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

Directory of Open Access Journals (Sweden)

Liang Mao

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

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

Science.gov (United States)

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

2006-09-01

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

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

Directory of Open Access Journals (Sweden)

Somayeh Shahba

2014-06-01

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

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

Science.gov (United States)

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

2014-10-01

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

Oncologists' strategies and barriers to effective communication about the end of life.

Science.gov (United States)

Granek, Leeat; Krzyzanowska, Monika K; Tozer, Richard; Mazzotta, Paolo

2013-07-01

Communicating about the end of life with patients has been reported as one of the most difficult and stressful part of the work of oncologists. Despite this fact, oncologists receive little training in this area, and many do not communicate effectively with patients. The purpose of this analysis, part of a larger study examining oncologists' experiences of patient loss, was to explore oncologists' communication strategies and communication barriers when discussing end-of-life issues with patients. Twenty oncologists were interviewed at three hospitals about their communication strategies on end-of-life issues with patients. The data were analyzed using the grounded theory method. The findings revealed the strategies to effective communication about the end of life included: being open and honest; having ongoing, early conversations; communicating about modifying treatment goals; and balancing hope and reality. Barriers to implementing these strategies fell broadly into three domains, including physician factors, patient factors, and institutional factors. Physician factors included difficulty with treatment and palliation, personal discomfort with death and dying, diffusion of responsibility among colleagues, using the "death-defying mode," lack of experience, and lack of mentorship. Patient factors included, patients and/or families being reluctant to talk about the end of life, language barriers, and younger age. Institutional factors included stigma around palliative care, lack of protocol about end-of-life issues; and lack of training for oncologists on how to talk with patients about end-of-life issues. We conclude by drawing implications from our study and suggest that further research and intervention are necessary to aid oncologists in achieving effective communication about end-of-life issues.

Effects of direct instruction and strategy modeling on upper-primary students' writing development

NARCIS (Netherlands)

López, P.; Torrance, M.; Rijlaarsdam, G.; Fidalgo, R.

Strategy-focused instruction is one of the most effective approaches to improve writing skills. It aims to teach developing writers strategies that give them executive control over their writing processes. Programs under this kind of instruction tend to have multiple components that include direct

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

Science.gov (United States)

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

2003-05-06

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

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

Science.gov (United States)

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

2013-02-01

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

SDRE control strategy applied to a nonlinear robotic including drive motor

Energy Technology Data Exchange (ETDEWEB)

Lima, Jeferson J. de, E-mail: jefersonjl82@gmail.com, E-mail: tusset@utfpr.edu.br, E-mail: fcjanzen@utfpr.edu.br, E-mail: piccirillo@utfpr.edu.br, E-mail: claudinor@utfpr.edu.br; Tusset, Angelo M., E-mail: jefersonjl82@gmail.com, E-mail: tusset@utfpr.edu.br, E-mail: fcjanzen@utfpr.edu.br, E-mail: piccirillo@utfpr.edu.br, E-mail: claudinor@utfpr.edu.br; Janzen, Frederic C., E-mail: jefersonjl82@gmail.com, E-mail: tusset@utfpr.edu.br, E-mail: fcjanzen@utfpr.edu.br, E-mail: piccirillo@utfpr.edu.br, E-mail: claudinor@utfpr.edu.br; Piccirillo, Vinicius, E-mail: jefersonjl82@gmail.com, E-mail: tusset@utfpr.edu.br, E-mail: fcjanzen@utfpr.edu.br, E-mail: piccirillo@utfpr.edu.br, E-mail: claudinor@utfpr.edu.br; Nascimento, Claudinor B., E-mail: jefersonjl82@gmail.com, E-mail: tusset@utfpr.edu.br, E-mail: fcjanzen@utfpr.edu.br, E-mail: piccirillo@utfpr.edu.br, E-mail: claudinor@utfpr.edu.br [UTFPR-PONTA GROSSA, PR (Brazil); Balthazar, José M., E-mail: jmbaltha@rc.unesp.br [UNESP-BAURU, SP (Brazil); Brasil, Reyolando M. L. R. da Fonseca, E-mail: reyolando.brasil@ufabc.edu.br [UFABC-SANTO ANDRE, SP (Brazil)

2014-12-10

A robotic control design considering all the inherent nonlinearities of the robot-engine configuration is developed. The interactions between the robot and joint motor drive mechanism are considered. The proposed control combines two strategies, one feedforward control in order to maintain the system in the desired coordinate, and feedback control system to take the system into a desired coordinate. The feedback control is obtained using State-Dependent Riccati Equation (SDRE). For link positioning two cases are considered. Case I: For control positioning, it is only used motor voltage; Case II: For control positioning, it is used both motor voltage and torque between the links. Simulation results, including parametric uncertainties in control shows the feasibility of the proposed control for the considered system.

Developing an explicit strategy towards social responsibility in the NHS: a case for including NHS managers in this strategy.

Science.gov (United States)

Merali, Faruk

2006-01-01

To explore the concept of corporate social responsibility (CSR) within the UK National Health Service (NHS) and to examine how it may be developed to positively influence the psyche, behaviour and performance of NHS managers. Primary research based upon semi-structured individual face to face interviews with 20 NHS managers. Theoretical frameworks and concepts relating to organisational culture and CSR are drawn upon to discuss the findings. The NHS managers see themselves as being driven by altruistic core values. However, they feel that the public does not believe that they share the altruistic NHS value system. The study is based on a relatively small sample of NHS managers working exclusively in London and may not necessarily represent the views of managers either London-wide or nation-wide. It is suggested that an explicit recognition by the NHS of the socially responsible commitment of its managers within its CSR strategy would help challenge the existing negative public image of NHS managers and in turn improve the managers' self esteem and morale. This paper addresses the relative lacunae in research relating to public sector organisations (such as the NHS) explicitly including the role and commitment of its staff within the way it publicises its CSR strategy. This paper would be of interest to a wide readership including public sector and NHS policy formulators, NHS practitioners, academics and students.

Strategies for replacement of obsolete equipment - including reverse engineering

International Nuclear Information System (INIS)

Irish, C.S.

2000-01-01

The presentation shall detail the challenges facing nuclear power plants with the replacement of obsolete equipment and the strategies used to overcome those challenges. The presentation will outline the common equipment types which are either obsolete or are becoming obsolete, with a focus on safety related components. The four options of the obsolete equipment replacement philosophy will be presented with replacement examples from each of the options shown for discussion purposes. Detailed examples from each of the four obsolete equipment replacement options of: commercially available equivalent component; modification of a commercial available component; reverse engineering of the original component; and finally, design changes using a new component, shall be presented to evaluate the advantages and disadvantages of each option. The presentation will include the technical challenges, cost and schedule concerns for each of the four options. Emphasis will be placed on the technological challenges associated with replacing old and obsolete equipment. The following is a bullet list of the challenges which will be discussed: Missing, misleading or no information on the original component; Acquiring information from the original equipment manufacturer and the plant; Using a sample component for the replacement evaluation and or reverse engineering; and Reverse engineering old equipment with newly available discrete components. The presentation will include the equivalency documentation using the EPRI guidelines when replacing an original component with a different yet form, fit and functional equivalent component. The presentation will conclude with a discussion of the advantages and disadvantages of the replacement of the obsolete component with a form, fit and functional equivalent component vs. the replacement of the original component with a new component with today's technology. (author)

Privacy-preserving smart meter control strategy including energy storage losses

OpenAIRE

Avula, Chinni Venkata Ramana R.; Oechtering, Tobias J.; Månsson, Daniel

2018-01-01

Privacy-preserving smart meter control strategies proposed in the literature so far make some ideal assumptions such as instantaneous control without delay, lossless energy storage systems etc. In this paper, we present a one-step-ahead predictive control strategy using Bayesian risk to measure and control privacy leakage with an energy storage system. The controller estimates energy state using a three-circuit energy storage model to account for steady-state energy losses. With numerical exp...

Energy savings for heat-island reduction strategies in Chicago and Houston (including updates for Baton Rouge, Sacramento, and Salt Lake City)

Energy Technology Data Exchange (ETDEWEB)

Konopacki, S.; Akbari, H.

2002-02-28

In 1997, the U.S. Environmental Protection Agency (EPA) established the ''Heat Island Reduction Initiative'' to quantify the potential benefits of Heat-Island Reduction (HIR) strategies (i.e., shade trees, reflective roofs, reflective pavements and urban vegetation) to reduce cooling-energy use in buildings, lower the ambient air temperature and improve urban air quality in cities, and reduce CO2 emissions from power plants. Under this initiative, the Urban Heat Island Pilot Project (UHIPP) was created with the objective of investigating the potential of HIR strategies in residential and commercial buildings in three initial UHIPP cities: Baton Rouge, LA; Sacramento, CA; and Salt Lake City, UT. Later two other cities, Chicago, IL and Houston, TX were added to the UHIPP. In an earlier report we summarized our efforts to calculate the annual energy savings, peak power avoidance, and annual CO2 reduction obtainable from the introduction of HIR strategies in the initial three cities. This report summarizes the results of our study for Chicago and Houston. In this analysis, we focused on three building types that offer the highest potential savings: single-family residence, office and retail store. Each building type was characterized in detail by vintage and system type (i.e., old and new building constructions, and gas and electric heat). We used the prototypical building characteristics developed earlier for each building type and simulated the impact of HIR strategies on building cooling- and heating-energy use and peak power demand using the DOE-2.1E model. Our simulations included the impact of (1) strategically-placed shade trees near buildings [direct effect], (2) use of high-albedo roofing material on the building [direct effect], (3) urban reforestation with high-albedo pavements and building surfaces [indirect effect] and (4) combined strategies 1, 2, and 3 [direct and indirect effects]. We then estimated the total roof area of air

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

Directory of Open Access Journals (Sweden)

Natalia К. Shemetova

2015-01-01

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

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

DEFF Research Database (Denmark)

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

2017-01-01

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

The Effect of Summarizing and Presentation Strategies

Directory of Open Access Journals (Sweden)

Hooshang Khoshsima

2014-07-01

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

Energy savings for heat-island reduction strategies in Chicago and Houston (including updates for Baton Rouge, Sacramento, and Salt Lake City); FINAL

International Nuclear Information System (INIS)

Konopacki, S.; Akbari, H.

2002-01-01

In 1997, the U.S. Environmental Protection Agency (EPA) established the ''Heat Island Reduction Initiative'' to quantify the potential benefits of Heat-Island Reduction (HIR) strategies (i.e., shade trees, reflective roofs, reflective pavements and urban vegetation) to reduce cooling-energy use in buildings, lower the ambient air temperature and improve urban air quality in cities, and reduce CO2 emissions from power plants. Under this initiative, the Urban Heat Island Pilot Project (UHIPP) was created with the objective of investigating the potential of HIR strategies in residential and commercial buildings in three initial UHIPP cities: Baton Rouge, LA; Sacramento, CA; and Salt Lake City, UT. Later two other cities, Chicago, IL and Houston, TX were added to the UHIPP. In an earlier report we summarized our efforts to calculate the annual energy savings, peak power avoidance, and annual CO2 reduction obtainable from the introduction of HIR strategies in the initial three cities. This report summarizes the results of our study for Chicago and Houston. In this analysis, we focused on three building types that offer the highest potential savings: single-family residence, office and retail store. Each building type was characterized in detail by vintage and system type (i.e., old and new building constructions, and gas and electric heat). We used the prototypical building characteristics developed earlier for each building type and simulated the impact of HIR strategies on building cooling- and heating-energy use and peak power demand using the DOE-2.1E model. Our simulations included the impact of (1) strategically-placed shade trees near buildings[direct effect], (2) use of high-albedo roofing material on the building[direct effect], (3) urban reforestation with high-albedo pavements and building surfaces[indirect effect] and (4) combined strategies 1, 2, and 3[direct and indirect effects]. We then estimated the total roof area of air-conditioned buildings in each

Strategies for replacement of obsolete equipment, including reverse engineering

International Nuclear Information System (INIS)

Irish, C.S.

2003-01-01

The presentation shall detail the challenges facing nuclear power plants with the replacement of obsolete equipment and the strategies used to overcome those challenges. The presentation will outline the common equipment types which are either obsolete or are becoming obsolete, with a focus on safety related components. The four options of the obsolete equipment replacement philosophy will be presented with replacement examples from each of the options shown for discussion purposes. Detailed examples from each of the four obsolete equipment replacement options of, (1) commercially available equivalent component, (2) modification of a commercial available component, (3) reverse engineering of the original component and finally (4) design changes using a new component, shall be presented to evaluate the advantages and disadvantages of each option. The presentation will include the technical challenges, cost and schedule concerns for each of the four options. Emphasis will be placed on the technological challenges associated with replacing old and obsolete equipment. The following is a bullet list of the challenges which will be discussed: 1) Missing, misleading or no information on the original component. 2) Acquiring information from the original equipment manufacturer and the plant. 3) Using a sample component for the replacement evaluation and or reverse engineering. 4) Reverse engineering old equipment with newly available discrete components. The presentation will include the equivalency documentation using the EPRI guidelines when replacing an original component with a different yet form, fit and functional equivalent component. The presentation will conclude with a discussion of the advantages and disadvantages of the replacement of the obsolete component with a form, fit and functional equivalent component vs. the replacement of the original component with a new component with today's technology. (author)

Patient-centred and professional-directed implementation strategies for diabetes guidelines: a cluster-randomized trial-based cost-effectiveness analysis.

NARCIS (Netherlands)

Dijkstra, R.F.; Niessen, L.W.; Braspenning, J.C.C.; Adang, E.M.M.; Grol, R.P.T.M.

2006-01-01

AIMS: Economic evaluations of diabetes interventions do not usually include analyses on effects and cost of implementation strategies. This leads to optimistic cost-effectiveness estimates. This study reports empirical findings on the cost-effectiveness of two implementation strategies compared with

Competitive strategy in turbulent healthcare markets: an analysis of financially effective teaching hospitals.

Science.gov (United States)

Langabeer, J

1998-01-01

As the healthcare marketplace, characterized by declining revenues and heavy price competition, continues to evolve toward managed care, teaching hospitals are being forced to act more like traditional industrial organizations. Profit-oriented behavior, including emphases on market strategies and competitive advantage, is now a necessity if these hospitals are going to survive the transition to managed care. To help teaching hospitals evaluate strategic options that maximize financial effectiveness, this study examined the financial and operating data for 100 major U.S. teaching hospitals to determine relationships among competitive strategy, market environment, and financial return on invested capital. Results should help major hospitals formulate more effective strategies to combat environmental turbulence.

  A Cost-Effectiveness Analysis of Two Management Strategies for Dyspepsia

DEFF Research Database (Denmark)

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

2007-01-01

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

The effect of encoding strategy on the neural correlates of memory for faces.

Science.gov (United States)

Bernstein, Lori J; Beig, Sania; Siegenthaler, Amy L; Grady, Cheryl L

2002-01-01

Encoding and recognition of unfamiliar faces in young adults were examined using positron emission tomography to determine whether different encoding strategies would lead to encoding/retrieval differences in brain activity. Three types of encoding were compared: a 'deep' task (judging pleasantness/unpleasantness), a 'shallow' task (judging right/left orientation), and an intentional learning task in which subjects were instructed to learn the faces for a subsequent memory test but were not provided with a specific strategy. Memory for all faces was tested with an old/new recognition test. A modest behavioral effect was obtained, with deeply-encoded faces being recognized more accurately than shallowly-encoded or intentionally-learned faces. Regardless of encoding strategy, encoding activated a primarily ventral system including bilateral temporal and fusiform regions and left prefrontal cortices, whereas recognition activated a primarily dorsal set of regions including right prefrontal and parietal areas. Within encoding, the type of strategy produced different brain activity patterns, with deep encoding being characterized by left amygdala and left anterior cingulate activation. There was no effect of encoding strategy on brain activity during the recognition conditions. Posterior fusiform gyrus activation was related to better recognition accuracy in those conditions encouraging perceptual strategies, whereas activity in left frontal and temporal areas correlated with better performance during the 'deep' condition. Results highlight three important aspects of face memory: (1) the effect of encoding strategy was seen only at encoding and not at recognition; (2) left inferior prefrontal cortex was engaged during encoding of faces regardless of strategy; and (3) differential activity in fusiform gyrus was found, suggesting that activity in this area is not only a result of automatic face processing but is modulated by controlled processes.

Evaluating the effect of structural dimensions on the successful implementation of strategies in Payam-e-noor University of Iran

Directory of Open Access Journals (Sweden)

Hamidreza Shahhosseini

2013-07-01

Full Text Available This study aims to assess the relationship between structural dimensions of organization including centralization, complexity and formalization on one side and strategy effectiveness on the other side. Structural dimensions are determined based on Robbins theory, and each of them is considered as independent variables of research. Strategy effectiveness, which includes achieving strategic goals or successful implementation of strategies are the independent variable of the research, based on Noble’s strategy implementation model. One primary thesis and three secondary these are defined. This is a descriptive research of two variable correlation. The target population includes 600 senior managers of Payam-e-noor university around the country, including staff administrative managers, province and unit headmasters, of Iran at the time of data collection. Simple random sampling is used, with sample size of 120. Library resources are used for theoretical foundation data collection and note-taking. Questionnaires are used to collect data and evaluate research theses. Inferential Statistics and Pearson correlation coefficient are used to analyze the research theses. The first two theses are confirmed, at 95% and 99% respectively, but the third thesis is rejected based on the collected data. Therefore, based on this study, complexity and formalization have respectively inverse and direct effect on strategy effectiveness, but centralization does not affect strategy effectiveness in Payam-e-noor University.

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

Science.gov (United States)

Cody, M

1996-01-01

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

Including environmental concerns in management strategies for depleted uranium hexafluoride

International Nuclear Information System (INIS)

Goldberg, M.; Avci, H.I.; Bradley, C.E.

1995-01-01

One of the major programs within the Office of Nuclear Energy, Science, and Technology of the US Department of Energy (DOE) is the depleted uranium hexafluoride (DUF 6 ) management program. The program is intended to find a long-term management strategy for the DUF 6 that is currently stored in approximately 46,400 cylinders at Paducah, KY; Portsmouth, OH; and Oak Ridge, TN, USA. The program has four major components: technology assessment, engineering analysis, cost analysis, and the environmental impact statement (EIS). From the beginning of the program, the DOE has incorporated the environmental considerations into the process of strategy selection. Currently, the DOE has no preferred alternative. The results of the environmental impacts assessment from the EIS, as well as the results from the other components of the program, will be factored into the strategy selection process. In addition to the DOE's current management plan, other alternatives continued storage, reuse, or disposal of depleted uranium, will be considered in the EIS. The EIS is expected to be completed and issued in its final form in the fall of 1997

Impact of Guided Reflection with Peers on the Development of Effective Problem Solving Strategies and Physics Learning

Science.gov (United States)

Mason, Andrew J.; Singh, Chandralekha

2016-01-01

Students must learn effective problem solving strategies in order to develop expertise in physics. Effective problem solving strategies include a conceptual analysis of the problem followed by planning of the solution, and then implementation, evaluation, and reflection upon the process. Research suggests that converting a problem from the initial…

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

OpenAIRE

Somayeh Shahba; Seyed Mehdi Alvani; Shams Alsadat Zahedi; Gholamreza Memarzadeh

2014-01-01

This paper examined the effects of cognitive emotion regulation on employees’ job satisfaction. In this survey, Questionnaire and the questions were divided into two categories of cognitive emotion regulation and job satisfaction. To measure cognitive emotion regulation, including unadjusted emotion regulation strategies and adjusted strategies, 36 items questionnaire was used originally developed by Garnefski et al. (2001) [Garnefski, N., Kraaij, V., & Spinhoven, P. (2001). Negative life eve...

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

Science.gov (United States)

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

2008-05-01

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

A Systematic Review of the Effect of Cognitive Strategies on Strength Performance.

Science.gov (United States)

Tod, David; Edwards, Christian; McGuigan, Mike; Lovell, Geoff

2015-11-01

Researchers have tested the beliefs of sportspeople and sports medicine specialists that cognitive strategies influence strength performance. Few investigators have synthesised the literature. The specific objectives were to review evidence regarding (a) the cognitive strategy-strength performance relationship; (b) participant skill level as a moderator; and (c) cognitive, motivational, biomechanical/physiological, and emotional mediators. Studies were sourced via electronic databases, reference lists of retrieved articles, and manual searches of relevant journals. Studies had to be randomised or counterbalanced experiments with a control group or condition, repeated measures, and a quality control score above 0.5 (out of 1). Cognitive strategies included goal setting, imagery, self-talk, preparatory arousal, and free choice. Dependent variables included maximal strength, local muscular endurance, or muscular power. Globally, cognitive strategies were reliability associated with increased strength performance (results ranged from 61 to 65 %). Results were mixed when examining the effects of specific strategies on particular dependent variables, although no intervention had an overall negative influence. Indeterminate relationships emerged regarding hypothesised mediators (except cognitive variables) and participant skill level as a moderator. Although cognitive strategies influence strength performance, there are knowledge gaps regarding specific types of strength, especially muscular power. Cognitive variables, such as concentration, show promise as possible mediators.

Israel's Counter-Terrorism Strategy and its Effectiveness

National Research Council Canada - National Science Library

Smith, Jerry D

2005-01-01

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

Effective Strategy-Making in Multinational Subsidiaries

DEFF Research Database (Denmark)

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

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

Effective strategies to recruit young adults into an online wellbeing intervention

Directory of Open Access Journals (Sweden)

Gaston Antezana

2015-09-01

Objectives This paper will describe the outcomes of different methods for recruiting young adults (16-25 to the ‘Online Wellbeing Centre’, an online resource to assess wellbeing and access apps for mental health and general wellbeing. Methods Online and community strategies, which were of paid and unpaid nature, were utilised for recruiting participants aged between 16-25. Online paid strategies included 9 Facebook ads, 2 Twitter ads, 2 Google ads, and 1 YouTube ad. Online unpaid channels included Facebook and Twitter posts on the official pages of selected partner organisations, links on the websites of selected partner organisations, tailored messages and link via a University student learning portal, and bulk emails to various networks of young people. Unpaid community based recruitment strategies included a bulk email to various community contacts, and face-to-face contact via meetings and presentations in schools and mental health services. The one paid community based strategy was the use of a recruitment agency. All ads and posts were designed with final user input following principles of participatory methodology. All recruited participants were asked to complete a self-assessment of mood, energy levels, and sleep quality presented via visual analog scales, and also the Mental Health Continuum-Short Form assessment survey. Recruitment success via each of the strategies was descriptively analysed. Univariate analysis of variance was conducted to explore if self reported measures varied between paid and unpaid channels of recruitment. Results A total of 378 participants were recruited over a timeframe of 10 months. 26.7% of recruited participants were from paid channels with the recruitment agency and Facebook ads accounting for 15.6% and 8.5% respectively. Least effective paid strategies included Google ads and YouTube ads, each accounting for only 0.5% of participants. The average cost per participant recruited through paid channels was 85 AUD. Amongst

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

Science.gov (United States)

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

2014-02-01

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

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

Science.gov (United States)

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

2013-05-01

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

Feedback providing improvement strategies and reflection on feedback use: Effects on students' writing motivation, process, and performance

NARCIS (Netherlands)

Duijnhouwer, H.; Prins, F.J.; Stokking, K.M.

2012-01-01

This study investigated the effects of feedback providing improvement strategies and a reflection assignment on students’ writing motivation, process, and performance. Students in the experimental feedback condition (n = 41) received feedback including improvement strategies, whereas students in the

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

Science.gov (United States)

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

2014-06-01

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

Effective instructional strategies in physics classrooms

Science.gov (United States)

Tosa, Sachiko

2011-04-01

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

Brain tumor radiosurgery. Current status and strategies to enhance the effect of radiosurgery

International Nuclear Information System (INIS)

Niranjan, A.; Lunsford, L.D.; Gobbel, G.T.; Kondziolka, D.; Maitz, A.; Flickinger, J.C.

2000-01-01

First, the current status of brain tumor radiosurgery is reviewed, and radiosurgery for brain tumors, including benign tumors, malignant tumors, primary glial tumors, and metastatic tumors, is described. Rapid developments in neuroimaging, stereotactic techniques, and robotic technology in the last decade have contributed to improved results and wider applications of radiosurgery. Radiosurgery has become the preferred management modality for many intracranial tumors, including schwannomas, meningiomas, and metastatic tumors. Although radiosurgery provides survival benefits in patients with diffuse malignant brain tumors, cure is still not possible. Microscopic tumor infiltration into surrounding normal tissue is the main cause of recurrence. Additional strategies are needed to specifically target tumor cells. Next, strategies to enhance the effect of radiosurgery are reviewed. Whereas the long-term clinical results of radiosurgery have established its role in the treatment of benign tumors, additional strategies are needed to improve cell killing in malignant brain tumors and to protect normal surrounding brain. The first strategy included the use of various agents to protect normal brain while delivering a high dose to the tumor cells, but finding an effective radioprotective agent has been problematic. Pentobarbital and 21-aminosteroid (21-AS) are presented as examples. The second strategy for radiation protection aimed at the repair of radiation-induced damage to the normal brain. The cause of radiation-induced breakdown of normal tissue is unclear. The white matter and the cerebral vasculature appear to be particularly susceptible to radiation. Oligodendrocytes and endothelial cells may be critical targets of radiation. The authors hypothesize that radiation-induced damage to these cell types can be repaired by neural stem cells. They also describe the use of tumor necrosis factor alpha (TNF-alpha) and neural stem cells as a means of enhancing the effect of

The Effect of Context on the EFL Learners' Idiom Processing Strategies

Science.gov (United States)

Rohani, Gholamreza; Ketabi, Saeed; Tavakoli, Mansoor

2012-01-01

The present study investigated the effect of context on the strategies the EFL learners utilized to process idioms. To do so, ten Iranian intermediate EFL learners were randomly assigned to two groups who then attended a think-aloud session. The 5 subjects in the first group were exposed to an animated cartoon including 23 unfamiliar idioms while…

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

DEFF Research Database (Denmark)

Sethi, Naqash J; Feinberg, Joshua; Nielsen, Emil E

2017-01-01

-effect meta-analysis and chose the most conservative result as our primary result. We used Trial Sequential Analysis (TSA) to control for random errors. Statistical heterogeneity was assessed by visual inspection of forest plots and by calculating inconsistency (I2) for traditional meta-analyses and diversity...... (D2) for TSA. Sensitivity analyses and subgroup analyses were conducted to explore the reasons for substantial statistical heterogeneity. We assessed the risk of publication bias in meta-analyses consisting of 10 trials or more with tests for funnel plot asymmetry. We used GRADE to assess the quality...... of the body of evidence. RESULTS: 25 randomized clinical trials (n = 9354 participants) were included, all of which were at high risk of bias. Meta-analysis showed that rhythm control strategies versus rate control strategies significantly increased the risk of a serious adverse event (risk ratio (RR), 1...

Individualized Instruction Strategies in Mainstream Classrooms: Including Students with Autistic Spectrum Disorder

Science.gov (United States)

Betts, Stephanie R.

2008-01-01

This literature review describes research based teaching strategies for general education teachers to provide equal education for students diagnosed with autism. General education classrooms are often made up of students with a broad spectrum of abilities, and it is the teacher's job to meet the needs of those students. Strategies addressed in…

Genetic gain and economic values of selection strategies including semen traits in three- and four-way crossbreeding systems for swine production.

Science.gov (United States)

González-Peña, D; Knox, R V; MacNeil, M D; Rodriguez-Zas, S L

2015-03-01

Four semen traits: volume (VOL), concentration (CON), progressive motility of spermatozoa (MOT), and abnormal spermatozoa (ABN) provide complementary information on boar fertility. Assessment of the impact of selection for semen traits is hindered by limited information on economic parameters. Objectives of this study were to estimate economic values for semen traits and to evaluate the genetic gain when these traits are incorporated into traditional selection strategies in a 3-tier system of swine production. Three-way (maternal nucleus lines A and B and paternal nucleus line C) and 4-way (additional paternal nucleus line D) crossbreeding schemes were compared. A novel population structure that accommodated selection for semen traits was developed. Three selection strategies were simulated. Selection Strategy I (baseline) encompassed selection for maternal traits: number of pigs born alive (NBA), litter birth weight (LBW), adjusted 21-d litter weight (A21), and number of pigs at 21 d (N21); and paternal traits: number of days to 113.5 kg (D113), backfat (BF), ADG, feed efficiency (FE), and carcass lean % (LEAN). Selection Strategy II included Strategy I and the number of usable semen doses per collection (DOSES), a function of the 4 semen traits. Selection Strategy III included Strategy I and the 4 semen traits individually. The estimated economic values of VOL, CON, MOT, ABN, and DOSES for 7 to 1 collections/wk ranged from $0.21 to $1.44/mL, $0.12 to $0.83/10 spermatozoa/mm, $0.61 to $12.66/%, -$0.53 to -$10.88/%, and $2.01 to $41.43/%, respectively. The decrease in the relative economic values of semen traits and DOSES with higher number of collections per wk was sharper between 1 and 2.33 collections/wk than between 2.33 and 7 collections/wk. The higher economic value of MOT and ABN relative to VOL and CON could be linked to the genetic variances and covariances of these traits. Average genetic gains for the maternal traits were comparable across strategies

Feedback Providing Improvement Strategies and Reflection on Feedback Use: Effects on Students' Writing Motivation, Process, and Performance

Science.gov (United States)

Duijnhouwer, Hendrien; Prins, Frans J.; Stokking, Karel M.

2012-01-01

This study investigated the effects of feedback providing improvement strategies and a reflection assignment on students' writing motivation, process, and performance. Students in the experimental feedback condition (n = 41) received feedback including improvement strategies, whereas students in the control feedback condition (n = 41) received…

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

Science.gov (United States)

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

2011-03-01

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

Strategies for communicating contraceptive effectiveness.

Science.gov (United States)

Lopez, Laureen M; Steiner, Markus; Grimes, David A; Hilgenberg, Deborah; Schulz, Kenneth F

2013-04-30

Knowledge of contraceptive effectiveness is crucial to making an informed choice. The consumer has to comprehend the pros and cons of the contraceptive methods being considered. Choice may be influenced by understanding the likelihood of pregnancy with each method and factors that influence effectiveness. To review all randomized controlled trials comparing strategies for communicating to consumers the effectiveness of contraceptives in preventing pregnancy. Through February 2013, we searched the computerized databases of MEDLINE, POPLINE, CENTRAL, PsycINFO and CINAHL, ClinicalTrials.gov, and ICTRP. Previous searches also included EMBASE. We also examined references lists of relevant articles. For the initial review, we wrote to known investigators for information about other published or unpublished trials. We included randomized controlled trials that compared methods for communicating contraceptive effectiveness to consumers. The comparison could be usual practice or an alternative to the experimental intervention.Outcome measures were knowledge of contraceptive effectiveness, attitude about contraception or toward any particular contraceptive, and choice or use of contraceptive method. For the initial review, two authors independently extracted the data. One author entered the data into RevMan, and a second author verified accuracy. For the update, an author and a research associate extracted, entered, and checked the data.For dichotomous variables, we calculated the Mantel-Haenszel odds ratio with 95% confidence intervals (CI). For continuous variables, we computed the mean difference (MD) with 95% CI. Seven trials met the inclusion criteria and had a total of 4526 women. Five were multi-site studies. Four trials were conducted in the USA, while Nigeria and Zambia were represented by one study each, and one trial was done in both Jamaica and India.Two trials provided multiple sessions for participants. In one study that examined contraceptive choice, women in

Impact of guided reflection with peers on the development of effective problem solving strategies and physics learning

OpenAIRE

Mason, Andrew J.; Singh, Chandralekha

2016-01-01

Students must learn effective problem solving strategies in order to develop expertise in physics. Effective problem solving strategies include a conceptual analysis of the problem followed by planning of the solution, and then implementation, evaluation and reflection upon the process. Research suggests that converting a problem from the initial verbal representation to other suitable representation, e.g., diagrammatic representation, during the initial conceptual analysis can facilitate fur...

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

Science.gov (United States)

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

2017-11-14

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

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

African Journals Online (AJOL)

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

Visualizing topography: Effects of presentation strategy, gender, and spatial ability

Science.gov (United States)

McAuliffe, Carla

2003-10-01

This study investigated the effect of different presentation strategies (2-D static visuals, 3-D animated visuals, and 3-D interactive, animated visuals) and gender on achievement, time-spent-on visual treatment, and attitude during a computer-based science lesson about reading and interpreting topographic maps. The study also examined the relationship of spatial ability and prior knowledge to gender, achievement, and time-spent-on visual treatment. Students enrolled in high school chemistry-physics were pretested and given two spatial ability tests. They were blocked by gender and randomly assigned to one of three levels of presentation strategy or the control group. After controlling for the effects of spatial ability and prior knowledge with analysis of covariance, three significant differences were found between the versions: (a) the 2-D static treatment group scored significantly higher on the posttest than the control group; (b) the 3-D animated treatment group scored significantly higher on the posttest than the control group; and (c) the 2-D static treatment group scored significantly higher on the posttest than the 3-D interactive animated treatment group. Furthermore, the 3-D interactive animated treatment group spent significantly more time on the visual screens than the 2-D static treatment group. Analyses of student attitudes revealed that most students felt the landform visuals in the computer-based program helped them learn, but not in a way they would describe as fun. Significant differences in attitude were found by treatment and by gender. In contrast to findings from other studies, no gender differences were found on either of the two spatial tests given in this study. Cognitive load, cognitive involvement, and solution strategy are offered as three key factors that may help explain the results of this study. Implications for instructional design include suggestions about the use of 2-D static, 3-D animated and 3-D interactive animations as well

Effective strategies for behavior change.

Science.gov (United States)

Coleman, Mary Thoesen; Pasternak, Ryan H

2012-06-01

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

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

Directory of Open Access Journals (Sweden)

Carla Sabariego

2018-03-01

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

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

Science.gov (United States)

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

2018-03-19

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

Cooling Strategies for Vane Leading Edges in a Syngas Environment Including Effects of Deposition and Turbulence

Energy Technology Data Exchange (ETDEWEB)

Ames, Forrest [Univ. of North Dakota, Grand Forks, ND (United States); Bons, Jeffrey [Univ. of North Dakota, Grand Forks, ND (United States)

2014-09-30

The Department of Energy has goals to move land based gas turbine systems to alternate fuels including coal derived synthetic gas and hydrogen. Coal is the most abundant energy resource in the US and in the world and it is economically advantageous to develop power systems which can use coal. Integrated gasification combined cycles are (IGCC) expected to allow the clean use of coal derived fuels while improving the ability to capture and sequester carbon dioxide. These cycles will need to maintain or increase turbine entry temperatures to develop competitive efficiencies. The use of coal derived syngas introduces a range of potential contaminants into the hot section of the gas turbine including sulfur, iron, calcium, and various alkali metals. Depending on the effectiveness of the gas clean up processes, there exists significant likelihood that the remaining materials will become molten in the combustion process and potentially deposit on downstream turbine surfaces. Past evidence suggests that deposition will be a strong function of increasing temperature. Currently, even with the best gas cleanup processes a small level of particulate matter in the syngas is expected. Consequently, particulate deposition is expected to be an important consideration in the design of turbine components. The leading edge region of first stage vanes most often have higher deposition rates than other areas due to strong fluid acceleration and streamline curvature in the vicinity of the surface. This region remains one of the most difficult areas in a turbine nozzle to cool due to high inlet temperatures and only a small pressure ratio for cooling. The leading edge of a vane often has relatively high heat transfer coefficients and is often cooled using showerhead film cooling arrays. The throat of the first stage nozzle is another area where deposition potentially has a strongly adverse effect on turbine performance as this region meters the turbine inlet flow. Based on roughness

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

Science.gov (United States)

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

2018-03-01

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

The Effectiveness of Metacognition Strategies Training on Problem-Solving Function in Guidance School Students

Directory of Open Access Journals (Sweden)

Ali Reza Jazayeri

2003-01-01

Full Text Available Objective: The main purpose of this study is to assign the effect and role of metacognition strategies trainings in problem-solving function. In other word, a comparison among-different educational methods in these skills and assigning the most effective strategy for training metacognition skills. Materials & Methods: For this reason, through a multi-stages clustral sampling, 62 senior guidance school students were selected as sample group in Tehran. Then, all the subjects completed children attribution styles Questionnaire (Peterson & Seligman, 1984 and metacognition knowledge Questionnaire (Flavell, 1985 as pre-test. Results: Also, each subject was exposed to hanging situation individually. Then, the sample group was divided to three experimental groups include: Compound training, reciprocal/raining and attributional training, and a control group. After training, all four groups accomplished questionnaires as post-test. The data gathered from pre-test and post-test were analyzed through nonparametric procedures. Conclusion: We concluded that metacognition strategies training has too effects on problem-solving functions in students.

Dosimetric evaluation of three adaptive strategies for prostate cancer treatment including pelvic lymph nodes irradiation.

Science.gov (United States)

Cantin, Audrey; Gingras, Luc; Lachance, Bernard; Foster, William; Goudreault, Julie; Archambault, Louis

2015-12-01

where a reduction of 7% is observed. However, a correction of the systematic shift reduced the problem, and the adaptive strategies remain robust against the prostate movement across the fraction. The bladder V55Gy is reduced by 35% on average for the adaptive strategies. Because they offer increased CTV coverage and OAR sparing, adaptive methods may be suitable candidates for simple and efficient adaptive treatment strategies for prostate cancer. Margin reduction and systematic error correction in the prostate position improve the protection of the OAR and the dose coverage. A cumulative dose to simulate a complete treatment would show real effects and allow a better comparison between each method.

Dosimetric evaluation of three adaptive strategies for prostate cancer treatment including pelvic lymph nodes irradiation

International Nuclear Information System (INIS)

Cantin, Audrey; Gingras, Luc; Archambault, Louis; Lachance, Bernard; Foster, William; Goudreault, Julie

2015-01-01

, except for the gradient approach where a reduction of 7% is observed. However, a correction of the systematic shift reduced the problem, and the adaptive strategies remain robust against the prostate movement across the fraction. The bladder V 55Gy is reduced by 35% on average for the adaptive strategies. Conclusions: Because they offer increased CTV coverage and OAR sparing, adaptive methods may be suitable candidates for simple and efficient adaptive treatment strategies for prostate cancer. Margin reduction and systematic error correction in the prostate position improve the protection of the OAR and the dose coverage. A cumulative dose to simulate a complete treatment would show real effects and allow a better comparison between each method

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

Directory of Open Access Journals (Sweden)

Babak Monzavi

2013-07-01

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

Utility-Marketer Partnerships. An Effective Strategy for Marketing Green Power?

Energy Technology Data Exchange (ETDEWEB)

Bird, L. A. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Brown, E. S. [National Renewable Energy Lab. (NREL), Golden, CO (United States)

2006-04-01

This paper explores whether partnerships between utilities and independent marketers are an effective strategy for marketing green power. We present case studies of voluntary and mandatory partnerships covering green power program design and implementation in both regulated and restructured electricity markets. We also include perspectives (based on interviews) from utilities, marketers, and regulators involved in developing and implementing these partnerships. From these case studies and interviews, we describe lessons learned about developing effective partnerships, including such issues as respective roles in marketing and administration, product branding, and contract and incentive structures. Based on experience to date, strategic partnerships between utilities and marketers can be an effective approach to marketing green power. Partnerships leverage the sales and resource procurement experience of marketers and the utility’s reputation and access to customers. Further, partnerships can create greater incentives for success because marketers have a vested financial interest in maximizing customer participation and green power sales.

Utility-Marketing Partnerships: An Effective Strategy for Marketing Green Power?

Energy Technology Data Exchange (ETDEWEB)

Bird, L. A.; Brown, E. S.

2006-04-01

This paper explores whether partnerships between utilities and independent marketers are an effective strategy for marketing green power. We present case studies of voluntary and mandatory partnerships covering green power program design and implementation in both regulated and restructured electricity markets. We also include perspectives (based on interviews) from utilities, marketers, and regulators involved in developing and implementing these partnerships. From these case studies and interviews, we describe lessons learned about developing effective partnerships, including such issues as respective roles in marketing and administration, product branding, and contract and incentive structures. Based on experience to date, strategic partnerships between utilities and marketers can be an effective approach to marketing green power. Partnerships leverage the sales and resource procurement experience of marketers and the utility?s reputation and access to customers. Further, partnerships can create greater incentives for success because marketers have a vested financial interest in maximizing customer participation and green power sales.

Dominant Advertisement Strategies in Iranian TV Commercials and their Cognitive Effect

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Parvaneh Khosravizadeh

2017-12-01

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

Evaluating the effect of three teaching strategies on student nurses' moral sensitivity.

Science.gov (United States)

Lee, Hsiao Lu; Huang, Shu-He; Huang, Chiu-Mieh

2017-09-01

The Taiwan Nursing Accreditation Council has proposed eight core professional nursing qualities including ethical literacy. Consequently, nursing ethics education is a required course for student nurses. These courses are intended to improve the ethical literacy. Moral sensitivity is the cornerstone of ethical literacy, and learning moral sensitivity is the initial step towards developing ethical literacy. To explore the effect of nursing ethics educational interventions based on multiple teaching strategies on student nurses moral sensitivity. Based on the visual, auditory and kinaesthetic model, three strategies were developed for determining the programme components and corresponding learning styles. This was a quasi-experimental study. A total of 234 junior-college student nurses participated in this study. All participants were aged 18-19 years. Ethical considerations: The study protocol was approved by the institutional review boards of Kaohsiung Veterans General Hospital. Only the participants who signed an informed consent form took part in the study. The participants were permitted to withdraw from the study at any point if they wished to do so without affecting their academic score. The scores of Modified Moral Sensitivity Questionnaire for Student Nurses were significantly improved after the intervention of integrating multiple teaching strategies ( p = .042). Significant relationships were observed between the satisfaction scores of two teaching strategies and moral sensitivity. The results indicated that using multiple teaching strategies is effective for promoting nursing ethics learning. This strategy was consistent with the student nurses' preferred learning style and was used to correct their erroneous ethical conceptions, assisting in developing their ethical knowledge.

Cost-effective strategy to mitigate transportation disruptions in supply chain

Science.gov (United States)

Albertzeth, G.; Pujawan, I. N.

2018-04-01

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

Testing the implementation and sustainment facilitation (ISF) strategy as an effective adjunct to the Addiction Technology Transfer Center (ATTC) strategy: study protocol for a cluster randomized trial.

Science.gov (United States)

Garner, Bryan R; Zehner, Mark; Roosa, Mathew R; Martino, Steve; Gotham, Heather J; Ball, Elizabeth L; Stilen, Patricia; Speck, Kathryn; Vandersloot, Denna; Rieckmann, Traci R; Chaple, Michael; Martin, Erika G; Kaiser, David; Ford, James H

2017-11-17

Improving the extent to which evidence-based practices (EBPs)-treatments that have been empirically shown to be efficacious or effective-are integrated within routine practice is a well-documented challenge across numerous areas of health. In 2014, the National Institute on Drug Abuse funded a type 2 effectiveness-implementation hybrid trial titled the substance abuse treatment to HIV Care (SAT2HIV) Project. Aim 1 of the SAT2HIV Project tests the effectiveness of a motivational interviewing-based brief intervention (MIBI) for substance use as an adjunct to usual care within AIDS service organizations (ASOs) as part of its MIBI Experiment. Aim 2 of the SAT2HIV Project tests the effectiveness of implementation and sustainment facilitation (ISF) as an adjunct to the Addiction Technology Transfer Center (ATTC) model for training staff in motivational interviewing as part of its ISF Experiment. The current paper describes the study protocol for the ISF Experiment. Using a cluster randomized design, case management and leadership staff from 39 ASOs across the United States were randomized to receive either the ATTC strategy (control condition) or the ATTC + ISF strategy (experimental condition). The ATTC strategy is staff-focused and includes 10 discrete strategies (e.g., provide centralized technical assistance, conduct educational meetings, provide ongoing consultation). The ISF strategy is organization-focused and includes seven discrete strategies (e.g., use an implementation advisor, organize implementation team meetings, conduct cyclical small tests of change). Building upon the exploration-preparation-implementation-sustainment (EPIS) framework, the effectiveness of the ISF strategy is examined via three staff-level measures: (1) time-to-proficiency (i.e., preparation phase outcome), (2) implementation effectiveness (i.e., implementation phase outcome), and (3) level of sustainment (i.e., sustainment phase outcome). Although not without limitations, the ISF

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

African Journals Online (AJOL)

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

Developing a weighting strategy to include mobile phone numbers into an ongoing population health survey using an overlapping dual-frame design with limited benchmark information.

Science.gov (United States)

Barr, Margo L; Ferguson, Raymond A; Hughes, Phil J; Steel, David G

2014-09-04

In 2012 mobile phone numbers were included into the ongoing New South Wales Population Health Survey (NSWPHS) using an overlapping dual-frame design. Previously in the NSWPHS the sample was selected using random digit dialing (RDD) of landline phone numbers. The survey was undertaken using computer assisted telephone interviewing (CATI). The weighting strategy needed to be significantly expanded to manage the differing probabilities of selection by frame, including that of children of mobile-only phone users, and to adjust for the increased chance of selection of dual-phone users. This paper describes the development of the final weighting strategy to properly combine the data from two overlapping sample frames accounting for the fact that population benchmarks for the different sampling frames were not available at the state or regional level. Estimates of the number of phone numbers for the landline and mobile phone frames used to calculate the differing probabilities of selection by frame, for New South Wales (NSW) and by stratum, were obtained by apportioning Australian estimates as none were available for NSW. The weighting strategy was then developed by calculating person selection probabilities, selection weights, applying a constant composite factor to the dual-phone users sample weights, and benchmarking to the latest NSW population by age group, sex and stratum. Data from the NSWPHS for the first quarter of 2012 was used to test the weighting strategy. This consisted of data on 3395 respondents with 2171 (64%) from the landline frame and 1224 (36%) from the mobile frame. However, in order to calculate the weights, data needed to be available for all core weighting variables and so 3378 respondents, 2933 adults and 445 children, had sufficient data to be included. Average person weights were 3.3 times higher for the mobile-only respondents, 1.3 times higher for the landline-only respondents and 1.7 times higher for dual-phone users in the mobile frame

Cost Effectiveness Analysis of Optimal Malaria Control Strategies in Kenya

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Gabriel Otieno

2016-03-01

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

Impact of Guided Reflection with Peers on the Development of Effective Problem Solving Strategies and Physics Learning

Science.gov (United States)

Mason, Andrew J.; Singh, Chandralekha

2016-05-01

Students must learn effective problem solving strategies in order to develop expertise in physics. Effective problem solving strategies include a conceptual analysis of the problem followed by planning of the solution, and then implementation, evaluation, and reflection upon the process. Research suggests that converting a problem from the initial verbal representation to other suitable representation, e.g., diagrammatic representation, during the initial conceptual analysis can facilitate further analysis of the problem. But without guidance, many introductory physics students solve problems using superficial clues and cues and do not perceive problem solving as an opportunity for learning. Here, we describe a study that suggests that engaging students in reflection with peers about effective problem solving strategies while effective approaches are modeled for them and prompt feedback is provided may enhance desirable skills.

Effectiveness of alternative management strategies in meeting conservation objectives

Science.gov (United States)

Richards S. Holthausen; Carolyn Hull Sieg

2007-01-01

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

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

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John Spillane

2013-12-01

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

Towards evenly distributed grazing patterns: including social context in sheep management strategies

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Agustina di Virgilio

2016-06-01

Full Text Available Background. A large proportion of natural grasslands around the world is exposed to overgrazing resulting in land degradation and biodiversity loss. Although there is an increasing effort in the promotion of sustainable livestock management, rangeland degradation still occurs because animals’ foraging behaviour is highly selective at different spatial scales. The assessment of the ecological mechanisms modulating the spatial distribution of grazing and how to control it has critical implications for long term conservation of resources and the sustainability of livestock production. Considering the relevance of social interactions on animals’ space use patterns, our aim was to explore the potential effects of including animals’ social context into management strategies using domestic sheep grazing in rangelands as case study. Methods. We used GPS data from 19 Merino sheep (approximately 10% of the flock grazing on three different paddocks (with sizes from 80 to 1000 Ha during a year, to estimate resource selection functions of sheep grazing in flocks of different levels of heterogeneity. We assessed the effects of sheep class (i.e., ewes, wethers, and hoggets, age, body condition and time since release on habitat selection patterns. Results. We found that social rank was reflected on sheep habitat use, where dominant individuals (i.e., reproductive females used more intensively the most preferred areas and low-ranked (i.e., yearlings used less preferred areas. Our results showed that when sheep grazed on more heterogeneous flocks, grazing patterns were more evenly distributed at all the paddocks considered in this study. On the other hand, when high-ranked individuals were removed from the flock, low-ranked sheep shifted their selection patterns by increasing the use of the most preferred areas and strongly avoided to use less preferred sites (i.e., a highly selective grazing behaviour. Discussion. Although homogenization and segregation of

Towards evenly distributed grazing patterns: including social context in sheep management strategies.

Science.gov (United States)

di Virgilio, Agustina; Morales, Juan Manuel

2016-01-01

Background. A large proportion of natural grasslands around the world is exposed to overgrazing resulting in land degradation and biodiversity loss. Although there is an increasing effort in the promotion of sustainable livestock management, rangeland degradation still occurs because animals' foraging behaviour is highly selective at different spatial scales. The assessment of the ecological mechanisms modulating the spatial distribution of grazing and how to control it has critical implications for long term conservation of resources and the sustainability of livestock production. Considering the relevance of social interactions on animals' space use patterns, our aim was to explore the potential effects of including animals' social context into management strategies using domestic sheep grazing in rangelands as case study. Methods. We used GPS data from 19 Merino sheep (approximately 10% of the flock) grazing on three different paddocks (with sizes from 80 to 1000 Ha) during a year, to estimate resource selection functions of sheep grazing in flocks of different levels of heterogeneity. We assessed the effects of sheep class (i.e., ewes, wethers, and hoggets), age, body condition and time since release on habitat selection patterns. Results. We found that social rank was reflected on sheep habitat use, where dominant individuals (i.e., reproductive females) used more intensively the most preferred areas and low-ranked (i.e., yearlings) used less preferred areas. Our results showed that when sheep grazed on more heterogeneous flocks, grazing patterns were more evenly distributed at all the paddocks considered in this study. On the other hand, when high-ranked individuals were removed from the flock, low-ranked sheep shifted their selection patterns by increasing the use of the most preferred areas and strongly avoided to use less preferred sites (i.e., a highly selective grazing behaviour). Discussion. Although homogenization and segregation of flocks by classes

Effects of strategy on visual working memory capacity.

Science.gov (United States)

Bengson, Jesse J; Luck, Steven J

2016-02-01

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

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

Directory of Open Access Journals (Sweden)

Gerald A. Matua

2014-10-01

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

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

Science.gov (United States)

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

2014-11-01

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

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

Science.gov (United States)

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

2016-01-01

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

Quasi-Experiment Study on Effectiveness Evaluation of Health Communication Strategies

Science.gov (United States)

2016-01-01

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

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

Science.gov (United States)

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

2016-07-01

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

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

OpenAIRE

Hashem Valipour; Hamid Birjandi; Samira Honarbakhsh

2012-01-01

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

Comparative effectiveness of correction strategies in connected discourse tracking.

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Lunato, K E; Weisenberger, J M

1994-10-01

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

A systematic review of implementation strategies for assessment, prevention, and management of ICU delirium and their effect on clinical outcomes.

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Trogrlić, Zoran; van der Jagt, Mathieu; Bakker, Jan; Balas, Michele C; Ely, E Wesley; van der Voort, Peter H J; Ista, Erwin

2015-04-09

Despite recommendations from professional societies and patient safety organizations, the majority of ICU patients worldwide are not routinely monitored for delirium, thus preventing timely prevention and management. The purpose of this systematic review is to summarize what types of implementation strategies have been tested to improve ICU clinicians' ability to effectively assess, prevent and treat delirium and to evaluate the effect of these strategies on clinical outcomes. We searched PubMed, Embase, PsychINFO, Cochrane and CINAHL (January 2000 and April 2014) for studies on implementation strategies that included delirium-oriented interventions in adult ICU patients. Studies were suitable for inclusion if implementation strategies' efficacy, in terms of a clinical outcome, or process outcome was described. We included 21 studies, all including process measures, while 9 reported both process measures and clinical outcomes. Some individual strategies such as "audit and feedback" and "tailored interventions" may be important to establish clinical outcome improvements, but otherwise robust data on effectiveness of specific implementation strategies were scarce. Successful implementation interventions were frequently reported to change process measures, such as improvements in adherence to delirium screening with up to 92%, but relating process measures to outcome changes was generally not possible. In meta-analyses, reduced mortality and ICU length of stay reduction were statistically more likely with implementation programs that employed more (six or more) rather than less implementation strategies and when a framework was used that either integrated current evidence on pain, agitation and delirium management (PAD) or when a strategy of early awakening, breathing, delirium screening and early exercise (ABCDE bundle) was employed. Using implementation strategies aimed at organizational change, next to behavioral change, was also associated with reduced mortality

Effects of Two Listening Strategies for Melodic Dictation

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Buonviri, Nathan O.

2017-01-01

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

Cost-effectiveness analysis of left atrial appendage occlusion compared with pharmacological strategies for stroke prevention in atrial fibrillation.

Science.gov (United States)

Lee, Vivian Wing-Yan; Tsai, Ronald Bing-Ching; Chow, Ines Hang-Iao; Yan, Bryan Ping-Yen; Kaya, Mehmet Gungor; Park, Jai-Wun; Lam, Yat-Yin

2016-08-31

Transcatheter left atrial appendage occlusion (LAAO) is a promising therapy for stroke prophylaxis in non-valvular atrial fibrillation (NVAF) but its cost-effectiveness remains understudied. This study evaluated the cost-effectiveness of LAAO for stroke prophylaxis in NVAF. A Markov decision analytic model was used to compare the cost-effectiveness of LAAO with 7 pharmacological strategies: aspirin alone, clopidogrel plus aspirin, warfarin, dabigatran 110 mg, dabigatran 150 mg, apixaban, and rivaroxaban. Outcome measures included quality-adjusted life years (QALYs), lifetime costs and incremental cost-effectiveness ratios (ICERs). Base-case data were derived from ACTIVE, RE-LY, ARISTOTLE, ROCKET-AF, PROTECT-AF and PREVAIL trials. One-way sensitivity analysis varied by CHADS2 score, HAS-BLED score, time horizons, and LAAO costs; and probabilistic sensitivity analysis using 10,000 Monte Carlo simulations was conducted to assess parameter uncertainty. LAAO was considered cost-effective compared with aspirin, clopidogrel plus aspirin, and warfarin, with ICER of US$5,115, $2,447, and $6,298 per QALY gained, respectively. LAAO was dominant (i.e. less costly but more effective) compared to other strategies. Sensitivity analysis demonstrated favorable ICERs of LAAO against other strategies in varied CHADS2 score, HAS-BLED score, time horizons (5 to 15 years) and LAAO costs. LAAO was cost-effective in 86.24 % of 10,000 simulations using a threshold of US$50,000/QALY. Transcatheter LAAO is cost-effective for prevention of stroke in NVAF compared with 7 pharmacological strategies. The transcatheter left atrial appendage occlusion (LAAO) is considered cost-effective against the standard 7 oral pharmacological strategies including acetylsalicylic acid (ASA) alone, clopidogrel plus ASA, warfarin, dabigatran 110 mg, dabigatran 150 mg, apixaban, and rivaroxaban for stroke prophylaxis in non-valvular atrial fibrillation management.

A Study on the Operation Strategy for Combined Accident including TLOFW accident

International Nuclear Information System (INIS)

Kim, Bo Gyung; Kang, Gook Young; Yoon, Ho Joon

2014-01-01

It is difficult for operators to recognize the necessity of a feed-and-bleed (F-B) operation when the loss of coolant accident and failure of secondary side occur. An F-B operation directly cools down the reactor coolant system (RCS) using the primary cooling system when residual heat removal by the secondary cooling system is not available. The plant is not always necessary the F-B operation when the secondary side is failed. It is not necessary to initiate an F-B operation in the case of a medium or large break because these cases correspond to low RCS pressure sequences when the secondary side is failed. If the break size is too small to sufficiently decrease the RCS pressure, the F-B operation is necessary. Therefore, in the case of a combined accident including a secondary cooling system failure, the provision of clear information will play a critical role in the operators' decision to initiate an F-B operation. This study focuses on the how we establish the operation strategy for combined accident including the failure of secondary side in consideration of plant and operating conditions. Previous studies have usually focused on accidents involving a TLOFW accident. The plant conditions to make the operators confused seriously are usually the combined accident because the ORP only focuses on a single accident and FRP is less familiar with operators. The relationship between CET and PCT under various plant conditions is important to decide the limitation of initiating the F-B operation to prevent core damage

Facebook as an effective recruitment strategy for mental health research of hard to reach populations

Directory of Open Access Journals (Sweden)

Rony Kayrouz

2016-05-01

Full Text Available Recent reports indicate that Facebook (FB may facilitate recruitment of hard to reach participants into mental health research. The present study aimed to contribute to this emerging literature by exploring recruitment data from a recently completed trial of online treatment for symptoms of anxiety and depression that targeted Arab people. The present study compared traditional recruitment strategies such as media releases, emails, and print advertisements with Facebook strategies including boosting posts, promoting websites, events and FB public fan pages. The main outcomes of interest were the number of started applications and the time and cost per application associated with the FB and traditional recruitment strategies. A target sample of 350 was sought and a total of 81 participants applied to participate over the 42-week recruitment period. Overall, 86% of the resultant applications occurred via FB recruitment and a Poisson regression analysis indicated the FB strategies were more time-effective, recruiting participants 2.5 times faster than the traditional strategies. However, there were no differences in cost-effectiveness for FB ($US37 per participant and traditional strategies ($US40 per participant. The findings of the current study add to existing literature detailing the value of FB recruitment strategies, alongside more traditional strategies, as a way of recruiting hard-to-reach populations for research. However, more research is needed to explore alternative and optimal strategies for the successful recruitment of hard to reach populations via FB and other online social media platforms.

Effectiveness of Quality Improvement Strategies for the Management of CKD: A Meta-Analysis.

Science.gov (United States)

Silver, Samuel A; Bell, Chaim M; Chertow, Glenn M; Shah, Prakesh S; Shojania, Kaveh; Wald, Ron; Harel, Ziv

2017-10-06

Quality improvement interventions have enhanced care for other chronic illnesses, but their effectiveness for patients with CKD is unknown. We sought to determine the effects of quality improvement strategies on clinical outcomes in adult patients with nondialysis-requiring CKD. We conducted a systematic review of randomized trials, searching Medline and the Cochrane Effective Practice and Organization of Care database from January of 2003 to April of 2015. Eligible studies evaluated one or more of 11 prespecified quality improvement strategies, and prespecified study outcomes included at least one process of care measure, surrogate outcome, or hard clinical outcome. We used a random effects model to estimate the pooled risk ratio (RR; dichotomous data) or the mean difference (continuous data). We reviewed 15 patient-level randomized trials ( n =3298 patients), and six cluster-randomized trials ( n =30,042 patients). Quality improvement strategies reduced dialysis incidence (seven trials; RR, 0.85; 95% confidence interval [95% CI], 0.74 to 0.97) and LDL cholesterol concentrations (four trials; mean difference, -17.6 mg/dl; 95% CI, -28.7 to -6.5), and increased the likelihood that patients received renin-angiotensin-aldosterone system inhibitors (nine trials; RR, 1.16; 95% CI, 1.06 to 1.27). We did not observe statistically significant effects on mortality, cardiovascular events, eGFR, glycated hemoglobin, and systolic or diastolic BP. Quality improvement interventions yielded significant beneficial effects on three elements of CKD care. Estimates of the effectiveness of quality improvement strategies were limited by study number and adherence to quality improvement principles. This article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2017_09_06_CJASNPodcast_17_10.mp3. Copyright © 2017 by the American Society of Nephrology.

Five types of organizational strategy

DEFF Research Database (Denmark)

Steensen, Elmer Fly

2014-01-01

Models in the strategy field defining the strategy concept emphasize schools of thought or strategy perspectives, but not how to define the idiosyncratic composition of an organization’s strategy content. Based on a literature review in which meanings have been attached to the concept, this paper...... presents a new model including five types of organizational strategy. The model emphasizes that key influencers may make heterogeneous contributions to an organization’s strategy and also that significant effects may result from interaction between types of strategy....

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

International Nuclear Information System (INIS)

Haverkate, B.R.W.

2002-01-01

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

The Effect of Teaching Search Strategies on Perceptual Performance.

Science.gov (United States)

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

2017-06-01

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

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

DEFF Research Database (Denmark)

Fuchs, Christoph; Diamantopoulos, Adamantios

2010-01-01

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

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

Science.gov (United States)

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

2010-01-01

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

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

Directory of Open Access Journals (Sweden)

Sue J Goldie

2010-04-01

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

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

Science.gov (United States)

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

2010-04-20

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

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

Directory of Open Access Journals (Sweden)

Jan Vogelij

2015-08-01

Full Text Available Subject of this study For establishing main lines of their future development, governments on several levels of government prepare spatial development visions, for assessing individual plans and initiatives against the background of a desired direction of development. Such strategic visions help to avoid the necessity to start considering again and again the question which direction long-term development should take. The European Commission promotes making such development strategies, hoping this leads to innovation in the regions and increased competitiveness of Europe. More particularly, the Commission expects a substantial contribution to prosperity of the rich diversity of local characteristics as assets for the development and innovation of the European territory. This study aims to explore the factors for success of strategic spatial planning. Strategy making happens in the different circumstances in European countries, legally regulated or informally, using terms like: Structure plans, structural visions, master plans, development visions and spatial development strategies. Here the term (spatial development vision is used. The central question is: Which aspects of planning processes and place-related conditions support the effectiveness of strategy making? The processes of strategy making and the place related circumstances are intensively interrelated. The diversity of circumstances in the European countries is expressed in the different national and regional planning cultures. That includes the set of procedures, competencies, education of planners and other experts and their resulting attitudes towards strategy making. In a development strategy all interests of society come together. Therefore the constructive working together of representatives of different sectors and interest is key to the success. Because of this crucial issue, we distinguished between co-operation, as just contributing to someone else’s activity, co

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

Science.gov (United States)

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

2017-10-01

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

Maintenance as a corporate strategy.

Science.gov (United States)

Clarke, D

2000-11-01

As we move towards the 21st century, those Manufacturing Industries that survive, will have changed their "efficiency" focus away from the conventional wisdom of "efficient individual tasks", to focus on the "effectiveness of a total manufacturing process". This seemingly insignificant change of emphasis, (from task to process) must include "the integration of process plant maintenance into the production process". Manufacturing companies, which do not include an effective plant maintenance strategy into their business strategy, will not survive the business environment of the 21st Century.

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

Directory of Open Access Journals (Sweden)

Anita Habók

2018-01-01

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

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

Science.gov (United States)

Habók, Anita; Magyar, Andrea

2017-01-01

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

Effects of EFL Individual Learner Variables on Foreign Language Reading Anxiety and Metacognitive Reading Strategy Use.

Science.gov (United States)

Lien, Hsin-Yi

2016-08-01

Past research has shown an association between foreign language reading anxiety and reading strategy. However, individual variables tend to affect foreign language anxiety and strategy use. The present study examined a hypothesized model that specified direct and indirect effects among English and foreign languages readers' distinct variables, including academic level; self-perceived English level; and satisfaction with reading proficiency, reading anxiety, and metacognitive awareness of reading strategies. A total of 523 volunteer Taiwanese college students provided 372 valid responses to a written questionnaire (281 women and 91 men; M age = 19.7 years, SD = 1.1) containing the translated versions of Foreign Language Reading Anxiety Scale, Survey of Reading Strategies Inventory, and self-assessment background questionnaire. The results showed that self-evaluation of reading proficiency did not correlate with academic level and readers' perceptions. Satisfaction had a direct effect on foreign language reading anxiety but not on metacognitive awareness of reading strategies. Results of path analysis demonstrated that the perception learners who had their own reading proficiency predicted their foreign language reading anxiety and was a mediating variable for metacognitive reading strategy use. © The Author(s) 2016.

Suppressor Effects of Coping Strategies on Resilience

Science.gov (United States)

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

2014-01-01

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

The effectiveness of technology-based strategies to promote engagement with digital interventions: a systematic review protocol.

Science.gov (United States)

Alkhaldi, Ghadah; Hamilton, Fiona L; Lau, Rosa; Webster, Rosie; Michie, Susan; Murray, Elizabeth

2015-04-28

Digital interventions provide effective and potentially cost-effective models for improving health outcomes as they deliver health information and services that are widely disseminated, confidential, and can be tailored to needs of the individual user. Digital interventions have been used successfully for health promotion, mental health, and for enabling self-management of long-term conditions. However, their effectiveness is limited by low usage rates, with non-engagement a major challenge. Hence, it is crucial to find effective strategies to increase user engagement with digital interventions. This systematic review will aim to evaluate the effectiveness of technology-based strategies to promote engagement with digital interventions. We will follow Cochrane Collaboration guidelines on systematic review methodology. The search strategy will be executed across seven e-databases (including MEDLINE, EMBASE, PsycINFO, CINAHL) using the concepts "digital intervention" and "engagement", limited by study type (randomized controlled trial). Grey literature and reference lists of included studies will be searched. Titles and abstracts will be independently screened by 2 authors. Then the full text of potentially eligible papers will be obtained and double screened. Data from eligible papers will be extracted by 1 author and checked for accuracy by another author. Bias will be assessed using the Cochrane bias assessment tool. Narrative synthesis will report on all included studies, and where appropriate, data will be pooled using meta-analysis. All findings will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Sources of heterogeneity will be further investigated if required. Our research is in progress. The final draft of the systematic review is being written and will be submitted before the end of 2015. The review findings will inform researchers and digital intervention providers about optimal use of technology

The Effect of Reading Involvement through Open-Ended Strategy vs. Fill-in- the- Blanks Strategy on Young EFL Learners’ Reading Comprehension Ability

Directory of Open Access Journals (Sweden)

Rita Salehi Sepehr

2014-11-01

Full Text Available The present study investigated the extent to which an instructional framework of integrating strategy instruction (open-ended strategy and fill-in-the blanks strategy with motivation- support affected on reading result for young EFL learners. The central area of exploration included a comparison among three approaches to reading instruction: First, fill-in-the blanks strategy intervention; second, open-ended strategy intervention; and last, a control group which received the conventional reading strategies. The participants were sampled from amongst a group of seventy-seven pre-intermediate EFL learners in a language school in Tehran- Iran based on convenient sampling technique. For the sake of measurement, the researchers administered PET and CELT along with reading strategy based-test to quantify the participants’ current level of knowledge as well as the degree of achievement after treatment. For measurement’s sake, different types of tests such as PET, reading comprehension test (CELT, and reading strategy based- test were employed to quantify the participants’ current level of knowledge as well as the degree of achievement before and after instruction. The result of the present study indicated that the experimental groups had a significant improvement over the control group. Also, the level of learners’ reading engagement during classroom work mediated the instructional effects on reading outcomes. The results of this study can be to the benefit of both EFL and ESL teachers to teach reading comprehension using the student's critical mind as well as critical involvement in the reading tasks.

Effect of perestroika on disarmament strategy

International Nuclear Information System (INIS)

Kalyadine, A.N.

1990-01-01

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

Why is the NORM Waste Included in to the Croatian RadWaste Strategy

International Nuclear Information System (INIS)

Prlic, I.; Suric Mihic, M.; Hajdinjak, M.

2016-01-01

Croatian RADWASTE Strategy uses modern approach according to EC Directive 2013/59/EURATOM and Croatian Act on Radiological and Nuclear Safety (Official Gazette 141/13, 39/15) linking the entire field of, till modern times non regulated industrial NORM wastes to properly regulated RADWastes. This approach has brought some obscurities to a professional radiation protection community because the fact that NORM will be treated together with the 'heavy' concept of nuclear and radioactive waste was not acceptable due to a historical division of those two fields of radioactivity. As NORM is still regarded as a slightly technologically blended radioactivity which is of no concern to be a risk for the population and RADWASTE is a 'murder' of any population in its vicinity, the need for terminology harmonization and scientifically correct public education was recognized. It is barely known that during the recent past some Croatian professionals did included the NORM sites into the state documents and reports to international regulatory bodies as pure RADWASTE sites. This fact produces immense regulatory difficulties even today. The one and only legal way to solve both, regulatory issues providing real radiation protection procedures during existing NORM waste site sanation and exempting sites to be reused for a legal public purpose (industrial or any other) was to incorporate the existing Croatian NORM sites into the RADWASTE Strategy and to solve all legal radioactivity burden issues during the governmental acceptance process. This approach is a new one in Croatian regulatory acquits and first responses from the stake holders and public involved are promising. The experience from the field and first responses to a concept of harmonizing the reuse approach of existing NORM waste sites from stake holders and partly from general public will be discussed.(author).

[The Effectiveness of a Strategy for the Flexible Management of Nursing Human Resources: A Pilot Study].

Science.gov (United States)

Huang, Chung-I; Lu, Meei-Shiow

2017-12-01

The flexibility of a hospital's nursing-related human resource management policies affects the working willingness and retention of nurses. To explore the effectiveness of a flexible nursing-related human resource management strategy. This quasi-experimental research used a one group pretest-posttest design. Supervisors at participating hospitals attended the "Application of Flexible Nursing Human Resources Management Strategies" workshop, which introduced the related measures and assessed nurses' pretest satisfaction. After these measures were implemented at the participating hospitals, implementation-related problems were investigated and appropriate consultation was provided. The posttest was implemented after the end of the project. Data were collected from nurses at the participating hospitals who had served in their present hospital for more than three months. The participating hospitals were all nationally certified healthcare providers, including 13 medical centers, 17 regional hospitals, and 3 district hospitals. A total of nurses 2,810 nurses took the pretest and 2,437 took the posttest. The research instruments included the "Satisfaction with working conditions and system flexibility" scale and the "Flexible nursing human resource management strategies". The effectiveness of the implemented strategy was assessed using independent samples t-test and variance analysis. The result of implementing the flexible strategies shows that the total mean of pretest satisfaction (Likert 5 scores) was 3.47 (SD = 0.65), and the posttest satisfaction was 3.52 (SD = 0.65), with significant statistical differences in task, numerical, divisional, and leading flexibility. Due to the good implementation effectiveness, the authors strongly suggest that all of the participating hospitals continue to apply this strategic model to move toward a more flexible nursing system and work.

Effectiveness of Pressure Ulcer Prevention Strategies for Adult Patients in Intensive Care Units: A Systematic Review.

Science.gov (United States)

Tayyib, Nahla; Coyer, Fiona

2016-12-01

Pressure ulcers are associated with substantial health burden, but could be preventable. Hospital-acquired pressure ulcers (HAPUs) prevention has become a priority for all healthcare settings, as it is considered a sign of quality of care providing. Intensive care unit (ICU) patients are at higher risk for HAPUs development. Despite the availability of published prevention strategies, there is a little evidence about which strategies can be safely integrated into routine standard care and have an impact on HAPUs prevention. The aim was to synthesize the best available evidence regarding the effectiveness of single strategies designed to reduce the incidence and prevalence of HAPUs development in ICUs. The search strategy was designed to retrieve studies published in English across CINAHL, Medline, Cochrane Central Register of Controlled Trials, Embase, Scopus, and Mednar between 2000 and 2015. All adult ICU participants were aged 18 years or over. This review included randomized controlled trials, quasi-experimental and comparative studies. The studies that were selected for retrieval were assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardized critical-appraisal instruments. The review included 25 studies, and the meta-analysis revealed a statistically significant effect of a silicon foam dressing strategy in reducing HAPUs incidence (effect size = 4.62; 95% CI: 0.05-0.29; p prevention of HAPUs development in the ICU was limited, which precludes strong conclusions. The review provides an evidence-based guide to future priorities for clinical practice. In particular, a silicone foam dressing has positive impact in reducing sacrum and heel HAPUs incidence in the ICU. © 2016 Sigma Theta Tau International.

Effects of Downsizing Strategies on Survivors' Organizational ...

African Journals Online (AJOL)

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

The Effects of Cognitive Strategy Instruction on Knowledge of Math Problem-Solving Processes of Middle School Students with Learning Disabilities

Science.gov (United States)

Krawec, Jennifer; Huang, Jia; Montague, Marjorie; Kressler, Benikia; de Alba, Amanda Melia

2013-01-01

This study investigated the effectiveness of "Solve It!" instruction on students' knowledge of math problem-solving strategies. "Solve It!" is a cognitive strategy intervention designed to improve the math problem solving of middle school students with learning disabilities (LD). Participants included seventh- and eighth-grade…

Testing the implementation and sustainment facilitation (ISF strategy as an effective adjunct to the Addiction Technology Transfer Center (ATTC strategy: study protocol for a cluster randomized trial

Directory of Open Access Journals (Sweden)

Bryan R. Garner

2017-11-01

Full Text Available Abstract Background Improving the extent to which evidence-based practices (EBPs—treatments that have been empirically shown to be efficacious or effective—are integrated within routine practice is a well-documented challenge across numerous areas of health. In 2014, the National Institute on Drug Abuse funded a type 2 effectiveness–implementation hybrid trial titled the substance abuse treatment to HIV Care (SAT2HIV Project. Aim 1 of the SAT2HIV Project tests the effectiveness of a motivational interviewing-based brief intervention (MIBI for substance use as an adjunct to usual care within AIDS service organizations (ASOs as part of its MIBI Experiment. Aim 2 of the SAT2HIV Project tests the effectiveness of implementation and sustainment facilitation (ISF as an adjunct to the Addiction Technology Transfer Center (ATTC model for training staff in motivational interviewing as part of its ISF Experiment. The current paper describes the study protocol for the ISF Experiment. Methods Using a cluster randomized design, case management and leadership staff from 39 ASOs across the United States were randomized to receive either the ATTC strategy (control condition or the ATTC + ISF strategy (experimental condition. The ATTC strategy is staff-focused and includes 10 discrete strategies (e.g., provide centralized technical assistance, conduct educational meetings, provide ongoing consultation. The ISF strategy is organization-focused and includes seven discrete strategies (e.g., use an implementation advisor, organize implementation team meetings, conduct cyclical small tests of change. Building upon the exploration–preparation–implementation–sustainment (EPIS framework, the effectiveness of the ISF strategy is examined via three staff-level measures: (1 time-to-proficiency (i.e., preparation phase outcome, (2 implementation effectiveness (i.e., implementation phase outcome, and (3 level of sustainment (i.e., sustainment phase outcome

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

African Journals Online (AJOL)

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

Preservice Teachers' Knowledge and Perceptions of Effective Behavior Management Strategies

Science.gov (United States)

Nields, Allison N.

2014-01-01

This study examined student teachers' perceptions and knowledge of behavior management strategies. A questionnaire that included questions about broad behavior management techniques, behavioral learning theory, and behavior management strategies related to behavioral learning theory was given to sixty-one student teacher candidates at a large…

Adolescents’ Perceptions Regarding Effective Tobacco Use Prevention Strategies for their Younger Counterparts: A Qualitative Study in Malaysia

Science.gov (United States)

Mohd Zin, Faridah; Hillaluddin, Azlin Hilma; Mustaffa, Jamaludin

2016-12-01

Purpose:The present qualitative study explored adolescents’ perceptions regarding effective strategies to prevent adolescents from using tobacco products (TP). Apart from the commercial TPs, there has been emerging use of alternatives such as vapes, e-cigarettes and shisha. This unfortunate phenomenon continues despite the currently available preventive strategies. Thus, understanding of the perceptions of the current generation would be valuable to provide new insights. Methods: Purposive sampling was utilized to recruit 40 adolescents between the age of 15 and 16 years old attending public daily secondary schools. Eight focus group discussions were conducted among the TP users, ex-users and non-users. Data were analyzed using a thematic content analysis procedure with NVivo. Results: Among barriers with the currently available strategies were having teachers who smoke tobacco, addiction to nicotine and self-perceptions of being healthy. The content of any program should include knowledge on negative outcomes of using tobacco products and awareness of the legislation together with ways to overcome peer and family influence including improving self-efficacy and refusal skills. Strategies were suggested to be delivered using information technology which provides interactive learning and visual effects. Conclusions: Adolescents agreed that the content and delivery of tobacco use prevention strategies need to be revised to suit the current generation to ensure sustainability. Creative Commons Attribution License

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

Science.gov (United States)

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

2014-07-01

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

Enthesopathy of the Extensor Carpi Radialis Brevis Origin: Effective Communication Strategies.

Science.gov (United States)

Drake, Matthew L; Ring, David C

2016-06-01

Enthesopathy of the extensor carpi radialis brevis origin, generally known as tennis elbow, is a common condition arising in middle-aged persons. The diagnosis is typically clear based on the patient interview and physical examination alone; therefore, imaging and other diagnostic tests are usually unnecessary. The natural history of the disorder is spontaneous resolution, but it can last for >1 year. The patient's attitude and circumstances, including stress, distress, and ineffective coping strategies, determine the intensity of the pain and the magnitude of the disability. Despite the best efforts of medical science, no treatments, invasive or noninvasive, have been proven to alter the natural history of the condition. Given the lack of disease-modifying treatments for enthesopathy of the extensor carpi radialis brevis origin, orthopaedic surgeons can benefit from learning effective communication strategies to help convey accurate information that is hopeful and enabling.

The Effect of Note Taking vs. Summarizing Strategy on Iranian EFL Learners’ Listening Comprehension

OpenAIRE

Mehri Khavazi; Mandana Yousefi; Naeemeh Kharaghani

2018-01-01

This study, specifically, investigated the effect of note taking and summarizing strategies on Iranian EFL learners’ listening comprehension. The study aimed at investigating the effects of note taking and summarizing on listening comprehension of Iranian EFL learners. The participants of the study included 75 female language learners in Bojnord who were homogenized in terms of language proficiency. They were divided into two experimental and onecontrol groups. ANCOVA test was used to analyze...

Effect of postharvest practices including degreening on citrus carpoplane microbial biomes.

Science.gov (United States)

Gomba, A; Chidamba, L; Korsten, L

2017-04-01

To investigate the effect of commercial citrus packhouse processing steps on the fruit surface microbiome of Clementines and Palmer navel oranges. Viable bacteria, yeast and fungi counts, and the pyrosequencing analysis of the 16S rRNA and ITS were used to evaluate the community structure and population dynamics of phylloepiphytic bacteria and fungi associated with commercial postharvest processing. Drenching significantly reduced microbial counts in all cases except for yeasts on navels, while the extent of degreening effects varied between the citrus varieties. Pyrosequencing analysis showed a total of 4409 bacteria and 5792 fungi nonchimeric unique sequences with an average of 1102 bacteria and 1448 fungi reads per sample. Dominant phyla on the citrus carpoplane were Proteobacteria (53·5%), Actinobacteria (19·9%), Bacteroidetes (5·6%) and Deinococcus-Thermus (5·4%) for bacteria and Ascomycota (80·5%) and Basidiomycota (9·8%) for fungi. Beginning with freshly harvested fruit fungal diversity declined significantly after drenching, but had little effect on bacteria and populations recovered during degreening treatments, including those for Penicillium sp. Packhouse processing greatly influences microbial communities on the citrus carpoplane. A broad orange biome was described with pyrosequencing and gave insight into the likely survival and persistence of pathogens, especially as they may affect the quality and safety of the packed product. A close examination of the microbiota of fruit and the impact of intervention strategies on the ecological balance may provide a more durable approach to reduce losses and spoilage. © 2017 The Society for Applied Microbiology.

MOS modeling hierarchy including radiation effects

International Nuclear Information System (INIS)

Alexander, D.R.; Turfler, R.M.

1975-01-01

A hierarchy of modeling procedures has been developed for MOS transistors, circuit blocks, and integrated circuits which include the effects of total dose radiation and photocurrent response. The models were developed for use with the SCEPTRE circuit analysis program, but the techniques are suitable for other modern computer aided analysis programs. The modeling hierarchy permits the designer or analyst to select the level of modeling complexity consistent with circuit size, parametric information, and accuracy requirements. Improvements have been made in the implementation of important second order effects in the transistor MOS model, in the definition of MOS building block models, and in the development of composite terminal models for MOS integrated circuits

Microfluidic System Simulation Including the Electro-Viscous Effect

Science.gov (United States)

Rojas, Eileen; Chen, C. P.; Majumdar, Alok

2007-01-01

This paper describes a practical approach using a general purpose lumped-parameter computer program, GFSSP (Generalized Fluid System Simulation Program) for calculating flow distribution in a network of micro-channels including electro-viscous effects due to the existence of electrical double layer (EDL). In this study, an empirical formulation for calculating an effective viscosity of ionic solutions based on dimensional analysis is described to account for surface charge and bulk fluid conductivity, which give rise to electro-viscous effect in microfluidics network. Two dimensional slit micro flow data was used to determine the model coefficients. Geometry effect is then included through a Poiseuille number correlation in GFSSP. The bi-power model was used to calculate flow distribution of isotropically etched straight channel and T-junction microflows involving ionic solutions. Performance of the proposed model is assessed against experimental test data.

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

African Journals Online (AJOL)

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

Web-based information search and retrieval: effects of strategy use and age on search success.

Science.gov (United States)

Stronge, Aideen J; Rogers, Wendy A; Fisk, Arthur D

2006-01-01

The purpose of this study was to investigate the relationship between strategy use and search success on the World Wide Web (i.e., the Web) for experienced Web users. An additional goal was to extend understanding of how the age of the searcher may influence strategy use. Current investigations of information search and retrieval on the Web have provided an incomplete picture of Web strategy use because participants have not been given the opportunity to demonstrate their knowledge of Web strategies while also searching for information on the Web. Using both behavioral and knowledge-engineering methods, we investigated searching behavior and system knowledge for 16 younger adults (M = 20.88 years of age) and 16 older adults (M = 67.88 years). Older adults were less successful than younger adults in finding correct answers to the search tasks. Knowledge engineering revealed that the age-related effect resulted from ineffective search strategies and amount of Web experience rather than age per se. Our analysis led to the development of a decision-action diagram representing search behavior for both age groups. Older adults had more difficulty than younger adults when searching for information on the Web. However, this difficulty was related to the selection of inefficient search strategies, which may have been attributable to a lack of knowledge about available Web search strategies. Actual or potential applications of this research include training Web users to search more effectively and suggestions to improve the design of search engines.

THE EFFECT OF IRANIAN FEMALE EFL LEARNERS’ POLITENESS STRATEGIES AWARENESS ON THEIR LETTER WRITING ABILITY

Directory of Open Access Journals (Sweden)

Faezeh Yousefian Dastmalchi

2014-12-01

Full Text Available This research examines the effect of teaching politeness strategies based on the models proposed by Brown and Levinson (1987 and Leech (1983 to intermediate English learners on their ability in writing more polite letters. The instrumentation includes an IELTS test, used as a placement test, an inventory, used to measure learners’ awareness of politeness strategies, and a letter-writing test, used as a measurement of learners’ ability in using politeness strategies. Among all the participants, twenty of them were put in the control group, and twenty-four of them in the experimental group, who went under the treatment. They were taught how to write politely based on the politeness strategy models proposed by Brown and Levinson (1987 and Leech (1983. After the treatment, learners wrote letters to the same people with the same situations. Comparing the twenty learners in the control group with the twenty-four learners in experimental group, the researchers concluded that the treatment had a significant effect on the learners’ ability in writing more polite letters. They selected to use more formal strategies with those who they saw further distance with, and more informal strategies with more intimate people. Furthermore, the answers the learners provided to the questions of the inventory offered more awareness of politeness strategies. This implies that they were more aware of various choices of polite language that were available for them to use in the given situations.

Possible Effects of Strategy Instruction on L1 and L2 Reading.

Science.gov (United States)

Salataci, Reyhan; Akyel, Ayse

2002-01-01

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

Parents' Adoption of Social Communication Intervention Strategies: Families Including Children with Autism Spectrum Disorder Who are Minimally Verbal.

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Shire, Stephanie Y; Goods, Kelly; Shih, Wendy; Distefano, Charlotte; Kaiser, Ann; Wright, Courtney; Mathy, Pamela; Landa, Rebecca; Kasari, Connie

2015-06-01

Notably absent from the intervention literature are parent training programs targeting school-aged children with autism who have limited communication skills (Tager-Flusberg and Kasari in Autism Res 6:468-478, 2013). Sixty-one children with autism age 5-8 with minimal spontaneous communication received a 6-month social communication intervention including parent training. Parent-child play interactions were coded for parents' strategy implementation and children's time jointly engaged (Adamson et al. in J Autism Dev Disord 39:84-96, 2009). Parents mastered an average of 70% of the strategies. Further analyses indicated some gains in implementation occurred from mere observation of sessions, while the greatest gains occurred in the first month of active coaching and workshops. Children's joint engagement was associated with parents' implementation success across time demonstrating parents' implementation was relevant to children's social engagement.

The effectiveness of a learning strategies program for university students.

Science.gov (United States)

Roces Montero, Cristina; Sierra Y Arizmendiarrieta, Beatriz

2017-11-01

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

Long-term Cost-Effectiveness of Diagnostic Tests for Assessing Stable Chest Pain: Modeled Analysis of Anatomical and Functional Strategies.

Science.gov (United States)

Bertoldi, Eduardo G; Stella, Steffan F; Rohde, Luis E; Polanczyk, Carisi A

2016-05-01

Several tests exist for diagnosing coronary artery disease, with varying accuracy and cost. We sought to provide cost-effectiveness information to aid physicians and decision-makers in selecting the most appropriate testing strategy. We used the state-transitions (Markov) model from the Brazilian public health system perspective with a lifetime horizon. Diagnostic strategies were based on exercise electrocardiography (Ex-ECG), stress echocardiography (ECHO), single-photon emission computed tomography (SPECT), computed tomography coronary angiography (CTA), or stress cardiac magnetic resonance imaging (C-MRI) as the initial test. Systematic review provided input data for test accuracy and long-term prognosis. Cost data were derived from the Brazilian public health system. Diagnostic test strategy had a small but measurable impact in quality-adjusted life-years gained. Switching from Ex-ECG to CTA-based strategies improved outcomes at an incremental cost-effectiveness ratio of 3100 international dollars per quality-adjusted life-year. ECHO-based strategies resulted in cost and effectiveness almost identical to CTA, and SPECT-based strategies were dominated because of their much higher cost. Strategies based on stress C-MRI were most effective, but the incremental cost-effectiveness ratio vs CTA was higher than the proposed willingness-to-pay threshold. Invasive strategies were dominant in the high pretest probability setting. Sensitivity analysis showed that results were sensitive to costs of CTA, ECHO, and C-MRI. Coronary CT is cost-effective for the diagnosis of coronary artery disease and should be included in the Brazilian public health system. Stress ECHO has a similar performance and is an acceptable alternative for most patients, but invasive strategies should be reserved for patients at high risk. © 2016 Wiley Periodicals, Inc.

Sampling strategies for estimating brook trout effective population size

Science.gov (United States)

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

2012-01-01

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

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

Science.gov (United States)

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

2015-06-01

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

Effectiveness of control strategies against Botrytis cinerea in vineyard and evaluation of the residual fungicide concentrations.

Science.gov (United States)

Gabriolotto, Chiara; Monchiero, Matteo; Negre, Michele; Spadaro, Davide; Gullino, Maria Lodovica

2009-05-01

This investigation was undertaken to test different control strategies against Botrytis cinerea vineyards. Two commercial vineyards, "Barbera" and "Moscato," located in Piedmont (Northern Italy) were divided into seven plots and treated with different combinations of fungicides including fenhexamid, pyrimethanil, fludioxonil + cyprodinil, iprodione, and boscalid, a new carboxamide compound. An integrated strategy including a chemical (pyrimethanil) and a biocontrol agent (Trichoderma spp. t2/4ph1) was also included. At harvest, the percentage of bunches and berries attacked by B. cinerea and the concentration of the chemical fungicides were determined. All the pesticide residues at harvest were below the maximum residue level (MRL), except when two applications of pyrimethanil per season were applied. Boscalid was the most effective active ingredient against B. cinerea among the tested chemicals. When boscalid application was followed by a treatment with pyrimethanil, its efficacy was similar to that shown by two treatments of pyrimethanil. However, this second strategy was not feasible due to the risks of resistance development in the pathogen and to the residue accumulation as indicated by the analysis.

Clinical multi-omics strategies for the effective cancer management.

Science.gov (United States)

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

2017-08-15

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

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

African Journals Online (AJOL)

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

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

Directory of Open Access Journals (Sweden)

N. Kochkina

2015-08-01

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

Enhancing Historical Reasoning: A Strategy Including Formative Assessment with Systematic Continuous Feedback

Science.gov (United States)

Méndez, Sergio; Tirado, Felipe

2016-01-01

Learning History promotes students' reasoning. According to Van Drie & Van Boxtel (2008), historical reasoning involves six elements: substantive concepts, metaconcepts, asking historical questions, using sources, contextualization, and argumentation. Although there are didactic strategies that promote historical reasoning, these do not…

The Effects of Physical Manipulatives on Children's Numerical Strategies

Science.gov (United States)

Manches, Andrew; O'Malley, Claire

2016-01-01

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

Effective sourcing strategies for perishable product supply chains

NARCIS (Netherlands)

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

2014-01-01

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

Effectiveness of teaching strategies on the development of critical thinking in undergraduate nursing students: a meta-analysis

Directory of Open Access Journals (Sweden)

Larissa Bertacchini de Oliveira

2016-04-01

Full Text Available Abstract OBJECTIVE To evaluate the effectiveness of teaching strategies used for development of critical thinking (CT in undergraduate nursing students. METHOD Systematic review with meta-analysis based on the recommendations of the Joanna Briggs Institute . Searches were conducted in the following databases: PubMed, CINAHL, EMBASE, Web of Science, SCOPUS, LILACS, Cochrane CENTRAL, PsycINFO, ERIC, and a database of theses from four continents. The initial selection and evaluation of studies and assessment of methodological quality was performed by two reviewers independently. RESULTS Twelve randomized clinical trials were included in the study. In the meta-analysis of the four studies included that evaluated the strategy of problem-based learning (PBL, compared to lectures, the effectiveness of PBL was demonstrated with statistical significance (SMD = 0.21 and 95% CI = 0.01 to 0.42; p = 0.0434 for the development of CT in undergraduate nursing students, and the studies were homogeneous (chi-square = 6.10, p = 0.106. CONCLUSION The effectiveness of PBL was demonstrated in the increase of overall CT scores. Further studies need to be conducted in order to develop, implement and evaluate teaching strategies that are guided in high methodological rigor, and supported in theoretical models of teaching and learning.

Task-selective memory effects for successfully implemented encoding strategies.

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

2012-01-01

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

Towards an Effective Management Strategy for Passive RFID Implementation

National Research Council Canada - National Science Library

Fisch, John N; Koch, David M

2004-01-01

.... However, many issues central to passive RFID implementation remain unresolved. First and foremost, a comprehensive management strategy, including a complete redesign of business practices, must be developed...

Explaining the effects of two different strategies for promoting hand hygiene in hospital nurses: a process evaluation alongside a cluster randomised controlled trial.

Science.gov (United States)

Huis, Anita; Holleman, Gerda; van Achterberg, Theo; Grol, Richard; Schoonhoven, Lisette; Hulscher, Marlies

2013-04-08

There is only limited understanding of why hand hygiene improvement strategies are successful or fail. It is therefore important to look inside the 'black box' of such strategies, to ascertain which components of a strategy work well or less well. This study examined which components of two hand hygiene improvement strategies were associated with increased nurses' hand hygiene compliance. A process evaluation of a cluster randomised controlled trial was conducted in which part of the nursing wards of three hospitals in the Netherlands received a state-of-the-art strategy, including education, reminders, feedback, and optimising materials and facilities; another part received a team and leaders-directed strategy that included all elements of the state-of-the-art strategy, supplemented with activities aimed at the social and enhancing leadership. This process evaluation used four sets of measures: effects on nurses' hand hygiene compliance, adherence to the improvement strategies, contextual factors, and nurses' experiences with strategy components. Analyses of variance and multiple regression analyses were used to explore changes in nurses' hand hygiene compliance and thereby better understand trial effects. Both strategies were performed with good adherence to protocol. Two contextual factors were associated with changes in hand hygiene compliance: a hospital effect in long term (p feedback about their hand hygiene performance (p manager holds team members accountable for hand hygiene performance p < 0.01) correlated positively with changes in nurses' hand hygiene compliance. This study illustrates the use of a process evaluation to uncover mechanisms underlying change in hand hygiene improvement strategies. Our study results demonstrate the added value of specific aspects of social influence and leadership in hand hygiene improvement strategies, thus offering an interpretation of the trial effects. The study is registered in ClinicalTrials.gov, dossier number: NCT

Soil indicators to assess the effectiveness of restoration strategies in dryland ecosystems

Science.gov (United States)

Costantini, Edoardo; Branquinho, Cristina; Nunes, Alice; Schwilch, Gudrun; Stavi, Ilan; Valdecantos, Alejandro; Zucca, Claudio

2016-04-01

Soil indicators may be used for assessing both land suitability for restoration and the effectiveness of restoration strategies in restoring ecosystem functioning and services. In this review paper, several soil indicators, which can be used to assess the effectiveness of restoration strategies in dryland ecosystems at different spatial and temporal scales, are discussed. The selected indicators represent the different viewpoints of pedology, ecology, hydrology, and land management. The recovery of soil capacity to provide ecosystem services is primarily obtained by increasing soil rooting depth and volume, and augmenting water accessibility for vegetation. Soil characteristics can be used either as indicators of suitability, that is, inherently slow-changing soil qualities, or as indicators for modifications, namely dynamic, thus "manageable" soil qualities. Soil organic matter forms, as well as biochemistry, micro- and meso-biology, are among the most utilized dynamic indicators. On broader territorial scales, the Landscape Function Analysis uses a functional approach, where the effectiveness of restoration strategies is assessed by combining the analysis of spatial pattern of vegetation with qualitative soil indicators. For more holistic and comprehensive projects, effective strategies to combat desertification should integrate soil indicators with biophysical and socio-economic evaluation and include participatory approaches. The integrated assessment protocol of Sustainable Land Management developed by the World Overview of Conservation Approaches and Technologies network is thoroughly discussed. Two overall outcomes stem from the review: i) the success of restoration projects relies on a proper understanding of their ecology, namely the relationships between soil, plants, hydrology, climate, and land management at different scales, which is particularly complex due to the heterogeneous pattern of ecosystems functioning in drylands, and ii) the selection of

A Systematic Review of Combination Therapy with Stimulants and Atomoxetine for Attention-Deficit/Hyperactivity Disorder, Including Patient Characteristics, Treatment Strategies, Effectiveness, and Tolerability

Science.gov (United States)

Gau, Susan Shur-Fen; Méndez, Luis; Montgomery, William; Monk, Julie A.; Altin, Murat; Wu, Shenghu; Lin, Chaucer C.H.; Dueñas, Héctor J.

2013-01-01

Abstract Objective The purpose of this article was to systematically review the literature on stimulant and atomoxetine combination therapy, in particular: 1) Characteristics of patients with attention-deficit/hyperactivity disorder (ADHD) given combination therapy, 2) treatment strategies used, 3) efficacy and effectiveness, and 4) safety and tolerability. Methods Literature databases (MEDLINE®, EMBASE, Cochrane Central Register of Controlled Trials, Science Citation Index Expanded, and SciVerse Scopus) were systematically searched using prespecified criteria. Publications describing stimulant and atomoxetine combination therapy in patients with ADHD or healthy volunteers were selected for review. Exclusion criteria were comorbid psychosis, bipolar disorder, epilepsy, or other psychiatric/neurologic diseases that could confound ADHD symptom assessment, or other concomitant medication(s) to treat ADHD symptoms. Results Of the 16 publications included for review, 14 reported findings from 3 prospective studies (4 publications), 7 retrospective studies, and 3 narrative reviews/medication algorithms of patients with ADHD. The other two publications reported findings from two prospective studies of healthy volunteers. The main reason for prescribing combination therapy was inadequate response to previous treatment. In the studies of patients with ADHD, if reported, 1) most patients were children/adolescents and male, and had a combined ADHD subtype; 2) methylphenidate was most often used in combination with atomoxetine for treatment augmentation or switch; 3) ADHD symptom control was improved in some, but not all, patients; and 4) there were no serious adverse events. Conclusions Published evidence of the off-label use of stimulant and atomoxetine combination therapy is limited because of the small number of publications, heterogeneous study designs (there was only one prospective, randomized controlled trial), small sample sizes, and geographic bias. Existing

Effective Strategies for Sustaining Professional Learning Communities

Science.gov (United States)

Bennett, Patricia R.

2010-01-01

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

Effects of constructing versus playing an educational game on student motivation and deep learning strategy use

NARCIS (Netherlands)

Vos, N.W.; Meijden, H.A.T. van der; Denessen, E.J.P.G.

2011-01-01

In this study the effects of two different interactive learning tasks, in which simple games were included were described with respect to student motivation and deep strategy use. The research involved 235 students from four elementary schools in The Netherlands. One group of students (N = 128)

The VOICES/VOCES Success Story: Effective Strategies for Training, Technical Assistance and Community-Based Organization Implementation

Science.gov (United States)

Hamdallah, Myriam; Vargo, Sue; Herrera, Jennifer

2006-01-01

The Centers for Disease Control and Prevention's Diffusion of Effective Behavioral Interventions (DEBI) project successfully disseminated VOICES/VOCES, a brief video-based HIV risk reduction intervention targeting African American and Latino heterosexual men and women at risk for HIV infection. Elements of the dissemination strategy included a…

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

OpenAIRE

Kaplan, Tugba

2017-01-01

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

The Effect of Explicit Affective Strategy Training on Iranian EFL learners’ Oral Language Proficiency and Anxiety Reduction

Directory of Open Access Journals (Sweden)

Fatemeh Mostafavi

2016-08-01

Full Text Available The current study aimed at investigating the possible effects of explicit teaching of affective strategies on Iranian EFL learners’ oral language proficiency and the extent of their anxiety in EFL classroom.  First, PET test was administered to a total number of 120 female third grade high school EFL students.  Then, 60 participants whose score fell within the range of + 1 SD from the mean score were selected for the main study.  Next, they were randomly assigned into two groups (one control and one experimental.  The design of the study was Experimental comparison-group plan.  Foreign Language Classroom Anxiety Scale adopted from Horwitz (1986 was used to examine the EFL learners’ anxiety level in English class.  Moreover, two equivalent oral tests adopted from Heaton (1975 were administered to the participants of the two groups both at the beginning and at the end of the study served as pre and post-tests.  The treatment for the experimental group included Oxford's (1990 taxonomy of affective strategies, which included explicit affective strategy instruction (in relaxation, music, visualization, humor, positive self-talk, risk-taking, and monitoring emotions.  The control group did not receive any special instruction in terms of affective strategies.  To investigate the possible effects of explicit affective strategy use instruction on the participants’ oral language proficiency and their anxiety level, the pre and posttests of oral tests and the participants’ self-reports of anxiety control in both groups were analyzed and compared.  The results of independent samples T- test indicated that while the two groups were homogeneous in terms of oral proficiency and level of anxiety control before introducing the treatment, the experimental group performed better than the control group in the oral post-test.  Moreover, the level of anxiety control for the experimental group was significantly different and higher than that of the

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

Science.gov (United States)

McNamara, John M; Dall, Sasha R X

2011-03-01

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

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

International Nuclear Information System (INIS)

Kim, Jong Hyun; Seong, Poong Hyun

2007-01-01

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

Uncovering effective strategies for hearing loss prevention

Science.gov (United States)

Morata, Thais C.; Meinke, Deanna

2016-01-01

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

BIOLOGIC AND ECONOMIC EFFECTS OF INCLUDING DIFFERENT ...

African Journals Online (AJOL)

The biologic and economic effects of including three agro-industrial by-products as ingredients in turkey poult diets were investigated using 48 turkey poults in a completely randomised design experiment. Diets were formulated to contain the three by-products – wheat offal, rice husk and palm kernel meal, each at 20% level ...

LTRACK: Beam-transport calculation including wakefield effects

International Nuclear Information System (INIS)

Chan, K.C.D.; Cooper, R.K.

1988-01-01

LTRACK is a first-order beam-transport code that includes wakefield effects up to quadrupole modes. This paper will introduce the readers to this computer code by describing the history, the method of calculations, and a brief summary of the input/output information. Future plans for the code will also be described

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

Science.gov (United States)

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

2014-01-01

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

Task-selective memory effects for successfully implemented encoding strategies.

Directory of Open Access Journals (Sweden)

Eric D Leshikar

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

Implementation Strategies for Educational Intranet Resources.

Science.gov (United States)

Herson, Katie; Sosabowski, Michael; Lloyd, Andrew; Flowers, Stephen; Paine, Cameron; Newton, Becci

2000-01-01

Describes two alternative strategies for intranet implementation based on experiences at the University of Brighton (United Kingdom). Highlights include differing degrees of staff and student utilization; barriers to success; a unified strategy for effective intranet implementation; and how to manage organizational resistance to change.…

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

Science.gov (United States)

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

2006-01-01

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

Math Fact Strategies Research Project

Science.gov (United States)

Boso, Annie

2011-01-01

An action research project was conducted in order to determine effective math fact strategies for first graders. The traditional way of teaching math facts included using timed tests and flashcards, with most students counting on their fingers or a number line. Six new research-based strategies were taught and analyzed to decide which methods…

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

Directory of Open Access Journals (Sweden)

Lauren Lapointe-Shaw

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

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

Science.gov (United States)

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

2016-01-01

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

Towards effective extension delivery approach and strategies for ...

African Journals Online (AJOL)

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

What are the most effective strategies for improving quality and safety of health care?

Science.gov (United States)

Scott, I

2009-06-01

There is now a plethora of different quality improvement strategies (QIS) for optimizing health care, some clinician/patient driven, others manager/policy-maker driven. Which of these are most effective remains unclear despite expressed concerns about potential for QIS-related patient harm and wasting of resources. The objective of this study was to review published literature assessing the relative effectiveness of different QIS. Data sources comprising PubMed Clinical Queries, Cochrane Library and its Effective Practice and Organization of Care database, and HealthStar were searched for studies of QIS between January 1985 and February 2008 using search terms based on an a priori QIS classification suggested by experts. Systematic reviews of controlled trials were selected in determining effect sizes for specific QIS, which were compared as a narrative meta-review. Clinician/patient driven QIS were associated with stronger evidence of efficacy and larger effect sizes than manager/policy-maker driven QIS. The most effective strategies (>10% absolute increase in appropriate care or equivalent measure) included clinician-directed audit and feedback cycles, clinical decision support systems, specialty outreach programmes, chronic disease management programmes, continuing professional education based on interactive small-group case discussions, and patient-mediated clinician reminders. Pay-for-performance schemes directed to clinician groups and organizational process redesign were modestly effective. Other manager/policy-maker driven QIS including continuous quality improvement programmes, risk and safety management systems, public scorecards and performance reports, external accreditation, and clinical governance arrangements have not been adequately evaluated with regard to effectiveness. QIS are heterogeneous and methodological flaws in much of the evaluative literature limit validity and generalizability of results. Based on current best available evidence

Indirect effects of recovery strategies

DEFF Research Database (Denmark)

Andersen, Ken Haste; Rice, Jake

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

Strategies to mitigate dissociative and psychotomimetic effects of ketamine in the treatment of major depressive episodes: a narrative review.

Science.gov (United States)

Cooper, Matthew D; Rosenblat, Joshua D; Cha, Danielle S; Lee, Yena; Kakar, Ron; McIntyre, Roger S

2017-09-01

Objectives Replicated evidence has demonstrated that ketamine exerts rapid-acting and potent antidepressant effects. Notwithstanding, its promise to mitigate depressive symptoms and suicidality in antidepressant-resistant populations, several limitations and safety concerns accompany ketamine including, but not limited to, the potential for abuse and psychotomimetic/dissociative experiences. The focus of the current narrative review is to synthesise available evidence of strategies that may mitigate and fully prevent treatment-emergent psychotomimetic and dissociative effects associated with ketamine administration. Methods PubMed, Google Scholar and ClinicalTrials.gov were searched for relevant articles. Results Potential avenues investigated to minimise psychotomimetic effects associated with ketamine administration include the following: (1) altering dosing and infusion rates; (2) route of administration; (3) enantiomer choice; (4) co-administration with mood stabilisers of antipsychotics; and (5) use of alternative N-methyl-d-aspartate (NMDA)-modulating agents. Emerging evidence indicates that dissociative experiences can be significantly mitigated by using an intranasal route of administration, lower dosages, or use of alternative NMDA-modulating agents, namely lanicemine (AZD6765) and GLYX-13. Conclusions Currently, intranasal administration presents as the most promising strategy to mitigate dissociative and psychotomimetic effects; however, studies of strategies to mitigate the adverse events of ketamine are limited in number and quality and thus further investigation is still needed.

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

Science.gov (United States)

Sinkey, R G; Odibo, A O

2018-05-22

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

Effectiveness Of Communication Outreach Strategies Of Extension ...

African Journals Online (AJOL)

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

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

NARCIS (Netherlands)

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

2007-01-01

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

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

Science.gov (United States)

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

2014-12-11

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

Control strategies for effective robot assisted gait rehabilitation: the state of art and future prospects.

Science.gov (United States)

Cao, Jinghui; Xie, Sheng Quan; Das, Raj; Zhu, Guo L

2014-12-01

A large number of gait rehabilitation robots, together with a variety of control strategies, have been developed and evaluated during the last decade. Initially, control strategies applied to rehabilitation robots were adapted from those applied to traditional industrial robots. However, these strategies cannot optimise effectiveness of gait rehabilitation. As a result, researchers have been investigating control strategies tailored for the needs of rehabilitation. Among these control strategies, assisted-as-needed (AAN) control is one of the most popular research topics in this field. AAN training strategies have gained the theoretical and practical evidence based backup from motor learning principles and clinical studies. Various approaches to AAN training have been proposed and investigated by research groups all around the world. This article presents a review on control algorithms of gait rehabilitation robots to summarise related knowledge and investigate potential trends of development. There are existing review papers on control strategies of rehabilitation robots. The review by Marchal-Crespo and Reinkensmeyer (2009) had a broad cover of control strategies of all kinds of rehabilitation robots. Hussain et al. (2011) had specifically focused on treadmill gait training robots and covered a limited number of control implementations on them. This review article encompasses more detailed information on control strategies for robot assisted gait rehabilitation, but is not limited to treadmill based training. It also investigates the potential to further develop assist-as-needed gait training based on assessments of patients' ability. In this paper, control strategies are generally divided into the trajectory tracking control and AAN control. The review covers these two basic categories, as well as other control algorithm and technologies derived from them, such as biofeedback control. Assessments on human gait ability are also included to investigate how to

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

Directory of Open Access Journals (Sweden)

Rhys Andrews

2017-02-01

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

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

Science.gov (United States)

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

2016-01-01

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

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

Science.gov (United States)

Shorkaee, Hossein Zabihi; Talebi, Seyed Hassan

2018-01-01

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

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

Science.gov (United States)

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

2006-01-01

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

Evaluation of Simulation Models that Estimate the Effect of Dietary Strategies on Nutritional Intake: A Systematic Review.

Science.gov (United States)

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

2017-05-01

Background: Dietary simulation modeling can predict dietary strategies that may improve nutritional or health outcomes. Objectives: The study aims were to undertake a systematic review of simulation studies that model dietary strategies aiming to improve nutritional intake, body weight, and related chronic disease, and to assess the methodologic and reporting quality of these models. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guided the search strategy with studies located through electronic searches [Cochrane Library, Ovid (MEDLINE and Embase), EBSCOhost (CINAHL), and Scopus]. Study findings were described and dietary modeling methodology and reporting quality were critiqued by using a set of quality criteria adapted for dietary modeling from general modeling guidelines. Results: Forty-five studies were included and categorized as modeling moderation, substitution, reformulation, or promotion dietary strategies. Moderation and reformulation strategies targeted individual nutrients or foods to theoretically improve one particular nutrient or health outcome, estimating small to modest improvements. Substituting unhealthy foods with healthier choices was estimated to be effective across a range of nutrients, including an estimated reduction in intake of saturated fatty acids, sodium, and added sugar. Promotion of fruits and vegetables predicted marginal changes in intake. Overall, the quality of the studies was moderate to high, with certain features of the quality criteria consistently reported. Conclusions: Based on the results of reviewed simulation dietary modeling studies, targeting a variety of foods rather than individual foods or nutrients theoretically appears most effective in estimating improvements in nutritional intake, particularly reducing intake of nutrients commonly consumed in excess. A combination of strategies could theoretically be used to deliver the best improvement in outcomes. Study quality was moderate to

Effects of Constructing versus Playing an Educational Game on Student Motivation and Deep Learning Strategy Use

Science.gov (United States)

Vos, Nienke; van der Meijden, Henny; Denessen, Eddie

2011-01-01

In this study the effects of two different interactive learning tasks, in which simple games were included were described with respect to student motivation and deep strategy use. The research involved 235 students from four elementary schools in The Netherlands. One group of students (N = 128) constructed their own memory "drag and…

Fix my child: The importance of including siblings in clinical assessments.

Science.gov (United States)

Farnfield, Steve

2017-07-01

This study examined concordance in the attachment strategies of school-aged siblings with reference to environmental risk in terms of poverty and maltreatment. It also investigated the effect of child maltreatment and maternal mental illness on children's psychosocial functioning in terms of the Dynamic-Maturational Model of Attachment and Adaptation (DMM) including unresolved trauma and the DMM Depressed modifier. The attachment strategies of 30 sibling pairs, aged 5-14 years, were assessed using the School-age Assessment of Attachment (SAA). Unlike most previous studies, this study included siblings from large families of two to six children. The main finding was that as environmental risk increases, the diversity of sibling attachment strategies decreases with greater recourse to the DMM Type A3-6 and A/C strategies. Unlike previous studies, the highest level of concordance was found in sibling pairs with the opposite gender. Boys whose mothers had a history of mental illness were significantly more likely than girls to be assessed with the DMM-depression modifier. As danger increases, children in the same family experience more of the same childhood. Further research should focus on single case, intra-familial studies to build a systemic model of the shared environment. Research should also evaluate the effects of environmental risk compared with size of the sibling group on children's attachment strategies. The clinical implications point to the importance of assessing all children in the family using a model built around functional formulation rather than diagnosing the symptoms of a particular child.

A study on strategies for effective participation in the Forum for Nuclear Cooperation in Asia

International Nuclear Information System (INIS)

Chung, Joon Keuk; Lee, Eui Jin; Jun, Byung Jin; Chung, Yong Sam; Lee, Chang Hee; Shim, Jae Sun; Noh, In Young; Lee, Jeong Kong; Han, Bong O

2001-02-01

In an effort to achieve the objectives, the following scopes were categorized for in-depth study. First of all, a general overview of FNCA, the including background and strategic plans of the forum, structure and activities of the forum, and the FNCA framework was reviewed. Secondly, major activities and implemented achievements in the 7 cooperation projects were also reviewed. Thirdly, the trends and prospects of nuclear power development programs in the participating countries in the FNCA were studied. Finally, proper strategies and recommendations for effective participation in FNCA were presented. This study can be utilized as basic reference material in the efficient implementation of FNCA in the future and for personnel involved in the FNCA affairs as the fundamental elements for implementing FNCA cooperation are presented. Strategies for strengthening Korea's participation in FNCA can be utilized as basic reference for the effective planning and implementation of FNCA activities in the future. Strategies for contributing to promoting nuclear cooperation in the region, for example, cash or in-kind contributions, should be established to effectively participate in the FNCA. It is hoped that this study will be widely utilized for encouraging Korea's participation in the FNCA and for establishing a future direction for FNCA by governments, industries, academic circles and research institutions

Effects of age on navigation strategy.

Science.gov (United States)

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

2012-01-01

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

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

Science.gov (United States)

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

2007-01-01

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

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

Science.gov (United States)

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

2015-12-01

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

Cost-effectiveness analysis of mammography and clinical breast examination strategies

Science.gov (United States)

Ahern, Charlotte Hsieh; Shen, Yu

2009-01-01

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

Effects of emotion regulation strategies on smoking craving, attentional bias, and task persistence.

Science.gov (United States)

Szasz, Paul Lucian; Szentagotai, Aurora; Hofmann, Stefan G

2012-05-01

The goal of this study was to investigate the effects of different strategies for regulating emotions associated with smoking on subjective, cognitive, and behavioral correlates of smoking. Emotion regulation was manipulated by instructing participants to reappraise (n = 32), accept (n = 31), or suppress (n = 31) their emotions associated with smoking. The dependent measures included subjective reports of craving, negative affect, and attentional biases, as measured by a modified dot-probe task, and persistence during a task to measure distress tolerance. Individuals who were encouraged to reappraise the consequences of smoking showed diminished craving, lower negative affect, had reduced attentional biases for smoking-related cues, and exhibited greater task persistence than those who were instructed to accept and suppress their urge to smoke. These findings suggest that reappraisal techniques are more effective than acceptance or suppression strategies for targeting smoking-related problems. Copyright © 2012 Elsevier Ltd. All rights reserved.

Sit-to-Stand in People with Stroke: Effect of Lower Limb Constraint-Induced Movement Strategies

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Charla Krystine Gray

2014-01-01

Full Text Available Background. Weight-bearing asymmetry and impaired balance may contribute to the increased fall risk in people with stroke when rising to stand from sitting. Objective. This study investigated the effect of constraint-induced movement (CIM strategies on weight-bearing symmetry and balance during sit-to-stand in people with stroke. Methods. A nonrandom convenience sample of fifteen people with stroke performed the sit-to-stand task using three CIM strategies including a solid or compliant (foam block strategy, with the unaffected limb placed on the block, and an asymmetrical foot position strategy, with the unaffected limb placed ahead of the affected limb. Duration of the task, affected limb weight-bearing, and centre of pressure and centre of mass displacement were measured in the frontal and sagittal plane. Results. Affected limb weight-bearing was increased and frontal plane centre of pressure and centre of mass moved toward the affected limb compared to baseline with all CIM strategies. Centre of mass displacement in the sagittal plane was greater with the compliant block and asymmetrical foot strategies. Conclusions. The CIM strategies demonstrated greater loading of the affected limb and movement of the centre of pressure and centre of mass toward the affected limb. The compliant block and asymmetrical foot conditions may challenge sagittal plane balance during sit-to-stand in people with stroke.

Supermarket revolution in Asia and emerging development strategies to include small farmers.

Science.gov (United States)

Reardon, Thomas; Timmer, C Peter; Minten, Bart

2012-07-31

A "supermarket revolution" has occurred in developing countries in the past 2 decades. We focus on three specific issues that reflect the impact of this revolution, particularly in Asia: continuity in transformation, innovation in transformation, and unique development strategies. First, the record shows that the rapid growth observed in the early 2000s in China, Indonesia, Malaysia, and Thailand has continued, and the "newcomers"--India and Vietnam--have grown even faster. Although foreign direct investment has been important, the roles of domestic conglomerates and even state investment have been significant and unique. Second, Asia's supermarket revolution has exhibited unique pathways of retail diffusion and procurement system change. There has been "precocious" penetration of rural towns by rural supermarkets and rural business hubs, emergence of penetration of fresh produce retail that took much longer to initiate in other regions, and emergence of Asian retail developing-country multinational chains. In procurement, a symbiosis between modern retail and the emerging and consolidating modern food processing and logistics sectors has arisen. Third, several approaches are being tried to link small farmers to supermarkets. Some are unique to Asia, for example assembling into a "hub" or "platform" or "park" the various companies and services that link farmers to modern markets. Other approaches relatively new to Asia are found elsewhere, especially in Latin America, including "bringing modern markets to farmers" by establishing collection centers and multipronged collection cum service provision arrangements, and forming market cooperatives and farmer companies to help small farmers access supermarkets.

The Effect of Communication Strategy Training on the Development of EFL Learners' Strategic Competence and Oral Communicative Ability.

Science.gov (United States)

Rabab'ah, Ghaleb

2016-06-01

This study examines the effect of communication strategy instruction on EFL students' oral communicative ability and their strategic competence. In a 14-week English as a Foreign Language (EFL) course (English Use II) based on Communicative Language Teaching approach, 80 learners were divided into two groups. The strategy training group ([Formula: see text]) received CS training based on a training program designed for the purpose of the present research, whereas the control group ([Formula: see text]) received only the normal communicative course using Click On 3, with no explicit focus on CSs. The communication strategies targeted in the training program included circumlocution (paraphrase), appeal for help, asking for repetition, clarification request, confirmation request, self-repair, and guessing. Pre- and post-test procedures were used to find out the effect of strategy training on language proficiency and CS use. The effect of the training was assessed by three types of data collection: the participants' pre- and post-IELTS speaking test scores, transcription data from the speaking IELTS test, and 'Click On' Exit Test scores. The findings revealed that participants in the strategy training group significantly outperformed the control group in their IELTS speaking test scores. The results of the post-test transcription data also confirmed that the participants in the strategy training group used more CSs, which could be attributed to the CS training program. The findings of the present research have implications for language teachers, and syllabus designers.

Is Inspiring Group Members an Effective Predictor of Social Dominance in Early Adolescence? Direct and Moderated Effects of Behavioral Strategies, Social Skills, and Gender on Resource Control and Popularity.

Science.gov (United States)

Vermande, Marjolijn M; Gilholm, Patricia A; Reijntjes, Albert H A; Hessen, Dave J; Sterck, Elisabeth H M; Overduin-de Vries, Anne M

2018-03-13

Dominance in the peer group is important for adolescents. Resource Control Theory posits that both coercive and prosocial (positively assertive) strategies are associated with dominance. Combining Resource Control Theory with Socioanalytic Theory on personality, we hypothesized that inspiring group members would be an additional effective strategy. This study examined whether the three behavioral strategies and two types of social skills (social competence and manipulation) predicted dominance (resource control and popularity). Participants were 619 Dutch adolescents (M age  = 13.1; 47% female) in the first grade of secondary school. They completed peer reports (behavioral strategies and dominance) and self-reports (social skills). Only inspirational and coercive strategies substantially predicted dominance. Main effects of social skills emerged. Moderation between strategies and social skills was only observed for girls (e.g., coercive strategy use was associated with more popularity for girls with higher levels of social manipulation skills). This study furthered our understanding of the predictors of dominance in adolescence by including inspirational behavior and examining prosocial and antisocial skills.

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

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Guohua Cao

2013-01-01

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

Crude oil hedging: benchmarking price protection strategies

International Nuclear Information System (INIS)

Krapels, Edward N.; Pratt, Michael

1998-01-01

This report presents a review of hedging (protection against a loss) strategies in the crude oil futures and options markets. The introductory section of the report gives details of hedging instruments, and the purposes of hedging crude oil. Hedging strategies including pure futures strategies, pure options strategies, options combination strategies, exotic (Asian) options strategies, and insurance instruments are described. The West Texas intermediate (WTI) market depth, liquidity and hedging effectiveness are examined, and winners and losers, and energy consumers are considered. The appendix gives tables and charts summarising the outcomes of futures and options strategies under different market conditions and expectations. (UK)

The Effectiveness of Using Contextual Clues, Dictionary Strategy and Computer Assisted Language Learning (Call In Learning Vocabulary

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Zuraina Ali

2013-07-01

Full Text Available This study investigates the effectiveness of three vocabulary learning methods that are Contextual Clues, Dictionary Strategy, and Computer Assisted Language Learning (CALL in learning vocabulary among ESL learners. First, it aims at finding which of the vocabulary learning methods namely Dictionary Strategy, Contextual Clues, and CALL that may result in the highest number of words learnt in the immediate and delayed recall tests. Second, it compares the results of the Pre-test and the Delayed Recall Post-test to determine the differences of learning vocabulary using the methods. A quasi-experiment that tested the effectiveness of learning vocabulary using Dictionary Strategy, Contextual clues, and CALL involved 123 first year university students. Qualitative procedures included the collection of data from interviews which were conducted to triangulate the data obtain from the quantitative inquiries. Findings from the study using ANOVA revealed that there were significant differences when students were exposed to Dictionary Strategy, Contextual Clues and CALL in the immediate recall tests but not in the Delayed Recall Post-test. Also, there were significant differences when t test was used to compare the scores between the Pre-test and the Delayed Recall Post-test in using the three methods of vocabulary learning. Although many researchers have advocated the relative effectiveness of Dictionary Strategy, Contextual Clues, and CALL in learning vocabulary, the study however, is still paramount since there is no study has ever empirically investigated the relative efficacy of these three methods in a single study.

Identifying research priorities for effective retention strategies in clinical trials.

Science.gov (United States)

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

2017-08-31

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

Effect of the Holy Month of Ramadan on Coping Strategies

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S Akuchekian

2004-04-01

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

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

African Journals Online (AJOL)

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

Integrating human resources and program-planning strategies.

Science.gov (United States)

Smith, J E

1989-06-01

The integration of human resources management (HRM) strategies with long-term program-planning strategies in hospital pharmacy departments is described. HRM is a behaviorally based, comprehensive strategy for the effective management and use of people that seeks to achieve coordination and integration with overall planning strategies and other managerial functions. It encompasses forecasting of staffing requirements; determining work-related factors that are strong "motivators" and thus contribute to employee productivity and job satisfaction; conducting a departmental personnel and skills inventory; employee career planning and development, including training and education programs; strategies for promotion and succession, including routes of advancement that provide alternatives to the managerial route; and recruitment and selection of new personnel to meet changing departmental needs. Increased competitiveness among hospitals and a shortage of pharmacists make it imperative that hospital pharmacy managers create strategies to attract, develop, and retain the right individuals to enable the department--and the hospital as a whole--to grow and change in response to the changing health-care environment in the United States. Pharmacy managers would be greatly aided in this mission by the establishment of a well-defined, national strategic plan for pharmacy programs and services that includes an analysis of what education and training are necessary for their successful accomplishment. Creation of links between overall program objectives and people-planning strategies will aid hospital pharmacy departments in maximizing the long-term effectiveness of their practice.

Cost-effectiveness analysis of optimal strategy for tumor treatment

International Nuclear Information System (INIS)

Pang, Liuyong; Zhao, Zhong; Song, Xinyu

2016-01-01

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

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

Science.gov (United States)

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

2012-12-01

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

Effective recruitment of minority populations through community-led strategies.

Science.gov (United States)

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

2009-12-01

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

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

Science.gov (United States)

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

2005-10-01

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

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

Science.gov (United States)

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

2007-01-01

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

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

African Journals Online (AJOL)

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

Cost-effectiveness of feeding strategies to reduce greenhouse gas emissions from dairy farming.

Science.gov (United States)

Van Middelaar, C E; Dijkstra, J; Berentsen, P B M; De Boer, I J M

2014-01-01

The objective of this paper was to evaluate the cost-effectiveness of 3 feeding strategies to reduce enteric CH4 production in dairy cows by calculating the effect on labor income at the farm level and on greenhouse gas (GHG) emissions at the chain level (i.e., from production of farm inputs to the farm gate). Strategies included were (1) dietary supplementation of an extruded linseed product (56% linseed; 1kg/cow per day in summer and 2kg/cow per day in winter), (2) dietary supplementation of a nitrate source (75% nitrate; 1% of dry matter intake), and (3) reducing the maturity stage of grass and grass silage (grazing at 1,400 instead of 1,700kg of dry matter/ha and harvesting at 3,000 instead of 3,500kg of dry matter/ha). A dairy farm linear programing model was used to define an average Dutch dairy farm on sandy soil without a predefined feeding strategy (reference situation). Subsequently, 1 of the 3 feeding strategies was implemented and the model was optimized again to determine the new economically optimal farm situation. Enteric CH4 production in the reference situation and after implementing the strategies was calculated based on a mechanistic model for enteric CH4 and empirical formulas explaining the effect of fat and nitrate supplementation on enteric CH4 production. Other GHG emissions along the chain were calculated using life cycle assessment. Total GHG emissions in the reference situation added up to 840kg of CO2 equivalents (CO2e) per t of fat- and protein-corrected milk (FPCM) and yearly labor income of €42,605. Supplementation of the extruded linseed product reduced emissions by 9kg of CO2e/t of FPCM and labor income by €16,041; supplementation of the dietary nitrate source reduced emissions by 32kg of CO2e/t of FPCM and labor income by €5,463; reducing the maturity stage of grass and grass silage reduced emissions by 11kg of CO2e/t of FPCM and labor income by €463. Of the 3 strategies, reducing grass maturity was the most cost-effective

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

Science.gov (United States)

Masoudi, Golfam

2017-01-01

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

Effective Fragmentation and Flyrock Control Strategies at Quarries

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Sedat Esen

2017-01-01

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

Helping hands: A cluster randomised trial to evaluate the effectiveness of two different strategies for promoting hand hygiene in hospital nurses

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Hulscher Marlies

2011-09-01

Full Text Available Abstract Background Hand hygiene prescriptions are the most important measure in the prevention of hospital-acquired infections. Yet, compliance rates are generally below 50% of all opportunities for hand hygiene. This study aims at evaluating the short- and long-term effects of two different strategies for promoting hand hygiene in hospital nurses. Methods/design This study is a cluster randomised controlled trial with inpatient wards as the unit of randomisation. Guidelines for hand hygiene will be implemented in this study. Two strategies will be used to improve the adherence to guidelines for hand hygiene. The state-of-the-art strategy is derived from the literature and includes education, reminders, feedback, and targeting adequate products and facilities. The extended strategy also contains activities aimed at influencing social influence in groups and enhancing leadership. The unique contribution of the extended strategy is built upon relevant behavioural science theories. The extended strategy includes all elements of the state-of-the-art strategy supplemented with gaining active commitment and initiative of ward management, modelling by informal leaders at the ward, and setting norms and targets within the team. Data will be collected at four points in time, with six-month intervals. An average of 3,000 opportunities for hand hygiene in approximately 900 nurses will be observed at each time point. Discussion Performing and evaluating an implementation strategy that also targets the social context of teams may considerably add to the general body of knowledge in this field. Results from our study will allow us to draw conclusions on the effects of different strategies for the implementation of hand hygiene guidelines, and based on these results we will be able to define a preferred implementation strategy for hospital based nursing. Trial registration The study is registered as a Clinical Trial in ClinicalTrials.gov, dossier number: NCT

Bringing Value-Based Perspectives to Care: Including Patient and Family Members in Decision-Making Processes

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Graeme Kohler

2017-11-01

Full Text Available n a gap in consistent application of system-level strategies that can effectively translate organizational policies around patient and family engagement into practice. Methods The broad objective of this initiative was to develop a system-level implementation strategy to include patient and family advisors (PFAs at decision-making points in primary healthcare (PHC based on wellestablished evidence and literature. In this opportunity sponsored by the Canadian Foundation for Healthcare Improvement (CFHI a co-design methodology, also well-established was applied in identifying and developing a suitable implementation strategy to engage PFAs as members of quality teams in PHC. Diabetes management centres (DMCs was selected as the pilot site to develop the strategy. Key steps in the process included review of evidence, review of the current state in PHC through engagement of key stakeholders and a co-design approach. Results The project team included a diverse representation of members from the PHC system including patient advisors, DMC team members, system leads, providers, Public Engagement team members and CFHI improvement coaches. Key outcomes of this 18-month long initiative included development of a working definition of patient and family engagement, development of a Patient and Family Engagement Resource Guide and evaluation of the resource guide. Conclusion This novel initiative provided us an opportunity to develop a supportive system-wide implementation plan and a strategy to include PFAs in decision-making processes in PHC. The well-established co-design methodology further allowed us to include value-based (customer driven quality and experience of care perspectives of several important stakeholders including patient advisors. The next step will be to implement the strategy within DMCs, spread the strategy PHC, both locally and provincially with a focus on sustainability.

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

Science.gov (United States)

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

2017-01-01

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

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

International Nuclear Information System (INIS)

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

1996-01-01

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

Economic and Managerial Analysis of Effective Managerial Strategies on Prevention from Ketosis in Transition Period in Shahroud Commercial Dairy Farms

Science.gov (United States)

Kashfi, H.; Yazdani, A. R.; Latifi, M.; Shirani Bidabadi, F.

2011-01-01

The purpose of this research is to study any effects of managerial strategies on prevention of ketosis metabolic disorder in transition period in Shahroud commercial dairy farms. For this purpose, a questionnaire was prepared in order to obtain required information about the performance of these managerial strategies, performance costs, involvement situation with disorders relying upon clinical signs and treatment and health records, producing and economic situation, and fertility rate and its costs. The considered managerial guidelines include body condition score management or type evaluation in transition period, increase in dry matter intake close to parturition, using propylene glycol, using niacin, and high-quality feeding (the importance of feed quality) in transition period. Finally and upon arrangement of data, it was possible to study any effects of mentioned managerial strategies on related variants through multiple linear regressions. Furthermore, in order to study any relation among variables, we considered Pearson correlation coefficients as well. Finally, it was revealed that any application of managerial strategies for prevention from Ketosis in transition period has a significant effect in betterment of managerial and economic parameters. PMID:23738102

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

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Nazli Tyfekci

2017-12-01

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

Effectiveness of using blended learning strategies for teaching and learning human anatomy.

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Pereira, José A; Pleguezuelos, Eulogio; Merí, Alex; Molina-Ros, Antoni; Molina-Tomás, M Carmen; Masdeu, Carlos

2007-02-01

This study aimed to implement innovative teaching methods--blended learning strategies--that include the use of new information technologies in the teaching of human anatomy and to analyse both the impact of these strategies on academic performance, and the degree of user satisfaction. The study was carried out among students in Year 1 of the biology degree curriculum (human biology profile) at Pompeu Fabra University, Barcelona. Two groups of students were tested on knowledge of the anatomy of the locomotor system and results compared between groups. Blended learning strategies were employed in 1 group (BL group, n = 69); the other (TT group; n = 65) received traditional teaching aided by complementary material that could be accessed on the Internet. Both groups were evaluated using the same types of examination. The average marks presented statistically significant differences (BL 6.3 versus TT 5.0; P < 0.0001). The percentage pass rate for the subject in the first call was higher in the BL group (87.9% versus 71.4%; P = 0.02), reflecting a lower incidence of students who failed to sit the examination (BL 4.3% versus TT 13.8%; P = 0.05). There were no differences regarding overall satisfaction with the teaching received. Blended learning was more effective than traditional teaching for teaching human anatomy.

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

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Aghaie, Reza; Zhang, Lawrence Jun

2012-01-01

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

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

Science.gov (United States)

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

2015-04-01

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

strategies for improving supervisory skills for effective primary ...

African Journals Online (AJOL)

Elizabeth

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

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

OpenAIRE

Rahmi Yücel; Kayhan Ahmetoğulları

2015-01-01

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

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

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Ying-Erh Chen

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

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

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

2009-07-01

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

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

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Erdenk, Nigar; Altuntaş, Serap

2017-07-01

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

The Effect of Queueing Strategy on Network Traffic

International Nuclear Information System (INIS)

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

2013-01-01

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

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

Science.gov (United States)

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

2011-01-19

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

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

African Journals Online (AJOL)

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

Teaching Written Communication Strategies: A Training to Improve Writing

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Hanane Benali Taouis

2018-03-01

Full Text Available This research can be described as an experimental quantitative one including: a strategy training; two homogenous experimental groups with different levels of proficiency; and two homogenous control groups. The subjects are 60 Spanish high school students, who have been selected after taking the Oxford Quick Placement-Test. The study aims at investigating the possible relationship between the effect of the strategy training and the subjects' level of proficiency. It is also designed to analyze the effect of the training on the use of communication strategies in the written medium. It is meant to study the effect of the strategy training on the subjects' writing skill in English. The results show that the students' level of proficiency exerts a strong effect on the subjects' use of written communication strategies (CSs and on their strategy preference in written production. They also demonstrate how strategy training improves the subjects' written communication ability.

Forest Strategy in Republic of Macedonia: Barriers to Effective Implementation

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Jana Baumgartner

2014-06-01

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

Strategies for cost-effective and enhanced production of bacterial cellulose.

Science.gov (United States)

Islam, Mazhar Ul; Ullah, Muhammad Wajid; Khan, Shaukat; Shah, Nasrullah; Park, Joong Kon

2017-09-01

Bacterial cellulose (BC) has received substantial attention because of its high purity, mechanical strength, crystallinity, liquid-absorbing capabilities, biocompatibility, and biodegradability etc. These properties allow BC to be used in various fields, especially in industries producing medical, electronic, and food products etc. A major discrepancy associated with BC is its high production cost, usually much higher than the plant cellulose. To address this limitations, researchers have developed several strategies for enhanced production of BC including the designing of advanced reactors and utilization of various carbon sources. Another promising approach is the production of BC from waste materials such as food, industrial, agricultural, and brewery wastes etc. which not only reduces the overall BC production cost but is also environment-friendly. Besides, exploration of novel and efficient BC producing microbial strains provides impressive boost to the BC production processes. To this end, development of genetically engineered microbial strains has proven useful for enhanced BC production. In this review, we have summarized major efforts to enhance BC production in order to make it a cost-effective biopolymer. This review can be of interest to researchers investigating strategies for enhanced BC production, as well as companies exploring pilot projects to scale up BC production for industrial applications. Copyright © 2017 Elsevier B.V. All rights reserved.

Effectiveness of External Reactor Vessel Cooling (ERVC) strategy for APR1400 and issues of phenomenological uncertainties

International Nuclear Information System (INIS)

Oh, S.J.; Kim, H.T.

2007-01-01

The APR1400(Advanced Power Reactor 1400) is an evolutionary advanced light water reactor with rated thermal power of 4000 MWt. For APR1400, External Reactor Vessel Cooling (ERVC) is adopted as a primary severe accident management strategy for in-vessel retention (IVR) of corium. The ERVC is a method of IVR by submerging the reactor vessel exterior. At the early stage of the APR1400 design, only ex-vessel cooling, cooling of the core melt outside the vessel after vessel is breached, is considered based on the EPRI Utility Requirement Document for Evolutionary LWR. However, based on the progress in implementation of Severe Accident Management Guidance (SAMG) for operating plants, as well as the research findings related to ERVC, ERVC strategy is adopted as a part of key severe accident management strategies. To improve its success, the strategy is reviewed and we implemented necessary design arrangement to increase its usefulness in managing the severe accident. In this paper, we examine the evolution of ERVC concept and its implementation in APR1400. Then, we review possible approach, including Risk-Oriented Accident Analysis Methodology (ROAAM), to evaluate the effectiveness of the strategy. (authors)

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

Science.gov (United States)

Kobayashi, Keiichi

2009-01-01

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

Assessment of the effectiveness of flood adaptation strategies for HCMC

Science.gov (United States)

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

2014-06-01

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

Effectiveness of counteraggression strategies in reducing interactive aggression by males.

Science.gov (United States)

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

1977-04-01

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

The effectiveness of neuromuscular warm-up strategies, that require no additional equipment, for preventing lower limb injuries during sports participation: a systematic review.

Science.gov (United States)

Herman, Katherine; Barton, Christian; Malliaras, Peter; Morrissey, Dylan

2012-07-19

Lower limb injuries in sport are increasingly prevalent and responsible for large economic as well as personal burdens. In this review we seek to determine which easily implemented functional neuromuscular warm-up strategies are effective in preventing lower limb injuries during sports participation and in which sporting groups they are effective. Seven electronic databases were searched from inception to January 2012 for studies investigating neuromuscular warm-up strategies and injury prevention. The quality of each included study was evaluated using a modified version of the van Tulder scale. Data were extracted from each study and used to calculate the risk of injury following application of each evaluated strategy. Nine studies were identified including six randomized controlled trials (RCT) and three controlled clinical trials (CCT). Heterogeneity in study design and warm-up strategies prevented pooling of results. Two studies investigated male and female participants, while the remaining seven investigated women only. Risk Ratio (RR) statistics indicated 'The 11+' prevention strategy significantly reduces overall (RR 0.67, confidence interval (CI) 0.54 to 0.84) and overuse (RR 0.45, CI 0.28 to 0.71) lower limb injuries as well as knee (RR 0.48, CI 0.32 to 0.72) injuries among young amateur female footballers. The 'Knee Injury Prevention Program' (KIPP) significantly reduced the risk of noncontact lower limb (RR 0.5, CI 0.33 to 0.76) and overuse (RR 0.44, CI 0.22 to 0.86) injuries in young amateur female football and basketball players. The 'Prevent Injury and Enhance Performance' (PEP) strategy reduces the incidence of anterior cruciate ligament (ACL) injuries (RR 0.18, CI 0.08 to 0.42). The 'HarmoKnee' programme reduces the risk of knee injuries (RR 0.22, CI 0.06 to 0.76) in teenage female footballers. The 'Anterior Knee Pain Prevention Training Programme' (AKP PTP) significantly reduces the incidence of anterior knee pain (RR 0.27, CI 0.14 to 0.54) in

The effectiveness of neuromuscular warm-up strategies, that require no additional equipment, for preventing lower limb injuries during sports participation: a systematic review

Directory of Open Access Journals (Sweden)

Herman Katherine

2012-07-01

Full Text Available Abstract Background Lower limb injuries in sport are increasingly prevalent and responsible for large economic as well as personal burdens. In this review we seek to determine which easily implemented functional neuromuscular warm-up strategies are effective in preventing lower limb injuries during sports participation and in which sporting groups they are effective. Methods Seven electronic databases were searched from inception to January 2012 for studies investigating neuromuscular warm-up strategies and injury prevention. The quality of each included study was evaluated using a modified version of the van Tulder scale. Data were extracted from each study and used to calculate the risk of injury following application of each evaluated strategy. Results Nine studies were identified including six randomized controlled trials (RCT and three controlled clinical trials (CCT. Heterogeneity in study design and warm-up strategies prevented pooling of results. Two studies investigated male and female participants, while the remaining seven investigated women only. Risk Ratio (RR statistics indicated 'The 11+' prevention strategy significantly reduces overall (RR 0.67, confidence interval (CI 0.54 to 0.84 and overuse (RR 0.45, CI 0.28 to 0.71 lower limb injuries as well as knee (RR 0.48, CI 0.32 to 0.72 injuries among young amateur female footballers. The 'Knee Injury Prevention Program' (KIPP significantly reduced the risk of noncontact lower limb (RR 0.5, CI 0.33 to 0.76 and overuse (RR 0.44, CI 0.22 to 0.86 injuries in young amateur female football and basketball players. The 'Prevent Injury and Enhance Performance' (PEP strategy reduces the incidence of anterior cruciate ligament (ACL injuries (RR 0.18, CI 0.08 to 0.42. The 'HarmoKnee' programme reduces the risk of knee injuries (RR 0.22, CI 0.06 to 0.76 in teenage female footballers. The 'Anterior Knee Pain Prevention Training Programme' (AKP PTP significantly reduces the incidence of anterior

Investigating the effect of different conflict management strategies on brand promise: A case study of banking industry

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Hosseinali Aziziha

2014-01-01

Full Text Available The purpose of this paper is to study the effect of different conflict management strategies including competition, cooperation, prevention and compromise on brand promise. The proposed study uses the questionnaire developed by Putnam and Wilson (1982 [Putnam, L. L., & Wilson, C. E. (1982. Communicative strategies in organizational conflicts: Reliability and validity of a measurement scale. Communication yearbook, 6, 629-652.] to measure conflict management measures and to measure the components of brand promise, the study develops a questionnaire. The proposed study is executed among some employees of bank Melli Iran in city of Tehran, Iran. Cronbach alphas have been calculated as 0.76 and 0.83 for conflict management and brand promise, respectively. Using Pearson correlation ratios as well as multiple regression technique, the study determines that there was a reverse relationship between two conflict management strategies, cooperation and compromise, and brand promise. In addition, there was a positive relationship between two conflict management strategies, competition and compromise, and brand promise.

Implementation of effective alcohol control strategies is needed at large sports and entertainment events.

Science.gov (United States)

Lyne, Mark; Galloway, Andrew

2012-02-01

To assess the implementation and effectiveness of strategies and actions to eliminate and/or reduce alcohol-related problems at large sports and entertainment events in New Zealand. We conducted site visits and monitoring observations at venues before, during and after a variety of large events between March 2009 and November 2010. Thirteen events were attended at nine different venues. Events included rugby, rugby league and cricket matches, motor racing, rowing, horse racing, an outdoor music festival, and food and wine festivals. Most large events appeared to pass with few or no alcohol-related problems. The exceptions were one of the horse-race meetings, a rugby league match and one food and wine festival. Common contexts at events where alcohol-related problems were seen included: inadequate alcohol control and management by security staff; the ability to purchase four alcoholic drinks (rather than two) at a time; inexperienced bar staff untrained in responsible alcohol service; no or little promotion of low and non-alcoholic drinks; and a lack of monitoring and enforcement of the law on intoxication. An important approach to prevent and reduce alcohol-related problems at large spots and entertainment events is the use of specific alcohol-control strategies. The management of alcohol consumption is a major part of event management that must be planned with harm-minimisation strategies well in advance of the event itself. If strategies and actions are not properly implemented to manage the sale and supply of alcohol at large events, there is significant risk of alcohol-related problems and harm resulting from them. © 2012 The Authors. ANZJPH © 2012 Public Health Association of Australia.

CREATIVE MARKETING STRATEGY AND EFFECTIVE EXECUTION ON PERFORMANCE IN PAKISTAN

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Muhammad Ishtiaq Ishaq

2016-11-01

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

[Coping strategy and its effect on occupational stress among rail freight dispatchers].

Science.gov (United States)

Gu, Gui-zhen; Yu, Shan-fa; Li, Kui-rong; Jiang, Kai-you

2010-08-01

To analyse the relationship between coping strategy and occupational stress in rail freight dispatchers. 115 rail freight dispatchers were investigated by using group sampling method, investigation contents included coping strategies, occupational stressors, strains and personalities. The proportion of using coping strategy in rail freight dispatchers is lower. The scores of job future ambiguity, type A behavior and work locus of control in workers with insufficient coping strategy were higher than those in workers with sufficient strategy (P family balance, job involvement coping factors of coping strategy were remarkable significant (P 0.05). Logistic regression analysis showed that risk of being job dissatisfaction and daily life stress in workers with insufficient social support coping was three or four times than those with sufficient coping (OR = 3.06 or 4.38, respectively), risk of being daily life stress in workers with insufficient job involvement coping was three times than those with sufficient coping (OR = 3.26). The proportion of using coping strategy in rail freight dispatchers is lower. Coping strategy has influence on the individual's perception of occuaptional stressors, strains and personalities.

A study on strategies for effective participation in the IAEA/RCA projects

International Nuclear Information System (INIS)

Chung, Joon Keuk; Jun, Byung Jin; Lee, Man Ki; Jin, Joon Ha; Choi, Pyung Hoon; Kim, Myung Ro; Min, Do Young

2002-07-01

In an effort to achieve the objectives, the following provisions were made. First of all, how this project supported RCA events that were held in Korea during the project period was described. Also, participation in RCA major policy level meetings, RCA-30 Scientific Forum, RCA Regional Office Opening were briefly reviewed. Secondly, RCA's general features including history and objective of its establishment, basic policy, administrative structure, major meetings was also reviewed. Thirdly, Overview of RCA projects, project implementation mechanism, on-going and planned project, review of technology utilization so fat and success stories were described. Fourthly, the issues related to the effective RCA management such as lead countries, Regional Resources Units (RRUs), RCA future vision and outsourcing of technical cooperation projects were reviewed. Finally, proper strategies and recommendations for active implementation of RCA projects were presented. This study can be utilized as basic reference material in the efficient implementation of RCA programmes in the future and for the personnel involved in the RCA projects as the fundamental elements for implementing the RCA cooperation are presented. The effective implementation direction for RCA programmes and strategies for strengthening Korea's participation in RCA projects can be utilized as basic reference material for the effective planning and implementation of RCA projects. It is hoped that this study will be widely utilized for expanding Korea's participation in the RCA project and for establishing a future direction for RCA projects by the governments, industries, academic circles and research institutions

Effective Teaching Strategies for Predicting Reading Growth in English Language Learners

Science.gov (United States)

Melgarejo, Melina

2017-01-01

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

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

Science.gov (United States)

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

2014-01-01

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

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

Directory of Open Access Journals (Sweden)

Rakita Branko

2010-01-01

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

Principles for characterizing the potential human health effects from exposure to nanomaterials: elements of a screening strategy

Directory of Open Access Journals (Sweden)

Lai David

2005-10-01

Full Text Available Abstract The rapid proliferation of many different engineered nanomaterials (defined as materials designed and produced to have structural features with at least one dimension of 100 nanometers or less presents a dilemma to regulators regarding hazard identification. The International Life Sciences Institute Research Foundation/Risk Science Institute convened an expert working group to develop a screening strategy for the hazard identification of engineered nanomaterials. The working group report presents the elements of a screening strategy rather than a detailed testing protocol. Based on an evaluation of the limited data currently available, the report presents a broad data gathering strategy applicable to this early stage in the development of a risk assessment process for nanomaterials. Oral, dermal, inhalation, and injection routes of exposure are included recognizing that, depending on use patterns, exposure to nanomaterials may occur by any of these routes. The three key elements of the toxicity screening strategy are: Physicochemical Characteristics, In Vitro Assays (cellular and non-cellular, and In Vivo Assays. There is a strong likelihood that biological activity of nanoparticles will depend on physicochemical parameters not routinely considered in toxicity screening studies. Physicochemical properties that may be important in understanding the toxic effects of test materials include particle size and size distribution, agglomeration state, shape, crystal structure, chemical composition, surface area, surface chemistry, surface charge, and porosity. In vitro techniques allow specific biological and mechanistic pathways to be isolated and tested under controlled conditions, in ways that are not feasible in in vivo tests. Tests are suggested for portal-of-entry toxicity for lungs, skin, and the mucosal membranes, and target organ toxicity for endothelium, blood, spleen, liver, nervous system, heart, and kidney. Non-cellular assessment

Double-photoionization of helium including quadrupole radiation effects

Energy Technology Data Exchange (ETDEWEB)

Colgan, James [Los Alamos National Laboratory; Ludlow, J A [AUBURN UNIV; Lee, Teck - Ghee [AUBURN UNIV; Pindzola, M S [AUBURN UNIV; Robicheaux, F [AUBURN UNIV

2009-01-01

Non-perturbative time-dependent close-coupling calculations are carried out for the double photoionization of helium including both dipole and quadrupole radiation effects. At a photon energy of 800 eV, accessible at CUlTent synchrotron light sources, the quadrupole interaction contributes around 6% to the total integral double photoionization cross section. The pure quadrupole single energy differential cross section shows a local maxima at equal energy sharing, as opposed to the minimum found in the pure dipole single energy differential cross section. The sum of the pure dipole and pure quadrupole single energy differentials is insensitive to non-dipole effects at 800 eV. However, the triple differential cross section at equal energy sharing of the two ejected electrons shows strong non-dipole effects due to the quadrupole interaction that may be experimentally observable.

Effects of Strategies Marketing of Collective Buying about Impulsive Behavior

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Suzi Elen Ferreira Dias

2014-08-01

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

Effectiveness of multiple therapeutic strategies in neovascular glaucoma patients: A PRISMA-compliant network meta-analysis.

Science.gov (United States)

Dong, Zixian; Gong, Jianyang; Liao, Rongfeng; Xu, Shaojun

2018-04-01

Neovascular glaucoma (NVG) is a severe secondary glaucoma with uncontrolled intraocular pressure that leads to serious eye pain and vision loss. Presently, the therapeutic strategies for NVG are diverse, but the therapeutic effects are still not ideal. We performed a network analysis to assess the effect of multiple therapeutic strategies on the treatment of NVG patients. We searched public electronic databases through April 2017 using the following keywords "neovascular glaucoma," "iris neovascularization," "hemorrhagic glaucoma," and "random" without language restrictions. The outcome considered in the present analysis was treatment success rate. A network meta-analysis and multilevel mixed-effects logistic regression were used to compare regimens. We included 27 articles assessing a total of 1884 NVG patients in our analysis. According to the network analysis, interferon and mitomycin plus trabeculectomy (94.9%), glaucoma valve implantation (86.9%), and iris photocoagulation plus trabeculectomy (81.9%) were the most likely to improve treatment success rate in NVG patients. The multilevel logistic regression analysis showed that glaucoma valve, bevacizumab, interferon, cyclophotocoagulation, trabeculectomy, iris photocoagulation, ranibizumab, and mitomycin had advantages in terms of improving treatment success rate in NVG patients. However, the application of retinal photocoagulation and vitrectomy reduced patient treatment success rate. The regimen including mitomycin, interferon, and trabeculectomy was the most likely to improve the treatment success rate in NVG patients. The application of glaucoma valve and bevacizumab were more beneficial for improving patient treatment success rate as a surgery and as an agent, respectively.

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

Energy Technology Data Exchange (ETDEWEB)

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

2018-01-15

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

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

International Nuclear Information System (INIS)

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

2018-01-01

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

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

Science.gov (United States)

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

2015-12-01

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

Effects of selected coping strategies on impediment oriented ...

African Journals Online (AJOL)

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

Emergency response facilities including primary and secondary prevention strategies across 79 professional football clubs in England.

Science.gov (United States)

Malhotra, Aneil; Dhutia, Harshil; Gati, Sabiha; Yeo, Tee-Joo; Finocchiaro, Gherardo; Keteepe-Arachi, Tracey; Richards, Thomas; Walker, Mike; Birt, Robin; Stuckey, David; Robinson, Laurence; Tome, Maite; Beasley, Ian; Papadakis, Michael; Sharma, Sanjay

2017-06-14

To assess the emergency response planning and prevention strategies for sudden cardiac arrest (SCA) across a wide range of professional football clubs in England. A written survey was sent to all professional clubs in the English football league, namely the Premiership, Championship, League 1 and League 2. Outcomes included: (1) number of clubs performing cardiac screening and frequency of screening; (2) emergency planning and documentation; (3) automated external defibrillator (AED) training and availability; and (4) provision of emergency services at sporting venues. 79 clubs (86%) responded to the survey. 100% clubs participated in cardiac screening. All clubs had AEDs available on match days and during training sessions. 100% Premiership clubs provided AED training to designated staff. In contrast, 30% of lower division clubs with AEDs available did not provide formal training. Most clubs (n=66; 83%) reported the existence of an emergency action plan for SCA but formal documentation was variable. All clubs in the Premiership and League 1 provided an ambulance equipped for medical emergencies on match days compared with 75% of clubs in the Championship and 66% in League 2. The majority of football clubs in England have satisfactory prevention strategies and emergency response planning in line with European recommendations. Additional improvements such as increasing awareness of European guidelines for emergency planning, AED training and mentorship with financial support to lower division clubs are necessary to further enhance cardiovascular safety of athletes and spectators and close the gap between the highest and lower divisions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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

Science.gov (United States)

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

2014-09-01

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

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

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Hooshang Khoshsima

2014-06-01

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

From the Cause of the Other to Minoritarian Strategy: The Politics and Clinic of Included Alterity

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Guillaume Sibertin-Blanc

2015-01-01

Full Text Available This article examines certain problems related to the “antinomical” distinction, proposed by Étienne Balibar, between a majority strategy and a minority strategy. Orientated by the deleuzo-guattarian theory of “becoming-minor”, and confronting it with three different political scenes taken from Frantz Fanon, Jacques Rancière and Judith Butler, we seek to distinguish different manners of thinking the inclusion of a “cause of the other”, or of a minority point of view, in the construction of emancipatory political identities. These are different ways of problematizing a minority strategy by relating it to practices of disidentification as the very content of political subjectivation. But the hypothesis that will crystalize in the course of this confrontation is that of an internal antinomy in the idea of minority strategy itself, that intensifies when the dominant identities loose the assurance of their own “majority”, or when the difference between the majoritarian and the minoritarian becomes tendencially unassignable at the same time as it becomes more difficult to differentiate the violence of the exclusion of minorities to the violence of their inclusion.

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

Science.gov (United States)

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

2015-07-01

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

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

Science.gov (United States)

Wijethilake, Chaminda

2017-07-01

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

Revealing the Effectivenesses of Communication Strategies

Science.gov (United States)

Lin, Grace Hui Chin

2013-01-01

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

A cost effective CO2 strategy

DEFF Research Database (Denmark)

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

Strategies facilitating practice change in pediatric cancer: a systematic review.

Science.gov (United States)

Robinson, Paula D; Dupuis, Lee L; Tomlinson, George; Phillips, Bob; Greenberg, Mark; Sung, Lillian

2016-09-01

By conducting a systematic review, we describe strategies to actively disseminate knowledge or facilitate practice change among healthcare providers caring for children with cancer and we evaluate the effectiveness of these strategies. We searched Ovid Medline, EMBASE and PsychINFO. Fully published primary studies were included if they evaluated one or more professional intervention strategies to actively disseminate knowledge or facilitate practice change in pediatric cancer or hematopoietic stem cell transplantation. Data extracted included study characteristics and strategies evaluated. In studies with a quantitative analysis of patient outcomes, the relationship between study-level characteristics and statistically significant primary analyses was evaluated. Of 20 644 titles and abstracts screened, 146 studies were retrieved in full and 60 were included. In 20 studies, quantitative evaluation of patient outcomes was examined and a primary outcome was stated. Eighteen studies were 'before and after' design; there were no randomized studies. All studies were at risk for bias. Interrupted time series was never the primary analytic approach. No specific strategy type was successful at improving patient outcomes. Literature describing strategies to facilitate practice change in pediatric cancer is emerging. However, major methodological limitations exist. Studies with robust designs are required to identify effective strategies to effect practice change. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Recruitment strategy effectiveness for a cryotherapy intervention for a venous leg ulcer prevention study.

Science.gov (United States)

Kelechi, Teresa J; Watts, Ashlee; Wiseman, Jan

2010-01-01

To describe the strategies and costs associated with recruiting African American and white adults into a randomized controlled pilot trial. "Cryotherapy for Venous Disorders: A Pilot Study" is a randomized controlled trial designed to determine the effects of a cool gel wrap and leg elevation intervention versus a leg elevation alone intervention on skin temperature, skin microcirculation, quality of life, and pain in adults with stages 4 and 5 chronic venous disorders. We sought to recruit 60 participants (21 African Americans, 37 whites, and 2 Hispanic or Latino) to complete the study. These enrollment targets reflect the demographic distribution of the community in which the study was conducted (33% African American, 66% white, and 2% Latino). Proactive and reactive recruitment strategies were implemented to recruit subjects. Seventy-three individuals (9 African American men, 29 African American women, 11 white men, 22 white women, 1 Asian woman, and 1 Hispanic woman) were screened, and of those, 67 were randomized (9 African American men, 25 African American women, 9 white men, 22 white women, 1 Asian woman, and 1 Hispanic women). Fifty-eight completed the study, yielding an overall 11% attrition rate. An additional 8 subjects canceled or did not show up for a first appointment. Reactive recruitment strategies were most successful for recruiting men, women, African American, and white participants. The 3 most successful reactive strategies were referrals from providers/clinics (34%), flyers posted in the hospital elevators (22%), and targeted mailings from a business (16%). Of the healthcare provider referrals (19), wound care nurses referred 12 completed participants. The amount budgeted for advertisement was $5,000 (2% of the total grant award). The amount spent on recruitment including labor was $5,978, which averaged $103 per participant who completed the study (N = 58). Reactive strategies per participant completer proved more cost-efficient than proactive

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

Science.gov (United States)

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

2011-04-03

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

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

OpenAIRE

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

2013-01-01

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

Cost-effectiveness analysis of population-based tobacco control strategies in the prevention of cardiovascular diseases in Tanzania.

Directory of Open Access Journals (Sweden)

Frida Ngalesoni

Full Text Available Tobacco consumption contributes significantly to the global burden of disease. The prevalence of smoking is estimated to be increasing in many low-income countries, including Tanzania, especially among women and youth. Even so, the implementation of tobacco control measures has been discouraging in the country. Efforts to foster investment in tobacco control are hindered by lack of evidence on what works and at what cost.We aim to estimate the cost and cost-effectiveness of population-based tobacco control strategies in the prevention of cardiovascular diseases (CVD in Tanzania.A cost-effectiveness analysis was performed using an Excel-based Markov model, from a governmental perspective. We employed an ingredient approach and step-down methodologies in the costing exercise following a government perspective. Epidemiological data and efficacy inputs were derived from the literature. We used disability-adjusted life years (DALYs averted as the outcome measure. A probabilistic sensitivity analysis was carried out with Ersatz to incorporate uncertainties in the model parameters.Our model results showed that all five tobacco control strategies were very cost-effective since they fell below the ceiling ratio of one GDP per capita suggested by the WHO. Increase in tobacco taxes was the most cost-effective strategy, while a workplace smoking ban was the least cost-effective option, with a cost-effectiveness ratio of US$5 and US$267, respectively.Even though all five interventions are deemed very cost-effective in the prevention of CVD in Tanzania, more research on budget impact analysis is required to further assess the government's ability to implement these interventions.

Effects of Technology-Based Teacher Training and Teacher-Led Classroom Implementation on Learning Reading Comprehension Strategies

OpenAIRE

Graves, Michael; Sales, Gregory C.; Lawrenz, Frances; Robelia, Beth; Richardson, Jayson W.

2010-01-01

This study examined the effectiveness of a professionally developed comprehensive reading comprehension strategies program when compared to traditional reading comprehension instruction presented to 865 fourth and fifth graders (682 with full data sets) in 34 classrooms in the United States. The treatment included a strong, technology-based teacher training component as well as highly motivational materials for 53 classroom-delivered student lessons. The research design was a randomized tria...

Strategy and space

DEFF Research Database (Denmark)

Jensen, Per Anker

2011-01-01

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

Taste alteration in breast cancer patients treated with taxane chemotherapy: experience, effect, and coping strategies.

Science.gov (United States)

Speck, Rebecca M; DeMichele, Angela; Farrar, John T; Hennessy, Sean; Mao, Jun J; Stineman, Margaret G; Barg, Frances K

2013-02-01

This study examined the experience and coping strategies for taste alteration in female breast cancer patients treated with docetaxel or paclitaxel. A purposive sample of 25 patients currently receiving docetaxel or paclitaxel or within 6 months of having completed treatment was recruited. Semi-structured interviews and patient-level data were utilized for this exploratory descriptive study. Interview data were analyzed with the constant comparative method; patient-level data were abstracted from the electronic medical record. Of all side effects reported from taxanes, the most common was taste alteration (8 of 10 docetaxel patients, 3 of 15 paclitaxel patients). Women that experience taste alteration chose not to eat as much, ate on an irregular schedule, and/or lost interest in preparing meals for themselves and/or their family. Women adopted a variety of new behaviors to deal with the taste alteration and its effects, including trying new recipes, eating strongly flavored foods, honoring specific food cravings, eating candy before meals, cutting food with lemon, drinking sweetened drinks, using plastic eating utensils, drinking from a straw, brushing their teeth and tongue before meals, and using baking soda and salt wash or antibacterial mouthwash. Taste alteration affects breast cancer patients' lives, and they develop management strategies to deal with the effect. While some self-management strategies can be seen as positively adaptive, the potential for increased caloric consumption and poor eating behaviors associated with some coping strategies may be a cause for concern given the observation of weight gain during breast cancer treatment and association of obesity with poor treatment outcomes in breast cancer patients. Further studies are warranted to determine the overall burden of this symptom and measurement of cancer and non-cancer-related consequences of these behavioral adaptations.

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

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

2014-06-01

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

The Effectiveness of the Unified Protocol on Emotional Dysregulation and Cognitive Emotion Regulation Strategies in Patients with Psychosomatic Disorders

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Mina Mazaheri

2014-01-01

Full Text Available Background: The unified treatment approach (UP is an emotion-focused cognitive-behavioral therapy in which the main object of treatment is emotional processes. The aim of the present research was to examine the effectiveness of The Unified Protocol (UP on emotional dysregulation and cognitive emotion regulation strategies in patients with psychosomatic disorders. Methods: Emotion-focused cognitive behavioral therapy (ECBT, a unified treatment, with 12 weekly group sessions of 2 hours, was presented to 14 patients with psychosomatic complaints at the Subspecialty Center of Psychiatry in Isfahan in 2013. Pre- and post-intervention assessments were done by means of the self-report tests of Difficulties in Emotion Regulation Scale (DERS and Cognitive Emotion Regulation Questionnaire (CERQ. Results: Significant reductions in post-test scores of total emotional dysregulation (P < 0.01 as well as the factors of non-acceptance (P < 0.05 and strategy (P < 0.01 were seen, while the other factors (goal, impulse, awareness, and clarity did not change. Moreover, a significant reduction was observed in the catastrophizing strategy score (P < 0.05, in comparison with other cognitive strategies. Conclusion: This pilot study including 14 patients with psychosomatic disorders indicates that the Unified treatment approach is an effective treatment in improvement of emotional dysregulation and in reduction of utilizing maladaptive cognitive strategies.

Cost-Effectiveness of Competing Treatment Strategies for Clostridium difficile Infection: A Systematic Review.

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Le, Phuc; Nghiem, Van T; Mullen, Patricia Dolan; Deshpande, Abhishek

2018-04-01

BACKGROUND Clostridium difficile infection (CDI) presents a substantial economic burden and is associated with significant morbidity. While multiple treatment strategies have been evaluated, a cost-effective management strategy remains unclear. OBJECTIVE We conducted a systematic review to assess cost-effectiveness analyses of CDI treatment and to summarize key issues for clinicians and policy makers to consider. METHODS We searched PubMed and 5 other databases from inception to August 2016. These searches were not limited by study design or language of publication. Two reviewers independently screened the literature, abstracted data, and assessed methodological quality using the Drummond and Jefferson checklist. We extracted data on study characteristics, type of CDI, treatment characteristics, and model structure and inputs. RESULTS We included 14 studies, and 13 of these were from high-income countries. More than 90% of these studies were deemed moderate-to-high or high quality. Overall, 6 studies used a decision-tree model and 7 studies used a Markov model. Cost of therapy, time horizon, treatment cure rates, and recurrence rates were common influential factors in the study results. For initial CDI, fidaxomicin was a more cost-effective therapy than metronidazole or vancomycin in 2 of 3 studies. For severe initial CDI, 2 of 3 studies found fidaxomicin to be the most cost-effective therapy. For recurrent CDI, fidaxomicin was cost-effective in 3 of 5 studies, while fecal microbiota transplantation (FMT) by colonoscopy was consistently cost-effective in 4 of 4 studies. CONCLUSIONS The cost-effectiveness of fidaxomicin compared with other pharmacologic therapies was not definitive for either initial or recurrent CDI. Despite its high cost, FMT by colonoscopy may be a cost-effective therapy for recurrent CDI. A consensus on model design and assumptions are necessary for future comparison of CDI treatment. Infect Control Hosp Epidemiol 2018;39:412-424.

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

NARCIS (Netherlands)

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

2007-01-01

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

Managerial strategies for creating an effective work environment.

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Luse, Kimberly A

2013-01-01

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

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

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Haynes, Scott

2014-01-01

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

Faculty ratings of retention strategies for minority nursing students.

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Baker, Barbara H

2010-01-01

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

Adaptive strategies for cumulative cultural learning.

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Ehn, Micael; Laland, Kevin

2012-05-21

The demographic and ecological success of our species is frequently attributed to our capacity for cumulative culture. However, it is not yet known how humans combine social and asocial learning to generate effective strategies for learning in a cumulative cultural context. Here we explore how cumulative culture influences the relative merits of various pure and conditional learning strategies, including pure asocial and social learning, critical social learning, conditional social learning and individual refiner strategies. We replicate the Rogers' paradox in the cumulative setting. However, our analysis suggests that strategies that resolved Rogers' paradox in a non-cumulative setting may not necessarily evolve in a cumulative setting, thus different strategies will optimize cumulative and non-cumulative cultural learning. Copyright © 2012 Elsevier Ltd. All rights reserved.

Effect of organizational strategy on visual memory in patients with schizophrenia.

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Kim, Myung-Sun; Namgoong, Yoon; Youn, Tak

2008-08-01

The aim of the present study was to examine how copy organization mediated immediate recall among patients with schizophrenia using the Rey-Osterrieth Complex Figure Test (ROCF). The Boston Qualitative Scoring System (BQSS) was applied for qualitative and quantitative analyses of ROCF performances. Subjects included 20 patients with schizophrenia and 20 age- and gender-matched healthy controls. During the copy condition, the schizophrenia group and the control group differed in fragmentation; during the immediate recall condition, the two groups differed in configural presence and planning; and during the delayed recall condition, they differed in several qualitative measurements, including configural presence, cluster presence/placement, detail presence/placement, fragmentation, planning, and neatness. The two groups also differed in several quantitative measurements, including immediate presence and accuracy, immediate retention, delayed retention, and organization. Although organizational strategies used during the copy condition mediated the difference between the two groups during the immediate recall condition, group also had a significant direct effect on immediate recall. Schizophrenia patients are deficient in visual memory, and a piecemeal approach to the figure and organizational deficit seem to be related to the visual memory deficit. But schizophrenia patients also appeared to have some memory problems, including retention and/or retrieval deficits.

Effective treatment strategies against Ebola virus

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Amina Yaqoob

2015-08-01

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

Commercial secret as an instrument of company competitive strategy effectiveness increase

Directory of Open Access Journals (Sweden)

Peskova Dinara

2017-01-01

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

Creating marketing strategies for higher education institutions

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Lidia Białoń

2015-12-01

Full Text Available The article presents a thesis that the primary premise of creating marketing strategies for higher education institution is a three-dimensional notion of marketing. The first dimension lies in the theoretical notions of the essence of marketing, including the transactional marketing (1.0, relationship marketing (2.0 and spiritual marketing (3.0. The second dimension is formed by methods of marketing research and accurate notions of marketing, while the third are channels of marketing information. Harmonizing these three dimensions is a precondition for effective marketing. Among other conditions for effective strategies there are: aligning goals of the chosen strategy with the mission of higher education institution, correct choice of targeted segments of the market and of marketing tools. The article also gives a sample classification of marketing strategies based on these criteria, with emphasis on the fact, that every higher education institution employs its own strategy.

Strategies for Improving the Performance of Sensors Based on Organic Field-Effect Transistors.

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Wu, Xiaohan; Mao, Shun; Chen, Junhong; Huang, Jia

2018-04-01

Organic semiconductors (OSCs) have been extensively studied as sensing channel materials in field-effect transistors due to their unique charge transport properties. Stimulation caused by its environmental conditions can readily change the charge-carrier density and mobility of OSCs. Organic field-effect transistors (OFETs) can act as both signal transducers and signal amplifiers, which greatly simplifies the device structure. Over the past decades, various sensors based on OFETs have been developed, including physical sensors, chemical sensors, biosensors, and integrated sensor arrays with advanced functionalities. However, the performance of OFET-based sensors still needs to be improved to meet the requirements from various practical applications, such as high sensitivity, high selectivity, and rapid response speed. Tailoring molecular structures and micro/nanofilm structures of OSCs is a vital strategy for achieving better sensing performance. Modification of the dielectric layer and the semiconductor/dielectric interface is another approach for improving the sensor performance. Moreover, advanced sensory functionalities have been achieved by developing integrated device arrays. Here, a brief review of strategies used for improving the performance of OFET sensors is presented, which is expected to inspire and provide guidance for the design of future OFET sensors for various specific and practical applications. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Testing the effectiveness of in-home behavioral economics strategies to increase vegetable intake, liking, and variety among children residing in households that receive food assistance.

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Leak, Tashara M; Swenson, Alison; Vickers, Zata; Mann, Traci; Mykerezi, Elton; Redden, Joseph P; Rendahl, Aaron; Reicks, Marla

2015-01-01

To test the effectiveness of behavioral economics strategies for increasing vegetable intake, variety, and liking among children residing in homes receiving food assistance. A randomized controlled trial with data collected at baseline, once weekly for 6 weeks, and at study conclusion. Family homes. Families with a child (9-12 years) will be recruited through community organizations and randomly assigned to an intervention (n = 36) or control (n = 10) group. The intervention group will incorporate a new behavioral economics strategy during home dinner meal occasions each week for 6 weeks. Strategies are simple and low-cost. The primary dependent variable will be child's dinner meal vegetable consumption based on weekly reports by caregivers. Fixed independent variables will include the strategy and week of strategy implementation. Secondary dependent variables will include vegetable liking and variety of vegetables consumed based on data collected at baseline and study conclusion. Mean vegetable intake for each strategy across families will be compared using a mixed-model analysis of variance with a random effect for child. In additionally, overall mean changes in vegetable consumption, variety, and liking will be compared between intervention and control groups. Copyright © 2015 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

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

International Nuclear Information System (INIS)

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

2015-01-01

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

Comparison of the Effects of Seated, Supine, and Walking Interset Rest Strategies on Work Rate.

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Ouellette, Kristen A; Brusseau, Timothy A; Davidson, Lance E; Ford, Candus N; Hatfield, Disa L; Shaw, Janet M; Eisenman, Patricia A

2016-12-01

Ouellette, KA, Brusseau, TA, Davidson, LE, Ford, CN, Hatfield, DL, Shaw, JM, and Eisenman, PA. Comparison of the effects of seated, supine, and walking interset rest strategies on work rate. J Strength Cond Res 30(12): 3396-3404, 2016-The idea that an upright posture should be maintained during the interset rest periods of training sessions is pervasive. The primary aim of this study was to determine differences in work rate associated with 3 interset rest strategies. Male and female members of the CrossFit community (male n = 5, female n = 10) were recruited to perform a strenuous training session designed to enhance work capacity that involved both cardiovascular and muscular endurance exercises. The training session was repeated on 3 separate occasions to evaluate 3 interset rest strategies, which included lying supine on the floor, sitting on a flat bench, and walking on a treadmill (0.67 m·s). Work rate was calculated for each training session by summing session joules of work and dividing by the time to complete the training session (joules of work per second). Data were also collected during the interset rest periods (heart rate [HR], respiratory rate [RR], and volume of oxygen consumed) and were used to explain why one rest strategy may positively impact work rate compared with another. Statistical analyses revealed significant differences (p ≤ 0.05) between the passive and active rest strategies, with the passive strategies allowing for improved work rate (supine = 62.77 ± 7.32, seated = 63.66 ± 8.37, and walking = 60.61 ± 6.42 average joules of work per second). Results also suggest that the passive strategies resulted in superior HR, RR, and oxygen consumption recovery. In conclusion, work rate and physiological recovery were enhanced when supine and seated interset rest strategies were used compared with walking interset rest.

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

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Khanintipparat Prommaraj

2017-09-01

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

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

Science.gov (United States)

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

2016-01-01

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

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

Science.gov (United States)

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

2017-05-01

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

Cost reducing code implementation strategies

International Nuclear Information System (INIS)

Kurtz, Randall L.; Griswold, Michael E.; Jones, Gary C.; Daley, Thomas J.

1995-01-01

Sargent and Lundy's Code consulting experience reveals a wide variety of approaches toward implementing the requirements of various nuclear Codes Standards. This paper will describe various Code implementation strategies which assure that Code requirements are fully met in a practical and cost-effective manner. Applications to be discussed includes the following: new construction; repair, replacement and modifications; assessments and life extensions. Lessons learned and illustrative examples will be included. Preferred strategies and specific recommendations will also be addressed. Sargent and Lundy appreciates the opportunity provided by the Korea Atomic Industrial Forum and Korean Nuclear Society to share our ideas and enhance global cooperation through the exchange of information and views on relevant topics

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

DEFF Research Database (Denmark)

Thapa, Subash; Hannes, Karin; Cargo, Margaret

2015-01-01

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

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

OpenAIRE

Buško, Vesna; Mujagić, Amela

2013-01-01

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

Provoking "Eureka" moments for effective infection control strategies.

Science.gov (United States)

Pittet, Didier

2014-01-01

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

Social Justice Activism: Feminism and Strategies for Action

Science.gov (United States)

Fernflores, Rachel

2016-01-01

Success in social justice activism often hinges on judging when to employ the most effective strategy for action. Strategies for action include militancy, peaceful protest, and sometimes, engaging in a longer term program of "marginal gains." The militant feminism of many 19th century suffragettes, such as Emmeline Pankhurst, is a good…

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

Science.gov (United States)

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

2018-04-01

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

Relativistic effects in local inertial frames including parametrized-post-Newtonian effects

International Nuclear Information System (INIS)

Shahid-Saless, B.; Ashby, N.

1988-01-01

We use the concept of a generalized Fermi frame to describe relativistic effects, due to local and distant sources of gravitation, on a body placed in a local inertial frame of reference. In particular we have considered a model of two spherically symmetric gravitating point sources, moving in circular orbits around a common barycenter where one of the bodies is chosen to be the local and the other the distant one. This has been done using the slow-motion, weak-field approximation and including four of the parametrized-post-Newtonian (PPN) parameters. The position of the classical center of mass must be modified when the PPN parameter zeta 2 is included. We show that the main relativistic effect on a local satellite is described by the Schwarzschild field of the local body and the nonlinear term corresponding to the self-interaction of the local source with itself. There are also much smaller terms that are proportional, respectively, to the product of the potentials of local and distant bodies and to the distant body's self-interactions. The spatial axes of the local frame undergo geodetic precession. In addition we have an acceleration of the order of 10/sup -11/ cm sec -2 that vanish in the case of general relativity, which is discussed in detail

Cost-Effectiveness of Including a Nurse Specialist in the Treatment of Urinary Incontinence in Primary Care in the Netherlands.

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K M Holtzer-Goor

Full Text Available Incontinence is an important health problem. Effectively treating incontinence could lead to important health gains in patients and caregivers. Management of incontinence is currently suboptimal, especially in elderly patients. To optimise the provision of incontinence care a global optimum continence service specification (OCSS was developed. The current study evaluates the costs and effects of implementing this OCSS for community-dwelling patients older than 65 years with four or more chronic diseases in the Netherlands.A decision analytic model was developed comparing the current care pathway for urinary incontinence in the Netherlands with the pathway as described in the OCSS. The new care strategy was operationalised as the appointment of a continence nurse specialist (NS located with the general practitioner (GP. This was assumed to increase case detection and to include initial assessment and treatment by the NS. The analysis used a societal perspective, including medical costs, containment products (out-of-pocket and paid by insurer, home care, informal care, and implementation costs.With the new care strategy a QALY gain of 0.005 per patient is achieved while saving €402 per patient over a 3 year period from a societal perspective. In interpreting these findings it is important to realise that many patients are undetected, even in the new care situation (36%, or receive care for containment only. In both of these groups no health gains were achieved.Implementing the OCSS in the Netherlands by locating a NS in the GP practice is likely to reduce incontinence, improve quality of life, and reduce costs. Furthermore, the study also highlighted that various areas of the continence care process lack data, which would be valuable to collect through the introduction of the NS in a study setting.

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

Science.gov (United States)

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

2017-08-01

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

Learning to modulate one's own brain activity: The effect of spontaneous mental strategies

Directory of Open Access Journals (Sweden)

Silvia Erika Kober

2013-10-01

Full Text Available Using neurofeedback (NF, individuals can learn to modulate their own brain activity, in most cases electroencephalographic (EEG rhythms. Although a large body of literature reports positive effects of NF training on behavior and cognitive functions, there are hardly any reports on how participants can successfully learn to gain control over their own brain activity. About one third of people fail to gain significant control over their brain signals even after repeated training sessions. The reasons for this failure are still largely unknown. In this context, we investigated the effects of spontaneous mental strategies on NF performance. Twenty healthy participants performed either a SMR (sensorimotor rhythm, 12-15 Hz based or a Gamma (40-43 Hz based NF training over ten sessions. After the first and the last training session, they were asked to write down which mental strategy they have used for self-regulating their EEG. After the first session, all participants reported the use of various types of mental strategies such as visual strategies, concentration, or relaxation. After the last NF training session, four participants of the SMR group reported to employ no specific strategy. These four participants showed linear improvements in NF performance over the ten training sessions. In contrast, participants still reporting the use of specific mental strategies in the last NF session showed no changes in SMR based NF performance over the ten sessions. This effect could not be observed in the Gamma group. The Gamma group showed no prominent changes in Gamma power over the NF training sessions, regardless of the mental strategies used. These results indicate that successful SMR based NF performance is associated with implicit learning mechanisms. Participants stating vivid reports on strategies to control their SMR probably overload cognitive resources, which might be counterproductive in terms of increasing SMR power.

Relative effectiveness of context-based teaching strategy on senior ...

African Journals Online (AJOL)

This study adopted the quasi experimental research design to examine the relative effectiveness of context-based teaching strategy on senior secondary school students' achievements in inorganic chemistry. The sample consists of 451 SSII chemistry students (224 males and 227 females) drawn from four out of 46 ...

Assessment of the effectiveness of participatory developed adaptation strategies for HCMC

Science.gov (United States)

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

2014-01-01

Coastal cities are vulnerable to flooding, and flood risk to coastal cities will increase due to sea-level rise. Moreover, especially Asian cities are subject to considerable population growth and associated urban developments, increasing this risk even more. Empirical data on vulnerability and the cost and benefits of flood risk reducing measures are therefore paramount for sustainable development of these cities. This paper presents an approach to explore the impacts of sea level rise and socio-economic developments on flood risk for the flood prone District 4 in Ho Chi Minh City, Vietnam, and to develop and evaluate the effects of different adaptation strategies (new levees, dry- and wet flood proofing of buildings). A flood damage model was developed to simulate current and future flood risk using the results from a household survey to establish stage-damage curves for residential buildings. the model has been used to assess the effects of several participatory developed adaptation strategies to reduce flood risk, expressed in Expected Annual Damage (EAD). Adaptation strategies were evaluated assuming combinations of both sea level scenarios and land use scenarios. Together with information on costs of these strategies, we calculated the benefit-cost ratio and net present value for the adaptation strategies until 2100, taking into account depreciation rates of 2.5% and 5%. The results of this modeling study indicate that the current flood risk in District 4 is 0.31 million USD yr-1, increasing up to 0.78 million USD yr-1 in 2100. The net present value and benefit-cost ratios using a discount rate of 5% range from USD -107 to -1.5 million, and from 0.086 to 0.796 for the different strategies. Using a discount rate of 2.5% leads to an increase in both net present value and benefit cost ratio. The adaptation strategies wet proofing and dry proofing generate the best results using these economic indicators. The information on different strategies will be used by

Effective home-school partnership: Some strategies to help strengthen parental involvement

Directory of Open Access Journals (Sweden)

Chinedu I Okeke

2014-03-01

Full Text Available The primary aim of the study from which this paper derives was to investigate the level of parental involvement in the schooling of their children. The study employed a descriptive case study research design. All data were based on unstructured interviews with the 30 parents whose children attended one of the primary schools located in the London area of England, United Kingdom. The results of the study showed that parents care about their children's education, and want to get involved. However, results also showed that most parents do not always know how to get involved, and some are even intimidated by the operational structures within the school. The study concludes that to effectively involve parents in the affairs of the school, as well as in their children's education, certain strategies must be popularised within the school. It is recommended that parents be made aware of the strategies for their involvement in children's education if such strategies are to be effective.

The Effect of Latitudinal Variation on Shrimp Reproductive Strategies.

Science.gov (United States)

van de Kerk, Madelon; Jones Littles, Chanda; Saucedo, Omar; Lorenzen, Kai

2016-01-01

Reproductive strategies comprise the timing and frequency of reproductive events and the number of offspring per reproductive event, depending on factors such as climate conditions. Therefore, species that exhibit plasticity in the allocation of reproductive effort can alter their behavior in response to climate change. Studying how the reproductive strategy of species varies along the latitudinal gradient can help us understand and predict how they will respond to climate change. We investigated the effects of the temporal allocation of reproductive effort on the population size of brown shrimp (Farfantepenaeus aztecus) along a latitudinal gradient. Multiple shrimp species exhibit variation in their reproductive strategies, and given the economic importance of brown shrimp to the commercial fishing sector of the Unites States, changes in the timing of their reproduction could have significant economic and social consequences. We used a stage-based, density-dependent matrix population model tailored to the life history of brown shrimp. Shrimp growth rates and environmental carrying capacity were varied based on the seasonal climate conditions at different latitudes, and we estimated the population size at equilibrium. The length of the growing season increased with decreasing latitude and the reproductive strategy leading to the highest population size changed from one annual birth pulse with high reproductive output to continuous low-output reproduction. Hence, our model confirms the classical paradigm of continuous reproduction at low latitudes, with increased seasonality of the breeding period towards the poles. Our results also demonstrate the potential for variation in climate to affect the optimal reproductive strategy for achieving maximum population sizes. Certainly, understanding these dynamics may inform more comprehensive management strategies for commercially important species like brown shrimp.

The Effect of Latitudinal Variation on Shrimp Reproductive Strategies.

Directory of Open Access Journals (Sweden)

Madelon van de Kerk

Full Text Available Reproductive strategies comprise the timing and frequency of reproductive events and the number of offspring per reproductive event, depending on factors such as climate conditions. Therefore, species that exhibit plasticity in the allocation of reproductive effort can alter their behavior in response to climate change. Studying how the reproductive strategy of species varies along the latitudinal gradient can help us understand and predict how they will respond to climate change. We investigated the effects of the temporal allocation of reproductive effort on the population size of brown shrimp (Farfantepenaeus aztecus along a latitudinal gradient. Multiple shrimp species exhibit variation in their reproductive strategies, and given the economic importance of brown shrimp to the commercial fishing sector of the Unites States, changes in the timing of their reproduction could have significant economic and social consequences. We used a stage-based, density-dependent matrix population model tailored to the life history of brown shrimp. Shrimp growth rates and environmental carrying capacity were varied based on the seasonal climate conditions at different latitudes, and we estimated the population size at equilibrium. The length of the growing season increased with decreasing latitude and the reproductive strategy leading to the highest population size changed from one annual birth pulse with high reproductive output to continuous low-output reproduction. Hence, our model confirms the classical paradigm of continuous reproduction at low latitudes, with increased seasonality of the breeding period towards the poles. Our results also demonstrate the potential for variation in climate to affect the optimal reproductive strategy for achieving maximum population sizes. Certainly, understanding these dynamics may inform more comprehensive management strategies for commercially important species like brown shrimp.

Time management strategies for research productivity.

Science.gov (United States)

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

2013-02-01

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

Active Figure Control Effects on Mounting Strategy for X-Ray Optics

Science.gov (United States)

Kolodziejczak, Jeffery J.; Atkins, Carolyn; Roche, Jacqueline M.; ODell, Stephen L.; Ramsey, Brian D.; Elsner, Ronald F.; Weisskopf, Martin C.; Gubarev, Mikhail V.

2014-01-01

As part of ongoing development efforts at MSFC, we have begun to investigate mounting strategies for highly nested xray optics in both full-shell and segmented configurations. The analytical infrastructure for this effort also lends itself to investigation of active strategies. We expect that a consequence of active figure control on relatively thin substrates is that errors are propagated to the edges, where they might affect the effective precision of the mounting points. Based upon modeling, we describe parametrically, the conditions under which active mounts are preferred over fixed ones, and the effect of active figure corrections on the required number, locations, and kinematic characteristics of mounting points.

Strategies for maximizing clinical effectiveness in the treatment of schizophrenia.

Science.gov (United States)

Tandon, Rajiv; Targum, Steven D; Nasrallah, Henry A; Ross, Ruth

2006-11-01

The ultimate clinical objective in the treatment of schizophrenia is to enable affected individuals to lead maximally productive and personally meaningful lives. As with other chronic diseases that lack a definitive cure, the individual's service/recovery plan must include treatment interventions directed towards decreasing manifestations of the illness, rehabilitative services directed towards enhancing adaptive skills, and social support mobilization aimed at optimizing function and quality of life. In this review, we provide a conceptual framework for considering approaches for maximizing the effectiveness of the array of treatments and other services towards promoting recovery of persons with schizophrenia. We discuss pharmacological, psychological, and social strategies that decrease the burden of the disease of schizophrenia on affected individuals and their families while adding the least possible burden of treatment. In view of the multitude of treatments necessary to optimize outcomes for individuals with schizophrenia, effective coordination of these services is essential. In addition to providing best possible clinical assessment and pharmacological treatment, the psychiatrist must function as an effective leader of the treatment team. To do so, however, the psychiatrist must be knowledgeable about the range of available services, must have skills in clinical-administrative leadership, and must accept the responsibility of coordinating the planning and delivery of this multidimensional array of treatments and services. Finally, the effectiveness of providing optimal individualized treatment/rehabilitation is best gauged by measuring progress on multiple effectiveness domains. Approaches for efficient and reliable assessment are discussed.

Can GWOT Primary Prevention Strategy More Effectively Impede Religious Extremism?

National Research Council Canada - National Science Library

Meyers, Michael A

2007-01-01

.... This concept, when related to the Global War on Terrorism (GWOT) in the Middle East, provides insights on the current strategy's effort and effectiveness in staying ahead of religious extremism expansion. Current U.S...

Cost-effectiveness of treatment strategies for BRAF-mutated metastatic melanoma.

Directory of Open Access Journals (Sweden)

Patti Curl

Full Text Available Genetically-targeted therapies are both promising and costly advances in the field of oncology. Several treatments for metastatic melanoma with a mutation in the BRAF gene have been approved. They extend life but are more expensive than the previous standard of care (dacarbazine. Vemurafenib, the first drug in this class, costs $13,000 per month ($207,000 for a patient with median survival. Patients failing vemurafenib are often given ipilimumab, an immunomodulator, at $150,000 per course. Assessment of cost-effectiveness is a valuable tool to help navigate the transition toward targeted cancer therapy.We performed a cost-utility analysis to compare three strategies for patients with BRAF+ metastatic melanoma using a deterministic expected-value decision tree model to calculate the present value of lifetime costs and quality-adjusted life years (QALYs for each strategy. We performed sensitivity analyses on all variables.In the base case, the incremental cost-effectiveness ratio (ICER for vemurafenib compared with dacarbazine was $353,993 per QALY gained (0.42 QALYs added, $156,831 added. The ICER for vemurafenib followed by ipilimumab compared with vemurafenib alone was $158,139. In sensitivity analysis, treatment cost had the largest influence on results: the ICER for vemurafenib versus dacarbazine dropped to $100,000 per QALY gained with a treatment cost of $3600 per month.The cost per QALY gained for treatment of BRAF+ metastatic melanoma with vemurafenib alone or in combination exceeds widely-cited thresholds for cost-effectiveness. These strategies may become cost-effective with lower drug prices or confirmation of a durable response without continued treatment.

Multinational Corporate Strategy-making

DEFF Research Database (Denmark)

Andersen, Torben Juul; Andersson, Ulf

2017-01-01

from corporate headquarters. The model considers local subsidiary actions of both operational and strategic nature and we argue that it may be futile to distinguish between these effects as incremental operational responses can cumulate into more substantial changes over time with dimensions...... the complementary effects of central planning and decentralized decision-making. We present and synthesize these rather field specific perspectives and try to synthesize insights from both fields in an adaptive strategy-making model including the effects of autonomous subsidiary initiatives and intended mandates...

Investigating effectiveness of clandestine advertisement and organizational strategy in brand management

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M. R. Shojaei

2014-12-01

Full Text Available This investigation tries to examine correlation between clandestine advertisement and organizational strategy in brand management via available sources and by using a field study. In fact, it intends to raise the question “Are clandestine advertisement and organizational strategy effective in management of products brands?” This is an applied and descriptive-approaching study. The study chooses a sample of 171 regular customers who do their day-to-day banking business activities through an Iranian bank named Sepah bank in city of Tehran, Iran. Using structural equation modeling, the study confirms a positive and meaningful relationship between clandestine advertisement and organizational strategy in brand management.

Effects of Direct and Indirect Instructional Strategies on Students ...

African Journals Online (AJOL)

This is a quasi experimental research designed to determine the effects of Direct and Indirect instructional strategies on Mathematics achievement among junior secondary school students. The population consisted of students in a Public Secondary School in Owerri, Imo State. A sample of 102 students from two (2) intact ...

Prevention strategies for herpes zoster and post-herpetic neuralgia

Science.gov (United States)

Levin, Myron J.; Gershon, Anne A.; Dworkin, Robert H.; Brisson, Marc; Stanberry, Lawrence

2017-01-01

SUMMARY Impairment of varicella zoster virus (VZV)-specific cell-mediated immunity, including impairment due to immunosenescence, is associated with an increased risk of developing herpes zoster (HZ), whereas levels of anti-VZV antibodies do not correlate with HZ risk. This crucial role of VZV-specific cell-mediated immunity suggests that boosting these responses by vaccination will be an effective strategy for reducing the burden of HZ. Other strategies focus on preventing the major complication of HZ – post-herpetic neuralgia. These strategies include pre-emptive treatment with drugs such as tricyclic antidepressants, anticonvulsants and analgesics. PMID:20510262

The Effect of Compliance-Gaining Strategy Choice and Communicator Style on Sales Success.

Science.gov (United States)

Parrish-Sprowl, John; And Others

1994-01-01

Explores the relationship among compliance-gaining strategy choice, communicator image, and sales person effectiveness. Finds no statistically significant relationship between the use of compliance-gaining strategies and sales success, but indicates a link between communicator image and sales success. (SR)

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

NARCIS (Netherlands)

S.E. Beyer (Sebastian E.); M.G.M. Hunink (Myriam); F. Schöberl (Florian); L. von Baumgarten; S.E. Petersen (Steffen); C. Kubisch (Christian); H. Janssen (Hendrik); B. Ertl-Wagner (Birgit); M.F. Reiser (Maximilian F.); W.H. Sommer (Wieland H.)

2015-01-01

textabstractBackground and Purpose-This study evaluated the cost-effectiveness of different noninvasive imaging strategies in patients with possible basilar artery occlusion. Methods-A Markov decision analytic model was used to evaluate long-term outcomes resulting from strategies using computed

The Effects of the Beatrice-Conagra Merger on Brand-level Marketing Strategies

OpenAIRE

Haller, Lawrence E.

1995-01-01

This paper uses graphical and statistical techniques to examine the effects of the acquisition of the Beatrice Foods Company by ConAgra, Inc. on brand-level marketing strategies. While some instances of postmerger brand harvesting were found, we did not find evidence that there was any systematic or widespread practice of a harvesting strategy.

Effects of Strategy Instruction in an EFL Reading Comprehension Course: A Case Study

Directory of Open Access Journals (Sweden)

Sergio Lopera Medina

2012-01-01

Full Text Available Strategy instruction is useful in teaching contexts. This paper examines the effects of strategy instruction in an EFL reading comprehension course carried out with 26 undergraduate students at a Colombian university. As a research method, a case study was implemented. There were three instruments with which to collect data: reading comprehension tests, teacher's field notes and self-reflection in class at the strategy instruction phase, and a learning perception questionnaire. Given that students improved in reading comprehension, it would seem that reading strategy instruction is indeed very useful. Also, it was noted that when students applied reading strategies, they became more self-confident and this in turn enhanced their motivation. Finally, when students applied the reading strategy approach, the use of dictionaries decreased considerably.

Comparing effectiveness of top-down and bottom-up strategies in containing influenza.

Directory of Open Access Journals (Sweden)

Achla Marathe

Full Text Available This research compares the performance of bottom-up, self-motivated behavioral interventions with top-down interventions targeted at controlling an "Influenza-like-illness". Both types of interventions use a variant of the ring strategy. In the first case, when the fraction of a person's direct contacts who are diagnosed exceeds a threshold, that person decides to seek prophylaxis, e.g. vaccine or antivirals; in the second case, we consider two intervention protocols, denoted Block and School: when a fraction of people who are diagnosed in a Census Block (resp., School exceeds the threshold, prophylax the entire Block (resp., School. Results show that the bottom-up strategy outperforms the top-down strategies under our parameter settings. Even in situations where the Block strategy reduces the overall attack rate well, it incurs a much higher cost. These findings lend credence to the notion that if people used antivirals effectively, making them available quickly on demand to private citizens could be a very effective way to control an outbreak.

Coal and the greenhouse effect: strategies for the future

Energy Technology Data Exchange (ETDEWEB)

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

1991-07-01

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

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

Science.gov (United States)

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

2017-03-06

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

[The new German prevention act: an effective strategy?].

Science.gov (United States)

Garlichs, Dietrich

2015-10-01

The new German prevention act attempts to deal with the influx of obesity and chronic diseases by educating and informing. It seeks to change individual behaviour and supress lifestyle-related risk factors. In the past, however this behavioural prevention strategy has proved ineffective. A structural prevention strategy, as requested by the WHO, should additionally be put into effect with measures that reach all walks of life, not just the health-conscious people in society. It proposes the following: · At least one hour of daily physical activity or sport at school and kindergarten. · A differential food tax that makes unhealthy foods more expensive and healthy foods cheaper (taxing sugary / fatty foods). · Mandatory quality standards for kindergarten and school meals. · Banning food advertising targeted at children. © Georg Thieme Verlag KG Stuttgart · New York.

Hemodialysis: stressors and coping strategies.

Science.gov (United States)

Ahmad, Muayyad M; Al Nazly, Eman K

2015-01-01

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

Bringing Value-Based Perspectives to Care: Including Patient and Family Members in Decision-Making Processes.

Science.gov (United States)

Kohler, Graeme; Sampalli, Tara; Ryer, Ashley; Porter, Judy; Wood, Les; Bedford, Lisa; Higgins-Bowser, Irene; Edwards, Lynn; Christian, Erin; Dunn, Susan; Gibson, Rick; Ryan Carson, Shannon; Vallis, Michael; Zed, Joanna; Tugwell, Barna; Van Zoost, Colin; Canfield, Carolyn; Rivoire, Eleanor

2017-03-06

Recent evidence shows that patient engagement is an important strategy in achieving a high performing healthcare system. While there is considerable evidence of implementation initiatives in direct care context, there is limited investigation of implementation initiatives in decision-making context as it relates to program planning, service delivery and developing policies. Research has also shown a gap in consistent application of system-level strategies that can effectively translate organizational policies around patient and family engagement into practice. The broad objective of this initiative was to develop a system-level implementation strategy to include patient and family advisors (PFAs) at decision-making points in primary healthcare (PHC) based on wellestablished evidence and literature. In this opportunity sponsored by the Canadian Foundation for Healthcare Improvement (CFHI) a co-design methodology, also well-established was applied in identifying and developing a suitable implementation strategy to engage PFAs as members of quality teams in PHC. Diabetes management centres (DMCs) was selected as the pilot site to develop the strategy. Key steps in the process included review of evidence, review of the current state in PHC through engagement of key stakeholders and a co-design approach. The project team included a diverse representation of members from the PHC system including patient advisors, DMC team members, system leads, providers, Public Engagement team members and CFHI improvement coaches. Key outcomes of this 18-month long initiative included development of a working definition of patient and family engagement, development of a Patient and Family Engagement Resource Guide and evaluation of the resource guide. This novel initiative provided us an opportunity to develop a supportive system-wide implementation plan and a strategy to include PFAs in decision-making processes in PHC. The well-established co-design methodology further allowed us to

[Effective communication strategies to frame the trainer-trainee dialogue in the clinical setting].

Science.gov (United States)

Gachoud, D; Félix, S; Monti, M

2015-11-04

Communication between trainer and trainee plays a central role in teaching and learning in the clinical environment. There are various strategies to frame the dialogue between trainee and trainer. These strategies allow trainers to be more effective in their supervision, which is important in our busy clinical environment. Communication strategies are well adapted to both in- and out-patient settings, to both under- and postgraduate contexts. This article presents three strategies that we think are particularly useful. They are meant to give feedback, to ask questions and to present a case.

Effect of "owners" selection strategies on autumn weight in reindeer (Rangifer t. tarandus calves

Directory of Open Access Journals (Sweden)

Robert B. Weladji

2002-03-01

Full Text Available Many northern indigenous peoples, including the Sami are dependent on reindeer herding for their livelihood. In view of the socio-cultural and economical importance of reindeer herding, emphasis should be put on appropriate herd structure and selection strategies that maximise marketable products, such as meat (the primary marketable product nowadays. Empirical observations reveal that within a herd, some owners seem to have better productivity in term of carcass autumn weight of calves, than others. We hypothesized that there may be an "owner" effect in reindeer herding, i.e. some owners may be applying particular selection strategies that might be beneficial. We investigated this in three reindeer grazing districts in South Norway, using mixed linear models. We found that autumn carcass weight of calves varied significantly with year and "owner" within herd in all three districts. Consistently some particular owners within a herd had higher average autumn carcass weight of their calves than others. We attributed this difference to "individual selection strategies", meaning that some owners may follow more accurately the sex, age and weight-based recommended strategy and in addition, they may make superior choices when selecting animals for slaughtering. We conclude that individual owners have the capability, through appropriate selection decisions to improve the average annual autumn weight of their reindeer calves. This might be an important aspect of "Traditional Ecological Knowledge", in addition to the recommended modern sex, age and weight-based selection criteria.

Behavioral side effects of pediatric acute lymphoblastic leukemia treatment: the role of parenting strategies.

Science.gov (United States)

Williams, Lauren K; Lamb, Karen E; McCarthy, Maria C

2014-11-01

Behavioral and emotional difficulties are a recognised side effect of childhood acute lymphoblastic leukemia (ALL) treatment. Modifiable factors, such as parenting strategies, may be an appropriate target for interventions to assist families with managing their child's behavior, potentially leading to improved psychosocial and clinical outcomes. This study examined whether parenting strategies are associated with child behavioral and emotional problems in a pediatric oncology context, with the aim of establishing whether parenting is a potential modifiable target for psychosocial intervention. Participants included 73 parents of children aged 2-6 years who were either (i) in the maintenance phase of treatment for ALL at the Royal Children's Hospital Children's Cancer Centre, Melbourne (N = 43), or (ii) had no major medical history (healthy control group) (N = 30). Participants completed psychometrically validated questionnaires that assessed parenting strategies and child emotional and behavioral problems. Results revealed that the ALL group parents reported higher lax parenting and more spoiling and bribing of their child than the healthy control group. Results from regression models indicated that, after controlling for the significant contribution of illness status and child age on child emotional and behavioral difficulties, parental laxness and parental overprotection were significantly associated with child emotional and behavioral difficulties. Supporting parents to minimise sub-optimal parenting strategies, particularly lax parenting, may offer a fruitful avenue for future research directed toward modifiable factors associated with managing child emotional and behavioral problems in a pediatric oncology context. © 2014 Wiley Periodicals, Inc.

[Cost-effectiveness and cost-benefit analysis on the integrated schistosomiasis control strategies with emphasis on infection source in Poyang Lake region].

Science.gov (United States)

Lin, Dan-Dan; Zeng, Xiao-Jun; Chen, Hong-Gen; Hong, Xian-Lin; Tao, Bo; Li, Yi-Feng; Xiong, Ji-Jie; Zhou, Xiao-Nong

2009-08-01

To evaluate the cost-effectiveness and cost-benefit on the integrated schistosomiasis control strategies with emphasis on infection source, and provide scientific basis for the improvement of schistosomiasis control strategy. Aiguo and Xinhe villages in Jinxian County were selected as intervention group where the new comprehensive strategy was implemented, while Ximiao and Zuxi villages in Xinzi County served as control where routine control program was implemented. New strategy of interventions included removing cattle from snail-infested grasslands and providing farmers with farm machinery, improving sanitation by supplying tap water and building lavatories and methane gas tanks, and implementing an intensive health education program. Routine interventions were carried out in the control villages including diagnosis and treatment for human and cattle, health education, and focal mollusciciding. Data were collected from retrospective investigation and field survey for the analysis and comparison of cost-effectiveness and cost-benefit between intervention and control groups. The control effect of the intervention group was better than that of the control. The cost for 1% decrease of infection rate per 100 people, 100 cattle, and 100 snails in intervention group was 480.01, 6 851.24, and 683.63 Yuan, respectively, which were about 2.70, 4.37 and 20.25 times as those in the control respectively. The total cost/benefit ratio (BCR) was lower than 1 (0.94 in intervention group and 0.08 in the control). But the total benefit of intervention group was higher than that of the control from 2005 to 2008. The forecasting analysis indicated that the total BCR in intervention group would be 1.13 at the 4th year and all cost could be recalled. Sensitivity analysis revealed that the BCR in intervention group changed in the range around 1.0 and that of the control ranged blow 0.5. The cost-benefit of intervention group was evidently higher than that of the control. The integrated

Strategies for effective collaborative manuscript development in interdisciplinary science teams

Science.gov (United States)

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

2018-01-01

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

The effect of a total rewards strategy on school teachers’ retention

OpenAIRE

Boitomelo Makhuzeni; E. Nicolene Barkhuizen

2015-01-01

Orientation: South African schools are facing significant challenges to retain a talented pool of school teachers. A total rewards strategy could assist schools to reduce teacher turnover. Research purpose: The aim of this study was to determine the effect of a total rewards strategy on the turnover intentions of school teachers in the North-West province. Motivation: The under supply of quality teachers has negative consequences for both school pupils and the larger community. Re...

Geographic assistance of decontamination strategy elaboration

International Nuclear Information System (INIS)

Davydchuk, V.; Arapis, G.

1996-01-01

Those who elaborates the strategy of decontamination of vast territories is to take into consideration the heterogeneity of such elements of landscape as relief, lithology, humidity and types of soils and, vegetation, both on local and regional level. Geographic assistance includes evaluation of efficacy of decontamination technologies in different natural conditions, identification of areas of their effective application and definition of ecological damage, estimation of balances of the radionuclides in the landscapes to create background of the decontamination strategy

Effectiveness of a multi-level implementation strategy for ASD interventions: study protocol for two linked cluster randomized trials.

Science.gov (United States)

Brookman-Frazee, Lauren; Stahmer, Aubyn C

2018-05-09

The Centers for Disease Control (2018) estimates that 1 in 59 children has autism spectrum disorder, and the annual cost of ASD in the U.S. is estimated to be $236 billion. Evidence-based interventions have been developed and demonstrate effectiveness in improving child outcomes. However, research on generalizable methods to scale up these practices in the multiple service systems caring for these children has been limited and is critical to meet this growing public health need. This project includes two, coordinated studies testing the effectiveness of the Translating Evidence-based Interventions (EBI) for ASD: Multi-Level Implementation Strategy (TEAMS) model. TEAMS focuses on improving implementation leadership, organizational climate, and provider attitudes and motivation in order to improve two key implementation outcomes-provider training completion and intervention fidelity and subsequent child outcomes. The TEAMS Leadership Institute applies implementation leadership strategies and TEAMS Individualized Provider Strategies for training applies motivational interviewing strategies to facilitate provider and organizational behavior change. A cluster randomized implementation/effectiveness Hybrid, type 3, trial with a dismantling design will be used to understand the effectiveness of TEAMS and the mechanisms of change across settings and participants. Study #1 will test the TEAMS model with AIM HI (An Individualized Mental Health Intervention for ASD) in publicly funded mental health services. Study #2 will test TEAMS with CPRT (Classroom Pivotal Response Teaching) in education settings. Thirty-seven mental health programs and 37 school districts will be randomized, stratified by county and study, to one of four groups (Standard Provider Training Only, Standard Provider Training + Leader Training, Enhanced Provider Training, Enhanced Provider Training + Leader Training) to test the effectiveness of combining standard, EBI-specific training with the two TEAMS

The effects of emotion regulation on explicit memory depend on strategy and testing method.

Science.gov (United States)

Knight, Marisa; Ponzio, Allison

2013-12-01

Although previous work has shown that emotion regulation strategies can influence memory, the mechanisms through which different strategies produce different memory outcomes are not well understood. We examined how two cognitive reappraisal strategies with similar elaboration demands but diverging effects on visual attention and emotional arousal influenced explicit memory for emotional stimuli and for the strategies used to evaluate the stimuli. At encoding, participants used reappraisal to increase and decrease the personal relevance of neutral and emotional pictures. In two experiments, recall accuracy was highest for emotional pictures featured on increase trials, intermediate for emotional pictures featured on look (respond naturally) trials, and lowest for emotional pictures featured on decrease trials. This recall pattern emerged after a short delay (15 min) and persisted over a longer delay (48 hr). Memory accuracy for the strategies used to evaluate the pictures showed a different pattern: Strategy memory was better for emotional pictures featured on decrease and increase trials than for pictures featured on look trials. Our findings show that the effects of emotion regulation on memory depend both on the particular strategy engaged and the particular aspect of memory being tested.

Human capital strategy: talent management.

Science.gov (United States)

Nagra, Michael

2011-01-01

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

Dissociating the effects of semantic grouping and rehearsal strategies on event-related brain potentials.

Science.gov (United States)

Schleepen, T M J; Markus, C R; Jonkman, L M

2014-12-01

The application of elaborative encoding strategies during learning, such as grouping items on similar semantic categories, increases the likelihood of later recall. Previous studies have suggested that stimuli that encourage semantic grouping strategies had modulating effects on specific ERP components. However, these studies did not differentiate between ERP activation patterns evoked by elaborative working memory strategies like semantic grouping and more simple strategies like rote rehearsal. Identification of neurocognitive correlates underlying successful use of elaborative strategies is important to understand better why certain populations, like children or elderly people, have problems applying such strategies. To compare ERP activation during the application of elaborative versus more simple strategies subjects had to encode either four semantically related or unrelated pictures by respectively applying a semantic category grouping or a simple rehearsal strategy. Another goal was to investigate if maintenance of semantically grouped vs. ungrouped pictures modulated ERP-slow waves differently. At the behavioral level there was only a semantic grouping benefit in terms of faster responding on correct rejections (i.e. when the memory probe stimulus was not part of the memory set). At the neural level, during encoding semantic grouping only had a modest specific modulatory effect on a fronto-central Late Positive Component (LPC), emerging around 650 ms. Other ERP components (i.e. P200, N400 and a second Late Positive Component) that had been earlier related to semantic grouping encoding processes now showed stronger modulation by rehearsal than by semantic grouping. During maintenance semantic grouping had specific modulatory effects on left and right frontal slow wave activity. These results stress the importance of careful control of strategy use when investigating the neural correlates of elaborative encoding. Copyright © 2014 Elsevier B.V. All rights

Combination strategies for pandemic influenza response - a systematic review of mathematical modeling studies

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Lee Vernon J

2009-12-01

Full Text Available Abstract Background Individual strategies in pandemic preparedness plans may not reduce the impact of an influenza pandemic. Methods We searched modeling publications through PubMed and associated references from 1990 to 30 September 2009. Inclusion criteria were modeling papers quantifying the effectiveness of combination strategies, both pharmaceutical and non-pharmaceutical. Results Nineteen modeling papers on combination strategies were selected. Four studies examined combination strategies on a global scale, 14 on single countries, and one on a small community. Stochastic individual-based modeling was used in nine studies, stochastic meta-population modeling in five, and deterministic compartmental modeling in another five. As part of combination strategies, vaccination was explored in eight studies, antiviral prophylaxis and/or treatment in 16, area or household quarantine in eight, case isolation in six, social distancing measures in 10 and air travel restriction in six studies. Two studies suggested a high probability of successful influenza epicenter containment with combination strategies under favorable conditions. During a pandemic, combination strategies delayed spread, reduced overall number of cases, and delayed and reduced peak attack rate more than individual strategies. Combination strategies remained effective at high reproductive numbers compared with single strategy. Global cooperative strategies, including redistribution of antiviral drugs, were effective in reducing the global impact and attack rates of pandemic influenza. Conclusion Combination strategies increase the effectiveness of individual strategies. They include pharmaceutical (antiviral agents, antibiotics and vaccines and non-pharmaceutical interventions (case isolation, quarantine, personal hygiene measures, social distancing and travel restriction. Local epidemiological and modeling studies are needed to validate efficacy and feasibility.

The effect of acquisition moves on income, pre-tax profits and future strategy of logistics firms

Directory of Open Access Journals (Sweden)

Judit Oláh

2017-12-01

Full Text Available Our research deals with a comprehensive study of the management success factors of logistics service providers using a new approach, and examines the life of logistics service companies. The data were collected from 51 logistics service providers in Hungary. We searched for the proper enterprise scale – acquisitions – strategies (including the method of looking for the economies of scale in the LSP segment to be examined, and the role of strategy choice. Our research has found that among logistics companies those firms which followed the growth pattern has significantly higher sales revenue than the companies growing organically. Additionally, logistics companies – considering their pre-tax profits - work more efficiently when they have a growth strategy (regardless of its time lag. However, this claim is true only for those companies that did not have any (revenue growth over the previous period. The results of our research can effectively help logistics service providers find their business success factors, which will enable them fulfil the expectations of their customers in the supply chain better.

Hierarchical Control Strategy of Heat and Power for Zero Energy Buildings including Hybrid Fuel Cell/Photovoltaic Power Sources and Plug-in Electric Vehicle

DEFF Research Database (Denmark)

Ghiasi, Mohammad Iman; Aliakbar Golkar, Masoud; Hajizadeh, Amin

2016-01-01

to demonstrate the effectiveness and capability of the proposed control strategy during different operating conditions in the utility grid. Finally, the performance of the proposed controller is verified using hardware-in-the-loop (HIL) real-time simulations carried out in OPAL-RT technologies for a real...

Mode shift strategies in intercity transportation and their effect on energy consumption

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Sokolsky, S.

1975-01-01

Policies are examined which, if implemented, could lead to significant energy savings in intercity travel in the northeast corridor arena, without restricting the traveler's freedom of mode choice. The effects on arena energy consumption of introducing new, more energy-efficient aircraft are investigated; and several strategies unrelated to the implementation of new aircraft are introduced to yield reductions in overall intercity energy use. In both parts of this analysis, resulting changes in patronage (modal share) and energy use are demonstrated, leading to new insights into the effectiveness of different potential policies for achieving energy conservation. Some observations on induced demand trends that could be associated with certain strategies and the resultant potential effect on energy conservation are provided.

Effects of Three Questioning Strategies on EFL Reading Comprehension.

Science.gov (United States)

El-Koumy, Abdel Salam A.

This study investigated the effects of three classroom questioning strategies on the reading comprehension of learners of English as a Foreign Language (EFL). Subjects were 86 first-year EFL students in the school of education of Suez Canal University (Egypt), randomly assigned to three treatment groups. The same instructor taught the three groups…

Your Graduates and You: Effective Strategies for Graduate Recruitment and Development. IES Report.

Science.gov (United States)

Connor, H.; Hirsh, W.; Barber, L.

Many employing organizations in the United Kingdom and elsewhere are finding it increasingly important to have an effective strategy for recruiting and developing higher education graduates. Numerous external and internal factors affect employers' graduate recruitment and development strategies. The following main approaches to graduates' entry…

Strategies in Gene Therapy for Glioblastoma

International Nuclear Information System (INIS)

Kwiatkowska, Aneta; Nandhu, Mohan S.; Behera, Prajna; Chiocca, E. Antonio; Viapiano, Mariano S.

2013-01-01

Glioblastoma (GBM) is the most aggressive form of brain cancer, with a dismal prognosis and extremely low percentage of survivors. Novel therapies are in dire need to improve the clinical management of these tumors and extend patient survival. Genetic therapies for GBM have been postulated and attempted for the past twenty years, with variable degrees of success in pre-clinical models and clinical trials. Here we review the most common approaches to treat GBM by gene therapy, including strategies to deliver tumor-suppressor genes, suicide genes, immunomodulatory cytokines to improve immune response, and conditionally-replicating oncolytic viruses. The review focuses on the strategies used for gene delivery, including the most common and widely used vehicles (i.e., replicating and non-replicating viruses) as well as novel therapeutic approaches such as stem cell-mediated therapy and nanotechnologies used for gene delivery. We present an overview of these strategies, their targets, different advantages, and challenges for success. Finally, we discuss the potential of gene therapy-based strategies to effectively attack such a complex genetic target as GBM, alone or in combination with conventional therapy

Strategies in Gene Therapy for Glioblastoma

Energy Technology Data Exchange (ETDEWEB)

Kwiatkowska, Aneta; Nandhu, Mohan S.; Behera, Prajna; Chiocca, E. Antonio; Viapiano, Mariano S., E-mail: mviapiano@partners.org [Department of Neurosurgery, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115 (United States)

2013-10-22

Glioblastoma (GBM) is the most aggressive form of brain cancer, with a dismal prognosis and extremely low percentage of survivors. Novel therapies are in dire need to improve the clinical management of these tumors and extend patient survival. Genetic therapies for GBM have been postulated and attempted for the past twenty years, with variable degrees of success in pre-clinical models and clinical trials. Here we review the most common approaches to treat GBM by gene therapy, including strategies to deliver tumor-suppressor genes, suicide genes, immunomodulatory cytokines to improve immune response, and conditionally-replicating oncolytic viruses. The review focuses on the strategies used for gene delivery, including the most common and widely used vehicles (i.e., replicating and non-replicating viruses) as well as novel therapeutic approaches such as stem cell-mediated therapy and nanotechnologies used for gene delivery. We present an overview of these strategies, their targets, different advantages, and challenges for success. Finally, we discuss the potential of gene therapy-based strategies to effectively attack such a complex genetic target as GBM, alone or in combination with conventional therapy.

Promotional Strategy of Advent Himalaya Trekks Private Limited

OpenAIRE

Gurung, Sabin

2017-01-01

The purpose of conducting this thesis was to study on the promotional strategy of a trekking company. The aim of this thesis was to study on current promotional strategy and suggest the case company with new and effective ideas and tools for promotion. The theoretical part of this thesis includes basic knowledge of marketing, promotion, promotional mix and promotional strategy. Also, a short overview of tourism business of Nepal and promotional strengths of the case company is also done. H...

Teaching basic medical sciences at a distance: strategies for effective teaching and learning in internet-based courses.

Science.gov (United States)

Ertmer, Peggy A; Nour, Abdelfattah Y M

2007-01-01

In recent years, the Internet has become an effective and accessible delivery mechanism for distance education. In 2003, 81% of all institutions of higher education offered at least one fully online or hybrid course. By 2005, the proportion of institutions that listed online education as important to their long-term goals had increased by 8%. This growth in available online courses and their increased convenience and flexibility have stimulated dramatic increases in enrollment in online programs, including the Veterinary Technology Distance Learning Program (VT-DLP) at Purdue University. Regardless of the obvious benefits, distance learning (DL) can be frustrating for the learners if course developers are unable to merge their knowledge about the learners, the process of instructional design, and the appropriate uses of technology and interactivity options into effective course designs. This article describes strategies that we have used to increase students' learning of physiology content in an online environment. While some of these are similar, if not identical, to strategies that might be used in a face-to-face (f2f) environment (e.g., case studies, videos, concept maps), additional strategies (e.g., animations, virtual microscopy) are needed to replace or supplement what might normally occur in a f2f course. We describe how we have addressed students' need for instructional interaction, specifically in the context of two foundational physiology courses that occur early in the VT-DLP. Although the teaching and learning strategies we have used have led to increasingly high levels of interaction, there is an ongoing need to evaluate these strategies to determine their impact on students' learning of physiology content, their development of problem-solving skills, and their retention of information.

The Effects of Computer-Assisted Feedback Strategies in Technology Education: A Comparison of Learning Outcomes

Science.gov (United States)

Adams, Ruifang Hope; Strickland, Jane

2012-01-01

This study investigated the effects of computer-assisted feedback strategies that have been utilized by university students in a technology education curriculum. Specifically, the study examined the effectiveness of the computer-assisted feedback strategy "Knowledge of Response feedback" (KOR), and the "Knowledge of Correct Responses feedback"…

Effects of imposed monitoring and blunting strategies on emotional reactivity

NARCIS (Netherlands)

Muris, Peter; Jong, de Peter; Merckelbach, Harald; van Zuuren, Florence J.

1994-01-01

The present study examined the effects of imposed monitoring and blunting coping strategies on emotional reactivity in 40 subjects who prepared themselves for upcoming neutral and aversive slides. Besides subjective indices, electrodermal measures and eye blink startle responses were used to

Identifying strategies to improve the effectiveness of booster seat laws

Science.gov (United States)

2008-05-01

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

Effective Strategies for Teaching Evolution: The Primary Evolution Project

Science.gov (United States)

Hatcher, Chris

2015-01-01

When Chris Hatcher joined the Primary Evolution Project team at the University of Reading, his goal was to find effective strategies to teach evolution in a way that keeps children engaged and enthused. Hatcher has collaborated with colleagues at the University's Institute of Education to break the evolution unit down into distinct topics and…

Cognitive Strategies for Learning from Static and Dynamic Visuals.

Science.gov (United States)

Lewalter, D.

2003-01-01

Studied the effects of including static or dynamic visuals in an expository text on a learning outcome and the use of learning strategies when working with these visuals. Results for 60 undergraduates for both types of illustration indicate different frequencies in the use of learning strategies relevant for the learning outcome. (SLD)

Effective and ineffective coping strategies in a low-autonomy work environment.

Science.gov (United States)

Britt, Thomas W; Crane, Monique; Hodson, Stephanie E; Adler, Amy B

2016-04-01

The authors examined the effectiveness of different coping strategies in buffering the negative effects of uncontrollable stressors and predicting mental health symptoms in a low-autonomy work environment using a longitudinal design. Soldiers in training indicated the extent to which they engaged in various coping strategies to deal with stressors related to the training environment at 4 different points in time. Factor analyses of soldiers in 2 different countries (i.e., United States and Australia) yielded 5 coping dimensions: active coping, acceptance of demands, seeking social support, humor, and denial/self-criticism. Among U.S. soldiers in basic training, acceptance of demands and denial/self-criticism interacted with the magnitude of basic-training stressors to predict mental health symptoms (depression and anxiety) at 3 different points during training while controlling for symptoms at the immediate prior time period. Acceptance buffered soldiers from the negative effects of the stressors, whereas denial/self-criticism exacerbated the effects of the stressors. The results of LGC models also indicated that the slopes of acceptance and active coping were negatively related to the slope of mental health symptoms across training, whereas the slope for denial/self-criticism was positively related to the slope of symptoms. Active coping was less predictive of functioning in the face of stressors and in the prediction of symptoms over time. The results demonstrated that in a low-autonomy occupational setting, acceptance coping was more effective in facilitating good mental health outcomes compared with other coping strategies considered important in prior research (e.g., active coping). (c) 2016 APA, all rights reserved).

Strategies for Primary Prevention of Coronary Heart Disease Based on Risk Stratification by the ACC/AHA Lipid Guidelines, ATP III Guidelines, Coronary Calcium Scoring, and C-Reactive Protein, and a Global Treat-All Strategy: A Comparative--Effectiveness Modeling Study.

Directory of Open Access Journals (Sweden)

Benjamin Z Galper

Full Text Available Several approaches have been proposed for risk-stratification and primary prevention of coronary heart disease (CHD, but their comparative and cost-effectiveness is unknown.We constructed a state-transition microsimulation model to compare multiple approaches to the primary prevention of CHD in a simulated cohort of men aged 45-75 and women 55-75. Risk-stratification strategies included the 2013 American College of Cardiology/American Heart Association (ACC/AHA guidelines on the treatment of blood cholesterol, the Adult Treatment Panel (ATP III guidelines, and approaches based on coronary artery calcium (CAC scoring and C-reactive protein (CRP. Additionally we assessed a treat-all strategy in which all individuals were prescribed either moderate-dose or high-dose statins and all males received low-dose aspirin. Outcome measures included CHD events, costs, medication-related side effects, radiation-attributable cancers, and quality-adjusted-life-years (QALYs over a 30-year timeframe.Treat-all with high-dose statins dominated all other strategies for both men and women, gaining 15.7 million QALYs, preventing 7.3 million myocardial infarctions, and saving over $238 billion, compared to the status quo, far outweighing its associated adverse events including bleeding, hepatitis, myopathy, and new-onset diabetes. ACC/AHA guidelines were more cost-effective than ATP III guidelines for both men and women despite placing 8.7 million more people on statins. For women at low CHD risk, treat-all with high-dose statins was more likely to cause a statin-related adverse event than to prevent a CHD event.Despite leading to a greater proportion of the population placed on statin therapy, the ACC/AHA guidelines are more cost-effective than ATP III. Even so, at generic prices, treating all men and women with statins and all men with low-dose aspirin appears to be more cost-effective than all risk-stratification approaches for the primary prevention of CHD

Examining the Effects of Two Computer Programming Learning Strategies: Self-Explanation versus Reading Questions and Answers

Directory of Open Access Journals (Sweden)

Nancy Lee

2017-08-01

Full Text Available The study described here explored the differential effects of two learning strategies, self-explanation and reading questions and answers, on learning the computer programming language JavaScript. Students’ test performance and perceptions of effectiveness toward the two strategies were examined. An online interactive tutorial instruction implementing worked-examples and multimedia learning principles was developed for this study. Participants were 147 high school students (ages 14 to 18 of a computer introductory course in six periods which were randomly divided into two groups (n = 78; n = 69 of three periods each. The two groups alternated learning strategies to learn five lessons. Students’ prerequisite knowledge of XHTML and motivation to learn computer programming languages were measured before starting the tutorial. Students largely expressed their preference toward self-explanation over reading questions and answers. They thought self-explanation incurred much more work yet was more effective. However, the two learning strategies did not have differential effects on students’ test performance. The seeming discrepancy arising from students’ preferred strategy and their test performance was discussed in the areas of familiar versus new strategy, difficulty of learning materials and testing method, and experimental duration.

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

Science.gov (United States)

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

2017-11-22

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

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

Directory of Open Access Journals (Sweden)

Ali Ben Charif

2017-11-01

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

Investigating the effectiveness of response strategies for vulnerabilities to corruption in the chinese public construction sector.

Science.gov (United States)

Shan, Ming; Chan, Albert P C; Le, Yun; Hu, Yi

2015-06-01

Response strategy is a key for preventing widespread corruption vulnerabilities in the public construction sector. Although several studies have been devoted to this area, the effectiveness of response strategies has seldom been evaluated in China. This study aims to fill this gap by investigating the effectiveness of response strategies for corruption vulnerabilities through a survey in the Chinese public construction sector. Survey data obtained from selected experts involved in the Chinese public construction sector were analyzed by factor analysis and partial least squares-structural equation modeling. Analysis results showed that four response strategies of leadership, rules and regulations, training, and sanctions, only achieved an acceptable level in preventing corruption vulnerabilities in the Chinese public construction sector. This study contributes to knowledge by improving the understanding of the effectiveness of response strategies for corruption vulnerabilities in the public construction sector of developing countries.

Effects of different intervention strategies on the incidence of papillomatous digital dermatitis in dairy cows

NARCIS (Netherlands)

Holzhauer, M.; Doepfer, D.; Boer, de J.; Schaik, van G.

2008-01-01

The effects of four different intervention strategies on the incidence of severe lesions of digital dermatitis in an experimental dairy herd were compared with the effects of a control strategy consisting of walking the cows twice through a footbath containing 4 per cent formaldehyde on one day a

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

Science.gov (United States)

Razumnikov, S.; Prankevich, D.

2016-04-01

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

Cost-Effectiveness of Alternative Blood-Screening Strategies for West Nile Virus in the United States.

Directory of Open Access Journals (Sweden)

2006-01-01

Full Text Available BACKGROUND: West Nile virus (WNV is endemic in the US, varying seasonally and by geographic region. WNV can be transmitted by blood transfusion, and mandatory screening of blood for WNV was recently introduced throughout the US. Guidelines for selecting cost-effective strategies for screening blood for WNV do not exist. METHODS AND FINDINGS: We conducted a cost-effectiveness analysis for screening blood for WNV using a computer-based mathematical model, and using data from prospective studies, retrospective studies, and published literature. For three geographic areas with varying WNV-transmission intensity and length of transmission season, the model was used to estimate lifetime costs, quality-adjusted life expectancy, and incremental cost-effectiveness ratios associated with alternative screening strategies in a target population of blood-transfusion recipients. We compared the status quo (baseline screening using a donor questionnaire to several strategies which differed by nucleic acid testing of either pooled or individual samples, universal versus targeted screening of donations designated for immunocompromised patients, and seasonal versus year-long screening. In low-transmission areas with short WNV seasons, screening by questionnaire alone was the most cost-effective strategy. In areas with high levels of WNV transmission, seasonal screening of individual samples and restricting screening to blood donations designated for immunocompromised recipients was the most cost-effective strategy. Seasonal screening of the entire recipient pool added minimal clinical benefit, with incremental cost-effectiveness ratios exceeding US$1.7 million per quality-adjusted life-year gained. Year-round screening offered no additional benefit compared to seasonal screening in any of the transmission settings. CONCLUSIONS: In areas with high levels of WNV transmission, seasonal screening of individual samples and restricting screening to blood donations

Cost-effectiveness of alternative blood-screening strategies for West Nile Virus in the United States.

Directory of Open Access Journals (Sweden)

Caroline T Korves

2006-02-01

Full Text Available West Nile virus (WNV is endemic in the US, varying seasonally and by geographic region. WNV can be transmitted by blood transfusion, and mandatory screening of blood for WNV was recently introduced throughout the US. Guidelines for selecting cost-effective strategies for screening blood for WNV do not exist.We conducted a cost-effectiveness analysis for screening blood for WNV using a computer-based mathematical model, and using data from prospective studies, retrospective studies, and published literature. For three geographic areas with varying WNV-transmission intensity and length of transmission season, the model was used to estimate lifetime costs, quality-adjusted life expectancy, and incremental cost-effectiveness ratios associated with alternative screening strategies in a target population of blood-transfusion recipients. We compared the status quo (baseline screening using a donor questionnaire to several strategies which differed by nucleic acid testing of either pooled or individual samples, universal versus targeted screening of donations designated for immunocompromised patients, and seasonal versus year-long screening. In low-transmission areas with short WNV seasons, screening by questionnaire alone was the most cost-effective strategy. In areas with high levels of WNV transmission, seasonal screening of individual samples and restricting screening to blood donations designated for immunocompromised recipients was the most cost-effective strategy. Seasonal screening of the entire recipient pool added minimal clinical benefit, with incremental cost-effectiveness ratios exceeding USD 1.7 million per quality-adjusted life-year gained. Year-round screening offered no additional benefit compared to seasonal screening in any of the transmission settings.In areas with high levels of WNV transmission, seasonal screening of individual samples and restricting screening to blood donations designated for immunocompromised recipients is cost

The Effects of Pupil Control Ideology of Teachers on Their Conflict Management Strategies

Science.gov (United States)

Cobanoglu, Necati; Kaya, Oguz; Angay, Abdurrahman

2015-01-01

The aim of this study was to determine teachers' perspectives on conflict management strategies and further to determine the effects of pupil control ideologies on their conflict management strategies. 120 primary and secondary school teachers were administered a Likert type questionnaire. The data collected were analyzed through multiple…

Cost-Effectiveness of HIV Testing Referral Strategies among Tuberculosis Patients in India

Science.gov (United States)

Uhler, Lauren M.; Kumarasamy, Nagalingeswaran; Mayer, Kenneth H.; Saxena, Anjali; Losina, Elena; Muniyandi, Malaisamy; Stoler, Adam W.; Lu, Zhigang; Walensky, Rochelle P.; Flanigan, Timothy P.; Bender, Melissa A.; Freedberg, Kenneth A.; Swaminathan, Soumya

2010-01-01

Background Indian guidelines recommend routine referral for HIV testing of all tuberculosis (TB) patients in the nine states with the highest HIV prevalence, and selective referral for testing elsewhere. We assessed the clinical impact and cost-effectiveness of alternative HIV testing referral strategies among TB patients in India. Methods and Findings We utilized a computer model of HIV and TB disease to project outcomes for patients with active TB in India. We compared life expectancy, cost, and cost-effectiveness for three HIV testing referral strategies: 1) selective referral for HIV testing of those with increased HIV risk, 2) routine referral of patients in the nine highest HIV prevalence states with selective referral elsewhere (current standard), and 3) routine referral of all patients for HIV testing. TB-related data were from the World Health Organization. HIV prevalence among TB patients was 9.0% in the highest prevalence states, 2.9% in the other states, and 4.9% overall. The selective referral strategy, beginning from age 33.50 years, had a projected discounted life expectancy of 16.88 years and a mean lifetime HIV/TB treatment cost of US$100. The current standard increased mean life expectancy to 16.90 years with additional per-person cost of US$10; the incremental cost-effectiveness ratio was US$650/year of life saved (YLS) compared to selective referral. Routine referral of all patients for HIV testing increased life expectancy to 16.91 years, with an incremental cost-effectiveness ratio of US$730/YLS compared to the current standard. For HIV-infected patients cured of TB, receiving antiretroviral therapy increased survival from 4.71 to 13.87 years. Results were most sensitive to the HIV prevalence and the cost of second-line antiretroviral therapy. Conclusions Referral of all patients with active TB in India for HIV testing will be both effective and cost-effective. While effective implementation of this strategy would require investment, routine

Living renal donors: optimizing the imaging strategy--decision- and cost-effectiveness analysis

NARCIS (Netherlands)

Y.S. Liem (Ylian Serina); M.C.J.M. Kock (Marc); W. Weimar (Willem); K. Visser (Karen); M.G.M. Hunink (Myriam); J.N.M. IJzermans (Jan)

2003-01-01

textabstractPURPOSE: To determine the most cost-effective strategy for preoperative imaging performed in potential living renal donors. MATERIALS AND METHODS: In a decision-analytic model, the societal cost-effectiveness of digital subtraction angiography (DSA), gadolinium-enhanced

Effectiveness of business strategies in Brazilian textile industry

Directory of Open Access Journals (Sweden)

Paulo César de Sousa Batista

2016-06-01

Full Text Available ABSTRACT This research analyses how the interaction between strategy capabilities, strategy types, strategy formulation quality and implementation capability affect organizational performance in Brazilian textiles companies. This article proposes and tests a conceptual framework, using a structural equation modeling of a set of 211 valid questionnaires on Brazilian textiles firms. The results support links between focus strategy and marketing capabilities, and between cost leadership strategy and management capabilities. However, the relationship between technologic capabilities and differentiation strategy was not statistically significant. The existence of an inter-relationship between generic strategies of focus, cost leadership and differentiation indicates the use of combined strategies. Concerning the firms' financial performance, the results show that management capability and market performance have a statistically significant relationship with financial performance.

Optimum Performance Enhancing Strategies of the Gas Turbine Based on the Effective Temperatures

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Ibrahim Thamir K.

2016-01-01

Full Text Available Gas turbines (GT have come to play a significant role in distributed energy systems due to its multi-fuel capability, compact size and low environmental impact and reduced cost. Nevertheless, the low electrical efficiency, typically about 30% (LHV, is an important obstruction to the development of the GT plants. New strategies are designed for the GT plant, to increase the overall performance based on the operational modeling and optimization of GT power plants. The enhancing strategies effect on the GT power plant’s performance (with intercooler, two-shaft, reheat and regenerative based on the real power plant of GT. An analysis based on thermodynamics has been carried out on the modifications of the cycle configurations’ enhancements. Then, the results showed the effect of the ambient and turbine inlet temperatures on the performance of the GT plants to select an optimum strategy for the GT. The performance model code to compare the strategies of the GT plants were developed utilizing the MATLAB software. The results show that, the best thermal efficiency occurs in the intercooler-regenerative-reheated GT strategy (IRHGT; it decreased from 51.5 to 48%, when the ambient temperature increased (from 273 to 327K. Furthermore, the thermal efficiency of the GT for the strategies without the regenerative increased (about 3.3%, while thermal efficiency for the strategies with regenerative increased (about 22% with increased of the turbine inlet temperature. The lower thermal efficiency occurs in the IHGT strategy, while the higher thermal efficiency occurs in the IRHGT strategy. However, the power output variation is more significant at a higher value of the turbine inlet temperature. The simulation model gives a consistent result compared with Baiji GT plant. The extensive modeling performed in this study reveals that; the ambient temperature and turbine inlet temperature are strongly influenced on the performance of GT plant.

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

OpenAIRE

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

2014-01-01

Background Despite extensive research, institutional policies, and practice guidelines, procedural pain remains undertreated in hospitalized children. Knowledge translation (KT) strategies have been employed to bridge the research to practice gap with varying success. The most effective single or combination of KT strategies has not been found. A multifaceted KT intervention, Evidence-based Practice for Improving Quality (EPIQ), that included tailored KT strategies was effective in improving ...

The effectiveness of research-based physics learning module with predict-observe-explain strategies to improve the student’s competence

Science.gov (United States)

Usmeldi

2018-05-01

The preliminary study shows that many students are difficult to master the concept of physics. There are still many students who have not mastery learning physics. Teachers and students still use textbooks. Students rarely do experiments in the laboratory. One model of learning that can improve students’ competence is a research-based learning with Predict- Observe-Explain (POE) strategies. To implement this learning, research-based physics learning modules with POE strategy are used. The research aims to find out the effectiveness of implementation of research-based physics learning modules with POE strategy to improving the students’ competence. The research used a quasi-experimental with pretest-posttest group control design. Data were collected using observation sheets, achievement test, skill assessment sheets, questionnaire of attitude and student responses to learning implementation. The results of research showed that research-based physics learning modules with POE strategy was effective to improve the students’ competence, in the case of (1) mastery learning of physics has been achieved by majority of students, (2) improving the students competency of experimental class including high category, (3) there is a significant difference between the average score of students’ competence of experimental class and the control class, (4) the average score of the students competency of experimental class is higher than the control class, (5) the average score of the students’ responses to the learning implementation is very good category, this means that most students can implement research-based learning with POE strategies.

The effect of resuscitation strategy on the longitudinal immuno-inflammatory response to blunt trauma

DEFF Research Database (Denmark)

Bonde, Alexander; Nordestgaard, Ask Tybjærg; Kirial, Rasmus

2017-01-01

INTRODUCTION: Resuscitation strategies following blunt trauma have been linked to immuno-inflammatory complications leading to systemic inflammatory syndrome (SIRS), sepsis and multiple organ failure (MOF). The effect of resuscitation strategy on longitudinal inflammation marker trajectories is...

Two-dimensional analysis of motion artifacts, including flow effects

International Nuclear Information System (INIS)

Litt, A.M.; Brody, A.S.; Spangler, R.A.; Scott, P.D.

1990-01-01

The effects of motion on magnetic resonance images have been theoretically analyzed for the case of a point-like object in simple harmonic motion and for other one-dimensional trajectories. The authors of this paper extend this analysis to a generalized two-dimensional magnetization with an arbitrary motion trajectory. The authors provide specific solutions for the clinically relevant cases of the cross-sections of cylindrical objects in the body, such as the aorta, which has a roughly one-dimensional, simple harmonic motion during respiration. By extending the solution to include inhomogeneous magnetizations, the authors present a model which allows the effects of motion artifacts and flow artifacts to be analyzed simultaneously

THE TASK TYPE EFFECT ON THE USE OF COMMUNICATION STRATEGIES

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Elvir Shtavica

2018-03-01

Full Text Available An argument that many foreign language students encounter oral communication problems while they try to express their meaning to their partners has encouraged a number of eminent scholars to analyze the use of communication strategies based on the type of the task activity and the level of proficiency. In this paper, the task type effect and the students’ proficiency levels on the communication strategies employed by Kosovan and Bosnian speakers of English were investigated. The purpose of the study was to determine if the students’ proficiency levels and the task type influenced the choice and the number of communication strategies at lexical degree in verbal communication. The study numbered 20 participants in total; Kosovan and Bosnian languages that use English as a foreign language. The subjects were selected upon their degree of proficiency (i.e. Elementary and Intermediate levels and were asked to carry out three different types of the tasks: ten minutes of oral communication, picture story narration and photographic description. The data of the assigned tasks came from audio and video-recording. Thus, the current study used the taxonomy of communication strategies employed by Tarone (1977. Likewise, the communication strategies used by both levels of the students were observed and compared in special instances. It was summarized that the task type and the level of proficiency influenced the number and the choice of different communication strategies in verbal performances. To indicate the present observable facts, two main aspects of the nature of the given tasks were pointed out: context in the task and task demands, respectively.

A framework for the assessment of severe accident management strategies

International Nuclear Information System (INIS)

Kastenberg, W.E.; Apostolakis, G.; Dhir, V.K.

1993-09-01

Severe accident management can be defined as the use of existing and/or altemative resources, systems and actors to prevent or mitigate a core-melt accident. For each accident sequence and each combination of severe accident management strategies, there may be several options available to the operator, and each involves phenomenological and operational considerations regarding uncertainty. Operational uncertainties include operator, system and instrumentation behavior during an accident. A framework based on decision trees and influence diagrams has been developed which incorporates such criteria as feasibility, effectiveness, and adverse effects, for evaluating potential severe accident management strategies. The framework is also capable of propagating both data and model uncertainty. It is applied to several potential strategies including PWR cavity flooding, BWR drywell flooding, PWR depressurization and PWR feed and bleed

A framework for the assessment of severe accident management strategies

Energy Technology Data Exchange (ETDEWEB)

Kastenberg, W.E. [ed.; Apostolakis, G.; Dhir, V.K. [California Univ., Los Angeles, CA (United States). Dept. of Mechanical, Aerospace and Nuclear Engineering] [and others

1993-09-01

Severe accident management can be defined as the use of existing and/or altemative resources, systems and actors to prevent or mitigate a core-melt accident. For each accident sequence and each combination of severe accident management strategies, there may be several options available to the operator, and each involves phenomenological and operational considerations regarding uncertainty. Operational uncertainties include operator, system and instrumentation behavior during an accident. A framework based on decision trees and influence diagrams has been developed which incorporates such criteria as feasibility, effectiveness, and adverse effects, for evaluating potential severe accident management strategies. The framework is also capable of propagating both data and model uncertainty. It is applied to several potential strategies including PWR cavity flooding, BWR drywell flooding, PWR depressurization and PWR feed and bleed.

Self-Regulated Strategies for School Writing Tasks: A Cross-Cultural Report

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Malpique Anabela

2017-11-01

Full Text Available We investigated cross-cultural differences in ninth-grade students’ reported use of self-regulated strategies for writing. We assessed 12 self-regulated strategies for writing tapping environmental, behavioural, and personal self-regulated processes. Seven hundred and thirty-two Portuguese and Brazilian students in transition to high school (Mage = 14.3; 372 male and 306 female from mainstream urban schools reported on their use of the strategies. Statistical analyses included a multivariate analysis of variance (MANOVA with 12 dependent variables (self-regulated strategies for writing and 2 between-subjects variables (country and gender. There were significant main effects for country with medium effect sizes and statistically significant small effect sizes for gender main effects. All-male and all-female comparisons indicated significant differences and medium effect sizes within gender groups. The majority of the differences tapped personal self-regulated strategies. Taken together, these findings suggest that initiating and controlling writing may be a contextualised bounded process.

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

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Santanu Biswas

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

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

Science.gov (United States)

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

2013-07-30

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

Effectiveness of an implementation strategy for a breastfeeding guideline in Primary Care: cluster randomised trial

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Martín-Iglesias Susana

2011-12-01

Full Text Available Abstract Background The protection and promotion of breastfeeding is considered a priority in Europe where only 22% of infants less than 6 months old are exclusively breastfed. In Spain this percentage reaches 24.8% but in our city it falls to 18.26%. Various studies emphasise that the improvement of these results should be based upon the training of health professionals. Following the recommendations of a breastfeeding guide can modify the practice of health professionals and improve results with respect to exclusively or predominatly breastfed children at 6 months of age. Method/Design This study involves a community based cluster randomized trial in primary healthcare centres in Leganés (Madrid, Spain. The project aims to determine whether the use of an implementation strategy (including training session, information distribution, opinion leader of a breastfeeding guideline in primary care is more effective than usual diffusion. The number of patients required will be 240 (120 in each arm. It will be included all the mothers of infants born during the study period (6 months who come to the health centre on the first visit of the child care programme and who give their consent to participate. The main outcome variable is the exclusive o predominant breastfeeding at 6 moths of age.. Main effectiveness will be analyzed by comparing the percentage of infants with exclusive or predominant breastfeeding at 6 months between the intervention group and the control group. All statistical tests will be performed with intention to treat. Logistic regression with random effects will be used to adjust for prognostic factors. Confounding factors or factors that might alter the effect recorded will be taken into account in this analysis. Discussion Strategies need to be found which facilitate the giving of effective advice on breastfeeding by professionals and which provide support to women during the breastfeeding period. By applying the guide

The Study of Frequency Self Care Strategies against Auditory Hallucinations

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Mahin Nadem

2012-03-01

Full Text Available Background: In schizophrenic clients, self-care strategies against auditory hallucinations can decrease disturbances results in hallucination. This study was aimed to assess frequency of self-care strategies against auditory hallucinations in paranoid schizophrenic patients, hospitalized in Shafa Hospital.Materials and Method: This was a descriptive study on 201 patients with paranoid schizophrenia hospitalized in psychiatry unit with convenience sampling in Rasht. The gathered data consists of two parts, first unit demographic characteristic and the second part, self- report questionnaire include 38 items about self-care strategies.Results: There were statistically significant relationship between demographic variables and knowledg effect and self-care strategies against auditory hallucinaions. Sex with phisical domain p0.07, marriage status with cognitive domain (p>0.07 and life status with behavioural domain (p>0.01. 53.2% of reported type of our auditory hallucinations were command hallucinations, furtheremore the most effective self-care strategies against auditory hallucinations were from physical domain and substance abuse (82.1% was the most effective strategies in this domain.Conclusion: The client with paranoid schizophrenia used more than physical domain strategies against auditory hallucinaions and this result highlight need those to approprait nursing intervention. Instruction and leading about selection the effective self-care strategies against auditory ha

Data Sets Replicas Placements Strategy from Cost-Effective View in the Cloud

Directory of Open Access Journals (Sweden)

Xiuguo Wu

2016-01-01

Full Text Available Replication technology is commonly used to improve data availability and reduce data access latency in the cloud storage system by providing users with different replicas of the same service. Most current approaches largely focus on system performance improvement, neglecting management cost in deciding replicas number and their store places, which cause great financial burden for cloud users because the cost for replicas storage and consistency maintenance may lead to high overhead with the number of new replicas increased in a pay-as-you-go paradigm. In this paper, towards achieving the approximate minimum data sets management cost benchmark in a practical manner, we propose a replicas placements strategy from cost-effective view with the premise that system performance meets requirements. Firstly, we design data sets management cost models, including storage cost and transfer cost. Secondly, we use the access frequency and the average response time to decide which data set should be replicated. Then, the method of calculating replicas’ number and their store places with minimum management cost is proposed based on location problem graph. Both the theoretical analysis and simulations have shown that the proposed strategy offers the benefits of lower management cost with fewer replicas.

Effectiveness of Motor Skill Intervention Varies Based on Implementation Strategy

Science.gov (United States)

Brian, Ali; Taunton, Sally

2018-01-01

Background: Young children from disadvantaged settings often present delays in fundamental motor skills (FMS). Young children can improve their FMS delays through developmentally appropriate motor skill intervention programming. However, it is unclear which pedagogical strategy is most effective for novice and expert instructors. Purpose: The…

The effect of emotion regulation strategies on anger.

Science.gov (United States)

Szasz, Paul Lucian; Szentagotai, Aurora; Hofmann, Stefan G

2011-02-01

This study examined the effects of different emotion regulation strategies on the experience and expression of anger. Participants consisted of undergraduate students who endorsed at least a moderate level of state anger. As part of a laboratory experiment, they were instructed to reappraise (n = 24), suppress (n = 24), or accept (n = 25) their anger during a frustrating task. Reappraisal was more effective at reducing anger than attempts to suppress or accept it. Furthermore, participants in the reappraisal condition persisted significantly longer with the frustrating task than those who were instructed to suppress or accept their negative feelings. These findings suggest that reappraisal techniques are more effective than acceptance and suppression techniques for modulating the experience and expression of anger. Copyright © 2010 Elsevier Ltd. All rights reserved.

Smoking cessation strategies in patients with COPD

DEFF Research Database (Denmark)

Warnier, Miriam J; van Riet, Evelien E S; Rutten, Frans H

2013-01-01

Smoking cessation is the cornerstone of treatment of chronic obstructive pulmonary disease (COPD) patients. This systematic review evaluates the effectiveness of behavioural and pharmacological smoking cessation strategies in COPD patients. MEDLINE was searched from January 2002 to October 2011....... Randomised controlled trials evaluating the effect of smoking cessation interventions for COPD patients, published in English, were selected. The methodological quality of included trials was assessed using the Delphi list by two reviewers independently. The relative risks of smoking cessation due...... that in COPD patients, pharmacological therapy combined with behavioural counselling is more effective than each strategy separately. Neither the intensity of counselling nor the type of anti-smoking drug made a difference....

A simulation model to estimate the cost and effectiveness of alternative dialysis initiation strategies.

Science.gov (United States)

Lee, Chris P; Chertow, Glenn M; Zenios, Stefanos A

2006-01-01

Patients with end-stage renal disease (ESRD) require dialysis to maintain survival. The optimal timing of dialysis initiation in terms of cost-effectiveness has not been established. We developed a simulation model of individuals progressing towards ESRD and requiring dialysis. It can be used to analyze dialysis strategies and scenarios. It was embedded in an optimization frame worked to derive improved strategies. Actual (historical) and simulated survival curves and hospitalization rates were virtually indistinguishable. The model overestimated transplantation costs (10%) but it was related to confounding by Medicare coverage. To assess the model's robustness, we examined several dialysis strategies while input parameters were perturbed. Under all 38 scenarios, relative rankings remained unchanged. An improved policy for a hypothetical patient was derived using an optimization algorithm. The model produces reliable results and is robust. It enables the cost-effectiveness analysis of dialysis strategies.

Effectiveness of business strategies in Brazilian textile industry

OpenAIRE

Batista, Paulo César de Sousa; Lisboa, João Veríssimo de Oliveira; Augusto, Mário Gomes; Almeida, Fátima Evaneide Barbosa de

2016-01-01

ABSTRACT This research analyses how the interaction between strategy capabilities, strategy types, strategy formulation quality and implementation capability affect organizational performance in Brazilian textiles companies. This article proposes and tests a conceptual framework, using a structural equation modeling of a set of 211 valid questionnaires on Brazilian textiles firms. The results support links between focus strategy and marketing capabilities, and between cost leadership strategy...

Effectiveness of strategies for recruiting overweight and obese Generation Y women to a clinical weight management trial.

Science.gov (United States)

Griffin, Hayley J; O'Connor, Helen T; Rooney, Kieron B; Steinbeck, Katharine S

2013-01-01

Limited research in young overweight and obese women indicates that they are difficult to recruit to weight management trials, with attrition higher and weight loss success lower than middle to older age participants. This study aimed to evaluate the effectiveness of different recruitment strategies for a clinical weight loss trial in overweight and obese Generation Y women. Overweight and obese (BMI >=27.5 kg/m-2) women aged 18-25 years (n=70) were required for a 12 month clinical weight management trial including diet, exercise and behaviour modification. Contact with researchers and eventual recruitment are reported for the various strategies employed to engage participants. Data reported as % or mean±SE. Recruitment was challenging with only 50 of the total 70 participants recruited within the scheduled time frame (24 months). Just over one quarter (27%) of volunteers assessed were recruited. Flyers posted around local tertiary education campuses were the most successful method, yielding 36% of included participants. This was followed by advertisements on the local area health service intranet (26%) and in local and metropolitan newspapers (16%). Recruitment of overweight and obese Generation Y women for a clinical weight loss trial was difficult. Multiple strategies targeted at this age and gender group were required. Less rigorous selection criteria and reduced face-to-face intervention time may improve recruitment and retention rates into clinical trials for this age group.

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

Science.gov (United States)

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

2013-09-01

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

The effectiveness of cool and green roofs as urban heat island mitigation strategies

International Nuclear Information System (INIS)

Li, Dan; Bou-Zeid, Elie; Oppenheimer, Michael

2014-01-01

Mitigation of the urban heat island (UHI) effect at the city-scale is investigated using the Weather Research and Forecasting (WRF) model in conjunction with the Princeton Urban Canopy Model (PUCM). Specifically, the cooling impacts of green roof and cool (white/high-albedo) roof strategies over the Baltimore-Washington metropolitan area during a heat wave period (7 June–10 June 2008) are assessed using the optimal set-up of WRF-PUCM described in the companion paper by Li and Bou-Zeid (2014). Results indicate that the surface UHI effect (defined based on the urban–rural surface temperature difference) is reduced significantly more than the near-surface UHI effect (defined based on urban–rural 2 m air temperature difference) when these mitigation strategies are adopted. In addition, as the green and cool roof fractions increase, the surface and near-surface UHIs are reduced almost linearly. Green roofs with relatively abundant soil moisture have comparable effect in reducing the surface and near-surface UHIs to cool roofs with an albedo value of 0.7. Significant indirect effects are also observed for both green and cool roof strategies; mainly, the low-level advection of atmospheric moisture from rural areas into urban terrain is enhanced when the fraction of these roofs increases, thus increasing the humidity in urban areas. The additional benefits or penalties associated with modifications of the main physical determinants of green or cool roof performance are also investigated. For green roofs, when the soil moisture is increased by irrigation, additional cooling effect is obtained, especially when the ‘unmanaged’ soil moisture is low. The effects of changing the albedo of cool roofs are also substantial. These results also underline the capabilities of the WRF-PUCM framework to support detailed analysis and diagnosis of the UHI phenomenon, and of its different mitigation strategies. (letter)

Nuclear fuel reprocessing expansion strategies

International Nuclear Information System (INIS)

Gallagher, J.M.

1975-01-01

A description is given of an effort to apply the techniques of operations research and energy system modeling to the problem of determination of cost-effective strategies for capacity expansion of the domestic nuclear fuel reprocessing industry for the 1975 to 2000 time period. The research also determines cost disadvantages associated with alternative strategies that may be attractive for political, social, or ecological reasons. The sensitivity of results to changes in cost assumptions was investigated at some length. Reactor fuel types covered by the analysis include the Light Water Reactor (LWR), High-Temperature Gas-Cooled Reactor (HTGR), and the Fast Breeder Reactor (FBR)

Effects of different lower-limb sensory stimulation strategies on postural regulation?A systematic review and meta-analysis

OpenAIRE

Woo, Mei Teng; Davids, Keith; Liukkonen, Jarmo; Orth, Dominic; Chow, Jia Yi; Jaakkola, Timo

2017-01-01

Systematic reviews of balance control have tended to only focus on the effects of single lower-limb stimulation strategies, and a current limitation is the lack of comparison between different relevant stimulation strategies. The aim of this systematic review and meta-analysis was to examine evidence of effects of different lower-limb sensory stimulation strategies on postural regulation and stability. Moderate- to high- pooled effect sizes (Unbiased (Hedges’ g) standardized mean differences ...

The effects of invasive pests and pathogens on strategies for forest diversification.

Science.gov (United States)

Macpherson, Morag F; Kleczkowski, Adam; Healey, John R; Quine, Christopher P; Hanley, Nick

2017-04-24

Diversification of the tree species composition of production forests is a frequently advocated strategy to increase resilience to pests and pathogens; however, there is a lack of a general framework to analyse the impact of economic and biological conditions on the optimal planting strategy in the presence of tree disease. To meet this need we use a novel bioeconomic model to quantitatively assess the effect of tree disease on the optimal planting proportion of two tree species. We find that diversifying the species composition can reduce the economic loss from disease even when the benefit from the resistant species is small. However, this key result is sensitive to a pathogen's characteristics (probability of arrival, time of arrival, rate of spread of infection) and the losses (damage of the disease to the susceptible species and reduced benefit of planting the resistant species). This study provides an exemplar framework which can be used to help understand the effect of a pathogen on forest management strategies.

Effects of "Fair Play Game" Strategy on Moderate to Vigorous Physical Activity in Physical Education

Science.gov (United States)

Azevedo, Liane B.; Vidoni, Carla; Dinsdale, Sarah

2016-01-01

Less than 50% of a PE lesson is usually spent in MVPA. A dependent-group contingency strategy, "Fair Play Game," has shown effectiveness in increasing MVPA during PE lessons among students from affluent schools. The purpose of this study was to determine the effectiveness of this strategy on MVPA among students from an undeserved…

Assertive classroom management strategies and students’ performance: The case of EFL classroom

OpenAIRE

Mohammad Aliakbari; Bafrin Bozorgmanesh

2015-01-01

Ample research findings support the effective role that classroom management strategies play in enhancing students’ learning. Drawing upon Iranian high school teachers’ classroom management strategies, this article is intended to examine the extent to which these teachers follow assertive classroom management strategies and if these strategies affect students’ performance. Conducting a survey including 123 female students, it was found out that Iranian teachers apply classroom management stra...

Including Students with Severe Disabilities in General Education Settings.

Science.gov (United States)

Wisniewski, Lech; Alper, Sandra

1994-01-01

This paper presents five systematic phases for bringing about successful regular education inclusion of students with severe disabilities. Phases include develop networks within the community, assess school and community resources, review strategies for integration, install strategies that lead to integration, and develop a system of feedback and…

Effects of Preschool Intervention Strategies on School Readiness in Kindergarten

Science.gov (United States)

Ma, Xin; Nelson, Regena F.; Shen, Jianping; Krenn, Huilan Y.

2015-01-01

Using hierarchical linear modeling, the present study aimed to examine whether targeted intervention strategies implemented individually during a preschool program exhibited any short-term and long-term effects on children's school readiness in kindergarten, utilizing data gathered through the Supporting Partnerships to Assure Ready Kids (SPARK)…

The effect of student learning strategies on performance and carrier ...

African Journals Online (AJOL)