations at different scale. In an effort to promote a coherent understanding in our learners, we sought to develop tools that can provide dynamic feedback that will enable them to modify, enrich, and repair their mental models as needed (e.g., Roschelle, 1996). Additionally, we also wanted to develop a conceptual representation that can be used across multiple ecosystems to prepare students to learn about new systems in the future (Bransford & Schwartz, 1999). Our approach to this has been to use the structure-behavior-function (SBF) conceptual representation (Liu & Hmelo-Silver, 2009; Vattam et al., in press). Often, learning life science is about learning the names of structures. One of our design principles is to ensure instruction emphasizes the behaviors (or mechanisms) of systems as well as the functions (the system outputs) in addition to the structures. We have used simulations to help make behaviors and functions visible and a modeling tool that supports students in thinking about the SBF conceptual representation. In this presentation, we will report on the results of classroom interventions and the lessons learned.
Fuller, Richard L; Goldfield, Norbert I; Averill, Richard F; Hughes, John S
In this article, the authors demonstrate that the use of relative weights, as incorporated within the National Quality Forum-endorsed PacifiCare readmission measure, is inappropriate for risk adjusting rates of hospital readmission.
Wouters, Hans; Scheper, Jessica; Koning, Hedi; Brouwer, Chris; Twisk, Jos W.; van der Meer, Helene; Boersma, Froukje; Zuidema, Sytse U.; Taxis, Katja
Background: Inappropriate prescribing is a well-known clinical problem in nursing home residents, but few interventions have focused on reducing inappropriate medication use. Objective: To examine successful discontinuation of inappropriate medication use and to improve prescribing in nursing home
Wouters, H.; Scheper, J.; Koning, H.; Brouwer, C.; Twisk, J.; Van Der Meer, H.; Boersma, F.; Zuidema, S.; Taxis, K.
Introduction: Inappropriate prescribing is a prevalent problem in nursing home residents that is associated with cognitive and physical impairment. Few interventions have been shown to reduce inappropriate prescribing. The aim was therefore to examine successful discontinuation of inappropriate
Design and methods of the Echo WISELY (Will Inappropriate Scenarios for Echocardiography Lessen SignificantlY) study: An investigator-blinded randomized controlled trial of education and feedback intervention to reduce inappropriate echocardiograms.
Bhatia, R Sacha; Ivers, Noah; Yin, Cindy X; Myers, Dorothy; Nesbitt, Gillian; Edwards, Jeremy; Yared, Kibar; Wadhera, Rishi; Wu, Justina C; Wong, Brian; Hansen, Mark; Weinerman, Adina; Shadowitz, Steven; Johri, Amer; Farkouh, Michael; Thavendiranathan, Paaladinesh; Udell, Jacob A; Rambihar, Sherryn; Chow, Chi-Ming; Hall, Judith; Thorpe, Kevin E; Rakowski, Harry; Weiner, Rory B
Appropriate use criteria (AUC) for transthoracic echocardiography (TTE) were developed to address concerns regarding inappropriate use of TTE. A previous pilot study suggests that an educational and feedback intervention can reduce inappropriate TTEs ordered by physicians in training. It is unknown if this type of intervention will be effective when targeted at attending level physicians in a variety of clinical settings. The aim of this international, multicenter study is to evaluate the hypothesis that an AUC-based educational and feedback intervention will reduce the proportion of inappropriate echocardiograms ordered by attending physicians in the ambulatory environment. In an ongoing multicentered, investigator-blinded, randomized controlled trial across Canada and the United States, cardiologists and primary care physicians practicing in the ambulatory setting will be enrolled. The intervention arm will receive (1) a lecture outlining the AUC and most recent available evidence highlighting appropriate use of TTE, (2) access to the American Society of Echocardiography mobile phone app, and (3) individualized feedback reports e-mailed monthly summarizing TTE ordering behavior including information on inappropriate TTEs and brief explanations of the inappropriate designation. The control group will receive no education on TTE appropriate use and order TTEs as usual practice. The Echo WISELY (Will Inappropriate Scenarios for Echocardiography Lessen Significantly in an education RCT) study is the first multicenter randomized trial of an AUC-based educational intervention. The study will examine whether an education and feedback intervention will reduce the rate of outpatient inappropriate TTEs ordered by attending level cardiologists and primary care physicians (www.clinicaltrials.gov identifier NCT02038101). Copyright © 2015 Elsevier Inc. All rights reserved.
Pimperton, Hannah; Nation, Kate
Differing etiological explanations have been proposed to account for poor comprehenders' difficulties with reading comprehension, with some researchers emphasizing working memory deficits and others arguing for oral language weaknesses playing a key causal role. The authors contrasted these two theoretical accounts using data obtained from direct measures of working memory and from teacher ratings of poor comprehenders' behavior in the classroom. At the group level, poor comprehenders showed weaknesses on verbal but not nonverbal working memory tasks, in keeping with the "language account." However, they also showed evidence of elevated levels of problem behaviors specifically associated with working memory deficits. Further analysis revealed that these group differences in working-memory-related problem behaviors were carried by a small subgroup of poor comprehenders who also displayed domain-general (verbal and nonverbal) working memory problems, argued to be reflective of "genuine" underlying working memory deficits.
Schimpf, Rainer; Wolpert, Christian; Bianchi, Francesca; Giustetto, Carla; Gaita, Florenzo; Bauersfeld, Urs; Borggrefe, Martin
A congenital short QT interval constitutes a new primary electrical abnormality associated with syncope and/or sudden cardiac death. We report on the initial use of implantable cardioverter defibrillator (ICD) therapy in patients with inherited short QT interval and discuss sensing abnormalities and detection issues. In five consecutive patients from two unrelated European families who had structurally normal hearts, excessively shortened QT intervals, and a strong positive family history of sudden cardiac death, ICDs were placed for primary and secondary prevention. Mean QT intervals were 252 +/- 13 ms (QTc 287 +/- 13 ms). Despite normal sensing behavior during intraoperative and postoperative device testing, 3 of 5 patients experienced inappropriate shock therapies for T wave oversensing 30 +/- 26 days after implantation. Programming lower sensitivities and decay delays prevented further inappropriate discharges. The congenital short QT syndrome constitutes a new clinical entity with an increased risk for sudden cardiac death. Currently, ICD treatment is the only therapeutic option. In patients with short QT interval and implanted ICD, increased risk for inappropriate therapy is inherent due to the detection of short-coupled and prominent T waves. Careful testing of ICD function and adaptation of sensing levels and decay delays without sacrificing correct arrhythmia detection are essential.
Kendall, Leslie Threadgill
Connectedness and classroom management has been defined as the ability to relate to students and keep order and maintain successful relationships with individuals. This qualitative study utilized surveys, questionnaires, interviews, and observations to examine the best practices implemented by educators to develop and maintain connections with…
Wilson, Travis; Rodkin, Philip C.
With a sample of African American and European American 3rd- and 4th-grade children (N = 486, ages 8-11 years), this study examined classroom ethnic composition, peer social status (i.e., social preference and perceived popularity as nominated by same- and cross-ethnicity peers), and patterns of ethnic segregation (i.e., friendship, peer group,…
Kelly, Donald Edward
This study found no significant difference in classroom teaching performance between participants enrolled in the three semester on-site teacher preparation sequence and participants enrolled in a one semester on-campus and two semester on-site sequence. Subjects were 39 volunteer undergraduate students enrolled in the Department of Secondary…
Howard, Larry L.
This paper estimates models of the transitional effects of food insecurity experiences on children's non-cognitive performance in school classrooms using a panel of 4710 elementary students enrolled in 1st, 3rd, and 5th grade (1999-2003). In addition to an extensive set of child and household-level characteristics, we use information on U.S.…
Olde Nordkamp, Louise R. A.; Brouwer, Tom F.; Barr, Craig; Theuns, Dominic A. M. J.; Boersma, Lucas V. A.; Johansen, Jens B.; Neuzil, Petr; Wilde, Arthur A. M.; Carter, Nathan; Husby, Michael; Lambiase, Pier D.; Knops, Reinoud E.
The entirely subcutaneous implantable cardioverter-defibrillator (S-ICD) eliminates the need for transvenous leads, and therefore has the potential to improve lead-longevity and reduce lead-related complications. The S-ICD has a morphology-based sensing algorithm of which inappropriate shocks have
Kristensen, Rachel Underlien; Nørgaard, Ane; Jensen-Dahm, Christina
BACKGROUND: Polypharmacy (use of ≥5 different medications) and potentially inappropriate medication (PIM) are well-known risk factors for numerous negative health outcomes. However, the use of polypharmacy and PIM in people with dementia is not well-described. OBJECTIVE: To examine the prevalence...
Delgado Silveira, Eva
Older people are a heterogeneous group of patients, often with multiple comorbidities for which they are prescribed a large number of drugs, leading to an increased risk of adverse drug reactions (ADR) and drug interactions. This risk is compounded by physiological age-related changes in physiology, changes in drug pharmacokinetics and pharmacodynamics, as well as by disease-related, functional and social issues. Inappropriate prescription of drugs is common in the older individuals and contributes to the increased risk of ADR. Several tools have been developed to detect potentially inappropriate prescription, the most frequently used in Spain being Beers\\' criteria. However, the value of these criteria is limited, especially as they were developed in a different healthcare system. In this article, the Spanish version of a new tool to detect potentially inappropriate prescriptions-STOPP (Screening Tool of Older Person\\'s Prescriptions) and START (Screening Tool to Alert doctors to Right i.e. appropriate, indicated Treatment) criteria-is presented. The creation, development, reliability, and use of these criteria in routine practice is described and discussed. These criteria have shown better sensitivity than Beers\\' criteria in detecting prescription problems and have the added value of being able to detect not only inappropriate prescription of some drugs, but also the omission of well indicated drugs. The STOPP\\/START criteria could become a useful screening tool to improve prescription in older people.
Zhu, Xihe; Davis, Summer; Kirk, T. Nicole; Haegele, Justin A.; Knott, Stephen E.
Fitness education is becoming an integrated component for many physical education programs. As such, many physical educators conduct health-related fitness tests on a regular basis. Some states even mandate certain types of physical fitness tests to be administered and reported annually or by semester. Yet, inappropriate practices have been…
By comparing the patients according to their site of care, 52.4 % (43/82) of ICU patients compared to 87.4 % (97/111) of medically hospitalized patient (non-ICU) were inappropriately receiving PPIs (p = 0.000). Conclusion: Adherence to the current practice guidelines for safe prescription of PPIs is poor. Thus, updating ...
Mauka, Wilhellmuss I; Mtuy, Tara B; Mahande, Michael J; Msuya, Sia E; Mboya, Innocent B; Juma, Abdul; Philemon, Rune N
Blood is a critical aspect of treatment in life saving situations, increasing demand. Blood requisition practices greatly effect sufficient supply in blood banks. This study aimed to determine the risk factors for inappropriate blood requisition in Tanzania. This was a cross sectional study using secondary data of 14,460 patients' blood requests from 42 transfusion hospitals. Primary data were obtained by using cluster-sampling design. Data were analysed using a two-level mixed-effects Poisson regression to determine fixed-effects of individual-level factors and hospital level factors associated with inappropriate blood requests. P-value Factors significantly associated with inappropriate requisition were; reporting pulse rate and capillary refill decrease the risk (RR 0.74; 95% CI 0.64, 0.84) and (RR 0.73; 95% CI 0.63, 0.85) respectively and the following increased the risk; having surgery during hospital stay (RR 1.22; 95% CI 1.06, 1.4); being in general surgical ward (RR 3.3; 95% CI 2.7, 4.2), paediatric ward (RR 1.8; 95% CI 1.2, 2.7), obstetric ward (RR 2.5; 95% CI 2.0, 3.1), gynaecological ward (RR 2.1; 95% CI 1.5, 2.9), orthopaedics ward (RR 3.8; 95% CI 2.2, 6.7). Age of the patient, pallor and confirmation of pre-transfusion haemoglobin level were also significantly associated with inappropriate requisition. Majority of appropriate requisitions within the wards were marked in internal medicine (91.7%) and gynaecological wards (77.8%). The proportion of inappropriate blood requests was high. Blood requisition was determined by clinical and laboratory findings and the ward patients were admitted to. Adherence to transfusion guidelines is recommended to assure the best use of limited blood supply.
A qualitative study of the instructional behaviors and practices of a dyad of educators in self-contained and inclusive co-taught secondary biology classrooms during a nine-week science instruction grading period
Hardy, Shanon D.
The Individuals with Disabilities Education Act (IDEA) (1997) mandates that students with disabilities have access to the general education curriculum. School districts have developed a variety of service delivery models to provide challenging educational experiences for all students. Co-teaching or collaborative teaching is the most widely used of the different service delivery models. While the philosophy of inclusion is widely accepted, the efficacy of the various inclusion models has recently been the focus of educational research. Researchers have questioned whether the presence of a special educator in the general education classroom has resulted in students with high incidence disabilities receiving specialized instruction. A qualitative study was designed to examine the instructional behaviors and practices exhibited and used by a dyad of educators in self-contained learning disabilities and inclusive co-taught secondary Biology classrooms during a nine-week science instruction grading period. In addition to utilizing interviews, observations, and classroom observation scales to answer the research questions, supporting student data (time-sampling measurement/opportunity to learn and student grades) were collected. The study concluded that the presence of a special educator in a co-taught classroom: (1) did contribute to the creation of a new learning environment, and notable changes in the instructional behaviors and practices of a general educator; (2) did contribute to limited specialized instruction for students with disabilities in the co-taught classrooms and embedded (not overt) special education practices related to the planning and decision-making of the educators; (3) did contribute to the creation of a successful co-teaching partnership including the use of effective teaching behaviors; and (4) did impact success for some of the students with disabilities in the co-taught classrooms; but (5) did not ensure the continuation of some of the new
Casabianca, Jodi M.; Lockwood, J. R.; McCaffrey, Daniel F.
Observations and ratings of classroom teaching and interactions collected over time are susceptible to trends in both the quality of instruction and rater behavior. These trends have potential implications for inferences about teaching and for study design. We use scores on the Classroom Assessment Scoring System-Secondary (CLASS-S) protocol from…
Objective:To explore strategies to motivate students in the classroom of Medical English. Methods:The motivational strategies applied in medical English classroom including defining course goals early in the semester, appropriate teacher behavior, creating real context and giving helpful and frequent Feedback were recommended. Results & Conclusion: The motivational strategies make a positive impact on students’motivation in medical English classroom.
Anderson, Lorin W.
The IEA's Classroom Environment Study, implemented in grades 5-9 in 9 countries, examined effects on student outcomes of home, community, school, teacher, and student characteristics and classroom practices. Across countries, course content varied widely, but teachers relied on relatively few classroom behaviors. Student learning was affected by…
Decaux, G; Waterlot, Y; Genette, F; Hallemans, R; Demanet, J C
Seven out of nine patients with chronic inappropriate secretion of antidiuretic hormone were successfully treated with 40 mg frusemide daily. One patient needed 80 mg, and the remaining patient achieved only a small increase in diuresis after 40 mg frusemide; this was probably related to his low creatinine clearance. In order to maintain a salt intake high enough to compensate for the loss of urine electrolytes 3 to 6 g sodium chloride was added as tablets to the sodium-free diet in six patients. Hypokalaemia occurred in five patients but was easily corrected with either supplements of potassium chloride or a potassium-sparing diuretic. These findings add further weight to evidence that Frusemide is a good alternative for the treatment of patients with inappropriate secretion of antidiuretic hormone who cannot tolerate water restriction.
Inappropriate prescribing (IP) is a common and serious global healthcare problem in elderly people, leading to increased risk of adverse drug reactions (ADRs), polypharmacy being the main risk factor for both IP and ADRs. IP in older people is highly prevalent but preventable; hence screening tools for IP have been devised, principally Beers\\' Criteria and the Inappropriate Prescribing in the Elderly Tool (IPET). Although Beers\\' Criteria have become the most widely cited IP criteria in the literature, nevertheless, they have serious deficiencies, including several drugs that are rarely prescribed nowadays, a lack of structure in the presentation of the criteria and omission of several important and common IP instances. New, more up-to-date, systems-based and easily applicable criteria are needed that can be applied in the routine clinical setting.
Hannon, M J
Hyponatraemia is the commonest electrolyte abnormality found in hospital inpatients, and is associated with a greatly increased morbidity and mortality. The syndrome of inappropriate antidiuretic hormone (SIADH) is the most frequent cause of hyponatraemia in hospital inpatients. SIADH is the clinical and biochemical manifestation of a wide range of disease processes, and every case warrants investigation of the underlying cause. In this review, we will examine the prevalence, pathophysiology, clinical characteristics and clinical consequences of hyponatraemia due to SIADH.
Chan, A. W.; MacFarlane, I. A.; van Heyningen, C.; Foy, P. M.
We report a case of hyperthyroidism due to inappropriate thyrotrophin (TSH) secretion in a patient with selective pituitary resistance to thyroid hormone action. Symptoms of hyperthyroidism in patients with this disorder are usually mild, implying some peripheral tissue resistance to the metabolic effects of thyroid hormone. Our patient had unusually severe symptoms, including marked weight loss and cardiac arrythmias which required carbimazole and beta-blocker therapy for control. Somatostat...
Menon, Aditya Krishna; Jiang, Xiaoqian; Kim, Jihoon; Vaidya, Jaideep; Ohno-Machado, Lucila
Many healthcare facilities enforce security on their electronic health records (EHRs) through a corrective mechanism: some staff nominally have almost unrestricted access to the records, but there is a strict ex post facto audit process for inappropriate accesses, i.e., accesses that violate the facility's security and privacy policies. This process is inefficient, as each suspicious access has to be reviewed by a security expert, and is purely retrospective, as it occurs after damage may have been incurred. This motivates automated approaches based on machine learning using historical data. Previous attempts at such a system have successfully applied supervised learning models to this end, such as SVMs and logistic regression. While providing benefits over manual auditing, these approaches ignore the identity of the users and patients involved in a record access. Therefore, they cannot exploit the fact that a patient whose record was previously involved in a violation has an increased risk of being involved in a future violation. Motivated by this, in this paper, we propose a collaborative filtering inspired approach to predicting inappropriate accesses. Our solution integrates both explicit and latent features for staff and patients, the latter acting as a personalized "finger-print" based on historical access patterns. The proposed method, when applied to real EHR access data from two tertiary hospitals and a file-access dataset from Amazon, shows not only significantly improved performance compared to existing methods, but also provides insights as to what indicates an inappropriate access.
Goga, Joshana K; Depaolo, Antonio; Khushalani, Sunil; Walters, J Ken; Roca, Robert; Zisselman, Marc; Borleis, Christopher
To Evaluate the Effects of Applying Lean Methodology-Improving Quality Increasing Efficiency by Eliminating Waste and Reducing Costs-An Approach To Decrease the Prescribing Frequency of Antipsychotics for The Indication of Agitation. Historically Controlled Study. Bheppard Pratt Health System is the Largest Private Provider of Psychiatric Care in Maryland With a Total Bed Capacity of 300. There Were 4 337 Patient Days From November 1 2012 to October 31 2013 on the Dementia Unit. All Patients Admitted on the Dementia Unit Were 65 Years of Age and Older with a Primary Diagnosis of Dementia. our Multidisciplinary Team Used Lean Methodology to Identify the Root Causes and Interventions Necessary to Reduce Inappropriate Antipsychotic Use. The Primary Outcome Was Rate of Inappropriately Indicating Agitation as the Rationale When Prescribing Antipsychotic Medications. There Was a 90% (P Agitation. The Lean Methodology Interventions Led To A 90% (P Agitation and a 10% Rate Reduction in Overall Antipsychotic Prescribing. Key Words: Agitation Alzheimer's Antipsychotics Behavioral and Psychological Symptoms of Dementia Centers For Medicare & Medicaid Services Dementia Root-cause Analysis. BPSD = Behavioral and Psychological Symptoms of Dementia CATIE-AD = Clinical Antipsychotic Trials of Intervention Effectiveness in Alzheimer's Disease EMR = Electronic Medical Records GAO = Government Accountability Office GNCIS = Geriatric Neuropsychiatric Clinical Indicator Scale.
Wilson, Travis; Rodkin, Philip C.
With a sample of African American and European American 3rd and 4th grade children (N = 486, ages 8–11 years), this study examined classroom ethnic composition, peer social status (i.e., social preference and perceived popularity as nominated by same- and cross-ethnicity peers), and patterns of ethnic segregation (i.e., friendship, peer group, and cross-ethnicity dislike). African American—but not European American—children had more segregated relationships and were more disliked by cross-eth...
Eva Fitriani Syarifah; Raynesa Noor Emiliasari
In a foreign language context, classroom management is very important to be considered by the teachers since the target language is taught mostly in classroom. However, managing classroom is not an easy task to do. Most of teachers think it is difficult because they need to organize the class, deal with students‘ behavior and manage the time. Taking the issues above into account, this research was conducted to find out strategies in managing EFL classrooms applied by a teacher ...
Rancifer, Jesse L.
This paper presents classroom management practices that can be used to avoid the "revolving classroom door." In the revolving classroom door, misbehaving students are sent to the principal, and eventually returned to the classroom with no gains in student behavior or opportunity for learning. The paper begins by discussing the meaning of classroom…
Bruin-Huisman, Linette; Abu-Hanna, Ameen; van Weert, Henk C. P. M.; Beers, Erna
potentially inappropriate prescribing (PIP) is associated with adverse health effects in older patients. PIP comprises prescription of potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs). to estimate the prevalence of PIMs and PPOs among older patients in primary
Holm, Ellen Astrid; Bie, Peter; Ottesen, Michael
BACKGROUND: Hyponatremia is a frequent condition in elderly patients. In diagnostic workup, a 24-hour urine sample is used to measure urinary osmolality and urinary sodium concentration necessary to confirm the diagnosis of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH...... natriuretic peptides, renin, and aldosterone were measured in the supine and upright positions of patients and compared with nine healthy age-matched control patients. RESULTS: The patients had low plasma osmolality (median 266 mOsm/kg) and measurable levels of arginine vasopressin (median 1.8 pg/mL). Values...
This paper develops a simple model where a manager of a firm in a Less-Developed Country (LDC) has the choice of whether or not to purchase an inappropriate technology in return for a bribe (kick-back) from the supplier of the technology. Provided that the manager achieves some minimum level of profit, the manager has a positive probability of not getting caught taking the bribe. The actual size of the bribe is determined by Nash axiomatic bargaining between the manager and the supplier. An i...
Full Text Available Superficial mycoses are estimated to affect more than 20-25% of the world’s population with a consistent increase over the years. Most patients referred to our clinic for suspected dermatomycoses have already been treated with pharmacotherapy, without a previous mycological examination and many show changes in the clinical manifestations. Indeed, some medications, such as steroids, antiviral, antibiotics and antihistamines are not able to erase a fungal infection, but also they can cause atypical clinical manifestations. The consequences of inappropriate treatment include delayed diagnosis, prolonged healing time, and additional costs. The aims of this study were (1 to evaluate the incidence of increased costs attributable to inappropriate therapy sustained by the National Health Service and patients and (2 to highlight the importance of mycological evaluation before starting treatment, in order to improve diagnostic accuracy. An observational retrospective and prospective study was performed from September 2013 to February 2014, in 765 patients referred to our center (University Hospital “ Federico II” in Naples, Italy, for suspected mycological infection. The following treatments (alone or in combination were defined as inappropriate: (1 cortisone in a patient with at least one positive site; (2 antifungals in (a patients with all negative sites or (b ineffective antifungal treatment (in terms of drug chosen, dose or duration in those with all positive sites; or (3 antibiotics; (4 antivirals or (5 antihistamines, in patients with ≥ 1 positive site. Five hundred and fifty patients were using medications before the assessment visit. The total amount of avoidable costs related to inappropriate previous treatments was € 121,417, representing 74% of the total treatment costs. 253/550 patients received drugs also after the visit. For these patients, the cost of treatment prescribed after mycological testing was € 42,952, with a decrease
Brian Marino, DO
Full Text Available An 80-year-old woman with a history of paroxysmal atrial fibrillation and atrioventricular node disease status post-dual chamber pacemaker placement was noted to have abnormal pacing episodes during a percutaneous coronary intervention. Pacemaker interrogation revealed a high number of short duration mode switching episodes. Representative electrograms demonstrated high frequency nonphysiologic recordings predominantly in the atrial lead. Intrinsic pacemaker malfunction was excluded. A chest radiograph showed excess atrial and ventricular lead slack in the right ventricular inflow. It was suspected that lead–lead interaction resulted in artifacts and oversensing, causing frequent short episodes of inappropriate mode switching.
Donaldson, Jeanne M.; Matter, Ashley L.; Wiskow, Katie M.
The Good Behavior Game (GBG) is a classwide group contingency shown to reduce disruptive student behavior. We examined the feasibility of training young students to lead the GBG in one first-grade and three kindergarten classes. We also examined teacher preference for teacher-led GBG, student-led GBG, or no GBG using a concurrent chains procedure.…
Wang, Ze; Bergin, Christi; Bergin, David A.
Research on factors that may promote engagement is hampered by the absence of a measure of classroom-level engagement. Literature has suggested that engagement may have 3 dimensions--affective, behavioral, and cognitive. No existing engagement scales measure all 3 dimensions at the classroom level. The Classroom Engagement Inventory (CEI) was…
An outdoor classroom is the ideal vehicle for community involvement: Parents, native plant societies, 4-H, garden clubs, and master naturalists are all resources waiting to be tapped, as are local businesses offering support. If you enlist your community in the development and maintenance of your outdoor classroom, the entire community will…
Skov, Tobias Kidde; Jørgensen, Søren
Artiklen beskriver Flipped Classroom som et didaktisk princip, der kan være med til at organisere og tilrettelægge en undervisning, med fokus på forskellige læringsformer. Det handler om at forstå Flipped Classroom som en opdeling i 2 faser og 3 led, som samlet set skaber en didaktisk organisering....
Shah, Neil; Baker, Steven A; Spain, David; Shieh, Lisa; Shepard, John; Hadhazy, Eric; Maggio, Paul; Goodnough, Lawrence T
To curtail inappropriate plasma transfusions, we instituted clinical decision support as an alert upon order entry if the patient's recent international normalized ratio (INR) was 1.7 or less. The alert was suppressed for massive transfusion and within operative or apheresis settings. The plasma order was automatically removed upon alert acceptance while clinical exception reasons allowed for continued transfusion. Alert impact was studied comparing a 7-month control period with a 4-month intervention period. Monthly plasma utilization decreased 17.4%, from a mean ± SD of 3.40 ± 0.48 to 2.82 ± 0.6 plasma units per hundred patient days (95% confidence interval [CI] of difference, -0.1 to 1.3). Plasma transfused below an INR of 1.7 or less decreased from 47.6% to 41.6% (P = .0002; odds ratio, 0.78; 95% CI, 0.69-0.89). The alert recommendation was accepted 33% of the time while clinical exceptions were chosen in the remaining cases (active bleeding, 31%; other clinical indication, 33%; and apheresis, 2%). Alert acceptance rate varied significantly among different provider specialties. Clinical decision support can help curtail inappropriate plasma use but needs to be part of a comprehensive strategy including audit and feedback for comprehensive, long-term changes. © American Society for Clinical Pathology, 2017. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org
Fajreldines, A; Insua, J; Schnitzler, E
One of the causes of preventable adverse drug events (ADES) in older patients constitutes inappropriate prescription of drugs (PIM). The PIM is where risks exceed the clinical benefit. Several instruments can be use to measure this problem, the most used are: a) Beers criteria; b) Screening tool to Older People Potentially inappropriate Prescription (STOPP); c) Screening tool to Alert Doctors to Right Appropriate indicated Treatments (START); d) The Medication Appropriateness Index (MAI). This study aims to assess the prevalence of PIM, in a population of older adults in three clinical scopes of university hospital. cross sectional study of 300 cases from a random sample of fields: hospitalization (n=100), ambulatory (n=100) and emergency (n=100), all patients over 65 years old or more who where treated at our hospital. 1355 prescription drugs were analized, finding patients hospitalized (PIM) of 57.7%, 55%, 26%, and 80% according to Beers, in ambulatory 36%, 36.5%, 5% and 52% with the same tools and in emergency 35%, 35%, 6% y 52% with the same tools. Was found significant association the PIM with polipharmacy with Beers, STOPP and MAI. results can be compare to world literature (26-80% vs 11-73.1%). The STOPP-START used in an integrated manner would be best estimating the problem of PIM. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.
Scott, Terrance M.; Alter, Peter J.
This article is a review of functional behavior assessment studies in general education setting for students with emotional and behavioral disorders. The studies were assessed in accordance with published standards for evidence-based practices. Overall, few studies met criteria for inclusion in this review and even fewer studies included all three…
Sisson, L. A.; Dixon, M. J.
Inappropriate mealtime behaviors of a blind, mentally retarded, behaviorally disordered 10-year-old were modified via behavior therapy techniques, including audiotape of favorite stories turned off during inappropriate behavior and praise (plus access to food) for appropriate napkin and utensil use, once desired sitting posture had been…
This report describes classroom observation techniques used to record the behavior of educational specialists (teachers) and students in a kindergarten and a first grade classroom of the Kamehameha Early Education Program (KEEP). Classroom behavior was observed and recorded daily during the 1973-1974 school year. Each student was observed three…
The Impact of Prolonged Participation in a Pro-Social Cognitive Behavioral Skills Program on Elementary Age Students, with Behavior Related Disorders, Behavior Accelerative, Behavior Reductive, and Return to Regular Classroom Outcomes
Esser, Ted H.
Overall, pretest-posttest results indicated statistically significant pretest beginning program compared to posttest ending program percentage of behavioral improvement for on task, following directions, and positive interactions outcomes improvement for individual students who completed the elementary grades pro-social cognitive behavioral skills…
Full Text Available Abstract Background Although the survival benefits of antiretroviral therapy (ART for the treatment of HIV infection are well established, the clinical management of HIV disease continues to present major challenges. There are particular concerns regarding access to appropriate HIV treatment among HIV-infected injection drug users (IDU. Methods In a prospective cohort study of HIV-infected IDU in Vancouver, Canada, we examined initial ART regimens vis-à-vis the provincial government's therapeutic guidelines at the time ART was initiated. Briefly, there have been four sets of guidelines: Era 1 (1992 to November 1995; double-drug (dual NRTIs ART for patients with a CD4 cell count of 350 or less; Era 2 (December 1995 to May 1996; double-drug therapy for patients with a CD4+ cell count of 500 or less; Era 3 (June 1996 to June 1997; triple-drug therapy (dual NRTIs with a PI or NNRTI for patients who had a plasma viral load of > 100,000 HIV-1 RNA copies/mL; dual therapy with two NRTIs for those with a plasma viral load of 5,000 to 100,000 HIV-1 RNA copies/mL; Era 4 (since July 1997; universal use of triple drug therapy as first-line treatment. Results Between May 1996 and May 2003, 431 HIV-infected individuals were enrolled into the cohort. By May 31, 2003, 291 (67.5% individuals had initiated ART. We noted instances of inappropriate antiretroviral prescription in each guideline era, with 9 (53% in Era 1, 3 (12% in Era 2, 22 (28% in Era 3, and 23 (15% in Era 4. Of the 57 subjects who received an inappropriate ART regimen initially, 14 never received the appropriate therapy; among the remaining 43, the median time to the initiation of a guideline-appropriate ART regimen was 12 months (inter-quartile range 5 – 20. Conclusion The present study identified measurable rates of guideline-inappropriate ART prescription for patients who were injection drug users. Rates were highest in the era of dual therapy, although high rates persisted into the triple
Conners-Burrow, Nicola Allison; Swindle, Taren; McKelvey, Lorraine; Bokony, Patti
Research Findings: The purpose of this study was to examine the relationship between low-level depressive symptoms in mothers and teacher-reported child behavioral outcomes. Participants included 442 low-income mothers of preschool-age children who were screened for maternal depression by their child's preschool teacher. Teacher reports of child…
King, Elizabeth K.; Johnson, Amy V.; Cassidy, Deborah J.; Wang, Yudan C.; Lower, Joanna K.; Kintner-Duffy, Victoria L.
The current study examined associations among teachers' financial well-being, including teachers' wages and their perceptions of their ability to pay for basic expenses, and teachers' work time supports, including teachers' paid planning time, vacation days, and sick days, and children's positive emotional expressions and behaviors in preschool…
Szymanski, Christen A.
The prevalence of Autism Spectrum Disorders (ASD)--a group of developmental disabilities that cause severe problems with socialization, behavior, and communication--continues to grow. In 2008, the year that "Odyssey" focused on autism, the estimated prevalence of ASD for hearing children was 1 in 150 (CDC, 2007), while today estimates suggest…
Frantz, Rebecca Jane
Naturalistic behavioral interventions increase the acquisition, generalization, and maintenance of child social communication skills among children with developmental delays (DD). Teaching Assistants (TAs) are ideal interventionists for delivering social communication interventions because of the significant amount of time they spend working…
Miller, Margery Staman
Two groups of seventh-grade students participated in a comparison of the effects of an experimental remedial reading program emphasizing positive self-concept and improved behavior and a control program. A total of 57 students participated in the thirty-week program. Results from the Coopersmith Self-Esteem Inventory, the Stanford Diagnostic…
Pollan, Savannah; Wilson-Younger, Dylinda
This article discusses conflict and provides five resolutions for teachers on managing negative behaviors within the classroom. Acknowledging and implementing conflict resolution strategies in the classroom enables every student to fully participate in the learning process.
McCormick, Jennifer A.
The purpose of this study was to examine inclusive elementary teacher knowledge and attitude toward Autism Spectrum Disorder (ASD) and applied behavior analysis (ABA) and their use of ABA. Furthermore, this study examined if knowledge and attitude predicted use of ABA. A survey was developed and administered through a web-based program. Of the…
Madill, Rebecca A.; Gest, Scott D.; Rodkin, Philip C.
This study contributes to the literature clarifying teaching practices in elementary classrooms that promote students' social relatedness. The focus on teaching practices reflects the need to understand malleable elements of the classroom, which can then be targeted for professional development. Specifically, this study examines whether children…
Mauro Cunha Xavier Pinto
Full Text Available Potentially inappropriate medication use by the Diamantina (Minas Gerais State population was investigated by analyzing medicine consumption, self-medication, polypharmacy and drug interactions of medicines prescribed among those interviewed. Level of knowledge about rational drug use and its relationship to socio-economic variables was also evaluated using a semi-structured questionnaire. This survey was based on stratified sampling of 423 individuals selected randomly. The prevalence of prescription drug consumption was 42.32% (n=179 and cardiovascular drugs were the most prescribed. Drug interactions were found in 45.81% (n=82 of prescriptions and 92.68% (n=76 of these interactions were moderate, with co-administration of cardiovascular drugs occurring in more than half of the cases. The inappropriate use of medication, according to Beers criteria, occurred in 44.73% of prescriptions to the elderly. The prevalence of self-medication was 63.34% (n=268 while 21.99% (n=91 of individuals administered medications to their children without formal prescriptions, where this practice was associated to analgesic/antipyretic consumption. The population showed a high prevalence of inappropriate use of drugs across all strata of society, representing an issue requiring effective actions to promote rational use of medicines.O consumo inapropriado de medicamentos pela população de Diamantina-MG foi investigado através da análise do consumo de medicamentos, automedicação, polifarmácia e interações medicamentosas prescritas aos entrevistados. Também foi avaliado o nível de conhecimento sobre uso racional de medicamentos e sua relação com variáveis sócio-econômicas através de um questionário semi-estruturado. Este estudo transversal foi baseado em amostragem estratificada e contou com a participação de 423 indivíduos selecionados aleatoriamente. A prevalência do consumo de medicamentos prescritos foi de 42,32% (n=179, sendo os
Cardona-Morrell, Magnolia; Kim, James C H; Brabrand, Mikkel
: English language publications in Medline, EMBASE, PubMed, Cochrane library, and the grey literature (January 1995-December 2016) covering community and nursing home residents aged ≥60years admitted to hospital. OUTCOMES: measurements of inappropriateness. A 17-item quality score was estimated...... estimation of clinical inappropriateness. CONCLUSIONS: Clinical inappropriateness and system factors that preclude alternative community care must be measured separately. They are two very different justifications for hospital admissions, requiring different solutions. Society has a duty to ensure...
WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT: * Potentially inappropriate prescribing in older people is a well-documented problem and has been associated with adverse drug reactions and hospitalization. * Beers\\' criteria, Screening Tool of Older Persons\\' potentially inappropriate Prescriptions (STOPP) and Screening Tool to Alert doctors to Right Treatment (START) are screening tools that have been formulated to help physicians and pharmacists identify potentially inappropriate prescribing and potential prescribing omissions. * The prevalence of potentially inappropriate prescribing and prescribing omissions in the elderly population presenting to hospital with acute illness is high according to STOPP and START criteria.
Casadevall, Arturo; Fang, Ferric C.
ABSTRACT Inaccurate data in scientific papers can result from honest error or intentional falsification. This study attempted to determine the percentage of published papers that contain inappropriate image duplication, a specific type of inaccurate data. The images from a total of 20,621 papers published in 40 scientific journals from 1995 to 2014 were visually screened. Overall, 3.8% of published papers contained problematic figures, with at least half exhibiting features suggestive of deliberate manipulation. The prevalence of papers with problematic images has risen markedly during the past decade. Additional papers written by authors of papers with problematic images had an increased likelihood of containing problematic images as well. As this analysis focused only on one type of data, it is likely that the actual prevalence of inaccurate data in the published literature is higher. The marked variation in the frequency of problematic images among journals suggests that journal practices, such as prepublication image screening, influence the quality of the scientific literature. PMID:27273827
Holmås, Tor Helge; Islam, Mohammad Kamrul; Kjerstad, Egil
Acknowledging the necessity of a division of labour between hospitals and social care services regarding treatment and care of patients with chronic and complex conditions, is to acknowledge the potential conflict of interests between health care providers. A potentially important conflict is that hospitals prefer comparatively short length of stay (LOS) at hospital, while social care services prefer longer LOS all else equal. Furthermore, inappropriately delayed discharges from hospital, i.e. bed blocking, is costly for society. Our aim is to discuss which factors that may influence bed blocking and to quantify bed blocking costs using individual Norwegian patient data, merged with social care and hospital data. The data allow us to divide hospital LOS into length of appropriate stay (LAS) and length of delay (LOD), the bed blocking period. We find that additional resources allocated to social care services contribute to shorten LOD indicating that social care services may exploit hospital resources as a buffer for insufficient capacity. LAS increases as medical complexity increases indicating hospitals incentives to reduce LOS are softened by considerations related to patients’ medical needs. Bed blocking costs constitute a relatively large share of the total costs of inpatient care.
Csete, Joanne; Dube, Siddharth
Asian countries have applied criminal sanctions widely in areas directly relevant to national HIV programmes and policies, including criminalization of HIV transmission, sex work, homosexuality and drug injection. This criminalization may impede universal access to HIV prevention and treatment services in Asia and undermine vulnerable people's ability to be part of the HIV response. To review the status of application of criminal law in key HIV-related areas in Asia and analyze its impact. Review of literature and application of human rights norms to analysis of criminal law measures. Criminal laws in the areas considered here and their enforcement, while intended to reduce HIV transmission, are inappropriate and counterproductive with respect to health and human rights. Governments should remove punitive laws that impede the HIV response and should ensure meaningful participation of people living with HIV, people who use illicit drugs, sex workers and men who have sex with men in combating stigma and discrimination and developing rights-centered approaches to HIV.
Alhmoud, Eman; Khalifa, Sabah; Bahi, Asma Abdulaziz
Older patients receiving home health care are particularly at risk of receiving potentially inappropriate medications compared to community-dwelling population. Data on appropriateness of prescribing in these patients is limited. To investigate the prevalence, patterns and determinants of potentially inappropriate medications among elderly patients receiving Home Health Care Services in Qatar. Home Health Care Services department in Hamad Medical Corporation-Qatar. A cross-sectional study, conducted over a 3 months period. Patients 65 years and older, taking at least one medication and receiving home care services were included. Potentially inappropriate medications were identified and classified in accordance with the American Geriatrics Society 2012 Beers Criteria. Prevalence of potentially inappropriate medications using updated Beers criteria. A total of 191 patients (38.2%) had at least one potentially inappropriate medication. As per Beers criteria, 35% of medications were classified as medications to be avoided in older adults regardless of conditions and 9% as potentially inappropriate medications when used with certain diseases or syndromes. The majority of potentially inappropriate medications (56%) were classified as medications to be used with caution. The two leading classes of potentially inappropriate medications were antipsychotics (27.4%) and selective serotonin reuptake inhibitors (16%). Significant predictors of inappropriate prescribing were hypertension [adjusted OR 1.7; 95% CI (1.0, 2.8)], dementia [adjusted OR 2.0; 95% CI (1.2, 3.1)], depression [adjusted OR 21.6; 95% CI (2.8, 168.4)], and taking more than ten prescribed medications [adjusted OR 1.9; 95% CI (1.3, 2.8)]. Prescribing potentially inappropriate medications is common among older adults receiving home health care services in Qatar, a finding that warrants further attention. Polypharmacy, hypertension, depression and dementia were significantly associated with potentially
Suggestions and background information to help teachers use classroom currency to influence students' behavior and academic efforts are provided. There are five parts to the publication. Part 1 discusses the many uses of classroom currency in teaching economics content, for motivation, and in discipline. For example, if teachers find that…
Barman, Charles R.
Guinea pigs are presented as versatile classroom animals. Suggestions for animal behavior and genetics studies are given. Also included is information concerning sex determination and the breeding of guinea pigs, and hints on keeping these animals in the classroom. References and illustrations complete the article. (MA)
Gallagher Paul F
Full Text Available Abstract Inappropriate prescribing (IP in older patients is highly prevalent and is associated with an increased risk of adverse drug events (ADEs, morbidity, mortality and healthcare utilisation. Consequently, IP is a major safety concern and with changing population demographics, it is likely to become even more prevalent in the future. IP can be detected using explicit or implicit prescribing indicators. Theoretically, the routine clinical application of these IP criteria could represent an inexpensive and time efficient method to optimise prescribing practice. However, IP criteria must be sensitive, specific, have good inter-rater reliability and incorporate those medications most commonly associated with ADEs in older people. To be clinically relevant, use of prescribing appropriateness tools must translate into positive patient outcomes, such as reduced rates of ADEs. To accurately measure these outcomes, a reliable method of assessing the relationship between the administration of a drug and an adverse clinical event is required. The Naranjo criteria are the most widely used tool for assessing ADE causality, however, they are often difficult to interpret in the context of older patients. ADE causality criteria that allow for the multiple co-morbidities and prescribed medications in older people are required. Ultimately, the current high prevalence of IP and ADEs is unacceptable. IP screening criteria need to be tested as an intervention to assess their impact on the incidence of ADEs in vulnerable older patients. There is a role for IP screening tools in everyday clinical practice. These should enhance, not replace good clinical judgement, which in turn should be based on sound pharmacogeriatric training.
Hamilton, Hilary J
Inappropriate prescribing (IP) in older patients is highly prevalent and is associated with an increased risk of adverse drug events (ADEs), morbidity, mortality and healthcare utilisation. Consequently, IP is a major safety concern and with changing population demographics, it is likely to become even more prevalent in the future. IP can be detected using explicit or implicit prescribing indicators. Theoretically, the routine clinical application of these IP criteria could represent an inexpensive and time efficient method to optimise prescribing practice. However, IP criteria must be sensitive, specific, have good inter-rater reliability and incorporate those medications most commonly associated with ADEs in older people. To be clinically relevant, use of prescribing appropriateness tools must translate into positive patient outcomes, such as reduced rates of ADEs. To accurately measure these outcomes, a reliable method of assessing the relationship between the administration of a drug and an adverse clinical event is required. The Naranjo criteria are the most widely used tool for assessing ADE causality, however, they are often difficult to interpret in the context of older patients. ADE causality criteria that allow for the multiple co-morbidities and prescribed medications in older people are required. Ultimately, the current high prevalence of IP and ADEs is unacceptable. IP screening criteria need to be tested as an intervention to assess their impact on the incidence of ADEs in vulnerable older patients. There is a role for IP screening tools in everyday clinical practice. These should enhance, not replace good clinical judgement, which in turn should be based on sound pharmacogeriatric training.
Bookstein, Fred L
In today's geometric morphometrics the commonest multivariate statistical procedures, such as principal component analysis or regressions of Procrustes shape coordinates on Centroid Size, embody a tacit roster of symmetries -axioms concerning the homogeneity of the multiple spatial domains or descriptor vectors involved-that do not correspond to actual biological fact. These techniques are hence inappropriate for any application regarding which we have a-priori biological knowledge to the contrary (e.g., genetic/morphogenetic processes common to multiple landmarks, the range of normal in anatomy atlases, the consequences of growth or function for form). But nearly every morphometric investigation is motivated by prior insights of this sort. We therefore need new tools that explicitly incorporate these elements of knowledge, should they be quantitative, to break the symmetries of the classic morphometric approaches. Some of these are already available in our literature but deserve to be known more widely: deflated (spatially adaptive) reference distributions of Procrustes coordinates, Sewall Wright's century-old variant of factor analysis, the geometric algebra of importing explicit biomechanical formulas into Procrustes space. Other methods, not yet fully formulated, might involve parameterized models for strain in idealized forms under load, principled approaches to the separation of functional from Brownian aspects of shape variation over time, and, in general, a better understanding of how the formalism of landmarks interacts with the many other approaches to quantification of anatomy. To more powerfully organize inferences from the high-dimensional measurements that characterize so much of today's organismal biology, tomorrow's toolkit must rely neither on principal component analysis nor on the Procrustes distance formula, but instead on sound prior biological knowledge as expressed in formulas whose coefficients are not all the same. I describe the problems
In the Scandinavian countries: Sweden, Norway and Denmark, the project GNU (Grænseoverskridende Nordisk Undervisning, i.e. Transnational Nordic Teaching) is experimenting with ways of conducting teaching across the borders in the elementary schools. The cloud classes are organised with one class...... and benefits in regard to learning and pedagogy with virtual classroom....
Australian company Antarctica Flights runs summer sightseeing trips out of Australian capital cities to tour the Antarctic coast. The Laby Foundation of the University of Melbourne, through its "Classroom Antarctica" program, sponsored Kent Street High School science teacher, Ms Suzy Urbaniak and 18 of her students to take the trip, to…
Kelly, Stephanie; Liu, Liping; Denton, Zachary; Lee, Clinton; Croucher, Stephen
The present investigation examined instructor immediacy behaviors, students' perceptions of those behaviors, and student math anxiety in Chinese classrooms. Consistent with the American college classroom, a simple causal chain was anticipated in which instructor immediacy behaviors positively induced a psychological response to immediacy, which…
Gonzalez, Dayana; Kornreich, Hagit; Rodriguez, Idaykis; Monslave, Camila; Pena-Flores, Norma
Our expanded multi-site study on active learning classrooms supported by Learning Assistants (LAs) aims to understand the connections between three classroom elements: the activity, student learning, and how LAs support the learning process in the classroom. At FIU, LAs are used in a variety of active learning settings, from large auditorium settings to studio classroom with movable tables. Our study uses the COPUS observation protocol as a way to characterize LAs behaviors in these classrooms. With a focus on LA-student interactions, our analysis of how LAs interact with students during a 'learning session' generated new observational codes for specific new categories of LA roles. Preliminary results show that LAs spend more time interacting with students in some classes, regardless of the classroom setting, while in other classrooms, LA-student interactions are mostly brief. We discuss how LA-student interactions contribute to the dynamics and mechanism of the socially shared learning activity.
Leonardo de Sousa Fortes
Full Text Available OBJECTIVE: The aim of this study was to compare the inappropriate eating behaviors of adolescents as a function of habitual level of physical activity. METHODS: Participants were 462 youth of both genders aged 10 to 19 years. The Eating Attitudes Test-26 was used for inappropriate eating behaviors assessment. A short version of the International Physical Activity Questionnaire was used for classifying the habitual level of physical activity. RESULTS: No statistically significant differences were found for the comparison of inappropriate eating behaviors in the multivariate covariance model either for females or males. Moreover, the level of physical activity had no significant influence on the inappropriate eating behaviors of these adolescents. CONCLUSION: In conclusion, inappropriate eating behaviors in both genders were similar regardless of the habitual level of physical activity.
The role of children's on-task behavior in the prevention of aggressive behavior development and peer rejection: A randomized controlled study of the Good Behavior Game in Belgian elementary classrooms
Leflot, G.; van Lier, P.A.C.; Onghena, P.; Colpin, H.
The role of children's on-task behavior in the prevention of aggressive behavior was assessed among 570 Dutch speaking children followed from second- to third-grade elementary school in Flanders, Belgium. A first objective was to investigate whether individual level variation of on-task behavior
Full Text Available As a genre, horror tends to be marginalized in literature classes because it is often mistakenly perceived to be inappropriate for the classroom environment due to the intensive emotional effects that the genre’s typical macabre motifs and topics may produce in the reader. However, this paper argues that, for two reasons, horror texts represent a valid and important addition to a literary syllabus. First, they typically have a positive impact on the students’ increased interest in reading, which is, in the pedagogical and scholarly sense, a desirable activity. Second, they tend to contribute significantly to the development of empathy with and tolerance for others, which is an especially valuable learning outcome in a multicultural classroom characterized by implied intercultural communication.
McCluskey, Frank; Winter, Melanie
The bricks and mortar classroom has a long and storied history. The digital classroom is so new and different it may be wrong to even call it a "classroom". The authors argue that architecture influences behavior. So in constructing our new digital classrooms we must pay attention to the architecture and what job we want that…
Lippard, Christine N.; La Paro, Karen M.; Rouse, Heather L.; Crosby, Danielle A.
Background: Children's early classroom experiences, particularly their interpersonal interactions with teachers, have implications for their academic achievement and classroom behavior. Teacher-child relationships and classroom interactions are both important aspects of children's early classroom experiences, but they are not typically considered…
Although research evidence indicates that multitasking results in poorer learning and poorer performance, many students engage with text messaging, Facebook, internet searching, emailing, and instant messaging, while sitting in university classrooms. Research also suggests that multitasking may be related to risk behaviors. This study's purpose…
Fusco, Marco; Buja, Alessandra; Piergentili, Paolo; Golfetto, Maria Teresa; Serafin, Gianni; Gallo, Silvia; Dalla Barba, Livio; Baldo, Vincenzo
The appropriate use of health care is an important issue in developed countries. The purpose of this study was to ascertain the extent of potentially inappropriate hospital admissions and their individual, clinical and hospital-related determinants. Medical records were analyzed for the year 2014 held by the Local Heath Unit n. 13 in the Veneto Region of north-east Italy (19,000 records). The outcomes calculated were: admissions for conditions amenable to day hospital care; brief medical admissions; outlier lengths of stay for elderly patients' medical admissions; and medical admissions to surgical wards. Univariate analyses and logistic regression models were used to test associations with demographic, clinical and hospital ward covariates, including organizational indicators. Inappropriate reliance on acute care beds ranged from 6% to 28%, depending on the type of quality indicator analyzed. Some individual features, and wards' specific characteristics were associated with at least one of the phenomena of inappropriate hospital resource usage. In particular, male gender, younger age and transferals seemed to affect inappropriate admissions to surgical wards. Potentially avoidable admissions featuring inpatients amenable to day hospital care were associated with subjects with fewer comorbidities and lower case-mix wards, while inappropriately short medical stays were influenced by patients' higher functional status and local residency and by lower bed occupancy rates. In conclusion, inappropriately long hospital stays for elderly cases were associated with patients with multiple pathologies in wards with a low bed-occupancy. Education level and citizenship did not seem to influence inappropriate admissions. Some individual, clinical ad structural characteristics of patients and wards emerging from administrative records could be associated with inappropriate reliance on acute hospital beds. Analyzing the indicators considered in this study could generate
Full Text Available Abstract Background The prevalence and risk factors of potentially inappropriate medication use among the elderly patients have been studied in various countries, but because of the difficulty of obtaining data on patient characteristics and medications they have not been studied in Japan. Methods We conducted a retrospective cross-sectional study in 17 Japanese long-term care (LTC facilities by collecting data from the comprehensive MDS assessment forms for 1669 patients aged 65 years and over who were assessed between January and July of 2002. Potentially inappropriate medications were identified on the basis of the 2003 Beers criteria. Results The patients in the sample were similar in terms of demographic characteristics to those in the national survey. Our study revealed that 356 (21.1% of the patients were treated with potentially inappropriate medication independent of disease or condition. The most commonly inappropriately prescribed medication was ticlopidine, which had been prescribed for 107 patients (6.3%. There were 300 (18.0% patients treated with at least 1 inappropriate medication dependent on the disease or condition. The highest prevalence of inappropriate medication use dependent on the disease or condition was found in patients with chronic constipation. Multiple logistic regression analysis revealed psychotropic drug use (OR = 1.511, medication cost of per day (OR = 1.173, number of medications (OR = 1.140, and age (OR = 0.981 as factors related to inappropriate medication use independent of disease or condition. Neither patient characteristics nor facility characteristics emerged as predictors of inappropriate prescription. Conclusion The prevalence and predictors of inappropriate medication use in Japanese LTC facilities were similar to those in other countries.
Summary We assert that a classification of gas flow regimes in shales that is widely accepted in the petroleum industry, may be inconsistent with the physics of high-pressure gas flow in capillaries. This classification follows from the 1946 work by Brown et al. (1946) that deals with the flow of gases in large industrial metal pipes, elbows and orifices under vacuum, with gas pressures of the order of 1 mm Hg or less. In another pioneering paper that year, Tsien (1946) analyzed the hypersonic flight of rockets in the thermosphere (above 50 miles of altitude), and established the widely accepted Knudsen flow regimes for the high-Reynolds, high-Mach flow of rarified gases. We show why both these papers are not quite applicable to flow of compressed gas in the hot, high-pressure shale pores with rough surfaces. In addition, it may be inappropriate to use the capillary tube metaphor to describe shale micropores or microcracks, simply because each is fed with gas by dozens or hundreds of intricately connected nanopores, which themselves may be slits rather than circular cylinders, and are charged with the dense, liquid-like gas. In the small-scale, low-velocity flows of gases, failure of the standard Navier-Stokes description (the standard Darcy law in petroleum engineering) can be quantified by the Knudsen number, ratio of the mean free path, λ, of gas molecules at the reservoir pressure and temperature to the characteristic pore radius, R. We carefully enumerate the multiple restrictive conditions that must hold for the slip-flow boundary condition to emerge. We also describe the dependence of the slip correction factor on the gas pressure and temperature, as well as the median pore size and rock roughness. In the derivation, we revisit the original approaches of Helmholtz and von Piotrowski (1860) and Maxwell, Niven (1890), which were somehow lost in the multiple translations from physics to petroleum engineering. For example, in Barnett mudrocks, naturally
Pharmacotherapy Group, Faculty of Pharmacy, University of Benin, Benin City, 300001 Nigeria. All rights reserved. ... marketing surveillance indicate that PPIs are safe and well ... consumer-oriented advertising . Based on this, the ..... evaluate the prescription behavior of these ... afford a basis to establish strategies for.
Ryan, Ellen Bouchard; And Others
Overaccommodation in communication with elders is frequently based on stereotyped expectations of frailty and dependence. In this study, volunteers read either a patronizing or neutral version of a conversation between a nursing home resident and a nurse. The main analyses indicated that negative nonverbal behaviors were rated more likely to occur…
Kramer, David C.
Suggests using crickets for classroom activities, providing background information on their anatomy and reproduction and tips on keeping individual organisms or a breeding colony in the classroom. (JN)
Kimbrough-Walls, Vickie J.
Student success is dependent on effective instruction. Yet, effective teaching is difficult to define and described differently by students, faculty, and administrators. Nursing and dental hygiene education programs require faculty to teach in both classroom and clinical environments. However, accreditation agencies for these programs mandate…
Moore, D.W.; Anderson, A.; Glassenbury, M.; Didden, H.C.M.; Lang, R.B.
Self-management strategies have been shown to be widely effective. However, limited classroom-based research exists involving low performing but developmentally normal high school-aged participants. This study examined the effectiveness of a self-management strategy aimed at increasing on-task
In a 2 1/2-year study of the application of interaction analysis (a method of classroom observation) to preservice teacher education, approximately 40 secondary student teachers were involved in an experiment during each of 3 semesters. A 2 by 2 factorial design made it possible to test the influence of 2 independent variables (student teacher…
Conclusion: Considering the high prevalence of agitation in the poisoning emergency department due to inappropriate use of naltrexone, more accurate planning for administration of naltrexone in addicts seems necessary.
Ruwald, Martin H; Abu-Zeitone, Abeer; Jons, Christian
The goal of this study was to evaluate the effects of carvedilol and metoprolol on the endpoint of inappropriate implantable cardioverter-defibrillator therapy in the MADIT-CRT (Multicenter Automatic Defibrillator Implantation With Cardiac Resynchronization Therapy) study....
Verdoorn, M.A.; Kwint, H.-F.; Faber, A.; L. Bouvy, M.
Background and objectives: Medication review has been suggested as a way to prevent drug related problems (DRPs). Screening tools have been formulated to identify potentially inappropriate medicines (PIMs) and potential prescribing omissions (PPOs) respectively called Screening Tool of Older
Fernández-Ruiz, Mario; Calvo, Beatriz; Vara, Rebeca; Villar, Rocío N; Aguado, José María
The prevalence and predisposing factors were determined for inappropriate urinary catheterization (UC) among inpatients in medical wards. A cross-sectional study was conducted including all patients aged ≥ 18 years admitted to medical wards in a 1300-bed tertiary-care centre, and who had a urinary catheter in place on the day of the survey. Of 380 patients observed, 46 (12.1%) had a urinary catheter in place. Twelve of them (26.1%) were inappropriately catheterized. The most common indication for inappropriate UC was urine output monitoring in a cooperative, non-critically ill patient. Inappropriateness was associated with increased age, poor functional status, urinary incontinence, dementia, and admission from a long-term care facility. Further educational efforts should be focused on improving catheterization prescribing practices by physicians. Copyright © 2012 Elsevier España, S.L. All rights reserved.
Kim, Ar Ryum; Lee, Seung Woo; Park, Jinkyun; Kang, Hyun Gook; Seong, Poong Hyun
Highlights: • We proposed a method to evaluate team communication characteristics based on social network analysis. • We compare team communication characteristics with the frequency of inappropriate communications. • Frequency of inappropriate communications were decreased when more operators perform the same types of role as others. • Frequency of inappropriate communications were decreased for teams who provide more number of acknowledgment. - Abstract: The characteristics of team communications are important since large process systems such as nuclear power plants, airline, and railways are operated by operating teams. In such situation, inappropriate communications can cause a lack of situational information and lead to serious consequences for the systems. As a result, the communication characteristics of operating teams should be understood in order to extract meaningful insights to address the nature of inappropriate communications. The purpose of this study was to develop a method to evaluate the characteristics of team communications based on social network analysis and compare them with the frequency of inappropriate communications. In order to perform the analysis, verbal protocol data, which were audio-visual recorded under training sessions by operating teams, were used and interfacing system loss of coolant accident scenarios were selected. As a result of the study, it was found that the frequency of inappropriate communications decreased when more operators perform the same types of role as other operators, since they can easily and effectively back up each other. Also, the frequency of inappropriate communication is decreased for teams which provide a relatively large communication content that acknowledge or confirm another communication content
Full Text Available Abstract Background To reduce inappropriate admissions and stays with the application of an improvement cycle in patients admitted to a University Hospital. The secondary objective is to analyze the hospital cost saved by reducing inadequacy after the implementation of measures proposed by the group for improvement. Methods Pre- and post-analysis of a sample of clinical histories studied retrospectively, in which the Appropriateness Evaluation Protocol (AEP was applied to a representative hospital sample of 1350 clinical histories in two phases. In the first phase the AEP was applied retrospectively to 725 admissions and 1350 stays. The factors associated with inappropriateness were analysed together with the causes, and specific measures were implemented in a bid to reduce inappropriateness. In the second phase the AEP was reapplied to a similar group of clinical histories and the results of the two groups were compared. The cost of inappropriate stays was calculated by cost accounting. Setting: General University Hospital with 426 beds serving a population of 320,000 inhabitants in the centre of Murcia, a city in south-eastern Spain. Results Inappropriate admissions were reduced significantly: 7.4% in the control group and 3.2% in the intervention group. Likewise, inappropriate stays decreased significantly from 24.6% to 10.4%. The cost of inappropriateness in the study sample fell from 147,044 euros to 66,642 euros. The causes of inappropriateness for which corrective measures were adopted were those that showed the most significant decrease. Conclusions It is possible to reduce inadequacy by applying measures based on prior analysis of the situation in each hospital.
Full Text Available AIMS: Radiological inappropriateness in medical imaging leads to loss of resources and accumulation of avoidable population cancer risk. Aim of the study was to audit the appropriateness rate of different cardiac radiological examinations. METHODS AND PRINCIPAL FINDINGS: With a retrospective, observational study we reviewed clinical records of 818 consecutive patients (67 ± 12 years, 75% males admitted from January 1-May 31, 2010 to the National Research Council - Tuscany Region Gabriele Monasterio Foundation cardiology division. A total of 940 procedures were audited: 250 chest x-rays (CXR; 240 coronary computed tomographies (CCT; 250 coronary angiographies (CA; 200 percutaneous coronary interventions (PCI. For each test, indications were rated on the basis of guidelines class of recommendation and level of evidence: definitely appropriate (A, including class I, appropriate, and class IIa, probably appropriate, uncertain (U, class IIb, probably inappropriate, or inappropriate (I, class III, definitely inappropriate. Appropriateness was suboptimal for all tests: CXR (A = 48%, U = 10%, I = 42%; CCT (A = 58%, U = 24%, I = 18%; CA (A = 45%, U = 25%, I = 30%; PCI (A = 63%, U = 15%, I = 22%. Top reasons for inappropriateness were: routine on hospital admission (70% of inappropriate CXR; first line application in asymptomatic low-risk patients (42% of CCT or in patients with unchanged clinical status post-revascularization (20% of CA; PCI in patients either asymptomatic or with miscellaneous symptoms and without inducible ischemia on non-invasive testing (36% of inappropriate PCI. CONCLUSION AND SIGNIFICANCE: Public healthcare system--with universal access paid for with public money--is haemorrhaging significant resources and accumulating avoidable long-term cancer risk with inappropriate cardiovascular imaging prevention.
Peeraully, R; Henderson, K; Davies, B
Introduction In England, emergency readmissions within 30 days of hospital discharge after an elective admission are not reimbursed if they do not meet Payment by Results (PbR) exclusion criteria. However, coding errors could inappropriately penalise hospitals. We aimed to assess the accuracy of coding for emergency readmissions. Methods Emergency readmissions attributed to paediatric surgery and urology between September 2012 and August 2014 to our tertiary referral centre were retrospectively reviewed. Payment by Results (PbR) coding data were obtained from the hospital's Family Health Directorate. Clinical details were obtained from contemporaneous records. All readmissions were categorised as appropriately coded (postoperative or nonoperative) or inappropriately coded (planned surgical readmission, unrelated surgical admission, unrelated medical admission or coding error). Results Over the 24-month period, 241 patients were coded as 30-day readmissions, with 143 (59%) meeting the PbR exclusion criteria. Of the remaining 98 (41%) patients, 24 (25%) were inappropriately coded as emergency readmissions. These readmissions resulted in 352 extra bed days, of which 117 (33%) were attributable to inappropriately coded cases. Conclusions One-quarter of non-excluded emergency readmissions were inappropriately coded, accounting for one-third of additional bed days. As a stay on a paediatric ward costs up to £500 a day, the potential cost to our institution due to inappropriate readmission coding was over £50,000. Diagnoses and the reason for admission for each care episode should be accurately documented and coded, and readmission data should be reviewed at a senior clinician level.
Daimee, Usama A; Vermilye, Katherine; Rosero, Spencer; Schuger, Claudio D; Daubert, James P; Zareba, Wojciech; McNitt, Scott; Polonsky, Bronislava; Moss, Arthur J; Kutyifa, Valentina
The effects of heart failure (HF) severity on risk of inappropriate implantable cardioverter-defibrillator (ICD) therapy have not been thoroughly investigated. We aimed to study the association between HF severity and inappropriate ICD therapy in MADIT-RIT. MADIT-RIT randomized 1,500 patients to three ICD programming arms: conventional (Arm A), high-rate cut-off (Arm B: ≥200 beats/min), and delayed therapy (Arm C: 60-second delay for ≥170 beats/min). We evaluated the association between New York Heart Association (NYHA) class III (n = 256) versus class I-II (n = 251) and inappropriate ICD therapy in Arm A patients with ICD-only and cardiac resynchronization therapy with defibrillator (CRT-D). We additionally assessed benefit of novel ICD programming in Arms B and C versus Arm A by NYHA classification. In Arm A, the risk of inappropriate therapy was significantly higher in those with NYHA III versus NYHA I-II for both ICD (hazard ratio [HR] = 2.55, confidence interval [CI]: 1.51-4.30, P programming significantly reduced inappropriate therapy in patients with both NYHA III (Arm B vs Arm A: HR = 0.08, P programming with high-rate cut-off or delayed detection reduces inappropriate ICD therapies in both mild and moderate HF. © 2017 Wiley Periodicals, Inc.
Binit N Jhaveri
Full Text Available Aim: To evaluate the use of potentially inappropriate medicines in elderly inpatients in a tertiary care teaching hospital. Materials and Methods: Retrospective analysis was performed for cases of elderly patients admitted between January 2010 and December 2010. Data on age, gender, diagnosis, duration of hospital stay, treatment, and outcome were collected. Prescriptions were assessed for the use of potentially inappropriate medications in geriatric patients by using American Geriatric Society Beer′s criteria (2012 and PRISCUS list (2010. Results: A total of 676 geriatric patients (52.12% females were admitted in the medicine ward. The average age of geriatric patients was 72.69 years. According to Beer′s criteria, at least one inappropriate medicine was prescribed in 590 (87.3% patients. Metoclopramide (54.3%, alprazolam (9%, diazepam (8%, digoxin > 0.125 mg/day (5%, and diclofenac (3.7% were the commonly used inappropriate medications. Use of nonsteroidal anti-inflammatory drugs (NSAIDs in heart and renal failure patients was the commonly identified drug-disease interaction. According to PRISCUS list, at least one inappropriate medication was prescribed in 210 (31.06% patients. Conclusion: Use of inappropriate medicines is highly prevalent in elderly patients.
Sarmiento, Lorena; Rojas-Soto, Gladys E.
Background The aim of the present study was to determine predictors of inappropriate use of diagnostic tests and management of bronchiolitis in a population of hospitalized infants. Methods In an analytical cross-sectional study, we determined independent predictors of the inappropriate use of diagnostic tests and management of bronchiolitis in a population of hospitalized infants. We defined a composite outcome score as the main outcome variable. Results Of the 303 included patients, 216 (71.3%) experienced an inappropriate use of diagnostic tests and treatment of bronchiolitis. After controlling for potential confounders, it was found that atopic dermatitis (OR 5.30; CI 95% 1.14–24.79; p = 0.034), length of hospital stay (OR 1.48; CI 95% 1.08–2.03; p = 0.015), and the number of siblings (OR 1.92; CI 95% 1.13–3.26; p = 0.015) were independent predictors of an inappropriate use of diagnostic tests and treatment of the disease. Conclusions Inappropriate use of diagnostic tests and treatment of bronchiolitis was a highly prevalent outcome in our population of study. Participants with atopic dermatitis, a longer hospital stay, and a greater number of siblings were at increased risk for inappropriate use of diagnostic tests and management of the disease. PMID:28758127
Full Text Available Children with autism spectrum disorders (ASD who have neurodevelopmental impairments in social communication often refuse to go to school because of difficulties in learning in class. The exact cause of maladaptation to school in such children is unknown. We hypothesized that these children have difficulty in paying attention to objects at which teachers are pointing. We performed gaze behavior analysis of children with ASD to understand their difficulties in the classroom. The subjects were 26 children with ASD (19 boys and 7 girls; mean age, 8.6 years and 27 age-matched children with typical development (TD (14 boys and 13 girls; mean age, 8.2 years. We measured eye movements of the children while they performed free viewing of two movies depicting actual classes: a Japanese class in which a teacher pointed at cartoon characters and an arithmetic class in which the teacher pointed at geometric figures. In the analysis, we defined the regions of interest (ROIs as the teacher's face and finger, the cartoon characters and geometric figures at which the teacher pointed, and the classroom wall that contained no objects. We then compared total gaze time for each ROI between the children with ASD and TD by two-way ANOVA. Children with ASD spent less gaze time on the cartoon characters pointed at by the teacher; they spent more gaze time on the wall in both classroom scenes. We could differentiate children with ASD from those with TD almost perfectly by the proportion of total gaze time that children with ASD spent looking at the wall. These results suggest that children with ASD do not follow the teacher's instructions in class and persist in gazing at inappropriate visual areas such as walls. Thus, they may have difficulties in understanding content in class, leading to maladaptation to school.
Higuchi, Takahiro; Ishizaki, Yuko; Noritake, Atsushi; Yanagimoto, Yoshitoki; Kobayashi, Hodaka; Nakamura, Kae; Kaneko, Kazunari
Children with autism spectrum disorders (ASD) who have neurodevelopmental impairments in social communication often refuse to go to school because of difficulties in learning in class. The exact cause of maladaptation to school in such children is unknown. We hypothesized that these children have difficulty in paying attention to objects at which teachers are pointing. We performed gaze behavior analysis of children with ASD to understand their difficulties in the classroom. The subjects were 26 children with ASD (19 boys and 7 girls; mean age, 8.6 years) and 27 age-matched children with typical development (TD) (14 boys and 13 girls; mean age, 8.2 years). We measured eye movements of the children while they performed free viewing of two movies depicting actual classes: a Japanese class in which a teacher pointed at cartoon characters and an arithmetic class in which the teacher pointed at geometric figures. In the analysis, we defined the regions of interest (ROIs) as the teacher's face and finger, the cartoon characters and geometric figures at which the teacher pointed, and the classroom wall that contained no objects. We then compared total gaze time for each ROI between the children with ASD and TD by two-way ANOVA. Children with ASD spent less gaze time on the cartoon characters pointed at by the teacher; they spent more gaze time on the wall in both classroom scenes. We could differentiate children with ASD from those with TD almost perfectly by the proportion of total gaze time that children with ASD spent looking at the wall. These results suggest that children with ASD do not follow the teacher's instructions in class and persist in gazing at inappropriate visual areas such as walls. Thus, they may have difficulties in understanding content in class, leading to maladaptation to school.
Landis, Dan; Triandis, Harry C; Adamopoulos, John
This research assessed the relative impact of habit and behavioral intentions in predicting classroom teacher behavior, using a model proposed by Triandis. Responses from a behavioral differential, as well as two hours of classroom observations, were taken on 77 male and female black and white junior high school teachers. The classroom observation technique (STOIC) obtained the frequencies of emitted behaviors (both verbal and nonverbal), categorized by race and sex of the target child. Results indicated that habit was a more potent predictor of classroom behavior than intentions. However, a post-hoc analysis supported the notion that intentions become important when the habit component can be suppressed.
Full Text Available INTRODUCTION: The ageing population means prescribing for chronic illnesses in older people is expected to rise. Comorbidities and compromised organ function may complicate prescribing and increase medication-related risks. Comorbid depression in older people is highly prevalent and complicates medication prescribing decisions. AIM: To determine the prevalence of potentially inappropriate medication use in a community-dwelling population of older adults with depressive symptoms. METHODS: The medications of 191 community-dwelling older people selected because of depressive symptoms for a randomised trial were reviewed and assessed using the modified version of the Beers' Criteria. The association between inappropriate medication use and various population characteristics was assessed using Chi-square statistics and logistic regression analyses. RESULTS: The mean age was 81 (±4.3 years and 59% were women. The median number of medications used was 6 (range 1-21 medications. The most commonly prescribed potentially inappropriate medications were amitriptyline, dextropropoxyphene, quinine and benzodiazepines. Almost half (49% of the participants were prescribed at least one potentially inappropriate medication; 29% were considered to suffer significant depressive symptoms (Geriatric Depression Scale ≥5 and no differences were found in the number of inappropriate medications used between those with and without significant depressive symptoms (Chi-square 0.005 p=0.54. DISCUSSION: Potentially inappropriate medication use, as per the modified Beers' Criteria, is very common among community-dwelling older people with depressive symptoms. However, the utility of the Beers' Criteria is lessened by lack of clinical correlation. Ongoing research to examine outcomes related to apparent inappropriate medication use is needed.
Full Text Available Background: Each year, around one out of two nursing home (NH residents are hospitalized in France, and about half to the emergency department (ED. These transfers are frequently inappropriate. This paper describes the protocol of the FINE study. The first aim of this study is to identify the factors associated with inappropriate transfers to ED. Methods/design: FINE is a case-control observational study. Sixteen hospitals participate. Inclusion period lasts 7 days per season in each center for a total period of inclusion of one year. All the NH residents admitted in ED during these periods are included. Data are collected in 4 times: before transfer in the NH, at the ED, in hospital wards in case of patient's hospitalization and at the patient's return to NH. The appropriateness of ED transfers (i.e. case versus control NH residents is determined by a multidisciplinary team of experts. Results: Our primary objective is to determine the factors predisposing NH residents to inappropriate transfer to ED. Our secondary objectives are to assess the cost of the transfers to ED; study the evolution of NH residents' functional status and the psychotropic and inappropriate drugs prescription between before and after the transfer; calculate the prevalence of potentially avoidable transfers to ED; and identify the factors predisposing NH residents to potentially avoidable transfer to ED. Discussion: A better understanding of the determinant factors of inappropriate transfers to ED of NH residents may lead to proposals of recommendations of better practice in NH and would allow implementing quality improvement programs in the health organization. Keywords: Inappropriate transfer, Nursing home resident, Emergency department transfer, Potentially avoidable transfer, Appropriateness of transfer, Inappropriate hospitalization
Full Text Available Abstract Background Inappropriate medication use is a major healthcare issue for the elderly population. This study explored the prevalence of potentially inappropriate prescriptions (PIPs in long-term care in metropolitan Quebec. Methods A cross sectional chart review of 2,633 long-term care older patients of the Quebec City area was performed. An explicit criteria list for PIPs was developed based on the literature and validated by a modified Delphi method. Medication orders were reviewed to describe prescribing patterns and to determine the prevalence of PIPs. A multivariate analysis was performed to identify predictors of PIPs. Results Almost all residents (94.0% were receiving one or more prescribed medication; on average patients had 4.8 prescribed medications. A majority (54.7% of treated patients had a potentially inappropriate prescription (PIP. Most common PIPs were drug interactions (33.9% of treated patients, followed by potentially inappropriate duration (23.6%, potentially inappropriate medication (14.7% and potentially inappropriate dosage (9.6%. PIPs were most frequent for medications of the central nervous system (10.8% of prescribed medication. The likelihood of PIP increased significantly as the number of drugs prescribed increased (odds ratio [OR]: 1.38, 95% confidence interval [CI]: 1.33 – 1.43 and with the length of stay (OR: 1.78, CI: 1.43 – 2.20. On the other hand, the risk of receiving a PIP decreased with age. Conclusion Potentially inappropriate prescribing is a serious problem in the highly medicated long-term care population in metropolitan Quebec. Use of explicit criteria lists may help identify the most critical issues and prioritize interventions to improve quality of care and patient safety.
McIntosh, W; Dean, W
Antimicrobial resistance continues to grow and antimicrobial use in food animal production and to a lesser extent in human patients is under fire. Much of the criticism has to do with the misapplication of these drugs in both settings. Research indicates that patients, food animal producers, physicians and veterinarians have all played a part in misusing antimicrobials, often because of mistaken beliefs. This paper reviews this research and introduces a theoretical perspective, the Theory of Planned Behavior (TPB), which broadens our understanding of the motivations for misuse. In particular this approach shows that individuals making decisions about antimicrobial use take into account social pressures from and a sense of obligation to significant others in their social networks. Our own work summarized in this paper indicates that both feedlot veterinarians and feedlot managers' antimicrobial decisions are influenced by both expectations from and obligations to a variety of actors in the feedlot network (other veterinarians, feedlot clients, consumers, pharmaceutical companies, and regulatory bodies). Generally across 4 circumstances of antimicrobial use (for acutely sick cattle, chronically-sick cattle, at-risk cattle, high-risk cattle), it is largely the perception that peers and clients expect feedlot veterinarians to use antimicrobials and feedlot veterinarians sense of obligation to these groups that have the most influence on their decisions to recommend antimicrobials. Based on these findings, the question of engaging in changing the choices made by those working with food animals must start with those who influence the decision to proscribe or use antimicrobials. As our data come from the United States and may be unique relative to other countries, these efforts should begin by ascertaining who influences these decisions. The next step is to then change the beliefs of these significant others. © 2014 Blackwell Verlag GmbH.
Full Text Available Recently, in the context of telemedicine, telemonitoring services are gaining attention. They are offered, for example, to patients with implantable cardioverter defibrillators (ICDs. A major problem associated with ICD therapy is the occurrence of inappropriate shocks which impair patients’ quality of life and may also be arrhythmogenic. The telemonitoring can provide a valid support to intensify followup visits, in order to improve the prevention of inappropriate defibrillator shock, thus enhancing patient safety. Inappropriate shock generally depends on atrial fibrillation, supraventricular tachycardia, and abnormal sensing (such as those caused by electromagnetic interferences. As a practical example, an unusual case of an ICD patient who risked an inappropriate shock while taking a shower is reported. Continuous remote telemonitoring was able to timely warn cardiologist via GSM-SMS, who were able to detect improper sensing examining the intracardiac electrogram via Web. Patient was promptly contacted and warned to not further come in contact with the hydraulic system and any electrical appliance to prevent an inappropriate defibrillator shock. This demonstrates the effectiveness and usefulness of continuous remote telemonitoring in supporting ICD patients.
Full Text Available Appropriate prescribing remains an important priority in all medical areas of practice. Objective: The objective of this study was to apply a Medication Appropriateness Index (MAI to identify issues of inappropriate prescribing amongst patients admitted from the Emergency Department (ED.Method: This study was carried out at Malta’s general hospital on 125 patients following a two-week pilot period on 10 patients. Patients aged 18 years and over and on medication therapy were included. Medication treatment for inappropriateness was assessed by using the MAI. Under-prescribing was also screened for. Results: Treatment charts of 125 patients, including 697 medications, were assessed using a MAI. Overall, 115 (92% patients had one or more medications with one or more MAI criteria rated as inappropriate, giving a total of 384 (55.1% medications prescribed inappropriately. The mean SD MAI score per drug was 1.78 (SD=2.19. The most common medication classes with appropriateness problems were supplements (20.1%, antibiotics (20.0% and steroids (19.8%. The most common problems involved incorrect directions (26% and incorrect dosages (18.5%. There were 36 omitted medications with untreated indications. Conclusion: There is considerable inappropriate prescribing which could have significant negative effects regarding patient care.
Beddows, Nicola; Brooks, Rachel
Autism spectrum disorder (ASD) is a neurodevelopmental disorder impairing social skills and communication. Adolescents with ASD have sexual needs, but may not understand their physical and emotional development resulting in inappropriate sexual behaviour. The aim of this review is to describe the type of inappropriate behaviour that presents in these adolescents, explain why such behaviours occur, suggest what education is suitable and identify current gaps in research. The databases EMBASE, OVID MEDLINE and PSYCINFO were searched for relevant articles. In total, 5241 articles were found, with an additional 15 sources found via soft searches, of which 42 met inclusion criteria and were subsequently reviewed. Sexual behaviours that occur in these adolescents with ASD include hypermasturbation, public masturbation, inappropriate romantic gestures, inappropriate arousal and exhibitionism. Such behaviours are thought to be caused via a lack of understanding of normal puberty, the absence of appropriate sex education, the severity of their ASD and other associated problems. It is suggested that individualized, repetitive education should be started from an early age in an accessible form. Social skills development is also important before more technical aspects of sex education are taught. Despite being such a common problem for schools, institutions and families to manage, it is surprising how sparse literature is particularly regarding why inappropriate behaviour occurs and what education is effective. © 2015 Wiley Publishing Asia Pty Ltd.
Ajit Kumar Sah
Full Text Available Background & Objectives: Older individuals often suffer from multiple systemic diseases and are particularly more vulnerable to potentially inappropriate medicine prescribing. Inappropriate medication can cause serious medical problem for the elderly. The study was conducted with objectives to determine the prevalence of potentially inappropriate medicine (PIM prescribing in older Nepalese patients in a medicine outpatient department.Materials & Methods: A prospective observational analysis of drugs prescribed in medicine out-patient department (OPD of a tertiary hospital of central Nepal was conducted during November 2012 to October 2013 among 869 older adults aged 65 years and above. The use of potentially inappropriate medications (PIM in elderly patients was analysed using Beer’s Criteria updated to 2013. Results: In the 869 patients included, the average number of drugs prescribed per prescription was 5.56. The most commonly used drugs were atenolol (24.3%, amlodipine (23.16%, paracetamol (17.6%, salbutamol (15.72% and vitamin B complex (13.26%. The total number of medications prescribed was 4833. At least one instance of PIM was experienced by approximately 26.3% of patients when evaluated using the Beers criteria. Conclusion: Potentially inappropriate medications are highly prevalent among older patients attending medical OPD and are associated with number of medications prescribed. Further research is warranted to study the impact of PIMs towards health related outcomes in these elderly.
Full Text Available Yada Vivatkusol, Thaovalai Thavaramara, Chadakarn Phaloprakarn Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand Objective: To study the prevalence and pregnancy outcomes of inappropriate gestational weight gain (GWG among teenage pregnant women.Methods: A retrospective descriptive study was conducted on 2,165 teenage pregnant women who attended our antenatal clinic between January 2007 and August 2015. Adverse pregnancy outcomes, including maternal and neonatal outcomes of women with inappropriate GWG, including underweight and overweight, were studied and compared with those of women with appropriate GWG.Results: Complete data of 1,943 women were obtained. Among these women, the mean age was 17.4±1.4 years and mean body mass index at first visit was 19.1±3.0 kg/m2. The prevalence of inappropriate GWG was 61.7%. Underweight women were more likely to experience anemia and preterm delivery, whereas overweight women required more cesarean sections because of cephalopelvic disproportion and preeclampsia, compared to women with appropriate weight gain (all P<0.001. The rates of gestational diabetes mellitus among women who were underweight, overweight, or appropriate weight were not significantly different.Conclusion: More than 60% of teenage pregnancies showed inappropriate GWG. GWG had a significant impact on pregnancy outcomes. Keywords: prevalence, pregnancy outcome, inappropriate gestational weight gain, teenage pregnancy
Gallagher, Paul F
INTRODUCTION: Adverse drug events (ADEs) are associated with inappropriate prescribing (IP) and result in increased morbidity, mortality and resource utilisation. We used Beers\\' Criteria to determine the three-month prevalence of IP in a non-selected community-dwelling population of acutely ill older people requiring hospitalisation. METHODS: A prospective, observational study of 597 consecutive acute admissions was performed. Diagnoses and concurrent medications were recorded before hospital physician intervention, and Beers\\' Criteria applied. RESULTS: Mean patient age (SD) was 77 (7) years. Median number of medications was 5, range 0-13. IP occurred in 32% of patients (n = 191), with 24%, 6% and 2% taking 1, 2 and 3 inappropriate medications respectively. Patients taking >5 medications were 3.3 times more likely to receive an inappropriate medication than those taking < or =5 medications (OR 3.34: 95%, CI 2.37-4.79; P<0.001). Forty-nine per cent of patients with inappropriate prescriptions were admitted with adverse effects of the inappropriate medications. Sixteen per cent of all admissions were associated with such adverse effects. CONCLUSION: IP is highly prevalent in acutely ill older patients and is associated with polypharmacy and hospitalisation. However, Beers\\' Criteria cannot be used as a gold standard as they do not comprehensively address all aspects of IP in older people.
Instructor listening skill is an understudied area in instructional communication research. This study looks at teachers' active empathic listening behavior association with student incivility. Scholars recognize student incivility as a growing problem and have called for research that identifies classroom behaviors that can affect classroom…
Kirschke, Malin; Böhme, Jacqueline
In Germany a list was drawn up that included 83 potentially inappropriate drugs. The PRISCUS list published in 2010 was intended to highlight certain problems in the pharmakotherapy of elderly patients and serve as a support for improved medicine safety. Almost a third of the insurance portfolio of the HALLESCHE Krankenversicherung aged over 75 years takes drugs that are on the PRISCUS list. Benzodiazepine and Z-drugs are taken most frequently. The costs per insurant with potentially inappropriate medication are on average higher than for policyholders who do not take drugs on the PRISCUS list. The costs per insurant are rising, with an increase in the number of PRISCUS agents being taken as well. However, there is still no scientific proof that potentially inappropriate drugs lead to adverse drug events.
Durkin, Michael J; Feng, Qianxi; Warren, Kyle; Lockhart, Peter B; Thornhill, Martin H; Munshi, Kiraat D; Henderson, Rochelle R; Hsueh, Kevin; Fraser, Victoria J
The purpose of this study was to assess dental antibiotic prescribing trends over time, to quantify the number and types of antibiotics dentists prescribe inappropriately, and to estimate the excess health care costs of inappropriate antibiotic prescribing with the use of a large cohort of general dentists in the United States. We used a quasi-Poisson regression model to analyze antibiotic prescriptions trends by general dentists between January 1, 2013, and December 31, 2015, with the use of data from Express Scripts Holding Company, a large pharmacy benefits manager. We evaluated antibiotic duration and appropriateness for general dentists. Appropriateness was evaluated by reviewing the antibiotic prescribed and the duration of the prescription. Overall, the number and rate of antibiotic prescriptions prescribed by general dentists remained stable in our cohort. During the 3-year study period, approximately 14% of antibiotic prescriptions were deemed inappropriate, based on the antibiotic prescribed, antibiotic treatment duration, or both indicators. The quasi-Poisson regression model, which adjusted for number of beneficiaries covered, revealed a small but statistically significant decrease in the monthly rate of inappropriate antibiotic prescriptions by 0.32% (95% confidence interval, 0.14% to 0.50%; P = .001). Overall antibiotic prescribing practices among general dentists in this cohort remained stable over time. The rate of inappropriate antibiotic prescriptions by general dentists decreased slightly over time. From these authors' definition of appropriate antibiotic prescription choice and duration, inappropriate antibiotic prescriptions are common (14% of all antibiotic prescriptions) among general dentists. Further analyses with the use of chart review, administrative data sets, or other approaches are needed to better evaluate antibiotic prescribing practices among dentists. Copyright © 2018 American Dental Association. Published by Elsevier Inc. All
Rodriguez Recio, F. J.; Sanz, J. C.; Vera, S.; Peiro, S.
To identify the percentage of inappropriate lumbar spine magnetic resonance imaging in the Soria Health Service, to quantify the costs and the possible association between inadequate use, the characteristics of the patient and the services requested. A descriptive study of the inappropriate use of MRI of the lumbar spine, taken from the retrospective examination, carried out by a radiologist, of the 233 MRI's requested between 1995 and 1998. For the valuation, the criteria of the American College of Radiology (ACR) and the Basque Agency for the Evaluation of Technologies (OSTEBA) were used. All the MRI's were carried out at an approved centre, the costs were calculated taken form the expenses paid by the Insalud, including the transport costs, calculated at prices applicable for the year in question. 11.7% of the studies were values as inappropriate, 2.1% debatable and the remainder adequate according to the ACR criteria, concentrating the inadequacy on studies for lumbago, that reached 80% of the inappropriate requests. The ACR and OSTEBA criteria coincided to a high degree (kappa statistics: 0.87). The expense related to the unnecessary studies was a litter higher than a million pesetas. No differences were found in the proportion of inappropriate studies according to the characteristics of the patient or the service requested, except the one already mentioned for the supposition diagnosis. Although the results of the study cannot be generalised to other environments, they suggest the possibility of a significant proportion of inappropriate use of lumbar spine MRI that could have an important repercussion on health care expenses. (Author) 11 refs
Christine Grützmann Faustino
Full Text Available Objective: To establish the prevalence of potentially inappropriate medications prescribed for elderly patients, to identify the most commonly involved drugs, and to investigate whether age, sex and number of medications were related with the prescription of these drugs. Methods: Prescriptions for 1,800 elderly patients (≥ 60 years were gathered from a database. These prescriptions were written by general physicians at a tertiary level university hospital in the city of Sao Paulo, Brazil, from February to May 2008. Only one prescription per patient was considered. The prescriptions were classified according to sex and age (60-69, 70-79 and ≥ 80. The Beers criteria (2003 version were used to evaluate potentially inappropriate medications. Results: Most of the sample comprised women (66.6% with a mean age of 71.3 years. The mean prevalence of potentially inappropriate medication prescriptions was 37.6%. The 60-69 age group presented the highest prevalence (49.9%. The most frequently prescribed potentially inappropriate medications to women were carisoprodol, amitriptyline, and fluoxetine; amitriptyline, carisoprodol, fluoxetine and clonidine were prescribed more often to men. The female sex (p<0.001; OR=2.0 and number of medications prescribed (p<0.001 were associated with prescription of potentially inappropriate medications. The chance of having a prescription of these drugs was lower among patients aged over 80 years (OR=0.7. The mean number of prescribed medications for both sexes and all age groups was 7.1. The mean number of medications per patient was higher among females (p<0.001; this result was not age-dependent (p=0.285. Conclusion: The prevalence of potentially inappropriate medications was similar to previously reported values in the literature and was correlated with the female sex. The chance of having a potentially inappropriate medication prescription was lower among patients aged over 80 years. The chance of having a
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Objectives. To identify 1 the characteristics of patients receiving non acute (inappropriate care and 2 the variables associated to inappropriate hospital use, in order to 3 estimate the relevance of the problem and to 4 focus future concurrent reviews and efforts to allocate patients to alternative health care settings.
Design. A prospective review of a random sample of adult patients who presented to the Emergency Department of the Molinette Hospital. Patients were assessed at admission and on day 3, 5and 8 using the Appropriateness Evaluation Protocol (Italian validated version. Patients: 490 overall; 312 (64 % medical and 178 (36 % surgical.
Outcome measures. Acute (appropriate and non acute (inappropriate admissions, Major Disease Category, costs, mean weights of Diagnosis Related Groups, and length of stay (days.
Results. The proportion of patients requiring acute care declined rapidly from presentation (84.5% to the fifth day of admission (60.9%. Patients admitted during weekends showed a higher rate of inappropriate stay on day 5 (P=0.04. The proportion of inappropriate admissions was higher for medical rather than surgical patients (P=0.07 at presentation and at day 5 (P < 0.01. Traditional social-demographic variables were not significant risk indicators for inappropriate admissions. The likelihood ratio for inappropriate admission at presentation was significantly higher for minor illnesses and disturbances (P=0.03.
Inappropriate stay on day 5 was significantly associated with lower cost (P < 0.01, lower mean DRG weight (P < 0.01 and shorter length of stay (P=0.05 for medical but not for surgical admissions.
Conclusions. Traditional epidemiological indicators are inadequate to target prospective concurrent reviews. Qualitative studies focusing on patient physician dialogue in different situations and contexts could
Early forms of psychology assumed that mental life was the appropriate subject matter for psychology, and introspection was an appropriate method to engage that subject matter. In 1913, John B. Watson proposed an alternative: classical S-R behaviorism. According to Watson, behavior was a subject matter in its own right, to be studied by the…
Naylor, Anna Schmidt; Kamps, Debra; Wills, Howard
The current study examined the effects of the Class-wide Function-related Intervention Teams (CW-FIT), a class-wide group contingency, on the on-task behavior of all students in a first grade class and the on-task and disruptive behavior of three target students within that class who were nominated by their teacher through a behavioral screening.…
Piltcher, Otávio Bejzman; Kosugi, Eduardo Macoto; Sakano, Eulalia; Mion, Olavo; Testa, José Ricardo Gurgel; Romano, Fabrizio Ricci; Santos, Marco Cesar Jorge; Di Francesco, Renata Cantisani; Mitre, Edson Ibrahim; Bezerra, Thiago Freire Pinto; Roithmann, Renato; Padua, Francini Greco; Valera, Fabiana Cardoso Pereira; Lubianca Neto, José Faibes; Sá, Leonardo Conrado Barbosa; Pignatari, Shirley Shizue Nagata; Avelino, Melissa Ameloti Gomes; Caixeta, Juliana Alves de Souza; Anselmo-Lima, Wilma Terezinha; Tamashiro, Edwin
Bacterial resistance burden has increased in the past years, mainly due to inappropriate antibiotic use. Recently it has become an urgent public health concern due to its impact on the prolongation of hospitalization, an increase of total cost of treatment and mortality associated with infectious disease. Almost half of the antimicrobial prescriptions in outpatient care visits are prescribed for acute upper respiratory infections, especially rhinosinusitis, otitis media, and pharyngotonsillitis. In this context, otorhinolaryngologists play an important role in orienting patients and non-specialists in the utilization of antibiotics rationally and properly in these infections. To review the most recent recommendations and guidelines for the use of antibiotics in acute otitis media, acute rhinosinusitis, and pharyngotonsillitis, adapted to our national reality. A literature review on PubMed database including the medical management in acute otitis media, acute rhinosinusitis, and pharyngotonsillitis, followed by a discussion with a panel of specialists. Antibiotics must be judiciously prescribed in uncomplicated acute upper respiratory tract infections. The severity of clinical presentation and the potential risks for evolution to suppurative and non-suppurative complications must be taken into 'consideration'. Periodic revisions on guidelines and recommendations for treatment of the main acute infections are necessary to orient rationale and appropriate use of antibiotics. Continuous medical education and changes in physicians' and patients' behavior are required to modify the paradigm that all upper respiratory infection needs antibiotic therapy, minimizing the consequences of its inadequate and inappropriate use. Copyright © 2018 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.
Kim, Ar Ryum; Lee, Seung Woo; Jang, In Seok; Kang, Hyun Gook; Seong, Poong Hyun; Park, Jin Kyun
Inappropriate communications can cause a lack of necessary information exchange between operators and lead to serious consequences in large process systems such as nuclear power plants (NPPs). In this regard, various kinds of taxonomies of inappropriate communications have been developed to prevent inappropriate communications. However, there seems to be difficult to identify inappropriate communications from verbal protocol data between operators. Because the existing taxonomies were developed for use in report analysis, there is a problem of 'uncertainty'. In consequence, this paper proposes a new taxonomy of inappropriate communications and provides some insights to prevent inappropriate communications. In order to develop the taxonomy, existing taxonomies for four industries from 1980 to 2010 were collected and a new taxonomy is developed based on the simplified one-way communication model. In addition, the ratio of inappropriate communications from 8 samples of audio-visual format verbal protocol data recorded during emergency training sessions by operating teams is compared with performance scores calculated based on the task analysis. As a result, inappropriate communications can be easily identified from the verbal protocol data using the suggested taxonomy, and teams with a higher ratio of inappropriate communications tend to have a lower performance score.
Kim, Ar Ryum; Lee, Seung Woo; Jang, In Seok; Kang, Hyun Gook; Seong, Poong Hyun [Dept. of Nuclear and Quantum Engineering, Korea Advanced Institute of Science and Technology, Daejeon (Korea, Republic of); Park, Jin Kyun [Integrated Safety Assessment Division, Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)
Inappropriate communications can cause a lack of necessary information exchange between operators and lead to serious consequences in large process systems such as nuclear power plants (NPPs). In this regard, various kinds of taxonomies of inappropriate communications have been developed to prevent inappropriate communications. However, there seems to be difficult to identify inappropriate communications from verbal protocol data between operators. Because the existing taxonomies were developed for use in report analysis, there is a problem of 'uncertainty'. In consequence, this paper proposes a new taxonomy of inappropriate communications and provides some insights to prevent inappropriate communications. In order to develop the taxonomy, existing taxonomies for four industries from 1980 to 2010 were collected and a new taxonomy is developed based on the simplified one-way communication model. In addition, the ratio of inappropriate communications from 8 samples of audio-visual format verbal protocol data recorded during emergency training sessions by operating teams is compared with performance scores calculated based on the task analysis. As a result, inappropriate communications can be easily identified from the verbal protocol data using the suggested taxonomy, and teams with a higher ratio of inappropriate communications tend to have a lower performance score.
Vivatkusol, Yada; Thavaramara, Thaovalai; Phaloprakarn, Chadakarn
To study the prevalence and pregnancy outcomes of inappropriate gestational weight gain (GWG) among teenage pregnant women. A retrospective descriptive study was conducted on 2,165 teenage pregnant women who attended our antenatal clinic between January 2007 and August 2015. Adverse pregnancy outcomes, including maternal and neonatal outcomes of women with inappropriate GWG, including underweight and overweight, were studied and compared with those of women with appropriate GWG. Complete data of 1,943 women were obtained. Among these women, the mean age was 17.4±1.4 years and mean body mass index at first visit was 19.1±3.0 kg/m 2 . The prevalence of inappropriate GWG was 61.7%. Underweight women were more likely to experience anemia and preterm delivery, whereas overweight women required more cesarean sections because of cephalopelvic disproportion and preeclampsia, compared to women with appropriate weight gain (all P teenage pregnancies showed inappropriate GWG. GWG had a significant impact on pregnancy outcomes.
Vaz Patto, Maria Carlota; Rubiales, Diego
Little is known about the nature of effective defense mechanisms in legumes to pathogens of remotely related plant species. Some rust species are among pathogens with broad host range causing dramatic losses in various crop plants. To understand and compare the different host and nonhost resistance (NHR) responses of legume species against rusts, we characterized the reaction of the model legume Medicago truncatula to one appropriate (Uromyces striatus) and two inappropriate (U. viciae-fabae and U. lupinicolus) rusts. We found that similar pre and post-haustorial mechanisms of resistance appear to be operative in M. truncatula against appropriate and inappropriate rust fungus. The appropriate U. striatus germinated better on M. truncatula accessions then the inappropriate U. viciae-fabae and U. lupinicolus, but once germinated, germ tubes of the three rusts had a similar level of success in finding stomata and forming an appressoria over a stoma. However, responses to different inappropriate rust species also showed some specificity, suggesting a combination of non-specific and specific responses underlying this legume NHR to rust fungi. Further genetic and expression analysis studies will contribute to the development of the necessary molecular tools to use the present information on host and NHR mechanisms to breed for broad-spectrum resistance to rust in legume species. PMID:25426128
Conclusion: Inappropriate shock is common in Brugada syndrome during the early periods after an ICD implantation, and seems to be more likely in asymptomatic patients. This finding may warrant a review of the indications for ICD implantation, especially in the young and apparently healthy population of patients with Brugada syndrome.
Inappropriate complementary feeding practice increased the risk of stunting in 12-24 months old children by 8.26. This study confirms the need to scale up interventions during the first 2 years of life, including appropriate infant feeding practices.
Fialová, D.; Topinková, E.; Gambassi, G.; Finne-Soveri, H.; Jónsson, P.; Carpenter, I.; Schroll, M.; Onder, G.; Sorbye, L.W.; Wagner, C.; Reissigová, Jindra; Bernabei, R.
Roč. 293, č. 11 (2005), s. 1348-1358 ISSN 0098-7484 Institutional research plan: CEZ:AV0Z10300504 Keywords : potentially inappropriate medication * prevalence * independent correlates Subject RIV: FQ - Public Health Care , Social Medicine Impact factor: 23.332, year: 2005 http://jama.ama-assn.org/cgi/content/abstract/293/11/1348
Gier, Vicki; Kreiner, David; Hudnell, Jason; Montoya, Jodi; Herring, Daniel
The purpose of the present experiment was to determine whether using an active learning technique, electronic highlighting, can eliminate the negative effects of pre-existing, poor highlighting on reading comprehension. Participants read passages containing no highlighting, appropriate highlighting, or inappropriate highlighting. We hypothesized…
Maria Carlota eVaz Patto
Full Text Available Little is known about the nature of effective defense mechanisms in legumes to pathogens of remotely related plant species. Some rust species are among pathogens with broad host range causing dramatic losses in various crop plants. To understand and compare the different host and nonhost resistance responses of legume species against rusts, we characterized the reaction of the model legume Medicago truncatula to one appropriate (Uromyces striatus and two inappropriate (U. viciae-fabae and U. lupinicolus rusts. We found that similar pre and post-haustorial mechanisms of resistance appear to be operative in M. truncatula against appropriate and inappropriate rust fungus. The appropriate U. striatus germinated better on M. truncatula accessions then the inappropriate U. viciae-fabae and U. lupinicolus, but once germinated, germ tubes of the three rusts had a similar level of success in finding stomata and forming an appressoria over a stoma. However responses to different inappropriate rust species also showed some specificity, suggesting a combination of non specific and specific responses underlying this legume nonhost resistance to rust fungi. Further genetic and expression analysis studies will contribute to the development of the necessary molecular tools to use the present information on host and nonhost resistance mechanisms to breed for broad-spectrum resistance to rust in legume species.
Ruwald, Anne-Christine H.; Zareba, Wojciech; Jons, Christian
tachycardia zone of 170 to 199 bpm (arm A), high-rate cutoff with a ventricular tachycardia zone ≥200 bpm (arm B), or 60-second-delayed therapy (arm C). The end points of inappropriate therapy, appropriate therapy, and death were assessed among 485 patients with and 998 without diabetes mellitus. Innovative...
Niwata, Satoko; Yamada, Yukari; Ikegami, Naoki
dependent on the disease or condition was found in patients with chronic constipation. Multiple logistic regression analysis revealed psychotropic drug use (OR = 1.511), medication cost of per day (OR = 1.173), number of medications (OR = 1.140), and age (OR = 0.981) as factors related to inappropriate...
Mauro Cunha Xavier Pinto
Full Text Available In recent decades, the elderly population in Brazil has grown rapidly, as has concern for the health of this population. Institutionalization in nursing homes has appeared as an alternative form of health care for frail elderly that live alone. The present study evaluated the pharmacotherapy and inappropriate drug prescriptions for institutionalized elderly patients living in long-term institutions in southeastern Brazil. This research was conducted at five institutions with a total sample of 151 individuals aged at least 60 years. Databases were used to identify drug interactions, defined daily dose and inappropriate prescriptions. The prevalence of drug intake among the elderly was 95.36%, and there were an average of 3.31 ± 1.80 drug prescriptions per individual. Based on Beers criteria, the prevalence of inappropriate prescriptions was 25.83%. In addition, 70.2% of prescriptions were prescribed at a higher dosage than the defined daily dose (ATC/WHO. Potential drug interactions were identified for 54.11% of prescriptions; 81.42% of these were of moderate severity. The main inappropriate drugs were prescribed for cardiovascular and nervous system problems. Institutionalized elderly individuals presented a high consumption and misuse of medications, requiring professional intervention to monitor prescriptions and improve the quality of service for this population.
Full Text Available Inappropriate use of indwelling urinary catheters (IUCs and their related complications is one of the most important problems in hospital wards. The aim of this study was to evaluate inappropriate use of IUCs and their complications among patients in Tehran, Iran. Two hundred and six consecutive patients hospitalized in the intensive care unit (ICU as well as medical and surgical wards at the Shahid Mohammadi Hospital in Bandarabbas from September 1 to 30, 2005 and in whom IUCs were used, were studied. Data collected included age of the patients, diagnoses, reason for use of IUC and the complications related to it. Overall, 164 patients (79.6% had IUCs used appropriately while 42 of them (20.6% were catheterized unjustifiably. Inappropriate use of IUCs in the ICU, medical and surgical wards was reported in 12 (18.5%, 16 (19.0% and 14 patients (24.6%, respectively. The most common complication of IUCs was urinary tract infection, which occurred in 91 patients (44.2% and hematuria, which was seen in 3.9% of the patients. Our study suggests that inappropriate use of IUCs is prevalent, particularly in the surgical wards, and the most common complication observed was catheter-associated urinary tract infection.
Chongtham, Dhanaraj Singh; Bahl, Ajay; Kumar, Rohit Manoj; Talwar, K K
We report a patient with hypertrophic cardiomyopathy who received an inappropriate implantable cardioverter defibrillator shock due to electrical interference from a washing machine. This electrical interference was detected as an episode of ventricular fibrillation with delivery of shock without warning symptoms.
Edward Samuel Roberto
Full Text Available Electromagnetic interference (EMI includes any electromagnetic field signal that can be detected by device circuitry, with potentially serious consequences: incorrect sensing, pacing, device mode switching, and defibrillation. This is a unique case of extracardiac EMI by alternating current leakage from a submerged motor used to recycle chlorinated water, resulting in false rhythm detection and inappropriate ICD discharge. A 31-year-old female with arrhythmogenic right ventricular cardiomyopathy and Medtronic dual-chamber ICD placement presented after several inappropriate ICD shocks at the public swimming pool. Patient had never received prior shocks and device was appropriate at all regular follow-ups. Intracardiac electrograms revealed unique, high-frequency signals at exactly 120 msec suggestive of EMI from a strong external source of alternating current. Electrical artifact was incorrectly sensed as a ventricular arrhythmia which resulted in discharge. ICD parameters including sensing, pacing thresholds, and impedance were all normal suggesting against device malfunction. With device failure and intracardiac sources excluded, EMI was therefore strongly suspected. Avoidance of EMI source brought complete resolution with no further inappropriate shocks. After exclusion of intracardiac interference, device malfunction, and abnormal settings, extracardiac etiologies such as EMI must be thoughtfully considered and excluded. Elimination of inappropriate shocks is to “first, do no harm.”
Tilghman-Osborne, Carlos; Cole, David A.; Felton, Julia W.
Inappropriate or excessive guilt is listed as a symptom of depression by the American Psychiatric Association ("1994"). Although many measures of guilt have been developed, definitional and operational problems exist, especially in the application of such measures in childhood and adolescence. To address these problems, the current study…
Farrell, Thomas S. C., Ed.
This series captures the dynamics of the contemporary ESOL classroom. It showcases state-of-the-art curricula, materials, tasks, and activities reflecting emerging trends in language education and seeks to build localized language teaching and learning theories based on teachers' and students' unique experiences in and beyond the classroom. Each…
Classroom observation is a crucial aspect of any system of teacher evaluation. No matter how skilled a teacher is in other aspects of teaching--such as careful planning, working well with colleagues, and communicating with parents--if classroom practice is deficient, that individual cannot be considered a good teacher. Classroom observations can…
Robert Joseph McKee
Full Text Available Classroom discussion has the potential to enhance the learning environment and encourages students to become active participants in the educational process. Student participation in classroom discussion has been shown to significantly improve the student learning experience. Research suggests that classroom discussion is an effective method for encouraging student classroom participation and for motivating student learning beyond the classroom. Participation in classroom discussion encourages students to become active collaborators in the learning process, while at the same time providing instructors with a practical method of assessing student learning. Classroom discussion is an effective tool for developing higher-level cognitive skills like critical thinking. Despite the potential discussion holds for student learning, many in academia lament the lack of participation in the classroom. The lack of student participation in classroom discussion is not a recent problem; it is one that has frustrated instructors for decades. Instructors report that some of the more current methods for encouraging classroom discussion can be exasperating and at times non-productive. This two-year study of 510 college and university students provides insight into the reasons why some students do not participate in classroom discussion. This study, which also elicited input from sixteen college and university professors and two high school teachers, offers some suggestions for creating and encouraging an environment conducive to student participation in the classroom.
Kecskemeti, Maria; Winslade, John
The usual approaches to classroom relationships are either teacher-centred or student-centred. This book breaks new ground in its exploration of relationship-centred classrooms. In relationship-centred classrooms, the teacher and the student are equally important. That shifts the focus to the quality of their interaction and whether it is…
Smith, Stephen W.; Daunic, Ann P.; Aydin, Burak; Van Loan, Christopher L.; Barber, Brian R.; Taylor, Gregory G.
Social-emotional learning curricula to prevent student problematic behaviors should play a prominent role in public school instruction. While social-emotional curricula have been shown to be effective, there are few replication studies that substantiate their capacity to improve outcomes for students who exhibit problem behaviors. Thus, we…
Silver, R.B.; Measelle, J.R.; Armstrong, J.M.; Essex, M.J.
The unique and interactive contributions of past externalizing behavior, negative parenting, and teacher-child relationship quality to externalizing behavior trajectories after the transition to school were examined. In a sample of 283 children, random regression analyses indicated that conflict in the teacher-child relationship during the school…
Franchuk, V V
Despite the fact that the ever growing relevance of the problem of the inappropriate medical care was long ago brought to the worldwide attention, it has not been practically addressed in the Ukraine since the country gained independence in 1991. The objective of the present study was to consider the specific features of expert examination of the cases of inappropriate medical care as exemplified by the materials of the legal actions and lawsuits instituted against healthcare specialists violating their occupational duties. The results of forensic medical examination by the local Bureaux of forensic medical expertise concerning the 350 so-called malpractice suits instituted in the Ternopol, Zhitomir, and Chernovtsy regions during the period from 207 to 2016 were available for the analysis. The facts of inadequate and inappropriate medical care were documented in 245 (72.0%) cases. The frequency of diagnostic and therapeutic errors amounted to 29.7% and 26.9% respectively while the improper formulation of the medical documentation was recorded in 21.3% of the cases. The cases of poor organization of the diagnostic and treatment process accounted for 14.6% of the total whereas the improper behaviour of the medical personnel was reported in 7.5% of all the known cases of provision of the healthcare services. It is concluded that in the majority of the cases, the citizens of the modern-day Ukraine receive the inappropriate (insufficient and untimely) medical care. Over 80% of the cases of the inappropriate medical care currently provided in the country can be accounted for by the objective reasons, with each fifths case being due to the violation of professional responsibilities by the healthcare providers.
Ruvinsky, Silvina; Mónaco, Andrea; Pérez, Guadalupe; Taicz, Moira; Inda, Laura; Kijko, Ivana; Constanzo, Patricia; Bologna, Rosa
Determine the reasons for inappropriate prescription of antibiotics and identify opportunities to improve prescription of these drugs in pediatric patients hospitalized in intermediate and intensive care units. A prospective, descriptive longitudinal study was conducted of pediatric patients in intermediate and intensive care units who received parenteral administration of antibiotics, with the exception of newborns, burn unit patients, and surgical prophylaxis patients. A univariate analysis and multiple logistic regression were performed. A total of 376 patients with a median of age of 50 months were studied (interquartile range [IQR] 14.5-127 months). Out of the total patients studied, 75% had one or more underlying conditions. A total of 40.6% of these patients had an oncologic pathology and 33.5% had neurological conditions. The remaining 25.9% had other underlying conditions. Antibiotic treatment was inappropriate in 35.6% of the patients studied (N = 134). In 73 (54.4%) of the 134 cases, inappropriate use was due to the type of antibiotic prescribed, the dose administered, or the treatment period. The 61 (45.5%) remaining cases did not require antibiotic treatment. In the multivariate analysis, the risk factors for inappropriate use of antibiotics were: administration of ceftriaxone OR 2 (95% CI, 1.3-3.7; P = 0.02); acute lower respiratory tract infection OR 1.8 (95% CI, 1.1-3.3; P < 0.04); onset of fever of unknown origin in hospital inpatients OR 5.55 (95% CI, 2.5-12; P < 0.0001); and febrile neutropenia OR 0.3 (95% CI, 0.1-0.7; P = 0.009). Inappropriate use of antibiotics was less common in the clinical conditions that were well-characterized. Prescribing practices that could be improved were identified through the preparation and circulation of guidelines for antibiotic use in hospital inpatients.
This 51-item bibliography offers a selection of writings on issues and problems related to classroom management and discipline. Most citations concern works written between 1972-1983. Intervention techniques in dealing with deviant behavior are highlighted along with discipline and control in the classroom. Articles on methods of behavior…
Stahmer, Aubyn C.; Suhrheinrich, Jessica; Reed, Sarah; Schreibman, Laura; Bolduc, Cynthia
This practical manual and accompanying DVD-ROM present a research-supported behavioral intervention for children with autism that teachers can easily integrate into their existing classroom curriculum. Classroom Pivotal Response Teaching (CPRT) enhances children's motivation and participation in learning; increases the number of learning…
Summarizes results of a study on implementation and impact of classroom assessment techniques (CATs) in community colleges, examining how classroom assessment has been applied by teachers, documenting changes in teaching behaviors, and considering costs and benefits. Also examines students' experiences and satisfaction with courses taught using…
Bloom, Sarah E.; Iwata, Brian A.; Fritz, Jennifer N.; Roscoe, Eileen M.; Carreau, Abbey B.
We evaluated a trial-based approach to conducting functional analyses in classroom settings. Ten students referred for problem behavior were exposed to a series of assessment trials, which were interspersed among classroom activities throughout the day. Results of these trial-based functional analyses were compared to those of more traditional…
Webber, Jo; Coleman, Maggie
Teachers are encouraged to utilize rational-emotive therapy to prevent and deal with classroom behavior problems. Rational-emotive therapy is defined, the ABC model of rational thinking briefly explained, types of irrational thinking identified, and suggestions for becoming a rational thinker are offered. Classroom examples are given. (DB)
Fortes,Leonardo de Sousa; Morgado,Fabiane Frota da Rocha; Almeida,Sebastião de Sousa; Ferreira,Maria Elisa Caputo
OBJECTIVE: The aim of this study was to compare the inappropriate eating behaviors of adolescents as a function of habitual level of physical activity. METHODS: Participants were 462 youth of both genders aged 10 to 19 years. The Eating Attitudes Test-26 was used for inappropriate eating behaviors assessment. A short version of the International Physical Activity Questionnaire was used for classifying the habitual level of physical activity. RESULTS: No statistically significant differences w...
Booren, Leslie M.; Downer, Jason T.; Vitiello, Virginia E.
This descriptive study examined classroom activity settings in relation to children’s observed behavior during classroom interactions, child gender, and basic teacher behavior within the preschool classroom. 145 children were observed for an average of 80 minutes during 8 occasions across 2 days using the inCLASS, an observational measure that conceptualizes behavior into teacher, peer, task, and conflict interactions. Findings indicated that on average children’s interactions with teachers w...
Bahat, Gulistan; Ilhan, Birkan; Bay, Ilker; Kilic, Cihan; Kucukdagli, Pinar; Oren, Meryem Merve; Karan, Mehmet Akif
The rates and reasons why clinicians decide not to follow recommendations from explicit-criteria have been studied scarce. We aimed to compare STOPP version 2 representing one of the most commonly used excplicit tool with the implicit comprehensive geriatric assessment mediated clinical evaluation considered as gold standard. Two hundred and six (n = 206) outpatients ≥65 years old were included. The study was designed as retrospective, cross-sectional, and randomised. STOPP version 2 criteria were systematically used to assess pre-admission treatments followed by implicit clinical evaluation regarding two questions: Were the STOPP criteria recommendations valid for the individual patient and were there any potentially inappropriate-prescription other than depicted by STOPP version 2 criteria? The underlying reason(s) and associated clinical-features were noted. About 62.6% potentially inappropriate-prescriptions were identified (0.6 per-subject) according to systematic application of STOPP v2 while it was 53.4% (0.5 potentially inappropriate-prescriptions per subject) by clinician's application of STOPP v2. Prevalence of non-compliance was 14.7% in 18 (21.7%) of 83 patients identified by systematic application. Suggestion to stop a drug was not accepted because of need of treatment despite likelihood of anticipated side-effects in about 2/3 and with no-anticipated side-effects in about 1/3 of non-compliances. Not following STOPP v2 was significantly associated with lower functional level. According to clinician's implicit-evaluation, there were an extra 59.2% potentially inappropriate-prescriptions (0.6 per subject) in 80 (38.8%) patients yielding a total of 112.6% potentially inappropriate-prescription. Most of the STOPP v2 directed drug cessations are decided valid by the clinicians. In patients with higher functional dependency, it is likely that they are not followed due to palliation focussed care/patient-family preferences. There may be as much as STOPP
Previous studies have not demonstrated a consistent association between potentially inappropriate medicines (PIMs) in older patients as defined by Beers criteria and avoidable adverse drug events (ADEs). This study aimed to assess whether PIMs defined by new STOPP (Screening Tool of Older Persons\\' potentially inappropriate Prescriptions) criteria are significantly associated with ADEs in older people with acute illness.
Mancina, Catherine; Tankersley, Melody; Kamps, Debra; Kravits, Tammy; Parrett, Jean
A study examined the effects of a self-management program used to reduce high rates of inappropriate vocalizations (e.g., humming, tongue clucking, perseveration, and echolalic words/phases) in a 12-year-old girl with autism. When self-management was applied to inappropriate vocalizations during leisure, prevocational, and reading tasks, the…
Full Text Available For making teaching and learning more visible, classroom observation plays a central role. It provides teachers with constructive critical feedback in order to improve their classroom management and instructional techniques. For teachers it is important to observe the interaction between teacher-learner within the classroom because it can determine the learning opportunities that students get. Not only that, classroom observation encourages colleagues to collaborate to improve teacher practice and student learning. Feedback from classroom observations is an effective way for providing teachers with the information they need about their classroom behavior, and it can help them in their continuous professional development (CPD. This paper is based upon a practical approach to professional development among teachers through classroom observation. Since we, as teachers, are not born with innate teaching abilities, in fact, we learn and develop gradually with the help of some practical approaches, and classroom observation is a well-known powerful practical approach in primary and higher education to help teachers improve their teaching quality. This article mainly highlights the importance of classroom observation and its guidelines adapted from Observing Classes-CETaL. Further, it emphasizes the limitations of classroom observation, and suggests the ways to carry it out effectively based upon Observing Classes CETaL Model.
This article describes “humanistic antidotes” to offset the widespread social media/cell phone addiction prevalent in current US college classrooms. The inappropriate use of cell phones to engage in social media in college classrooms is a pervasive problem that many college instructors have complained about. The dominant focus of this article is in humanistic education, in which the author's efforts at getting psychology college students to put away their cell phones, “talk with each other,”...
Purvis, Johnny R.; And Others
This article discusses classroom strategies used with students with attention deficit hyperactivity disorder (ADHD), methods for controlling the ADHD child's behavior, and the need for consistency and collaboration between the school and home. (Author/JDD)
This study describes the procedure and results of a behavior modification program carried out in the classroom and aimed at eliminating encopresis (involuntary defecation) in an 8-year-old boy. (Editor/RK)
Decaux, G; Genette, F
The efficacy of oral urea in producing a sufficiently high osmotic diuresis was tested in seven patients with the syndrome of inappropriate secretion of antidiuretic hormone. In all patients urea corrected the hyponatraemia despite a normal fluid intake. Five patients were controlled (serum sodium concentration greater than 128 mmol(mEq)/1) with a dose of 30 g urea daily, and two with 60 g daily. The patients who needed 30 g drank 1-2 1 of fluid daily, while those who needed 60 g drank up to 3.1 per day. No major side effects were noted, even after treatment periods of up to 270 days. These findings suggest that urea is a safe and efficacious treatment of the syndrome of inappropriate secretion of antidiuretic hormone.
Full Text Available A 57-year-old Japanese man visited our hospital with a moist cough. Chest radiographic imaging showed a left hilar shadow. Adenocarcinoma cells were found on cytologic screening of fresh sputum. Although multiple metastases including brain were detected, no tumor was observed in the kidneys. The patient underwent whole-brain irradiation and chemotherapy for advanced-stage lung cancer. One month before his death, carcinomatous meningitis was detected. Hyponatremia, hypo-osmolality, and hypertonic urine suggested the syndrome of inappropriate antidiuresis. Restricting water intake improved the hyponatremia; however, he developed fever and hematuria. Despite systemic administration of an antibacterial drug, he died. Primary tumor in the lung was absent, but adenocarcinoma of the right kidney was evident on autopsy. Lectin histochemical analysis of the carcinoma revealed its distal nephron origin, confirming collecting duct carcinoma. Severe carcinomatous meningitis, which is possibly caused the syndrome of inappropriate antidiuresis, was observed, with no cancer involvement of the pituitary gland and hypothalamus.
Yoon Hi Cho
Full Text Available We report a familial case of the nephrogenic syndrome of inappropriate antidiuresis (NSIAD, including 30-year followup data on two patients. The proband and one maternal uncle presented in their infancy with severe recurrent hyponatremia, and clinical pictures consistent with the syndrome of inappropriate antidiuretic hormone (SIADH in the absence of an elevated ADH level. They were both confirmed to be hemizygous for the R137C mutation on the V2R gene (AVPR2, the same locus of the gain of function mutation demonstrated in the original reports of this condition. The proband's mother was identified as an asymptomatic carrier of this X-linked condition. Our case describes a favourable long-term outcome for NSIAD, in particular, successful treatment with oral urea during the infancy period, and with self-regulated precautions on fluid intake into adult life.
Full Text Available We report a familial case of the nephrogenic syndrome of inappropriate antidiuresis (NSIAD, including 30-year followup data on two patients. The proband and one maternal uncle presented in their infancy with severe recurrent hyponatremia, and clinical pictures consistent with the syndrome of inappropriate antidiuretic hormone (SIADH in the absence of an elevated ADH level. They were both confirmed to be hemizygous for the R137C mutation on the V2R gene (AVPR2, the same locus of the gain of function mutation demonstrated in the original reports of this condition. The proband's mother was identified as an asymptomatic carrier of this X-linked condition. Our case describes a favourable long-term outcome for NSIAD, in particular, successful treatment with oral urea during the infancy period, and with self-regulated precautions on fluid intake into adult life.
Full Text Available AIM: To proposed control measures by exploring visual fatigue caused by college students wearing inappropriate glasses.METHODS: A total of 124 cases of asthenopia patients underwent optometry students audition, checked the original spectacles; TOPCON-CL100 computer center was used to checked the original mirror glasses(glasses, the distance between the optical center; with near vision as the standard examination table nearly with vergence and regulation near point, and checked the visual function. RESULTS: All 124 cases(248 eyeshad refractive errors, 77% were spherical mirror and 69% column mirror with error ≥±0.50D, and the pupil center distance from the lens had significant difference(U=5.27, PCONCLUSION: Students wearing inappropriate spectacle asthenopia is caused by one of the main scientific wearing glasses can effectively control asthenopia.
Oudit, Gavin Y; Cameron, Doug; Harris, Louise
The present case describes a patient who received inappropriate, but potentially life-saving, therapy from her implantable cardioverter defibrillator (ICD) in the setting of acute hyperkalemia (plasma potassium concentration = 8 mM). Hyperkalemia was associated with the development of a slow sinusoidal ventricular tachycardia, at a rate of 100 beats/min to 125 beats/min (610 ms to 480 ms) in a patient who is pacemaker-dependent. There was associated fractionation of the ICD electrogram and T ...
Marques, Antonio C.
The systematics of Hydrozoa is considered from the viewpoint of logical consistency between phylogeny and classification. The validity of the nominal taxon Hydroidomedusae (including all groups of Hydrozoa except the Siphonophorae) is discussed with regard to its distinctness and inclusive relationships. In general, phylogenetic systematic evidence suggest that the use of the term Hydroidomedusae is inappropriate given our current level of understanding. It is concluded that no new, or resurr...
DEMIRBAS, SEREF; AYKAN, MUSA BARIS; ZENGIN, HAYDAR; MAZMAN, SEMIR; SAGLAM, KENAN
The syndrome of inappropriate antidiuretic hormone secretion (SIADH) accounts for an important part of hyponatremia cases. The causes of SIADH can be detected almost always. As a rare disorder, Morvan Syndrome can be defined by the sum of peripheral nerve hyperexcitability, autonomic instability and neuropsychiatric features. Antibodies to voltage-gated potassium channels (Anti ? VGKC-Ab) including contactin associated protein-like 2 antibodies (CASPR2-Ab) and leucine-rich glioma inactivated ...
Abel, Gregory A; Chen, Kun; Taback, Nathan; Hassett, Michael J; Schrag, Deborah; Weeks, Jane C
Little is known about the impact of direct-to-consumer advertising (DTCA) on appropriate versus inappropriate prescribing. Aromatase inhibitor (AI) therapy for breast cancer provides an ideal paradigm for studying this issue, because AIs have been the focus of substantial DTCA, and because they should only be used in postmenopausal women, age can serve as a simple surrogate marker of appropriateness. Data regarding national DTCA spending for the AIs were obtained from TNS Multimedia; hormonal therapy prescription data were obtained from IMS Health. Time series analyses were performed to characterize the association between monthly changes in DTCA spending for the AIs and monthly changes in the proportion of all new hormonal therapy prescriptions represented by the AIs from October 2005 to September 2007. Analyses were stratified by age, considering prescriptions for women ≤ 40 (likely premenopausal) to be inappropriate and those for women > 60 (likely postmenopausal) to be appropriate. Monthly dollars spent on AI-associated DTCA varied considerably ($118,600 to $22,019,660). Time series analysis revealed that for every million dollars spent on DTCA for the AIs, there was an associated increase 3 months later in the new AI prescription proportion of 0.15% for all ages (P 60 years (P < .0001), but no significant change for those ≤ 40 at any time from 0 to 6 months. DTCA for the AIs was associated with increases in appropriate prescriptions with no significant effect on inappropriate prescriptions, suggesting that DTCA may not foster inappropriate medication use for certain drug classes. Copyright © 2012 American Cancer Society.
Optimization of drug prescribing in older populations is a priority due to the significant clinical and economic costs of drug-related illness. This study aimed to: (i) estimate the prevalence of potentially inappropriate prescribing (PIP) in a national Irish older population using European specific explicit prescribing criteria; (ii) investigate the association between PIP, number of drug classes, gender and age and; (iii) establish the total cost of PIP.
Yang, Hsuan-Chia; Iqbal, Usman; Nguyen, Phung Anh; Lin, Shen-Hsien; Huang, Chih-Wei; Jian, Wen-Shan; Li, Yu-Chuan
Medication errors such as potential inappropriate prescriptions would induce serious adverse drug events to patients. Information technology has the ability to prevent medication errors; however, the pharmacology of traditional Chinese medicine (TCM) is not as clear as in western medicine. The aim of this study was to apply the appropriateness of prescription (AOP) model to identify potential inappropriate TCM prescriptions. We used the association rule of mining techniques to analyze 14.5 million prescriptions from the Taiwan National Health Insurance Research Database. The disease and TCM (DTCM) and traditional Chinese medicine-traditional Chinese medicine (TCMM) associations are computed by their co-occurrence, and the associations' strength was measured as Q-values, which often referred to as interestingness or life values. By considering the number of Q-values, the AOP model was applied to identify the inappropriate prescriptions. Afterwards, three traditional Chinese physicians evaluated 1920 prescriptions and validated the detected outcomes from the AOP model. Out of 1920 prescriptions, 97.1% of positive predictive value and 19.5% of negative predictive value were shown by the system as compared with those by experts. The sensitivity analysis indicated that the negative predictive value could improve up to 27.5% when the model's threshold changed to 0.4. We successfully applied the AOP model to automatically identify potential inappropriate TCM prescriptions. This model could be a potential TCM clinical decision support system in order to improve drug safety and quality of care. Copyright © 2016 John Wiley & Sons, Ltd.
Chen, Li Li; Tangiisuran, Balamurugan; Shafie, Asrul Akmal; Hassali, Mohamed Azmi Ahmad
There is an increasing evidence of medicines related issues such as inappropriate prescribing among older people. Inappropriate prescribing is an important risk factor for adverse drug reactions and hospitalizations in the older people. To assess and characterize the prevalence of Potentially Inappropriate Medications (PIMs) in nursing home care in Malaysia as defined by Screening Tool of Older Peoples Prescriptions (STOPP) and Beers criteria. Four Nursing Homes situated in Penang, Malaysia. A multicenter and cross-sectional study was conducted over 2 months period at four large non-governmental organizations nursing homes in Penang, Malaysia. The study population included older residents (≥65 years old) taking at least one medication. Residents who had been diagnosed with dementia or taking anti dementia drugs, delirium, too frail or refused to give consent were excluded. Demographic, clinical data and concurrent medications were collected through direct interview and also by reviewing medical records. STOPP and Beers criteria were applied in the medical review to screen for PIMs. Potentially Inappropriate Medication using STOPP and Beers criteria. Two hundred eleven residents were included in the study with the median age of 77 (inter quartile range (IQR) 72-82) years. Median number of prescription medicines was 4 (IQR 1-14). STOPP identified less residents (50 residents, 23.7 %) being prescribed on PIMs compared with Beers criteria (69 residents, 32.7 %) (p older residents living in the nursing homes and are associated with number of medications and longer nursing home stay. Further research is warranted to study the impact of PIMs towards health related outcomes in these elderly.
van Dijk, D P; Dinant, G; Jacobs, J A
Drug donations to developing countries may be part of medical relief operations in acute emergencies, development aid in non-emergency situations, or a corporate donations programme. After a number of documented inappropriate drug donations, the World Health Organization developed the 'Guidelines for Drug Donations', with the second and final version published in 1999. We reviewed the medical literature on drug donations since the Guidelines publication in 1999. Literature was retrieved from PubMed and other on-line databases as well as from relevant websites providing medical literature for use in developing countries. We considered the following donations to be inappropriate: (i) essential drugs in excessive quantities; (ii) mixed unused drugs (unsorted medicines and free samples); and (iii) drug dumping (large quantities of useless medicines). We retrieved 25 publications dated after 1999, including 20 and 5 from the scientific literature and 'grey' literature (technical reports, working papers), respectively. New information concerned emergencies in East Timor, Mozambique, El Salvador, Gujarat State (India), Aceh (Indonesia) and Sri Lanka. Except for East Timor and Gujarat, inappropriate donations still occurred, accounting for 85%, 37%, 70% and 80% of donations in Mozambique, El Salvador, Aceh and Sri Lanka, respectively. Very little information was found on drug donations in non-emergency situations. There are few recent reports on the compliance of drug donations with the World Health Organization guidelines. For emergency situations, there is still room for improvement. Drug donations in non-emergency situations need to be evaluated. A reform of drug donations policy is needed.
Leban, Vid; Kozelj, Gordana; Brvar, Miran
In Europe body purification and natural balance restoring rituals are becoming increasingly popular, but an introduction of Amazonian shamanic rituals in urban Europe can result in unexpected adverse events. A 44-year-old woman attended a Kambô or Sapo ritual in Slovenia where dried skin secretion from a giant leaf frog (Phyllomedusa bicolor) was applied to five freshly burned wounds at her shoulder. Afterwards, she drank 6 litres of water and gradually developed nausea and vomiting, confusion, lethargy, muscle weakness, spasms and cramps, seizure, decreased consciousness level and short-term memory loss. The initial laboratory tests showed profound plasma hypoosmolality (251 mOsm/kg) proportional to hyponatremia (116 mmol/L) combined with inappropriately elevated urine osmolality (523 mOsm/kg) and high urine sodium concentration (87 mmol/L) indicating a syndrome of inappropriate antidiuretic hormone secretion. The patient was treated with 0.9% sodium chloride and a restriction of water intake. Plasma osmolality and hyponatremia improved one day after venom exposure, but the symptoms disappeared as late as the third day. In patients presenting with neurological symptoms and a line of small body burns Phyllomedusa bicolor venom exposure should be suspected. Acute symptomatic hyponatremia after Phyllomedusa bicolor venom exposure is the result of inappropriate antidiuretic hormone secretion that can be exacerbated by excessive water intake. Copyright © 2016 Elsevier Ltd. All rights reserved.
Jiang, Cunmei; Hamm, Jeff P; Lim, Vanessa K; Kirk, Ian J; Chen, Xuhai; Yang, Yufang
Pitch processing is a critical ability on which humans' tonal musical experience depends, and which is also of paramount importance for decoding prosody in speech. Congenital amusia refers to deficits in the ability to properly process musical pitch, and recent evidence has suggested that this musical pitch disorder may impact upon the processing of speech sounds. Here we present the first electrophysiological evidence demonstrating that individuals with amusia who speak Mandarin Chinese are impaired in classifying prosody as appropriate or inappropriate during a speech comprehension task. When presented with inappropriate prosody stimuli, control participants elicited a larger P600 and smaller N100 relative to the appropriate condition. In contrast, amusics did not show significant differences between the appropriate and inappropriate conditions in either the N100 or the P600 component. This provides further evidence that the pitch perception deficits associated with amusia may also affect intonation processing during speech comprehension in those who speak a tonal language such as Mandarin, and suggests music and language share some cognitive and neural resources.
Yin, Hailong; Lu, Yi; Xu, Zuxin; Li, Huaizheng; Schwegler, Benedict R
To probe the overflow pollution of separate storm drains with inappropriate sewage entries, in terms of the relationship between sewage entries and the corresponding dry-weather and wet-weather overflow, the monitoring activities were conducted in a storm drainage system in the Shanghai downtown area (374 ha). In this study site, samples from inappropriately entered dry-weather sewage and the overflow due to storm pumps operation on dry-weather and wet-weather days were collected and then monitored for six water quality constituents. It was found that overflow concentrations of dry-weather period could be higher than those of wet-weather period; under wet-weather period, the overflow concentrations of storm drains were close to or even higher than that of combined sewers. Relatively strong first flush mostly occurred under heavy rain that satisfied critical rainfall amount, maximum rainfall intensity, and maximum pumping discharge, while almost no first flush effect or only weak first flush effect was found for the other rainfall events. Such phenomenon was attributed to lower in-line pipe storage as compared to that of the combined sewers, and serious sediment accumulation within the storm pipes due to sewage entry. For this kind of system, treating a continuous overflow rate is a better strategy than treating the maximum amount of early part of the overflow. Correcting the key inappropriate sewage entries into storm drains should also be focused.
Full Text Available Pitch processing is a critical ability on which humans' tonal musical experience depends, and which is also of paramount importance for decoding prosody in speech. Congenital amusia refers to deficits in the ability to properly process musical pitch, and recent evidence has suggested that this musical pitch disorder may impact upon the processing of speech sounds. Here we present the first electrophysiological evidence demonstrating that individuals with amusia who speak Mandarin Chinese are impaired in classifying prosody as appropriate or inappropriate during a speech comprehension task. When presented with inappropriate prosody stimuli, control participants elicited a larger P600 and smaller N100 relative to the appropriate condition. In contrast, amusics did not show significant differences between the appropriate and inappropriate conditions in either the N100 or the P600 component. This provides further evidence that the pitch perception deficits associated with amusia may also affect intonation processing during speech comprehension in those who speak a tonal language such as Mandarin, and suggests music and language share some cognitive and neural resources.
Sam, Ann; Reszka, Stephanie; Odom, Samuel; Hume, Kara; Boyd, Brian
Momentary time sampling, partial-interval recording, and event coding are observational coding methods commonly used to examine the social and challenging behaviors of children at risk for or with developmental delays or disabilities. Yet there is limited research comparing the accuracy of and relationship between these three coding methods. By…
Tourette Syndrome: Overview and Classroom Interventions. A Complex Neurobehavioral Disorder Which May Involve Learning Problems, Attention Deficit Hyperactivity Disorder, Obsessive Compulsive Symptoms, and Stereotypical Behaviors.
Fisher, Ramona A.; Collins, Edward C.
Tourette Syndrome is conceptualized as a neurobehavioral disorder, with behavioral aspects that are sometimes difficult for teachers to understand and deal with. The disorder has five layers of complexity: (1) observable multiple motor, vocal, and cognitive tics and sensory involvement; (2) Attention Deficit Hyperactivity Disorder; (3)…
Er, Erkan; Kopcha, Theodore J.; Orey, Michael
Today's generation often seeks help from each other in online environments; however, only a few investigated the role of Internet technologies and the nature of online help-seeking behavior in collaborative learning environments. This paper presents an educational design research project that examines college students' online help-seeking…
Busacca, Margherita L.; Anderson, Angelika; Moore, Dennis W.
This review evaluates self-management literature targeting problem behaviors of primary school students in general education settings. Thirty-one single-case design studies met inclusion criteria, of which 16 demonstrated adequate methodological rigor, according to What Works Clearinghouse (WWC) design standards. Visual analysis and WWC…
Sometimes students will exhibit various aggressive behaviors in the preschool classroom. Early childhood educators need to have behavior management strategies to manage the students' negative behaviors within the classroom setting. This article will provide a rationale for embedding literacy instruction within behavior management strategies to…
Petrie, Garth; Lindauer, Patricia; Bennett, Brenda; Gibson, Sherri
Principals should familiarize teachers with the benefits of nonverbal procedures for classroom management and discipline enforcement. A behavior-management checklist of nonverbal techniques (eye contact, touching, smiling, and frowning) can be used in a series of short visits. At least 75% of control techniques should be nonverbal. Relying on…
In this article, we discuss the behavior of high-temperature superconductors and how to demonstrate them safely and effectively in the high school or introductory physics classroom. Included here is a discussion of the most relevant physics topics that can be demonstrated, some safety tips, and a bit of the history of superconductors. In an effort…
Birnie, Billie F.
Teachers are responsible for what happens in their classrooms, and promoting civil discourse should be among their top priorities. Not only should they model civil speech and behavior, but they also should establish clear boundaries for students, create a climate that nourishes courteous exchange, and help students build vocabularies that enable…
Freiberg, H. Jerome; Lamb, Stacey M.
Public opinion trends over the last five decades show that lack of discipline continues to be one of America's top public educational concerns. This trend suggests that alternatives to the traditional model are urgently needed. In this traditional model of classroom management, based on behaviorism and still common in some areas, discipline is…
Perkins, David; Johnston, Tim; Lytle, Rick
Student debt is a national concern. The authors address debt in the classroom to enhance students' understanding of the consequences of debt and the need for caution when financing their education. However, student feedback indicates this understanding has a delayed effect on borrowing behavior and underscores the importance of making difficult…
Swindell, James W., Jr.
If students are not in the classroom, they can't learn. The author serves a dual role of teacher and administrator for middle school and high school students who are at high risk for academic failure. Their academic difficulties are mainly due to their negative behavioral patterns, which lead to frequent absences from class. Negative in-class…
This project aims to provide students with disabilities the same in class learning experience through virtual reality technology, 360-degree video capture, and the use of Arduino units. These technologies will be combined to facilitate communication between teachers in physical classrooms with students in virtual classrooms. The goal is to provide a person who is affected by a disability (which makes it hard to be in a traditional classroom) the same benefits of a safe and interactive learnin...
Full Text Available Flipped classroom is an active, student-centered approach that was formed to increase the quality of period within class. Generally this approach whose applications are done mostly in Physical Sciences, also attracts the attention of educators and researchers in different disciplines recently. Flipped classroom learning which wide-spreads rapidly in the world, is not well recognized in our country. That is why the aim of study is to attract attention to its potential in education field and provide to make it recognize more by educators and researchers. With this aim, in the study what flipped classroom approach is, flipped classroom technology models, its advantages and limitations were explained.
Evaluación psicométrica de la escala de conducta delictiva y violenta en el aula, en estudiantes chilenos (Psychometric Assessment Of The Criminal And Violent Behavior Scale In The Classroom, In Chilean Students
Full Text Available RESUMEN: Se reporta evidencia empírica sobre las propiedades psicométricas de la Escala de conducta delictiva y violenta en el aula, en una muestra de 877 estudiantes secundarios chilenos, cuyas edades están comprendidas entre los 13 y los 20 años (M = 15.94, DT = 1.31. Los análisis factoriales exploratorios y confirmatorios han aportado evidencia de validez cruzada, corroborando la estructura original de dos factores; factor conducta violenta disruptiva y factor victimización. Las medidas de consistencia interna y homogeneidad fueron satisfactorias para ambas subescalas, así como su correlación con medidas de clima social escolar. Se concluye que esta escala brinda garantías de confiabilidad y validez para su uso en Chile. ABSTRACT: Empirical evidence is reported on the psychometric properties of the Scale of criminal and violent behaviorin the classroom, in a sample of 877 Chilean high school students, between the ages of 13 and 20 (M = 15.94, DT = 1.31 . Exploratory and confirmatory factor analysis have provided evidence of cross validity, corroborating the original two factor structure; the violent behavior disruptive factor and the victimization factor. Measures of internal consistency and uniformity were satisfactory for both subscales, as well as their correlation with school social climate measures. It is concluded that this scale provides guarantee of reliability and validity for its use in Chile.
Impacts of a parent intervention program: their children's academic achievement and classroom behavior / Impactos de uma intervenção com pais: o desempenho acadêmico e comportamento das crianças na escola
Full Text Available This paper presents the impacts of a parent intervention program on the academic performance and classroom behavior of their children. The participants of the study were either first or second grade students. There were three groups of participants: Experimental Group 1 (EG1 - 29 children whose fathers participated in the intervention program along with the children's teachers; Experimental Group 2 (EG2 - 36 children whose mothers participated in the intervention program along with the children's teachers; and Control Experimental Group (CG - 34 children, whose parents did not participate in the intervention program, and the children's teachers. Before and after the intervention program, the children were evaluated using the Academic Achievement Test (AAT and their teachers completed an open-ended questionnaire as well as the teacher's version of the Social Skills Rating Scale (SSRS-T. In comparison with the pre-test, in the post-test the children in the EG1 and EG2 (but not in the CG obtained: (a higher overall scores in the AAT and in the reading sub-test; (b more positive results in the SSRS-T; and (c were rated by their teachers as presenting a greater number of positive attributes and a smaller number of negative attributes.
Gilboy, Mary Beth; Heinerichs, Scott; Pazzaglia, Gina
The flipped classroom is an innovative pedagogical approach that focuses on learner-centered instruction. The purposes of this report were to illustrate how to implement the flipped classroom and to describe students' perceptions of this approach within 2 undergraduate nutrition courses. The template provided enables faculty to design before, during, and after class activities and assessments based on objectives using all levels of Bloom's taxonomy. The majority of the 142 students completing the evaluation preferred the flipped method compared with traditional pedagogical strategies. The process described in the report was successful for both faculty and students. Copyright © 2015 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.
Potentially inappropriate medications in elderly Japanese patients: effects of pharmacists' assessment and intervention based on Screening Tool of Older Persons' Potentially Inappropriate Prescriptions criteria ver.2.
Kimura, T; Ogura, F; Yamamoto, K; Uda, A; Nishioka, T; Kume, M; Makimoto, H; Yano, I; Hirai, M
The Screening Tool of Older Persons' Potentially Inappropriate Prescriptions (stopp) criteria were updated in 2014 (stopp criteria ver.2), but few studies have evaluated the usefulness of stopp criteria in elderly patients. This prospective observational study evaluated the prevalence of potentially inappropriate medications (PIMs), and the efficacy of hospital pharmacists' assessment and intervention based on stopp criteria ver.2. The study was conducted at three medical units of Kobe University Hospital between April 2015 and March 2016. Pharmacists assessed and detected PIMs based on stopp criteria ver.2 and considered the patient's intention to change the prescription at the time of admission of each patient. If the pharmacists judged that benefits outweighed risks of prescription change and the patients consented to change the medications, they recommended the doctor to change the prescription. If there was a risk of exacerbation of disease by the change of medications and the pharmacists judged it to be difficult to adjust medications during hospitalization or the patients did not consent to change the medications, they did not recommend to change it. The pharmacists and the doctors discussed and finally decided whether to change the PIMs or not. The number of patients prescribed PIMs, the number and contents of PIMs, and the number of medications changed after pharmacists' intervention were calculated. Totally, 822 new inpatients aged ≥65 years prescribed ≥1 daily medicine were included. Their median (interquartile range) age was 75·0 (71·0-80·0) years, and 54·9% were male. According to the criteria, 346 patients (42·1%) were prescribed ≥1 PIMs. Patients prescribed PIMs took significantly more medications than others: 10·0 (7·0-13·0) vs. 6·0 (4·0-9·0), P older people (benzodiazepines) (30/67) and (iii) drugs that predictably increase the risk of falls in older people (hypnotic Z-drugs) (15/31). Over 40% elderly patients were prescribed PIMs
Inappropriate pharmacological treatment in older adults affected by cardiovascular disease and other chronic comorbidities: a systematic literature review to identify potentially inappropriate prescription indicators
Full Text Available Ersilia Lucenteforte,1 Niccolò Lombardi,1,* Davide Liborio Vetrano,2,* Domenico La Carpia,2,* Zuzana Mitrova,3 Ursula Kirchmayer,3 Giovanni Corrao,4 Francesco Lapi,5 Alessandro Mugelli,1 Alfredo Vannacci1 On behalf of the Italian Group for Appropriate Drug prescription in the Elderly (I-GrADE 1Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA, University of Florence, Florence, Italy; 2Department of Geriatrics Catholic University, Rome, Italy; 3Department of Epidemiology, ASL 1 Rome, Italy; 4Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy; 5Epidemiology Unit, ARS Toscana, Florence, Italy *These authors contributed equally to this work Abstract: Avoiding medications in which the risks outweigh the benefits in the elderly patient is a challenge for physicians, and different criteria to identify inappropriate prescription (IP exist to aid prescribers. Definition of IP indicators in the Italian geriatric population affected by cardiovascular disease and chronic comorbidities could be extremely useful for prescribers and could offer advantages from a public health perspective. The purpose of the present study was to identify IP indicators by means of a systematic literature review coupled with consensus criteria. A systematic search of PubMed, EMBASE, and CENTRAL databases was conducted, with the search structured around four themes and combining each with the Boolean operator “and”. The first regarded “prescriptions”, the second “adverse events”, the third “cardiovascular conditions”, and the last was planned to identify studies on “older people”. Two investigators independently reviewed titles, abstracts, full texts, and selected articles addressing IP in the elderly affected by cardiovascular condition using the following inclusion criteria: studies on people aged ≥65 years; studies on patients with no restriction on age but with data on subjects
Long, James D.
Schools need to meet unique problems through the development of special classroom management techniques. Factors which contribute to classroom problems include lack of supervision at home, broken homes, economic deprivation, and a desire for peer attention. The educational atmosphere should encourage creativity for both the student and the…
in a classroom situation. We may suggest strategies for dealing with them, or invite responses, or both. "Classroom" is equally a forum for raising broader issues and sharing personal experiences and viewpoints on matters related to· teaching and learning science. Logarithm and agM. In  we had discussed the evaluation.
raised in a classroom situation. We may suggest strategies for dealing with them, or invite responses, or both. "Classroom" is equally a forum for raising broader issues and sharing personal experiences and viewpoints on matters related to teaching and learning science. Proving a Result in Combinatorics using Equations.
Santos, Graça Duarte; Sardinha, Susana; Reis, Silvia
Climate in the classroom is one of the determining factors in the development of practices in Inclusive Education. Many factors contribute to the climate in the classroom. However, there are predominance on affective-relational factors, with impact on action, norms and values, social interactions and learning processes. In this paper, the authors…
Andersen, Thomas Dyreborg; Levinsen, Henrik; Philipps, Morten
Action research is conducted in three physics classes over a period of eighteen weeks with the aim of studying the effect of flipped classroom on the pupils agency and learning processes. The hypothesis is that flipped classroom teaching will potentially allocate more time to work actively...
Ozdamli, Fezile; Asiksoy, Gulsum
Flipped classroom is an active, student-centered approach that was formed to increase the quality of period within class. Generally this approach whose applications are done mostly in Physical Sciences, also attracts the attention of educators and researchers in different disciplines recently. Flipped classroom learning which wide-spreads rapidly…
Hammond Christina L
Full Text Available Abstract Background Research has shown that a number of patients, with a variety of diagnoses, are admitted to hospital when it is not essential and can remain in hospital unnecessarily. To date, research in this area has been primarily quantitative. The purpose of this study was to explore the perceived causes of inappropriate or prolonged lengths of stay and focuses on a specific population (i.e., patients with long term neurological conditions. We also wanted to identify interventions which might avoid admission or expedite discharge as periods of hospitalisation pose particular risks for this group. Methods Two focus groups were conducted with a convenience sample of eight primary and secondary care clinicians working in the Derbyshire area. Data were analysed using a thematic content approach. Results The participants identified a number of key causes of inappropriate admissions and lengths of stay, including: the limited capacity of health and social care resources; poor communication between primary and secondary care clinicians and the cautiousness of clinicians who manage patients in community settings. The participants also suggested a number of strategies that may prevent inappropriate admissions or reduce length of stay (LoS, including: the introduction of new sub-acute care facilities; the introduction of auxiliary nurses to support specialist nursing staff and patient held summaries of specialist consultations. Conclusion Clinicians in both the secondary and primary care sectors acknowledged that some admissions were unnecessary and some patients remain in hospital for a prolonged period. These events were attributed to problems with the current capacity or structuring of services. It was noted, for example, that there is a shortage of appropriate therapeutic services and that the distribution of beds between community and sub-acute care should be reviewed.
Fried, Terri R; Niehoff, Kristina M; Street, Richard L; Charpentier, Peter A; Rajeevan, Nallakkandi; Miller, Perry L; Goldstein, Mary K; O'Leary, John R; Fenton, Brenda T
To examine the effect of the Tool to Reduce Inappropriate Medications (TRIM), a web tool linking an electronic health record (EHR) to a clinical decision support system, on medication communication and prescribing. Randomized clinical trial. Primary care clinics at a Veterans Affairs Medical Center. Veterans aged 65 and older prescribed seven or more medications randomized to receipt of TRIM or usual care (N = 128). TRIM extracts information on medications and chronic conditions from the EHR and contains data entry screens for information obtained from brief chart review and telephonic patient assessment. These data serve as input for automated algorithms identifying medication reconciliation discrepancies, potentially inappropriate medications (PIMs), and potentially inappropriate regimens. Clinician feedback reports summarize discrepancies and provide recommendations for deprescribing. Patient feedback reports summarize discrepancies and self-reported medication problems. Primary: subscales of the Patient Assessment of Care for Chronic Conditions (PACIC) related to shared decision-making; clinician and patient communication. Secondary: changes in medications. 29.7% of TRIM participants and 15.6% of control participants provided the highest PACIC ratings; this difference was not significant. Adjusting for covariates and clustering of patients within clinicians, TRIM was associated with significantly more-active patient communication and facilitative clinician communication and with more medication-related communication among patients and clinicians. TRIM was significantly associated with correction of medication discrepancies but had no effect on number of medications or reduction in PIMs. TRIM improved communication about medications and accuracy of documentation. Although there was no association with prescribing, the small sample size provided limited power to examine medication-related outcomes. © 2017, Copyright the Authors Journal compilation © 2017, The
Dahan, M; Anract, P; Babinet, A; Larousserie, F; Biau, D
The proximal femuris is an uncommon site of osteosarcoma. The unusual manifestations at this site may lead to diagnostic and therapeutic mistakes. We therefore performed a retrospective study to estimate the proportions of patients with imaging study findings and/or clinical manifestations typical for osteosarcoma and/or inappropriate treatment decisions. Proximal femoral osteosarcoma often produces atypical clinical and radiological presentations. Consecutive patients who underwent surgery at our center to treat proximal femoral osteosarcoma were included. For each patient, we collected the epidemiological characteristics, clinical symptoms, imaging study findings, treatment, and tumor outcome. Proportions were computed with their confidence intervals. Twelve patients had surgery for proximal femoral osteosarcoma between 1986 and 2015. Imaging findings were typical in 1 (8%) patient; they consisted of ill-defined osteolysis in 11/12 (92%) patients, a periosteal reaction in 1/12 (8%) patient, soft tissue involvement in 7/12 (58%) patients, and immature osteoid matrix in 11/12 (92%) patients. No patient had the typical combination of pain with a soft tissue swelling. Management was inappropriate in 2/12 (17%) patients, who did not undergo all the recommended imaging studies before surgery and were treated in another center before the correct diagnosis was established. At last follow-up, 4 patients had died (after a mean of 7 years) and 8 were alive (after a mean of 4 years). Proximal femoral osteosarcoma is uncommon and rarely produces the typical clinical and imaging study findings. The atypical presentation often results in diagnostic errors and inappropriate treatments. Ill-defined osteolysis on standard radiographs should prompt computed tomography or magnetic resonance imaging of the proximal femur. Treatment in a specialized center is imperative. IV, retrospective study. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
Ellis, David W.; Karr-Kidwell, PJ
Lee Canter's Assertive Discipline method was studied using a survey of 72 high school teachers' attitudes. Assertive Discipline calls for firm but fair rules, negative consequences for inappropriate behavior, and positive consequences for positive behavior, all set by the teacher. After a lengthy literature review, the survey is discussed.…
Examines gender-related patterns of behavior in the second-language classroom and argues that these patterns dovetail with all the other dynamics of language behavior. The article concludes that drawing on the theoretical foundations of frames theory will ensure that research into gender-related patterns of classroom discourse will reflect the…
Harsch, Igor Alexander; Schiffer, Anne; Konturek, Peter C
To investigate a potential cause of the syndrome of inappropriate antidiuretic hormone secretion (SIADH). A 70-year-old female patient had nausea and collapsed. Although euvolemic, pathological laboratory findings showed hyponatremia and hypoosmolality, and cerebral magnetic resonance imaging showed hypertrophic pachymeningitis. Secondary hypertrophic pachymeningitis was excluded. Other nonneurological reasons for SIADH were also excluded. Moderate fluid restriction restored an almost normal serum osmolality and sodium. This case of SIADH was conservatively treated with moderate fluid restriction that almost restored normal serum osmolality and sodium levels. © 2017 S. Karger AG, Basel.
Demirbas, Seref; Aykan, Musa Baris; Zengin, Haydar; Mazman, Semir; Saglam, Kenan
The syndrome of inappropriate antidiuretic hormone secretion (SIADH) accounts for an important part of hyponatremia cases. The causes of SIADH can be detected almost always. As a rare disorder, Morvan Syndrome can be defined by the sum of peripheral nerve hyperexcitability, autonomic instability and neuropsychiatric features. Antibodies to voltage-gated potassium channels (Anti - VGKC-Ab) including contactin associated protein-like 2 antibodies (CASPR2-Ab) and leucine-rich glioma inactivated protein 1 antibodies (LGI1-Ab) were previously known for the potential association with this condition. We present a Morvan Syndrome in a patient who presented with various neuropsychiatric symptoms and SIADH.
Full Text Available BACKGROUND The laboratory overuse is widely prevalent in hospital practice, mostly in the emergency care. Reasons for excessive and inappropriate test-ordering include defensive behaviour and fear or uncertainty, lack of experience, the misuse of protocols and guidelines, “routine” and local attitudes, inadequate educational feedback and clinician’s unawareness about the cost of examinations and their related implications. AIM OF THE STUDY AND METHODS The primary target of our working group was to reduce inappropriate ordering on a urgent basis test, implementing further examinations not yet previewed in the hospital panel of the available urgencies, according to the evidence based diagnosis concept. The secondary goal was to indicate strategies of re-engineering of the processes, improving turnaround time in the laboratory management of emergencies. After evaluating, as first intervention, the more reliable sources for practice guidelines, systematic reviews and RCTs, the committee further discussed main topics with in-hospital stakeholders, selected from Emergency, Internal Medicine and Surgery Depts. The working group, in many subsequent audits, tried to obtain a systematic feed back with all involved professionals. RESULTS After reviewing literature’s evidence, the board constrained testing options by defining the basic emergency laboratory panel tests (blood type, hemogram, blood urea nitrogen, plasma creatinine, glucose, sodium, potassium, chloride, osmolarity, CRP, bicarbonate, CPK, creatine phosphokinase-MB, myoglobin, troponin, BNP and NT-proBNP, PT-INR, PTT, D-dimer, beta- HCG, biochemical urinalysis etc.. As final result, the proposed tests reduced the overall number of inappropriate investigations and increased, with newer and updated tests, the available panel for critical patients. DISCUSSION A collegiate review of data reporting, in-hospital deepening of problems and the inter- professional discussion of the evidences
Haddon, J E; Killcross, S
Previous research suggests the infralimbic cortex is important in situations when there is competition between goal-directed and habitual responding. Here we used a response conflict procedure to further explore the involvement of the infralimbic cortex in this relationship. Rats received training on two instrumental biconditional discriminations, one auditory and one visual, in two distinct contexts. One discrimination was "over-trained" relative to the other, "under-trained," discrimination in the ratio 3:1. At test, animals were presented with incongruent audiovisual stimulus compounds of the training stimuli in the under-trained context. The stimulus elements of these test compounds have previously dictated different lever press responses during training. Rats receiving control infusions into the infralimbic cortex showed a significant interference effect, producing more responses to the over-trained (habitual), but context-inappropriate, stimulus element of the incongruent compound. This interference effect was abolished by inactivation of the infralimbic cortex; animals showed a reduced tendency to produce the habitual but inappropriate response compared with animals receiving control infusions. This finding provides evidence that the infralimbic cortex is involved in attenuating the influence of goal-directed behavior, for example context-appropriate responding. Copyright © 2011 IBRO. Published by Elsevier Ltd. All rights reserved.
Johnson, Cheryl DeConde
Emphasis on classroom listening has gained importance for all children and especially for those with hearing loss and special listening needs. The rationale can be supported from trends in educational placements, the Response to Intervention initiative, student performance and accountability, the role of audition in reading, and improvement in hearing technologies. Speech-language pathologists have an instrumental role advocating for the accommodations that are necessary for effective listening for these children in school. To identify individual listening needs and make relevant recommendations for accommodations, a classroom listening assessment is suggested. Components of the classroom listening assessment include observation, behavioral assessment, self-assessment, and classroom acoustics measurements. Together, with a strong rationale, the results can be used to implement a plan that results in effective classroom listening for these children. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Wong, Harry; Wong, Rosemary; Rogers, Karen; Brooks, Amanda
Effective teachers view classroom management as a process of organizing and structuring classroom events for student learning. Creating a well-managed classroom with established procedures is the priority of a teacher the first two weeks of school. In an elementary classroom where each day may have a different array of subjects and at different…
Full Text Available This article describes “humanistic antidotes” to offset the widespread social media/cell phone addiction prevalent in current US college classrooms. The inappropriate use of cell phones to engage in social media in college classrooms is a pervasive problem that many college instructors have complained about. The dominant focus of this article is in humanistic education, in which the author's efforts at getting psychology college students to put away their cell phones, “talk with each other,” and gain awareness of the detrimental effects of social media addiction and narcissism is illustrated. The methodology utilized in this article is based upon autoethnographic research, where relevant experiences of the researcher are considered to be an informative and fundamental part of the research. The author describes in narrative form his relevant experiences in formulating humanistic antidotes to the excessive and inappropriate use of cell phones to engage in social media, that he encountered in his college psychology teaching. These humanistic antidotes are described as a three-step process: 1 take necessary actions to eliminate as much as possible the inappropriate use of cell phones in the classroom; 2 engage students in required personal/academic small group discussions every class period; 3 include small discussions about the excessive and inappropriate use of cell phones and social media, and require them to write and present project papers of their own choosing, which will likely include some papers on the topic of cell phone/social media addiction, demonstrating their awareness of the detrimental aspects of this pervasive problem.
Wei, M.; Zhou, Yalun; Barber, C. E.; Brok, den P.J.
Students' perceptions are one of the most important elements in evaluating the learning environment. Although the literature is replete with studies investigating teacher-student interpersonal behavior in science classrooms, relatively few studies have been conducted in foreign language classrooms,
Full Text Available The article is analyzing the inappropriateness of the “classical” theories of transition for the analyses of democratic consolidation in the contemporary post-communist societies, including the Croatian one. The authors are claiming that the aforementioned theories are insufficient for a subtle explanation of the recent ongoing major political and social changes in the post-communist societies. The article is stressing the most characteristic examples of the “bluntness”, i.e. of the inappropriateness of the transition theory basic concepts for the analyses of democratic consolidation, as well as of the socio-cultural and socio-structural assumptions and other important concepts related to the post-communist transition phenomenon. Furthermore, the article is exposing the problems connected with various interpretations of the phases of the transition period in relation to the cleavage between the institutional constitution of the democratic system and the democratic deficit characteristic of the post-communist states. Finally, the article is bolding the necessity of re-conceptualization of the basic concepts of the theory of transition; however, not towards the construction of a new theory, but rather towards the adaptation of the existing theory to the recent social and political processes in the contemporaneous post-communist societies.
Rodwin, Marc A
Prescribing drugs for uses that the FDA has not approved - off-label drug use - can sometimes be justified but is typically not supported by substantial evidence of effectiveness. At the root of inappropriate off-label drug use lie perverse incentives for pharmaceutical firms and flawed oversight of prescribing physicians. Typical reform proposals such as increased sanctions for manufacturers might reduce the incidence of unjustified off-label use, but they do not remove the source of the problem. Public policy should address the cause and control the practice. To manage inappropriate off-label drug use, off-label prescriptions must be tracked in order to monitor the risks and benefits and the manufacturers' conduct. Even more important, reimbursement rules should be changed so that manufacturers cannot profit from off-label sales. When off-label sales pass a critical threshold, manufacturers should also be required to pay for independent testing of the safety and effectiveness of off-label drug uses and for the FDA to review the evidence. Manufacturers should also finance, under FDA supervision, programs designed to warn physicians and the public about the risks of off-label drug use. © 2013 American Society of Law, Medicine & Ethics, Inc.
Vandenabeele, Sylvie P.; Grundy, Edward; Friswell, Michael I.; Grogan, Adam; Votier, Stephen C.; Wilson, Rory P.
Devices attached to flying birds can hugely enhance our understanding of their behavioural ecology for periods when they cannot be observed directly. For this, scientists routinely attach units to either birds' backs or their tails. However, inappropriate payload distribution is critical in aircraft and, since birds and planes are subject to the same laws of physics during flight, we considered aircraft aerodynamic constraints to explain flight patterns displayed by northern gannets Sula bassana equipped with (small ca. 14 g) tail- and back-mounted accelerometers and (larger ca. 30 g) tail-mounted GPS units. Tail-mounted GPS-fitted birds showed significantly higher cumulative numbers of flap-glide cycles and a higher pitch angle of the tail than accelerometer-equipped birds, indicating problems with balancing inappropriately placed weights with knock-on consequences relating to energy expenditure. These problems can be addressed by carefully choosing where to place tags on birds according to the mass of the tags and the lifestyle of the subject species. PMID:24671007
Buri, L; Bersani, G; Hassan, C; Anti, M; Bianco, M A; Cipolletta, L; Di Giulio, E; Di Matteo, G; Familiari, L; Ficano, L; Loriga, P; Morini, S; Pietropaolo, V; Zambelli, A; Grossi, E; Intraligi, M; Tessari, F; Buscema, M
Inappropriateness of upper endoscopy (EGD) indication causes decreased diagnostic yield. Our aim of was to identify predictors of appropriateness rate for EGD among endoscopic centres. A post-hoc analysis of two multicentre cross-sectional studies, including 6270 and 8252 patients consecutively referred to EGD in 44 (group A) and 55 (group B) endoscopic Italian centres in 2003 and 2007, respectively, was performed. A multiple forward stepwise regression was applied to group A, and independently validated in group B. A <70% threshold was adopted to define inadequate appropriateness rate clustered by centre. discrete variability of clustered appropriateness rates among the 44 group A centres was observed (median: 77%; range: 41-97%), and a <70% appropriateness rate was detected in 11 (25%). Independent predictors of centre appropriateness rate were: percentage of patients referred by general practitioners (GP), rate of urgent examinations, prevalence of relevant diseases, and academic status. For group B, sensitivity, specificity and area under receiver operating characteristic curve of the model in detecting centres with a <70% appropriateness rate were 54%, 93% and 0.72, respectively. A simple predictive rule, based on rate of patients referred by GPs, rate of urgent examinations, prevalence of relevant diseases and academic status, identified a small subset of centres characterised by a high rate of inappropriateness. These centres may be presumed to obtain the largest benefit from targeted educational programs. Copyright (c) 2010 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
Le Louer, B; Lemale, J; Garcette, K; Orzechowski, C; Chalvon, A; Girardet, J-P; Tounian, P
Over the past few years, we have observed increasing consumption of inappropriate plant milks as an alternative to infant milk formula. Some families believe that foods labeled as natural are the most healthy and an appropriate nutritional choice. However, their composition does not respect European recommendations. They are always hypocaloric and protein, vitamin, and mineral concentrations are inadequate. The aim of this study was to report severe nutritional complications after inappropriate plant milk consumption. Between 2008 and 2011, we studied severe nutritional deficiencies caused by consumption of plant milks bought in health food stores or online shops. Infants were identified in our centers and examined through medical history, physical examination, and laboratory testing. Nine cases of infants aged from 4 to 14 months were observed. In all cases, these milks were used as an alternative to milk formulas for supposed cow's milk allergy. At diagnosis, four patients were aged 6 months or less. They had received plant milk exclusively for 1-3 months. The beverages consumed were rice, soya, almond and sweet chestnut milks. In three cases, infants presented severe protein-calorie malnutrition with substantial hypoalbuminemia (slow down the progress of this social trend. Copyright © 2014 Elsevier Masson SAS. All rights reserved.
Tanner, Michael, Ed.
This volume celebrates teachers as life-long learners of the art of teaching, by presenting 21 action research studies designed and implemented by classroom teachers. A "How To Get Started" section outlines action research steps and offers worksheets. Descriptions of the research studies begin with ethnographic studies, which include "Adopt a…
Full Text Available Abstract Background There are many examples of physicians using treatments inappropriately, despite clear evidence about the circumstances under which the benefits of such treatments outweigh their harms. When such over- or under- use of treatments occurs for common diseases, the burden to the healthcare system and risks to patients can be substantial. We propose that a major contributor to inappropriate treatment may be how clinicians judge the likelihood of important treatment outcomes, and how these judgments influence their treatment decisions. The current study will examine the role of judged outcome probabilities and other cognitive factors in the context of two clinical treatment decisions: 1 prescription of antibiotics for sore throat, where we hypothesize overestimation of benefit and underestimation of harm leads to over-prescription of antibiotics; and 2 initiation of anticoagulation for patients with atrial fibrillation (AF, where we hypothesize that underestimation of benefit and overestimation of harm leads to under-prescription of warfarin. Methods For each of the two conditions, we will administer surveys of two types (Type 1 and Type 2 to different samples of Canadian physicians. The primary goal of the Type 1 survey is to assess physicians' perceived outcome probabilities (both good and bad outcomes for the target treatment. Type 1 surveys will assess judged outcome probabilities in the context of a representative patient, and include questions about how physicians currently treat such cases, the recollection of rare or vivid outcomes, as well as practice and demographic details. The primary goal of the Type 2 surveys is to measure the specific factors that drive individual clinical judgments and treatment decisions, using a 'clinical judgment analysis' or 'lens modeling' approach. This survey will manipulate eight clinical variables across a series of sixteen realistic case vignettes. Based on the survey responses, we will be
Yang, Junfeng; Yu, Huiju; Gong, Chaohua; Chen, Nian-Shing
Kurt Lewin proposed the field theory which stated that our behaviour was a result of both our personality and our environment. Based on this theory, it could be deduced that teacher's teaching behavior was a result of both teacher's personality and classroom environment. Considering the challenges of pedagogy transformation and the modest use of…
Full Text Available Abstract Background Explicit criteria for determining potentially inappropriate medication consumption in elderly were elaborated by Beers et al. These lists have been used worldwide to evaluate medical prescriptions but there is little epidemiologic evidence demonstrating negative consequences of inappropriate medication use. It has been reported that some drugs could increase the risk of falls, which are a frequent and serious problem in elderly population. We aimed to evaluate the association between the use of potentially inappropriate medications and the risk of falls. Methods The 3C Study is a multicentre prospective cohort study conducted in France with 4 years of follow-up. Non-institutionalized men and women aged 65 years or over (N = 6343 were randomly selected from electoral rolls. Data on socio-demographic, medical characteristics and medication use (based on self-reports and data from the national healthcare insurance were collected. Use of inappropriate medication for elderly was defined from established criteria. Data about falls were collected at the two follow-up examinations (2 years and 4 years after baseline. The association between the exposure to inappropriate medications and the risk of falls was evaluated using multivariate models (Cox model and logistic regression. Results 32% of subjects reported inappropriate medication use at baseline and 29% at least two of the three examinations; 22% had fallen 2 times or more during follow-up. Overall, inappropriate medication users had an increased risk of falling. This increase was mainly due to the use of long-acting benzodiazepines (adjusted odds ratio (OR = 1.4, 95% confidence interval: [1.1–1.8], in both occasional and regular users, other inappropriate psychotropics (adjusted OR = 1.7 [1.7–2.7] in regular users, or medication with anticholinergic properties (adjusted OR = 1.6 [1.2–2.1] in regular users. Neither occasional, nor regular use of short- or intermediate
Full Text Available Background: Current algorithms and device morphology templates have been proposed in current Implantable Cardioverter-Defibrillators (ICDs to minimize inappropriate therapies (ITS, but this has not been completely successful. Aim: Assess the impact of a deliberate strategy of using an atrial lead implant with standardized parameters; based on all current ICD discriminators and technologies, on the burden of ITS. Method: A retrospective single-centre analysis of 250 patients with either dual chamber (DR ICDs or biventricular ICDs (CRTDs over a (41.9 ± 27.3 month period was performed. The incidence of ITS on all ICD and CRTD patients was chronicled after the implementation of standardized programming. Results: 39 events of anti-tachycardial pacing (ATP and/or shocks were identified in 20 patients (8% incidence rate among patients. The total number of individual therapies was 120, of which 34% were inappropriate ATP, and 36% were inappropriate shocks. 11 patients of the 250 patients received ITS (4.4%. Of the 20 patients, four had ICDs for primary prevention and 16 for a secondary prevention. All the episodes in the primary indication group were inappropriate, while seven patients (43% of the secondary indication group experienced inappropriate therapies. Conclusions: The burden of ITS in the population of patients receiving ICDs was 4.4% in the presence of atrial leads. The proposed rationalized programming criteria seems an effective strategy to minimize the burden of inappropriate therapies and will require further validation. Keywords: Implantable cardioverter-defibrillator (ICDs, Inappropriate therapies, Standardized programming
Kramer, David C., Ed.
Describes appearance, longevity, and changes in each step of the mealworm life cycle. Guidelines for starting a classroom colony are given with housing and care instructions. Suggested observations, activities, and questions for students are included. (DH)
Procedures are described for practicing the art of scrimshaw in the classroom. Several materials are suggested for use. These include beef soup bones, old piano keys, nails, sandpaper, and lampblack or charcoal. (SA)
Medin, Douglas L.; Bang, Megan
Culture plays a large but often unnoticeable role in what we teach and how we teach children. We are a country of immense diversity, but in classrooms the dominant European-American culture has become the language of learning.
Discusses the location of corporate training in view of modern technology. Indicates that training will be brought out of the classroom and to the work station. Describes training programs offered at several large corporations. (JOW)
"Classroom" is equally a forum for raising broader issues and sharing personal experiences and viewpoints on matters related to teaching and learning science. ! Energy transfer in an elastic collision. One may intuitively feel that in an elastic ...
Dollard, Norin; And Others
Reviews classroom management strategies that are child-centered and consistent with constructivist approaches to education, in which teachers create situations that facilitate learning. Describes strategies including techniques for establishing dialog, cognitive interventions (including self management and conflict resolution), cognitive…
Fezile Ozdamli; Gulsum Asiksoy
Flipped classroom is an active, student-centered approach that was formed to increase the quality of period within class. Generally this approach whose applications are done mostly in Physical Sciences, also attracts the attention of educators and researchers in different disciplines recently. Flipped classroom learning which wide-spreads rapidly in the world, is not well recognized in our country. That is why the aim of study is to attract attention to its potential in education field and pr...
Full Text Available Classroom observation is a didactic activity from which both the observer and the observed teacher are to win. The present article comments on and discusses the aims of observation, the stages of observation, the methodological recommendations of offering feedback and the need to introduce a system of classroom observation at institutional or even national level, which would contribute to improving the teaching/learning process.
Susan K. Laury; Charles A. Holt
Economics is often taught at a level of abstraction that can hinder some students from gaining basic intuition. However, lecture and textbook presentations can be complemented with classroom exercises in which students make decisions and interact. The approach can increase interest in and decrease skepticism about economic theory. This feature offers short descriptions of classroom exercises for a variety of economics courses, with something of an emphasis on the more popular undergraduate co...
Oudit, Gavin Y; Cameron, Doug; Harris, Louise
The present case describes a patient who received inappropriate, but potentially life-saving, therapy from her implantable cardioverter defibrillator (ICD) in the setting of acute hyperkalemia (plasma potassium concentration = 8 mM). Hyperkalemia was associated with the development of a slow sinusoidal ventricular tachycardia, at a rate of 100 beats/min to 125 beats/min (610 ms to 480 ms) in a patient who is pacemaker-dependent. There was associated fractionation of the ICD electrogram and T wave oversensing, leading to ventricular oversensing with resultant detection in the ventricular fibrillation rate zone. This was followed by shock therapy, even though the ventricular tachycardia rate was below the programmed detection rate of the ICD. The subsequent emergency treatment of the hyperkalemia normalized the electrogram, corrected the ventricular oversensing and arrhythmia, and restored rate-adaptive single-chamber ventricular pacing. PMID:18340383
Holst, Anders Gaarsdal; Jensen, Henrik Kjærulf; Eschen, Ole
AimsBrugada syndrome (BrS) is an inherited channelopathy that predisposes to malignant ventricular arrhythmias and thereby syncope and sudden cardiac death. Prior studies characterizing BrS patients have used highly selected referral populations from tertiary centres and prevalence estimates have...... been carried out using electrocardiogram (ECG) surveys only. We aimed to identify and characterize all diagnosed BrS patients in Denmark (population 5.4 million).Methods and resultsBrugada syndrome patients were identified using several modalities including identification in all Danish tertiary......%) experienced inappropriate shocks during a median follow-up of 47 months. No patient died or experienced aborted sudden cardiac death during follow-up.ConclusionsWe report the first nationwide study of BrS patients. We found a low incidence of diagnosed definite BrS compared with estimates from ECG surveys...
Binu P Pillai
Full Text Available Hyponatremia occurs in about 30% of hospitalized patients and syndrome of inappropriate antidiuretic hormone secretion (SIADH is a common cause of hyponatremia. SIADH should be differentiated from other causes of hyponatremia like diuretic therapy, hypothyroidism and hypocortisolism. Where possible, all attempts should be made to identify and rectify the cause of SIADH. The main problem in SIADH is fluid excess, and hyponatremia is dilutional in nature. Fluid restriction is the main stay in the treatment of SIADH; however, cerebral salt wasting should be excluded in the clinical setting of brain surgeries, subarachnoid hemorrhage, etc. Fluid restriction in cerebral salt wasting can be hazardous. Sodium correction in chronic hyponatremia (onset >48 hours should be done slowly to avoid deleterious effects in brain.
Kiechle, Frederick L; Arcenas, Rodney C; Rogers, Linda C
Benchmarks and metrics related to laboratory test utilization are based on evidence-based medical literature that may suffer from a positive publication bias. Guidelines are only as good as the data reviewed to create them. Disruptive technologies require time for appropriate use to be established before utilization review will be meaningful. Metrics include monitoring the use of obsolete tests and the inappropriate use of lab tests. Test utilization by clients in a hospital outreach program can be used to monitor the impact of new clients on lab workload. A multi-disciplinary laboratory utilization committee is the most effective tool for modifying bad habits, and reviewing and approving new tests for the lab formulary or by sending them out to a reference lab. Copyright © 2013 Elsevier B.V. All rights reserved.
Hyponatraemia is the commonest electrolyte abnormality, and syndrome of inappropriate antidiuretic hormone (SIADH) is the most frequent underlying pathophysiology. Hyponatraemia is associated with significant morbidity and mortality, and as such appropriate treatment is essential. Treatment options for SIADH include fluid restriction, demeclocycline, urea, frusemide and saline infusion, all of which have their limitations. The introduction of the vasopressin-2 receptor antagonists has allowed clinicians to specifically target the underlying pathophysiology of SIADH. Initial studies have shown good efficacy and safety profiles in the treatment of mild to moderate hyponatraemia. However, studies assessing the efficacy and safety of these agents in acute severe symptomatic hyponatraemia are awaited. Furthermore, the cost of these agents at present may limit their use.
Full Text Available Vancomycin is an antibiotic used for infections by gram-positive bacteria with a two-compartment pharmacokinetic model. Its monitoring has an established therapeutic range (10-20 mg/L to prevent nephrotoxicity and ototoxicity due to supratherapeutic levels, and inefficiency and development of resistance by subtherapeutic levels. Nephrotoxicity for vancomycin monotherapy at standard doses according to pathogen and typical regimens (usual dose: 15-20 mg/kg/12 h is rare and usually reversible. Moreover, monitoring plasma concentrations allows to achieve concentrations within therapeutic range to allow safe and effective drug use. The renal hypoperfusion can cause pre-renal damage, resulting in elevated levels of serum creatinine, resulting in decreased antibiotic elimination and nephrotoxicity. We report a case of unexpected vancomycin nephrotoxicity in a patient with syndrome Inappropriate antidiuretic hormone secretion associated paraneoplastic
Cooper, P David; Smart, David R
Recent Australian attempts to facilitate disinvestment in healthcare, by identifying instances of 'inappropriate' care from large Government datasets, are subject to significant methodological flaws. Amongst other criticisms has been the fact that the Government datasets utilized for this purpose correlate poorly with datasets collected by relevant professional bodies. Government data derive from official hospital coding, collected retrospectively by clerical personnel, whilst professional body data derive from unit-specific databases, collected contemporaneously with care by clinical personnel. Assessment of accuracy of official hospital coding data for hyperbaric services in a tertiary referral hospital. All official hyperbaric-relevant coding data submitted to the relevant Australian Government agencies by the Royal Hobart Hospital, Tasmania, Australia for financial year 2010-2011 were reviewed and compared against actual hyperbaric unit activity as determined by reference to original source documents. Hospital coding data contained one or more errors in diagnoses and/or procedures in 70% of patients treated with hyperbaric oxygen that year. Multiple discrete error types were identified, including (but not limited to): missing patients; missing treatments; 'additional' treatments; 'additional' patients; incorrect procedure codes and incorrect diagnostic codes. Incidental observations of errors in surgical, anaesthetic and intensive care coding within this cohort suggest that the problems are not restricted to the specialty of hyperbaric medicine alone. Publications from other centres indicate that these problems are not unique to this institution or State. Current Government datasets are irretrievably compromised and not fit for purpose. Attempting to inform the healthcare policy debate by reference to these datasets is inappropriate. Urgent clinical engagement with hospital coding departments is warranted.