Sample records for regression team trial

  1. Teams Talking Trials: results of an RCT to improve the communication of cancer teams about treatment trials. (United States)

    Jenkins, V A; Farewell, D; Farewell, V; Batt, L; Wagstaff, J; Langridge, C; Fallowfield, L J


    Previous research has shown that communication between members of multidisciplinary teams (MDTs) is often suboptimal and communication about trials between MDTs and their patients is difficult. Educational interventions can help dyadic exchanges with different aspects of trial recruitment but less work has focussed on team interventions. 22 multidisciplinary cancer teams in the UK participated in an RCT of a novel Teams Talking Trials (TTT) Workshop aimed at improving the following: awareness, involvement, communication and recruitment to cancer trials. MDTs were randomised following either 6 or 12 months of audits, which were repeated after the intervention. Audits included numbers approached about trials, team members' attitudes, involvement and awareness of their teams' trial portfolios. There was no significant difference in the rate of approaching patients about trials post workshop (estimated improvement 22% higher regression coefficient of 0.2, exp. (0.2)=1.22). There was improvement in team members' involvement in trials in 4 areas (p≤0.04): the pressure to enter patients into RCTs, the likelihood of a start-up meeting to discuss a newly accepted trial, the informational role played by individuals and recognition of this HCP's role by other team members. Also, confidence in communication about RCTS increased and awareness of different aspects of trial management improved on all 14 aspects (p=0.001). Attendance by teams at focussed workshops designed to enhance communication and trial recruitment improved several aspects of team functioning, but a significant impact on the number of patients approached could not be demonstrated. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. Regression Discontinuity Design: Simulation and Application in Two Cardiovascular Trials with Continuous Outcomes

    NARCIS (Netherlands)

    van Leeuwen, Nikki; Lingsma, Hester F.; de Craen, Anton J. M.; Nieboer, Daan; Mooijaart, Simon P.; Richard, Edo; Steyerberg, Ewout W.


    In epidemiology, the regression discontinuity design has received increasing attention recently and might be an alternative to randomized controlled trials (RCTs) to evaluate treatment effects. In regression discontinuity, treatment is assigned above a certain threshold of an assignment variable for

  3. TEAM. (United States)

    National Highway Traffic Safety Administration (DOT), Washington, DC.

    This document presents materials covering the television campaign against drunk driving called "TEAM" (Techniques for Effective Alcohol Management). It is noted that TEAM's purpose is to promote effective alcohol management in public facilities and other establishments that serve alcoholic beverages. TEAM sponsors are listed, including…

  4. Development and Validation of a Clinical Trial Accrual Predictive Regression Model at a Single NCI-Designated Comprehensive Cancer Center. (United States)

    Tate, Wendy R; Cranmer, Lee D


    Clinical study sites often do not achieve anticipated accrual to clinical trials, wasting critical patient, material, and human resources. The expensive and extensive process to bring a drug to approval highlights the need to streamline clinical pipeline processes. We sought to create a predictive accrual model to be used when considering clinical trial activation at the level of the individual site. This retrospective cohort study used 7 years of registry data from treatment and supportive care interventional studies at a single academic cancer center to build a negative binomial regression model with local and protocol variables known prestudy. Actual, team-predicted, and model-predicted accrual and sensitivity/specificity were calculated. To build the model, 207 trials were used. Investigational drug application, disease team, number of national sites, local Institutional Review Board use, total national accrual time, accrual completed, and national enrollment goal were independently and significantly associated with accrual. Predicted accrual was 94% of actual, maintaining predictive value at multiple cutoff values. Validation included 61 trials. The model correctly predicted whether a study would accrue at least 4 subjects 75% of the time. Correlation at the category level was 44.3%, and model sensitivity and specificity are 70% and 78%, respectively. We identified and validated national and local key factors associated with accrual at our site. This methodology has not been previously validated broadly with the intent of trial feasibility. Model validation shows it to be an accurate and quick metric in anticipating accrual success that can be used for resource allocation. Copyright © 2016 by the National Comprehensive Cancer Network.

  5. Team trails, trials and tribulations – rigorously reckoning with ...

    African Journals Online (AJOL)

    A major challenge to the efficacy of student team learning projects occurs when some members of a group are unable to contribute effectively to the collaborative endeavour due to their academic deficits. A graded benchmark for the requisite academic maturity is the setting of admission requirements. Various research ...

  6. Simulation-based team training for multi-professional obstetric care teams to improve patient outcome : a multicentre, cluster randomised controlled trial

    NARCIS (Netherlands)

    Fransen, A F; van de Ven, J; Schuit, E|info:eu-repo/dai/nl/341652385; van Tetering, Aac; Mol, B W; Oei, S G

    OBJECTIVE: To investigate whether simulation-based obstetric team training in a simulation centre improves patient outcome. DESIGN: Multicentre, open, cluster randomised controlled trial. SETTING: Obstetric units in the Netherlands. POPULATION: Women with a singleton pregnancy beyond 24 weeks of

  7. 'The trial is owned by the team, not by an individual': a qualitative study exploring the role of teamwork in recruitment to randomised controlled trials in surgical oncology

    National Research Council Canada - National Science Library

    Strong, Sean; Paramasivan, Sangeetha; Mills, Nicola; Wilson, Caroline; Donovan, Jenny L; Blazeby, Jane M


    .... Collaboration is required between clinical specialty and research teams. The aim of this study was to explore how teamwork influences recruitment to a multicentre randomised controlled trial (RCT...

  8. A systematic review of core implementation components in team ball sport injury prevention trials. (United States)

    O'Brien, James; Finch, Caroline F


    Recently, the use of specific exercise programmes to prevent musculoskeletal injuries in team ball sports has gained considerable attention, and the results of large-scale, randomised controlled trials have supported their efficacy. To enhance the translation of these interventions into widespread use, research trials must be reported in a way that allows the players, staff and policymakers associated with sports teams to implement these interventions effectively. In particular, information is needed on core implementation components, which represent the essential and indispensable aspects of successful implementation. To assess the extent to which team ball sport injury prevention trial reports have reported the core implementation components of the intervention, the intervention target and the use of any delivery agents (ie, staff or other personnel delivering the intervention). To summarise which specific types of intervention, intervention target and delivery agents are reported. To develop consensus between reviewers on the reporting of these components. Six electronic databases were systematically searched for English-language, peer-reviewed papers on injury prevention exercise programme (IPEP) trials in team ball sports. The reporting of all eligible trials was assessed by two independent reviewers. The reporting of the three core implementation components were coded as 'yes', 'no' or 'unclear'. For cases coded as 'yes', the specific types of interventions, intervention targets and delivery agents were extracted and summarised. The search strategy identified 52 eligible trials. The intervention and the intervention target were reported in all 52 trials. The reporting of 25 trials (48%) specified the use of delivery agents, the reporting of three trials (6%) specified not using delivery agents, and in the reporting of the remaining 24 trials (46%) the use of delivery agents was unclear. The reported intervention type was an IPEP alone in 43 trials (83

  9. Multiple linear regression to estimate time-frequency electrophysiological responses in single trials. (United States)

    Hu, L; Zhang, Z G; Mouraux, A; Iannetti, G D


    Transient sensory, motor or cognitive event elicit not only phase-locked event-related potentials (ERPs) in the ongoing electroencephalogram (EEG), but also induce non-phase-locked modulations of ongoing EEG oscillations. These modulations can be detected when single-trial waveforms are analysed in the time-frequency domain, and consist in stimulus-induced decreases (event-related desynchronization, ERD) or increases (event-related synchronization, ERS) of synchrony in the activity of the underlying neuronal populations. ERD and ERS reflect changes in the parameters that control oscillations in neuronal networks and, depending on the frequency at which they occur, represent neuronal mechanisms involved in cortical activation, inhibition and binding. ERD and ERS are commonly estimated by averaging the time-frequency decomposition of single trials. However, their trial-to-trial variability that can reflect physiologically-important information is lost by across-trial averaging. Here, we aim to (1) develop novel approaches to explore single-trial parameters (including latency, frequency and magnitude) of ERP/ERD/ERS; (2) disclose the relationship between estimated single-trial parameters and other experimental factors (e.g., perceived intensity). We found that (1) stimulus-elicited ERP/ERD/ERS can be correctly separated using principal component analysis (PCA) decomposition with Varimax rotation on the single-trial time-frequency distributions; (2) time-frequency multiple linear regression with dispersion term (TF-MLRd) enhances the signal-to-noise ratio of ERP/ERD/ERS in single trials, and provides an unbiased estimation of their latency, frequency, and magnitude at single-trial level; (3) these estimates can be meaningfully correlated with each other and with other experimental factors at single-trial level (e.g., perceived stimulus intensity and ERP magnitude). The methods described in this article allow exploring fully non-phase-locked stimulus-induced cortical

  10. Impact of Nursing Home Palliative Care Teams on End-of-Life Outcomes: A Randomized Controlled Trial. (United States)

    Temkin-Greener, Helena; Mukamel, Dana B; Ladd, Heather; Ladwig, Susan; Caprio, Thomas V; Norton, Sally A; Quill, Timothy E; Olsan, Tobie H; Cai, Xueya


    Deficits in end-of-life care in nursing homes (NHs) are reported, but the impact of palliative care teams (PCTeams) on resident outcomes remains largely untested. Test the impact of PCTeams on end-of-life outcomes. Multicomponent strategy employing a randomized, 2-arm controlled trial with a difference-in-difference analysis, and a nonrandomized second control group to assess the intervention's placebo effect. In all, 25 New York State NHs completed the trial (5830 decedent residents) and 609 NHs were in the nonrandomized group (119,486 decedents). Four risk-adjusted outcome measures: place of death, number of hospitalizations, self-reported moderate-to-severe pain, and depressive symptoms. The Minimum Data Set, vital status files, staff surveys, and in-depth interviews were employed. For each outcome, a difference-in-difference model compared the pre-post intervention periods using logistic and Poisson regressions. Overall, we found no statistically significant effect of the intervention. However, independent analysis of the interview data found that only 6 of the 14 treatment facilities had continuously working PCTeams throughout the study period. Decedents in homes with working teams had significant reductions in the odds of in-hospital death compared to the other treatment [odds ratio (OR), 0.400; Phomes vary in their ability to adopt new care practices, and in their capacity to sustain them, reforms to create the environment in which effective palliative care can become broadly implemented are needed.

  11. Treatment comparison in randomized clinical trials with nonignorable missingness: A reverse regression approach. (United States)

    Zhang, Zhiwei; Cheon, Kyeongmi


    A common problem in randomized clinical trials is nonignorable missingness, namely that the clinical outcome(s) of interest can be missing in a way that is not fully explained by the observed quantities. This happens when the continued participation of patients depends on the current outcome after adjusting for the observed history. Standard methods for handling nonignorable missingness typically require specification of the response mechanism, which can be difficult in practice. This article proposes a reverse regression approach that does not require a model for the response mechanism. Instead, the proposed approach relies on the assumption that missingness is independent of treatment assignment upon conditioning on the relevant outcome(s). This conditional independence assumption is motivated by the observation that, when patients are effectively masked to the assigned treatment, their decision to either stay in the trial or drop out cannot depend on the assigned treatment directly. Under this assumption, one can estimate parameters in the reverse regression model, test for the presence of a treatment effect, and in some cases estimate the outcome distributions. The methodology can be extended to longitudinal outcomes under natural conditions. The proposed approach is illustrated with real data from a cardiovascular study.

  12. Cluster randomized trial to evaluate the impact of team training on surgical outcomes. (United States)

    Duclos, A; Peix, J L; Piriou, V; Occelli, P; Denis, A; Bourdy, S; Carty, M J; Gawande, A A; Debouck, F; Vacca, C; Lifante, J C; Colin, C


    The application of safety principles from the aviation industry to the operating room has offered hope in reducing surgical complications. This study aimed to assess the impact on major surgical complications of adding an aviation-based team training programme after checklist implementation. A prospective parallel-group cluster trial was undertaken between September 2011 and March 2013. Operating room teams from 31 hospitals were assigned randomly to participate in a team training programme focused on major concepts of crew resource management and checklist utilization. The primary outcome measure was the occurrence of any major adverse event, including death, during the hospital stay within the first 30 days after surgery. Using a difference-in-difference approach, the ratio of the odds ratios (ROR) was estimated to compare changes in surgical outcomes between intervention and control hospitals. Some 22 779 patients were enrolled, including 5934 before and 16 845 after team training implementation. The risk of major adverse events fell from 8·8 to 5·5 per cent in 16 intervention hospitals (adjusted odds ratio 0·57, 95 per cent c.i. 0·48 to 0·68; P training programme appears to require modification and adaptation of its principles in the context of the the surgical milieu. Registration number: NCT01384474 ( © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd.

  13. Is pancreaticogastrostomy safer than pancreaticojejunostomy after pancreaticoduodenectomy? A meta-regression analysis of randomized clinical trials. (United States)

    Ricci, Claudio; Casadei, Riccardo; Taffurelli, Giovanni; Pacilio, Carlo Alberto; Beltrami, Denis; Minni, Francesco

    To evaluate the clinically relevant POPF rate between Pancreatogastrostomy (PG) and pancreaticojejunostomy (PJ) after pancreaticoduodenectomy (PD). To evaluate the confounding factors affecting meta-analytic results. A systematic literature search of randomized clinical trials (RCTs) comparing PG to PJ with an International Study Group of Pancreatic Fistula (ISGPF) definition of postoperative pancreatic fistula (POPF). Risk difference (RD) and number needed to treat or harm (NNT and NNH) were used. Fixed and random-effect models were applied. Impact of confounding covariates on the meta-analytic results was evaluated using meta-regression analysis, reporting β coefficient ± standard error (SE). Seven RCTs were identified involving 1184 patients: 603 PG and 581 PJ. RD in the fixed model of clinically relevant POPFs suggested that PG was superior to PJ (RD-0.07; 95% CI: -0.11 to -0.03) with an NNT of 14 (95% CI: 9 to 33). In random model, PG was not superior to PJ (RD-0.06; 95% CI: -0.13 to 0.01) with an NNT of 17 and a possibility of harm in some cases (NNH = 100). Meta-regression suggested that the increase in the proportion of "soft pancreas" in the PG arm corresponded to a more positive value of RD (β = 0.47 ± 0.19; P value: 0.045 ± 0.003). A PG could be slightly superior to PJ in the prevention of clinically relevant POPF. The presence of high risk pancreatic remnant remains the main limitation of PG. Copyright © 2017. Published by Elsevier B.V.

  14. Verbal Selective Reminding Test (six-trial administration): Regression-based norms for a portuguese version. (United States)

    Neves, Mariana Rigueiro; Sousa, Cláudia; Passos, Ana Margarida; Ferreira, Aristides I; Sá, Maria José


    The Verbal Selective Reminding Test (VSRT) is a widely used measure to evaluate verbal learning and memory associated with different neurological conditions. The goal of this study was to extend the use of the six-version trial of this test to the Portuguese population, through the production of adjusted normative data. The normative sample consists of 309 healthy participants aged between 20 and 70, with an educational level ranging from 4 to 23 years of formal. Gender, education, and age effects were explored. In addition, the reliability of the test was also analyzed and normative data produced. Gender, age, and education were significantly associated with VSRT performance. The test revealed excellent inter-rater reliability and good test-retest reliability. The normative data is presented as a regression-based formula to adjust test scores for gender, education and age. The correspondence between adjusted scores and percentile distribution was calculated. Since a test with appropriate norms is fundamental to an appropriate assessment of memory functioning, the normative data produced in this study improves the applicability of VRST for both clinical and research proposes in the Portuguese population. Further studies might also explore the adequacy of these norms for other Portuguese-speaking countries.

  15. On Some Aspects of Conditional Power Evaluation In Two-phase Clinical Trials Under Linear Regression

    Directory of Open Access Journals (Sweden)

    A. S. Hedayat


    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman","serif";} We investigate the conditional power under the framework of linear regression models so that it can be applied to most actual clinical trials in which multiple treatment effects and covariate effects are included. It is well known that the standard power of a regular test for a treatment contrast depends on unknown parameters only through the contrast itself. However it is not true in general for conditional power. Conditions for this to happen are established here and some instances are illustrated. We also show that similar arguments can be made about the sufficient statistics for the conditional power.

  16. Management of diabetes by a healthcare team in a cardiology unit: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Maria Antonieta P. de Moraes


    Full Text Available OBJECTIVE: To assess the effectiveness of healthcare team guidance in the implementation of a glycemic control protocol in the non-intensive care unit of a cardiology hospital. METHODS: This was a randomized clinical trial comparing 9 months of intensive guidance by a healthcare team on a protocol for diabetes care (Intervention Group, n = 95 with 9 months of standard care (Control Group, n = 87. NCT01154413. RESULTS: The mean age of the patients was 61.7±10 years, and the mean glycated hemoglobin level was 71±23 mmol/mol (8.7±2.1%. The mean capillary glycemia during hospitalization was similar between the groups (9.8±2.9 and 9.1±2.4 mmol/l for the Intervention Group and Control Group, respectively, p = 0.078. The number of hypoglycemic episodes (p = 0.77, hyperglycemic episodes (47 vs. 50 in the Intervention Group and Control Group, p = 0.35, respectively, and the length of stay in the hospital were similar between the groups (p = 0.64. The amount of regular insulin administered was 0 (0-10 IU in the Intervention Group and 28 (7-56 IU in the Control Group (p<0.001, and the amount of NPH insulin administered was similar between the groups (p = 0.16. CONCLUSIONS: While guidance on a glycemic control protocol given by a healthcare team resulted in a modification of the therapeutic strategy, no changes in glycemic control, frequency of episodes of hypoglycemia and hyperglycemia, or hospitalization duration were observed.

  17. Team sports for overweight children: the Stanford Sports to Prevent Obesity Randomized Trial (SPORT). (United States)

    Weintraub, Dana L; Tirumalai, Evelyn C; Haydel, K Farish; Fujimoto, Michelle; Fulton, Janet E; Robinson, Thomas N


    To evaluate the feasibility, acceptability, and efficacy of an after-school team sports program for reducing weight gain in low-income overweight children. Six-month, 2-arm, parallel-group, pilot randomized controlled trial. Low-income, racial/ethnic minority community. Twenty-one children in grades 4 and 5 with a body mass index at or above the 85th percentile. The treatment intervention consisted of an after-school soccer program. The "active placebo" control intervention consisted of an after-school health education program. Implementation, acceptability, body mass index, physical activity measured using accelerometers, reported television and other screen time, self-esteem, depressive symptoms, and weight concerns. All 21 children completed the study. Compared with children receiving health education, children in the soccer group had significant decreases in body mass index z scores at 3 and 6 months and significant increases in total daily, moderate, and vigorous physical activity at 3 months. An after-school team soccer program for overweight children can be a feasible, acceptable, and efficacious intervention for weight control.

  18. Strengthening primary health care teams with palliative care leaders: protocol for a cluster randomized clinical trial. (United States)

    Llobera, Joan; Sansó, Noemí; Ruiz, Amador; Llagostera, Merce; Serratusell, Estefania; Serrano, Carlos; Roselló, María Luisa Martín; Benito, Enric; Castaño, Eusebio J; Leiva, Alfonso


    The objective of the Balearic Islands Palliative Care (PC) Program is to improve the quality of PC through a shared model consisting of primary health care professionals, home-based PC teams, and PC units in hospitals. According to the World Health Organization (WHO), patients with advanced cancer and other terminal diseases benefit from early identification and proactive PC. We will evaluate the effectiveness of an intervention in which a PC leader is established in the primary health care center, and assess the effect of this intervention on the early identification of patients in need of PC, the efficient use of health care services, and direct health care costs. Design: A two-arm cluster randomized clinical trial of 30 Primary Health Care Centers (PHCC) in Mallorca (Spain), in which each center was randomized to an intervention arm or a usual care arm. We expect that the number of patients identified as suitable for PC (including non-oncological PC) is at least 5% greater in the intervention arm. A total of 4640 deceased patients. Outcomes will be assessed by a blinded external review of the electronic records. General practitioners (GPs) and nurse leaders in PC for each PHCC will be appointed. These leaders will help promote PC training of colleagues, improve symptom management and psychological support of patients, and evaluate the complexity of individual cases so that these cases receive assistance from PC home-based teams. Early identification (>90 days before death), evaluation of case complexity, level of case complexity (with referral to a home-based PC team), use and cost of hospital and primary care services, and quality of life during the last month of life (≥2 emergency room visits, ≥2 hospital admissions, ≥14 days of hospitalization). PC leaders in primary care teams will improve the early identification of patients eligible for PC. This initiative could improve the quality of end-of-life care and utilization of hospital resources. ISRCTN

  19. Team cohesiveness, team size and team performance in team-based learning teams. (United States)

    Thompson, Britta M; Haidet, Paul; Borges, Nicole J; Carchedi, Lisa R; Roman, Brenda J B; Townsend, Mark H; Butler, Agata P; Swanson, David B; Anderson, Michael P; Levine, Ruth E


    The purpose of this study was to explore the relationships among variables associated with teams in team-based learning (TBL) settings and team outcomes. We administered the National Board of Medical Examiners (NBME) Psychiatry Subject Test first to individuals and then to teams of Year three students at four medical schools that used TBL in their psychiatry core clerkships. Team cohesion was analysed using the Team Performance Scale (TPS). Bivariate correlation and linear regression analysis were used to analyse the relationships among team-level variables (mean individual TPS scores for each team, mean individual NBME scores of teams, team size, rotation and gender make-up) and team NBME test scores. A hierarchical linear model was used to test the effects of individual TPS and individual NBME test scores within each team, as well as the effects of the team-level variables of team size, team rotation and gender on team NBME test scores. Individual NBME test and TPS scores were nested within teams and treated as subsampling units. Individual NBME test scores and individual TPS scores were positively and statistically significantly (p team NBME test scores, when team rotation, team size and gender make-up were controlled for. Higher team NBME test scores were associated with teams rotating later in the year and larger teams (p teams at four medical schools suggest that larger teams on later rotations score higher on a team NBME test. Individual NBME test scores and team cohesion were positively and significantly associated with team NBME test scores. These results suggest the need for additional studies focusing on team outcomes, team cohesion, team size, rotation and other factors as they relate to the effective and efficient performance of TBL teams in health science education. © 2015 John Wiley & Sons Ltd.

  20. Comparing cluster-level dynamic treatment regimens using sequential, multiple assignment, randomized trials: Regression estimation and sample size considerations. (United States)

    NeCamp, Timothy; Kilbourne, Amy; Almirall, Daniel


    Cluster-level dynamic treatment regimens can be used to guide sequential treatment decision-making at the cluster level in order to improve outcomes at the individual or patient-level. In a cluster-level dynamic treatment regimen, the treatment is potentially adapted and re-adapted over time based on changes in the cluster that could be impacted by prior intervention, including aggregate measures of the individuals or patients that compose it. Cluster-randomized sequential multiple assignment randomized trials can be used to answer multiple open questions preventing scientists from developing high-quality cluster-level dynamic treatment regimens. In a cluster-randomized sequential multiple assignment randomized trial, sequential randomizations occur at the cluster level and outcomes are observed at the individual level. This manuscript makes two contributions to the design and analysis of cluster-randomized sequential multiple assignment randomized trials. First, a weighted least squares regression approach is proposed for comparing the mean of a patient-level outcome between the cluster-level dynamic treatment regimens embedded in a sequential multiple assignment randomized trial. The regression approach facilitates the use of baseline covariates which is often critical in the analysis of cluster-level trials. Second, sample size calculators are derived for two common cluster-randomized sequential multiple assignment randomized trial designs for use when the primary aim is a between-dynamic treatment regimen comparison of the mean of a continuous patient-level outcome. The methods are motivated by the Adaptive Implementation of Effective Programs Trial which is, to our knowledge, the first-ever cluster-randomized sequential multiple assignment randomized trial in psychiatry.

  1. The effectiveness of crisis resource management and team debriefing in resuscitation education of nursing students: A randomised controlled trial. (United States)

    Coppens, Imgard; Verhaeghe, Sofie; Van Hecke, Ann; Beeckman, Dimitri


    The aim of this study was to investigate (i) whether integrating a course on crisis resource management principles and team debriefings in simulation training, increases self-efficacy, team efficacy and technical skills of nursing students in resuscitation settings and (ii) which phases contribute the most to these outcomes. Crisis resource management principles have been introduced in health care to optimise teamwork. Simulation training offers patient safe training opportunities. There is evidence that simulation training increases self-efficacy and team efficacy but the contribution of the different phases like crisis resource management principles, simulation training and debriefing on self-efficacy, team efficacy and technical skills is not clear. Randomised controlled trial in a convenience sample (n = 116) in Belgium. Data were collected between February 2015-April 2015. Participants in the intervention group (n = 60) completed a course on crisis resource management principles, followed by a simulation training session, a team debriefing and a second simulation training session. Participants in the control group (n = 56) only completed two simulation training sessions. The outcomes self-efficacy, team efficacy and technical skills were assessed after each simulation training. An ancillary analysis of the learning effect was conducted. The intervention group increased on self-efficacy (2.13%, p = .02) and team efficacy (9.92%, p intervention group scored significantly higher on team efficacy (8.49%, p crisis resource management principles and team debriefings in simulation training increases self-efficacy and team efficacy. The debriefing phase contributes the most to these effects. By partnering with healthcare settings, it becomes possible to offer interdisciplinary simulation training that can increase patient safety. © 2017 John Wiley & Sons Ltd.

  2. Randomized controlled trial of multidisciplinary team stress and performance in immersive simulation for management of infant in shock: study protocol. (United States)

    Ghazali, Daniel Aiham; Ragot, Stéphanie; Breque, Cyril; Guechi, Youcef; Boureau-Voultoury, Amélie; Petitpas, Franck; Oriot, Denis


    Human error and system failures continue to play a substantial role in adverse outcomes in healthcare. Simulation improves management of patients in critical condition, especially if it is undertaken by a multidisciplinary team. It covers technical skills (technical and therapeutic procedures) and non-technical skills, known as Crisis Resource Management. The relationship between stress and performance is theoretically described by the Yerkes-Dodson law as an inverted U-shaped curve. Performance is very low for a low level of stress and increases with an increased level of stress, up to a point, after which performance decreases and becomes severely impaired. The objectives of this randomized trial are to study the effect of stress on performance and the effect of repeated simulation sessions on performance and stress. This study is a single-center, investigator-initiated randomized controlled trial including 48 participants distributed in 12 multidisciplinary teams. Each team is made up of 4 persons: an emergency physician, a resident, a nurse, and an ambulance driver who usually constitute a French Emergency Medical Service team. Six multidisciplinary teams are planning to undergo 9 simulation sessions over 1 year (experimental group), and 6 multidisciplinary teams are planning to undergo 3 simulation sessions over 1 year (control group). Evidence of the existence of stress will be assessed according to 3 criteria: biological, electrophysiological, and psychological stress. The impact of stress on overall team performance, technical procedure and teamwork will be evaluated. Participant self-assessment of the perceived impact of simulations on clinical practice will be collected. Detection of post-traumatic stress disorder will be performed by self-assessment questionnaire on the 7(th) day and after 1 month. We will concomitantly evaluate technical and non-technical performance, and the impact of stress on both. This is the first randomized trial studying

  3. Panel Management to Improve Smoking and Hypertension Outcomes by VA Primary Care Teams: A Cluster-Randomized Controlled Trial. (United States)

    Schwartz, Mark D; Jensen, Ashley; Wang, Binhuan; Bennett, Katelyn; Dembitzer, Anne; Strauss, Shiela; Schoenthaler, Antoinette; Gillespie, Colleen; Sherman, Scott


    Panel Management can expand prevention and chronic illness management beyond the office visit, but there is limited evidence for its effectiveness or guidance on how best to incorporate it into practice. We aimed to test the effectiveness of incorporating panel management into clinical practice by incorporating Panel Management Assistants (PMAs) into primary care teams with and without panel management education. We conducted an 8-month cluster-randomized controlled trial of panel management for improving hypertension and smoking cessation outcomes among veterans. Twenty primary care teams from the Veterans Affairs New York Harbor were randomized to control, panel management support, or panel management support plus education groups. Teams included 69 clinical staff serving 8,153 hypertensive and/or smoking veterans. Teams assigned to the intervention groups worked with non-clinical Panel Management Assistants (PMAs) who monitored care gaps and conducted proactive patient outreach, including referrals, mail reminders and motivational interviewing by telephone. Measurements included mean systolic and diastolic blood pressure, proportion of patients with controlled blood pressure, self-reported quit attempts, nicotine replacement therapy (NRT) prescriptions, and referrals to disease management services. Change in mean blood pressure, blood pressure control, and smoking quit rates were similar across study groups. Patients on intervention teams were more likely to receive NRT (OR = 1.4; 95% CI 1.2-1.6) and enroll in the disease management services MOVE! (OR = 1.2; 95% CI 1.1-1.6) and Telehealth (OR = 1.7, 95% CI 1.4-2.1) than patients on control teams. Panel Management support for primary care teams improved process, but not outcome variables among veterans with hypertension and smoking. Incorporating PMAs into teams was feasible and highly valued by the clinical staff, but clinical impact may require a longer intervention.

  4. The Impact of Rudeness on Medical Team Performance: A Randomized Trial. (United States)

    Riskin, Arieh; Erez, Amir; Foulk, Trevor A; Kugelman, Amir; Gover, Ayala; Shoris, Irit; Riskin, Kinneret S; Bamberger, Peter A


    Iatrogenesis often results from performance deficiencies among medical team members. Team-targeted rudeness may underlie such performance deficiencies, with individuals exposed to rude behavior being less helpful and cooperative. Our objective was to explore the impact of rudeness on the performance of medical teams. Twenty-four NICU teams participated in a training simulation involving a preterm infant whose condition acutely deteriorated due to necrotizing enterocolitis. Participants were informed that a foreign expert on team reflexivity in medicine would observe them. Teams were randomly assigned to either exposure to rudeness (in which the expert's comments included mildly rude statements completely unrelated to the teams' performance) or control (neutral comments). The videotaped simulation sessions were evaluated by 3 independent judges (blinded to team exposure) who used structured questionnaires to assess team performance, information-sharing, and help-seeking. The composite diagnostic and procedural performance scores were lower for members of teams exposed to rudeness than to members of the control teams (2.6 vs 3.2 [P = .005] and 2.8 vs 3.3 [P = .008], respectively). Rudeness alone explained nearly 12% of the variance in diagnostic and procedural performance. A model specifying information-sharing and help-seeking as mediators linking rudeness to team performance explained an even greater portion of the variance in diagnostic and procedural performance (R(2) = 52.3 and 42.7, respectively). Rudeness had adverse consequences on the diagnostic and procedural performance of the NICU team members. Information-sharing mediated the adverse effect of rudeness on diagnostic performance, and help-seeking mediated the effect of rudeness on procedural performance. Copyright © 2015 by the American Academy of Pediatrics.

  5. Clinical trials: odds ratios and multiple regression models--why and how to assess them

    NARCIS (Netherlands)

    Sobh, Mohamad; Cleophas, Ton J.; Hadj-Chaib, Amel; Zwinderman, Aeilko H.


    Odds ratios (ORs), unlike chi2 tests, provide direct insight into the strength of the relationship between treatment modalities and treatment effects. Multiple regression models can reduce the data spread due to certain patient characteristics and thus improve the precision of the treatment

  6. Randomised controlled trial of the clinical and cost effectiveness of a specialist team for managing refractory unipolar depressive disorder

    Directory of Open Access Journals (Sweden)

    Fox Richard


    Full Text Available Abstract Background Around 40 per cent of patients with unipolar depressive disorder who are treated in secondary care mental health services do not respond to first or second line treatments for depression. Such patients have 20 times the suicide rate of the general population and treatment response becomes harder to achieve and sustain the longer they remain depressed. Despite this there are no randomised controlled trials of community based service delivery interventions delivering both algorithm based pharmacotherapy and psychotherapy for patients with chronic depressive disorder in secondary care mental health services who remain moderately or severely depressed after six months treatment. Without such trials evidence based guidelines on services for such patients cannot be derived. Methods/design Single blind individually randomised controlled trial of a specialist depression disorder team (psychiatrist and psychotherapist jointly assessing and providing algorithm based drug and psychological treatment versus usual secondary care treatment. We will recruit 174 patients with unipolar depressive disorder in secondary mental health services with a Hamilton Depression Rating Scale (HDRS score ≥ 16 and global assessment of function (GAF ≤ 60 after ≥ 6 months treatment. The primary outcome measures will be the HDRS and GAF supplemented by economic analysis incuding the EQ5 D and analysis of barriers to care, implementation and the process of care. Audits to benchmark both treatment arms against national standards of care will aid the interpretation of the results of the study. Discussion This trial will be the first to assess the effectiveness and implementation of a community based specialist depression disorder team. The study has been specially designed as part of the CLAHRC Nottinghamshire, Derbyshire and Lincolnshire joint collaboration between university, health and social care organisations to provide information of direct relevance

  7. A note on Using regression models to analyze randomized trials: asymptotically valid hypothesis tests despite incorrectly specified models. (United States)

    Kim, Jane Paik


    In the context of randomized trials, Rosenblum and van der Laan (2009, Biometrics 63, 937-945) considered the null hypothesis of no treatment effect on the mean outcome within strata of baseline variables. They showed that hypothesis tests based on linear regression models and generalized linear regression models are guaranteed to have asymptotically correct Type I error regardless of the actual data generating distribution, assuming the treatment assignment is independent of covariates. We consider another important outcome in randomized trials, the time from randomization until failure, and the null hypothesis of no treatment effect on the survivor function conditional on a set of baseline variables. By a direct application of arguments in Rosenblum and van der Laan (2009), we show that hypothesis tests based on multiplicative hazards models with an exponential link, i.e., proportional hazards models, and multiplicative hazards models with linear link functions where the baseline hazard is parameterized, are asymptotically valid under model misspecification provided that the censoring distribution is independent of the treatment assignment given the covariates. In the case of the Cox model and linear link model with unspecified baseline hazard function, the arguments in Rosenblum and van der Laan (2009) cannot be applied to show the robustness of a misspecified model. Instead, we adopt an approach used in previous literature (Struthers and Kalbfleisch, 1986, Biometrika 73, 363-369) to show that hypothesis tests based on these models, including models with interaction terms, have correct type I error. Copyright © 2013, The International Biometric Society.

  8. Can team-based care improve patient satisfaction? A systematic review of randomized controlled trials

    National Research Council Canada - National Science Library

    Wen, Jin; Schulman, Kevin A


    .... The effectiveness of these approaches on patient outcomes has not been well documented. This paper reports a systematic review of the relationship between team-based care and patient satisfaction...

  9. Policy entrepreneurship in UK central government: The behavioural insights team and the use of randomized controlled trials. (United States)

    John, Peter


    What factors explain the success of the UK Cabinet Office's Behavioural Insights Team? To answer this question, this article applies insights from organizational theory, particularly accounts of change agents. Change agents are able-with senior sponsorship-to foster innovation by determination and skill: they win allies and circumvent more traditional bureaucratic procedures. Although Behavioural Insights Team is a change agent-maybe even a skunkworks unit-not all the facilitating factors identified in the literature apply in this central government context. Key factors are its willingness to work in a non-hierarchical way, skills at forming alliances, and the ability to form good relationships with expert audiences. It has been able to promote a more entrepreneurial approach to government by using randomized controlled trials as a robust method of policy evaluation.

  10. REFOCUS Trial: protocol for a cluster randomised controlled trial of a pro-recovery intervention within community based mental health teams

    Directory of Open Access Journals (Sweden)

    Slade Mike


    Full Text Available Abstract Background There is a consensus about the importance of 'recovery' in mental health services, but the evidence base is limited. Methods/Design A two centre, cluster randomised controlled trial. Participants are community-based mental health teams, and service users aged 18-65 years with a primary clinical diagnosis of psychosis. In relation to the REFOCUS Manual, which describes a 12-month, pro-recovery intervention based on the REFOCUS Model, the objectives are: (1 To establish the effectiveness of the intervention described in the REFOCUS Manual; (2 To validate the REFOCUS Model; (3 To establish and optimise trial parameters for the REFOCUS Manual; and (4 To understand the relationship between clinical outcomes and recovery outcomes. The hypothesis for the main study is that service users in the intervention arm will experience significantly greater increases in measures of personal recovery (as measured by the QPR compared to service users receiving care from control teams. The hypothesis for the secondary study is that black service users in the intervention arm will experience significantly greater increases in measures of personal recovery (as measured by the QPR and client satisfaction (as measured by the CSQ compared to Black service users receiving care from control teams. The intervention comprises treatment as usual plus two components: recovery-promoting relationships and working practices. The control condition is treatment as usual. The primary outcme is the Process of Recovery Questionnaire (QPR. Secondary outcomes are satisfaction, Goal setting - Personal Primary Outcome, hope, well-being, empowerment, and quality of life. Primary outcomes for the secondary study will be QPR and satisfaction. Cost data will be estimated, and clinical outcomes will also be reported (symptomatology, need, social disability, functioning. 29 teams (15 intervention and 14 control will be randomised. Within

  11. Does adding a dietician to the liaison team after discharge of geriatric patients improve nutritional outcome: a randomised controlled trial. (United States)

    Beck, A; Andersen, U T; Leedo, E; Jensen, L L; Martins, K; Quvang, M; Rask, K Ø; Vedelspang, A; Rønholt, F


    The objective was to test whether adding a dietician to a discharge Liaison-Team after discharge of geriatric patients improves nutritional status, muscle strength and patient relevant outcomes. Twelve-week randomized controlled trial. Geriatric patients (70 + years and at nutritional risk) at discharge. Participants were randomly allocated to receive discharge Liaison-Team vs. discharge Liaison-Team in cooperation with a dietician. The dietician performed a total of three home visits with the aim of developing and implementing an individual nutritional care plan. The first visit took place at the day of discharge together with the discharge Liaison-Team while the remaining visits took place approximately three and eight weeks after discharge and were performed by a dietician alone. Nutritional status (weight, and dietary intake), muscle strength (hand grip strength, chair-stand), functional status (mobility, and activities of daily living), quality of life, use of social services, re-/hospitalization and mortality. Seventy-one patients were included (34 in the intervention group), and 63 (89%) completed the second data collection after 12 weeks (31 in the intervention group). Odds ratios for hospitalization and mortality 6 months after discharge were 0.367 (0.129; 1.042) and 0.323 (0.060; 1.724). Nutritional status improved and some positive tendencies in favour of the intervention group were observed for patient relevant outcomes, i.e. activities of daily living, and quality of life. Almost 100% of the intervention group received three home visits by a dietician. Adding a dietician to the discharge Liaison-Team after discharge of geriatric patients can improve nutritional status and may reduce the number of times hospitalized within 6 months. A larger study is necessary to see a significant effect on other patient relevant outcomes. © The Author(s) 2014.

  12. Randomised controlled trial of the clinical and cost effectiveness of a specialist team for managing refractory unipolar depressive disorder. (United States)

    Morriss, Richard; Marttunnen, Sarah; Garland, Anne; Nixon, Neil; McDonald, Ruth; Sweeney, Tim; Flambert, Heather; Fox, Richard; Kaylor-Hughes, Catherine; James, Marilyn; Yang, Min


    Around 40 per cent of patients with unipolar depressive disorder who are treated in secondary care mental health services do not respond to first or second line treatments for depression. Such patients have 20 times the suicide rate of the general population and treatment response becomes harder to achieve and sustain the longer they remain depressed. Despite this there are no randomised controlled trials of community based service delivery interventions delivering both algorithm based pharmacotherapy and psychotherapy for patients with chronic depressive disorder in secondary care mental health services who remain moderately or severely depressed after six months treatment. Without such trials evidence based guidelines on services for such patients cannot be derived. Single blind individually randomised controlled trial of a specialist depression disorder team (psychiatrist and psychotherapist jointly assessing and providing algorithm based drug and psychological treatment) versus usual secondary care treatment. We will recruit 174 patients with unipolar depressive disorder in secondary mental health services with a Hamilton Depression Rating Scale (HDRS) score ≥ 16 and global assessment of function (GAF) ≤ 60 after ≥ 6 months treatment. The primary outcome measures will be the HDRS and GAF supplemented by economic analysis including the EQ5 D and analysis of barriers to care, implementation and the process of care. Audits to benchmark both treatment arms against national standards of care will aid the interpretation of the results of the study. This trial will be the first to assess the effectiveness and implementation of a community based specialist depression disorder team. The study has been specially designed as part of the CLAHRC Nottinghamshire, Derbyshire and Lincolnshire joint collaboration between university, health and social care organisations to provide information of direct relevance to decisions on commissioning, service provision and

  13. Student and Teacher Outcomes of the Class-Wide Function-Related Intervention Team Efficacy Trial (United States)

    Wills, Howard; Kamps, Debra; Fleming, Kandace; Hansen, Blake


    Schools continue to strive for the use of evidenced-based interventions and policies to foster well-managed classrooms that promote improved student outcomes. The present study examined the effects of the Class-Wide Function-related Intervention Teams (CW-FIT), a group contingency intervention, on the on-task and disruptive behavior of elementary…

  14. Acupuncture for musculoskeletal pain: A meta-analysis and meta-regression of sham-controlled randomized clinical trials. (United States)

    Yuan, Qi-Ling; Wang, Peng; Liu, Liang; Sun, Fu; Cai, Yong-Song; Wu, Wen-Tao; Ye, Mao-Lin; Ma, Jiang-Tao; Xu, Bang-Bang; Zhang, Yin-Gang


    The aims of this systematic review were to study the analgesic effect of real acupuncture and to explore whether sham acupuncture (SA) type is related to the estimated effect of real acupuncture for musculoskeletal pain. Five databases were searched. The outcome was pain or disability immediately (≤1 week) following an intervention. Standardized mean differences (SMDs) with 95% confidence intervals were calculated. Meta-regression was used to explore possible sources of heterogeneity. Sixty-three studies (6382 individuals) were included. Eight condition types were included. The pooled effect size was moderate for pain relief (59 trials, 4980 individuals, SMD -0.61, 95% CI -0.76 to -0.47; P meta-regression model, sham needle location and/or depth could explain most or all heterogeneities for some conditions (e.g., shoulder pain, low back pain, osteoarthritis, myofascial pain, and fibromyalgia); however, the interactions between subgroups via these covariates were not significant (P < 0.05). Our review provided low-quality evidence that real acupuncture has a moderate effect (approximate 12-point reduction on the 100-mm visual analogue scale) on musculoskeletal pain. SA type did not appear to be related to the estimated effect of real acupuncture.

  15. Placebo and nocebo reactions in randomized trials of pharmacological treatments for persistent depressive disorder. A meta-regression analysis. (United States)

    Meister, Ramona; Jansen, Alessa; Härter, Martin; Nestoriuc, Yvonne; Kriston, Levente


    We aimed to investigate placebo and nocebo reactions in randomized controlled trials (RCT) of pharmacological treatments for persistent depressive disorder (PDD). We conducted a systematic electronic search and included RCTs investigating antidepressants for the treatment of PDD. Outcomes were the number of patients experiencing response and remission in placebo arms (=placebo reaction). Additional outcomes were the incidence of patients experiencing adverse events and related discontinuations in placebo arms (=nocebo reaction). A priori defined effect modifiers were analyzed using a series of meta-regression analyses. Twenty-three trials were included in the analyses. We found a pooled placebo response rate of 31% and a placebo remission rate of 22%. The pooled adverse event rate and related discontinuations were 57% and 4%, respectively. All placebo arm outcomes were positively associated with the corresponding medication arm outcomes. Placebo response rate was associated with a greater proportion of patients with early onset depression, a smaller chance to receive placebo and a larger sample size. The adverse event rate in placebo arms was associated with a greater proportion of patients with early onset depression, a smaller proportion of females and a more recent publication. Pooled placebo and nocebo reaction rates in PDD were comparable to those in episodic depression. The identified effect modifiers should be considered to assess unbiased effects in RCTs, to influence placebo and nocebo reactions in practice. Limitations result from the methodology applied, the fact that we conducted only univariate analyses, and the number and quality of included trials. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Detection of domestic violence by community mental health teams: a multi-center, cluster randomized controlled trial. (United States)

    Ruijne, Roos E; Howard, Louise M; Trevillion, Kylee; Jongejan, Femke E; Garofalo, Carlo; Bogaerts, Stefan; Mulder, Cornelis L; Kamperman, Astrid M


    Domestic Violence and Abuse (DVA) is associated with a range of psychosocial and mental health problems. Having a psychiatric illness increases likelihood of being a victim of DVA. Despite the evidence of a high risk for DVA and the serious effects of violent victimization in psychiatric patients, detection rates are low and responses are inadequate. The aim of the BRAVE (Better Reduction trough Assessment of Violence and Evaluation) study is to improve detection of and response to DVA in psychiatric patients. In this article, we present the protocol of the BRAVE study which follows the SPIRIT guidelines. The BRAVE study is a cluster randomized controlled trial. We will include 24 community mental health teams from Rotterdam and The Hague. Twelve teams will provide care as usual and 12 teams will receive the intervention. The intervention consists of 1) a knowledge and skills training for mental health professionals about DVA, 2) a knowledge and skills training of DVA professionals about mental illness, 3) provision and implementation of a referral pathway between community mental health and DVA services. The follow up period is 12 months. Our primary outcome is the rate of detected cases of recent or any history of DVA in patients per team in 12 months. Detection rates are obtained through a systematic search in electronic patient files. Our secondary aims are to obtain information about the gain and sustainability of knowledge on DVA in mental health professionals, and to obtain insight into the feasibility, sustainability and acceptability of the intervention. Data on our secondary aims will be obtained through structured in depth interviews and a questionnaire on knowledge and attitudes on DVA. This study is the first cluster randomized controlled trial to target both male and female psychiatric patients that experience DVA, using an intervention that involves training of professionals. We expect the rate of detected cases of DVA to increase in the

  17. The reproducibility of 10 and 20km time trial cycling performance in recreational cyclists, runners and team sport athletes. (United States)

    Borg, David N; Osborne, John O; Stewart, Ian B; Costello, Joseph T; Sims, Jesse N L; Minett, Geoffrey M


    This study aimed to determine the reliability of 10 and 20km cycling time trial (TT) performance on the Velotron Pro in recreational cyclists, runners and intermittent-sprint based team sport athletes, with and without a familiarisation. Thirty-one male, recreationally active athletes completed four 10 or 20km cycling TTs on different days. During cycling, power output, speed and cadence were recorded at 23Hz, and heart rate and rating of perceived exertion (RPE) were recorded every km. Multiple statistical methods were used to ensure a comprehensive assessment of reliability. Intraclass correlations, standard error of the measurement, minimum difference required for a worthwhile change and coefficient of variation were determined for completion time and mean trial variables (power output, speed, cadence, heart rate, RPE, session RPE). A meaningful change in performance for cyclists, runners, team sport athletes would be represented by 7.5, 3.6 and 12.9% improvement for 10km and a 4.9, 4.0 and 5.6% for 20km completion time. After a familiarisation, a 4.0, 3.7 and 6.4% improvement for 10km and a 4.1, 3.0 and 4.4% would be required for 20km. Data from this study suggest not all athletic subgroups require a familiarisation to produce substantially reliable 10 and 20km cycling performance. However, a familiarisation considerably improves the reliability of pacing strategy adopted by recreational runners and team sport athletes across these distances. Copyright © 2018 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  18. Efficacy of dexamethasone versus bevacizumab on regression of hard exudates in diabetic maculopathy: data from the BEVORDEX randomised clinical trial. (United States)

    Mehta, Hemal; Fraser-Bell, Samantha; Yeung, Aaron; Campain, Anna; Lim, Lyndell L; Quin, Godfrey J; McAllister, Ian L; Keane, Pearse A; Gillies, Mark C


    To report the effect of bevacizumab versus dexamethasone on hard exudates (HEX) in diabetic macular oedema (DME). Post hoc analysis of 24-month data from the Randomised clinical trial of BEVacizumab OR DEXamethasone for diabetic macular oedema (BEVORDEX) phase 2 multicentre randomised clinical trial. Eyes with centre-involving DME resistant to or unlikely to benefit from macular laser therapy were included. Eyes were randomly assigned to bevacizumab every 4 weeks or Ozurdex dexamethasone implant (DEX) every 16 weeks, both as required. The 68 eyes from 48 patients that completed 24-month follow-up were analysed. Two masked graders assessed extent and location of HEX on baseline, 12-month and 24-month foveal-centred colour fundus photographs using validated grading software. Macular HEX was present in 60% of study eyes. Of these, 21 eyes were treated with DEX and 20 eyes with bevacizumab. Both treatments led to reduction in area of macular HEX at 12 months and 24 months. There was greater regression of HEX from the foveal centre in DEX-treated eyes (median change +890 µm, IQR=1040 µm) than bevacizumab-treated eyes (median change +7.0 µm, IQR=590 µm) at 12 months (p=0.04) but the difference was no longer statistically significant (p=0.10) by 24 months (DEX +1400 µm, IQR=1590 µm; bevacizumab +20 µm, IQR=2680 µm). Reassuringly, no study eye developed HEX at the foveal centre, a visually devastating consequence of diabetic maculopathy. Bevacizumab and DEX were effective in reducing area of HEX in eyes with DME. DEX provided more rapid regression of HEX from the foveal centre although bevacizumab-treated eyes started to catch up by 24 months. Distance from the foveal centre as well as total area of macular HEX should be assessed when evaluating treatments for foveal-threatening HEX. NCT01298076; Post-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  19. ERP correlates of word production predictors in picture naming: a trial by trial multiple regression analysis from stimulus onset to response. (United States)

    Valente, Andrea; Bürki, Audrey; Laganaro, Marina


    A major effort in cognitive neuroscience of language is to define the temporal and spatial characteristics of the core cognitive processes involved in word production. One approach consists in studying the effects of linguistic and pre-linguistic variables in picture naming tasks. So far, studies have analyzed event-related potentials (ERPs) during word production by examining one or two variables with factorial designs. Here we extended this approach by investigating simultaneously the effects of multiple theoretical relevant predictors in a picture naming task. High density EEG was recorded on 31 participants during overt naming of 100 pictures. ERPs were extracted on a trial by trial basis from picture onset to 100 ms before the onset of articulation. Mixed-effects regression models were conducted to examine which variables affected production latencies and the duration of periods of stable electrophysiological patterns (topographic maps). Results revealed an effect of a pre-linguistic variable, visual complexity, on an early period of stable electric field at scalp, from 140 to 180 ms after picture presentation, a result consistent with the proposal that this time period is associated with visual object recognition processes. Three other variables, word Age of Acquisition, Name Agreement, and Image Agreement influenced response latencies and modulated ERPs from ~380 ms to the end of the analyzed period. These results demonstrate that a topographic analysis fitted into the single trial ERPs and covering the entire processing period allows one to associate the cost generated by psycholinguistic variables to the duration of specific stable electrophysiological processes and to pinpoint the precise time-course of multiple word production predictors at once.

  20. ERP correlates of word production predictors in picture naming: A trial by trial multiple regression analysis from stimulus onset to response

    Directory of Open Access Journals (Sweden)

    Andrea eValente


    Full Text Available A major effort in cognitive neuroscience of language is to define the temporal and spatial characteristics of the core cognitive processes involved in word production. One approach consists in studying the effects of linguistic and pre-linguistic variables in picture naming tasks. So far, studies have analyzed event-related potentials (ERPs during word production by examining one or two variables with factorial designs. Here we extended this approach by investigating simultaneously the effects of multiple theoretical relevant predictors in a picture naming task. High density EEG was recorded on 31 participants during overt naming of 100 pictures. ERPs were extracted on a trial by trial basis from picture onset to 100 msec before the onset of articulation. Mixed-effects regression models were conducted to examine which variables affected production latencies and the duration of periods of stable electrophysiological patterns (topographic maps. Results revealed an effect of a pre-linguistic variable, visual complexity, on an early period of stable electric field at scalp, from 140 to 180 after picture presentation, a result consistent with the proposal that this time period is associated with visual object recognition processes. Three other variables, word age of acquisition, name agreement and image agreement, influenced response latencies and modulated ERPs from ~380 msec to the end of the analyzed period. These results demonstrate that a topographic analysis fitted into the single trial ERPs and covering the entire processing period allows one to associate the cost generated by psycholinguistic variables to the duration of specific stable electrophysiological processes and to pinpoint the precise time-course of multiple word production predictors at once.

  1. [The trial of the domiciliary nutrition support team in which a home medical care office offers]. (United States)

    Yamashita, Hisaki; Kamei, Miwa; Yamada, Akiko; Toshima, Kazue; Morita, Hideki; Kodama, Naoto; Okabayashi, Kiyoshi


    The function of home care support by a medical office is to offer the best medical care for the patient. It is essential that the medical office is capable of taking a call 24-hour a day and 365-day a year from a patient who needs help at home. Our medical office was specialized in home care treatment. Furthermore, we offer a home rehabilitation or a home nutrition education to the patient. On the other hand, a nutritional support is important as well as medical supports. To offer a high quality medical care at home, we created a nutrient support system in our hospital, and formed an at-home nutrition support team(at-home NST). The team is consisted of a medical staff and dietitian, a physical therapist and a speech therapist. As a result of the at-home NST, We improved the followings: (1) we were able to collect a nutritional data basis including a patient 's height and weight, (2) we made a good use of patient's eating habit at home during the medical treatment, and (3) we could make a good use of medical service to a home care patient by managing the information accumulated by nutritional surveillance. In multidisciplinary collaboration, at-home NST can grasp a versatility status of the patient positively. We continue to offer a medical care that is demanded from a home care patient because the activity of the at-home NST raises a quality of medical service we provide.

  2. Multicenter phase 2 trial of sirolimus for tuberous sclerosis: kidney angiomyolipomas and other tumors regress and VEGF- D levels decrease.

    Directory of Open Access Journals (Sweden)

    Sandra L Dabora

    Full Text Available Tuberous sclerosis (TSC related tumors are characterized by constitutively activated mTOR signaling due to mutations in TSC1 or TSC2.We completed a phase 2 multicenter trial to evaluate the efficacy and tolerability of the mTOR inhibitor, sirolimus, for the treatment of kidney angiomyolipomas.36 adults with TSC or TSC/LAM were enrolled and started on daily sirolimus. The overall response rate was 44.4% (95% confidence intervals [CI] 28 to 61; 16/36 had a partial response. The remainder had stable disease (47.2%, 17/36, or were unevaluable (8.3%, 3/36. The mean decrease in kidney tumor size (sum of the longest diameters [sum LD] was 29.9% (95% CI, 22 to 37; n = 28 at week 52. Drug related grade 1-2 toxicities that occurred with a frequency of >20% included: stomatitis, hypertriglyceridemia, hypercholesterolemia, bone marrow suppression (anemia, mild neutropenia, leucopenia, proteinuria, and joint pain. There were three drug related grade 3 events: lymphopenia, headache, weight gain. Kidney angiomyolipomas regrew when sirolimus was discontinued but responses tended to persist if treatment was continued after week 52. We observed regression of brain tumors (SEGAs in 7/11 cases (26% mean decrease in diameter, regression of liver angiomyolipomas in 4/5 cases (32.1% mean decrease in longest diameter, subjective improvement in facial angiofibromas in 57%, and stable lung function in women with TSC/LAM (n = 15. A correlative biomarker study showed that serum VEGF-D levels are elevated at baseline, decrease with sirolimus treatment, and correlate with kidney angiomyolipoma size (Spearman correlation coefficient 0.54, p = 0.001, at baseline.Sirolimus treatment for 52 weeks induced regression of kidney angiomyolipomas, SEGAs, and liver angiomyolipomas. Serum VEGF-D may be a useful biomarker for monitoring kidney angiomyolipoma size. Future studies are needed to determine benefits and risks of longer duration treatment in adults and children

  3. Sleep Apnea and Cardiovascular Disease: Lessons From Recent Trials and Need for Team Science. (United States)

    Drager, Luciano F; McEvoy, R Doug; Barbe, Ferran; Lorenzi-Filho, Geraldo; Redline, Susan


    Emerging research highlights the complex interrelationships between sleep-disordered breathing and cardiovascular disease, presenting clinical and research opportunities as well as challenges. Patients presenting to cardiology clinics have a high prevalence of obstructive and central sleep apnea associated with Cheyne-Stokes respiration. Multiple mechanisms have been identified by which sleep disturbances adversely affect cardiovascular structure and function. Epidemiological research indicates that obstructive sleep apnea is associated with increases in the incidence and progression of coronary heart disease, heart failure, stroke, and atrial fibrillation. Central sleep apnea associated with Cheyne-Stokes respiration predicts incident heart failure and atrial fibrillation; among patients with heart failure, it strongly predicts mortality. Thus, a strong literature provides the mechanistic and empirical bases for considering obstructive sleep apnea and central sleep apnea associated with Cheyne-Stokes respiration as potentially modifiable risk factors for cardiovascular disease. Data from small trials provide evidence that treatment of obstructive sleep apnea with continuous positive airway pressure improves not only patient-reported outcomes such as sleepiness, quality of life, and mood but also intermediate cardiovascular end points such as blood pressure, cardiac ejection fraction, vascular parameters, and arrhythmias. However, data from large-scale randomized controlled trials do not currently support a role for positive pressure therapies for reducing cardiovascular mortality. The results of 2 recent large randomized controlled trials, published in 2015 and 2016, raise questions about the effectiveness of pressure therapies in reducing clinical end points, although 1 trial supported the beneficial effect of continuous positive airway pressure on quality of life, mood, and work absenteeism. This review provides a contextual framework for interpreting the

  4. Team-based care approach to cholesterol management in diabetes mellitus: two-year cluster randomized controlled trial. (United States)

    Pape, Ginger A; Hunt, Jacquelyn S; Butler, Kristina L; Siemienczuk, Joseph; LeBlanc, Benjamin H; Gillanders, William; Rozenfeld, Yelena; Bonin, Kerry


    Creative, cost-effective interventions to improve the quality of care of chronic illnesses are needed. This study was designed to evaluate the impact of remote physician-pharmacist team-based care on cholesterol levels in patients with diabetes mellitus (DM). This 2-year prospective, cluster randomized controlled trial was conducted within the Providence Primary Care Research Network in Oregon. Participants at least 18 years of age were identified by a diagnosis of DM. The intervention included remote physician-pharmacist team-based care focused on cholesterol management in DM. All clinicians in the study had access to the health information technology tool CareManager, which provided automated DM-related point-of-care prompts, a Web-based registry, and performance feedback with benchmarking. Study outcomes included the difference in low-density lipoprotein cholesterol (LDL-C) goal attainment, mean LDL-C, prescribed lipid-lowering therapy, and patient satisfaction between the intervention and control arms. A total of 6963 patients with DM cared for by 68 physicians in 9 clinics were evaluated. Patients in the intervention arm were more likely to achieve their target LDL-C levels compared with controls (78% vs 50%; P = .003). The mean LDL-C level was 12 mg/dL lower in the intervention arm compared with the control arm (P < .001). The rate of LDL-C testing was significantly higher in the intervention arm compared with the control arm. Patients in the intervention arm were also 15% more likely to receive a prescription for a lipid-lowering medication (P = .008). There was no significant difference in patient satisfaction between study arms (P = .15). Remotely located physician-pharmacist team-based care resulted in significantly improved LDL-C levels and goal attainment among patients with DM.

  5. Within-team debriefing versus instructor-led debriefing for simulation-based education: a randomized controlled trial. (United States)

    Boet, Sylvain; Bould, M Dylan; Sharma, Bharat; Revees, Scott; Naik, Viren N; Triby, Emmanuel; Grantcharov, Teodor


    To compare the effectiveness of an interprofessional within-team debriefing with that of an instructor-led debriefing on team performance during a simulated crisis. Although instructor-led simulation debriefing is considered the "gold standard" in team-based simulation education, cost and logistics are limiting factors for its implementation. Within-team debriefing, led by the individuals of the team itself rather than an external instructor, has the potential to address these limitations. One hundred twenty subjects were grouped into 40 operating room teams consisting of 1 anesthesia trainee, 1 surgical trainee, and 1 staff circulating operating room nurse. All teams managed a simulated crisis scenario (pretest). Teams were then randomized to either a within-team debriefing group or an instructor-led debriefing group. In the within-team debriefing group, the teams reviewed the video of their scenario by themselves. The teams in the instructor-led debriefing group reviewed their scenario guided by a trained instructor. Immediately after debriefing, all teams managed a different intraoperative crisis scenario (posttest). All sessions were videotaped. Blinded expert examiners used the validated Team Emergency Assessment Measure scale to assess crisis resource management performance of all teams in random order. Team performance significantly improved from pretest to posttest (P = 0.008) regardless of the type of debriefing. There was no significant difference in the degree of improvement between within-team debriefing and instructor-led debriefing (P = 0.52). Within-team debriefing results in measurable improvements in team performance in simulated crisis scenarios. This form of debriefing may be as effective as instructor-led team debriefing, which could improve resource utilization and feasibility of team-based simulation (NCT01067378).

  6. Dropout from exercise randomized controlled trials among people with depression: A meta-analysis and meta regression. (United States)

    Stubbs, Brendon; Vancampfort, Davy; Rosenbaum, Simon; Ward, Philip B; Richards, Justin; Soundy, Andrew; Veronese, Nicola; Solmi, Marco; Schuch, Felipe B


    Exercise has established efficacy in improving depressive symptoms. Dropouts from randomized controlled trials (RCT's) pose a threat to the validity of this evidence base, with dropout rates varying across studies. We conducted a systematic review and meta-analysis to investigate the prevalence and predictors of dropout rates among adults with depression participating in exercise RCT's. Three authors identified RCT's from a recent Cochrane review and conducted updated searches of major electronic databases from 01/2013 to 08/2015. We included RCT's of exercise interventions in people with depression (including major depressive disorder (MDD) and depressive symptoms) that reported dropout rates. A random effects meta-analysis and meta regression were conducted. Overall, 40 RCT's were included reporting dropout rates across 52 exercise interventions including 1720 people with depression (49.1 years (range=19-76 years), 72% female (range=0-100)). The trim and fill adjusted prevalence of dropout across all studies was 18.1% (95%CI=15.0-21.8%) and 17.2% (95%CI=13.5-21.7, N=31) in MDD only. In MDD participants, higher baseline depressive symptoms (β=0.0409, 95%CI=0.0809-0.0009, P=0.04) predicted greater dropout, whilst supervised interventions delivered by physiotherapists (β=-1.2029, 95%CI=-2.0967 to -0.3091, p=0.008) and exercise physiologists (β=-1.3396, 95%CI=-2.4478 to -0.2313, p=0.01) predicted lower dropout. A comparative meta-analysis (N=29) established dropout was lower in exercise than control conditions (OR=0.642, 95%CI=0.43-0.95, p=0.02). Exercise is well tolerated by people with depression and drop out in RCT's is lower than control conditions. Thus, exercise is a feasible treatment, in particular when delivered by healthcare professionals with specific training in exercise prescription. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. Simulation-based multiprofessional obstetric anaesthesia training conducted in situ versus off-site leads to similar individual and team outcomes: a randomised educational trial (United States)

    Sørensen, Jette Led; van der Vleuten, Cees; Rosthøj, Susanne; Østergaard, Doris; LeBlanc, Vicki; Johansen, Marianne; Ekelund, Kim; Starkopf, Liis; Lindschou, Jane; Gluud, Christian; Weikop, Pia; Ottesen, Bent


    Objective To investigate the effect of in situ simulation (ISS) versus off-site simulation (OSS) on knowledge, patient safety attitude, stress, motivation, perceptions of simulation, team performance and organisational impact. Design Investigator-initiated single-centre randomised superiority educational trial. Setting Obstetrics and anaesthesiology departments, Rigshospitalet, University of Copenhagen, Denmark. Participants 100 participants in teams of 10, comprising midwives, specialised midwives, auxiliary nurses, nurse anaesthetists, operating theatre nurses, and consultant doctors and trainees in obstetrics and anaesthesiology. Interventions Two multiprofessional simulations (clinical management of an emergency caesarean section and a postpartum haemorrhage scenario) were conducted in teams of 10 in the ISS versus the OSS setting. Primary outcome Knowledge assessed by a multiple choice question test. Exploratory outcomes Individual outcomes: scores on the Safety Attitudes Questionnaire, stress measurements (State-Trait Anxiety Inventory, cognitive appraisal and salivary cortisol), Intrinsic Motivation Inventory and perceptions of simulations. Team outcome: video assessment of team performance. Organisational impact: suggestions for organisational changes. Results The trial was conducted from April to June 2013. No differences between the two groups were found for the multiple choice question test, patient safety attitude, stress measurements, motivation or the evaluation of the simulations. The participants in the ISS group scored the authenticity of the simulation significantly higher than did the participants in the OSS group. Expert video assessment of team performance showed no differences between the ISS versus the OSS group. The ISS group provided more ideas and suggestions for changes at the organisational level. Conclusions In this randomised trial, no significant differences were found regarding knowledge, patient safety attitude, motivation or stress

  8. Physical Activity Program Delivery by Professionals versus Volunteers: the TEAM Randomized Trial (United States)

    Castro, Cynthia M.; Pruitt, Leslie A.; Buman, Matthew P.; King, Abby C.


    Background Older adults have low rates of physical activity participation but respond positively to telephone-mediated support programs. Programs are often limited by reliance on professional staff. This study tested telephone-based physical activity advice delivered by professional staff versus trained volunteer peer mentors. Design A 12-month, randomized, controlled clinical trial was executed from 2003–2008. Setting/participants: Twelve volunteer peer mentors and 181 initially inactive adults ages 50 years and older were recruited from the San Francisco Bay Area. Intervention Participants were randomized to: (1) telephone-based physical activity advice delivered by professional staff, (2) telephone-based physical activity advice delivered by trained volunteer peers, or (3) an attention-control arm of staff-delivered telephone support for nutrition. Main Outcome Measures: Moderate-intensity or more vigorous physical activity (MVPA) was assessed at baseline, 6, and 12 months with the CHAMPS Questionnaire, with accelerometry validation (Actigraph) in a randomly selected subsample. Treatment fidelity was examined through analysis of quantity and quality of intervention delivery. Results At 6 and 12 months, both physical activity arms significantly increased MVPA relative to the control arm. Both physical activity arms were comparable in quantity of intervention delivery, but peers demonstrated more versatility and comprehensiveness in quality of intervention content. Conclusions This study demonstrates that trained peer volunteers can effectively promote physical activity increases through telephone-based advice. The results support a program delivery model with good dissemination potential for a variety of community settings. PMID:21553972

  9. Effect of prior chemotherapy regimens on the efficacy of endocrine therapy within a German cohort of the TEAM trial. (United States)

    Bossart, Michaela; Hadji, Peyman; Klar, Maximilian; Kieback, Dirk G; Hasenburg, Annette


    Prior chemotherapy may affect the efficacy of endocrine therapy. The tamoxifen exemestane adjuvant multinational (TEAM) trial compared 5 years of adjuvant exemestane with the sequence of tamoxifen followed by exemestane in postmenopausal women with hormone-receptor-positive breast cancer. A total of 1,502 patients were enrolled in Germany (739 received tamoxifen followed by exemestan and 610 exemestan alone). A retrospective analysis of the German cohort of TEAM was conducted to determine whether prior chemotherapy affected clinical outcome of endocrine therapy. Overall survival, disease-free survival and distant recurrence were similar between patients who received sequential therapy and those who received exemestane monotherapy, irrespective of prior chemotherapy. Overall survival was not significantly different between patients who had received prior chemotherapy and those who had not (P = 0.2836). Disease-free survival and distant recurrence were significantly better in patients who had not received prior chemotherapy versus those who had (P = 0.0308 and P = 0.0001). In patients receiving sequential therapy, there were no significant differences in overall survival according to prior chemotherapy use (P = 0.1812). However, disease-free survival and distant recurrence were significantly different dependent on prior chemotherapy (P = 0.0143 and P = 0.0053). In conclusion, there was no difference in overall survival between breast cancer patients who did receive prior chemotherapy before endocrine therapy and those who had not. Patients who had not received prior chemotherapy had significantly improved disease-free survival and less distant recurrence versus those who had received chemotherapy.

  10. Characteristics of Effective Collaborative Care for Treatment of Depression: A Systematic Review and Meta-Regression of 74 Randomised Controlled Trials (United States)

    Coventry, Peter A.; Hudson, Joanna L.; Kontopantelis, Evangelos; Archer, Janine; Richards, David A.; Gilbody, Simon; Lovell, Karina; Dickens, Chris; Gask, Linda; Waheed, Waquas; Bower, Peter


    Background Collaborative care is a complex intervention based on chronic disease management models and is effective in the management of depression. However, there is still uncertainty about which components of collaborative care are effective. We used meta-regression to identify factors in collaborative care associated with improvement in patient outcomes (depressive symptoms) and the process of care (use of anti-depressant medication). Methods and Findings Systematic review with meta-regression. The Cochrane Collaboration Depression, Anxiety and Neurosis Group trials registers were searched from inception to 9th February 2012. An update was run in the CENTRAL trials database on 29th December 2013. Inclusion criteria were: randomised controlled trials of collaborative care for adults ≥18 years with a primary diagnosis of depression or mixed anxiety and depressive disorder. Random effects meta-regression was used to estimate regression coefficients with 95% confidence intervals (CIs) between study level covariates and depressive symptoms and relative risk (95% CI) and anti-depressant use. The association between anti-depressant use and improvement in depression was also explored. Seventy four trials were identified (85 comparisons, across 21,345 participants). Collaborative care that included psychological interventions predicted improvement in depression (β coefficient −0.11, 95% CI −0.20 to −0.01, p = 0.03). Systematic identification of patients (relative risk 1.43, 95% CI 1.12 to 1.81, p = 0.004) and the presence of a chronic physical condition (relative risk 1.32, 95% CI 1.05 to 1.65, p = 0.02) predicted use of anti-depressant medication. Conclusion Trials of collaborative care that included psychological treatment, with or without anti-depressant medication, appeared to improve depression more than those without psychological treatment. Trials that used systematic methods to identify patients with depression and also trials that included

  11. Taking into account latency, amplitude, and morphology: improved estimation of single-trial ERPs by wavelet filtering and multiple linear regression. (United States)

    Hu, L; Liang, M; Mouraux, A; Wise, R G; Hu, Y; Iannetti, G D


    Across-trial averaging is a widely used approach to enhance the signal-to-noise ratio (SNR) of event-related potentials (ERPs). However, across-trial variability of ERP latency and amplitude may contain physiologically relevant information that is lost by across-trial averaging. Hence, we aimed to develop a novel method that uses 1) wavelet filtering (WF) to enhance the SNR of ERPs and 2) a multiple linear regression with a dispersion term (MLR(d)) that takes into account shape distortions to estimate the single-trial latency and amplitude of ERP peaks. Using simulated ERP data sets containing different levels of noise, we provide evidence that, compared with other approaches, the proposed WF+MLR(d) method yields the most accurate estimate of single-trial ERP features. When applied to a real laser-evoked potential data set, the WF+MLR(d) approach provides reliable estimation of single-trial latency, amplitude, and morphology of ERPs and thereby allows performing meaningful correlations at single-trial level. We obtained three main findings. First, WF significantly enhances the SNR of single-trial ERPs. Second, MLR(d) effectively captures and measures the variability in the morphology of single-trial ERPs, thus providing an accurate and unbiased estimate of their peak latency and amplitude. Third, intensity of pain perception significantly correlates with the single-trial estimates of N2 and P2 amplitude. These results indicate that WF+MLR(d) can be used to explore the dynamics between different ERP features, behavioral variables, and other neuroimaging measures of brain activity, thus providing new insights into the functional significance of the different brain processes underlying the brain responses to sensory stimuli.

  12. Taking into account latency, amplitude, and morphology: improved estimation of single-trial ERPs by wavelet filtering and multiple linear regression (United States)

    Hu, L.; Liang, M.; Mouraux, A.; Wise, R. G.; Hu, Y.


    Across-trial averaging is a widely used approach to enhance the signal-to-noise ratio (SNR) of event-related potentials (ERPs). However, across-trial variability of ERP latency and amplitude may contain physiologically relevant information that is lost by across-trial averaging. Hence, we aimed to develop a novel method that uses 1) wavelet filtering (WF) to enhance the SNR of ERPs and 2) a multiple linear regression with a dispersion term (MLRd) that takes into account shape distortions to estimate the single-trial latency and amplitude of ERP peaks. Using simulated ERP data sets containing different levels of noise, we provide evidence that, compared with other approaches, the proposed WF+MLRd method yields the most accurate estimate of single-trial ERP features. When applied to a real laser-evoked potential data set, the WF+MLRd approach provides reliable estimation of single-trial latency, amplitude, and morphology of ERPs and thereby allows performing meaningful correlations at single-trial level. We obtained three main findings. First, WF significantly enhances the SNR of single-trial ERPs. Second, MLRd effectively captures and measures the variability in the morphology of single-trial ERPs, thus providing an accurate and unbiased estimate of their peak latency and amplitude. Third, intensity of pain perception significantly correlates with the single-trial estimates of N2 and P2 amplitude. These results indicate that WF+MLRd can be used to explore the dynamics between different ERP features, behavioral variables, and other neuroimaging measures of brain activity, thus providing new insights into the functional significance of the different brain processes underlying the brain responses to sensory stimuli. PMID:21880936

  13. Attenuating posttraumatic distress with omega-3 polyunsaturated fatty acids among disaster medical assistance team members after the Great East Japan Earthquake: the APOP randomized controlled trial. (United States)

    Matsuoka, Yutaka; Nishi, Daisuke; Nakaya, Naoki; Sone, Toshimasa; Hamazaki, Kei; Hamazaki, Tomohito; Koido, Yuichi


    On March 11, 2011, a magnitude 9.0 earthquake, the most powerful ever recorded in Japan, and a massive tsunami struck off the coast of the Sanriku region. A Disaster Medical Assistance Team, a mobile medical team with specialized training that is deployed during the acute phase of a disaster, was dispatched to areas with large-scale destruction and multiple injured and sick casualties. Previous studies have reported critical incident stress (i.e. posttraumatic stress disorder symptoms and depressive symptoms) among rescue workers as well as the need for screening and prevention for posttraumatic stress disorder. So far we have shown in an open trial that posttraumatic stress disorder symptoms in critically injured patients can be reduced by taking omega-3 fatty acids intended to stimulate hippocampal neurogenesis. This study is designed to determine the effectiveness of attenuating posttraumatic distress with omega-3 polyunsaturated fatty acids among Disaster Medical Assistance Team members after the Great East Japan Earthquake, and is named the APOP randomized controlled trial which is currently ongoing. First, we will provide psycho-education on posttraumatic distress, which is common in responders to the Disaster Medical Assistance Team members deployed to the disaster area. Second, observational research will be conducted to evaluate critical incident stress following the completion of medical activities. Third, team members who provide consent to participate in the intervention research will be randomly divided into a group given an omega-3 fatty acid supplement and a group not given the supplements. Outcome will be evaluated at 12 weeks after the supplements are shipped to the team members. Measures that address critical incident stress in disaster responders are important, but there is no substantial evidence that links such measures with prevention of posttraumatic stress disorder. Thus, any confirmation through this study that the intake of omega-3 fatty

  14. The effect of journal impact factor, reporting conflicts, and reporting funding sources, on standardized effect sizes in back pain trials: a systematic review and meta-regression. (United States)

    Froud, Robert; Bjørkli, Tom; Bright, Philip; Rajendran, Dévan; Buchbinder, Rachelle; Underwood, Martin; Evans, David; Eldridge, Sandra


    Low back pain is a common and costly health complaint for which there are several moderately effective treatments. In some fields there is evidence that funder and financial conflicts are associated with trial outcomes. It is not clear whether effect sizes in back pain trials relate to journal impact factor, reporting conflicts of interest, or reporting funding. We performed a systematic review of English-language papers reporting randomised controlled trials of treatments for non-specific low back pain, published between 2006-2012. We modelled the relationship using 5-year journal impact factor, and categories of reported of conflicts of interest, and categories of reported funding (reported none and reported some, compared to not reporting these) using meta-regression, adjusting for sample size, and publication year. We also considered whether impact factor could be predicted by the direction of outcome, or trial sample size. We could abstract data to calculate effect size in 99 of 146 trials that met our inclusion criteria. Effect size is not associated with impact factor, reporting of funding source, or reporting of conflicts of interest. However, explicitly reporting 'no trial funding' is strongly associated with larger absolute values of effect size (adjusted β=1.02 (95 % CI 0.44 to 1.59), P=0.001). Impact factor increases by 0.008 (0.004 to 0.012) per unit increase in trial sample size (Pimpact factor, reporting sources of funding, and conflicts of interest reflects positively on research and publisher conduct in the field. Strong evidence of a large association between absolute magnitude of effect size and explicit reporting of 'no funding' suggests authors of unfunded trials are likely to report larger effect sizes, notwithstanding direction. This could relate in part to quality, resources, and/or how pragmatic a trial is.

  15. Better interprofessional teamwork, higher level of organized care, and lower risk of burnout in acute health care teams using care pathways: a cluster randomized controlled trial. (United States)

    Deneckere, Svin; Euwema, Martin; Lodewijckx, Cathy; Panella, Massimiliano; Mutsvari, Timothy; Sermeus, Walter; Vanhaecht, Kris


    Effective interprofessional teamwork is an essential component for the delivery of high-quality patient care in an increasingly complex medical environment. The objective is to evaluate whether the implementation of care pathways (CPs) improves teamwork in an acute hospital setting. A posttest-only cluster randomized controlled trial was performed in Belgian acute hospitals. Teams caring for patients hospitalized with a proximal femur fracture and those hospitalized with an exacerbation of chronic obstructive pulmonary disease, were randomized into intervention and control groups. The intervention group implemented a CP. The control group provided usual care. A set of team input, process, and output indicators were used as effect measures. To analyze the results, we performed multilevel statistical analysis. Thirty teams and a total of 581 individual team members participated. The intervention teams scored significantly better in conflict management [β=0.30 (0.11); 95% confidence interval (CI), 0.08 to 0.53]; team climate for innovation [β=0.29 (0.10); 95% CI, 0.09 to 0.49]; and level of organized care [β=5.56 (2.05); 95% CI, 1.35 to 9.76]. They also showed lower risk of burnout as they scored significantly lower in emotional exhaustion [β=-0.57 (0.21); 95% CI, -1.00 to -0.14] and higher in the level of competence (β=0.39; 95% CI, 0.15 to 0.64). No significant effect was found on relational coordination. CPs are effective interventions for improving teamwork, increasing the organizational level of care processes, and decreasing risk of burnout for health care teams in an acute hospital setting. Through this, high-performance teams can be built.

  16. Multisystemic engagement & nephrology based educational intervention: a randomized controlled trial protocol on the kidney team at home-study

    Directory of Open Access Journals (Sweden)

    Ismail Sohal Y


    Full Text Available Abstract Background Living donor kidney transplantation (LDKT is the most successful form of renal replacement therapy in terms of wait time and survival rates. However, we observed a significant inequality in the number of LDKT performed between the Dutch and the non-Dutch patients. The objective of this study is to adapt, implement and test an educational home-based intervention to contribute to the reduction of this inequality. Our aim is to establish this through guided communication together with the social network of the patients in an attempt that well-informed decisions regarding renal replacement therapy can be made: Multisystemic Engagement & Nephrology. This manuscript is a detailed description of the Kidney Team At Home-study protocol. Methods and design All patients (>18 yrs that are referred to the pre-transplantation outpatient clinic are eligible to participate in the study. Patients will be randomly assigned to either an experimental or a control group. The control group will continue to receive standard care. The experimental group will receive standard care plus a home-based educational intervention. The intervention consists of two sessions at the patient’s home, an initial session with the patient and a second session for which individuals from their social network are invited to take part. Based on the literature and behavioural change theories we hypothesize that reducing hurdles in knowledge, risk perception, subjective norm, self-efficacy, and communication contribute to well-informed decision making and reducing inequality in accessing LDKT programs. A change in these factors is consequently our primary outcome-measure. Based on power calculations, we aim to include 160 patients over a period of two years. Discussion If we are able to show that this home-based group educational intervention contributes to 1 achieving well-informed decision regarding treatment and 2 reducing the inequality in LDKT, the quality of life

  17. Sixty Years of Placebo-Controlled Antipsychotic Drug Trials in Acute Schizophrenia: Systematic Review, Bayesian Meta-Analysis, and Meta-Regression of Efficacy Predictors. (United States)

    Leucht, Stefan; Leucht, Claudia; Huhn, Maximilian; Chaimani, Anna; Mavridis, Dimitris; Helfer, Bartosz; Samara, Myrto; Rabaioli, Matteo; Bächer, Susanne; Cipriani, Andrea; Geddes, John R; Salanti, Georgia; Davis, John M


    Antipsychotic drug efficacy may have decreased over recent decades. The authors present a meta-analysis of all placebo-controlled trials in patients with acute exacerbations of schizophrenia, and they investigate which trial characteristics have changed over the years and which are moderators of drug-placebo efficacy differences. The search included multiple electronic databases. The outcomes were overall efficacy (primary outcome); responder and dropout rates; positive, negative, and depressive symptoms; quality of life; functioning; and major side effects. Potential moderators of efficacy were analyzed by meta-regression. The analysis included 167 double-blind randomized controlled trials with 28,102 mainly chronic participants. The standardized mean difference (SMD) for overall efficacy was 0.47 (95% credible interval 0.42, 0.51), but accounting for small-trial effects and publication bias reduced the SMD to 0.38. At least a "minimal" response occurred in 51% of the antipsychotic group versus 30% in the placebo group, and 23% versus 14% had a "good" response. Positive symptoms (SMD 0.45) improved more than negative symptoms (SMD 0.35) and depression (SMD 0.27). Quality of life (SMD 0.35) and functioning (SMD 0.34) improved even in the short term. Antipsychotics differed substantially in side effects. Of the response predictors analyzed, 16 trial characteristics changed over the decades. However, in a multivariable meta-regression, only industry sponsorship and increasing placebo response were significant moderators of effect sizes. Drug response remained stable over time. Approximately twice as many patients improved with antipsychotics as with placebo, but only a minority experienced a good response. Effect sizes were reduced by industry sponsorship and increasing placebo response, not decreasing drug response. Drug development may benefit from smaller samples but better-selected patients.

  18. Attenuating posttraumatic distress with omega-3 polyunsaturated fatty acids among disaster medical assistance team members after the Great East Japan Earthquake: The APOP randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Matsuoka Yutaka


    Full Text Available Abstract Background On March 11, 2011, a magnitude 9.0 earthquake, the most powerful ever recorded in Japan, and a massive tsunami struck off the coast of the Sanriku region. A Disaster Medical Assistance Team, a mobile medical team with specialized training that is deployed during the acute phase of a disaster, was dispatched to areas with large-scale destruction and multiple injured and sick casualties. Previous studies have reported critical incident stress (i.e. posttraumatic stress disorder symptoms and depressive symptoms among rescue workers as well as the need for screening and prevention for posttraumatic stress disorder. So far we have shown in an open trial that posttraumatic stress disorder symptoms in critically injured patients can be reduced by taking omega-3 fatty acids intended to stimulate hippocampal neurogenesis. Method/Design This study is designed to determine the effectiveness of attenuating posttraumatic distress with omega-3 polyunsaturated fatty acids among Disaster Medical Assistance Team members after the Great East Japan Earthquake, and is named the APOP randomized controlled trial which is currently ongoing. First, we will provide psycho-education on posttraumatic distress, which is common in responders to the Disaster Medical Assistance Team members deployed to the disaster area. Second, observational research will be conducted to evaluate critical incident stress following the completion of medical activities. Third, team members who provide consent to participate in the intervention research will be randomly divided into a group given an omega-3 fatty acid supplement and a group not given the supplements. Outcome will be evaluated at 12 weeks after the supplements are shipped to the team members. Discussion Measures that address critical incident stress in disaster responders are important, but there is no substantial evidence that links such measures with prevention of posttraumatic stress disorder. Thus, any

  19. Reducing errors in health care: cost-effectiveness of multidisciplinary team training in obstetric emergencies (TOSTI study; a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Mol Ben


    Dutch Society of Obstetrics and Gynaecology (NVOG. We anticipated that multidisciplinary team training would reduce this risk to 5%. A sample size of 24 centres with a cluster size of each at least 200 deliveries, each 12 centres per group, was needed for 80% power and a 5% type 1 error probability (two-sided. We assumed an Intraclass Correlation Coefficient (ICC value of maximum 0.08. The analysis will be performed according to the intention-to-treat principle and stratified for teaching or non-teaching hospitals. Primary outcome is the number of obstetric complications throughout the first year period after the intervention. If multidisciplinary team training appears to be effective a cost-effective analysis will be performed. Discussion If multidisciplinary team training appears to be cost-effective, this training should be implemented in extra training for gynaecologists. Trial Registration The protocol is registered in the clinical trial register number NTR1859

  20. Acupuncture for musculoskeletal pain: A meta-analysis and meta-regression of sham-controlled randomized clinical trials


    Qi-ling Yuan; Peng Wang; Liang Liu; Fu Sun; Yong-song Cai; Wen-tao Wu; Mao-lin Ye; Jiang-tao Ma; Bang-bang Xu; Yin-gang Zhang


    The aims of this systematic review were to study the analgesic effect of real acupuncture and to explore whether sham acupuncture (SA) type is related to the estimated effect of real acupuncture for musculoskeletal pain. Five databases were searched. The outcome was pain or disability immediately (?1 week) following an intervention. Standardized mean differences (SMDs) with 95% confidence intervals were calculated. Meta-regression was used to explore possible sources of heterogeneity. Sixty-t...

  1. Tumor regression grading after preoperative chemoradiotherapy for locally advanced rectal carcinoma revisited: updated results of the CAO/ARO/AIO-94 trial. (United States)

    Fokas, Emmanouil; Liersch, Torsten; Fietkau, Rainer; Hohenberger, Werner; Beissbarth, Tim; Hess, Clemens; Becker, Heinz; Ghadimi, Michael; Mrak, Karl; Merkel, Susanne; Raab, Hans-Rudolf; Sauer, Rolf; Wittekind, Christian; Rödel, Claus


    We previously described the prognostic impact of tumor regression grading (TRG) on the outcome of patients with rectal carcinoma treated with preoperative chemoradiotherapy (CRT) in the CAO/ARO/AIO-94 trial. Here we report long-term results after a median follow-up of 132 months. TRG after preoperative CRT was determined in 386 surgical specimens by the amount of viable tumor cells versus fibrosis, ranging from TRG 4 (no viable tumor cells) to TRG 0 (no signs of regression). Clinicopathologic parameters and TRG were correlated to the cumulative incidence of local recurrence, distant metastasis, and disease-free survival (DFS). Ten-year cumulative incidence of distant metastasis and DFS were 10.5% and 89.5% for patients with TRG 4 (complete regression), 29.3% and 73.6% for TRG 2 and 3 (intermediate regression), and 39.6% and 63% for TRG 0 and 1 (poor regression), respectively (P = .005 and P = .008, respectively). On multivariable analysis, residual lymph node metastasis (ypN+) and TRG were the only independent prognostic factors for cumulative incidence of distant metastasis (P < .001 and P = .035, respectively) and DFS (P < .001 and P = .039, respectively), whereas local recurrence was significantly affected by ypN status (P < .001) and lymphatic invasion (P = .026). Complete and intermediate tumor regressions were associated with improved long-term outcome in patients with rectal carcinoma after preoperative CRT independent of clinicopathologic parameters. This classification system needs to be prospectively tested in multiple data sets to validate its reproducibility in a wider setting. © 2014 by American Society of Clinical Oncology.

  2. Randomized controlled trial of anticipatory and preventive multidisciplinary team care: for complex patients in a community-based primary care setting. (United States)

    Hogg, William; Lemelin, Jacques; Dahrouge, Simone; Liddy, Clare; Armstrong, Catherine Deri; Legault, Frances; Dalziel, Bill; Zhang, Wei


    T o examine whether quality of care (QOC) improves when nurse practitioners and pharmacists work with family physicians in community practice and focus their work on patients who are 50 years of age and older and considered to be at risk of experiencing adverse health outcomes. Randomized controlled trial. A family health network with 8 family physicians, 5 nurses, and 11 administrative personnel serving 10 000 patients in a rural area near Ottawa, Ont. Patients 50 years of age and older at risk of experiencing adverse health outcomes (N = 241). At-risk patients were randomly assigned to receive usual care from their family physicians or Anticipatory and Preventive Team Care (APTCare) from a collaborative team composed of their physicians, 1 of 3 nurse practitioners, and a pharmacist. Quality of care for chronic disease management (CDM) for diabetes, coronary artery disease, congestive heart failure, and chronic obstructive pulmonary disease. Controlling for baseline demographic characteristics, the APTCare approach improved CDM QOC by 9.2% (P multidisciplinary care teams with intensive interventions in primary care can improve QOC for CDM in a population of older at-risk patients. The appropriateness of this intervention will depend on its cost-effectiveness. TRIAL REGISTRATION NUMBER NCT00238836 (CONSORT).

  3. What are People's Experiences of a Novel Cognitive Behavioural Therapy for Bipolar Disorders? A Qualitative Investigation with Participants on the TEAMS Trial. (United States)

    Joyce, Emmeline; Tai, Sara; Gebbia, Piersanti; Mansell, Warren


    Background Psychological interventions for bipolar disorders typically produce mixed outcomes and modest effects. The need for a more effective intervention prompted the development of a new cognitive behavioural therapy, based on an integrative cognitive model ('Think Effectively About Mood Swings' [TEAMS] therapy). Unlike previous interventions, TEAMS addresses current symptoms and comorbidities, and helps clients achieve long-term goals. A pilot randomized controlled trial (the TEAMS trial) of the therapy has recently concluded. This study explored participants' experiences of TEAMS, recommendations for improvement and experiences of useful changes post-therapy. Methods Fourteen TEAMS therapy participants took part in semi-structured interviews. Their accounts were analysed using interpretative thematic analysis. Two researchers coded the dataset independently. Member checks were conducted of the preliminary themes. Results Two overarching themes; 'useful elements of therapy' and 'changes from therapy' encompassed 12 emerging subthemes. Participants appreciated having opportunities to talk and described the therapy as person-centred and delivered by caring, approachable and skilled therapists. Some recommended more sessions than the 16 provided. Helpful therapeutic techniques were reported to be, normalization about moods, methods to increase understanding of moods, relapse-prevention, reappraisal techniques and metaphors. However, some did not find therapeutic techniques helpful. Post-therapy, many reported changes in managing mood swings more effectively and in their thinking (although some participants reported changes in neither). Many described increased acceptance of themselves and of having bipolar disorder, increased productivity and reduced anxiety in social situations. Conclusions The present study evaluates participants' therapy experiences in detail, including aspects of therapy viewed as helpful, and meaningful post-therapy outcomes. Copyright

  4. Policy entrepreneurship in UK central government: The behavioural insights team and the use of randomized controlled trials


    John, P.


    What factors explain the success of the UK Cabinet Office?s Behavioural Insights Team? To answer this question, this article applies insights from organizational theory, particularly accounts of change agents. Change agents are able?with senior sponsorship?to foster innovation by determination and skill: they win allies and circumvent more traditional bureaucratic procedures. Although Behavioural Insights Team is a change agent?maybe even a skunkworks unit?not all the facilitating factors ide...

  5. Reducing errors in health care: cost-effectiveness of multidisciplinary team training in obstetric emergencies (TOSTI study); a randomised controlled trial. (United States)

    van de Ven, Joost; Houterman, Saskia; Steinweg, Rob A J Q; Scherpbier, Albert J J A; Wijers, Willy; Mol, Ben William J; Oei, S Guid


    anticipated that multidisciplinary team training would reduce this risk to 5%. A sample size of 24 centres with a cluster size of each at least 200 deliveries, each 12 centres per group, was needed for 80% power and a 5% type 1 error probability (two-sided). We assumed an Intraclass Correlation Coefficient (ICC) value of maximum 0.08.The analysis will be performed according to the intention-to-treat principle and stratified for teaching or non-teaching hospitals.Primary outcome is the number of obstetric complications throughout the first year period after the intervention. If multidisciplinary team training appears to be effective a cost-effective analysis will be performed. If multidisciplinary team training appears to be cost-effective, this training should be implemented in extra training for gynaecologists. The protocol is registered in the clinical trial register number NTR1859.

  6. Improving Conduct and Feasibility of Clinical Trials to Evaluate Antibacterial Drugs to Treat Hospital-Acquired Bacterial Pneumonia and Ventilator-Associated Bacterial Pneumonia: Recommendations of the Clinical Trials Transformation Initiative Antibacterial Drug Development Project Team. (United States)

    Knirsch, Charles; Alemayehu, Demissie; Botgros, Radu; Comic-Savic, Sabrina; Friedland, David; Holland, Thomas L; Merchant, Kunal; Noel, Gary J; Pelfrene, Eric; Reith, Christina; Santiago, Jonas; Tiernan, Rosemary; Tenearts, Pamela; Goldsack, Jennifer C; Fowler, Vance G


    The etiology of hospital-acquired or ventilator-associated bacterial pneumonia (HABP/VABP) is often multidrug-resistant infections. The evaluation of new antibacterial drugs for efficacy in this population is important, as many antibacterial drugs have demonstrated limitations when studied in this population. HABP/VABP trials are expensive and challenging to conduct due to protocol complexity and low patient enrollment, among other factors. The Clinical Trials Transformation Initiative (CTTI) seeks to advance antibacterial drug development by streamlining HABP/VABP clinical trials to improve efficiency and feasibility while maintaining ethical rigor, patient safety, information value, and scientific validity. In 2013, CTTI engaged a multidisciplinary group of experts to discuss challenges impeding the conduct of HABP/VABP trials. Separate workstreams identified challenges associated with HABP/VABP protocol complexity. The Project Team developed potential solutions to streamline HABP/VABP trials using a Quality by Design approach. CTTI recommendations focus on 4 key areas to improve HABP/VABP trials: informed consent processes/practices, protocol design, choice of an institutional review board (IRB), and trial outcomes. Informed consent processes should include legally authorized representatives. Protocol design decisions should focus on eligibility criteria, prestudy antibacterial therapy considerations, use of new diagnostics, and sample size. CTTI recommends that sponsors use a central IRB and discuss trial endpoints with regulators, including defining a clinical failure and evaluating the impact of concomitant antibacterial drugs. Streamlining HABP/VABP trials by addressing key protocol elements can improve trial startup and patient recruitment/retention, reduce trial complexity and costs, and ensure patient safety while advancing antibacterial drug development. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of

  7. Enhancement of regression of cervical intraepithelial neoplasia II (moderate dysplasia) with topically applied all-trans-retinoic acid: a randomized trial. (United States)

    Meyskens, F L; Surwit, E; Moon, T E; Childers, J M; Davis, J R; Dorr, R T; Johnson, C S; Alberts, D S


    Retinoids enhance differentiation of most epithelial tissues. Epidemiologic studies have shown an inverse relationship between dietary intake or serum levels of vitamin A and the development of cervical dysplasia and/or cervical cancer. Pilot and phase I investigations demonstrated the feasibility of the local delivery of all-trans-retinoic acid (RA) to the cervix using a collagen sponge insert and cervical cap. A phase II trial produced a clinical complete response rate of 50%. This randomized phase III trial was designed to determine whether topically applied RA reversed moderate cervical intraepithelial neoplasia (CIN) II or severe CIN. Analyses were based on 301 women with CIN (moderate dysplasia, 151 women; severe dysplasia, 150 women), evaluated by serial colposcopy, Papanicolaou cytology, and cervical biopsy. Cervical caps with sponges containing either 1.0 mL of 0.372% beta-trans-RA or a placebo were inserted daily for 4 days when women entered the trial, and for 2 days at months 3 and 6. Patients receiving treatment and those receiving placebo were similar with respect to age, ethnicity, birth-control methods, histologic features of the endocervical biopsy specimen and koilocytotic atypia, and percentage of involvement of the cervix at study. Treatment effects were compared using Fisher's exact test and logistic regression methods. Side effects were recorded, and differences were compared using Fisher's exact test. RA increased the complete histologic regression rate of CIN II from 27% in the placebo group to 43% in the retinoic acid treatment group (P = .041). No treatment difference between the two arms was evident in the severe dysplasia group. More vaginal and vulvar side effects were seen in the patients receiving RA, but these effects were mild and reversible. A short course of locally applied RA can reverse CIN II, but not more advanced dysplasia, with acceptable local side effects. A derivative of vitamin A can reverse or suppress an epithelial

  8. Vitamin A supplementation and neonatal mortality in the developing world: a meta-regression of cluster-randomized trials. (United States)

    Rotondi, Michael Anthony; Khobzi, Nooshin


    To assess the relationship between the prevalence of vitamin A deficiency among pregnant women and the effect of neonatal vitamin A supplementation on infant mortality. Studies of neonatal supplementation with vitamin A have yielded contradictory findings with regard to its effect on the risk of infant death, possibly owing to heterogeneity between studies. One source of that heterogeneity is the prevalence of vitamin A deficiency among pregnant women, which we examined using meta-regression techniques on eligible individual and cluster-randomized trials. Adapting standard techniques to control for the inclusion of a cluster-randomized trial, we modelled the logarithm of the relative risk of infant death comparing vitamin A supplementation at birth to a standard treatment, as a linear function of the prevalence of vitamin A deficiency in pregnant women. Meta-regression analysis revealed a statistically significant linear relationship between the prevalence of vitamin A deficiency in pregnant women and the observed effectiveness of vitamin A supplementation at birth. In regions where at least 22% of pregnant women have vitamin A deficiency, giving neonates vitamin A supplements will have a protective effect against infant death. A meta-regression analysis is observational in nature and may suffer from confounding bias. Nevertheless, our study suggests that vitamin A supplementation can reduce infant mortality in regions where this micronutrient deficiency is common. Thus, neonatal supplementation programmes may prove most beneficial in regions where the prevalence of vitamin A deficiency among pregnant women is high.

  9. MRI-measured regression of carotid atherosclerosis induced by statins with and without niacin in a randomised controlled trial: the NIA plaque study. (United States)

    Sibley, Christopher T; Vavere, Andrea L; Gottlieb, Ilan; Cox, Christopher; Matheson, Matthew; Spooner, Amy; Godoy, Gustavo; Fernandes, Veronica; Wasserman, Bruce A; Bluemke, David A; Lima, Joao A C


    To evaluate the benefit of niacin in addition to statin therapy on plaque regression among older individuals with established atherosclerosis. Randomised, controlled, double-blind clinical trial. University outpatient center. 145 patients older than 65 years, half of them older than 75 years of age, with established atherosclerosis were enrolled. Participants received either extended release niacin (1500 mg daily) or placebo in addition to statin therapy to reach their National Cholesterol Education Program-defined low density lipoprotein (LDL) cholesterol target. The primary endpoint was reduction in the wall volume of the internal carotid artery (ICA) measured by MRI. After 18 months, high density lipoprotein cholesterol was higher with statins plus niacin compared with statins alone (1.6 ± 0.4 vs 1.4 ± 0.4 mmol/L p<0.001). Both groups had significant decreases in the main outcome measure of ICA wall volume, which regressed at 0.5%/month (SEM 0.2, p=0.004) in the statins plus placebo group and at 0.7%/month in the statins plus niacin group (SEM 0.2, p<0.001). There was no difference in the rate of regression between groups (p=0.49). Treatment with statin therapy to presently recommended LDL levels, with or without niacin, resulted in significant atherosclerosis reduction.

  10. Team Sports (United States)

    ... Living with Paralysis > Health > Staying active > Team sports Team sports ☷ ▾ Page contents Basketball Quad rugby Sled hockey ... on the East and West coasts. There are teams and divisions all over the country for men, ...

  11. The Contribution of Individual Exercise Training Components to Clinical Outcomes in Randomised Controlled Trials of Cardiac Rehabilitation: A Systematic Review and Meta-regression. (United States)

    Abell, Bridget; Glasziou, Paul; Hoffmann, Tammy


    While the clinical benefits of exercise-based cardiac rehabilitation are well established, there is extensive variation in the interventions used within these trials. It is unknown whether variations in individual components of these exercise interventions provide different relative contributions to overall clinical outcomes. This study aims to systematically examine the relationship between individual components of the exercise intervention in cardiac rehabilitation (such as intensity and frequency) and clinical outcomes for people with coronary heart disease. In this systematic review, eligible trials were identified via searches of databases (PubMed, Allied and Complementary Medicine, EMBASE, PEDro, Science Citation Index Expanded, CINAHL, The Cochrane Library, SPORTDiscus) from citation tracking and hand-searching. Studies were included if they were randomised trials of a structured exercise intervention (versus usual care) for participants with coronary heart disease and reported at least one of cardiovascular mortality, total mortality, myocardial infarction or revascularisation outcomes. Each included trial was assessed using the Cochrane Risk of Bias Tool. Authors were also contacted for missing intervention details or data. Random effects meta-analysis was performed to calculate a summary risk ratio (RR) with 95% confidence interval (CI) for the effect of exercise on outcomes. Random effects meta-regression and subgroup analyses were conducted to examine the association between pre-specified co-variates (exercise components or trial characteristics) and each clinical outcome. Sixty-nine trials were included, evaluating 72 interventions which differed markedly in terms of exercise components. Exercise-based cardiac rehabilitation was effective in reducing cardiovascular mortality (RR 0.74, 95% CI 0.65 to 0.86), total mortality (RR 0.90, 95% CI 0.83 to 0.99) and myocardial infarction (RR 0.80, 95% CI 0.70 to 0.92). This effect generally demonstrated no

  12. Streamlining Safety Data Collection in Hospital-Acquired Bacterial Pneumonia and Ventilator-Associated Bacterial Pneumonia Trials: Recommendations of the Clinical Trials Transformation Initiative Antibacterial Drug Development Project Team. (United States)

    Donnelly, Helen; Alemayehu, Demissie; Botgros, Radu; Comic-Savic, Sabrina; Eisenstein, Barry; Lorenz, Benjamin; Merchant, Kunal; Pelfrene, Eric; Reith, Christina; Santiago, Jonas; Tiernan, Rosemary; Wunderink, Richard; Tenaerts, Pamela; Knirsch, Charles


    Resistant bacteria are one of the leading causes of hospital-acquired/ventilator-associated bacterial pneumonia (HABP/VABP). HABP/VABP trials are complex and difficult to conduct due to the large number of medical procedures, adverse events, and concomitant medications involved. Differences in the legislative frameworks between different regions of the world may also lead to excessive data collection. The Clinical Trials Transformation Initiative (CTTI) seeks to advance antibacterial drug development (ABDD) by streamlining clinical trials to improve efficiency and feasibility while maintaining ethical rigor, patient safety, information value, and scientific validity. In 2013, CTTI engaged a multidisciplinary group of experts to discuss challenges impeding the conduct of HABP/VABP trials. Separate workstreams identified challenges associated with current data collection processes. Experts defined "data collection" as the act of capturing and reporting certain data on the case report form as opposed to recording of data as part of routine clinical care. The ABDD Project Team developed strategies for streamlining safety data collection in HABP/VABP trials using a Quality by Design approach. Current safety data collection processes in HABP/VABP trials often include extraneous information. More targeted strategies for safety data collection in HABP/VABP trials will rely on optimal protocol design and prespecification of which safety data are essential to satisfy regulatory reporting requirements. A consensus and a cultural change in clinical trial design and conduct, which involve recognition of the need for more efficient data collection, are urgently needed to advance ABDD and to improve HABP/VABP trials in particular. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail

  13. Prevention of central nervous system sequelae in sickle cell disease without evidence from randomized controlled trials: the case for a team-based learning collaborative. (United States)

    DeBaun, Michael R; King, Allison A


    Since 1998, the National Institutes of Health has funded 5 randomized controlled trials (RCTs) for primary and secondary prevention of strokes in children with sickle cell anemia (SCA). In a systematic fashion, these trials have significantly advanced the care of children with SCA. In the absence of an RCT, clinicians are often compelled to make decisions at the bedside, based on experience, observational studies, and principles of hematology. We will provide an initial example that describes how a team-based, learning collaborative developed a multisite standard care protocol with a low budget (children and adults with SCD will be discussed: (1) secondary stroke prevention in high-income countries; (2) primary stroke prevention in low- and middle-income countries (LMICs); (3) poor academic performance in students; and (4) cognitive disability in adults. With a commitment to a team-based learning collaborative, incremental advances are possible for the neurologic care of children and adults with SCD. © 2016 by The American Society of Hematology. All rights reserved.

  14. Randomised controlled trial of the clinical and cost-effectiveness of a peer-delivered self-management intervention to prevent relapse in crisis resolution team users: study protocol. (United States)

    Johnson, Sonia; Mason, Oliver; Osborn, David; Milton, Alyssa; Henderson, Claire; Marston, Louise; Ambler, Gareth; Hunter, Rachael; Pilling, Stephen; Morant, Nicola; Gray, Richard; Weaver, Tim; Nolan, Fiona; Lloyd-Evans, Brynmor


    Crisis resolution teams (CRTs) provide assessment and intensive home treatment in a crisis, aiming to offer an alternative for people who would otherwise require a psychiatric inpatient admission. They are available in most areas in England. Despite some evidence for their clinical and cost-effectiveness, recurrent concerns are expressed regarding discontinuity with other services and lack of focus on preventing future relapse and readmission to acute care. Currently evidence on how to prevent readmissions to acute care is limited. Self-management interventions, involving supporting service users in recognising and managing signs of their own illness and in actively planning their recovery, have some supporting evidence, but have not been tested as a means of preventing readmission to acute care in people leaving community crisis care. We thus proposed the current study to test the effectiveness of such an intervention. We selected peer support workers as the preferred staff to deliver such an intervention, as they are well-placed to model and encourage active and autonomous recovery from mental health problems. The CORE (CRT Optimisation and Relapse Prevention) self-management trial compares the effectiveness of a peer-provided self-management intervention for people leaving CRT care, with treatment as usual supplemented by a booklet on self-management. The planned sample is 440 participants, including 40 participants in an internal pilot. The primary outcome measure is whether participants are readmitted to acute care over 1 year of follow-up following entry to the trial. Secondary outcomes include self-rated recovery at 4 and at 18 months following trial entry, measured using the Questionnaire on the Process of Recovery. Analysis will follow an intention to treatment principle. Random effects logistic regression modelling with adjustment for clustering by peer support worker will be used to test the primary hypothesis. The CORE self-management trial was approved

  15. Effect of candesartan on progression and regression of retinopathy in type 2 diabetes (DIRECT-Protect 2): a randomised placebo-controlled trial

    DEFF Research Database (Denmark)

    Sjolie, A.K.; Klein, R.; Porta, M.


    BACKGROUND: Diabetic retinopathy remains a leading cause of visual loss in people of working age. We examined whether candesartan treatment could slow the progression and, secondly, induce regression of retinopathy in people with type 2 diabetes. METHODS: We did a randomised, double-blind, parallel......-group, placebo-controlled trial in 309 centres worldwide. We recruited normoalbuminuric, normotensive, or treated hypertensive people with type 2 diabetes with mild to moderately severe retinopathy and assigned them to candesartan 16 mg once a day or placebo. After a month, the dose was doubled to 32 mg once per...... participants (aged 37-75 years) were randomised to candesartan (n=951) or placebo (n=954). 161 (17%) patients in the candesartan group and 182 (19%) in the placebo group had progression of retinopathy by three steps or more on the Early Treatment Diabetic Retinopathy Study scale. The risk of progression...

  16. Efficacy of cognitive behavioral therapy for anxiety disorders in older people: a meta-analysis and meta-regression of randomized controlled trials. (United States)

    Gould, Rebecca L; Coulson, Mark C; Howard, Robert J


    To review the magnitude and duration of and factors associated with effects of cognitive behavioral therapy (CBT) for anxiety disorders in older people. Electronic literature databases and the Cochrane Trials Registry were searched for articles. A systematic critical review, random-effects meta-analysis, and meta-regression of randomized controlled trials were conducted. Community outpatient clinics. People with diagnoses of anxiety disorders. Outcome measures of anxiety and depression. Twelve studies were included. CBT was significantly more effective than treatment as usual or being on a waiting list at reducing anxiety symptoms at 0-month follow-up, with the effect size being moderate, but when CBT was compared with an active control condition, the between-group difference in favor of CBT was not statistically significant, and the effect size was small. At 6- but not 3- or 12-month follow-up, CBT was significantly more effective at reducing anxiety symptoms than an active control condition, although the effect size was again small. Meta-regression analyses revealed only one factor (type of control group) to be significantly associated with the magnitude of effect sizes. The review confirms the effectiveness of CBT for anxiety disorders in older people but is suggestive of lower efficacy in older than working-age people. The small effect sizes in favor of CBT over an active control condition illustrate the need to investigate other treatment approaches that may be used to substitute or augment CBT to increase the effectiveness of treatment of anxiety disorders in older people. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

  17. Cost-effectiveness of a team and leaders-directed strategy to improve nurses' adherence to hand hygiene guidelines: a cluster randomised trial. (United States)

    Huis, Anita; Hulscher, Marlies; Adang, Eddy; Grol, Richard; van Achterberg, Theo; Schoonhoven, Lisette


    Many strategies have been designed and evaluated to address poor hand hygiene compliance. Unfortunately, well-designed economic evaluations of hand hygiene improvement strategies are lacking. To compare the cost-effectiveness of two successful implementation strategies for improving nurses' hand hygiene compliance and reducing hospital acquired infections (HAI's). A cost-effectiveness analysis alongside a cluster randomised controlled trial was conducted in 67 nursing wards of three hospitals in the Netherlands. The evaluation used a hospital perspective. All affiliated nurses of the nursing wards. Wards were randomly assigned to either the control group (n=30) or the experimental group (n=37). The control group received a state-of-the-art strategy including education, reminders feedback and optimising materials and facilities. The experimental group received a team and leaders-directed strategy which included all elements of the state-of-the-art strategy supplemented with interventions aimed at the social context of teams and enhancing leadership. The most efficient implementation strategy was determined by the incremental cost-effectiveness ratio per extra percentage of hand hygiene compliance gained and the incremental cost-effectiveness ratio per additional percentage reduction in the HAI rate. Bootstrap methods were used to determine confidence intervals for these incremental cost-effectiveness ratio's. Two scenarios of 15 and 30% were used to express the association between increased hand hygiene compliance and the reduction in HAIs. The team and leaders-directed strategy was significantly more effective in improving hand hygiene compliance. The mean difference effect was 8.91% (95% CI, 0.75-17.06). This extra increase was achieved at an average cost of €5497 per ward. The incremental cost per extra percentage of hand hygiene gained on ward level was €622. The incremental cost per additional percentage reduction in the HAI rate on ward level was €2074

  18. A generalized partially linear mean-covariance regression model for longitudinal proportional data, with applications to the analysis of quality of life data from cancer clinical trials. (United States)

    Zheng, Xueying; Qin, Guoyou; Tu, Dongsheng


    Motivated by the analysis of quality of life data from a clinical trial on early breast cancer, we propose in this paper a generalized partially linear mean-covariance regression model for longitudinal proportional data, which are bounded in a closed interval. Cholesky decomposition of the covariance matrix for within-subject responses and generalized estimation equations are used to estimate unknown parameters and the nonlinear function in the model. Simulation studies are performed to evaluate the performance of the proposed estimation procedures. Our new model is also applied to analyze the data from the cancer clinical trial that motivated this research. In comparison with available models in the literature, the proposed model does not require specific parametric assumptions on the density function of the longitudinal responses and the probability function of the boundary values and can capture dynamic changes of time or other interested variables on both mean and covariance of the correlated proportional responses. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  19. Regression to the mean and alcohol consumption: a cohort study exploring implications for the interpretation of change in control groups in brief intervention trials. (United States)

    McCambridge, Jim; Kypri, Kypros; McElduff, Patrick


    Reductions in drinking among individuals randomised to control groups in brief alcohol intervention trials are common and suggest that asking study participants about their drinking may itself cause them to reduce their consumption. We sought to test the hypothesis that the statistical artefact regression to the mean (RTM) explains part of the reduction in such studies. 967 participants in a cohort study of alcohol consumption in New Zealand provided data at baseline and again six months later. We use graphical methods and apply thresholds of 8, 12, 16 and 20 in AUDIT scores to explore RTM. There was a negative association between baseline AUDIT scores and change in AUDIT scores from baseline to six months, which in the absence of bias and confounding, is RTM. Students with lower baseline scores tended to have higher follow-up scores and conversely, those with higher baseline scores tended to have lower follow-up scores. When a threshold score of 8 was used to select a subgroup, the observed mean change was approximately half of that observed without a threshold. The application of higher thresholds produced greater apparent reductions in alcohol consumption. Part of the reduction seen in the control groups of brief alcohol intervention trials is likely to be due to RTM and the amount of change is likely to be greater as the threshold for entry to the trial increases. Quantification of RTM warrants further study and should assist understanding assessment and other research participation effects. Copyright © 2013 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  20. Regression Basics

    CERN Document Server

    Kahane, Leo H


    Using a friendly, nontechnical approach, the Second Edition of Regression Basics introduces readers to the fundamentals of regression. Accessible to anyone with an introductory statistics background, this book builds from a simple two-variable model to a model of greater complexity. Author Leo H. Kahane weaves four engaging examples throughout the text to illustrate not only the techniques of regression but also how this empirical tool can be applied in creative ways to consider a broad array of topics. New to the Second Edition Offers greater coverage of simple panel-data estimation:

  1. Management Teams

    CERN Document Server

    Belbin, R Meredith Meredith


    Meredith Belbin's work on teams has become part of everyday language in organizations all over the world. All kinds of teams and team behaviours are covered. At the end of the book is a self-perception inventory so that readers can match their own personalities to particular team roles. Management Teams is required reading for managers concerned with achieving results by getting the best from their key personnel.

  2. Heat and moisture exchangers (HMEs) and heated humidifiers (HHs) in adult critically ill patients: a systematic review, meta-analysis and meta-regression of randomized controlled trials. (United States)

    Vargas, Maria; Chiumello, Davide; Sutherasan, Yuda; Ball, Lorenzo; Esquinas, Antonio M; Pelosi, Paolo; Servillo, Giuseppe


    The aims of this systematic review and meta-analysis of randomized controlled trials are to evaluate the effects of active heated humidifiers (HHs) and moisture exchangers (HMEs) in preventing artificial airway occlusion and pneumonia, and on mortality in adult critically ill patients. In addition, we planned to perform a meta-regression analysis to evaluate the relationship between the incidence of artificial airway occlusion, pneumonia and mortality and clinical features of adult critically ill patients. Computerized databases were searched for randomized controlled trials (RCTs) comparing HHs and HMEs and reporting artificial airway occlusion, pneumonia and mortality as predefined outcomes. Relative risk (RR), 95% confidence interval for each outcome and I 2 were estimated for each outcome. Furthermore, weighted random-effect meta-regression analysis was performed to test the relationship between the effect size on each considered outcome and covariates. Eighteen RCTs and 2442 adult critically ill patients were included in the analysis. The incidence of artificial airway occlusion (RR = 1.853; 95% CI 0.792-4.338), pneumonia (RR = 932; 95% CI 0.730-1.190) and mortality (RR = 1.023; 95% CI 0.878-1.192) were not different in patients treated with HMEs and HHs. However, in the subgroup analyses the incidence of airway occlusion was higher in HMEs compared with HHs with non-heated wire (RR = 3.776; 95% CI 1.560-9.143). According to the meta-regression, the effect size in the treatment group on artificial airway occlusion was influenced by the percentage of patients with pneumonia (β = -0.058; p = 0.027; favors HMEs in studies with high prevalence of pneumonia), and a trend was observed for an effect of the duration of mechanical ventilation (MV) (β = -0.108; p = 0.054; favors HMEs in studies with longer MV time). In this meta-analysis we found no superiority of HMEs and HHs, in terms of artificial airway occlusion, pneumonia and

  3. Effectiveness and cost-effectiveness of an educational intervention for practice teams to deliver problem focused therapy for insomnia: rationale and design of a pilot cluster randomised trial

    Directory of Open Access Journals (Sweden)

    Ørner Roderick


    Full Text Available Abstract Background Sleep problems are common, affecting over a third of adults in the United Kingdom and leading to reduced productivity and impaired health-related quality of life. Many of those whose lives are affected seek medical help from primary care. Drug treatment is ineffective long term. Psychological methods for managing sleep problems, including cognitive behavioural therapy for insomnia (CBTi have been shown to be effective and cost effective but have not been widely implemented or evaluated in a general practice setting where they are most likely to be needed and most appropriately delivered. This paper outlines the protocol for a pilot study designed to evaluate the effectiveness and cost-effectiveness of an educational intervention for general practitioners, primary care nurses and other members of the primary care team to deliver problem focused therapy to adult patients presenting with sleep problems due to lifestyle causes, pain or mild to moderate depression or anxiety. Methods and design This will be a pilot cluster randomised controlled trial of a complex intervention. General practices will be randomised to an educational intervention for problem focused therapy which includes a consultation approach comprising careful assessment (using assessment of secondary causes, sleep diaries and severity and use of modified CBTi for insomnia in the consultation compared with usual care (general advice on sleep hygiene and pharmacotherapy with hypnotic drugs. Clinicians randomised to the intervention will receive an educational intervention (2 × 2 hours to implement a complex intervention of problem focused therapy. Clinicians randomised to the control group will receive reinforcement of usual care with sleep hygiene advice. Outcomes will be assessed via self-completion questionnaires and telephone interviews of patients and staff as well as clinical records for interventions and prescribing. Discussion Previous studies in adults

  4. Team Learning Ditinjau dari Team Diversity dan Team Efficacy


    Vivi Gusrini Rahmadani Pohan; Djamaludin Ancok


    This research attempted to observe team learning from the level of team diversity and team efficacy of work teams. This research used an individual level of analysis rather than the group level. The team members measured the level of team diversity, team efficacy and team learning of the teams through three scales, namely team learning scale, team diversity scale, and team efficacy scale. Respondents in this research were the active team members in a company, PT. Alkindo Mitraraya. The total ...

  5. Team Learning Ditinjau dari Team Diversity dan Team Efficacy


    Pohan, Vivi Gusrini Rahmadani; Ancok, Djamaludin


    This research attempted to observe team learning from the level of team diversity and team efficacy of work teams. This research used an individual level of analysis rather than the group level. The team members measured the level of team diversity, team efficacy and team learning of the teams through three scales, namely team learning scale, team diversity scale, and team efficacy scale. Respondents in this research were the active team members in a company, PT. Alkindo Mitraraya. The total ...

  6. The FEeding Support Team (FEST) randomised, controlled feasibility trial of proactive and reactive telephone support for breastfeeding women living in disadvantaged areas (United States)

    Craig, Leone; Maclennan, Graeme; Boyers, Dwayne; Vale, Luke


    Objective To assess the feasibility of implementing a dedicated feeding support team on a postnatal ward and pilot the potential effectiveness and cost-effectiveness of team (proactive) and woman-initiated (reactive) telephone support after discharge. Design Randomised controlled trial embedded within a before-and-after study. Participatory approach and mixed-method process evaluation. Setting A postnatal ward in Scotland. Sample Women living in disadvantaged areas initiating breast feeding. Methods Eligible women were recruited to a before-and-after intervention study, a proportion of whom were independently randomised after hospital discharge to intervention: daily proactive and reactive telephone calls for ≤14 days or control: reactive telephone calls ≤ day 14. Intention-to-treat analysis compared the randomised groups on cases with complete outcomes at follow-up. Main outcome measures Primary outcome: any breast feeding at 6–8 weeks assessed by a telephone call from a researcher blind to group allocation. Secondary outcomes: exclusive breast feeding, satisfaction with care, NHS costs and cost per additional woman breast feeding. Results There was no difference in feeding outcomes for women initiating breast feeding before the intervention (n=413) and after (n=388). 69 women were randomised to telephone support: 35 intervention (32 complete cases) and 34 control (26 complete cases). 22 intervention women compared with 12 control women were giving their baby some breast milk (RR 1.49, 95% CI 0.92 to 2.40) and 17 intervention women compared with eight control women were exclusively breast feeding (RR 1.73, 95% CI 0.88 to 3.37) at 6–8 weeks after birth. The incremental cost of providing proactive calls was £87 per additional woman breast feeding and £91 per additional woman exclusively breast feeding at 6–8 weeks; costs were sensitive to service organisation. Conclusions Proactive telephone care delivered by a dedicated feeding team shows

  7. Effect of Daily Caper Fruit Pickle Consumption on Disease Regression in Patients with Non-Alcoholic Fatty Liver Disease: a Double-Blinded Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Narjes Khavasi


    Full Text Available Purpose: Despite numerous studies on the effects of complementary medicine, to our knowledge, there is no study on the effects of Capparis spinosa on disease regression in non-alcoholic fatty liver disease (NAFLD patients. We compared the effects of caper fruit pickle consumption, as an Iranian traditional medicine product, on the anthropometric measures and biochemical parameters in different NAFLD patients. Methods: A 12-weeks randomized, controlled, double-blind trial was designed in 44 NAFLD patients randomly categorized for the control (n=22 or caper (n=22. The caper group received 40-50 gr of caper fruit pickles with meals daily. Before and after treatment, we assessed anthropometric measures, grade of fatty liver, serum lipoproteins and liver enzymes. Results: Weight and BMI were significantly decreased in the caper (p<0.001 and p<0.001 and control group (p=0.001 and p=0.001, respectively. Serum TG, TC and LDL.C just were significantly decreased in the control group (p=0.01, p<0.001 and p<0.001, respectively. Adjusted to the baseline measures, serum ALT and AST reduction were significantly higher in the caper than control group from baseline up to the end of the study (p<0.001 and p=0.02, respectively. After weeks 12, disease severity was significantly decreased in the caper group (p <0.001. Conclusion: Our results suggest that daily caper fruit pickle consumption for 12 weeks may be potentially effective on improving the biochemical parameters in NAFLD patients. Further, additional larger controlled trials are needed for the verification of these results.

  8. Effects of facilitated team meetings and learning collaboratives on colorectal cancer screening rates in primary care practices: a cluster randomized trial. (United States)

    Shaw, Eric K; Ohman-Strickland, Pamela A; Piasecki, Alicja; Hudson, Shawna V; Ferrante, Jeanne M; McDaniel, Reuben R; Nutting, Paul A; Crabtree, Benjamin F


    The purpose of this study was to evaluate a primary care practice-based quality improvement (QI) intervention aimed at improving colorectal cancer screening rates. The Supporting Colorectal Cancer Outcomes through Participatory Enhancements (SCOPE) study was a cluster randomized trial of New Jersey primary care practices. On-site facilitation and learning collaboratives were used to engage multiple stakeholders throughout the change process to identify and implement strategies to enhance colorectal cancer screening. Practices were analyzed using quantitative (medical records, surveys) and qualitative data (observations, interviews, and audio recordings) at baseline and a 12-month follow-up. Comparing intervention and control arms of the 23 participating practices did not yield statistically significant improvements in patients' colorectal cancer screening rates. Qualitative analyses provide insights into practices' QI implementation, including associations between how well leaders fostered team development and the extent to which team members felt psychologically safe. Successful QI implementation did not always translate into improved screening rates. Although single-target, incremental QI interventions can be effective, practice transformation requires enhanced organizational learning and change capacities. The SCOPE model of QI may not be an optimal strategy if short-term guideline concordant numerical gains are the goal. Advancing the knowledge base of QI interventions requires future reports to address how and why QI interventions work rather than simply measuring whether they work.

  9. A Team-Based Online Game Improves Blood Glucose Control in Veterans With Type 2 Diabetes: A Randomized Controlled Trial. (United States)

    Kerfoot, B Price; Gagnon, David R; McMahon, Graham T; Orlander, Jay D; Kurgansky, Katherine E; Conlin, Paul R


    Rigorous evidence is lacking whether online games can improve patients' longer-term health outcomes. We investigated whether an online team-based game delivering diabetes self-management education (DSME) to patients via e-mail or mobile application (app) can generate longer-term improvements in hemoglobin A1c (HbA1c). Patients (n = 456) on oral diabetes medications with HbA1c ≥58 mmol/mol were randomly assigned between a DSME game (with a civics booklet) and a civics game (with a DSME booklet). The 6-month games sent two questions twice weekly via e-mail or mobile app. Participants accrued points based on performance, with scores posted on leaderboards. Winning teams and individuals received modest financial rewards. Our primary outcome measure was HbA1c change over 12 months. DSME game patients had significantly greater HbA1c reductions over 12 months than civics game patients (-8 mmol/mol [95% CI -10 to -7] and -5 mmol/mol [95% CI -7 to -3], respectively; P = 0.048). HbA1c reductions were greater among patients with baseline HbA1c >75 mmol/mol: -16 mmol/mol [95% CI -21 to -12] and -9 mmol/mol [95% CI -14 to -5] for DSME and civics game patients, respectively; P = 0.031. Patients with diabetes who were randomized to an online game delivering DSME demonstrated sustained and meaningful HbA1c improvements. Among patients with poorly controlled diabetes, the DSME game reduced HbA1c by a magnitude comparable to starting a new diabetes medication. Online games may be a scalable approach to improve outcomes among geographically dispersed patients with diabetes and other chronic diseases. © 2017 by the American Diabetes Association.

  10. Effect of the School-Based Telemedicine Enhanced Asthma Management (SB-TEAM) Program on Asthma Morbidity: A Randomized Clinical Trial. (United States)

    Halterman, Jill S; Fagnano, Maria; Tajon, Reynaldo S; Tremblay, Paul; Wang, Hongyue; Butz, Arlene; Perry, Tamara T; McConnochie, Kenneth M


    Poor adherence to recommended preventive asthma medications is common, leading to preventable morbidity. We developed the School-Based Telemedicine Enhanced Asthma Management (SB-TEAM) program to build on school-based supervised therapy programs by incorporating telemedicine at school to overcome barriers to preventive asthma care. To evaluate the effect of the SB-TEAM program on asthma morbidity among urban children with persistent asthma. In this randomized clinical trial, children with persistent asthma aged 3 to 10 years in the Rochester City School District in Rochester, New York, were stratified by preventive medication use at baseline and randomly assigned to the SB-TEAM program or enhanced usual care for 1 school year. Participants were enrolled at the beginning of the school year (2012-2016), and outcomes were assessed through the end of the school year. Data were analyzed between May 2017 and November 2017 using multivariable modified intention-to-treat analyses. Supervised administration of preventive asthma medication at school as well as 3 school-based telemedicine visits to ensure appropriate assessment, preventive medication prescription, and follow-up care. The school site component of the telemedicine visit was completed by telemedicine assistants, who obtained history and examination data. These data were stored in a secure virtual waiting room and then viewed by the primary care clinician, who completed the assessment and communicated with caregivers via videoconference or telephone. Preventive medication prescriptions were sent to pharmacies that deliver to schools for supervised daily administration. The primary outcome was the mean number of symptom-free days per 2 weeks, assessed by bimonthly blinded interviews. Of the 400 enrolled children, 247 (61.8%) were male and 230 (57.5%) were African American, and the mean (SD) age was 7.8 (1.7) years. Demographic characteristics and asthma severity in the 2 groups were similar at baseline. Among

  11. Netazepide, a gastrin receptor antagonist, normalises tumour biomarkers and causes regression of type 1 gastric neuroendocrine tumours in a nonrandomised trial of patients with chronic atrophic gastritis.

    Directory of Open Access Journals (Sweden)

    Andrew R Moore

    Full Text Available Autoimmune chronic atrophic gastritis (CAG causes hypochlorhydria and hypergastrinaemia, which can lead to enterochromaffin-like (ECL cell hyperplasia and gastric neuroendocrine tumours (type 1 gastric NETs. Most behave indolently, but some larger tumours metastasise. Antrectomy, which removes the source of the hypergastrinaemia, usually causes tumour regression. Non-clinical and healthy-subject studies have shown that netazepide (YF476 is a potent, highly selective and orally-active gastrin/CCK-2 receptor antagonist. Also, it is effective in animal models of ECL-cell tumours induced by hypergastrinaemia.To assess the effect of netazepide on tumour biomarkers, number and size in patients with type I gastric NETs.We studied 8 patients with multiple tumours and raised circulating gastrin and chromogranin A (CgA concentrations in an open trial of oral netazepide for 12 weeks, with follow-up 12 weeks later. At 0, 6, 12 and 24 weeks, we carried out gastroscopy, counted and measured tumours, and took biopsies to assess abundances of several ECL-cell constituents. At 0, 3, 6, 9, 12 and 24 weeks, we measured circulating gastrin and CgA and assessed safety and tolerability.Netazepide was safe and well tolerated. Abundances of CgA (p<0.05, histidine decarboxylase (p<0.05 and matrix metalloproteinase-7(p<0.10 were reduced at 6 and 12 weeks, but were raised again at follow-up. Likewise, plasma CgA was reduced at 3 weeks (p<0.01, remained so until 12 weeks, but was raised again at follow-up. Tumours were fewer and the size of the largest one was smaller (p<0.05 at 12 weeks, and remained so at follow-up. Serum gastrin was unaffected.The reduction in abundances, plasma CgA, and tumour number and size by netazepide show that type 1 NETs are gastrin-dependent tumours. Failure of netazepide to increase serum gastrin further is consistent with achlorhydria. Netazepide is a potential new treatment for type 1 NETs. Longer, controlled trials are justified

  12. "Active Team" a social and gamified app-based physical activity intervention: randomised controlled trial study protocol. (United States)

    Edney, Sarah; Plotnikoff, Ronald; Vandelanotte, Corneel; Olds, Tim; De Bourdeaudhuij, Ilse; Ryan, Jillian; Maher, Carol


    Physical inactivity is a leading preventable cause of chronic disease and premature death globally, yet over half of the adult Australian population is inactive. To address this, web-based physical activity interventions, which have the potential to reach large numbers of users at low costs, have received considerable attention. To fully realise the potential of such interventions, there is a need to further increase their appeal to boost engagement and retention, and sustain intervention effects over longer periods of time. This randomised controlled trial aims to evaluate the efficacy of a gamified physical activity intervention that connects users to each other via Facebook and is delivered via a mobile app. The study is a three-group, cluster-RCT. Four hundred and forty (440) inactive Australian adults who use Facebook at least weekly will be recruited in clusters of three to eight existing Facebook friends. Participant clusters will be randomly allocated to one of three conditions: (1) waitlist control condition, (2) basic experimental condition (pedometer plus basic app with no social and gamification features), or (3) socially-enhanced experimental condition (pedometer plus app with social and gamification features). Participants will undertake assessments at baseline, three and nine months. The primary outcome is change in total daily minutes of moderate-to-vigorous physical activity at three months measured objectively using GENEActive accelerometers [Activeinsights Ltd., UK]. Secondary outcomes include self-reported physical activity, depression and anxiety, wellbeing, quality of life, social-cognitive theory constructs and app usage and engagement. The current study will incorporate novel social and gamification elements in order to examine whether the inclusion of these components increases the efficacy of app-based physical activity interventions. The findings will be used to guide the development and increase the effectiveness of future health

  13. Linear regression

    CERN Document Server

    Olive, David J


    This text covers both multiple linear regression and some experimental design models. The text uses the response plot to visualize the model and to detect outliers, does not assume that the error distribution has a known parametric distribution, develops prediction intervals that work when the error distribution is unknown, suggests bootstrap hypothesis tests that may be useful for inference after variable selection, and develops prediction regions and large sample theory for the multivariate linear regression model that has m response variables. A relationship between multivariate prediction regions and confidence regions provides a simple way to bootstrap confidence regions. These confidence regions often provide a practical method for testing hypotheses. There is also a chapter on generalized linear models and generalized additive models. There are many R functions to produce response and residual plots, to simulate prediction intervals and hypothesis tests, to detect outliers, and to choose response trans...

  14. Team-based care for improving hypertension management among outpatients (TBC-HTA): study protocol for a pragmatic randomized controlled trial. (United States)

    Santschi, Valérie; Wuerzner, Grégoire; Chiolero, Arnaud; Burnand, Bernard; Schaller, Philippe; Cloutier, Lyne; Paradis, Gilles; Burnier, Michel


    Blood pressure (BP) is poorly controlled among a large proportion of hypertensive outpatients. Innovative models of care are therefore needed to improve BP control. The Team-Based Care for improving Hypertension management (TBC-HTA) study aims to evaluate the effect of a team-based care (TBC) interprofessional intervention, involving nurses, community pharmacists and physicians, on BP control of hypertensive outpatients compared to usual care in routine clinical practice. The TBC-HTA study is a pragmatic randomized controlled study with a 6-month follow-up which tests a TBC interprofessionnal intervention conducted among uncontrolled treated hypertensive outpatients in two ambulatory clinics and among seven nearby community pharmacies in Lausanne and Geneva, Switzerland. A total of 110 patients are being recruited and randomized to TBC (TBC: N = 55) or usual care group (UC: N = 55). Patients allocated to the TBC group receive the TBC intervention conducted by an interprofessional team, involving an ambulatory clinic nurse, a community pharmacist and a physician. A nurse and a community pharmacist meet patients every 6 weeks to measure BP, to assess lifestyle, to estimate medication adherence, and to provide education to the patient about disease, treatment and lifestyle. After each visit, the nurse and pharmacist write a summary report with recommendations related to medication adherence, lifestyle, and changes in therapy. The physician then adjusts antihypertensive therapy accordingly. Patients in the UC group receive usual routine care without sessions with a nurse and a pharmacist. The primary outcome is the difference in daytime ambulatory BP between TBC and UC patients at 6-month of follow-up. Secondary outcomes include patients' and healthcare professionals' satisfaction with the TBC intervention and BP control at 12 months (6 months after the end of the intervention). This ongoing study aims to evaluate the effect of a newly developed team

  15. Fraktal Regress

    Directory of Open Access Journals (Sweden)

    Igor K. Kochanenko


    Full Text Available Procedures of construction of curve regress by criterion of the least fractals, i.e. the greatest probability of the sums of degrees of the least deviations measured intensity from their modelling values are proved. The exponent is defined as fractal dimension of a time number. The difference of results of a well-founded method and a method of the least squares is quantitatively estimated.

  16. My Team of Care Study: A Pilot Randomized Controlled Trial of a Web-Based Communication Tool for Collaborative Care in Patients With Advanced Cancer. (United States)

    Voruganti, Teja; Grunfeld, Eva; Jamieson, Trevor; Kurahashi, Allison M; Lokuge, Bhadra; Krzyzanowska, Monika K; Mamdani, Muhammad; Moineddin, Rahim; Husain, Amna


    The management of patients with complex care needs requires the expertise of health care providers from multiple settings and specialties. As such, there is a need for cross-setting, cross-disciplinary solutions that address deficits in communication and continuity of care. We have developed a Web-based tool for clinical collaboration, called Loop, which assembles the patient and care team in a virtual space for the purpose of facilitating communication around care management. The objectives of this pilot study were to evaluate the feasibility of integrating a tool like Loop into current care practices and to capture preliminary measures of the effect of Loop on continuity of care, quality of care, symptom distress, and health care utilization. We conducted an open-label pilot cluster randomized controlled trial allocating patients with advanced cancer (defined as stage III or IV disease) with ≥3 months prognosis, their participating health care team and caregivers to receive either the Loop intervention or usual care. Outcome data were collected from patients on a monthly basis for 3 months. Trial feasibility was measured with rate of uptake, as well as recruitment and system usage. The Picker Continuity of Care subscale, Palliative care Outcomes Scale, Edmonton Symptom Assessment Scale, and Ambulatory and Home Care Record were patient self-reported measures of continuity of care, quality of care, symptom distress, and health services utilization, respectively. We conducted a content analysis of messages posted on Loop to understand how the system was used. Nineteen physicians (oncologists or palliative care physicians) were randomized to the intervention or control arms. One hundred twenty-seven of their patients with advanced cancer were approached and 48 patients enrolled. Of 24 patients in the intervention arm, 20 (83.3%) registered onto Loop. In the intervention and control arms, 12 and 11 patients completed three months of follow-up, respectively. A mean

  17. Implementation and evaluation of the 5As framework of obesity management in primary care: design of the 5As Team (5AsT) randomized control trial. (United States)

    Campbell-Scherer, Denise L; Asselin, Jodie; Osunlana, Adedayo M; Fielding, Sheri; Anderson, Robin; Rueda-Clausen, Christian F; Johnson, Jeffrey A; Ogunleye, Ayodele A; Cave, Andrew; Manca, Donna; Sharma, Arya M


    Obesity is a pressing public health concern, which frequently presents in primary care. With the explosive obesity epidemic, there is an urgent need to maximize effective management in primary care. The 5As of Obesity Management™ (5As) are a collection of knowledge tools developed by the Canadian Obesity Network. Low rates of obesity management visits in primary care suggest provider behaviour may be an important variable. The goal of the present study is to increase frequency and quality of obesity management in primary care using the 5As Team (5AsT) intervention to change provider behaviour. The 5AsT trial is a theoretically informed, pragmatic randomized controlled trial with mixed methods evaluation. Clinic-based multidisciplinary teams (RN/NP, mental health, dietitians) will be randomized to control or the 5AsT intervention group, to participate in biweekly learning collaborative sessions supported by internal and external practice facilitation. The learning collaborative content addresses provider-identified barriers to effective obesity management in primary care. Evidence-based shared decision making tools will be co-developed and iteratively tested by practitioners. Evaluation will be informed by the RE-AIM framework. The primary outcome measure, to which participants are blinded, is number of weight management visits/full-time equivalent (FTE) position. Patient-level outcomes will also be assessed, through a longitudinal cohort study of patients from randomized practices. Patient outcomes include clinical (e.g., body mass index [BMI], blood pressure), health-related quality of life (SF-12, EQ5D), and satisfaction with care. Qualitative data collected from providers and patients will be evaluated using thematic analysis to understand the context, implementation and effectiveness of the 5AsT program. The 5AsT trial will provide a wide range of insights into current practices, knowledge gaps and barriers that limit obesity management in primary practice

  18. A pragmatic cluster randomized controlled trial of early intervention for chronic obstructive pulmonary disease by practice nurse-general practitioner teams: Study Protocol

    Directory of Open Access Journals (Sweden)

    Bunker Jeremy M


    Full Text Available Abstract Background Chronic Obstructive Pulmonary Disease (COPD is a leading cause of disability, hospitalization, and premature mortality. General practice is well placed to diagnose and manage COPD, but there is a significant gap between evidence and current practice, with a low level of awareness and implementation of clinical practice guidelines. Under-diagnosis of COPD is a world-wide problem, limiting the benefit that could potentially be achieved through early intervention strategies such as smoking cessation, dietary advice, and exercise. General practice is moving towards more structured chronic disease management, and the increasing involvement of practice nurses in delivering chronic care. Design A pragmatic cluster randomised trial will test the hypothesis that intervention by a practice nurse-general practitioner (GP team leads to improved health-related quality of life and greater adherence with clinical practice guidelines for patients with newly-diagnosed COPD, compared with usual care. Forty general practices in greater metropolitan Sydney Australia will be recruited to identify patients at risk of COPD and invite them to attend a case finding appointment. Practices will be randomised to deliver either practice nurse-GP partnership care, or usual care, to patients newly-diagnosed with COPD. The active intervention will involve the practice nurse and GP working in partnership with the patient in developing and implementing a care plan involving (as appropriate, smoking cessation, immunisation, pulmonary rehabilitation, medication review, assessment and correction of inhaler technique, nutritional advice, management of psycho-social issues, patient education, and management of co-morbidities. The primary outcome measure is health-related quality of life, assessed with the St George’s Respiratory Questionnaire 12 months after diagnosis. Secondary outcome measures include validated disease-specific and general health related

  19. Risk stratification in 3-vessel coronary artery disease: Applying the SYNTAX Score II in the Heart Team Discussion of the SYNTAX II trial. (United States)

    Campos, Carlos M; Stanetic, Bojan M; Farooq, Vasim; Walsh, Simon; Ishibashi, Yuki; Onuma, Yoshinobu; Garcia-Garcia, Hector M; Escaned, Javier; Banning, Adrian; Serruys, Patrick W


    Heart Team (HT) and the SYNTAX Score II (SSII) have been integrated to the contemporary guidelines with the aim to provide a multidisciplinary decision-making process between coronary artery bypass surgery (CABG) and percutaneous coronary intervention (PCI). To prospectively assess the agreement between the HT decision and the SSII recommendation regarding the revascularization strategy in patients with 3-vessel coronary artery disease (CAD) of the SYNTAX II trial. The SSII predicts the 4-year mortality of an individual patient both after PCI and after CABG. Patients were treated by PCI when the SSII predicted a mortality risk favoring PCI or when risk predictions were equipoise between PCI and CABG. However, the HT could overrule the SSII and recommend either CABG or PCI. A total of 202 patients have been screened and 24 did not fulfill inclusion criteria. The median age was 67.0 (IQR 59.0-73.3), and 167 (82.7%) were male. The HT endorsed SSII treatment recommendation, for CABG or PCI, in 152 patients (85.4%). Three patients had preference for PCI, irrespective of the HT decision. The main reason for the HT to overrule the SSII and recommend CABG was the prospect of a more complete revascularization (21 of 25 patients). Patients recommended for CABG by the HT had significantly higher anatomical SYNTAX score (P = 0.03) and higher predicted mortality risk for PCI (P = 0.04) when compared with patients that were enrolled in the trial. The SYNTAX score II showed to be a suitable tool for guiding treatment decisions of patients with 3-vessel coronary artery disease being endorsed by the HT in the vast majority of the patients that have been enrolled in the SYNTAX II trial. © 2015 Wiley Periodicals, Inc.

  20. Team Members | Center for Cancer Research (United States)

    Our Team Members The Foregut Team includes experts in the diagnosis and treatment of the diseases listed below. Our clinical experience and active research offers patients the highest quality care in the setting of groundbreaking clinical trials.

  1. [Medical emergency teams

    DEFF Research Database (Denmark)

    Bunkenborg, G.; Lund, C.; Petersen, John Asger


    The aim of medical emergency teams (MET) is to identify and treat deteriorating patients on general wards, and to avoid cardiac arrest, unplanned intensive care unit admission and death. The effectiveness of METs has yet to be proven, as the only two randomised, controlled trials on the subject...

  2. Efficacy of immediate patient feedback in emergency psychiatry: a randomized controlled trial in a crisis intervention & brief therapy team. (United States)

    van Oenen, Flip Jan; Schipper, Suzy; Van, Rien; Schoevers, Robert; Visch, Irene; Peen, Jaap; Dekker, Jack


    This study looks at the effect of immediate session-by-session feedback using short questionnaires for evaluating outcome of and alliance in the therapy. Research data strongly suggests that using this feedback informed treatment improves the outcome of therapy. However, until now, this method of Miller and Duncan has only been examined in clients (generally students) with mild problems and in partner counselling. The question addressed by this study is whether immediate feedback is also effective when applied during crisis intervention and subsequent brief therapy in a psychiatric patient population in emergency situations. It also looks at whether 'feedback-informed treatment' affects the quality of the alliance. To test the hypotheses, all patients seeking help from the Crisis Intervention & Brief Therapy Team over a two-year period will be followed throughout their treatment up to a maximum of six months and a follow-up period of three months after ending the treatment. Patients are randomly assigned to two conditions: treatment without feedback and treatment with immediate feedback for each session. The therapists all operate in both conditions and so they deliver both treatments. An estimated total of 180 patients, aged 18 years and over, will be included in the study. The aim of this study is to make clear whether, and to what extent, systematic feedback from the patient in this target group during therapy determines the course and outcomes of therapy. We also look at whether, and to what extent, the quality of the alliance and the motivation of the person delivering treatment with respect to the instruments play a role. NTR3168.

  3. Clinical Trials

    Medline Plus

    Full Text Available ... care providers might be part of your treatment team. They will monitor your health closely. You may ... taking part in a clinical trial. Your treatment team also may ask you to do other tasks. ...

  4. Teaming up

    DEFF Research Database (Denmark)

    Warhuus, Jan; Günzel-Jensen, Franziska; Robinson, Sarah

    Questions we care about (Objectives): When students have to work on challenging tasks, as it is often the case in entrepreneurship classrooms that leverage experiential learning, team success becomes central to the students learning. Yet, the formation of teams is often left up to the students....... A rigorous coding and inductive analysis process was undertaken. Pattern and relationship coding were used to reveal underlying factors, which helped to unveil important similarities and differences between student in different teams’ project progress and perception of learning. Results: When students...... functioning entrepreneurial student teams as most teams lack personal chemistry which makes them anchor their work too much in a pre-defined project. In contrast, we find that students that can form their own teams aim for less diverse teams than what is achieved by random assignment. However, the homophily...

  5. Population-, intervention- and methodology-related characteristics of clinical trials impact exercise efficacy during adjuvant therapy for breast cancer: a meta-regression analysis. (United States)

    Carayol, Marion; Delpierre, Cyrille; Bernard, Paquito; Ninot, Grégory


    Significant heterogeneity was highlighted in recent meta-analyses examining exercise effects in cancer patients, suggesting that some characteristics may moderate exercise efficacy. The objectives of this meta-analysis are (1) to investigate the influence of methodology, population and intervention studies' characteristics on the association of exercise with fatigue, quality-of-life (QoL), anxiety and depression; (2) to identify exercise intervention characteristics that may maximize efficacy and evaluate the level of evidence about exercise efficacy in breast cancer patients receiving chemotherapy and/or radiotherapy. Thirty-three randomized controlled trials (RCTs) evaluating exercise were systematically identified. Population, intervention and methodology characteristics were extracted, coded by two independent investigators and tested as moderators of exercise effect in meta-regression models. Psychological outcomes summary effects were then computed by pooling subgroup of RCTs based on categorized moderators. Indications of selection bias (random sequence generation) or attrition bias (high attrition rate, no intent-to-treat analysis) were associated with better exercise efficacy on QoL, anxiety and depression. Low total prescribed exercise doses (<140 METs.h) or short duration (<16 weeks) interventions yielded fatigue, anxiety and depression reductions whereas higher doses or duration did not. Mind-body interventions led to greater decrease of fatigue and anxiety rather than aerobic/resistance-based interventions. Our findings indicated that exercise-based interventions may improve fatigue, QoL, anxiety and depression, but the evidence mainly rely on studies prone to methodological biases. A prescription of approximately 100 MET.h, e.g. ~120 min of weekly moderate physical exercise for 10 weeks involving mind-body activities, could be advised to maximize fatigue reduction. Copyright © 2014 John Wiley & Sons, Ltd.

  6. Comparing the effect of aromatase inhibitor (letrozole) + cabergoline (Dostinex) and letrozole alone on uterine myoma regression,a randomized clinical trial. (United States)

    Sayyah-Melli, M; Mobasseri, M; Gharabaghi, P M; Ouladsahebmadarek, E; Rahmani, V


    To evaluate the effect of letrozole in combination with cabergoline and letrozole alone on regression of symptomatic uterine myomas in women of reproductive age. Randomized controlled clinical trial. University hospital. Ninety-one women of reproductive age were enrolled in the study and 88 women were eligible. Eight participants were excluded from the study. Eighty women of reproductive age with symptomatic myomas >4cm were evaluated in two groups. Participants in Group 1 received 2.5mg letrozole once daily and cabergoline 0.5mg/week from the first day of the menstrual cycle for 12 weeks, and participants in Group 2 received letrozole alone. Changes in uterine size and volume; myoma size, volume and number; and side effects of treatment. Overall, 76 patients completed the study. Compared with baseline values, mean uterine volume was reduced significantly in both groups (p=0.01), and there was no significant difference between groups (p=0.99). The mean number of dominant myomas was reduced significantly in both groups (p=0.03), with no significant difference between groups (p=0.6). The mean volume of myomas was reduced significantly in both groups (p=0.01), with no significant difference between groups (p=0.45). Although a significant decrease in number and volume of myomas was documented in each group (pcabergoline group (nine vs two cases, p=0.02), but the two groups were comparable for the remaining minor side effects. This study showed that 12 weeks of treatment with letrozole with and without cabergoline improved the size and volume of the uterus and myomas, led to symptom improvement, and could be used for short-term treatment prior to surgery or fertility programmes. Condensation letrozole in combination with cabergoline in the management of uterine fibroids. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. A randomized controlled trial of the effects of nurse case manager and community health worker team interventions in urban African-Americans with type 2 diabetes. (United States)

    Gary, Tiffany L; Batts-Turner, Marian; Bone, Lee R; Yeh, Hsin-Chieh; Wang, Nae-Yuh; Hill-Briggs, Felicia; Levine, David M; Powe, Neil R; Hill, Martha N; Saudek, Christopher; McGuire, Maura; Brancati, Frederick L


    The objective of the study was to determine the effectiveness and cost-effectiveness of primary care and community-oriented interventions in managing HbA1c, blood pressure, and lipids, and reducing hospitalizations and emergency room visits over 2 years. We describe an ongoing, randomized controlled trial of 542 urban African-Americans with type 2 diabetes ages 25 years and older who are members of a university-affiliated managed-care organization in Baltimore, MD. The participants are 74% female, have a mean age of 58 years, and 35% have yearly incomes greater than 7500 US dollars. Participants were randomized to one of two intervention groups for a period of 2 years: (1) usual medical care plus minimal telephone intervention implemented by a trained lay health educator (control group) or (2) usual medical care plus intensive intervention implemented by a nurse case manager (NCM)/community health worker (CHW) team. The intensive NCM/CHW team executes individual plans of care using evidence-based algorithms that focus on traditional diabetes self-management, screening and management of diabetes-related complications, and social issues surrounding diabetes care. Face-to-face NCM visits are conducted in the clinic once per year and CHW visits are conducted in the participant's home one to three times per year, both with additional follow-up contacts as needed. Written and verbal feedback (when necessary) is provided to the participant's primary care physician. All participants are expected to attend a 24-month follow-up visit where data are collected by interviewers blinded to intervention assignment. As of May 1, 2003, recruitment is complete, interventions are being fully implemented, and 24-month follow-up visits are beginning. Baseline sociodemographic characteristics, health-care utilization, health behaviors, and clinical characteristics of the study population are reported. This study is designed to test the hypothesis that a primary-care-based NCM plus CHW

  8. Controlled trial of a collaborative primary care team model for patients with diabetes and depression: Rationale and design for a comprehensive evaluation

    Directory of Open Access Journals (Sweden)

    Johnson Jeffrey A


    Full Text Available Abstract Background When depression accompanies diabetes, it complicates treatment, portends worse outcomes and increases health care costs. A collaborative care case-management model, previously tested in an urban managed care organization in the US, achieved significant reduction of depressive symptoms, improved diabetes disease control and patient-reported outcomes, and saved money. While impressive, these findings need to be replicated and extended to other healthcare settings. Our objective is to comprehensively evaluate a collaborative care model for comorbid depression and type 2 diabetes within a Canadian primary care setting. Methods/design We initiated the TeamCare model in four Primary Care Networks in Northern Alberta. The intervention involves a nurse care manager guiding patient-centered care with family physicians and consultant physician specialists to monitor progress and develop tailored care plans. Patients eligible for the intervention will be identified using the Patient Health Questionnaire-9 as a screen for depressive symptoms. Care managers will then guide patients through three phases: 1 improving depressive symptoms, 2 improving blood glucose, blood pressure and cholesterol, and 3 improving lifestyle behaviors. We will employ the RE-AIM framework for a comprehensive and mixed-methods approach to our evaluation. Effectiveness will be assessed using a controlled “on-off” trial design, whereby eligible patients would be alternately enrolled in the TeamCare intervention or usual care on a monthly basis. All patients will be assessed at baseline, 6 and 12 months. Our primary analyses will be based on changes in two outcomes: depressive symptoms, and a multivariable, scaled marginal model for the combined outcome of global disease control (i.e., A1c, systolic blood pressure, LDL cholesterol. Our planned enrolment of 168 patients will provide greater than 80% power to observe clinically important improvements in all

  9. Editorial Team

    African Journals Online (AJOL)

    Editorial Team. Journal Home > About the Journal > Editorial Team. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Editors. admin · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's ...

  10. Aditya Team

    Indian Academy of Sciences (India)

    Home; Journals; Pramana – Journal of Physics. Aditya Team. Articles written in Pramana – Journal of Physics. Volume 55 Issue 5-6 November-December 2000 pp 727-732 Contributed Papers. Tokamak Plasmas : Mirnov coil data analysis for tokamak ADITYA · D Raju R Jha P K Kaw S K Mattoo Y C Saxena Aditya Team.

  11. Team Teaching. (United States)

    Bunyan, L. W.

    The purpose of this study was to review current developments in team teaching and to assess its potential in the Calgary, Alberta, schools. An investigation into team teaching situations in schools in the eastern half of the United States and Canada revealed characteristics common to successful programs (e.g., charismatic leadership and innovative…

  12. Does the effect of one-day simulation team training in obstetric emergencies decline within one year? A post-hoc analysis of a multicentre cluster randomised controlled trial. (United States)

    van de Ven, J; Fransen, A F; Schuit, E; van Runnard Heimel, P J; Mol, B W; Oei, S G


    Does the effect of one-day simulation team training in obstetric emergencies decline within one year? A post-hoc analysis of a multicentre cluster randomised controlled trial. J van de Ven, AF Fransen, E Schuit, PJ van Runnard Heimel, BW Mol, SG Oei OBJECTIVE: To investigate whether the effect of a one-day simulation-based obstetric team training on patient outcome changes over time. Post-hoc analysis of a multicentre, open, randomised controlled trial that evaluated team training in obstetrics (TOSTI study).We studied women with a singleton pregnancy beyond 24 weeks of gestation in 24 obstetric units. Included obstetric units were randomised to either a one-day, multi-professional simulation-based team training focusing on crew resource management in a medical simulation centre (12 units) or to no team training (12 units). We assessed whether outcomes differed between both groups in each of the first four quarters following the team training and compared the effect of team training over quarters. Primary outcome was a composite outcome of low Apgar score, severe postpartum haemorrhage, trauma due to shoulder dystocia, eclampsia and hypoxic-ischemic encephalopathy. During a one year period after the team training the rate of obstetric complications, both on the composite level and the individual component level, did not differ between any of the quarters. For trauma due to shoulder dystocia team training led to a significant decrease in the first quarter (0.06% versus 0.26%, OR 0.19, 95% CI 0.03 to 0.98) but in the subsequent quarters no significant reductions were observed. Similar results were found for invasive treatment for severe postpartum haemorrhage where a significant increase was only seen in the first quarter (0.4% versus 0.03%, OR 19, 95% CI 2.5-147), and not thereafter. The beneficial effect of a one-day, simulation-based, multiprofessional, obstetric team training seems to decline after three months. If team training is further evaluated or

  13. Clinical Trials

    Medline Plus

    Full Text Available ... and treatments that work best. How Clinical Trials Work If you take part in a clinical trial, ... care providers might be part of your treatment team. They will monitor your health closely. You may ...


    Directory of Open Access Journals (Sweden)

    Goparaju Purna SUDHAKAR


    Full Text Available Popularity ofteams is growing in 21st Century. Organizations are getting theirwork done through different types of teams. Teams have proved that thecollective performance is more than the sum of the individual performances.Thus, the teams have got different dimensions such as quantitative dimensionsand qualitative dimensions. The Quantitative dimensions of teams such as teamperformance, team productivity, team innovation, team effectiveness, teamefficiency, team decision making and team conflicts and Qualitative dimensionsof teams such as team communication, team coordination, team cooperation, teamcohesion, team climate, team creativity, team leadership and team conflictshave been discussed in this article.

  15. Effect of Village Health Team Home Visits and Mobile Phone Consultations on Maternal and Newborn Care Practices in Masindi and Kiryandongo, Uganda: A Community-Intervention Trial.

    Directory of Open Access Journals (Sweden)

    Richard Mangwi Ayiasi

    Full Text Available The World Health Organisation recommends home visits conducted by Community Health Workers (in Uganda known as Village Health Teams--VHTs in order to improve maternal and newborn health. This study measured the effect of home visits combined with mobile phone consultations on maternal and newborn care practices.In a community intervention trial design 16 health centres in Masindi and Kiryandongo districts, Uganda were randomly and equally allocated to one of two arms: control and intervention arms. Eight control health centres received the usual maternal and newborn educational messages offered by professional health workers and eight intervention health centres that received an intervention package for maternal care and essential newborn care practices. In the intervention arm VHTs made two prenatal and one postnatal home visit to households. VHTs were provided with mobile phones to enable them make regular telephone consultations with health workers at the health centre serving the catchment area. The primary outcome was health facility delivery. Other outcomes included antenatal attendances, birth preparedness, cord and thermal care and breastfeeding practices. Analysis was by intention-to-treat.A total of 1385 pregnant women were analysed: 758 and 627 in the control and intervention arms respectively. Significant post-intervention differences were: delivery place [adjusted Odds Ratio aOR: 17.94(95%CI: 6.26-51.37; p<0.001], cord care [aOR: 3.05(95%CI: 1.81-5.12; p<0.001] thermal care [aOR: 7.58(95%CI: 2.52-22.82; p<0.001], and timely care-seeking for newborn illness [aOR: 4.93(95%CI: 1.59-15.31; p = 0.006].VHTs can have an effect in promoting proper cord and thermal care for the newborn and improve timely care-seeking for health facility delivery and newborn illness, because they could answer questions and refer patients correctly. However, VHTs should be supported by professional health workers through the use of mobile phones.ClinicalTrials

  16. Project TEAMS (Talking about Eating, Activity, and Mutual Support: a randomized controlled trial of a theory-based weight loss program for couples

    Directory of Open Access Journals (Sweden)

    Amy A. Gorin


    Full Text Available Abstract Background Obesity risk is shared between spouses, yet existing weight loss programs focus on individuals and not the marital dyad. Given the interdependence of weight in couples, weight management outcomes might be improved by targeting joint weight loss and the creation of an interpersonal milieu that supports long-term behavior change. According to Self-Determination Theory (SDT, greater autonomous self-regulation of behaviors, and subsequently better treatment outcomes, are observed in needs supportive environments in which personally meaningful choice is supported and criticism and control are minimized. Correlational analyses confirm these pathways in weight management, with needs support from one’s spouse or partner emerging as a distinct predictor of weight loss success. Research is now needed to establish causal links and to develop and test weight loss interventions designed to facilitate the needs supportive behavior of spouses. Methods Project TEAMS (Talking about Eating, Activity, and Mutual Support is a randomized controlled trial testing a couples-based intervention, grounded in SDT, designed to change the social context of weight loss by training spouses to provide needs support for each other’s eating and physical activity behavior. Sixty-four couples will be randomized to either 6 months of behavioral weight loss treatment informed by SDT (SDT-WL or to 6 months of standard behavioral weight loss treatment (BWL. Couples will attend weekly sessions for 6 months and will be assessed at 0, 3, 6, and 12 months. By bolstering needs support, SDT-WL is predicted to increase autonomous self-regulation and perceived competence and produce greater weight loss and maintenance than standard behavioral treatment. Exploratory analyses will examine the SDT process model prediction that the influence of needs support on treatment outcomes will be mediated by autonomous self-regulation and perceived competence. Discussion This

  17. Integrated collaborative care teams to enhance service delivery to youth with mental health and substance use challenges: protocol for a pragmatic randomised controlled trial (United States)

    Cheung, Amy; Cleverley, Kristin; Chaim, Gloria; Moretti, Myla E; de Oliveira, Claire; Hawke, Lisa D; Willan, Andrew R; O'Brien, David; Heffernan, Olivia; Herzog, Tyson; Courey, Lynn; McDonald, Heather; Grant, Enid; Szatmari, Peter


    Introduction Among youth, the prevalence of mental health and addiction (MHA) disorders is roughly 20%, yet youth are challenged to access evidence-based services in a timely fashion. To address MHA system gaps, this study tests the benefits of an Integrated Collaborative Care Team (ICCT) model for youth with MHA challenges. A rapid, stepped-care approach geared to need in a youth-friendly environment is expected to result in better youth MHA outcomes. Moreover, the ICCT approach is expected to decrease service wait-times, be more youth-friendly and family-friendly, and be more cost-effective, providing substantial public health benefits. Methods and analysis In partnership with four community agencies, four adolescent psychiatry hospital departments, youth and family members with lived experience of MHA service use, and other stakeholders, we have developed an innovative model of collaborative, community-based service provision involving rapid access to needs-based MHA services. A total of 500 youth presenting for hospital-based, outpatient psychiatric service will be randomised to ICCT services or hospital-based treatment as usual, following a pragmatic randomised controlled trial design. The primary outcome variable will be the youth's functioning, assessed at intake, 6 months and 12 months. Secondary outcomes will include clinical change, youth/family satisfaction and perception of care, empowerment, engagement and the incremental cost-effectiveness ratio (ICER). Intent-to-treat analyses will be used on repeated-measures data, along with cost-effectiveness and cost-utility analyses, to determine intervention effectiveness. Ethics and dissemination Research Ethics Board approval has been received from the Centre for Addiction and Mental Health, as well as institutional ethical approval from participating community sites. This study will be conducted according to Good Clinical Practice guidelines. Participants will provide informed consent prior to study

  18. Effect of intensive statin therapy on regression of carotid intima-media thickness in patients with subclinical carotid atherosclerosis (a prospective, randomized trial: PEACE (Pitavastatin Evaluation of Atherosclerosis Regression by Intensive Cholesterol-lowering Therapy) study). (United States)

    Ikeda, Koji; Takahashi, Tomosaburo; Yamada, Hiroyuki; Matsui, Kiyoaki; Sawada, Takahisa; Nakamura, Takashi; Matsubara, Hiroaki


    Atherosclerosis often advances before symptoms appear. It remains uncertain whether intensive cholesterol-lowering therapy with statin is beneficial when compared with moderate cholesterol-lowering therapy in patients with subclinical carotid atherosclerosis. The PEACE study was a prospective, randomized, open-labeled, blinded end points, two-arm parallel treatment group comparison study conducted at 15 centers in Japan. A total of 303 patients with carotid intima-media thickness (CIMT) thickening (>1.1 mm) whose low-density lipoprotein cholesterol (LDL-C) level was more than 100 mg/dl were enrolled, in which 223 patients completed the 12 months' follow-up study. Patients were randomly assigned to receive either moderate (target LDL-C; 100 mg/dl) or intensive (target LDL-C; 80 mg/dl) cholesterol-lowering therapy with pitavastatin. The primary end point was the change in mean far wall common CIMT. LDL-C level declined to 89.4 ± 20 mg/dl in the intensive group, while it declined to 95.1 ± 22.5 mg/dl in the moderate group at 12 months' follow-up (p confidence interval -0.046 to -0.0014) mm/year (p confidence interval -0.028 to 0.012) mm/year (p = 0.4406 vs. baseline) in the moderate group. However, there was no significant difference in the change in mean far wall common CIMT between the groups (p = 0.29). Intensive cholesterol-lowering therapy did not show superior effects on the progression of CIMT to moderate cholesterol-lowering therapy, whereas only intensive cholesterol-lowering therapy regressed the carotid atherosclerosis over one year.

  19. Reducing errors in health care: cost-effectiveness of multidisciplinary team training in obstetric emergencies (TOSTI study); a randomised controlled trial

    NARCIS (Netherlands)

    van de Ven, Joost; Houterman, Saskia; Steinweg, Rob A. J. Q.; Scherpbier, Albert J. J. A.; Wijers, Willy; Mol, Ben Willem J.; Oei, S. Guid; Group, The Tosti-Trial


    ABSTRACT: BACKGROUND: There are many avoidable deaths in hospitals because the care team is not well attuned. Training in emergency situations is generally followed on an individual basis. In practice, however, hospital patients are treated by a team composed of various disciplines. To prevent



    Goparaju Purna SUDHAKAR


    Popularity of teams is growing in 21st Century. Organizations are getting their work done through different types of teams. Teams have proved that the collective performance is more than the sum of the individual performances. Thus, the teams have got different dimensions such as quantitative dimensions and qualitative dimensions. The Quantitative dimensions of teams such as team performance, team productivity, team innovation, team effectiveness, team efficiency, team decision making and tea...

  1. Inconsistency Between Univariate and Multiple Logistic Regressions


    WANG, HONGYUE; Peng, Jing; Wang, Bokai; Lu, Xiang; ZHENG, Julia Z.; Wang, Kejia; Tu, Xin M.; Feng, Changyong


    Summary Logistic regression is a popular statistical method in studying the effects of covariates on binary outcomes. It has been widely used in both clinical trials and observational studies. However, the results from the univariate regression and from the multiple logistic regression tend to be conflicting. A covariate may show very strong effect on the outcome in the multiple regression but not in the univariate regression, and vice versa. These facts have not been well appreciated in biom...

  2. Regression methods for medical research

    CERN Document Server

    Tai, Bee Choo


    Regression Methods for Medical Research provides medical researchers with the skills they need to critically read and interpret research using more advanced statistical methods. The statistical requirements of interpreting and publishing in medical journals, together with rapid changes in science and technology, increasingly demands an understanding of more complex and sophisticated analytic procedures.The text explains the application of statistical models to a wide variety of practical medical investigative studies and clinical trials. Regression methods are used to appropriately answer the

  3. Preventing falls in community-dwelling frail older people using a home intervention team (HIT): results from the randomized Falls-HIT trial. (United States)

    Nikolaus, Thorsten; Bach, Matthias


    To evaluate the effect of an intervention by a multidisciplinary team to reduce falls in older people's homes. Randomized, controlled trial with follow-up of subjects for 1 year. University-affiliated geriatric hospital and older patients' homes. Three hundred sixty subjects (mean age +/- standard deviation = 81.5 +/- 6.4) admitted from home to a geriatric hospital and showing functional decline, especially in mobility. The participants were randomly assigned to receive a comprehensive geriatric assessment followed by a diagnostic home visit and home intervention or a comprehensive geriatric assessment with recommendations and usual care at home. The home intervention included a diagnostic home visit, assessing the home for environmental hazards, advice about possible changes, offer of facilities for any necessary home modifications, and training in the use of technical and mobility aids. An additional home visit was made after 3 months to reinforce the recommendations. After 12 months of follow-up, a home visit was made to all study participants. Number of falls, type of recommended home modifications, and compliance with recommendations. After 1 year, there were 163 falls in the intervention group and 204 falls in the control group. The intervention group had 31% fewer falls than the control group (incidence rate ratio (IRR) = 0.69, 95% confidence interval (CI) = 0.51-0.97). The intervention was most effective in a subgroup of participants who reported having had two or more falls during the year before recruitment into the study. In this subgroup, the proportion of frequent fallers and the rate of falls was significantly reduced for the intervention group compared with the control group (21 vs 36 subjects with recurrent falls, P =.009; IRR = 0.63, 95% CI = 0.43-0.94). The compliance rate varied with the type of change recommended from 83% to 33% after 12 months of follow-up. Home intervention based on home visits to assess the home for environmental hazards

  4. Team-Sport Athletes' Improvement of Performance on the Yo-Yo Intermittent Recovery Test Level 2, but Not of Time-Trial Performance, With Intermittent Hypoxic Training. (United States)

    Inness M, W H; Billaut, François; Aughey, Robert J


    To determine the time course for physical-capacity adaptations to intermittent hypoxic training (IHT) in team-sport athletes and the time course for benefits remaining after IHT. A pre-post parallel-groups design was employed, with 21 Australian footballers assigned to IHT (n = 10) or control (CON; n = 11) matched for training load. IHT performed eleven 40-min bike sessions at 2500-m altitude over 4 wk. Yo-Yo Intermittent Recovery Test level 2 (Yo-Yo IR2) was performed before; after 3, 6, and 11 IHT sessions; and 30 and 44 d after IHT. Repeated time trials (2- and 1-km TTs, with 5 min rest) were performed before, after, and 3 wk after IHT. Hemoglobin mass (Hb(mass)) was measured in IHT before and after 3, 6, 9, and 11 sessions. Baseline Yo-Yo IR2 was similar between groups. After 6 sessions, the change in Yo-Yo IR2 in IHT was very likely higher than CON (27% greater change, effect size 0.77, 90% confidence limits 0.20;1.33) and likely higher 1 d after IHT (23%, 0.68, 0.05;1.30). The IHT group's change remained likely higher than CON 30 d after IHT (24%, 0.72, 0.12;1.33) but was not meaningfully different 44 d after (12%, 0.36, -0.24;0.97). The change in 2-km TT performance between groups was not different throughout. For 1-km TT, CON improved more after IHT, but IHT maintained performance better after 3 wk. Hb(mass) was higher after IHT (2.7%, 0.40, -0.40;1.19). Short-duration IHT increased Yo-Yo IR2 compared with training-load-matched controls in 2 wk. An additional 2 wk of IHT provided no further benefit. These changes remained until at least 30 d posttraining. IHT also protected improvement in 1-km TT.

  5. Team designing

    DEFF Research Database (Denmark)

    Denise J. Stokholm, Marianne


    Future wellbeing is depending on human competences in order to strengthen a sustainable development. This requires system thinking and ability to deal with complexity, dynamic and a vast of information. `We need to move away from present principles of breaking down problems into components and give...... and intercultural teams in design and the understanding of design as a process of transformation and information management call for a model with capacity to facilitate both `the what` and `the how` This paper will describe a systemic model of design based on a holistic approach to design developed by the author...... in relation to a design-engineering education at Aalborg University. It will exemplify how the model has been used in workshops on team designing, challenged design learning and affected design competence. In specific it will investigate the influence of visual models of the perception of design, design...

  6. Simulation-based multiprofessional obstetric anaesthesia training conducted in situ versus off-site leads to similar individual and team outcomes: a randomised educational trial

    NARCIS (Netherlands)

    Sorensen, J.L.; Vleuten, C. van der; Rosthoj, S.; Ostergaard, D.; Leblanc, V.; Johansen, M.; Ekelund, K.; Starkopf, L.; Lindschou, J.; Gluud, C.; Weikop, P.; Ottesen, B.


    OBJECTIVE: To investigate the effect of in situ simulation (ISS) versus off-site simulation (OSS) on knowledge, patient safety attitude, stress, motivation, perceptions of simulation, team performance and organisational impact. DESIGN: Investigator-initiated single-centre randomised superiority

  7. 'In situ simulation' versus 'off site simulation' in obstetric emergencies and their effect on knowledge, safety attitudes, team performance, stress, and motivation: study protocol for a randomized controlled trial. (United States)

    Sørensen, Jette Led; Van der Vleuten, Cees; Lindschou, Jane; Gluud, Christian; Østergaard, Doris; LeBlanc, Vicki; Johansen, Marianne; Ekelund, Kim; Albrechtsen, Charlotte Krebs; Pedersen, Berit Woetman; Kjærgaard, Hanne; Weikop, Pia; Ottesen, Bent


    Unexpected obstetric emergencies threaten the safety of pregnant women. As emergencies are rare, they are difficult to learn. Therefore, simulation-based medical education (SBME) seems relevant. In non-systematic reviews on SBME, medical simulation has been suggested to be associated with improved learner outcomes. However, many questions on how SBME can be optimized remain unanswered. One unresolved issue is how 'in situ simulation' (ISS) versus 'off site simulation' (OSS) impact learning. ISS means simulation-based training in the actual patient care unit (in other words, the labor room and operating room). OSS means training in facilities away from the actual patient care unit, either at a simulation centre or in hospital rooms that have been set up for this purpose. The objective of this randomized trial is to study the effect of ISS versus OSS on individual learning outcome, safety attitude, motivation, stress, and team performance amongst multi-professional obstetric-anesthesia teams.The trial is a single-centre randomized superiority trial including 100 participants. The inclusion criteria were health-care professionals employed at the department of obstetrics or anesthesia at Rigshospitalet, Copenhagen, who were working on shifts and gave written informed consent. Exclusion criteria were managers with staff responsibilities, and staff who were actively taking part in preparation of the trial. The same obstetric multi-professional training was conducted in the two simulation settings. The experimental group was exposed to training in the ISS setting, and the control group in the OSS setting. The primary outcome is the individual score on a knowledge test. Exploratory outcomes are individual scores on a safety attitudes questionnaire, a stress inventory, salivary cortisol levels, an intrinsic motivation inventory, results from a questionnaire evaluating perceptions of the simulation and suggested changes needed in the organization, a team-based score on video

  8. Differentiating regressed melanoma from regressed lichenoid keratosis. (United States)

    Chan, Aegean H; Shulman, Kenneth J; Lee, Bonnie A


    Distinguishing regressed lichen planus-like keratosis (LPLK) from regressed melanoma can be difficult on histopathologic examination, potentially resulting in mismanagement of patients. We aimed to identify histopathologic features by which regressed melanoma can be differentiated from regressed LPLK. Twenty actively inflamed LPLK, 12 LPLK with regression and 15 melanomas with regression were compared and evaluated by hematoxylin and eosin staining as well as Melan-A, microphthalmia transcription factor (MiTF) and cytokeratin (AE1/AE3) immunostaining. (1) A total of 40% of regressed melanomas showed complete or near complete loss of melanocytes within the epidermis with Melan-A and MiTF immunostaining, while 8% of regressed LPLK exhibited this finding. (2) Necrotic keratinocytes were seen in the epidermis in 33% regressed melanomas as opposed to all of the regressed LPLK. (3) A dense infiltrate of melanophages in the papillary dermis was seen in 40% of regressed melanomas, a feature not seen in regressed LPLK. In summary, our findings suggest that a complete or near complete loss of melanocytes within the epidermis strongly favors a regressed melanoma over a regressed LPLK. In addition, necrotic epidermal keratinocytes and the presence of a dense band-like distribution of dermal melanophages can be helpful in differentiating these lesions. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Team learning and context; assessing the relationship between team-learning activities and contextual factors of team-learning environment and team-configurations

    Directory of Open Access Journals (Sweden)

    Denekens J


    Full Text Available Olaf Timmermans1, Roland Van Linge2, Peter Van Petegem3, Joke Denekens4 1Faculty of Medicine, Nursing and Midwifery Science, University of Antwerp, Belgium; 2University Medical Centre Utrecht, Department of Nursing Sciences, Utrecht University, The Netherlands; 3Institute of Education and Information Sciences, University of Antwerp, Belgium; 4Department General Practice, University of Antwerp, Belgium Background: The prevalence of team-learning activities in nursing teams is influenced by contextual factors. Although team learning is important for nursing teams to perform, there is a paucity of research exploring the relationship between team-learning activities and contextual factors in nursing teams. The aim of this study was to study the relationship between team learning and contextual factors of the nursing team. Methodology: Correlation and multiple regression analyses were used to study the relationship between team learning and five contextual variables. One contextual variable represented the overall environment for learning, and the other four contextual variables characterized basic configurations of organizational characteristics of nursing teams. An interrelation between the contextual variables was expected, so multiple regression models were tested for multicollinearity by regression commonality analysis to detect unique and common contributions of each independent variable. Findings: Results of this study indicate that team-learning activities in nursing teams can be enhanced by contextual factors such as: (1 strengthening stimulation of the psychological safety, (2 openness, (3 shared goals, and (4 an open, external-oriented view. Multiple regressions yielded three models that explain 76%, 81%, and 83% of the variance in team learning. Commonality analyses showed the importance of interrelationships between the contextual factors. Practical implications: Nurses undertake team-learning activities to process information needed to

  10. Métodos por imagem da aterosclerose em estudos de progressão/regressão: marcador substituto ou janela direta para o processo patológico da aterosclerose? Atherosclerosis imaging in progression/regression trials: surrogate marker or direct window into the atherosclerotic disease process?

    Directory of Open Access Journals (Sweden)

    Paul Schoenhagen


    Full Text Available A DAC continua sendo uma das principais causas globais de morbimortalidade. Programas amplos de desenvolvimento de drogas para novas estratégias de tratamento medicamentoso freqüentemente utilizam estudos com desfechos de mortalidade/morbidade tradicionais e outros com desfechos substitutos. Essa abordagem paralela permite uma avaliação da eficácia vários anos antes dos dados de estudos com desfechos clínicos estarem disponíveis. Vários marcadores imagenológicos de aterosclerose foram introduzidos nessas estratégias de desenvolvimento de drogas, incluindo angiografia, ultrassonografia de carótida, USIV, RM e TC. Esta revisão discutirá a situação atual dos métodos por imagem da aterosclerose como um desfecho em estudos de progressão/regressão, com ênfase em dados baseados em evidências. Além de uma discussão sobre os resultados das modalidades de métodos por imagem individuais, serão apresentados os dados que têm surgido comparando as diferentes modalidades e abordagens.CAD remains a major global cause of morbidity and mortality. Comprehensive drug development programs of novel pharmacological treatment strategies frequently utilize traditional mortality/morbidity endpoints studies and additional surrogate endpoints trials. This parallel approach allows an assessment of efficacy several years in advance of the availability of data from clinical endpoint trials. Several atherosclerosis imaging markers have been introduced into these drug-development strategies, including angiography, carotid ultrasound, IVUS, MRI, and CT. This review will discuss the current status of atherosclerosis imaging as an endpoint in progression/regression trials, with an emphasis on evidence-based data. In addition to a discussion of the results of individual imaging modalities, the emerging data comparing different modalities and approaches are presented.

  11. Effects of epidural volume extension by saline injection on the efficacy and safety of intrathecal local anaesthetics: systematic review with meta-analysis, meta-regression and trial sequential analysis. (United States)

    Heesen, M; Weibel, S; Klimek, M; Rossaint, R; Arends, L R; Kranke, P


    Epidural volume extension, a modification of combined spinal-epidural anaesthesia, involves the epidural injection of saline in order to increase the spread of drugs given intrathecally. Results from individual studies have so far been contradictory and we aimed to gather the available evidence for this technique. We performed a systematic literature search for randomised, controlled trials comparing epidural volume extension after spinal injection with a control group without epidural injection in patients undergoing surgery. Conventional meta-analyses, trial sequential analyses and meta-regression were performed, with the Grading of Recommendations on Assessment, Development and Evaluation (GRADE) approach used to express reliability of outcome estimates. We included 15 studies with 1177 participants. Meta-analyses for the primary outcomes, such as maximum sensory height (6 studies, 274 participants, mean difference (MD) (95%CI) -0.59 (-1.24 to 0.07) dermatomes, low-quality evidence) and hypotension (10 studies, 683 participants, risk ratio (95%CI) 0.84 (0.66-1.07), low-quality evidence), did not differ significantly between the two treatment arms, but trial sequential analysis suggested insufficient evidence to be certain of these findings. Meta-regression suggested a volume-dependent effect, with higher volumes causing a higher spread of intrathecal drugs and a higher incidence of hypotension. A sub-group analysis indicated a pronounced effect on motor block recovery time when a lower anaesthetic dose plus epidural volume extension was compared with a higher anaesthetic dose without epidural volume extension, the MD (95%CI) being -66.75 (-76.0 to -57.5) min, with trial sequential analysis suggesting the evidence was sufficient to draw this conclusion. In trials using the same anaesthetic mixture in the epidural volume extension and the control groups, motor block recovery time did not differ between groups, with a MD (95%CI) of -1.06 (-5.48 to 3.36) min

  12. Do great teams think alike? An examination of team mental models and their impact on team performance. (United States)

    Gardner, Aimee K; Scott, Daniel J; AbdelFattah, Kareem R


    Team mental models represent the shared understanding of team members within their relevant environment. Thus, team mental models should have a substantial impact on a team's ability to engage in purposeful and coordinated action. We sought to examine the impact of shared team mental models on team performance and to investigate if team mental models increase over time as teams continue to work together. New surgery interns were assigned randomly to 1 of 10 teams. Each team participated in one unique simulation every day for 5 days, each followed by video-based debriefing with a facilitator. Participants also completed independently a concept similarity tool validated previously in nonmedical team literature to assess team mental models. All performances were video recorded and evaluated with a scenario-specific team performance tool by a single, blinded junior surgeon under an institutional review board-approved protocol. Changes in performance and team mental models over time were assessed with paired samples t tests. Regression analysis was used to examine the extent to which team mental models predicted team performance. Thirty interns (age 27; 77% men) participated in the training program. Percentage of items achieved (x¯ ± SD) on the performance evaluation was 39 ± 20, 51 ± 14, 22 ± 17, 63 ± 14, and 77 ± 25 for Days 1-5, respectively. Team mental models were 30 ± 5, 28 ± 6, 27 ± 8, 26 ± 7, and 25 ± 6 for Days 1-5 respectively, such that larger values corresponded to greater differences in team mental models. Paired sample t tests indicated that both average performance and team mental models similarity improved from the first to last day (P team mental models predicted team performance on Days 2-5 (all P team mental models among the teams leads to better team performance. Additionally, the increase in team mental models over time suggests that engaging in team-based simulation may catalyze the process by which surgery

  13. Impact of a team and leaders-directed strategy to improve nurses' adherence to hand hygiene guidelines: A cluster randomised trial

    NARCIS (Netherlands)

    Huis, A.M.P.; Schoonhoven, L.; Grol, R.P.T.M.; Donders, R.; Hulscher, M.E.J.L.; Achterberg, T. van


    BACKGROUND: Improving hand hygiene compliance is still a major challenge for most hospitals. Innovative approaches are needed. OBJECTIVE: We tested whether an innovative, theory based, team and leaders-directed strategy would be more effective in increasing hand hygiene compliance rates in nurses

  14. Collective autonomy and absenteeism within work teams: a team motivation approach. (United States)

    Rousseau, Vincent; Aubé, Caroline


    This study investigates the role of collective autonomy in regard to team absenteeism by considering team potency as a motivational mediator and task routineness as a moderator. The sample consists of 90 work teams (327 members and 90 immediate superiors) drawn from a public safety organization. Results of structural equation modeling indicate that the relationships between collective autonomy and two indicators of team absenteeism (i.e., absence frequency and time lost) are mediated by team potency. Specifically, collective autonomy is positively related to team potency which in turn is negatively related to team absenteeism. Furthermore, results of hierarchical regression analyses show that task routineness moderates the relationships between collective autonomy and the two indicators of team absenteeism such that these relationships are stronger when the level of task routineness is low. On the whole, this study points out that collective autonomy may exercise a motivational effect on attendance at work within teams, but this effect is contingent on task routineness.

  15. Effect of small-sided team sport training and protein intake on muscle mass, physical function and markers of health in older untrained adults: A randomized trial. (United States)

    Vorup, Jacob; Pedersen, Mogens Theisen; Brahe, Lena Kirchner; Melcher, Pia Sandfeld; Alstrøm, Joachim Meno; Bangsbo, Jens


    The effect of small-sided team sport training and protein intake on muscle mass, physical function, and adaptations important for health in untrained older adults was examined. Forty-eight untrained older (72±6 (±standard deviation, SD) years men and women were divided into either a team sport group ingesting a drink high in protein (18 g) immediately and 3 h after each training session (TS-HP, n = 13), a team sport group ingesting an isocaloric drink with low protein content (3 g; TS-LP, n = 18), or a control group continuing their normal activities (CON, n = 17). The team sport training was performed as ~20 min of small-sided ball games twice a week over 12 weeks. After the intervention period, leg muscle mass was 0.6 kg higher (P = 0.047) in TS-HP, with no effect in TS-LP. In TS-HP, number of sit-to-stand repetitions increased (1.2±0.6, P = 0.054), time to perform 2.45 m up-and-go was lower (0.7±0.3 s, P = 0.03) and number of arm curl repetitions increased (3.5±1.2, P = 0.01), whereas in TS-LP only number of repetitions in sit-to-stand was higher (1.6±0.6, P = 0.01). In TS-LP, reductions were observed in total and abdominal fat mass (1.2±0.5 and 0.4±0.2 kg, P = 0.03 and P = 0.02, respectively), heart rate at rest (9±3 bpm, P = 0.002) and plasma C-reactive protein (1.8±0.8 mmol/L, P = 0.03), with no effects in TS-HP. Thus, team sport training improves functional capacity of untrained older adults and increases leg muscle mass only when ingesting proteins after training. Furthermore, team sport training followed by intake of drink with low protein content does lower fat mass, heart rate at rest and level of systemic inflammation. NCT03120143.

  16. Evaluation of a practice team-supported exposure training for patients with panic disorder with or without agoraphobia in primary care - study protocol of a cluster randomised controlled superiority trial. (United States)

    Gensichen, Jochen; Hiller, Thomas S; Breitbart, Jörg; Teismann, Tobias; Brettschneider, Christian; Schumacher, Ulrike; Piwtorak, Alexander; König, Hans-Helmut; Hoyer, Heike; Schneider, Nico; Schelle, Mercedes; Blank, Wolfgang; Thiel, Paul; Wensing, Michel; Margraf, Jürgen


    Panic disorder and agoraphobia are debilitating and frequently comorbid anxiety disorders. A large number of patients with these conditions are treated by general practitioners in primary care. Cognitive behavioural exposure exercises have been shown to be effective in reducing anxiety symptoms. Practice team-based case management can improve clinical outcomes for patients with chronic diseases in primary care. The present study compares a practice team-supported, self-managed exposure programme for patients with panic disorder with or without agoraphobia in small general practices to usual care in terms of clinical efficacy and cost-effectiveness. This is a cluster randomised controlled superiority trial with a two-arm parallel group design. General practices represent the units of randomisation. General practitioners recruit adult patients with panic disorder with or without agoraphobia according to the International Classification of Diseases, version 10 (ICD-10). In the intervention group, patients receive cognitive behaviour therapy-oriented psychoeducation and instructions to self-managed exposure exercises in four manual-based appointments with the general practitioner. A trained health care assistant from the practice team delivers case management and is continuously monitoring symptoms and treatment progress in ten protocol-based telephone contacts with patients. In the control group, patients receive usual care from general practitioners. Outcomes are measured at baseline (T0), at follow-up after six months (T1), and at follow-up after twelve months (T2). The primary outcome is clinical severity of anxiety of patients as measured by the Beck Anxiety Inventory (BAI). To detect a standardised effect size of 0.35 at T1, 222 patients from 37 general practices are included in each group. Secondary outcomes include anxiety-related clinical parameters and health-economic costs. Current Controlled Trials [http://ISCRTN64669297].

  17. Clinical Trials

    Medline Plus

    Full Text Available ... to Expect During a clinical trial, doctors, nurses, social workers, and other health care providers might be ... the new approach. You also will have the support of a team of health care providers, who ...

  18. Regression analysis by example

    National Research Council Canada - National Science Library

    Chatterjee, Samprit; Hadi, Ali S


    .... The emphasis continues to be on exploratory data analysis rather than statistical theory. The coverage offers in-depth treatment of regression diagnostics, transformation, multicollinearity, logistic regression, and robust regression...

  19. Positive impact of crisis resource management training on no-flow time and team member verbalisations during simulated cardiopulmonary resuscitation: a randomised controlled trial. (United States)

    Fernandez Castelao, Ezequiel; Russo, Sebastian G; Cremer, Stephan; Strack, Micha; Kaminski, Lea; Eich, Christoph; Timmermann, Arnd; Boos, Margarete


    To evaluate the impact of video-based interactive crisis resource management (CRM) training on no-flow time (NFT) and on proportions of team member verbalisations (TMV) during simulated cardiopulmonary resuscitation (CPR). Further, to investigate the link between team leader verbalisation accuracy and NFT. The randomised controlled study was embedded in the obligatory advanced life support (ALS) course for final-year medical students. Students (176; 25.35±1.03 years, 63% female) were alphabetically assigned to 44 four-person teams that were then randomly (computer-generated) assigned to either CRM intervention (n=26), receiving interactive video-based CRM-training, or to control intervention (n=18), receiving an additional ALS-training. Primary outcomes were NFT and proportions of TMV, which were subdivided into eight categories: four team leader verbalisations (TLV) with different accuracy levels and four follower verbalisation categories (FV). Measurements were made of all groups administering simulated adult CPR. NFT rates were significantly lower in the CRM-training group (31.4±6.1% vs. 36.3±6.6%, p=0.014). Proportions of all TLV categories were higher in the CRM-training group (p<0.001). Differences in FV were only found for one category (unsolicited information) (p=0.012). The highest correlation with NFT was found for high accuracy TLV (direct orders) (p=0.06). The inclusion of CRM training in undergraduate medical education reduces NFT in simulated CPR and improves TLV proportions during simulated CPR. Further research will test how these results translate into clinical performance and patient outcome. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  20. Rationale and design of the Sodium Lowering In Dialysate (SoLID) trial: a randomised controlled trial of low versus standard dialysate sodium concentration during hemodialysis for regression of left ventricular mass (United States)


    Background The current literature recognises that left ventricular hypertrophy makes a key contribution to the high rate of premature cardiovascular mortality in dialysis patients. Determining how we might intervene to ameliorate left ventricular hypertrophy in dialysis populations has become a research priority. Reducing sodium exposure through lower dialysate sodium may be a promising intervention in this regard. However there is clinical equipoise around this intervention because the benefit has not yet been demonstrated in a robust prospective clinical trial, and several observational studies have suggested sodium lowering interventions may be deleterious in some dialysis patients. Methods/design The Sodium Lowering in Dialysate (SoLID) study is funded by the Health Research Council of New Zealand. It is a multi-centre, prospective, randomised, single-blind (outcomes assessor), controlled parallel assignment 3-year clinical trial. The SoLID study is designed to study what impact low dialysate sodium has upon cardiovascular risk in dialysis patients. The study intends to enrol 118 home hemodialysis patients from 6 sites in New Zealand over 24 months and follow up each participant over 12 months. Key exclusion criteria are: patients who dialyse more frequently than 3.5 times per week, pre-dialysis serum sodium of <135 mM, and maintenance hemodiafiltration. In addition, some medical conditions, treatments or participation in other dialysis trials, which contraindicate the SoLID study intervention or confound its effects, will be exclusion criteria. The intervention and control groups will be dialysed using dialysate sodium 135 mM and 140 mM respectively, for 12 months. The primary outcome measure is left ventricular mass index, as measured by cardiac magnetic resonance imaging, after 12 months of intervention. Eleven or more secondary outcomes will be studied in an attempt to better understand the physiologic and clinical mechanisms by which lower dialysate sodium

  1. Reduced Rank Regression

    DEFF Research Database (Denmark)

    Johansen, Søren


    The reduced rank regression model is a multivariate regression model with a coefficient matrix with reduced rank. The reduced rank regression algorithm is an estimation procedure, which estimates the reduced rank regression model. It is related to canonical correlations and involves calculating e...... eigenvalues and eigenvectors. We give a number of different applications to regression and time series analysis, and show how the reduced rank regression estimator can be derived as a Gaussian maximum likelihood estimator. We briefly mention asymptotic results......The reduced rank regression model is a multivariate regression model with a coefficient matrix with reduced rank. The reduced rank regression algorithm is an estimation procedure, which estimates the reduced rank regression model. It is related to canonical correlations and involves calculating...

  2. Work team

    Directory of Open Access Journals (Sweden)

    RBE Editorial


    Full Text Available Work Team 2016 (Jan-Jul1. Editorial TeamChief-editorsBayardo Bapstista Torres, Instituto de Química (USP, BrasilEduardo Galembeck, Depto. Bioquímica, Instituto de Biologia, Universidade de Campinas (Unicamp, Brasil Co-editorsGabriel Gerber Hornink, Depto. Bioquímica, Instituto de Ciências Biomédicas, Universidade - Federal de Alfenas (Unifal-MG, BrasilVera Maria Treis Trindade, Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul (UFRGS, Brasil Editorial BoardAdriana Cassina, Department of Biochemistry, Facultad de Medicina, Universidad de la República, UruguayAngel Herráez, Departamento de Bioquímica y Biología molecular, Universidad de Alcalá de Henares, Madrid, SpainAndré Amaral Gonçalves Bianco, Universidade Federal de São Paulo (Unifesp, BrasilDenise Vaz de Macedo, Depto. Bioquímica, Instituto de Biologia, Universidade Estadual de Campinas (Unicamp, BrasilEneida de Paula, Depto. Bioquímica, Instituto de Biologia, Universidade Estadual de Campinas (Unicamp, BrasilJose Antonio Martinez Oyanedel, Universidad de Concepción, ChileJosep Maria Fernández Novell, Department of Molecular Biology & Biochemistry, Universitat de Barcelona, SpainLeila Maria Beltramini, Instituto de Física de São Carlos, Universidade Estadual de São Paulo (USP, BrasilManuel João da Costa, Escola de Ciências da Saúde, Universidade do Minho, PortugalMaria Lucia Bianconi, Instituto de Bioquímica Médica, Universidade Federal do Rio de Janeiro (UFRJ, BrasilMaría Noel Alvarez, Department of Biochemistry, Facultad de Medicina, Universidad de la República, UruguayMiguel Ángel Medina Torres, Department of Molecular Biology & Biochemistry Faculty of Sciences University of Málaga, SpainNelma Regina Segnini Bossolan, Instituto de Física de São Carlos, Universidade de São Paulo (USP, BrasilPaulo De Avila Junior, Centro de Ciências Naturais e Humanas (CCNH Universidade Federal do ABC (UFABC

  3. Trust in Diverse Teams

    DEFF Research Database (Denmark)

    Clausen, Lisbeth

    Multicultural membership and diversity in teams are important to maintain effectiveness in organizations in a global business environment. Multicultural teams offer great potential in international collaboration just as top management teams are becoming increasingly diversified. However......, maintaining team cohesiveness in multicultural teams to collaborate effectively presents a number of challenges. The present study employs the concept of trust to explore influences on team collaboration in high performing teams. The study is based on observation of teams in seven multinational corporations...... as nationalities, gender, functional expertise and international experience. The study contributes insights to diverse teams through a processual study of micro-processes in global organizational contexts crossing multicultural boundaries....

  4. The favourable effects of long-term selenium supplementation on regression of cervical tissues and metabolic profiles of patients with cervical intraepithelial neoplasia: a randomised, double-blind, placebo-controlled trial. (United States)

    Karamali, Maryam; Nourgostar, Sepideh; Zamani, Ashraf; Vahedpoor, Zahra; Asemi, Zatollah


    This study was conducted to assess the effects of long-term Se administration on the regression and metabolic status of patients with cervical intraepithelial neoplasia grade 1 (CIN1). This randomised, double-blind, placebo-controlled trial was carried out among fifty-eight women diagnosed with CIN1. To diagnose CIN1, we used specific diagnostic procedures of biopsy, pathological diagnosis and colposcopy. Patients were randomly assigned to two groups to receive 200 μg Se supplements as Se yeast (n 28) or placebo (n 28) daily for 6 months. After 6 months of taking Se supplements, a greater percentage of women in the Se group had regressed CIN1 (88·0 v. 56·0 %; P=0·01) compared with those in the placebo group. Long-term Se supplementation, compared with the placebo, resulted in significant decreases in fasting plasma glucose levels (-0·37 (sd 0·32) v. +0·07 (sd 0·63) mmol/l; P=0·002), serum insulin levels (-28·8 (sd 31·2) v. +13·2 (sd 40·2) pmol/l; Pplacebo group, there were significant rises in plasma total antioxidant capacity (+186·1 (sd 274·6) v. +42·8 (sd 180·4) mmol/l; P=0·02) and GSH levels (+65·0 (sd 359·8) v. -294·2 (sd 581·8) μmol/l; P=0·007) and a significant decrease in malondialdehyde levels (-1·5 (sd 2·1) v. +0·1 (sd 1·4) μmol/l; P=0·001) among those who took Se supplements. Overall, taking Se supplements among patients with CIN1 led to its regression and had beneficial effects on their metabolic profiles.

  5. Impact of a nurse-led intervention to improve screening for cardiovascular risk factors in people with severe mental illnesses. Phase-two cluster randomised feasibility trial of community mental health teams

    Directory of Open Access Journals (Sweden)

    Nazareth Irwin


    Full Text Available Abstract Background People with severe mental illnesses (SMI are at increased risk of cardiovascular disease (CVD. Clinical guidelines recommend regular screening for CVD risk factors. We evaluated a nurse led intervention to improve screening rates across the primary-secondary care interface. Methods Six community mental health teams (CMHTs were randomised to receive either the nurse led intervention plus education pack (n = 3 or education pack only (n = 3. Intervention (6 months: The nurse promoted CVD screening in primary care and then in CMHTs. Patients who remained unscreened were offered screening by the nurse. After the intervention participants with SMI were recruited from each CMHT to collect outcome data. Main outcome: Numbers screened during the six months, confirmed in General Practice notes. Results All six CMHTs approached agreed to randomisation. 121 people with SMI participated in outcome interviews during two waves of recruitment (intervention arm n = 59, control arm n = 62. Participants from both arms of the trial had similar demographic profiles and rates of previous CVD screening in the previous year, with less than 20% having been screened for each risk factor. After the trial, CVD screening had increased in both arms but participants from the intervention arm were significantly more likely to have received screening for blood pressure (96% vs 68%; adjusted Odds Ratio (OR 13.6; 95% CI: 3.5-38.4, cholesterol (66.7% vs 26.9%, OR 6.1; 3.2-11.5, glucose (66.7% vs 36.5% OR 4.4; 2.7-7.1, BMI (92.5% vs 65.2% OR 6.5; 2.1-19.6, and smoking status (88.2% vs 57.8% OR 5.5; 3.2-9.5 and have a 10 year CVD risk score calculated (38.2% vs 10.9% OR 5.2 1.8-15.3. Within the intervention arm approximately half the screening was performed in general practice and half by the trial nurse. Conclusions The nurse-led intervention was superior, resulting in an absolute increase of approximately 30% more people with SMI receiving screening for each

  6. Leading Strategic Leader Teams (United States)


    develop teams which provide them capacity and diversity to make sound decisions.1 Strategic leader and top management teams exist throughout...looks at whether a leader should use a team to make a decision; it does not look at how to manage a team process to produce desired outcomes. Yet, the...choices on how to operate his/her team. Leaders of strategic leader teams must recognize and understand how they can manage the processes utilized

  7. Glycemic Control During Continuous Subcutaneous Insulin Infusion Versus Multiple Daily Insulin Injections in Type 2 Diabetes: Individual Patient Data Meta-analysis and Meta-regression of Randomized Controlled Trials. (United States)

    Pickup, John C; Reznik, Yves; Sutton, Alex J


    To compare glycemic control during continuous subcutaneous insulin infusion (CSII) and multiple daily insulin injections (MDI) in people with type 2 diabetes to identify patient characteristics that determine those best treated by CSII. Randomized controlled trials were selected comparing HbA1c during CSII versus MDI in people with type 2 diabetes. Data sources included Cochrane database and Ovid Medline. We explored patient-level determinants of final HbA1c level and insulin dose using Bayesian meta-regression models of individual patient data and summary effects using two-step meta-analysis. Hypoglycemia data were unavailable. Five trials were identified, with 287 patients randomized to receive MDI and 303 to receive CSII. Baseline HbA1c was the best determinant of final HbA1c: HbA1c difference (%) = 1.575 - (0.216 [95% credible interval 0.371-0.043] × baseline HbA1c) for all trials, but with largest effect in the trial with prerandomization optimization of control. Baseline insulin dose was best predictor of final insulin dose: insulin dose difference (units/kg) = 0.1245 - (0.382 [0.510-0.254] × baseline insulin dose). Overall HbA1c difference was -0.40% (-0.86 to 0.05 [-4.4 mmol/mol (-9.4 to 0.6)]). Overall insulin dose was reduced by -0.25 units/kg (-0.31 to -0.19) (26% reduction on CSII), and by -24.0 units/day (-30.6 to -17.5). Mean weight did not differ between treatments (0.08 kg [-0.33 to 0.48]). CSII achieves better glycemic control than MDI in people with poorly controlled type 2 diabetes, with ∼26% reduction in insulin requirements and no weight change. The best effect is in those worst controlled and with the highest insulin dose at baseline. © 2017 by the American Diabetes Association.

  8. Regression analysis by example

    CERN Document Server

    Chatterjee, Samprit


    Praise for the Fourth Edition: ""This book is . . . an excellent source of examples for regression analysis. It has been and still is readily readable and understandable."" -Journal of the American Statistical Association Regression analysis is a conceptually simple method for investigating relationships among variables. Carrying out a successful application of regression analysis, however, requires a balance of theoretical results, empirical rules, and subjective judgment. Regression Analysis by Example, Fifth Edition has been expanded

  9. Managing Team Learning in a Spanish Commercial Bank (United States)

    Doving, Erik; Martin-Rubio, Irene


    Purpose: The purpose of this paper is to analyze how team management affects team-learning activities. Design/methodology/approach: The authors empirically study 68 teams as they operate in the natural business context of a major Spanish bank. Quantitative research utilizing multiple regression analyses is used to test hypotheses. Findings: The…

  10. Flexible survival regression modelling

    DEFF Research Database (Denmark)

    Cortese, Giuliana; Scheike, Thomas H; Martinussen, Torben


    Regression analysis of survival data, and more generally event history data, is typically based on Cox's regression model. We here review some recent methodology, focusing on the limitations of Cox's regression model. The key limitation is that the model is not well suited to represent time-varyi...

  11. Team Learning in Teacher Teams: Team Entitativity as a Bridge between Teams-in-Theory and Teams-in-Practice (United States)

    Vangrieken, Katrien; Dochy, Filip; Raes, Elisabeth


    This study aimed to investigate team learning in the context of teacher teams in higher vocational education. As teacher teams often do not meet all criteria included in theoretical team definitions, the construct "team entitativity" was introduced. Defined as the degree to which a group of individuals possesses the quality of being a…

  12. Preventing disease through opportunistic, rapid engagement by primary care teams using behaviour change counselling (PRE-EMPT: protocol for a general practice-based cluster randomised trial

    Directory of Open Access Journals (Sweden)

    Smith Christine


    Full Text Available Abstract Background Smoking, excessive alcohol consumption, lack of exercise and an unhealthy diet are the key modifiable factors contributing to premature morbidity and mortality in the developed world. Brief interventions in health care consultations can be effective in changing single health behaviours. General Practice holds considerable potential for primary prevention through modifying patients' multiple risk behaviours, but feasible, acceptable and effective interventions are poorly developed, and uptake by practitioners is low. Through a process of theoretical development, modeling and exploratory trials, we have developed an intervention called Behaviour Change Counselling (BCC derived from Motivational Interviewing (MI. This paper describes the protocol for an evaluation of a training intervention (the Talking Lifestyles Programme which will enable practitioners to routinely use BCC during consultations for the above four risk behaviours. Methods/Design This cluster randomised controlled efficacy trial (RCT will evaluate the outcomes and costs of this training intervention for General Practitioners (GPs and nurses. Training methods will include: a practice-based seminar, online self-directed learning, and reflecting on video recorded and simulated consultations. The intervention will be evaluated in 29 practices in Wales, UK; two clinicians will take part (one GP and one nurse from each practice. In intervention practices both clinicians will receive training. The aim is to recruit 2000 patients into the study with an expected 30% drop out. The primary outcome will be the proportion of patients making changes in one or more of the four behaviours at three months. Results will be compared for patients seeing clinicians trained in BCC with patients seeing non-BCC trained clinicians. Economic and process evaluations will also be conducted. Discussion Opportunistic engagement by health professionals potentially represents a cost effective

  13. Short Duration vs Standard Duration of Dual-Antiplatelet Therapy After Percutaneous Coronary Intervention With Second-Generation Drug-Eluting Stents - A Systematic Review, Meta-Analysis, and Meta-Regression Analysis of Randomized Controlled Trials. (United States)

    Wassef, Anthony W A; Khafaji, Hadi; Syed, Ishba; Yan, Andrew T; Udell, Jacob A; Goodman, Shaun G; Cheema, Asim N; Bagai, Akshay


    Current guidelines recommend 12 months of dual-antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) with drug-eluting stent (DES) implantation. Whether the duration of DAPT can be safely shortened with use of second-generation DESs is unclear. We conducted a meta-analysis of randomized controlled trials comparing short duration (SD) (3-6 months) with standard longer duration (LD) (≥12 months) DAPT in patients treated with primarily second-generation DES implantation. Meta-regression was performed to explore the relationship between acute coronary syndrome (ACS) and the effect of DAPT duration. Six studies were included, with 12,752/13,928 (91.5%) patients receiving second-generation DESs. A total of 5367 patients (39%) had PCI in the setting of ACS. There was no difference in all-cause mortality (1.1% vs 1.2%; odds ratio [OR], 0.86; 95% confidence interval [CI], 0.63-1.18; P=.36) or cardiac mortality (0.9% vs 1.0%; OR, 0.92; 95% CI, 0.61-1.39; P=.69) with SD-DAPT vs LD-DAPT, respectively. Definite/probable stent thrombosis (0.5% vs 0.3%; OR, 1.33; 95% CI, 0.75-2.34; P=.51), myocardial infarction (1.5% vs 1.3%; OR, 1.17; 95% CI, 0.88-1.56; P=.29), and stroke (0.4% vs 0.4%; OR, 1.04; 95% CI, 0.60-1.81; P=.88) were similar between the groups. Compared with LD-DAPT, SD-DAPT was associated with lower clinically significant bleeding (0.9% vs 1.4%; OR, 0.64; 95% CI, 0.46-0.89; P=.01). Meta-regression analysis showed no significant association between the proportion of ACS patients in trials and duration of DAPT for the outcomes of mortality (P=.95), myocardial infarction (P=.98), or stent thrombosis (P=.89). In low-risk patients treated with contemporary second-generation DES implantation, SD-DAPT has similar rates of mortality, myocardial infarction, and stent thrombosis, with lower rates of bleeding compared with LD-DAPT.

  14. The moderating role of team resources in translating nursing teams' accountability into learning and performance: a cross-sectional study. (United States)

    Rashkovits, Sarit; Drach-Zahavy, Anat


    The aim of this study was to test the moderated-mediation model suggesting that nursing teams' accountability affects team effectiveness by enhancing team learning when relevant resources are available to the team. Disappointing evidence regarding improvement in nurses' safe and quality care elevate the need in broadening our knowledge regarding the factors that enhance constant learning in nursing teams. Accountability is considered as crucial for team learning and quality of care but empirical findings have shown mixed evidence. A cross-sectional design. Forty-four nursing teams participated in the study. Data were collected in 2013-2014: Head nurses completed validated questionnaires, regarding team resources for learning (time availability, team autonomy and team performance feedback), and nursing teams' effectiveness; and nurses answered questionnaires regarding teams' accountability and learning (answers were aggregated to the team level). The model was tested using a moderated-mediation analysis with resources as moderating variables, and team learning as the mediator in the team accountability-team effectiveness link. The results of a mixed linear regression show that, as expected, nursing teams' accountability was positively linked to nursing teams' learning, when time availability, and team autonomy were high rather than low, and team performance feedback was low rather than high. Nurturing team accountability is not enough for achieving team learning and subsequent team effectiveness. Rather there is a need to provide nursing teams with adequate time, autonomy, and be cautious with performance feedback, as the latter may motivate nurses to repeat routine work strategies rather than explore improved ones. © 2016 John Wiley & Sons Ltd.

  15. Rectal microbicides for U.S. gay men. Are clinical trials needed? Are they feasible? HIVNET Vaccine Preparedness Study Protocol Team. (United States)

    Gross, M; Buchbinder, S P; Celum, C; Heagerty, P; Seage, G R


    Incomplete condom use during anal sex persists among gay men; microbicides may provide additional protection. Despite the absence of efficacy or safety data, many gay men use sexual lubricants containing nonoxynol-9 (N-9), a detergent-based spermicide under evaluation for efficacy as a vaginal microbicide. Evaluate unprotected sex, lubricant use, and attitudes regarding possible participation in clinical trials of rectal microbicides among high-risk human immunodeficiency virus-(HIV) seronegative U.S. gay men in six cities. A total of 3,257 gay men were interviewed and responded to a self-administered questionnaire at enrollment into a longitudinal cohort study of HIV seroincidence. Among 2,216 men who practiced receptive anal intercourse in the previous 6 months, 438 (20%) reported they never used condoms. More than three fourths of 3,093 men who had anal sex used lubricants more than 80% of the time. 41% of whom actively sought N-9 containing products. About two thirds said they were definitely or probably willing to participate in rectal microbicide clinical trials. Condom use is imperfect among men who report anal sex. N-9 lubricants are popular. Most gay men in this cohort indicate willingness to participate in rectal microbicide studies.

  16. Assessing Team Performance. (United States)

    Trimble, Susan; Rottier, Jerry

    Interdisciplinary middle school level teams capitalize on the idea that the whole is greater than the sum of its parts. Administrators and team members can maximize the advantages of teamwork using team assessments to increase the benefits for students, teachers, and the school environment. Assessing team performance can lead to high performing…

  17. Speeding Up Team Learning. (United States)

    Edmondson, Amy; Bohmer, Richard; Pisano, Gary


    A study of 16 cardiac surgery teams looked at how the teams adapted to new ways of working. The challenge of team management is to implement new processes as quickly as possible. Steps for creating a learning team include selecting a mix of skills and expertise, framing the challenge, and creating an environment of psychological safety. (JOW)

  18. Travelling with football teams

    African Journals Online (AJOL)

    Football fans will always converge at a stadium on the day of the match to watch their favourite team play against a visiting team. The atmosphere at these matches is almost always electric with fans cheering their favourite teams on. The focus for everybody is ultimately on the performance of the teams on the playing field ...

  19. The PULSAR Specialist Care protocol: a stepped-wedge cluster randomized control trial of a training intervention for community mental health teams in recovery-oriented practice. (United States)

    Shawyer, Frances; Enticott, Joanne C; Brophy, Lisa; Bruxner, Annie; Fossey, Ellie; Inder, Brett; Julian, John; Kakuma, Ritsuko; Weller, Penelope; Wilson-Evered, Elisabeth; Edan, Vrinda; Slade, Mike; Meadows, Graham N


    Recovery features strongly in Australian mental health policy; however, evidence is limited for the efficacy of recovery-oriented practice at the service level. This paper describes the Principles Unite Local Services Assisting Recovery (PULSAR) Specialist Care trial protocol for a recovery-oriented practice training intervention delivered to specialist mental health services staff. The primary aim is to evaluate whether adult consumers accessing services where staff have received the intervention report superior recovery outcomes compared to adult consumers accessing services where staff have not yet received the intervention. A qualitative sub-study aims to examine staff and consumer views on implementing recovery-oriented practice. A process evaluation sub-study aims to articulate important explanatory variables affecting the interventions rollout and outcomes. The mixed methods design incorporates a two-step stepped-wedge cluster randomized controlled trial (cRCT) examining cross-sectional data from three phases, and nested qualitative and process evaluation sub-studies. Participating specialist mental health care services in Melbourne, Victoria are divided into 14 clusters with half randomly allocated to receive the staff training in year one and half in year two. Research participants are consumers aged 18-75 years who attended the cluster within a previous three-month period either at baseline, 12 (step 1) or 24 months (step 2). In the two nested sub-studies, participation extends to cluster staff. The primary outcome is the Questionnaire about the Process of Recovery collected from 756 consumers (252 each at baseline, step 1, step 2). Secondary and other outcomes measuring well-being, service satisfaction and health economic impact are collected from a subset of 252 consumers (63 at baseline; 126 at step 1; 63 at step 2) via interviews. Interview-based longitudinal data are also collected 12 months apart from 88 consumers with a psychotic disorder

  20. Team Leader Structuring for Team Effectiveness and Team Learning in Command-and-Control Teams. (United States)

    van der Haar, Selma; Koeslag-Kreunen, Mieke; Euwe, Eline; Segers, Mien


    Due to their crucial and highly consequential task, it is of utmost importance to understand the levers leading to effectiveness of multidisciplinary emergency management command-and-control (EMCC) teams. We argue that the formal EMCC team leader needs to initiate structure in the team meetings to support organizing the work as well as facilitate team learning, especially the team learning process of constructive conflict. In a sample of 17 EMCC teams performing a realistic EMCC exercise, including one or two team meetings (28 in sum), we coded the team leader's verbal structuring behaviors (1,704 events), rated constructive conflict by external experts, and rated team effectiveness by field experts. Results show that leaders of effective teams use structuring behaviors more often (except asking procedural questions) but decreasingly over time. They support constructive conflict by clarifying and by making summaries that conclude in a command or decision in a decreasing frequency over time.

  1. Developing Your Dream Team (United States)

    Gatlin, Kenda


    Almost anyone has held various roles on a team, be it a family unit, sports team, or a project-oriented team. As an educator, one must make a conscious decision to build and invest in a team. Gathering the best team possible will help one achieve one's goals. This article explores some of the key reasons why it is important to focus on the team…

  2. Visualisation of Regression Trees


    Brunsdon, Chris


    he regression tree [1] has been used as a tool for exploring multivariate data sets for some time. As in multiple linear regression, the technique is applied to a data set consisting of a contin- uous response variable y and a set of predictor variables { x 1 ,x 2 ,...,x k } which may be continuous or categorical. However, instead of modelling y as a linear function of the predictors, regression trees model y as a series of ...

  3. Smoothed Cox regression


    Dabrowska, Dorota M.


    Nonparametric regression was shown by Beran and McKeague and Utikal to provide a flexible method for analysis of censored failure times and more general counting processes models in the presence of covariates. We discuss application of kernel smoothing towards estimation in a generalized Cox regression model with baseline intensity dependent on a covariate. Under regularity conditions we show that estimates of the regression parameters are asymptotically normal at rate root-n, and we also dis...

  4. Introduction to regression graphics

    CERN Document Server

    Cook, R Dennis


    Covers the use of dynamic and interactive computer graphics in linear regression analysis, focusing on analytical graphics. Features new techniques like plot rotation. The authors have composed their own regression code, using Xlisp-Stat language called R-code, which is a nearly complete system for linear regression analysis and can be utilized as the main computer program in a linear regression course. The accompanying disks, for both Macintosh and Windows computers, contain the R-code and Xlisp-Stat. An Instructor's Manual presenting detailed solutions to all the problems in the book is ava

  5. Alternative Methods of Regression

    CERN Document Server

    Birkes, David


    Of related interest. Nonlinear Regression Analysis and its Applications Douglas M. Bates and Donald G. Watts ".an extraordinary presentation of concepts and methods concerning the use and analysis of nonlinear regression models.highly recommend[ed].for anyone needing to use and/or understand issues concerning the analysis of nonlinear regression models." --Technometrics This book provides a balance between theory and practice supported by extensive displays of instructive geometrical constructs. Numerous in-depth case studies illustrate the use of nonlinear regression analysis--with all data s

  6. Structuring Successful Global Virtual Teams (United States)


    effectively complete complex tasks that are beyond the scope of what an individual could reasonably accomplish. In particular, teams ...conditions for team effectiveness (Tannenbaum, Mathieu, Salas, & Cohen, 2012). When compared to traditional or conventional teams , organizational leaders may...following topics will be combined: global teams , virtual teams , multicultural teams , distributed teams , team diversity, S. Miloslavic et al. 21 22 23

  7. Training a team with simulated team members

    NARCIS (Netherlands)

    Schaafstal, A.M.; Hoeft, R.M.; Schaik, M. van


    The process of training teams increasingly occurs in synthetic environments. However, it is often still modeled after live team training, including the disadvantages of live training, for example, the fact that all teammates must be available. This paper explores overcoming the disadvantages of


    Directory of Open Access Journals (Sweden)

    Cezar SCARLAT


    Full Text Available The article is based on literature review and authors’ own recent experience in managing multicultural project teams, in international environment. This comparative study considers two groups of projects: technical assistance (TA projects versus information technology (IT projects. The aim is to explore the size and structure of the project teams – according to the team formation and its lifecycle, and to identify some distinctive attributes of the project teams – both similarities and differences between the above mentioned types of projects. Distinct focus of the research is on the multiculturalism of the project teams: how the cultural background of the team members influences the team performance and team management. Besides the results of the study are the managerial implications: how the team managers could soften the cultural clash, and avoid inter-cultural misunderstandings and even conflicts – in order to get a better performance. Some practical examples are provided as well.

  9. Morse–Smale Regression

    Energy Technology Data Exchange (ETDEWEB)

    Gerber, Samuel [Univ. of Utah, Salt Lake City, UT (United States); Rubel, Oliver [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Bremer, Peer -Timo [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Pascucci, Valerio [Univ. of Utah, Salt Lake City, UT (United States); Whitaker, Ross T. [Univ. of Utah, Salt Lake City, UT (United States)


    This paper introduces a novel partition-based regression approach that incorporates topological information. Partition-based regression typically introduces a quality-of-fit-driven decomposition of the domain. The emphasis in this work is on a topologically meaningful segmentation. Thus, the proposed regression approach is based on a segmentation induced by a discrete approximation of the Morse–Smale complex. This yields a segmentation with partitions corresponding to regions of the function with a single minimum and maximum that are often well approximated by a linear model. This approach yields regression models that are amenable to interpretation and have good predictive capacity. Typically, regression estimates are quantified by their geometrical accuracy. For the proposed regression, an important aspect is the quality of the segmentation itself. Thus, this article introduces a new criterion that measures the topological accuracy of the estimate. The topological accuracy provides a complementary measure to the classical geometrical error measures and is very sensitive to overfitting. The Morse–Smale regression is compared to state-of-the-art approaches in terms of geometry and topology and yields comparable or improved fits in many cases. Finally, a detailed study on climate-simulation data demonstrates the application of the Morse–Smale regression. Supplementary Materials are available online and contain an implementation of the proposed approach in the R package msr, an analysis and simulations on the stability of the Morse–Smale complex approximation, and additional tables for the climate-simulation study.

  10. Quantile Regression Methods

    DEFF Research Database (Denmark)

    Fitzenberger, Bernd; Wilke, Ralf Andreas


    Quantile regression is emerging as a popular statistical approach, which complements the estimation of conditional mean models. While the latter only focuses on one aspect of the conditional distribution of the dependent variable, the mean, quantile regression provides more detailed insights...

  11. Optimizing the Team for Required Power During Track-Cycling Team Pursuit. (United States)

    Heimans, Levi; Dijkshoorn, Wouter R; Hoozemans, Marco J M; de Koning, Jos J


    Since the aim of the men's team pursuit in time-trial track cycling is to accomplish a distance of 4000 m as fast as possible, optimizing aerodynamic drag can contribute to achieving this goal. The aim of this study was to determine the drafting effect in second, third, and fourth position during the team pursuit in track cycling as a function of the team members' individual frontal areas in order to minimize the required power. Eight experienced track cyclists of the Dutch national selection performed 39 trials of 3 km in different teams of 4 cyclists at a constant velocity of 15.75 m/s. Frontal projected areas were determined, and together with field-derived drag coefficients for all 4 positions, the relationships between frontal areas of team members and drag fractions were estimated using generalized estimating equations. The frontal area of both the cyclist directly in front of the drafter and the drafter himself turned out to be significant determinants of the drag fraction at the drafter's position (P < .05) for all 3 drafting positions. Predicted required power for individuals in drafting positions differed up to 35 W depending on team composition. For a team, a maximal difference in team efficiency (1.2%) exists by selecting cyclists in a specific sequence. Estimating required power for a specific team composition gives insight into differences in team efficiency for the team pursuit. Furthermore, required power for individual team members ranges substantially depending on team composition.

  12. Regression to Causality

    DEFF Research Database (Denmark)

    Bordacconi, Mats Joe; Larsen, Martin Vinæs


    Humans are fundamentally primed for making causal attributions based on correlations. This implies that researchers must be careful to present their results in a manner that inhibits unwarranted causal attribution. In this paper, we present the results of an experiment that suggests regression...... models – one of the primary vehicles for analyzing statistical results in political science – encourage causal interpretation. Specifically, we demonstrate that presenting observational results in a regression model, rather than as a simple comparison of means, makes causal interpretation of the results...... of equivalent results presented as either regression models or as a test of two sample means. Our experiment shows that the subjects who were presented with results as estimates from a regression model were more inclined to interpret these results causally. Our experiment implies that scholars using regression...

  13. A comparison of multidisciplinary team residential rehabilitation with conventional outpatient care for the treatment of non-arthritic intra-articular hip pain in UK Military personnel - a protocol for a randomised controlled trial. (United States)

    Coppack, Russell J; Bilzon, James L; Wills, Andrew K; McCurdie, Ian M; Partridge, Laura; Nicol, Alastair M; Bennett, Alexander N


    Non-arthritic hip disorders are defined as abnormalities of the articulating surfaces of the acetabulum and femur before the onset of osteoarthritis, including intra-articular structures such as the acetabular labrum and chondral surfaces. Abnormal femoroacetabular morphology is commonly seen in young men who constitute much of the UK military population. Residential multidisciplinary team (MDT) rehabilitation for patients with musculoskeletal injuries has a long tradition in the UK military, however, there are no studies presenting empirical data on the efficacy of a residential MDT approach compared with individualised conventional outpatient treatment. With no available data, the sustainability of this care pathway has been questioned. The purpose of this randomised controlled trial is to compare the effects of a residential multidisciplinary intervention, to usual outpatient care, on the clinical outcomes of young active adults undergoing treatment for non-arthritic intra-articular hip pain. The trial will be conducted at the Defence Medical Rehabilitation Centre, Headley Court, UK. One hundred military male participants with clinical indicators of non-arthritic intra-articular hip pain will be randomly allocated to either: (1) 7-day residential multidisciplinary team intervention, n = 50; (2) 6-week physiotherapist-led outpatient intervention (conventional care), n = 50. Measurements will be taken at baseline, post-treatment (1-week MDT group; 6-weeks physiotherapy group), and 12-weeks. The primary outcome measures are the function in daily living sub-scale of the Copenhagen Hip and Groin Outcome Score (HAGOS), the physical function subscale of the Non-arthritic Hip Score (NAHS), and VAS pain scale. Secondary outcomes include objective measures of physical capacity and general health. An intention-to-treat analysis will be performed using linear and mixed models. This study will be the first to assess the efficacy of intensive MDT rehabilitation

  14. Niacin and statin combination therapy for atherosclerosis regression and prevention of cardiovascular disease events: reconciling the AIM-HIGH (Atherothrombosis Intervention in Metabolic Syndrome With Low HDL/High Triglycerides: Impact on Global Health Outcomes) trial with previous surrogate endpoint trials. (United States)

    Michos, Erin D; Sibley, Christopher T; Baer, Jefferson T; Blaha, Michael J; Blumenthal, Roger S


    Despite substantial risk reductions targeting low-density lipoprotein cholesterol with statins, there remains significant residual risk as evidenced by incident and recurrent cardiovascular disease (CVD) events among statin-treated patients. Observational studies have shown that low levels of high-density lipoprotein cholesterol (HDL-C) are associated with increased CVD risk. It remains unclear whether strategies aimed at increasing HDL-C in addition to background statin therapy will further reduce risk. The AIM-HIGH (Atherothrombosis Intervention in Metabolic Syndrome With Low HDL/High Triglycerides: Impact on Global Health Outcomes) trial, which compared combined niacin/simvastatin with simvastatin alone, failed to demonstrate an incremental benefit of niacin among patients with atherosclerotic CVD and on-treatment low-density lipoprotein cholesterol values <70 mg/dl, but this study had some limitations. Previously, small randomized, clinical trials of niacin plus statins showed that modest regression of carotid atherosclerosis is possible in individuals with CVD, CVD risk equivalents, or atherosclerosis. This viewpoint summarizes these imaging trials studying niacin and places them in the context of the failure of AIM-HIGH to support the HDL-C-increasing hypothesis. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  15. Neurocognitive deficits in schizophrenia are associated with alterations in blood levels of neurosteroids: a multiple regression analysis of findings from a double-blind, randomized, placebo-controlled, crossover trial with DHEA. (United States)

    Ritsner, Michael S; Strous, Rael D


    While neurosteroids exert multiple effects in the central nervous system, their associations with neurocognitive deficits in schizophrenia are not yet fully understood. The purpose of this study was to identify the contribution of circulating levels of dehydroepiandrosterone (DHEA), its sulfate (DHEAS), androstenedione, and cortisol to neurocognitive deficits through DHEA administration in schizophrenia. Data regarding cognitive function, symptom severity, daily doses, side effects of antipsychotic agents and blood levels of DHEA, DHEAS, androstenedione and cortisol were collected among 55 schizophrenia patients in a double-blind, randomized, placebo-controlled, crossover trial with DHEA at three intervals: upon study entry, after 6weeks of DHEA administration (200mg/d), and after 6weeks of a placebo period. Multiple regression analysis was applied for predicting sustained attention, memory, and executive function scores across three examinations controlling for clinical, treatment and background covariates. Findings indicated that circulating DHEAS and androstenedione levels are shown as positive predictors of cognitive functioning, while DHEA level as negative predictor. Overall, blood neurosteroid levels and their molar ratios accounted for 16.5% of the total variance in sustained attention, 8-13% in visual memory tasks, and about 12% in executive functions. In addition, effects of symptoms, illness duration, daily doses of antipsychotic agents, side effects, education, and age of onset accounted for variability in cognitive functioning in schizophrenia. The present study suggests that alterations in circulating levels of neurosteroids and their molar ratios may reflect pathophysiological processes, which, at least partially, underlie cognitive dysfunction in schizophrenia. Copyright 2009 Elsevier Ltd. All rights reserved.

  16. A multisite randomized trial of the effects of physician education and organizational change in chronic asthma care: cost-effectiveness analysis of the Pediatric Asthma Care Patient Outcomes Research Team II (PAC-PORT II). (United States)

    Sullivan, Sean D; Lee, Todd A; Blough, David K; Finkelstein, Jonathan A; Lozano, Paula; Inui, Thomas S; Fuhlbrigge, Anne L; Carey, Vincent J; Wagner, Ed; Weiss, Kevin B


    A decision to implement innovative disease management interventions in health plans often requires evidence of clinical benefit and financial impact. The Pediatric Asthma Care Patient Outcomes Research Team II trial evaluated 2 asthma care strategies: a peer leader-based physician behavior change intervention (PLE) and a practice-based redesign called the planned asthma care intervention (PACI). To estimate the cost-effectiveness of the interventions. This was a 3-arm, cluster randomized trial conducted in 42 primary care practices. A total of 638 children (age range, 3-17 years) with mild to moderate persistent asthma were followed up for 2 years. Practices were randomized to PLE (n = 226), PACI (n = 213), or usual care (n = 199). The primary outcome was symptom-free days (SFDs). Costs included asthma-related health care utilization and intervention costs. Annual costs per patient were as follows: PACI, USD 1292; PLE, USD 504; and usual care, USD 385. The difference in annual SFDs was 6.5 days (95% confidence interval [CI], -3.6 to 16.9 days) for PLE vs usual care and 13.3 days (95% CI, 2.1-24.7 days) for PACI vs usual care. Compared with usual care, the incremental cost-effectiveness ratio was USD 18 per SFD gained for PLE (95% CI, USD 5.21-dominated) and USD 68 per SFD gained for PACI (95% CI, USD 37.36-361.16). Results of this study show that it is possible to increase SFDs in children and move organizations toward guideline recommendations on asthma control in settings where most children are receiving controller medications at baseline. However, the improvements were realized with an increase in the costs associated with asthma care.

  17. Applied linear regression

    CERN Document Server

    Weisberg, Sanford


    Praise for the Third Edition ""...this is an excellent book which could easily be used as a course text...""-International Statistical Institute The Fourth Edition of Applied Linear Regression provides a thorough update of the basic theory and methodology of linear regression modeling. Demonstrating the practical applications of linear regression analysis techniques, the Fourth Edition uses interesting, real-world exercises and examples. Stressing central concepts such as model building, understanding parameters, assessing fit and reliability, and drawing conclusions, the new edition illus

  18. Applied logistic regression

    CERN Document Server

    Hosmer, David W; Sturdivant, Rodney X


     A new edition of the definitive guide to logistic regression modeling for health science and other applications This thoroughly expanded Third Edition provides an easily accessible introduction to the logistic regression (LR) model and highlights the power of this model by examining the relationship between a dichotomous outcome and a set of covariables. Applied Logistic Regression, Third Edition emphasizes applications in the health sciences and handpicks topics that best suit the use of modern statistical software. The book provides readers with state-of-

  19. Toward Learning Teams

    DEFF Research Database (Denmark)

    Hoda, Rashina; Babb, Jeff; Nørbjerg, Jacob


    Today's software development challenges require learning teams that can continuously apply new engineering and management practices, new and complex technical skills, cross-functional skills, and experiential lessons learned. The pressure of delivering working software often forces software teams...... to sacrifice learning-focused practices. Effective learning under pressure involves conscious efforts to implement original agile practices such as retrospectives and adapted strategies such as learning spikes. Teams, their management, and customers must all recognize the importance of creating learning teams...

  20. Leadership for Distributed Teams

    NARCIS (Netherlands)

    De Rooij, J.P.G.


    The aim of this dissertation was to study the little examined, yet important issue of leadership for distributed teams. Distributed teams are defined as: “teams of which members are geographically distributed and are therefore working predominantly via mediated communication means on an

  1. Tracking dynamic team activity

    Energy Technology Data Exchange (ETDEWEB)

    Tambe, M. [Univ. of Southern California, Marina del Rey, CA (United States)


    AI researchers are striving to build complex multi-agent worlds with intended applications ranging from the RoboCup robotic soccer tournaments, to interactive virtual theatre, to large-scale real-world battlefield simulations. Agent tracking - monitoring other agent`s actions and inferring their higher-level goals and intentions - is a central requirement in such worlds. While previous work has mostly focused on tracking individual agents, this paper goes beyond by focusing on agent teams. Team tracking poses the challenge of tracking a team`s joint goals and plans. Dynamic, real-time environments add to the challenge, as ambiguities have to be resolved in real-time. The central hypothesis underlying the present work is that an explicit team-oriented perspective enables effective team tracking. This hypothesis is instantiated using the model tracing technology employed in tracking individual agents. Thus, to track team activities, team models are put to service. Team models are a concrete application of the joint intentions framework and enable an agent to track team activities, regardless of the agent`s being a collaborative participant or a non-participant in the team. To facilitate real-time ambiguity resolution with team models: (i) aspects of tracking are cast as constraint satisfaction problems to exploit constraint propagation techniques; and (ii) a cost minimality criterion is applied to constrain tracking search. Empirical results from two separate tasks in real-world, dynamic environments one collaborative and one competitive - are provided.

  2. Leadership for Distributed Teams

    NARCIS (Netherlands)

    Andriessen, J.H.T.H.; Den Hartog, D.N.; De Rooij, J.P.G.

    The aim of this dissertation was to study the little examined, yet important issue of leadership for distributed teams. Distributed teams are defined as: “teams of which members are geographically distributed and are therefore working predominantly via mediated communication means on an

  3. Multicultural team conflict management

    Directory of Open Access Journals (Sweden)

    Krystyna Heinz


    Full Text Available The article presents the potential problems related to conflict resolution while cooperating in multicultural teams. Special attention is paid to specific character of such teams as well as to the concept of productive conflict and the ways of resolving it. The experiences gained in the Erasmus Intenstive Programme - Effective Working in Multicultural Teams were used.

  4. Multicultural team conflict management


    Krystyna Heinz


    The article presents the potential problems related to conflict resolution while cooperating in multicultural teams. Special attention is paid to specific character of such teams as well as to the concept of productive conflict and the ways of resolving it. The experiences gained in the Erasmus Intenstive Programme - Effective Working in Multicultural Teams were used.

  5. Fostering teachers' team learning

    NARCIS (Netherlands)

    Bouwmans, Machiel; Runhaar, Piety; Wesselink, Renate; Mulder, Martin


    The implementation of educational innovations by teachers seems to benefit from a team approach and team learning. The study's goal is to examine to what extent transformational leadership is associated with team learning, and to investigate the mediating roles of participative decision-making,

  6. Endogenous leadership in teams


    Huck, S; Rey Biel, P.


    In this paper we study the mechanics of ``leading by example'' in teams. Leadership is beneficial for the entire team when agents are conformists, i.e., dislike effort differentials. We also show how leadership can arise endogenously and discuss what type of leader benefits a team most.

  7. Off-pump versus on-pump coronary artery bypass surgery: meta-analysis and meta-regression of 13,524 patients from randomized trials Cirurgia de revascularização miocárdica com CEC versus sem CEC: meta-análise e meta-regressão de 13.524 pacientes de estudos randomizados

    Directory of Open Access Journals (Sweden)

    Michel Pompeu Barros de Oliveira Sá


    Full Text Available BACKGROUND: Most recent published meta-analysis of randomized controlled trials (RCTs showed that off-pump coronary artery bypass graft surgery (CABG reduces incidence of stroke by 30% compared with on-pump CABG, but showed no difference in other outcomes. New RCTs were published, indicating need of new meta-analysis to investigate pooled results adding these further studies. METHODS: MEDLINE, EMBASE, CENTRAL/CCTR, SciELO, LILACS, Google Scholar and reference lists of relevant articles were searched for RCTs that compared outcomes (30-day mortality for all-cause, myocardial infarction or stroke between off-pump versus on-pump CABG until May 2012. The principal summary measures were relative risk (RR with 95% Confidence Interval (CI and P values (considered statistically significant when INTRODUÇÃO: A meta-análise mais recente de estudos randomizados controlados (ERC mostrou que cirurgia de revascularização (CRM sem circulação extracorpórea (CEC reduz a incidência de acidente vascular cerebral em 30% em comparação com CRM com CEC, mas não mostrou diferença em outros resultados. Novos ERCs foram publicados, indicando necessidade de nova meta-análise para investigar resultados agrupados adicionando esses estudos. MÉTODOS: MEDLINE, EMBASE, CENTRAL / CCTR, SciELO, LILACS, Google Scholar e listas de referências de artigos relevantes foram pesquisados para ERCs que compararam os resultados de 30 dias (mortalidade por todas as causas, infarto do miocárdio ou acidente vascular cerebral - AVC entre CRM com CEC versus sem CEC até maio de 2012. As medidas sumárias principais foram o risco relativo (RR com intervalo de confiança de 95% (IC e os valores de P (considerado estatisticamente significativo quando <0,05. Os RR foram combinados entre os estudos usando modelo de efeito randômico de DerSimonian-Laird. Meta-análise e meta-regressão foram concluídas usando o software versão Meta-Análise Abrangente 2 (Biostat Inc., Englewood

  8. Future Time Perspective in Occupational Teams: Do Older Workers Prefer More Familiar Teams?

    Directory of Open Access Journals (Sweden)

    Laura U. A. Gärtner


    Full Text Available Working in teams is quite popular across different industries and cultures. While some of these teams exist for longer time periods, other teams collaborate only for short periods and members switch into new teams after goals are accomplished. However, workers’ preferences for joining a new team might vary in different ways. Based on Carstensen’s socioemotional selectivity theory, we predict that emotionally meaningful teams are prioritized when occupational future time perspective (OFTP is perceived as limited. Building and expanding on studies outside of the work context, we expected that older as compared to younger workers prefer more familiar teams, and that this effect is mediated by workers’ OFTP. Moreover, we assumed that experimentally manipulated OFTP can change such team preferences. The hypotheses were tested in an online scenario study using three experimental conditions (within-person design. Four hundred and fifty-four workers (57% female, age M = 45.98, SD = 11.46 were asked to choose between a familiar and a new team in three consecutive trials: under an unspecified OFTP (baseline, under an expanded OFTP (amendment of retirement age, and under a restricted OFTP (insolvency of the current company. Whereas the baseline condition was always first, the order of the second and third conditions was randomized among participants. In the baseline condition, results showed the expected mediation effect of workers’ OFTP on the relation between workers’ age and preference for a familiar over a new team. Higher age was associated with more limited OFTP, which in turn was associated with higher preference for a familiar over a new team. Moreover, experimentally restricting OFTP increased preference for a familiar team over a new team regardless of workers’ age, providing further evidence for the assumed causal processes and showing interesting avenues for practical interventions in occupational teams.

  9. Future Time Perspective in Occupational Teams: Do Older Workers Prefer More Familiar Teams? (United States)

    Gärtner, Laura U. A.; Hertel, Guido


    Working in teams is quite popular across different industries and cultures. While some of these teams exist for longer time periods, other teams collaborate only for short periods and members switch into new teams after goals are accomplished. However, workers’ preferences for joining a new team might vary in different ways. Based on Carstensen’s socioemotional selectivity theory, we predict that emotionally meaningful teams are prioritized when occupational future time perspective (OFTP) is perceived as limited. Building and expanding on studies outside of the work context, we expected that older as compared to younger workers prefer more familiar teams, and that this effect is mediated by workers’ OFTP. Moreover, we assumed that experimentally manipulated OFTP can change such team preferences. The hypotheses were tested in an online scenario study using three experimental conditions (within-person design). Four hundred and fifty-four workers (57% female, age M = 45.98, SD = 11.46) were asked to choose between a familiar and a new team in three consecutive trials: under an unspecified OFTP (baseline), under an expanded OFTP (amendment of retirement age), and under a restricted OFTP (insolvency of the current company). Whereas the baseline condition was always first, the order of the second and third conditions was randomized among participants. In the baseline condition, results showed the expected mediation effect of workers’ OFTP on the relation between workers’ age and preference for a familiar over a new team. Higher age was associated with more limited OFTP, which in turn was associated with higher preference for a familiar over a new team. Moreover, experimentally restricting OFTP increased preference for a familiar team over a new team regardless of workers’ age, providing further evidence for the assumed causal processes and showing interesting avenues for practical interventions in occupational teams. PMID:29018376

  10. Future Time Perspective in Occupational Teams: Do Older Workers Prefer More Familiar Teams? (United States)

    Gärtner, Laura U A; Hertel, Guido


    Working in teams is quite popular across different industries and cultures. While some of these teams exist for longer time periods, other teams collaborate only for short periods and members switch into new teams after goals are accomplished. However, workers' preferences for joining a new team might vary in different ways. Based on Carstensen's socioemotional selectivity theory, we predict that emotionally meaningful teams are prioritized when occupational future time perspective (OFTP) is perceived as limited. Building and expanding on studies outside of the work context, we expected that older as compared to younger workers prefer more familiar teams, and that this effect is mediated by workers' OFTP. Moreover, we assumed that experimentally manipulated OFTP can change such team preferences. The hypotheses were tested in an online scenario study using three experimental conditions (within-person design). Four hundred and fifty-four workers (57% female, age M = 45.98, SD = 11.46) were asked to choose between a familiar and a new team in three consecutive trials: under an unspecified OFTP (baseline), under an expanded OFTP (amendment of retirement age), and under a restricted OFTP (insolvency of the current company). Whereas the baseline condition was always first, the order of the second and third conditions was randomized among participants. In the baseline condition, results showed the expected mediation effect of workers' OFTP on the relation between workers' age and preference for a familiar over a new team. Higher age was associated with more limited OFTP, which in turn was associated with higher preference for a familiar over a new team. Moreover, experimentally restricting OFTP increased preference for a familiar team over a new team regardless of workers' age, providing further evidence for the assumed causal processes and showing interesting avenues for practical interventions in occupational teams.

  11. The relationship between servant leadership, affective team commitment and team effectiveness

    Directory of Open Access Journals (Sweden)

    Bright Mahembe


    Full Text Available Orientation: Value-based leadership practices play a critical role in teamwork in high-performance organisations. Research purpose: The aim of the study was to empirically validate a theoretical model explicating the structural relationships between servant leadership, affective team commitment and team effectiveness. Motivation for the study: The increased eliance on teams for production calls for an analysis of the role of follower-focused leadership practices in enhancing eam effectiveness.Research design, approach and method: A non-probabilityand multicultural sample consisting of 202 primary and secondary school teachers was drawn from 32 chools in the Western Cape Province of South Africa.Main findings: High levels of reliability were found and uni-dimensionality of the subscales was demonstrated through exploratory factor analyses. Good fit with the data was found for the measurement models through confirmatory factor analyses. Structural equation modelling showed a reasonable fit for the structural model. Positive relationships were found amongst servant leadership, team effectiveness and affective team commitment. Standard multiple regression analysis showed that affective team commitment moderated the relationship between servant leadership and team effectiveness.Practical/managerial implications: The findings emphasise the central role played by servant leadership and affective team commitment in team performance. Servant leadership fosters team effectiveness if employees feel committed to their work team.Contribution/value-add: The servant leadership style alone may not be a sufficient condition for team effectiveness; other variables, such as affective team commitment, also play a role. The study suggested specific variables that may also combine with leadership to positively influence team effectiveness. 

  12. Is blood pressure reduction a valid surrogate endpoint for stroke prevention? an analysis incorporating a systematic review of randomised controlled trials, a by-trial weighted errors-in-variables regression, the surrogate threshold effect (STE) and the biomarker-surrogacy (BioSurrogate) evaluation schema (BSES) (United States)


    Background Blood pressure is considered to be a leading example of a valid surrogate endpoint. The aims of this study were to (i) formally evaluate systolic and diastolic blood pressure reduction as a surrogate endpoint for stroke prevention and (ii) determine what blood pressure reduction would predict a stroke benefit. Methods We identified randomised trials of at least six months duration comparing any pharmacologic anti-hypertensive treatment to placebo or no treatment, and reporting baseline blood pressure, on-trial blood pressure, and fatal and non-fatal stroke. Trials with fewer than five strokes in at least one arm were excluded. Errors-in-variables weighted least squares regression modelled the reduction in stroke as a function of systolic blood pressure reduction and diastolic blood pressure reduction respectively. The lower 95% prediction band was used to determine the minimum systolic blood pressure and diastolic blood pressure difference, the surrogate threshold effect (STE), below which there would be no predicted stroke benefit. The STE was used to generate the surrogate threshold effect proportion (STEP), a surrogacy metric, which with the R-squared trial-level association was used to evaluate blood pressure as a surrogate endpoint for stroke using the Biomarker-Surrogacy Evaluation Schema (BSES3). Results In 18 qualifying trials representing all pharmacologic drug classes of antihypertensives, assuming a reliability coefficient of 0.9, the surrogate threshold effect for a stroke benefit was 7.1 mmHg for systolic blood pressure and 2.4 mmHg for diastolic blood pressure. The trial-level association was 0.41 and 0.64 and the STEP was 66% and 78% for systolic and diastolic blood pressure respectively. The STE and STEP were more robust to measurement error in the independent variable than R-squared trial-level associations. Using the BSES3, assuming a reliability coefficient of 0.9, systolic blood pressure was a B + grade and diastolic blood pressure

  13. Semiparametric Regression Pursuit. (United States)

    Huang, Jian; Wei, Fengrong; Ma, Shuangge


    The semiparametric partially linear model allows flexible modeling of covariate effects on the response variable in regression. It combines the flexibility of nonparametric regression and parsimony of linear regression. The most important assumption in the existing methods for the estimation in this model is to assume a priori that it is known which covariates have a linear effect and which do not. However, in applied work, this is rarely known in advance. We consider the problem of estimation in the partially linear models without assuming a priori which covariates have linear effects. We propose a semiparametric regression pursuit method for identifying the covariates with a linear effect. Our proposed method is a penalized regression approach using a group minimax concave penalty. Under suitable conditions we show that the proposed approach is model-pursuit consistent, meaning that it can correctly determine which covariates have a linear effect and which do not with high probability. The performance of the proposed method is evaluated using simulation studies, which support our theoretical results. A real data example is used to illustrated the application of the proposed method.

  14. [Understanding logistic regression]. (United States)

    El Sanharawi, M; Naudet, F


    Logistic regression is one of the most common multivariate analysis models utilized in epidemiology. It allows the measurement of the association between the occurrence of an event (qualitative dependent variable) and factors susceptible to influence it (explicative variables). The choice of explicative variables that should be included in the logistic regression model is based on prior knowledge of the disease physiopathology and the statistical association between the variable and the event, as measured by the odds ratio. The main steps for the procedure, the conditions of application, and the essential tools for its interpretation are discussed concisely. We also discuss the importance of the choice of variables that must be included and retained in the regression model in order to avoid the omission of important confounding factors. Finally, by way of illustration, we provide an example from the literature, which should help the reader test his or her knowledge. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  15. Real-world data to assess changes in low-density lipoprotein cholesterol and predicted cardiovascular risk after ezetimibe discontinuation post reporting of the Ezetimibe and Simvastatin in Hypercholesterolemia Enhances Atherosclerosis Regression trial. (United States)

    Bays, Harold E; Patel, Mehul D; Mavros, Panagiotis; Ramey, Dena R; Tomassini, Joanne E; Tershakovec, Andrew M; Baxter, Carl A

    The 2008 Ezetimibe and Simvastatin in Hypercholesterolemia Enhances Atherosclerosis Regression (ENHANCE) study demonstrated ezetimibe + simvastatin vs simvastatin alone had a neutral effect on the surrogate endpoint of carotid intima-media thickness. Subsequent media portrayal of the study prompted ezetimibe discontinuation in many patients. The objective of the study was to assess the impact of ENHANCE reporting on ezetimibe discontinuation, low-density lipoprotein cholesterol (LDL-C) changes, and potential cardiovascular disease (CVD) risk. This analysis used claims data in a retrospective, observational study of patients receiving ezetimibe + statin and compared LDL-C for patients who discontinued ezetimibe (n = 970) vs those who continued ezetimibe + statins (n = 3706) after ENHANCE results disclosure. Change in relative CVD risk was estimated from the absolute LDL-C difference between groups per the Cholesterol Treatment Trialists' meta-analysis of statin trials. The rate of ezetimibe discontinuation was 2% in the 6 months before and 21% in the 6 months after reporting of ENHANCE results. Among patients who ultimately discontinued vs continued ezetimibe, respective mean LDL-C levels were 79.8 and 78.3 mg/dL 6 months before reporting of the ENHANCE results and 93.5 and 78.1 mg/dL 6 months after reporting of ENHANCE. Predictive application of the Cholesterol Treatment Trialists' meta-analysis suggested the 13.9 mg/dL increase in mean LDL-C translated to a 9.4% increase in relative CVD risk for those who discontinued ezetimibe. After reporting of the neutral ENHANCE results, ezetimibe discontinuation rate increased, LDL-C levels increased, and predicted CVD risk increased among those who discontinued ezetimibe. Characterization of clinical outcomes regarding lipid-altering agents based on surrogate biomarker studies not designed to assess CVD outcomes may be misleading, potentially placing patients at increased CVD risk. Copyright © 2017

  16. Simultaneous Inference in Regression

    CERN Document Server

    Liu, Wei


    The use of simultaneous confidence bands in linear regression is a vibrant area of research. This book presents an overview of the methodology and applications, including necessary background material on linear models. A special chapter on logistic regression gives readers a glimpse into how these methods can be used for generalized linear models. The appendices provide computational tools for simulating confidence bands. The author also includes MATLAB[registered] programs for all examples on the web. With many numerical examples and software implementation, this text serves the needs of rese

  17. Nonlinear Regression with R

    CERN Document Server

    Ritz, Christian; Parmigiani, Giovanni


    R is a rapidly evolving lingua franca of graphical display and statistical analysis of experiments from the applied sciences. This book provides a coherent treatment of nonlinear regression with R by means of examples from a diversity of applied sciences such as biology, chemistry, engineering, medicine and toxicology.

  18. Random regression models

    African Journals Online (AJOL)


    modelled as a quadratic regression, nested within parity. The previous lactation length was ... This proportion was mainly covered by linear and quadratic coefficients. Results suggest that RRM could .... The multiple trait models in scalar notation are presented by equations (1, 2), while equation. (3) represents the random ...

  19. Modern Regression Discontinuity Analysis (United States)

    Bloom, Howard S.


    This article provides a detailed discussion of the theory and practice of modern regression discontinuity (RD) analysis for estimating the effects of interventions or treatments. Part 1 briefly chronicles the history of RD analysis and summarizes its past applications. Part 2 explains how in theory an RD analysis can identify an average effect of…

  20. Multiple linear regression analysis (United States)

    Edwards, T. R.


    Program rapidly selects best-suited set of coefficients. User supplies only vectors of independent and dependent data and specifies confidence level required. Program uses stepwise statistical procedure for relating minimal set of variables to set of observations; final regression contains only most statistically significant coefficients. Program is written in FORTRAN IV for batch execution and has been implemented on NOVA 1200.

  1. Linear Regression Analysis

    CERN Document Server

    Seber, George A F


    Concise, mathematically clear, and comprehensive treatment of the subject.* Expanded coverage of diagnostics and methods of model fitting.* Requires no specialized knowledge beyond a good grasp of matrix algebra and some acquaintance with straight-line regression and simple analysis of variance models.* More than 200 problems throughout the book plus outline solutions for the exercises.* This revision has been extensively class-tested.

  2. Bayesian ARTMAP for regression. (United States)

    Sasu, L M; Andonie, R


    Bayesian ARTMAP (BA) is a recently introduced neural architecture which uses a combination of Fuzzy ARTMAP competitive learning and Bayesian learning. Training is generally performed online, in a single-epoch. During training, BA creates input data clusters as Gaussian categories, and also infers the conditional probabilities between input patterns and categories, and between categories and classes. During prediction, BA uses Bayesian posterior probability estimation. So far, BA was used only for classification. The goal of this paper is to analyze the efficiency of BA for regression problems. Our contributions are: (i) we generalize the BA algorithm using the clustering functionality of both ART modules, and name it BA for Regression (BAR); (ii) we prove that BAR is a universal approximator with the best approximation property. In other words, BAR approximates arbitrarily well any continuous function (universal approximation) and, for every given continuous function, there is one in the set of BAR approximators situated at minimum distance (best approximation); (iii) we experimentally compare the online trained BAR with several neural models, on the following standard regression benchmarks: CPU Computer Hardware, Boston Housing, Wisconsin Breast Cancer, and Communities and Crime. Our results show that BAR is an appropriate tool for regression tasks, both for theoretical and practical reasons. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. Bounded Gaussian process regression

    DEFF Research Database (Denmark)

    Jensen, Bjørn Sand; Nielsen, Jens Brehm; Larsen, Jan


    We extend the Gaussian process (GP) framework for bounded regression by introducing two bounded likelihood functions that model the noise on the dependent variable explicitly. This is fundamentally different from the implicit noise assumption in the previously suggested warped GP framework. We...

  4. Mechanisms of neuroblastoma regression (United States)

    Brodeur, Garrett M.; Bagatell, Rochelle


    Recent genomic and biological studies of neuroblastoma have shed light on the dramatic heterogeneity in the clinical behaviour of this disease, which spans from spontaneous regression or differentiation in some patients, to relentless disease progression in others, despite intensive multimodality therapy. This evidence also suggests several possible mechanisms to explain the phenomena of spontaneous regression in neuroblastomas, including neurotrophin deprivation, humoral or cellular immunity, loss of telomerase activity and alterations in epigenetic regulation. A better understanding of the mechanisms of spontaneous regression might help to identify optimal therapeutic approaches for patients with these tumours. Currently, the most druggable mechanism is the delayed activation of developmentally programmed cell death regulated by the tropomyosin receptor kinase A pathway. Indeed, targeted therapy aimed at inhibiting neurotrophin receptors might be used in lieu of conventional chemotherapy or radiation in infants with biologically favourable tumours that require treatment. Alternative approaches consist of breaking immune tolerance to tumour antigens or activating neurotrophin receptor pathways to induce neuronal differentiation. These approaches are likely to be most effective against biologically favourable tumours, but they might also provide insights into treatment of biologically unfavourable tumours. We describe the different mechanisms of spontaneous neuroblastoma regression and the consequent therapeutic approaches. PMID:25331179

  5. Leadership for Distributed Teams


    De Rooij, J.P.G.


    The aim of this dissertation was to study the little examined, yet important issue of leadership for distributed teams. Distributed teams are defined as: “teams of which members are geographically distributed and are therefore working predominantly via mediated communication means on an interdependent task and in realizing a joint goal” (adapted from Bell & Kozlowski, 2002 and Dubé & Paré, 2004). Chapter 1 first presents the outline of the dissertation. Next, several characteristics of distri...

  6. Managing multicultural teams. (United States)

    Brett, Jeanne; Behfar, Kristin; Kern, Mary C


    Multicultural teams offer a number of advantages to international firms, including deep knowledge of different product markets, culturally sensitive customer service, and 24-hour work rotations. But those advantages may be outweighed by problems stemming from cultural differences, which can seriously impair the effectiveness of a team or even bring itto a stalemate. How can managers best cope with culture-based challenges? The authors conducted in-depth interviews with managers and members of multicultural teams from all over the world. Drawing on their extensive research on dispute resolution and teamwork and those interviews, they identify four problem categories that can create barriers to a team's success: direct versus indirect communication, trouble with accents and fluency, differing attitudes toward hierarchy and authority, and conflicting norms for decision making. If a manager--or a team member--can pinpoint the root cause of the problem, he or she is likelier to select an appropriate strategy for solving it. The most successful teams and managers, the authors found, dealt with multicultural challenges in one of four ways: adaptation (acknowledging cultural gaps openly and working around them), structural intervention (changing the shape or makeup of the team), managerial intervention (setting norms early or bringing in a higher-level manager), and exit (removing a team member when other options have failed). Which strategy is best depends on the particular circumstances--and each has potential complications. In general, though, managers who intervene early and set norms; teams and managers who try to engage everyone on the team; and teams that can see challenges as stemming from culture, not personality, succeed in solving culture-based problems with good humor and creativity. They are the likeliest to harvest the benefits inherent in multicultural teams.

  7. Randomized controlled trial of a coordinated care intervention to improve risk factor control after stroke or transient ischemic attack in the safety net: Secondary stroke prevention by Uniting Community and Chronic care model teams Early to End Disparities (SUCCEED). (United States)

    Towfighi, Amytis; Cheng, Eric M; Ayala-Rivera, Monica; McCreath, Heather; Sanossian, Nerses; Dutta, Tara; Mehta, Bijal; Bryg, Robert; Rao, Neal; Song, Shlee; Razmara, Ali; Ramirez, Magaly; Sivers-Teixeira, Theresa; Tran, Jamie; Mojarro-Huang, Elizabeth; Montoya, Ana; Corrales, Marilyn; Martinez, Beatrice; Willis, Phyllis; Macias, Mireya; Ibrahim, Nancy; Wu, Shinyi; Wacksman, Jeremy; Haber, Hilary; Richards, Adam; Barry, Frances; Hill, Valerie; Mittman, Brian; Cunningham, William; Liu, Honghu; Ganz, David A; Factor, Diane; Vickrey, Barbara G


    Recurrent strokes are preventable through awareness and control of risk factors such as hypertension, and through lifestyle changes such as healthier diets, greater physical activity, and smoking cessation. However, vascular risk factor control is frequently poor among stroke survivors, particularly among socio-economically disadvantaged blacks, Latinos and other people of color. The Chronic Care Model (CCM) is an effective framework for multi-component interventions aimed at improving care processes and outcomes for individuals with chronic disease. In addition, community health workers (CHWs) have played an integral role in reducing health disparities; however, their effectiveness in reducing vascular risk among stroke survivors remains unknown. Our objectives are to develop, test, and assess the economic value of a CCM-based intervention using an Advanced Practice Clinician (APC)-CHW team to improve risk factor control after stroke in an under-resourced, racially/ethnically diverse population. In this single-blind randomized controlled trial, 516 adults (≥40 years) with an ischemic stroke, transient ischemic attack or intracerebral hemorrhage within the prior 90 days are being enrolled at five sites within the Los Angeles County safety-net setting and randomized 1:1 to intervention vs usual care. Participants are excluded if they do not speak English, Spanish, Cantonese, Mandarin, or Korean or if they are unable to consent. The intervention includes a minimum of three clinic visits in the healthcare setting, three home visits, and Chronic Disease Self-Management Program group workshops in community venues. The primary outcome is blood pressure (BP) control (systolic BP control of other vascular risk factors including lipids and hemoglobin A1c, (3) inflammation (C reactive protein [CRP]), (4) medication adherence, (5) lifestyle factors (smoking, diet, and physical activity), (6) estimated relative reduction in risk for recurrent stroke or myocardial

  8. Implementing wait-time reductions under Ontario government benchmarks (Pay-for-Results): a Cluster Randomized Trial of the Effect of a Physician-Nurse Supplementary Triage Assistance team (MDRNSTAT) on emergency department patient wait times. (United States)

    Cheng, Ivy; Lee, Jacques; Mittmann, Nicole; Tyberg, Jeffrey; Ramagnano, Sharon; Kiss, Alex; Schull, Michael; Kerr, Fergus; Zwarenstein, Merrick


    Internationally, emergency departments are struggling with crowding and its associated morbidity, mortality, and decreased patient and health-care worker satisfaction. The objective was to evaluate the addition of a MDRNSTAT (Physician (MD)-Nurse (RN) Supplementary Team At Triage) on emergency department patient flow and quality of care. Pragmatic cluster randomized trial. From 131 weekday shifts (8:00-14:30) during a 26-week period, we randomized 65 days (3173 visits) to the intervention cluster with a MDRNSTAT presence, and 66 days (3163 visits) to the nurse-only triage control cluster. The primary outcome was emergency department length-of-stay (EDLOS) for patients managed and discharged only by the emergency department. Secondary outcomes included EDLOS for patients initially seen by the emergency department, and subsequently consulted and admitted, patients reaching government-mandated thresholds, time to initial physician assessment, left-without being seen rate, time to investigation, and measurement of harm. The intervention's median EDLOS for discharged, non-consulted, high acuity patients was 4:05 [95th% CI: 3:58 to 4:15] versus 4:29 [95th% CI: 4:19-4:38] during comparator shifts. The intervention's median EDLOS for discharged, non-consulted, low acuity patients was 1:55 [95th% CI: 1:48 to 2:05] versus 2:08 [95th% CI: 2:02-2:14]. The intervention's median physician initial assessment time was 0:55 [95th% CI: 0:53 to 0:58] versus 1:21 [95th% CI: 1:18 to 1:25]. The intervention's left-without-being-seen rate was 1.5% versus 2.2% for the control (p = 0.06). The MDRNSTAT subgroup analysis resulted in significant decreases in median EDLOS for discharged, non-consulted high (4:01 [95th% CI: 3:43-4:16]) and low acuity patients (1:10 95th% CI: 0:58-1:19]), as well as physician initial assessment time (0:25 [95th% CI: 0:23-0:26]). No patients returned to the emergency department after being discharged by the MDRNSTAT at triage. The intervention reduced delays

  9. The effects of a nurse case manager and a community health worker team on diabetic control, emergency department visits, and hospitalizations among urban African Americans with type 2 diabetes mellitus: a randomized controlled trial. (United States)

    Gary, Tiffany L; Batts-Turner, Marian; Yeh, Hsin-Chieh; Hill-Briggs, Felicia; Bone, Lee R; Wang, Nae-Yuh; Levine, David M; Powe, Neil R; Saudek, Christopher D; Hill, Martha N; McGuire, Maura; Brancati, Frederick L


    Although African American adults bear a disproportionate burden from diabetes mellitus (DM), few randomized controlled trials have tested culturally appropriate interventions to improve DM care. We randomly assigned 542 African Americans with type 2 DM enrolled in an urban managed care organization to either an intensive or minimal intervention group. The intensive intervention group consisted of all components of the minimal intervention plus individualized, culturally tailored care provided by a nurse case manager (NCM) and a community health worker (CHW), using evidence-based clinical algorithms with feedback to primary care providers (eg, physicians, nurse practitioners, or physician assistants). The minimal intervention consisted of mailings and telephone calls every 6 months to remind participants about preventive screenings. Data on diabetic control were collected at baseline and at 24 months by blind observers; data emergency department (ER) visits and hospitalizations were assessed using administrative data. At baseline, participants had a mean age of 58 years, 73% were women, and 50% were living in poverty. At 24 months, compared with the minimal intervention group, those in the intensive intervention group were 23% less likely to have ER visits (rate difference [RD], -14.5; adjusted rate ratio [RR], 0.77; 95% confidence interval [CI], 0.59-1.00). In on-treatment analyses, the rate reduction was strongest for patients who received the most NCM and CHW visits (RD, -31.0; adjusted RR, 0.66; 95% CI, 0.43-1.00; rate reduction downward arrow 34%). These data suggest that a culturally tailored intervention conducted by an NCM/CHW team reduced ER visits in urban African Americans with type 2 DM. Identifier: NCT00022750.

  10. Scheduling for production teams

    Directory of Open Access Journals (Sweden)

    Yuri Mauergauz


    Full Text Available This paper presents a method of calendar (weekly scheduling for production teams, when the average orders utility function is used as the quality criterion. The method is based on the concept of “production intensity”, which is a dynamic parameter of production process. Applied software package allows scheduling for medium quantity of jobs. The result of software application is the team load on the planning horizon. The computed schedule may be corrected and recalculated in interactive mode. Current load of every team is taken into account at each recalculation. The method may be used for any combination of complex and specialized teams.

  11. The NPD team conflict

    DEFF Research Database (Denmark)

    Ma, Zheng; Lin, Chih-Cheng; Tanev, Stoyan


    elaborates on the role of culture diversity and geographical dispersion in NPD team conflict. A simulation is conducted where organizations may be regarded as complex systems to affect the team conflict with a variety of influences. The results firstly indicate that there are two dimensions of NPD team...... conflict: stable and unstable dimensions with four elements: task characteristics, group members’ relationship, cultural diversity and geographical dispersion; secondly, there are two phenomena whereby the geographical dispersion influences the NPD team interaction, and the influence between cultural...

  12. Subset selection in regression

    CERN Document Server

    Miller, Alan


    Originally published in 1990, the first edition of Subset Selection in Regression filled a significant gap in the literature, and its critical and popular success has continued for more than a decade. Thoroughly revised to reflect progress in theory, methods, and computing power, the second edition promises to continue that tradition. The author has thoroughly updated each chapter, incorporated new material on recent developments, and included more examples and references. New in the Second Edition:A separate chapter on Bayesian methodsComplete revision of the chapter on estimationA major example from the field of near infrared spectroscopyMore emphasis on cross-validationGreater focus on bootstrappingStochastic algorithms for finding good subsets from large numbers of predictors when an exhaustive search is not feasible Software available on the Internet for implementing many of the algorithms presentedMore examplesSubset Selection in Regression, Second Edition remains dedicated to the techniques for fitting...

  13. Classification and regression trees

    CERN Document Server

    Breiman, Leo; Olshen, Richard A; Stone, Charles J


    The methodology used to construct tree structured rules is the focus of this monograph. Unlike many other statistical procedures, which moved from pencil and paper to calculators, this text's use of trees was unthinkable before computers. Both the practical and theoretical sides have been developed in the authors' study of tree methods. Classification and Regression Trees reflects these two sides, covering the use of trees as a data analysis method, and in a more mathematical framework, proving some of their fundamental properties.

  14. Better Autologistic Regression

    Directory of Open Access Journals (Sweden)

    Mark A. Wolters


    Full Text Available Autologistic regression is an important probability model for dichotomous random variables observed along with covariate information. It has been used in various fields for analyzing binary data possessing spatial or network structure. The model can be viewed as an extension of the autologistic model (also known as the Ising model, quadratic exponential binary distribution, or Boltzmann machine to include covariates. It can also be viewed as an extension of logistic regression to handle responses that are not independent. Not all authors use exactly the same form of the autologistic regression model. Variations of the model differ in two respects. First, the variable coding—the two numbers used to represent the two possible states of the variables—might differ. Common coding choices are (zero, one and (minus one, plus one. Second, the model might appear in either of two algebraic forms: a standard form, or a recently proposed centered form. Little attention has been paid to the effect of these differences, and the literature shows ambiguity about their importance. It is shown here that changes to either coding or centering in fact produce distinct, non-nested probability models. Theoretical results, numerical studies, and analysis of an ecological data set all show that the differences among the models can be large and practically significant. Understanding the nature of the differences and making appropriate modeling choices can lead to significantly improved autologistic regression analyses. The results strongly suggest that the standard model with plus/minus coding, which we call the symmetric autologistic model, is the most natural choice among the autologistic variants.

  15. Aid and growth regressions

    DEFF Research Database (Denmark)

    Hansen, Henrik; Tarp, Finn


    . There are, however, decreasing returns to aid, and the estimated effectiveness of aid is highly sensitive to the choice of estimator and the set of control variables. When investment and human capital are controlled for, no positive effect of aid is found. Yet, aid continues to impact on growth via...... investment. We conclude by stressing the need for more theoretical work before this kind of cross-country regressions are used for policy purposes....

  16. Logistic regression models

    CERN Document Server

    Hilbe, Joseph M


    This book really does cover everything you ever wanted to know about logistic regression … with updates available on the author's website. Hilbe, a former national athletics champion, philosopher, and expert in astronomy, is a master at explaining statistical concepts and methods. Readers familiar with his other expository work will know what to expect-great clarity.The book provides considerable detail about all facets of logistic regression. No step of an argument is omitted so that the book will meet the needs of the reader who likes to see everything spelt out, while a person familiar with some of the topics has the option to skip "obvious" sections. The material has been thoroughly road-tested through classroom and web-based teaching. … The focus is on helping the reader to learn and understand logistic regression. The audience is not just students meeting the topic for the first time, but also experienced users. I believe the book really does meet the author's goal … .-Annette J. Dobson, Biometric...

  17. Virtual Trauma Team

    NARCIS (Netherlands)

    Jones, Valerie M.; Bults, Richard G.A.


    The clinical motivation for Virtual Trauma Team is to improve quality of care in trauma care in the vital first "golden hour" where correct intervention can greatly improve likely health outcome. The motivation for Virtual Homecare Team is to improve quality of life and independence for patients by

  18. Interactive Team Cognition (United States)

    Cooke, Nancy J.; Gorman, Jamie C.; Myers, Christopher W.; Duran, Jasmine L.


    Cognition in work teams has been predominantly understood and explained in terms of shared cognition with a focus on the similarity of static knowledge structures across individual team members. Inspired by the current zeitgeist in cognitive science, as well as by empirical data and pragmatic concerns, we offer an alternative theory of team…

  19. Meta-regression analyses, meta-analyses, and trial sequential analyses of the effects of supplementation with Beta-carotene, vitamin a, and vitamin e singly or in different combinations on all-cause mortality

    DEFF Research Database (Denmark)

    Bjelakovic, Goran; Nikolova, Dimitrinka; Gluud, Christian


    Evidence shows that antioxidant supplements may increase mortality. Our aims were to assess whether different doses of beta-carotene, vitamin A, and vitamin E affect mortality in primary and secondary prevention randomized clinical trials with low risk of bias.......Evidence shows that antioxidant supplements may increase mortality. Our aims were to assess whether different doses of beta-carotene, vitamin A, and vitamin E affect mortality in primary and secondary prevention randomized clinical trials with low risk of bias....

  20. Virtual Project Teams

    DEFF Research Database (Denmark)

    Bjørn, Pernille

    in virtual project teams whose members are spread across various geographical locations. The aim is to understand the specific factors, conditions and challenges underpinning such situations. This thesis describes, analyses and discusses three in-depth empirical studies on the practices and use of groupware...... technology in six real-life virtual teams, two in industry and four in education, applying interpretative research and action research methods. Two main lines of investigation are pursued: the first involves an examination of the organisational issues related to groupware adaptation in virtual project teams......, while the second looks at the social context and practices of virtual project teams. Two of the key findings are 1) that the process of groupware adaptation by virtual project teams can be viewed as a process of expanding and aligning the technological frames of the participants, which includes mutual...

  1. When Teams Go Crazy

    DEFF Research Database (Denmark)

    Kuhrmann, Marco; Münch, Jürgen


    Software development consists to a large extend of human-based processes with continuously increasing demands regarding interdisciplinary team work. Understanding the dynamics of software teams can be seen as highly important to successful project execution. Hence, for future project managers......, knowledge about non-technical processes in teams is significant. In this paper, we present a course unit that provides an environment in which students can learn and experience the impact of group dynamics on project performance and quality. The course unit uses the Tuckman model as theoretical framework...... of those factors. Moreover, students experienced what problems occur when teams work under stress and how to form a performing team despite exceptional situations....

  2. Trust in agile teams

    DEFF Research Database (Denmark)

    Tjørnehøj, Gitte; Fransgård, Mette; Skalkam, Signe


    of the problems of DSD. However important incompatibilities between the challenges of DSD and the key tenets of agility exist and achieving a beneficially balanced agile practice in DSD can be difficult. Trust could be the key to this, since trust is crucial for the necessary corporate behavior that leads to team...... success. This article reports from a study of two agile DSD teams with very different organization and collaboration patterns. It addresses the role of trust and distrust in DSD by analyzing how the team members’ trust developed and erode through the lifetime of the two collaborations and how management...... actions influenced this. We see two important lessons from the analysis. First the agile practices of daily Scrum and self organizing team can empower DSD teams to manage their own development of trust and thereby alleviate the obstacles of DSD. Second if management fails to support the development...

  3. Adaptive metric kernel regression

    DEFF Research Database (Denmark)

    Goutte, Cyril; Larsen, Jan


    Kernel smoothing is a widely used non-parametric pattern recognition technique. By nature, it suffers from the curse of dimensionality and is usually difficult to apply to high input dimensions. In this contribution, we propose an algorithm that adapts the input metric used in multivariate...... regression by minimising a cross-validation estimate of the generalisation error. This allows to automatically adjust the importance of different dimensions. The improvement in terms of modelling performance is illustrated on a variable selection task where the adaptive metric kernel clearly outperforms...

  4. Adaptive Metric Kernel Regression

    DEFF Research Database (Denmark)

    Goutte, Cyril; Larsen, Jan


    Kernel smoothing is a widely used nonparametric pattern recognition technique. By nature, it suffers from the curse of dimensionality and is usually difficult to apply to high input dimensions. In this paper, we propose an algorithm that adapts the input metric used in multivariate regression...... by minimising a cross-validation estimate of the generalisation error. This allows one to automatically adjust the importance of different dimensions. The improvement in terms of modelling performance is illustrated on a variable selection task where the adaptive metric kernel clearly outperforms the standard...

  5. Groups Meet . . . Teams Improve: Building Teams That Learn (United States)

    Hillier, Janet; Dunn-Jensen, Linda M.


    Although most business students participate in team-based projects during undergraduate or graduate course work, the team experience does not always teach team skills or capture the team members' potential: Students complete the task at hand but the explicit process of becoming a team is often not learned. Drawing from organizational learning…

  6. Team Learning Beliefs and Behaviours in Response Teams (United States)

    Boon, Anne; Raes, Elisabeth; Kyndt, Eva; Dochy, Filip


    Purpose: Teams, teamwork and team learning have been the subject of many research studies over the last decades. This article aims at investigating and confirming the Team Learning Beliefs and Behaviours (TLB&B) model within a very specific population, i.e. police and firemen teams. Within this context, the paper asks whether the team's…

  7. Dream team or nightmare? Collaboration in project teams

    NARCIS (Netherlands)

    Kauffeld, S.; Lehmann-Willenbrock, N.K.; Grote, S.; Wastian, M.; von Rosenstiel, L.; Braumandl, I.; West, M.


    Project teams are a contemporary organizing principle. They work on non-routine tasks. Team composition in project teams is often interdisciplinary (i.e., uniting team members from different departments or areas of expertise within an organization). Project teams face a number of challenges. In

  8. Team Psychological Safety and Team Learning: A Cultural Perspective (United States)

    Cauwelier, Peter; Ribière, Vincent M.; Bennet, Alex


    Purpose: The purpose of this paper was to evaluate if the concept of team psychological safety, a key driver of team learning and originally studied in the West, can be applied in teams from different national cultures. The model originally validated for teams in the West is applied to teams in Thailand to evaluate its validity, and the views team…

  9. Measuring Team Learning Behaviours through Observing Verbal Team Interaction (United States)

    Raes, Elisabeth; Boon, Anne; Kyndt, Eva; Dochy, Filip


    Purpose: This study aims to explore, as an answer to the observed lack of knowledge about actual team learning behaviours, the characteristics of the actual observed basic team learning behaviours and facilitating team learning behaviours more in-depth of three project teams. Over time, team learning in an organisational context has been…

  10. A contingency perspective on team learning and innovation in nursing. (United States)

    Timmermans, Olaf; Van Linge, Roland; Van Petegem, Peter; Van Rompaey, Bart; Denekens, Joke


    To report a correlational study of the relation between team learning activities and implementation-effectiveness of innovations in nursing teams. Non-compliance to implementation of innovations is a problem in nursing teams. In the literature, team learning is proposed as a facilitator for change. Still, studies reporting the effects of team learning activities on the implementation of innovations in nursing teams are scarce. To address this gap in the literature, this study explored the influence of team learning on the implementation of two innovations. A cross-sectional survey. The survey was conducted in 2008-2009 with a sample of 469 nurses, representing 30 nursing teams from The Netherlands and Belgium. The relationship between variables representing team learning and the use and the knowledge of an incremental (n = 14) or a radical innovation (n = 16) was examined by correlation and multiple regression analyses. Correlation analyses revealed positive relationships between the team learning activities handling production-oriented information and implementation-effectiveness of an incremental innovation. In addition, team learning activities about development-oriented information positively affected the implementation of a radical innovation. Multiple regression yielded models that explain 83% of the variance on the use of an incremental variable, 73% on knowledge of a radical innovation, and 80% on use of a radical innovation. In nursing teams, team learning activities that relate to the production of nursing care affect the implementation of an incremental innovation. The implementation of a radical innovation is effected by team learning activities that relate to the development of the provided nursing care. © 2012 Blackwell Publishing Ltd.

  11. Building the team for team science (United States)

    Read, Emily K.; O'Rourke, M.; Hong, G. S.; Hanson, P. C.; Winslow, Luke A.; Crowley, S.; Brewer, C. A.; Weathers, K. C.


    The ability to effectively exchange information and develop trusting, collaborative relationships across disciplinary boundaries is essential for 21st century scientists charged with solving complex and large-scale societal and environmental challenges, yet these communication skills are rarely taught. Here, we describe an adaptable training program designed to increase the capacity of scientists to engage in information exchange and relationship development in team science settings. A pilot of the program, developed by a leader in ecological network science, the Global Lake Ecological Observatory Network (GLEON), indicates that the training program resulted in improvement in early career scientists’ confidence in team-based network science collaborations within and outside of the program. Fellows in the program navigated human-network challenges, expanded communication skills, and improved their ability to build professional relationships, all in the context of producing collaborative scientific outcomes. Here, we describe the rationale for key communication training elements and provide evidence that such training is effective in building essential team science skills.

  12. Next generation red teaming

    CERN Document Server

    Dalziel, Henry


    Red Teaming is can be described as a type of wargaming.In private business, penetration testers audit and test organization security, often in a secretive setting. The entire point of the Red Team is to see how weak or otherwise the organization's security posture is. This course is particularly suited to CISO's and CTO's that need to learn how to build a successful Red Team, as well as budding cyber security professionals who would like to learn more about the world of information security. Teaches readers how to dentify systemic security issues based on the analysis of vulnerability and con

  13. Team-Based Global Organizations

    DEFF Research Database (Denmark)

    Zander, Lena; Butler, Christina Lea; Mockaitis, Audra


    questions at three levels for bringing research on team-based organizing in global organizations forward. At the within-Team individual level, we discuss the criticality of process and leadership in teams. At the between-Teams group level, we draw attention to that global teams also need to focus...

  14. Using the net benefit regression framework to construct cost-effectiveness acceptability curves: an example using data from a trial of external loop recorders versus Holter monitoring for ambulatory monitoring of "community acquired" syncope

    Directory of Open Access Journals (Sweden)

    Rockx Marie


    Full Text Available Abstract Background Cost-effectiveness acceptability curves (CEACs describe the probability that a new treatment or intervention is cost-effective. The net benefit regression framework (NBRF allows cost-effectiveness analysis to be done in a simple regression framework. The objective of the paper is to illustrate how net benefit regression can be used to construct a CEAC. Methods One hundred patients referred for ambulatory monitoring with syncope or presyncope were randomized to a one-month external loop recorder (n = 49 or 48-hour Holter monitor (n = 51. The primary endpoint was symptom-rhythm correlation during monitoring. Direct costs were calculated based on the 2003 Ontario Health Insurance Plan (OHIP fee schedule combined with hospital case costing of labour, materials, service and overhead costs for diagnostic testing and related equipment. Results In the loop recorder group, 63.27% of patients (31/49 had symptom recurrence and successful activation, compared to 23.53% in the Holter group (12/51. The cost in US dollars for loop recording was $648.50 and $212.92 for Holter monitoring. The incremental cost-effectiveness ratio (ICER of the loop recorder was $1,096 per extra successful diagnosis. The probability that the loop recorder was cost-effective compared to the Holter monitor was estimated using net benefit regression and plotted on a CEAC. In a sensitivity analysis, bootstrapping was used to examine the effect of distributional assumptions. Conclusion The NBRF is straightforward to use and interpret. The resulting uncertainty surrounding the regression coefficient relates to the CEAC. When the link from the regression's p-value to the probability of cost-effectiveness is tentative, bootstrapping may be used.

  15. A Project Team: A Team or Just a Group?


    Katerina Hrazdilova Bockova; Daniela Maťovcikova


    This paper deals with issues related to work in either teams or groups. The theoretical part which discusses a team and a group with regards to its definition, classification and basic distinction brings in more on the typology of team roles, personality assessment and sociometric methods. The analytical part tests the project (work) team of a medical center represented in terms of personality and motivational types, team roles and interpersonal team relations concerning t...

  16. A Project Team: a Team or Just a Group?


    Kateřina; Daniela; Martina


    This paper deals with issues related to work in either teams or groups. The theoretical part discusses a team and a group with regards to its definition, classification and basic distinction, brings in more on the typology of team roles, personality assessment and sociometric methods. The analytical part tests the project (work) team of a medical center represented in terms of personality and motivational types, team roles and interpersonal team relations concerning the willingness of coopera...

  17. Submarine Medicine Team (United States)

    Federal Laboratory Consortium — The Submarine Medicine Team conducts basic and applied research on biomedical aspects of submarine and diving environments. It focuses on ways to optimize the health...

  18. Biological Monitoring Team (United States)

    US Fish and Wildlife Service, Department of the Interior — The Biological Monitoring Team (BMT) was a pilot project focused on addressing NWRS inventory and monitoring needs in Regions 3 and 5. The BMT was a precursor to the...

  19. Hearing Conservation Team (United States)

    Federal Laboratory Consortium — The Hearing Conservation Team focuses on ways to identify the early stages of noise-induced damage to the human ear.Our current research involves the evaluation of...

  20. Environmental Response Team (United States)

    This website will serve as a resource directory of the Environmental Response Team's roles and capabilities as well as list contacts for each discipline to provide information to EPA personnel and the public.

  1. Leading Strategic Leader Teams

    National Research Council Canada - National Science Library

    Burleson, Willard M


    .... Although only 1 to 2 percent of the Army's senior leaders will attain a command position of strategic leadership, they are assisted by others, not only by teams specifically designed and structured...

  2. Forging Provincial Reconstruction Teams

    National Research Council Canada - National Science Library

    Honore, Russel L; Boslego, David V


    The Provincial Reconstruction Team (PRT) training mission completed by First U.S. Army in April 2006 was a joint Service effort to meet a requirement from the combatant commander to support goals in Afghanistan...

  3. Regional Response Teams (United States)

    There are thirteen in the U.S., each representing a geographic region (including the Caribbean and the Pacific Basin). Composed of representatives from field offices of the agencies that make up the National Response Team, and state representatives.

  4. Media and Security Team (United States)

    Federal Laboratory Consortium — The Media And Security Team led by Prof. Min Wu was established in Fall 2001 at University of Maryland, College Park. A number of research and education activities...

  5. Making Teamwork Work: Team Knowledge for Team Effectiveness. (United States)

    Guchait, Priyanko; Lei, Puiwa; Tews, Michael J


    This study examined the impact of two types of team knowledge on team effectiveness. The study assessed the impact of taskwork knowledge and teamwork knowledge on team satisfaction and performance. A longitudinal study was conducted with 27 service-management teams involving 178 students in a real-life restaurant setting. Teamwork knowledge was found to impact both team outcomes. Furthermore, team learning behavior was found to mediate the relationships between teamwork knowledge and team outcomes. Educators and managers should therefore ensure these types of knowledge are developed in teams along with learning behavior for maximum effectiveness.

  6. Managing Global Teams

    Directory of Open Access Journals (Sweden)

    Anca Stan


    Full Text Available Every global company’s competitive advantage depends on its ability to coordinate critical resources and information that are spread across different geographical locations. As a result of the increasingly global business environment, many companies are building teams that cross- national borders and / or include members from different countries of origin. Global teams are formed to enhance the efficiency of an organization by making effective use of the diversity or viewpoints.

  7. Team Modelling: Literature Review (United States)


    cognitive and/or reasoning ability (g), spatial orientation, and verbal comprehension. In terms of personality, Jordan (2001) has argued that research on...broadminded ( Jordan , 2001). Most of the team research pertaining to the Big Five factors has focused on the conscientiousness and agreeableness factors...transformational leadership on team performance, the findings have generally been positive. Dvir, Eden, Avolio, & Shamir (2002; cited in Lim & Ployhart

  8. The Motivated Project Team (United States)


    Recognition for exceptional per- formance. Motivator/Hygiene Theory ( Frederick Herzberg ) Herzberg believed that motivators such as the following...vating team members. It is very important to recognize that motivation is an intrinsic phenomenon. According to noted industrial psychologist Frederick ... Herzberg , “Extrinsic satisfaction only leads to movements, not mo- tivation.” Motivated team mem- bers, on the other hand, possess an internal

  9. Transforming Virtual Teams

    DEFF Research Database (Denmark)

    Bjørn, Pernille


    Investigating virtual team collaboration in industry using grounded theory this paper presents the in-dept analysis of empirical work conducted in a global organization of 100.000 employees where a global virtual team with participants from Sweden, United Kingdom, Canada, and North America were...... multiple communities, and bringing visibility to articulation work, and that groupware technology should facilitate communication and negotiation instead of implementing the workflows just enhancing existing abilities, practices, and skills....

  10. Teams make it work: how team work engagement mediates between social resources and performance in teams. (United States)

    Torrente, Pedro; Salanova, Marisa; Llorens, Susana; Schaufeli, Wilmar B


    In this study we analyze the mediating role of team work engagement between team social resources (i.e., supportive team climate, coordination, teamwork), and team performance (i.e., in-role and extra-role performance) as predicted by the Job Demands-Resources Model. Aggregated data of 533 employees nested within 62 teams and 13 organizations were used, whereas team performance was assessed by supervisor ratings. Structural equation modeling revealed that, as expected, team work engagement plays a mediating role between social resources perceived at the team level and team performance as assessed by the supervisor.

  11. Evaluation of how different implementation strategies of an injury prevention programme (FIFA 11+) impact team adherence and injury risk in Canadian female youth football players: a cluster-randomised trial. (United States)

    Steffen, Kathrin; Meeuwisse, Willem H; Romiti, Maria; Kang, Jian; McKay, Carly; Bizzini, Mario; Dvorak, Jiri; Finch, Caroline; Myklebust, Grethe; Emery, Carolyn A


    Injury prevention programme delivery on adherence and injury risk, specifically involving regular supervisions with coaches and players on programme execution on field, has not been examined. The objective of this cluster-randomised study was to evaluate different delivery methods of an effective injury prevention programme (FIFA 11+) on adherence and injury risk among female youth football teams. During the 4-month 2011 football season, coaches and 13-year-old to 18-year-old players from 31 tier 1-3 level teams were introduced to the 11+ through either an unsupervised website ('control') or a coach-focused workshop with ('comprehensive') and without ('regular') additional supervisions by a physiotherapist. Team and player adherence to the 11+, playing exposure, history and injuries were recorded. Teams in the comprehensive and regular intervention groups demonstrated adherence to the 11+ programme of 85.6% and 81.3% completion of total possible sessions, compared to 73.5% for teams in the control group. These differences were not statistically significant, after adjustment for cluster by team, age, level and injury history. Compared to players with low adherence, players with high adherence to the 11+ had a 57% lower injury risk (IRR 0.43, 95% CI 0.19 to 1.00). However, adjusting for covariates, this between-group difference was not statistically significant (IRR=0.44, 95% CI 0.18 to 1.06). Following a coach workshop, coach-led delivery of the FIFA 11+ was equally successful with or without the additional field involvement of a physiotherapist. Proper education of coaches during an extensive preseason workshop was more effective in terms of team adherence than an unsupervised delivery of the 11+ programme to the team. ISRCTN67835569.

  12. An Introduction to Logistic Regression. (United States)

    Cizek, Gregory J.; Fitzgerald, Shawn M.


    Where linearity cannot be assumed, logistic regression may be appropriate. This article describes conditions and tests for using logistic regression; introduces the logistic-regression model, the use of logistic-regression software, and some applications in published literature. Univariate and multiple independent-variable conditions and…

  13. Reciprocal Causation in Regression Analysis. (United States)

    Wolfle, Lee M.


    With even the simplest bivariate regression, least-squares solutions are inappropriate unless one assumes a priori that reciprocal effects are absent, or at least implausible. While this discussion is limited to bivariate regression, the issues apply equally to multivariate regression, including stepwise regression. (Author/CTM)

  14. How to Collaborate through Teams (United States)

    Conderman, Greg


    Teachers are spending more of their time and making more decisions within teams. Effective teacher-based teams provide academic and behavioral support for students as well as professional development for teachers. Learn how the best teams function.

  15. Modified Regression Correlation Coefficient for Poisson Regression Model (United States)

    Kaengthong, Nattacha; Domthong, Uthumporn


    This study gives attention to indicators in predictive power of the Generalized Linear Model (GLM) which are widely used; however, often having some restrictions. We are interested in regression correlation coefficient for a Poisson regression model. This is a measure of predictive power, and defined by the relationship between the dependent variable (Y) and the expected value of the dependent variable given the independent variables [E(Y|X)] for the Poisson regression model. The dependent variable is distributed as Poisson. The purpose of this research was modifying regression correlation coefficient for Poisson regression model. We also compare the proposed modified regression correlation coefficient with the traditional regression correlation coefficient in the case of two or more independent variables, and having multicollinearity in independent variables. The result shows that the proposed regression correlation coefficient is better than the traditional regression correlation coefficient based on Bias and the Root Mean Square Error (RMSE).

  16. Highly effective cystic fibrosis clinical research teams: critical success factors. (United States)

    Retsch-Bogart, George Z; Van Dalfsen, Jill M; Marshall, Bruce C; George, Cynthia; Pilewski, Joseph M; Nelson, Eugene C; Goss, Christopher H; Ramsey, Bonnie W


    Bringing new therapies to patients with rare diseases depends in part on optimizing clinical trial conduct through efficient study start-up processes and rapid enrollment. Suboptimal execution of clinical trials in academic medical centers not only results in high cost to institutions and sponsors, but also delays the availability of new therapies. Addressing the factors that contribute to poor outcomes requires novel, systematic approaches tailored to the institution and disease under study. To use clinical trial performance metrics data analysis to select high-performing cystic fibrosis (CF) clinical research teams and then identify factors contributing to their success. Mixed-methods research, including semi-structured qualitative interviews of high-performing research teams. CF research teams at nine clinical centers from the CF Foundation Therapeutics Development Network. Survey of site characteristics, direct observation of team meetings and facilities, and semi-structured interviews with clinical research team members and institutional program managers and leaders in clinical research. Critical success factors noted at all nine high-performing centers were: 1) strong leadership, 2) established and effective communication within the research team and with the clinical care team, and 3) adequate staff. Other frequent characteristics included a mature culture of research, customer service orientation in interactions with study participants, shared efficient processes, continuous process improvement activities, and a businesslike approach to clinical research. Clinical research metrics allowed identification of high-performing clinical research teams. Site visits identified several critical factors leading to highly successful teams that may help other clinical research teams improve clinical trial performance.

  17. The issue of virtual teams


    Fleiberková, Šárka


    The aim of this diploma thesis is the introduction of teamwork and virtual teams. The theoretical part of this work describes the birth of teamwork, its definition, properties, advantages and disadvantages. Next part of diploma thesis is dedicated to the virtual team. It describes the difference among virtual and traditional team, definition and characteristics of virtual team as well as tools that are used in virtual team. The second, practical, unit is focused on virtual teams at universiti...

  18. The Research of Self-Management Team and Superior-Direction Team in Team Learning Influential Factors


    Zhang Wei


    Team learning is a cure for bureaucracy; it facilitates team innovation and team performance. But team learning occurs only when necessary conditions were met. This research focused on differences of team learning influential factors between self-management team and superior-direction team. Four variables were chosen as predictors of team learning though literature review and pilot interview. The 4 variables are team motivation, team trust, team conflict and team leadership. Selected 54 self ...

  19. Self-reported teamwork in family health team practices in Ontario: organizational and cultural predictors of team climate. (United States)

    Howard, Michelle; Brazil, Kevin; Akhtar-Danesh, Noori; Agarwal, Gina


    To determine the organizational predictors of higher scores on team climate measures as an indicator of the functioning of a family health team (FHT). Cross-sectional study using a mailed survey. Family health teams in Ontario. Twenty-one of 144 consecutively approached FHTs; 628 team members were surveyed. Scores on the team climate inventory, which assessed organizational culture type (group, developmental, rational, or hierarchical); leadership perceptions; and organizational factors, such as use of electronic medical records (EMRs), team composition, governance of the FHT, location, meetings, and time since FHT initiation. All analyses were adjusted for clustering of respondents within the FHT using a mixed random-intercepts model. The response rate was 65.8% (413 of 628); 2 were excluded from analysis, for a total of 411 participants. At the time of survey completion, there was a median of 4 physicians, 11 other health professionals, and 4 management and clerical staff per FHT. The average team climate score was 3.8 out of a possible 5. In multivariable regression analysis, leadership score, group and developmental culture types, and use of more EMR capabilities were associated with higher team climate scores. Other organizational factors, such as number of sites and size of group, were not associated with the team climate score. Culture, leadership, and EMR functionality, rather than organizational composition of the teams (eg, number of professionals on staff, practice size), were the most important factors in predicting climate in primary care teams.

  20. Expertise of Team Leaders in Analysing Team Conflicts (United States)

    Rupprecht, Maria; Strasser, Josef; Gruber, Hans; Harteis, Christian


    Team leaders are expected to adequately analyse team conflicts. Both content and analytical depth of cognitive processes determine team leaders' performance and are assumed to differ with level of expertise. A study is reported in which team leaders at four different levels of expertise (novices, semi-experts, experts, mediators) were compared in…

  1. Team members' emotional displays as indicators of team functioning

    NARCIS (Netherlands)

    Homan, A.C.; van Kleef, G.A.; Sanchez-Burks, J.


    Emotions are inherent to team life, yet it is unclear how observers use team members’ emotional expressions to make sense of team processes. Drawing on Emotions as Social Information theory, we propose that observers use team members’ emotional displays as a source of information to predict the

  2. Perspectives on a Multidisciplinary Team Approach to Implementation of Planned Emergent Use Research. (United States)

    Racedo Africano, Carlos J; Gallo de Moraes, Alice; Smischney, Nathan J


    In this paper we present the viewpoints of three members of a research team, on the approach to teamwork in the development of an emergent use clinical trial when dealing with diversity of opinions, in order to facilitate stakeholder buy-in. We also discuss a specific approach to the coordination of the team members, which in our opinion had a positive impact on the implementation of the project. We also comment on the influence of the team organization in the timeline and completion of a clinical trial. We hope to start a conversation on team dynamics in the design of clinical trials, especially in the context of emergent use research.

  3. Creativity and Creative Teams (United States)

    Wood, Richard M.; Bauer, Steven X. S.; Hunter, Craig A.


    A review of the linkage between knowledge, creativity, and design is presented and related to the best practices of multidisciplinary design teams. The discussion related to design and design teams is presented in the context of both the complete aerodynamic design community and specifically the work environment at the NASA Langley Research Center. To explore ways to introduce knowledge and creativity into the research and design environment at NASA Langley Research Center a creative design activity was executed within the context of a national product development activity. The success of the creative design team activity gave rise to a need to communicate the experience in a straightforward and managed approach. As a result the concept of creative potential its formulated and assessed with a survey of a small portion of the aeronautics research staff at NASA Langley Research Center. The final section of the paper provides recommendations for future creative organizations and work environments.

  4. Virtual team collaboration

    DEFF Research Database (Denmark)

    Bjørn, Pernille; Ngwenyama, Ojelanki


    as the foundation for building shared meaning at three levels. Also we investigate communication breakdowns that can be attributed to differences in lifeworld structures, organizational structures, and work process structures within a virtual team. We find that all communication breakdowns are manifested...... and experienced by the participants at the work process level; however, resolving breakdowns may require critical reflection at other levels. Where previous research argues that face-to-face interaction is an important variable for virtual team performance, our empirical observations reveal that communication......Managing international teams with geographically distributed participants is a complex task. The risk of communication breakdowns increases due to cultural and organizational differences grounded in the geographical distribution of the participants. Such breakdowns indicate general...

  5. Beautiful Teams Inspiring and Cautionary Tales from Veteran Team Leaders

    CERN Document Server

    Stellman, Andrew


    What's it like to work on a great software development team facing an impossible problem? How do you build an effective team? Beautiful Teams takes you behind the scenes with some of the most interesting teams in software engineering history. You'll learn from veteran team leaders' successes and failures, told through a series of engaging personal stories -- and interviews -- by leading programmers, architects, project managers, and thought leaders.

  6. Autonomous mobile robot teams (United States)

    Agah, Arvin; Bekey, George A.


    This paper describes autonomous mobile robot teams performing tasks in unstructured environments. The behavior and the intelligence of the group is distributed, and the system does not include a central command base or leader. The novel concept of the Tropism-Based Cognitive Architecture is introduced, which is used by the robots in order to produce behavior transforming their sensory information to proper action. The results of a number of simulation experiments are presented. These experiments include worlds where the robot teams must locate, decompose, and gather objects, and defend themselves against hostile predators, while navigating around stationary and mobile obstacles.

  7. The cohesiveness of sourcing teams

    DEFF Research Database (Denmark)

    Lidegaard, Nina


    Sourcing teams are introduced as an approach to achieving the interdepartmental integration necessary for companies to address the complexity of strategic sourcing. Companies aim at facilitating teams capable of balancing the goals and tasks of the team with departmental expectations; however......, the practical implementation is often unsuccessful leading to poor performance. Originating in PSM literature, factors influencing sourcing team performance are categorised into three: top management support, organisational structures, and those related to team members. In this paper, the concept...... of cohesiveness is introduced as an explanatory factor and, consequently, linkages between team cohesiveness and team performance are proposed....

  8. Transformational Leadership and Team Performance

    Directory of Open Access Journals (Sweden)

    Huey-Wen Chou


    Full Text Available This study explores the relationships among transformational leadership style, cognitive trust, and collective efficacy as well as the impact of these variables on distal team performance. Data collected from 39 teams find that team cognitive trust as two process variables involves a transformational leadership process in which cognitive trust in the team leader and cognitive trust among team members mediate the impact of this leadership style on collective efficacy. Unlike previous studies, our results show that leveraging cognitive trust in the team leader is necessary but not sufficient for better proximal collective efficacy, which in turn facilitates distal team performance. Although cognitive trust among team members was more closely related to proximal collective efficacy than cognitive trust in the team leader was, the factors that foster the development of cognitive trust among team members remain scantly explored in the transformational leadership literature and deserve more attention in future research.


    African Journals Online (AJOL)

    gratitude goes to the guest editorial team, for their tireless efforts and commitment shown throughout the compilation of this issue of the Journal. I also wish to recognize the immense contributions made by Professor. Bellington Vwalika, Specialty Editor (Obstetrics &. Gynaecology/ Epidemiology) and this issue's sponsoring.

  10. Team Collaboration Software (United States)

    Wang, Yeou-Fang; Schrock, Mitchell; Baldwin, John R.; Borden, Charles S.


    The Ground Resource Allocation and Planning Environment (GRAPE 1.0) is a Web-based, collaborative team environment based on the Microsoft SharePoint platform, which provides Deep Space Network (DSN) resource planners tools and services for sharing information and performing analysis.

  11. Facilitating leadership team communication


    Hedman, Eerika


    The purpose of this study is to understand and describe how to facilitate competent communication in leadership teamwork. Grounded in the premises of social constructionism and informed by such theoretical frameworks as coordinated management of meaning theory (CMM), dialogic organization development (OD), systemic-constructionist leadership, communication competence, and reflexivity, this study seeks to produce further insights into understanding leadership team communicati...

  12. Web Team Development (United States)

    Church, Jennifer; Felker, Kyle


    The dynamic world of the Web has provided libraries with a wealth of opportunities, including new approaches to the provision of information and varied internal staffing structures. The development of self-managed Web teams, endowed with authority and resources, can create an adaptable and responsive culture within libraries. This new working team…

  13. Heterogeneity and Work Teams (United States)

    Dyaram, Lata; Kamalanabhan, T. J.


    This paper attempts to extend and contribute to the domestic diversity literature by presenting a comprehensive model that takes into consideration the Indian work set up. It proposes to examine the effects of the composition of information systems development teams in Indian firms. Besides the conventional demographics which were studied…

  14. AA magnet measurement team

    CERN Multimedia

    CERN PhotoLab


    Quickly improvised measurement equipment for the AA (Antiproton Accumulator) was all the tight schedule permitted, but the high motivation of the team made up for the lack of convenience. From left to right: Roy Billinge (Joint AA Project Leader, the other one was Simon van der Meer); Bruno Autin, Brian Pincott, Colin Johnson.

  15. Materials Technical Team Roadmap

    Energy Technology Data Exchange (ETDEWEB)



    Roadmap identifying the efforts of the Materials Technical Team (MTT) to focus primarily on reducing the mass of structural systems such as the body and chassis in light-duty vehicles (including passenger cars and light trucks) which enables improved vehicle efficiency regardless of the vehicle size or propulsion system employed.

  16. The CHIK Team

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. The CHIK Team. Arankalle VA, Mishra AC. Tandale BV Clinical. Yergolkar P, Sudeep Balan Virus Isolations. Cherian S, Walimbe A Bioinformatics. Sathe PS, Supriya Serology. Swati, Shubham, Supriya Sequence analysis. Tripathy AS Immunological. Parashar D ...

  17. The Adaptability of Teams

    DEFF Research Database (Denmark)

    Jørgensen, Frances; Boer, Harry


    In this paper, data from a longitudinal case study in an organization attempting to adapt its internal work processes to changes in its external context are presented, analyzed and discussed. Specifically, functionally structured work teams in one department of a Danish production facility were...

  18. Aircrew team management program (United States)

    Margerison, Charles; Mccann, Dick; Davies, Rod


    The key features of the Aircrew Team Management Workshop which was designed for and in consultation with Trans Australia Airlines are outlined. Five major sections are presented dealing with: (1) A profile of the airline and the designers; (2) Aircrew consultation and involvement; (3) Educational design and development; (4) Implementation and instruction; and (5) Evaluation and assessment. These areas are detailed.

  19. Survey team on

    DEFF Research Database (Denmark)

    Niss, Mogens Allan; Bruder, Regina; Planas, Núria


    This paper presents the outcomes of the work of the ICME 13 Survey Team on ‘Conceptualisation and the role of competencies, knowing and knowledge in mathematics education research’. It surveys a variety of historical and contemporary views and conceptualisations of what it means to master...

  20. Community and team member factors that influence the operations phase of local prevention teams: the PROSPER Project. (United States)

    Feinberg, Mark E; Chilenski, Sarah M; Greenberg, Mark T; Spoth, Richard L; Redmond, Cleve


    This study examined the longitudinal predictors of quality of functioning of community prevention teams during the "operations" phase of team development. The 14 community teams were involved in a randomized-trial of a university-community partnership project, PROSPER (Spoth et al., Prevention Science, 5(1): 31-39, 2004b), that implements evidence-based interventions intended to support positive youth development and reduce early substance use, as well as other problem behaviors. The study included a multi-informant approach to measurement of constructs, and included data from 137 team members, 59 human service agency directors and school administrators, 16 school principals, and 8 Prevention Coordinators (i.e. technical assistance providers). We examined how community demographics and social capital, team level characteristics, and team member attributes and attitudes are related to local team functioning across an 18-month period. Findings indicate that community demographics (poverty), social capital, team member attitudes towards prevention, and team members' views of the acceptability of teen alcohol use played a substantial role in predicting various indicators of the quality of team functioning 18 months later.

  1. Effects of team emotional authenticity on virtual team performance

    Directory of Open Access Journals (Sweden)

    Catherine E Connelly


    Full Text Available Members of virtual teams lack many of the visual or auditory cues that are usually used as the basis for impressions about fellow team members. We focus on the effects of the impressions formed in this context, and use social exchange theory to understand how these impressions affect team performance. Our pilot study, using content analysis (n = 191 students, suggested that most individuals believe that they can assess others’ emotional authenticity in online settings by focusing on the content and tone of the messages. Our quantitative study examined the effects of these assessments. Structural equation modeling (SEM analysis (n = 81 student teams suggested that team-level trust and teamwork behaviors mediate the relationship between team emotional authenticity and team performance, and illuminate the importance of team emotional authenticity for team processes and outcomes.

  2. A Project Team: a Team or Just a Group?

    Directory of Open Access Journals (Sweden)



    Full Text Available This paper deals with issues related to work in either teams or groups. The theoretical part discusses a team and a group with regards to its definition, classification and basic distinction, brings in more on the typology of team roles, personality assessment and sociometric methods. The analytical part tests the project (work team of a medical center represented in terms of personality and motivational types, team roles and interpersonal team relations concerning the willingness of cooperation and communication. The main objective of this work is to verify the validity of the assumptions that the analyzed team represents a very disparate group as for its composition from the perspective of personality types, types of motivation, team roles and interpersonal relations in terms of the willingness of cooperation and communication. A separate output shall focus on sociometric investigation of those team members where willingness to work together and communicate is based on the authors’ assumption of tight interdependence.

  3. Non-invasive Heart Team assessment of multivessel coronary disease with coronary computed tomography angiography based on SYNTAX score II treatment recommendations: design and rationale of the randomised SYNTAX III Revolution trial

    NARCIS (Netherlands)

    Cavalcante, Rafael; Onuma, Yoshinobu; Sotomi, Yohei; Collet, Carlos; Thomsen, Brian; Rogers, Campbell; Zeng, Yaping; Tenekecioglu, Erhan; Asano, Taku; Miyasaki, Yosuke; Abdelghani, Mohammad; Morel, Marie-Angèle; Serruys, Patrick W.


    The aim of this study was to investigate whether a Heart Team decision-making process regarding the choice of revascularisation strategy based on non-invasive coronary multislice computed tomography angiography (MSCT) assessment of coronary artery disease (CAD) is equivalent to the standard-of-care

  4. Combining Alphas via Bounded Regression

    Directory of Open Access Journals (Sweden)

    Zura Kakushadze


    Full Text Available We give an explicit algorithm and source code for combining alpha streams via bounded regression. In practical applications, typically, there is insufficient history to compute a sample covariance matrix (SCM for a large number of alphas. To compute alpha allocation weights, one then resorts to (weighted regression over SCM principal components. Regression often produces alpha weights with insufficient diversification and/or skewed distribution against, e.g., turnover. This can be rectified by imposing bounds on alpha weights within the regression procedure. Bounded regression can also be applied to stock and other asset portfolio construction. We discuss illustrative examples.

  5. Employee Knowledge Sharing in Work Teams: Effects of Team Diversity, Emergent States, and Team Leadership (United States)

    Noh, Jae Hang


    Knowledge sharing in work teams is one of the critical team processes. Without sharing of knowledge, work teams and organizations may not be able to fully utilize the diverse knowledge brought into work teams by their members. The purpose of this study was to investigate antecedents and underlying mechanisms influencing the extent to which team…

  6. Putting the "Team" in the Fine Arts Team: An Application of Business Management Team Concepts (United States)

    Fisher, Ryan


    In this article, the author discusses current challenges to the idea of teamwork in fine arts teams, redefines the terms team and collaboration using a business management perspective, discusses the success of effective teams in the business world and the characteristics of those teams, and proposes the implementation of the business model of…

  7. Leadership in anaesthesia teams: the most effective leadership is shared. (United States)

    Künzle, Barbara; Zala-Mezö, Enikö; Wacker, Johannes; Kolbe, Michaela; Spahn, Donat R; Grote, Gudela


    Leadership plays a crucial role in teams working in complex environments, and research has shown that shared leadership where all team members perform leadership functions is an effective strategy. The authors aimed to describe shared leadership patterns during anaesthesia induction and show how they are linked to team performance. 12 anaesthesia teams consisting of one resident and one nurse during a simulated anaesthesia induction including a non-routine event (asystole) were videotaped, and two kinds of leadership behaviour (content-oriented and structuring) were coded. Team performance was operationalised as the reaction time to the non-routine event. The amount of leadership sharedness was compared between low- and high-performing teams by performing a univariate analysis of variance. Wilcoxon signed-rank tests were used to analyse the distribution of the two kinds of leadership behaviour among team members. Statistical analysis revealed that in high-performing teams, residents and nurses shared their leadership, while in low-performing teams, residents showed significantly higher levels of leadership behaviour than nurses. Further analyses revealed different distributions of leadership functions among team members. While residents of low-performing teams assumed both kinds of leadership behaviour, members of high-performing teams seemed to have distinct leadership roles: nurses mainly used content-oriented leadership behaviour, and residents tended to show structuring leadership behaviour. The study documents the effectiveness of shared leadership in situations with high task complexity and indicates that a clear distribution of content-oriented and structuring leadership among team members is an effective strategy. The findings have implications for training in shared leadership and also give rise to a number of recommendations for further research. ClinicalTrials ( registration number is NCT00706108.

  8. Sounds like Team Spirit (United States)

    Hoffman, Edward


    I recently accompanied my son Dan to one of his guitar lessons. As I sat in a separate room, I focused on the music he was playing and the beautiful, robust sound that comes from a well-played guitar. Later that night, I woke up around 3 am. I tend to have my best thoughts at this hour. The trouble is I usually roll over and fall back asleep. This time I was still awake an hour later, so I got up and jotted some notes down in my study. I was thinking about the pure, honest sound of a well-played instrument. From there my mind wandered into the realm of high-performance teams and successful projects. (I know this sounds weird, but this is the sort of thing I think about at 3 am. Maybe you have your own weird thoughts around that time.) Consider a team in relation to music. It seems to me that a crack team can achieve a beautiful, perfect unity in the same way that a band of brilliant musicians can when they're in harmony with one another. With more than a little satisfaction I have to admit, I started to think about the great work performed for you by the Knowledge Sharing team, including this magazine you are reading. Over the past two years I personally have received some of my greatest pleasures as the APPL Director from the Knowledge Sharing activities - the Masters Forums, NASA Center visits, ASK Magazine. The Knowledge Sharing team expresses such passion for their work, just like great musicians convey their passion in the music they play. In the case of Knowledge Sharing, there are many factors that have made this so enjoyable (and hopefully worthwhile for NASA). Three ingredients come to mind -- ingredients that have produced a signature sound. First, through the crazy, passionate playing of Alex Laufer, Michelle Collins, Denise Lee, and Todd Post, I always know that something startling and original is going to come out of their activities. This team has consistently done things that are unique and innovative. For me, best of all is that they are always

  9. Transformational leadership as a moderator of the relationship between psychological safety and learning behaviour in work teams in Ghana

    Directory of Open Access Journals (Sweden)

    Stephen K. Kumako


    Full Text Available Orientation: Transformational team leadership is an important variable that influences team members’ perception of the team as psychologically safe enough to engage in learning behaviours.Research purpose: The study was aimed at investigating the relationship between psychological safety and learning behaviour in teams, as well as the moderating role of transformational team leadership in this relationship.Motivation for the study: For a team to be effective, adaptive and innovative and engage in learning behaviours, the transformational team leader must set the right climate in the team, where he or she welcomes the team members’ opinions, questions and feedback at no risk to their image. An understanding of this will be important in team leader selection and training.Research design, approach and method: Using a cross-sectional survey design, 57 work teams comprising 456 respondents in teams of 7–9 members were purposively sampled from five financial institutions in Accra, Ghana. Hierarchical regression and moderation analyses were run on the data at the team level.Main findings: Results indicated a positive relationship between team psychological safety and team learning behaviour, with transformational team leadership moderating this relationship.Practical/managerial implication: Transformational team leadership is important in creating a climate of psychological safety that will enable team members to engage in learning behaviours.Contribution/value-add: The study provided theoretical and empirical evidence that, in organisational contexts, transformational team leadership is an important variable that can facilitate psychological safety and learning behaviour in teams.

  10. Ability Dispersion and Team Performance

    DEFF Research Database (Denmark)

    Hoogendoorn, Sander; Parker, Simon C.; Van Praag, Mirjam

    What is the effect of dispersed levels of cognitive ability of members of a (business) team on their team's performance? This paper reports the results of a field experiment in which 573 students in 49 teams start up and manage real companies under identical circumstances. We ensured exogenous...... increases and then decreases with ability dispersion. We seek to understand this finding by developing a model in which team members of different ability levels form sub-teams with other team members with similar ability levels to specialize in different productive tasks. Diversity spreads production over...

  11. Ability Dispersion and Team Performance

    DEFF Research Database (Denmark)

    Hoogendoorn, Sander; Parker, Simon C.; Van Praag, Mirjam

    What is the effect of dispersed levels of cognitive ability of members of a (business) team on their team's performance? This paper reports the results of a field experiment in which 573 students in 49 teams start up and manage real companies under identical circumstances for one year. We ensured...... increases and then decreases with ability dispersion. We seek to understand this finding by developing a model in which team members of different ability levels form sub-teams with other team members with similar ability levels to specialize in different productive tasks. Diversity spreads production over...

  12. Ability Dispersion and Team Performance

    DEFF Research Database (Denmark)

    Hoogendoorn, Sander; Parker, Simon C.; Van Praag, Mirjam

    What is the effect of dispersed levels of cognitive ability of members of a (business) team on their team's performance? This paper reports the results of a field experiment in which 573 students in 49 (student) teams start up and manage real companies under identical circumstances for one year. We...... increases and then decreases with ability dispersion. We seek to understand this finding by developing a model in which team members of different ability levels form sub- teams with other team members with similar ability levels to specialize in different productive tasks. Diversity spreads production over...

  13. Leadership and team building in gastrointestinal endoscopy. (United States)

    Valori, Roland M; Johnston, Deborah J


    A modern endoscopy service delivers high volume procedures that can be daunting, embarrassing and uncomfortable for patients [1]. Endoscopy is hugely beneficial to patients but only if it is performed to high standards [2]. Some consequences of poor quality endoscopy include worse outcomes for cancer and gastrointestinal bleeding, unnecessary repeat procedures, needless damage to patients and even avoidable death [3]. New endoscopy technology and more rigorous decontamination procedures have made endoscopy more effective and safer, but they have placed additional demands on the service. Ever-scarcer resources require more efficient, higher turnover of patients, which can be at odds with a good patient experience, and with quality and safety. It is clear from the demands put upon it, that to deliver a modern endoscopy service requires effective leadership and team working [4]. This chapter explores what constitutes effective leadership and what makes great clinical teams. It makes the point that endoscopy services are not usually isolated, independent units, and as such are dependent for success on the organisations they sit within. It will explain how endoscopy services are affected by the wider policy and governance context. Finally, within the context of the collection of papers in this edition of Best Practice & Research: Clinical Gastroenterology, it explores the potentially conflicting relationship between training of endoscopists and service delivery. The effectiveness of leadership and teams is rarely the subject of classic experimental designs such as randomized controlled trials. Nevertheless there is a substantial literature on this subject within and particularly outside healthcare [5]. The authors draw on this wider, more diffuse literature and on their experience of delivering a Team Leadership Programme (TLP) to the leaders of 70 endoscopy teams during the period 2008-2012. (Team Leadership Programme Link-http

  14. Team Leader System description

    Energy Technology Data Exchange (ETDEWEB)

    Evans, B.J.; Lundeen, T.F.; Moon, B.D.


    Purpose of the project is to design, develop, and demonstrate an advanced, prototype computer system to support on-site inspections. The system is a highly portable field computer with on-line access to facilities information, real-time communications, positioning information, and an electronic notebook for data capture. The Team Leader System provides an inspection team with a suite of advanced communication, data gathering, and data analysis tools and can be implemented on many PC-based hardware platforms. The suitcase unit is a transportable system for on-site support in a vehicle or at a stationary location at an inspection site; the personal unit is a wearable computer for in-facility or on-foot inspections.

  15. Virologic response to tipranavir-ritonavir or darunavir-ritonavir based regimens in antiretroviral therapy experienced HIV-1 patients: a meta-analysis and meta-regression of randomized controlled clinical trials.

    Directory of Open Access Journals (Sweden)

    Asres Berhan

    Full Text Available The development of tipranavir and darunavir, second generation non-peptidic HIV protease inhibitors, with marked improved resistance profiles, has opened a new perspective on the treatment of antiretroviral therapy (ART experienced HIV patients with poor viral load control. The aim of this study was to determine the virologic response in ART experienced patients to tipranavir-ritonavir and darunavir-ritonavir based regimens.A computer based literature search was conducted in the databases of HINARI (Health InterNetwork Access to Research Initiative, Medline and Cochrane library. Meta-analysis was performed by including randomized controlled studies that were conducted in ART experienced patients with plasma viral load above 1,000 copies HIV RNA/ml. The odds ratios and 95% confidence intervals (CI for viral loads of <50 copies and <400 copies HIV RNA/ml at the end of the intervention were determined by the random effects model. Meta-regression, sensitivity analysis and funnel plots were done. The number of HIV-1 patients who were on either a tipranavir-ritonavir or darunavir-ritonavir based regimen and achieved viral load less than 50 copies HIV RNA/ml was significantly higher (overall OR = 3.4; 95% CI, 2.61-4.52 than the number of HIV-1 patients who were on investigator selected boosted comparator HIV-1 protease inhibitors (CPIs-ritonavir. Similarly, the number of patients with viral load less than 400 copies HIV RNA/ml was significantly higher in either the tipranavir-ritonavir or darunavir-ritonavir based regimen treated group (overall OR = 3.0; 95% CI, 2.15-4.11. Meta-regression showed that the viral load reduction was independent of baseline viral load, baseline CD4 count and duration of tipranavir-ritonavir or darunavir-ritonavir based regimen.Tipranavir and darunavir based regimens were more effective in patients who were ART experienced and had poor viral load control. Further studies are required to determine their consistent

  16. Time-adaptive quantile regression

    DEFF Research Database (Denmark)

    Møller, Jan Kloppenborg; Nielsen, Henrik Aalborg; Madsen, Henrik


    An algorithm for time-adaptive quantile regression is presented. The algorithm is based on the simplex algorithm, and the linear optimization formulation of the quantile regression problem is given. The observations have been split to allow a direct use of the simplex algorithm. The simplex method...... and an updating procedure are combined into a new algorithm for time-adaptive quantile regression, which generates new solutions on the basis of the old solution, leading to savings in computation time. The suggested algorithm is tested against a static quantile regression model on a data set with wind power...... production, where the models combine splines and quantile regression. The comparison indicates superior performance for the time-adaptive quantile regression in all the performance parameters considered....

  17. Professional Team Sports Clubs

    DEFF Research Database (Denmark)

    Storm, Rasmus K.

    Professional football in Europe is characterized by persistent deficits, growing debts and additional financial problems among the majority of the top league clubs. Despite these problems, these clubs have an abnormally high survival rate. This paper focuses on this apparent paradox and poses the...... in Europe, this paper argues that professional team sports clubs (PTSCs) are cases of an economic phenomenon normally found in socialist or post-socialist economies....

  18. Automated Cyber Red Teaming (United States)


    Technology Organisation DSTO-TN-1420 ABSTRACT Cyber Red Teaming (CRT) is an important exercise to conduct for Defence agencies built on large...and Electronic Warfare Division DSTO Defence Science and Technology Organisation PO Box 1500 Edinburgh South Australia 5111 Australia...referred to as the World Model [4] [5]. This naming captures the idea that cyber systems are large, complex digital ecosystems with many intelligent

  19. Transformational Leadership and Team Innovation : Integrating Team Climate Principles


    Eisenbeiss, Silke Astrid; Boerner, Sabine; Knippenberg, Daan


    Fostering team innovation is increasingly an important leadership function. However, the empirical evidence for the role of transformational leadership in engendering team innovation is scarce and mixed. To address this issue, the authors link transformational leadership theory to principles of M. A. West s (1990) team climate theory and propose an integrated model for the relationship between transformational leadership and team innovation. This model involves support for innovation as a med...

  20. Evaluating Differential Effects Using Regression Interactions and Regression Mixture Models (United States)

    Van Horn, M. Lee; Jaki, Thomas; Masyn, Katherine; Howe, George; Feaster, Daniel J.; Lamont, Andrea E.; George, Melissa R. W.; Kim, Minjung


    Research increasingly emphasizes understanding differential effects. This article focuses on understanding regression mixture models, which are relatively new statistical methods for assessing differential effects by comparing results to using an interactive term in linear regression. The research questions which each model answers, their…

  1. Bias-corrected quantile regression estimation of censored regression models

    NARCIS (Netherlands)

    Cizek, Pavel; Sadikoglu, Serhan


    In this paper, an extension of the indirect inference methodology to semiparametric estimation is explored in the context of censored regression. Motivated by weak small-sample performance of the censored regression quantile estimator proposed by Powell (J Econom 32:143–155, 1986a), two- and

  2. Quantum assisted Gaussian process regression


    Zhao, Zhikuan; Fitzsimons, Jack K.; Fitzsimons, Joseph F.


    Gaussian processes (GP) are a widely used model for regression problems in supervised machine learning. Implementation of GP regression typically requires $O(n^3)$ logic gates. We show that the quantum linear systems algorithm [Harrow et al., Phys. Rev. Lett. 103, 150502 (2009)] can be applied to Gaussian process regression (GPR), leading to an exponential reduction in computation time in some instances. We show that even in some cases not ideally suited to the quantum linear systems algorith...

  3. The Undergraduate ALFALFA Team (United States)

    Koopmann, Rebecca A.; Higdon, S.; Balonek, T. J.; Haynes, M. P.; Giovanelli, R.


    The Undergraduate ALFALFA (Arecibo Legacy Fast ALFA) Team is a consortium of 16 institutions engaged in an NSF-sponsored program to promote undergraduate research within the extragalactic ALFALFA HI blind survey project. In the first two years of the program, more than three dozen undergraduate students have been closely involved in ALFALFA science, observing, and data analysis. A total of 34 students have attended the annual undergraduate workshops at Arecibo Observatory, interacting with faculty, their peers, ALFALFA experts, and Arecibo staff in lectures, group activities, tours, and observing runs. Team faculty have supervised 26 summer research projects and 14 academic year (e.g., senior thesis) projects. Students and faculty have traveled to Arecibo Observatory for observing runs and to national meetings to present their results. Eight Team schools have joined to work collaboratively to analyze HI properties of galaxy groups within the ALFALFA volume. (See O'Brien et al., O'Malley et al., and Odekon et al. posters, this meeting.) Students involved in this program are learning how science is accomplished in a large collaboration while contributing to the scientific goals of a major legacy survey. This work has been supported by NSF grants AST-0724918, AST-0725267, and AST-0725380.

  4. Quantile regression theory and applications

    CERN Document Server

    Davino, Cristina; Vistocco, Domenico


    A guide to the implementation and interpretation of Quantile Regression models This book explores the theory and numerous applications of quantile regression, offering empirical data analysis as well as the software tools to implement the methods. The main focus of this book is to provide the reader with a comprehensivedescription of the main issues concerning quantile regression; these include basic modeling, geometrical interpretation, estimation and inference for quantile regression, as well as issues on validity of the model, diagnostic tools. Each methodological aspect is explored and

  5. Understanding medical practice team roles. (United States)

    Hills, Laura


    Do you believe that the roles your employees play on your medical practice team are identical to their job titles or job descriptions? Do you believe that team roles are determined by personality type? This article suggests that a more effective way to build and manage your medical practice team is to define team roles through employee behaviors. It provides 10 rules of behavioral team roles that can help practice managers to select and build high-performing teams, build more productive team relationships, improve the employee recruitment process, build greater team trust and understanding; and increase their own effectiveness. This article describes in detail Belbin's highly regarded and widely used team role theory and summarizes four additional behavioral team role theories and systems. It offers lessons learned when applying team role theory to practice. Finally, this article offers an easy-to-implement method for assessing current team roles. It provides a simple four-question checklist that will help practice managers balance an imbalanced medical practice team.

  6. Collocation Impact on Team Effectiveness

    Directory of Open Access Journals (Sweden)

    M Eccles


    Full Text Available The collocation of software development teams is common, specially in agile software development environments. However little is known about the impact of collocation on the team’s effectiveness. This paper explores the impact of collocating agile software development teams on a number of team effectiveness factors. The study focused on South African software development teams and gathered data through the use of questionnaires and interviews. The key finding was that collocation has a positive impact on a number of team effectiveness factors which can be categorised under team composition, team support, team management and structure and team communication. Some of the negative impact collocation had on team effectiveness relate to the fact that team members perceived that less emphasis was placed on roles, that morale of the group was influenced by individuals, and that collocation was invasive, reduced level of privacy and increased frequency of interruptions. Overall through it is proposed that companies should consider collocating their agile software development teams, as collocation might leverage overall team effectiveness.

  7. Using artificial team members for team training in virtual environments

    NARCIS (Netherlands)

    Diggelen, J. van; Muller, T.; Bosch, K. van den


    In a good team, members do not only perform their individual task, they also coordinate their actions with other members of the team. Developing such team skills usually involves exercises with all members playing their role. This approach is costly and has organizational and educational drawbacks.

  8. The Team Boat Exercise: Enhancing Team Communication Midsemester (United States)

    Cox, Pamela L.; Friedman, Barry A.


    This paper discusses the Team Boat Exercise, which was developed to provide students with a mechanism for addressing team problems and enhancing team communication midsemester. The inspiration for the exercise came from a video by Prentice Hall, Inc. (2001). Part III of the video, entitled "Corporate Coaching," shows senior staff members from the…

  9. Cohesion in Online Student Teams versus Traditional Teams (United States)

    Hansen, David E.


    Researchers have found that the electronic methods in use for online team communication today increase communication quality in project-based work situations. Because communication quality is known to influence group cohesion, the present research examined whether online student project teams are more cohesive than traditional teams. We tested…

  10. Engaging in Collaboration: A Team of Teams Approach (United States)

    Young, Carol; Hill, Rachel; Morris, Greg; Woods, Fabiola


    Adapting a Team of Teams model to a school environment provides a framework for a collaborative team culture based on trust, common vision, purposeful conversations, and interconnectivity. School leaders facilitate collaboration by modeling teamwork, as well as transparency and adaptability, to create a positive school culture and thereby improve…

  11. Team Machine: A Decision Support System for Team Formation (United States)

    Bergey, Paul; King, Mark


    This paper reports on the cross-disciplinary research that resulted in a decision-support tool, Team Machine (TM), which was designed to create maximally diverse student teams. TM was used at a large United States university between 2004 and 2012, and resulted in significant improvement in the performance of student teams, superior overall balance…

  12. Learning and performance in multidisciplinary teams : The importance of collective team identification

    NARCIS (Netherlands)

    Van der Vegt, Gerben S.; Bunderson, J. Stuart


    In multidisciplinary teams in the oil and gas industry, we examined expertise diversity's relationship with team learning and team performance under varying levels of collective team identification. In teams with low collective identification, expertise diversity was negatively related to team

  13. Cultural Diversity and Team Performance

    DEFF Research Database (Denmark)

    Hoogendoorn, Sander; Van Praag, Mirjam

    similar circumstances. We vary the cultural composition of otherwise randomly composed teams in a multi-cultural student population. Our data indicate that a moderate level of cultural diversity has no effect on team performance in terms of business outcomes (sales, profits and profits per share). However......One of the most salient and relevant dimensions of team heterogeneity is cultural background. We measure the impact of cultural diversity on the performance of business teams using a field experiment. Companies are set up by teams of undergraduate students in business studies in realistic though......, if at least the majority of team members is culturally diverse then more cultural diversity seems to affect the performance of teams positively. Our data suggest that this might be related to the more diverse pool of relevant knowledge facilitating (mutual) learning within culturally diverse teams....

  14. Diverse Teams Drive Leadership Development

    DEFF Research Database (Denmark)

    Holck, Lotte; Hjortlund Andersen, Lotte

    New research from ISS Denmark shows that leading diverse teams strengthens leaders’ competencies within communication, relationship building and talent development and ensures inclusion. This has a reinforcing effect as the better the leadership, the better the heterogeneous team will function....

  15. Testing discontinuities in nonparametric regression

    KAUST Repository

    Dai, Wenlin


    In nonparametric regression, it is often needed to detect whether there are jump discontinuities in the mean function. In this paper, we revisit the difference-based method in [13 H.-G. Müller and U. Stadtmüller, Discontinuous versus smooth regression, Ann. Stat. 27 (1999), pp. 299–337. doi: 10.1214/aos/1018031100

  16. Logistic Regression: Concept and Application (United States)

    Cokluk, Omay


    The main focus of logistic regression analysis is classification of individuals in different groups. The aim of the present study is to explain basic concepts and processes of binary logistic regression analysis intended to determine the combination of independent variables which best explain the membership in certain groups called dichotomous…

  17. Panel Smooth Transition Regression Models

    DEFF Research Database (Denmark)

    González, Andrés; Terasvirta, Timo; Dijk, Dick van

    We introduce the panel smooth transition regression model. This new model is intended for characterizing heterogeneous panels, allowing the regression coefficients to vary both across individuals and over time. Specifically, heterogeneity is allowed for by assuming that these coefficients are bou...

  18. Entrepreneurial team cognition: A review

    NARCIS (Netherlands)

    de Mol, E.; Khapova, S.N.; Elfring, T.


    Entrepreneurial team scholars highlight the importance of studying entrepreneurial team cognition in gaining a better understanding of why some entrepreneurial teams are capable of developing teamwork leading to successful entrepreneurial outcomes while others are not. However, in the absence of a

  19. Team Building through Physical Challenges. (United States)

    Gibbons, Sandra L.

    The enhancement of positive self-concept has been identified as a key benefit of participation in team-building programs. This paper reviews research on the impact of team-building activities that include demanding physical challenges on the self-concept of physical education students. Team Building through Physical Challenges (TBPC) is a program…

  20. Team Based Engineering Design Thinking (United States)

    Mentzer, Nathan


    The objective of this research was to explore design thinking among teams of high school students. This objective was encompassed in the research question driving the inquiry: How do teams of high school students allocate time across stages of design? Design thinking on the professional level typically occurs in a team environment. Many…

  1. Meta-regression analyses, meta-analyses, and trial sequential analyses of the effects of supplementation with beta-carotene, vitamin A, and vitamin E singly or in different combinations on all-cause mortality: do we have evidence for lack of harm?

    Directory of Open Access Journals (Sweden)

    Goran Bjelakovic

    Full Text Available BACKGROUND AND AIMS: Evidence shows that antioxidant supplements may increase mortality. Our aims were to assess whether different doses of beta-carotene, vitamin A, and vitamin E affect mortality in primary and secondary prevention randomized clinical trials with low risk of bias. METHODS: The present study is based on our 2012 Cochrane systematic review analyzing beneficial and harmful effects of antioxidant supplements in adults. Using random-effects meta-analyses, meta-regression analyses, and trial sequential analyses, we examined the association between beta-carotene, vitamin A, and vitamin E, and mortality according to their daily doses and doses below and above the recommended daily allowances (RDA. RESULTS: We included 53 randomized trials with low risk of bias (241,883 participants, aged 18 to 103 years, 44.6% women assessing beta-carotene, vitamin A, and vitamin E. Meta-regression analysis showed that the dose of vitamin A was significantly positively associated with all-cause mortality. Beta-carotene in a dose above 9.6 mg significantly increased mortality (relative risk (RR 1.06, 95% confidence interval (CI 1.02 to 1.09, I(2 = 13%. Vitamin A in a dose above the RDA (> 800 µg did not significantly influence mortality (RR 1.08, 95% CI 0.98 to 1.19, I(2 = 53%. Vitamin E in a dose above the RDA (> 15 mg significantly increased mortality (RR 1.03, 95% CI 1.00 to 1.05, I(2 = 0%. Doses below the RDAs did not affect mortality, but data were sparse. CONCLUSIONS: Beta-carotene and vitamin E in doses higher than the RDA seem to significantly increase mortality, whereas we lack information on vitamin A. Dose of vitamin A was significantly associated with increased mortality in meta-regression. We lack information on doses below the RDA. BACKGROUND: All essential compounds to stay healthy cannot be synthesized in our body. Therefore, these compounds must be taken through our diet or obtained in other ways [1]. Oxidative stress has been

  2. Team perfectionism and team performance: a prospective study. (United States)

    Hill, Andrew P; Stoeber, Joachim; Brown, Anna; Appleton, Paul R


    Perfectionism is a personality characteristic that has been found to predict sports performance in athletes. To date, however, research has exclusively examined this relationship at an individual level (i.e., athletes' perfectionism predicting their personal performance). The current study extends this research to team sports by examining whether, when manifested at the team level, perfectionism predicts team performance. A sample of 231 competitive rowers from 36 boats completed measures of self-oriented, team-oriented, and team-prescribed perfectionism before competing against one another in a 4-day rowing competition. Strong within-boat similarities in the levels of team members' team-oriented perfectionism supported the existence of collective team-oriented perfectionism at the boat level. Two-level latent growth curve modeling of day-by-day boat performance showed that team-oriented perfectionism positively predicted the position of the boat in midcompetition and the linear improvement in position. The findings suggest that imposing perfectionistic standards on team members may drive teams to greater levels of performance.

  3. A Project Team: A Team or Just a Group?

    Directory of Open Access Journals (Sweden)

    Katerina Hrazdilova Bockova


    Full Text Available This paper deals with issues related to work in either teams or groups. The theoretical part which discusses a team and a group with regards to its definition, classification and basic distinction brings in more on the typology of team roles, personality assessment and sociometric methods. The analytical part tests the project (work team of a medical center represented in terms of personality and motivational types, team roles and interpersonal team relations concerning the willingness of cooperation and communication. The main objective of this work was to determine whether the existing team is not by its nature rather a working group that contributes to the generally perceived stagnation of that field.

  4. [Regression of coronary arteriosclerosis with hypolipidemic treatment, myth or reality?]. (United States)

    Lahoz, C; Monereo, A; Mostaza, J M; de Oya, M


    Coronary atherosclerosis regression with hypolipemiant treatment is a well known fact in the animal model since years ago. In humans, during these last years, several clinical trials have been performed to ellucidate the truth to this fact. All of these clinical trials have in common the evolutive study of the coronary lesions with angiographies, in patients following treatment with diet, surgery or drugs, to reduce plasmatic cholesterol. Clinical, analytical and angiographic results of said studies are reviewed. We conclude that the bigger the lowering in plasmatic cholesterol levels, smaller is the progression of these coronary lesions and more probable is finding patients with partial regression of the lesions.

  5. Geospatial Information Response Team (United States)

    Witt, Emitt C.


    Extreme emergency events of national significance that include manmade and natural disasters seem to have become more frequent during the past two decades. The Nation is becoming more resilient to these emergencies through better preparedness, reduced duplication, and establishing better communications so every response and recovery effort saves lives and mitigates the long-term social and economic impacts on the Nation. The National Response Framework (NRF) ( was developed to provide the guiding principles that enable all response partners to prepare for and provide a unified national response to disasters and emergencies. The NRF provides five key principles for better preparation, coordination, and response: 1) engaged partnerships, 2) a tiered response, 3) scalable, flexible, and adaptable operations, 4) unity of effort, and 5) readiness to act. The NRF also describes how communities, tribes, States, Federal Government, privatesector, and non-governmental partners apply these principles for a coordinated, effective national response. The U.S. Geological Survey (USGS) has adopted the NRF doctrine by establishing several earth-sciences, discipline-level teams to ensure that USGS science, data, and individual expertise are readily available during emergencies. The Geospatial Information Response Team (GIRT) is one of these teams. The USGS established the GIRT to facilitate the effective collection, storage, and dissemination of geospatial data information and products during an emergency. The GIRT ensures that timely geospatial data are available for use by emergency responders, land and resource managers, and for scientific analysis. In an emergency and response capacity, the GIRT is responsible for establishing procedures for geospatial data acquisition, processing, and archiving; discovery, access, and delivery of data; anticipating geospatial needs; and providing coordinated products and services utilizing the USGS' exceptional pool of

  6. Targeted On-Demand Team Performance App Development (United States)


    epistemology of interdisciplinary inquiry. Journal of Aesthetic Education, 10, 29-43. 12. Petrioni, P. (1994). Interprofessional teamwork. In A...Urgent Emergent Care Teams, Emergency Medicine Teams, Impactful Team Factors, Team Training, Team Optimization, Team Performance Improvement, Emergency...Urgent Emergent Care Teams, Emergency Medicine Teams, Urgent Care Teams, Impactful Team Factors, Team Training, Team Optimization, Team Performance

  7. Regression analysis with categorized regression calibrated exposure: some interesting findings

    Directory of Open Access Journals (Sweden)

    Hjartåker Anette


    Full Text Available Abstract Background Regression calibration as a method for handling measurement error is becoming increasingly well-known and used in epidemiologic research. However, the standard version of the method is not appropriate for exposure analyzed on a categorical (e.g. quintile scale, an approach commonly used in epidemiologic studies. A tempting solution could then be to use the predicted continuous exposure obtained through the regression calibration method and treat it as an approximation to the true exposure, that is, include the categorized calibrated exposure in the main regression analysis. Methods We use semi-analytical calculations and simulations to evaluate the performance of the proposed approach compared to the naive approach of not correcting for measurement error, in situations where analyses are performed on quintile scale and when incorporating the original scale into the categorical variables, respectively. We also present analyses of real data, containing measures of folate intake and depression, from the Norwegian Women and Cancer study (NOWAC. Results In cases where extra information is available through replicated measurements and not validation data, regression calibration does not maintain important qualities of the true exposure distribution, thus estimates of variance and percentiles can be severely biased. We show that the outlined approach maintains much, in some cases all, of the misclassification found in the observed exposure. For that reason, regression analysis with the corrected variable included on a categorical scale is still biased. In some cases the corrected estimates are analytically equal to those obtained by the naive approach. Regression calibration is however vastly superior to the naive method when applying the medians of each category in the analysis. Conclusion Regression calibration in its most well-known form is not appropriate for measurement error correction when the exposure is analyzed on a

  8. Team player styles, team design variables and team work effectiveness in Egypt


    Hassan El-Kot, Ghada Awed


    The literature has revealed few studies of management in Arab countries in general and particularly in Egypt. Many Egyptian organisations implemented the team concept a number of years ago, however, there do not appear to be any studies investicitaýt inc",D team work effectiveness in Egypt. The literature review and the findings of a pilot study emphasised the need for empirical research in team work in Egypt. Team effectiveness models are examined in order to identify the fact...

  9. Advanced statistics: linear regression, part II: multiple linear regression. (United States)

    Marill, Keith A


    The applications of simple linear regression in medical research are limited, because in most situations, there are multiple relevant predictor variables. Univariate statistical techniques such as simple linear regression use a single predictor variable, and they often may be mathematically correct but clinically misleading. Multiple linear regression is a mathematical technique used to model the relationship between multiple independent predictor variables and a single dependent outcome variable. It is used in medical research to model observational data, as well as in diagnostic and therapeutic studies in which the outcome is dependent on more than one factor. Although the technique generally is limited to data that can be expressed with a linear function, it benefits from a well-developed mathematical framework that yields unique solutions and exact confidence intervals for regression coefficients. Building on Part I of this series, this article acquaints the reader with some of the important concepts in multiple regression analysis. These include multicollinearity, interaction effects, and an expansion of the discussion of inference testing, leverage, and variable transformations to multivariate models. Examples from the first article in this series are expanded on using a primarily graphic, rather than mathematical, approach. The importance of the relationships among the predictor variables and the dependence of the multivariate model coefficients on the choice of these variables are stressed. Finally, concepts in regression model building are discussed.

  10. Professional Team Foundation Server 2010

    CERN Document Server

    Blankenship, Ed; Holliday, Grant; Keller, Brian


    Authoritative guide to TFS 2010 from a dream team of Microsoft insiders and MVPs!Microsoft Visual Studio Team Foundation Server (TFS) has evolved until it is now an essential tool for Microsoft?s Application Lifestyle Management suite of productivity tools, enabling collaboration within and among software development teams. By 2011, TFS will replace Microsoft?s leading source control system, VisualSourceSafe, resulting in an even greater demand for information about it. Professional Team Foundation Server 2010, written by an accomplished team of Microsoft insiders and Microsoft MVPs, provides

  11. Commodity team motivation and performance

    DEFF Research Database (Denmark)

    Englyst, Linda; Jørgensen, Frances; Johansen, John


    In this article, an in-depth single case study is presented in order to explore and discuss the functioning of commodity teams in a global sourcing context. Specifically the study aimed at identifying factors that may influence team members' motivation to participate in activities consistent...... with a commodity team's objective of creating opportunities for synergy and coordination of purchasing. In the teams studied, motivation appeared to be influenced to some degree by a number of factors, including rewards, leadership behaviors, goal setting, and the career goals of the commodity team members...

  12. Logic regression and its extensions. (United States)

    Schwender, Holger; Ruczinski, Ingo


    Logic regression is an adaptive classification and regression procedure, initially developed to reveal interacting single nucleotide polymorphisms (SNPs) in genetic association studies. In general, this approach can be used in any setting with binary predictors, when the interaction of these covariates is of primary interest. Logic regression searches for Boolean (logic) combinations of binary variables that best explain the variability in the outcome variable, and thus, reveals variables and interactions that are associated with the response and/or have predictive capabilities. The logic expressions are embedded in a generalized linear regression framework, and thus, logic regression can handle a variety of outcome types, such as binary responses in case-control studies, numeric responses, and time-to-event data. In this chapter, we provide an introduction to the logic regression methodology, list some applications in public health and medicine, and summarize some of the direct extensions and modifications of logic regression that have been proposed in the literature. Copyright © 2010 Elsevier Inc. All rights reserved.



    MARTIN HOEGL; K Praveen Parboteeah


    In this paper, we investigate a relatively neglected but important aspect of team research, namely team goal commitment or the team member's attachment to the team goal. Specifically, we examine whether the performance effect of team goal commitment is contingent on the level of innovativeness of the team task. Furthermore, we also examine five controllable team-level antecedent factors to team goal commitment. Results provide support for the hypothesis that team goal commitment is related to...

  14. Leading Teams of Higher Education Administrators: Integrating Goal Setting, Team Role, and Team Life Cycle Theories (United States)

    Posthuma, Richard; Al-Riyami, Said


    Leaders of higher education institutions can create top management teams of academic administrators to guide and improve their organizations. This study illustrates how the leadership of top management teams can be accomplished successfully through a combination of goal setting (Doran, 1981; Locke & Latham, 1990), understanding of team roles…

  15. Practical Session: Simple Linear Regression (United States)

    Clausel, M.; Grégoire, G.


    Two exercises are proposed to illustrate the simple linear regression. The first one is based on the famous Galton's data set on heredity. We use the lm R command and get coefficients estimates, standard error of the error, R2, residuals …In the second example, devoted to data related to the vapor tension of mercury, we fit a simple linear regression, predict values, and anticipate on multiple linear regression. This pratical session is an excerpt from practical exercises proposed by A. Dalalyan at EPNC (see Exercises 1 and 2 of

  16. Building a rapid response team. (United States)

    Halvorsen, Lisa; Garolis, Salomeja; Wallace-Scroggs, Allyson; Stenstrom, Judy; Maunder, Richard


    The use of rapid response teams is a relatively new approach for decreasing or eliminating codes in acute care hospitals. Based on the principles of a code team for cardiac and/or respiratory arrest in non-critical care units, the rapid response teams have specially trained nursing, respiratory, and medical personnel to respond to calls from general care units to assess and manage decompensating or rapidly changing patients before their conditions escalate to a full code situation. This article describes the processes used to develop a rapid response team, clinical indicators for triggering a rapid response team call, topics addressed in an educational program for the rapid response team members, and methods for evaluating effectiveness of the rapid response team.

  17. School wellness team best practices to promote wellness policy implementation. (United States)

    Profili, Erika; Rubio, Diana S; Lane, Hannah G; Jaspers, Lea H; Lopes, Megan S; Black, Maureen M; Hager, Erin R


    Schools with wellness teams are more likely to implement federally mandated Local Wellness Policies (LWPs, Local Education Agency-level policies for healthy eating/physical activity). Best practices have been developed for wellness teams based on minimal empirical evidence. The purpose of this study is to determine, among schools with wellness teams, associations between LWP implementation and six wellness team best practices (individually and as a sum score). An online survey targeting Maryland school wellness leaders/administrators (52.4% response rate, 2012-2013 school year) was administered that included LWP implementation (17-item scale: categorized as no, low, and high implementation) and six wellness team best practices. Analyses included multi-level multinomial logistic regression. Wellness teams were present in 311/707 (44.0%) schools, with no (19.6%), low (36.0%), and high (44.4%) LWP implementation. A sum score representing active wellness teams (mean=2.6) included: setting healthy eating/physical activity goals (66.9%), informing the public of LWP activities (71.4%), meeting ≥4times/year (45.8%), and having school staff (46.9%), parent (25.4%), or student (14.8%) representation. In adjusted models, goal setting, meeting ≥4times/year, and student representation were associated with high LWP implementation. For every one-unit increase in active wellness team sum score, schools were 41% more likely to be in high versus no implementation (Likelihood Ratio=1.41, 95% C.I.=1.13, 1.76). In conclusion, wellness teams meeting best practices are more likely to implement LWPs. Interventions should focus on the formation of wellness teams with recommended composition/activities. Study findings provide support for wellness team recommendations stemming from the 2016 Healthy, Hunger-Free Kids Act final rule. Copyright © 2017. Published by Elsevier Inc.

  18. Cheap Talk: “Team Factors and Management Practices Influence on Team Trust”


    Doris Padmini Selvaratnam; Aini Aman; Muhamad Maziz Mahyuddin Bin Kamaludin; Gary Lynn; Richard Reilly


    Team trust has been cited as a contributing factor towards team performance. This paper looks at the antecedents of team trust and to what extent they influence team trust. The antecedents of team trust are team factors like team autonomy, team stability and team member experience; and the management practices are top management involvement and management support. The results demonstrated that team factors and management practices influence team trust individually. The key find...

  19. Multiple Regression and Its Discontents (United States)

    Snell, Joel C.; Marsh, Mitchell


    Multiple regression is part of a larger statistical strategy originated by Gauss. The authors raise questions about the theory and suggest some changes that would make room for Mandelbrot and Serendipity.

  20. Forecasting with Dynamic Regression Models

    CERN Document Server

    Pankratz, Alan


    One of the most widely used tools in statistical forecasting, single equation regression models is examined here. A companion to the author's earlier work, Forecasting with Univariate Box-Jenkins Models: Concepts and Cases, the present text pulls together recent time series ideas and gives special attention to possible intertemporal patterns, distributed lag responses of output to input series and the auto correlation patterns of regression disturbance. It also includes six case studies.

  1. National diversity and NHL team performance, 2007-2011

    Directory of Open Access Journals (Sweden)

    Louis Moustakas


    Full Text Available The effects of team diversity on work performance have been extensively studied both in general and sport-specific context, often yielding mixed results. However, little research exists on the impact of that diversity in the context of ice hockey. Though the sport is not as diverse as others, such as football, it has greatly increased its global footprint over the last 20 years. This paper looks at the impact of national diversity on overall team performance. Using data from NHL teams between 2007 and 2011, national diversity on each squad is calculated in three ways: Richness, the Gini-Simpson Index and Shannon’s Entropy. Controlling for team payroll and strength of schedule, we run correlations, linear regressions, logistic regressions and ordinal regressions to assess the effect of diversity on both regular season and playoff performance. Ultimately, we find that national diversity has no significant impact on team performance. We conclude by discussing potential explanations for this finding and propose further avenues of research.

  2. Academic family health teams (United States)

    Carroll, June C.; Talbot, Yves; Permaul, Joanne; Tobin, Anastasia; Moineddin, Rahim; Blaine, Sean; Bloom, Jeff; Butt, Debra; Kay, Kelly; Telner, Deanna


    Abstract Objective To explore patients’ perceptions of primary care (PC) in the early development of academic family health teams (aFHTs)—interprofessional PC teams delivering care where family medicine and other health professional learners are trained—focusing on patients’ perceptions of access and patients’ satisfaction with services. Design Self-administered survey. Setting Six aFHTs in Ontario. Participants Adult patients attending appointments and administrators at each of the aFHTs. Main outcome measures Answers to questions about access from the Primary Care Assessment Tool Adult Expanded Version, the Primary Care Assessment Survey, and research team questions. Results The response rate was 47.3% (1026 of 2167). The mean (SD) Primary Care Assessment Tool first-contact accessibility score was 2.28 (0.36) out of 4, with 96.5% of patients rating access less than 3, which was the minimum expected level of care. Two-thirds (66.6%) indicated someone from their aFHTs would definitely or probably see them the same day if they were sick, 56.8% could definitely or probably get advice quickly by telephone, and 14.5% indicated it was definitely or probably difficult to be seen by their primary health care provider (HCP). Additionally, 46.9% indicated they would like to get medical advice by e-mail. For a routine or follow-up visit, 73.4% would be willing to see another aFHT physician if their regular provider were unavailable, while only 48.3% would see a nonphysician HCP. If sick, 88.2% would see another aFHT physician and 55.2% would see a nonphysician HCP. Most (75.3%) were satisfied with access to their regular HCP. Conclusion Although patients are generally satisfied with care, there is room for improvement in access. Strategies are needed to enhance access to care, including addressing appropriate roles and scopes of practice for nonphysician HCPs. The accessibility challenges for aFHTs will likely affect new family physicians and other HCPs training in

  3. Transformational leadership and team innovation: integrating team climate principles. (United States)

    Eisenbeiss, Silke A; van Knippenberg, Daan; Boerner, Sabine


    Fostering team innovation is increasingly an important leadership function. However, the empirical evidence for the role of transformational leadership in engendering team innovation is scarce and mixed. To address this issue, the authors link transformational leadership theory to principles of M. A. West's (1990) team climate theory and propose an integrated model for the relationship between transformational leadership and team innovation. This model involves support for innovation as a mediating process and climate for excellence as a moderator. Results from a study of 33 research and development teams confirmed that transformational leadership works through support for innovation, which in turn interacts with climate for excellence such that support for innovation enhances team innovation only when climate for excellence is high.

  4. NCI at Frederick Ebola Response Team | Poster (United States)

    Editor’s note: This article was adapted from the Employee Diversity Team’s display case exhibit “Recognizing the NCI at Frederick Ebola Response Team,” in the lobby of Building 549. The Poster staff recognizes that this article does not include everyone who was involved in the response to the Ebola crisis, both at NCI at Frederick and in Africa. When the Ebola crisis broke out in 2014 in West Africa, staff members from the Frederick National Laboratory for Cancer Research responded quickly. Members of the Clinical Monitoring Research Program (CMRP) were instrumental not only in setting up the clinical trials of the vaccine in Liberia, but also in providing training, community outreach, and recruitment strategies for the trials.

  5. Individual and team performance in team-handball: a review. (United States)

    Wagner, Herbert; Finkenzeller, Thomas; Würth, Sabine; von Duvillard, Serge P


    Team handball is a complex sport game that is determined by the individual performance of each player as well as tactical components and interaction of the team. The aim of this review was to specify the elements of team-handball performance based on scientific studies and practical experience, and to convey perspectives for practical implication. Scientific studies were identified via data bases of PubMed, Web of Knowledge, SPORT Discus, Google Scholar, and Hercules. A total of 56 articles met the inclusion criteria. In addition, we supplemented the review with 13 additional articles, proceedings and book sections. It was found that the specific characteristics of team-handball with frequent intensity changes, team-handball techniques, hard body confrontations, mental skills and social factors specify the determinants of coordination, endurance, strength and cognition. Although we found comprehensive studies examining individual performance in team-handball players of different experience level, sex or age, there is a lack of studies, particularly for team-handball specific training, as well as cognition and social factors. Key PointsThe specific characteristics of team-handball with frequent intensity changes, specific skills, hard body confrontations, mental skills and social factors define the determinants of coordination, endurance, strength and cognition.To increase individual and team performance in team-handball specific training based on these determinants have been suggested.Although there are comprehensive studies examining individual performance in team-handball players of different experience level, sex, or age are published, there is a lack of training studies, particularly for team-handball specific techniques and endurance, as well as cognition and social factors.

  6. Team Work Engagement: Considering Team Dynamics for Engagement


    Patricia L. Costa; Ana Passos; Arnold B. Bakker


    Although teams are an important structure of organizations, most studies on work engagement focus almost exclusively the individual-level. The main goals of this paper are to argue that the construct of work engagement can be conceptualized at the team level and to discuss theoretically some of its possible emergence processes. A conceptual model that explains under which conditions team work engagement is more likely to emerge is developed. This model is developed based on the literature on ...

  7. Teams, Team Motivation, and the Theory of the Firm

    DEFF Research Database (Denmark)

    Foss, Nicolai Juul; Lindenberg, Siegwart

    A concern with teams was central to early attempts to grasp the nature of the firm, but fell out of favor in later work. We encourage a return to the emphasis on teams, but argue that the idea of teams as central to the nature of the firm needs to be grounded in an appreciation of the importance...... of We frames and group agency. We use converging insights from evolutionary anthropology, cognitive social psychology and work on team agency to develop such a grounding, and link it to the issues of the existence and boundaries of firms....

  8. Team-based global organizations

    DEFF Research Database (Denmark)

    Zander, Lena; Butler, Christina; Mockaitis, Audra


    of challenges and opportunities of future global organizing as being team-based, we presented new advancements in the study of global teams, leadership, process and outcomes divided into four themes. Two specifically address processes in global teams: 1) the benefits of openness towards linguistic and value......This chapter draws on a panel discussion of the future of global organizing as a team-based organization at EIBA 2014 in Uppsala, Sweden. We began by discussing contemporary developments of hybrid forms of hierarchy and teams-based organizing, but we venture to propose that as organizations become...... characterized by decreased importance of hierarchal structures, more fluidity across borders, even a possible dissolution of firm boundaries, we move towards team-based organizing as an alternative to more traditional forms of hierarchical-based organizing in global firms. To provide input for a discussion...

  9. Basketball Teams as Strategic Networks


    Jennifer H. Fewell; Dieter Armbruster; John Ingraham; Alexander Petersen; James S Waters


    We asked how team dynamics can be captured in relation to function by considering games in the first round of the NBA 2010 play-offs as networks. Defining players as nodes and ball movements as links, we analyzed the network properties of degree centrality, clustering, entropy and flow centrality across teams and positions, to characterize the game from a network perspective and to determine whether we can assess differences in team offensive strategy by their network properties. The compiled...

  10. Roles in Innovative Software Teams

    DEFF Research Database (Denmark)

    Aaen, Ivan


    With inspiration from role-play and improvisational theater, we are developing a framework for innovation in software teams called Essence. Based on agile principles, Essence is designed for teams of developers and an onsite customer. This paper reports from teaching experiments inspired by design...... science, where we tried to assign differentiated roles to team members. The experiments provided valuable insights into the design of roles in Essence. These insights are used for redesigning how roles are described and conveyed in Essence....

  11. Activity Recognition for Agent Teams (United States)


    particle filters that can han- dle partial observability and deep behavior hierarchies better than exact inference meth- ods. Often the specialized...after, around). Jug et al. [50] used a similar framework for basketball analysis. These frameworks do not address the problem of dynamic team...critical need for (1) supporting human team members in accessing, filtering , and synthesizing information from disparate sources; (2) increasing team

  12. External Tank Liquid Hydrogen (LH2) Prepress Regression Analysis Independent Review Technical Consultation Report (United States)

    Parsons, Vickie s.


    The request to conduct an independent review of regression models, developed for determining the expected Launch Commit Criteria (LCC) External Tank (ET)-04 cycle count for the Space Shuttle ET tanking process, was submitted to the NASA Engineering and Safety Center NESC on September 20, 2005. The NESC team performed an independent review of regression models documented in Prepress Regression Analysis, Tom Clark and Angela Krenn, 10/27/05. This consultation consisted of a peer review by statistical experts of the proposed regression models provided in the Prepress Regression Analysis. This document is the consultation's final report.

  13. The organizational neurodynamics of teams. (United States)

    Stevens, Ronald; Gorman, Jamie C; Amazeen, Polemnia; Likens, Aaron; Galloway, Trysha


    Our objective was to apply ideas from complexity theory to derive expanded neurodynamic models of Submarine Piloting and Navigation showing how teams cognitively organize around task changes. The cognitive metric highlighted was an electroencephalography-derived measure of engagement (termed neurophysiologic synchronies of engagement) that was modeled into collective team variables showing the engagement of each of six team members as well as that of the team as a whole. We modeled the cognitive organization of teams using the information content of the neurophysiologic data streams derived from calculations of their Shannon entropy. We show that the periods of team cognitive reorganization (a) occurred as a natural product of teamwork particularly around periods of stress, (b) appeared structured around episodes of communication, (c) occurred following deliberate external perturbation to team function, and (d) were less frequent in experienced navigation teams. These periods of reorganization were lengthy, lasting up to 10 minutes. As the overall entropy levels of the neurophysiologic data stream are significantly higher for expert teams, this measure may be a useful candidate for modeling teamwork and its development over prolonged periods of training.

  14. Commodity Team Motivation and Performance

    DEFF Research Database (Denmark)

    Englyst, Linda; Jørgensen, Frances; Johansen, John


    In this article, an in-depth single case study is presented in order to explore and discuss the functioning of commodity teams in a global sourcing context. Specifically, the study aimed at identifying factors that may influence team members' motivation to participate in activities that create...... opportunities for synergy and coordination of purchasing. In the teams studied, motivation appeared to be influenced to some degree by a number of factors, including rewards, leadership behaviours, goal setting, and the career goals of the commodity team members. In some cases, inconsistencies between...

  15. Commodity team motivation and performance

    DEFF Research Database (Denmark)

    Englyst, Linda; Jørgensen, Frances; Johansen, John


    In this article, an in-depth single case study is presented in order to explore and discuss the functioning of commodity teams in a global sourcing context. Specifically, the study aimed at identifying factors that may influence team members' motivation to participate in activities that create...... opportunities for synergy and coordination of purchasing. In the teams studied, motivation appeared to be influenced to some degree by a number of factors, including rewards, leadership behaviours, goal setting, and the career goals of the commodity team members. In some cases, inconsistencies between...

  16. Developing an Effective Board-Administrative Team. (United States)

    Martin, David B.

    It is beneficial to identify three administrative teams through linking pins: the principal is the linking pin between the instructional team and the administrative team; the superintendent is the linking pin between the administrative team and the policy team, which includes the board of education; the administrative team consisting of all…

  17. Inferential Models for Linear Regression

    Directory of Open Access Journals (Sweden)

    Zuoyi Zhang


    Full Text Available Linear regression is arguably one of the most widely used statistical methods in applications.  However, important problems, especially variable selection, remain a challenge for classical modes of inference.  This paper develops a recently proposed framework of inferential models (IMs in the linear regression context.  In general, an IM is able to produce meaningful probabilistic summaries of the statistical evidence for and against assertions about the unknown parameter of interest and, moreover, these summaries are shown to be properly calibrated in a frequentist sense.  Here we demonstrate, using simple examples, that the IM framework is promising for linear regression analysis --- including model checking, variable selection, and prediction --- and for uncertain inference in general.

  18. An empirical study using permutation-based resampling in meta-regression (United States)


    Background In meta-regression, as the number of trials in the analyses decreases, the risk of false positives or false negatives increases. This is partly due to the assumption of normality that may not hold in small samples. Creation of a distribution from the observed trials using permutation methods to calculate P values may allow for less spurious findings. Permutation has not been empirically tested in meta-regression. The objective of this study was to perform an empirical investigation to explore the differences in results for meta-analyses on a small number of trials using standard large sample approaches verses permutation-based methods for meta-regression. Methods We isolated a sample of randomized controlled clinical trials (RCTs) for interventions that have a small number of trials (herbal medicine trials). Trials were then grouped by herbal species and condition and assessed for methodological quality using the Jadad scale, and data were extracted for each outcome. Finally, we performed meta-analyses on the primary outcome of each group of trials and meta-regression for methodological quality subgroups within each meta-analysis. We used large sample methods and permutation methods in our meta-regression modeling. We then compared final models and final P values between methods. Results We collected 110 trials across 5 intervention/outcome pairings and 5 to 10 trials per covariate. When applying large sample methods and permutation-based methods in our backwards stepwise regression the covariates in the final models were identical in all cases. The P values for the covariates in the final model were larger in 78% (7/9) of the cases for permutation and identical for 22% (2/9) of the cases. Conclusions We present empirical evidence that permutation-based resampling may not change final models when using backwards stepwise regression, but may increase P values in meta-regression of multiple covariates for relatively small amount of trials. PMID:22587815

  19. A Matlab program for stepwise regression

    Directory of Open Access Journals (Sweden)

    Yanhong Qi


    Full Text Available The stepwise linear regression is a multi-variable regression for identifying statistically significant variables in the linear regression equation. In present study, we presented the Matlab program of stepwise regression.

  20. Logistic regression for circular data (United States)

    Al-Daffaie, Kadhem; Khan, Shahjahan


    This paper considers the relationship between a binary response and a circular predictor. It develops the logistic regression model by employing the linear-circular regression approach. The maximum likelihood method is used to estimate the parameters. The Newton-Raphson numerical method is used to find the estimated values of the parameters. A data set from weather records of Toowoomba city is analysed by the proposed methods. Moreover, a simulation study is considered. The R software is used for all computations and simulations.

  1. Quasi-least squares regression

    CERN Document Server

    Shults, Justine


    Drawing on the authors' substantial expertise in modeling longitudinal and clustered data, Quasi-Least Squares Regression provides a thorough treatment of quasi-least squares (QLS) regression-a computational approach for the estimation of correlation parameters within the framework of generalized estimating equations (GEEs). The authors present a detailed evaluation of QLS methodology, demonstrating the advantages of QLS in comparison with alternative methods. They describe how QLS can be used to extend the application of the traditional GEE approach to the analysis of unequally spaced longitu

  2. The impact of team and work characteristics on team functioning

    NARCIS (Netherlands)

    Molleman, E.; Slomp, J.


    In this article, the authors seek to strengthen the theoretical foundation of team and cell formation through the inclusion of human factors. They distinguish three types of team characteristics: global, shared, and compositional attributes. In this last category, they also deal with diversity in

  3. Leadership for Team Learning: The Case of University Teacher Teams (United States)

    Koeslag-Kreunen, Mieke G. M.; Van der Klink, Marcel R.; Van den Bossche, Piet; Gijselaers, Wim H.


    Teacher team involvement is considered a key factor in achieving sustainable innovation in higher education. This requires engaging in team learning behaviors that should result in new knowledge and solutions. However, university teachers are not used to discussing their work practices with one another and tend to neglect any innovation in their…

  4. Improving Team Performance: Proceedings of the Rand Team Performance Workshop. (United States)


    interaction as one promising area. For example, sexually , racially, or ethnically mixed teams may experience 86 i&: " 87 unique team problems, especially...Naval Research Arlinqton VA 22217 61 Chief of Naval Education and Traininq (N-5) ACOS Research & Proqram Development Naval Air Station Pensacola FL

  5. Effects of transformational and shared leadership styles on employees' perception of team effectiveness

    National Research Council Canada - National Science Library

    Kang, Seung-Wan; Kim, Kihwan; Choi, Suk Bong


    Using 3 sets of multiple regression models, we examined the effectiveness of transformational and shared leadership styles in relation to team effectiveness, based on the perceptions of 424 employees...

  6. Biplots in Reduced-Rank Regression

    NARCIS (Netherlands)

    Braak, ter C.J.F.; Looman, C.W.N.


    Regression problems with a number of related response variables are typically analyzed by separate multiple regressions. This paper shows how these regressions can be visualized jointly in a biplot based on reduced-rank regression. Reduced-rank regression combines multiple regression and principal

  7. Evaluation of Development Programs: Randomized Controlled Trials or Regressions?

    NARCIS (Netherlands)

    Elbers, C.T.M.; Gunning, J.W.


    Can project evaluation methods be used to evaluate programs: complex interventions involving multiple activities? A program evaluation cannot be based simply on separate evaluations of its components if interactions between the activities are important. In this paper a measure is proposed, the total

  8. Linear and logistic regression analysis

    NARCIS (Netherlands)

    Tripepi, G.; Jager, K. J.; Dekker, F. W.; Zoccali, C.


    In previous articles of this series, we focused on relative risks and odds ratios as measures of effect to assess the relationship between exposure to risk factors and clinical outcomes and on control for confounding. In randomized clinical trials, the random allocation of patients is hoped to

  9. Growth Regression and Economic Theory

    NARCIS (Netherlands)

    Elbers, Chris; Gunning, Jan Willem


    In this note we show that the standard, loglinear growth regression specificationis consistent with one and only one model in the class of stochastic Ramsey models. Thismodel is highly restrictive: it requires a Cobb-Douglas technology and a 100% depreciationrate and it implies that risk does not

  10. Regression of lumbar disk herniation

    Directory of Open Access Journals (Sweden)

    G. Yu Evzikov


    Full Text Available Compression of the spinal nerve root, giving rise to pain and sensory and motor disorders in the area of its innervation is the most vivid manifestation of herniated intervertebral disk. Different treatment modalities, including neurosurgery, for evolving these conditions are discussed. There has been recent evidence that spontaneous regression of disk herniation can regress. The paper describes a female patient with large lateralized disc extrusion that has caused compression of the nerve root S1, leading to obvious myotonic and radicular syndrome. Magnetic resonance imaging has shown that the clinical manifestations of discogenic radiculopathy, as well myotonic syndrome and morphological changes completely regressed 8 months later. The likely mechanism is inflammation-induced resorption of a large herniated disk fragment, which agrees with the data available in the literature. A decision to perform neurosurgery for which the patient had indications was made during her first consultation. After regression of discogenic radiculopathy, there was only moderate pain caused by musculoskeletal diseases (facet syndrome, piriformis syndrome that were successfully eliminated by minimally invasive techniques. 

  11. Claim reserving with fuzzy regression


    Bahrami, Tahereh; BAHRAMI, Masuod


    Abstract. Claims reserving plays a key role for the insurance. Therefore, various statistical methods are used to provide for an adequate amount of claim reserves. Since claim reserves are always variable, fuzzy set theory is used to handle this variability. In this paper, non-symmetric fuzzy regression is integrated in the Taylor’s method to develop a new method for claim reserving.

  12. Multimodality in GARCH regression models

    NARCIS (Netherlands)

    Ooms, M.; Doornik, J.A.


    It is shown empirically that mixed autoregressive moving average regression models with generalized autoregressive conditional heteroskedasticity (Reg-ARMA-GARCH models) can have multimodality in the likelihood that is caused by a dummy variable in the conditional mean. Maximum likelihood estimates

  13. Fungible Weights in Multiple Regression (United States)

    Waller, Niels G.


    Every set of alternate weights (i.e., nonleast squares weights) in a multiple regression analysis with three or more predictors is associated with an infinite class of weights. All members of a given class can be deemed "fungible" because they yield identical "SSE" (sum of squared errors) and R[superscript 2] values. Equations for generating…

  14. On Weighted Support Vector Regression

    DEFF Research Database (Denmark)

    Han, Xixuan; Clemmensen, Line Katrine Harder


    We propose a new type of weighted support vector regression (SVR), motivated by modeling local dependencies in time and space in prediction of house prices. The classic weights of the weighted SVR are added to the slack variables in the objective function (OF‐weights). This procedure directly...


    African Journals Online (AJOL)



    Dec 12, 2008 ... GLOBAL JOURNAL OF MATHEMATICAL SCIENCES VOL. ... INTRODUCTION. For some dichotomous variables, the response y is actually a proxy for a variable that is continuous (Newsom, 2005). A regression ... M. E. Nja, Dept. of Mathematics / Statistics Cross River University of Technology, Calabar ...

  16. Ridge Regression for Interactive Models. (United States)

    Tate, Richard L.


    An exploratory study of the value of ridge regression for interactive models is reported. Assuming that the linear terms in a simple interactive model are centered to eliminate non-essential multicollinearity, a variety of common models, representing both ordinal and disordinal interactions, are shown to have "orientations" that are…

  17. Logistic regression: a brief primer. (United States)

    Stoltzfus, Jill C


    Regression techniques are versatile in their application to medical research because they can measure associations, predict outcomes, and control for confounding variable effects. As one such technique, logistic regression is an efficient and powerful way to analyze the effect of a group of independent variables on a binary outcome by quantifying each independent variable's unique contribution. Using components of linear regression reflected in the logit scale, logistic regression iteratively identifies the strongest linear combination of variables with the greatest probability of detecting the observed outcome. Important considerations when conducting logistic regression include selecting independent variables, ensuring that relevant assumptions are met, and choosing an appropriate model building strategy. For independent variable selection, one should be guided by such factors as accepted theory, previous empirical investigations, clinical considerations, and univariate statistical analyses, with acknowledgement of potential confounding variables that should be accounted for. Basic assumptions that must be met for logistic regression include independence of errors, linearity in the logit for continuous variables, absence of multicollinearity, and lack of strongly influential outliers. Additionally, there should be an adequate number of events per independent variable to avoid an overfit model, with commonly recommended minimum "rules of thumb" ranging from 10 to 20 events per covariate. Regarding model building strategies, the three general types are direct/standard, sequential/hierarchical, and stepwise/statistical, with each having a different emphasis and purpose. Before reaching definitive conclusions from the results of any of these methods, one should formally quantify the model's internal validity (i.e., replicability within the same data set) and external validity (i.e., generalizability beyond the current sample). The resulting logistic regression model

  18. Hierarchical Adaptive Regression Kernels for Regression with Functional Predictors. (United States)

    Woodard, Dawn B; Crainiceanu, Ciprian; Ruppert, David


    We propose a new method for regression using a parsimonious and scientifically interpretable representation of functional predictors. Our approach is designed for data that exhibit features such as spikes, dips, and plateaus whose frequency, location, size, and shape varies stochastically across subjects. We propose Bayesian inference of the joint functional and exposure models, and give a method for efficient computation. We contrast our approach with existing state-of-the-art methods for regression with functional predictors, and show that our method is more effective and efficient for data that include features occurring at varying locations. We apply our methodology to a large and complex dataset from the Sleep Heart Health Study, to quantify the association between sleep characteristics and health outcomes. Software and technical appendices are provided in online supplemental materials.

  19. Hierarchical Adaptive Regression Kernels for Regression with Functional Predictors


    Woodard, Dawn B.; Crainiceanu, Ciprian; Ruppert, David


    We propose a new method for regression using a parsimonious and scientifically interpretable representation of functional predictors. Our approach is designed for data that exhibit features such as spikes, dips, and plateaus whose frequency, location, size, and shape varies stochastically across subjects. We propose Bayesian inference of the joint functional and exposure models, and give a method for efficient computation. We contrast our approach with existing state-of-the-art methods for re...

  20. Commodity Team Motivation and Performance

    DEFF Research Database (Denmark)

    Englyst, Linda; Jørgensen, Frances; Johansen, John


    system which was intended to support collective team effort, yet enhanced conflicts of interest in the matrix structure, discuss leadership, goal alignment and career tracks, and debate when and whether a team structure is appropriate in the pursuit of corporate purchasing synergies. The article is based...... on an in-depth case study in a multinational industrial company....

  1. Implementing the Change Team Concept. (United States)

    Coughlan, Robert J.; Zaltman, Gerald

    This paper focuses on variables to be considered in implementing the team approach to planned change in educational organizations. The first part deals with team considerations -- recruitment and selection, composition, training, and future roles of members in the client system. The second section presents various strategies and tactics for…

  2. Virtual Teams and Knowledge Communication

    DEFF Research Database (Denmark)

    Lehtonen, Miikka; Kampf, Constance Elizabeth


    How does culture affect virtual teams and the knowledge communication processes in which they engage? As virtual spaces are increasingly used to support teams and establish collaboration in cross-cultural projects, the notion of cross-cultural communication can be understood as shifting from...

  3. The Virtual Intercultural Team Tool (United States)

    Rus, Calin


    This article describes the Virtual Intercultural Team Tool (VITT) and discusses its processes and benefits. VIIT is a virtual platform designed with the aim of assisting European project teams to improve intercultural communication and build on their cultural diversity for effective implementation of their projects. It is a process-focused tool,…

  4. Data Teams for School Improvement (United States)

    Schildkamp, Kim; Poortman, Cindy L.; Handelzalts, Adam


    The use of data for educational decision making has never been more prevalent. However, teachers and school leaders need support in data use. Support can be provided by means of professional development in the form of "data teams". This study followed the functioning of 4 data teams over a period of 2 years, applying a qualitative case…

  5. ELI-NP Science Team

    Indian Academy of Sciences (India)

    Home; Journals; Pramana – Journal of Physics. ELI-NP Science Team. Articles written in Pramana – Journal of Physics. Volume 83 Issue 5 November 2014 pp 713-718. Physics studies with brilliant narrow-width -beams at the new ELI-NP Facility · Dimiter L Balabanski ELI-NP Science Team · More Details Abstract Fulltext ...

  6. Team Performance in the Army Acquisition Program Office (United States)


    and the installation organizacional structure. In addition, it combines the advantages of pure functional structure and the product organizational...teams, teams of psychological counselors, marketing teams, training teams, support/administrative teams, purchasing teams, a retail store team

  7. Diversity Management in Global Teams

    DEFF Research Database (Denmark)

    Clausen, Lisbeth


    This study is based on in-depth interviews in a successful diverse team in a Japanese subsidiary of an American multinational corporation. While this study exemplifies both processes of homogenization and diversification in global team communication, the focus is an investigation of global......, national, organization, professional and individual influences on team collaboration. It answers the following questions: what are the alignments of corporate diversity strategies in different national contexts (here US and Japan) –between headquarter and subsidiary? How are corporate strategies...... implemented in the local organization? How are organizational culture, vision and images aligned with the team processes to accomplish the task? Does professional (functional) expertise influence team collaboration and finally how do individual experiences and coping strategies matter? The US and Japan...

  8. Multidisciplinary team care in rehabilitation

    DEFF Research Database (Denmark)

    Momsen, Anne-Mette; Rasmussen, Jens Ole; Nielsen, Claus Vinther


    Objectives: To systematically investigate current scientific evidence about the effectiveness of multidisciplinary team rehabilitation for different health problems. Data sources: A comprehensive literature search was conducted in Cochrane, Medline, DARE, Embase, and Cinahl databases, and research...... from existing systematic reviews was critically appraised and summarized. Study selection: Using the search terms "rehabilitation", "multidisciplinary teams" or "team care", references were identified for existing studies published after 2000 that examined multidisciplinary rehabilitation team care......, interventions, and findings. Data synthesis: A total of 14 reviews were included to summarize the findings of 12 different study populations. Evidence was found to support improved functioning following multidisciplinary rehabilitation team care for 10 of 12 different study population: elderly people, elderly...

  9. Active set support vector regression. (United States)

    Musicant, David R; Feinberg, Alexander


    This paper presents active set support vector regression (ASVR), a new active set strategy to solve a straightforward reformulation of the standard support vector regression problem. This new algorithm is based on the successful ASVM algorithm for classification problems, and consists of solving a finite number of linear equations with a typically large dimensionality equal to the number of points to be approximated. However, by making use of the Sherman-Morrison-Woodbury formula, a much smaller matrix of the order of the original input space is inverted at each step. The algorithm requires no specialized quadratic or linear programming code, but merely a linear equation solver which is publicly available. ASVR is extremely fast, produces comparable generalization error to other popular algorithms, and is available on the web for download.


    Directory of Open Access Journals (Sweden)

    L. Yu. Glukhova


    Full Text Available The author represents the review of current scientific literature devoted to autistic epileptiform regression — the special form of autistic disorder, characterized by development of severe communicative disorders in children as a result of continuous prolonged epileptiform activity on EEG. This condition has been described by R.F. Tuchman and I. Rapin in 1997. The author describes the aspects of pathogenesis, clinical pictures and diagnostics of this disorder, including the peculiar anomalies on EEG (benign epileptiform patterns of childhood, with a high index of epileptiform activity, especially in the sleep. The especial attention is given to approaches to the treatment of autistic epileptiform regression. Efficacy of valproates, corticosteroid hormones and antiepileptic drugs of other groups is considered.

  11. Binary data regression: Weibull distribution (United States)

    Caron, Renault; Polpo, Adriano


    The problem of estimation in binary response data has receivied a great number of alternative statistical solutions. Generalized linear models allow for a wide range of statistical models for regression data. The most used model is the logistic regression, see Hosmer et al. [6]. However, as Chen et al. [5] mentions, when the probability of a given binary response approaches 0 at a different rate than it approaches 1, symmetric linkages are inappropriate. A class of models based on Weibull distribution indexed by three parameters is introduced here. Maximum likelihood methods are employed to estimate the parameters. The objective of the present paper is to show a solution for the estimation problem under the Weibull model. An example showing the quality of the model is illustrated by comparing it with the alternative probit and logit models.

  12. Spontaneous regression of colon cancer. (United States)

    Kihara, Kyoichi; Fujita, Shin; Ohshiro, Taihei; Yamamoto, Seiichiro; Sekine, Shigeki


    A case of spontaneous regression of transverse colon cancer is reported. A 64-year-old man was diagnosed as having cancer of the transverse colon at a local hospital. Initial and second colonoscopy examinations revealed a typical cancer of the transverse colon, which was diagnosed as moderately differentiated adenocarcinoma. The patient underwent right hemicolectomy 6 weeks after the initial colonoscopy. The resected specimen showed only a scar at the tumor site, and no cancerous tissue was proven histologically. The patient is alive with no evidence of recurrence 1 year after surgery. Although an antitumor immune response is the most likely explanation, the exact nature of the phenomenon was unclear. We describe this rare case and review the literature pertaining to spontaneous regression of colorectal cancer. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email:

  13. Polynomial Regressions and Nonsense Inference

    Directory of Open Access Journals (Sweden)

    Daniel Ventosa-Santaulària


    Full Text Available Polynomial specifications are widely used, not only in applied economics, but also in epidemiology, physics, political analysis and psychology, just to mention a few examples. In many cases, the data employed to estimate such specifications are time series that may exhibit stochastic nonstationary behavior. We extend Phillips’ results (Phillips, P. Understanding spurious regressions in econometrics. J. Econom. 1986, 33, 311–340. by proving that an inference drawn from polynomial specifications, under stochastic nonstationarity, is misleading unless the variables cointegrate. We use a generalized polynomial specification as a vehicle to study its asymptotic and finite-sample properties. Our results, therefore, lead to a call to be cautious whenever practitioners estimate polynomial regressions.

  14. Quantile Regression With Measurement Error

    KAUST Repository

    Wei, Ying


    Regression quantiles can be substantially biased when the covariates are measured with error. In this paper we propose a new method that produces consistent linear quantile estimation in the presence of covariate measurement error. The method corrects the measurement error induced bias by constructing joint estimating equations that simultaneously hold for all the quantile levels. An iterative EM-type estimation algorithm to obtain the solutions to such joint estimation equations is provided. The finite sample performance of the proposed method is investigated in a simulation study, and compared to the standard regression calibration approach. Finally, we apply our methodology to part of the National Collaborative Perinatal Project growth data, a longitudinal study with an unusual measurement error structure. © 2009 American Statistical Association.

  15. Directional quantile regression in R

    Czech Academy of Sciences Publication Activity Database

    Boček, Pavel; Šiman, Miroslav


    Roč. 53, č. 3 (2017), s. 480-492 ISSN 0023-5954 R&D Projects: GA ČR GA14-07234S Institutional support: RVO:67985556 Keywords : multivariate quantile * regression quantile * halfspace depth * depth contour Subject RIV: BD - Theory of Information Impact factor: 0.379, year: 2016 http:// library

  16. Harnessing members' positive mood for team-directed learning behaviour and team innovation : The moderating role of perceived team feedback

    NARCIS (Netherlands)

    Walter, Frank; van der Vegt, Gerben S.


    This study examines the role of individual team members' positive mood and perceived team feedback for their team-directed learning behaviour. Results obtained in a sample of 186 members from 27 work teams showed that positive mood was positively associated with team-directed learning behaviour if


    Huang, Yijian


    Quantile regression has been advocated in survival analysis to assess evolving covariate effects. However, challenges arise when the censoring time is not always observed and may be covariate-dependent, particularly in the presence of continuously-distributed covariates. In spite of several recent advances, existing methods either involve algorithmic complications or impose a probability grid. The former leads to difficulties in the implementation and asymptotics, whereas the latter introduces undesirable grid dependence. To resolve these issues, we develop fundamental and general quantile calculus on cumulative probability scale in this article, upon recognizing that probability and time scales do not always have a one-to-one mapping given a survival distribution. These results give rise to a novel estimation procedure for censored quantile regression, based on estimating integral equations. A numerically reliable and efficient Progressive Localized Minimization (PLMIN) algorithm is proposed for the computation. This procedure reduces exactly to the Kaplan-Meier method in the k-sample problem, and to standard uncensored quantile regression in the absence of censoring. Under regularity conditions, the proposed quantile coefficient estimator is uniformly consistent and converges weakly to a Gaussian process. Simulations show good statistical and algorithmic performance. The proposal is illustrated in the application to a clinical study.

  18. Gaussian Process Regression Model in Spatial Logistic Regression (United States)

    Sofro, A.; Oktaviarina, A.


    Spatial analysis has developed very quickly in the last decade. One of the favorite approaches is based on the neighbourhood of the region. Unfortunately, there are some limitations such as difficulty in prediction. Therefore, we offer Gaussian process regression (GPR) to accommodate the issue. In this paper, we will focus on spatial modeling with GPR for binomial data with logit link function. The performance of the model will be investigated. We will discuss the inference of how to estimate the parameters and hyper-parameters and to predict as well. Furthermore, simulation studies will be explained in the last section.

  19. A process evaluation of PRONTO simulation training for obstetric and neonatal emergency response teams in Guatemala. (United States)

    Walker, Dilys M; Holme, Francesca; Zelek, Sarah T; Olvera-García, Marisela; Montoya-Rodríguez, Airaín; Fritz, Jimena; Fahey, Jenifer; Lamadrid-Figueroa, Héctor; Cohen, Susanna; Kestler, Edgar


    Despite expanding access to institutional birth in Guatemala, maternal mortality remains largely unchanged over the last ten years. Enhancing the quality of emergency obstetric and neonatal care is one important strategy to decrease mortality. An innovative, low-tech, simulation-based team training program (PRONTO) aims to optimize care provided during obstetric and neonatal emergencies in low-resource settings. We conducted PRONTO simulation training between July 2012 and December 2012 in 15 clinics in Alta Verapaz, Huehuetenango, San Marcos, and Quiche, Guatemala. These clinics received PRONTO as part of a larger pair-matched cluster randomized trial of a comprehensive intervention package. Training participants were obstetric and neonatal care providers that completed pre- and post- training assessments for the two PRONTO training modules, which evaluated knowledge of evidence-based practice and self-efficacy in obstetric and neonatal topics. Part of the training included a session for trained teams to establish strategic goals to improve clinical practice. We utilized a pre/post-test design to evaluate the impact of the course on both knowledge and self-efficacy with longitudinal fixed effects linear regression with robust standard errors. Pearson correlation coefficients were used to assess the correlation between knowledge and self-efficacy. Poisson regression was used to assess the association between the number of goals achieved and knowledge, self-efficacy, and identified facility-level factors. Knowledge and self-efficacy scores improved significantly in all areas of teaching. Scores were correlated for all topics overall at training completion. More than 60 % of goals set to improve clinic functioning and emergency care were achieved. No predictors of goal achievement were identified. PRONTO training is effective at improving provider knowledge and self-efficacy in training areas. Further research is needed to evaluate the impact of the training on

  20. Teaching Engineering Students Team Work (United States)

    Levi, Daniel


    The purpose of this manual is to provide professor's in engineering classes which the background necessary to use student team projects effectively. This manual describes some of the characteristics of student teams and how to use them in class. It provides a set of class activities and films which can be used to introduce and support student teams. Finally, a set of teaching modules used in freshmen, sophomore, and senior aeronautical engineering classes are presented. This manual was developed as part of a NASA sponsored project to improve the undergraduate education of aeronautical engineers. The project has helped to purchase a set of team work films which can be checked out from Cal Poly's Learning Resources Center in the Kennedy Library. Research for this project has included literature reviews on team work and cooperative learning; interviews, observations, and surveys of Cal Poly students from Industrial and Manufacturing Engineering, Aeronautical Engineering and Psychology; participation in the Aeronautical Engineering senior design lab; and interviews with engineering faculty. In addition to this faculty manual, there is a student team work manual which has been designed to help engineering students work better in teams.

  1. Making a team of experts into an expert team. (United States)

    Charney, Carol


    Health care has traditionally been delivered primarily by experts working individually in a decentralized system lacking cohesive organization among professional disciplines. Only recently have the advantages of teamwork training been acknowledged in health care. This article explores the history, benefits, and recommendations for team training in neonatal care. TeamSTEPPS (Rockville, MD) and the revised Neonatal Resuscitation Program are cited as promising models for improved neonatal outcomes through professional teamwork.

  2. Leading a Virtual Intercultural Team. Implications for Virtual Team Leaders


    Chutnik, Monika; Grzesik, Katarzyna


    Increasing number of companies operate in the setup of teams whose members are geographically scattered and have different cultural origins. They work through access to the same digital network and communicate by means of modern technology. Sometimes they are located in different time zones and have never met each other face to face. This is the age of a virtual team leader. Virtual leadership in intercultural groups requires special skills from leaders. Many of these reflect leadership s...

  3. Team networking in palliative care

    Directory of Open Access Journals (Sweden)

    Odette Spruyt


    Full Text Available "If you want to travel quickly, go alone. But if you want to travel far, you must go together". African proverb. The delivery of palliative care is often complex and always involves a group of people, the team, gathered around the patient and those who are close to them. Effective communication and functional responsive systems of care are essential if palliative care is to be delivered in a timely and competent way. Creating and fostering an effective team is one of the greatest challenges for providers of palliative care. Teams are organic and can be life giving or life sapping for their members.

  4. Surgeons' Leadership Styles and Team Behavior in the Operating Room (United States)

    Hu, Yue-Yung; Parker, Sarah Henrickson; Lipsitz, Stuart R; Arriaga, Alexander F; Peyre, Sarah E; Corso, Katherine A; Roth, Emilie M; Yule, Steven J; Greenberg, Caprice C


    Background The importance of leadership is recognized in surgery, but the specific impact of leadership style on team behavior is not well understood. In other industries, leadership is a well-characterized construct. One dominant theory proposes that transactional (task-focused) leaders achieve minimum standards, whereas transformational (team-oriented) leaders inspire performance beyond expectations. Study Design We video-recorded 5 surgeons performing complex operations. Each surgeon was scored on the Multifactor Leadership Questionnaire, a validated method for scoring transformational and transactional leadership style, by an organizational psychologist and a surgeon-researcher. Independent coders assessed surgeons' leadership behaviors according to the Surgical Leadership Inventory and team behaviors (information-sharing, cooperative, and voice behaviors). All coders were blinded. Leadership style (MLQ) was correlated with surgeon behavior (SLI) and team behavior using Poisson regression, controlling for time and the total number of behaviors, respectively. Results All surgeons scored similarly on transactional leadership (2.38-2.69), but varied more widely on transformational leadership (1.98-3.60). Each 1-point increase in transformational score corresponded to 3× more information-sharing behaviors (pleadership and its impact on team performance in the OR. As in other fields, our data suggest that transformational leadership is associated with improved team behavior. Surgeon leadership development therefore has the potential to improve the efficiency and safety of operative care. PMID:26481409

  5. Surgeons' Leadership Styles and Team Behavior in the Operating Room. (United States)

    Hu, Yue-Yung; Parker, Sarah Henrickson; Lipsitz, Stuart R; Arriaga, Alexander F; Peyre, Sarah E; Corso, Katherine A; Roth, Emilie M; Yule, Steven J; Greenberg, Caprice C


    The importance of leadership is recognized in surgery, but the specific impact of leadership style on team behavior is not well understood. In other industries, leadership is a well-characterized construct. One dominant theory proposes that transactional (task-focused) leaders achieve minimum standards and transformational (team-oriented) leaders inspire performance beyond expectations. We videorecorded 5 surgeons performing complex operations. Each surgeon was scored on the Multifactor Leadership Questionnaire, a validated method for scoring transformational and transactional leadership style, by an organizational psychologist and a surgeon researcher. Independent coders assessed surgeons' leadership behaviors according to the Surgical Leadership Inventory and team behaviors (information sharing, cooperative, and voice behaviors). All coders were blinded. Leadership style (Multifactor Leadership Questionnaire) was correlated with surgeon behavior (Surgical Leadership Inventory) and team behavior using Poisson regression, controlling for time and the total number of behaviors, respectively. All surgeons scored similarly on transactional leadership (range 2.38 to 2.69), but varied more widely on transformational leadership (range 1.98 to 3.60). Each 1-point increase in transformational score corresponded to 3 times more information-sharing behaviors (p leadership and its impact on team performance in the operating room. As in other fields, our data suggest that transformational leadership is associated with improved team behavior. Surgeon leadership development, therefore, has the potential to improve the efficiency and safety of operative care. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  6. Analyzing genotype-by-environment interaction using curvilinear regression

    Directory of Open Access Journals (Sweden)

    Dulce Gamito Santinhos Pereira


    Full Text Available In the context of multi-environment trials, where a series of experiments is conducted across different environmental conditions, the analysis of the structure of genotype-by-environment interaction is an important topic. This paper presents a generalization of the joint regression analysis for the cases where the response (e.g. yield is not linear across environments and can be written as a second (or higher order polynomial or another non-linear function. After identifying the common form regression function for all genotypes, we propose a selection procedure based on the adaptation of two tests: (i a test for parallelism of regression curves; and (ii a test of coincidence for those regressions. When the hypothesis of parallelism is rejected, subgroups of genotypes where the responses are parallel (or coincident should be identified. The use of the Scheffé multiple comparison method for regression coefficients in second-order polynomials allows to group the genotypes in two types of groups: one with upward-facing concavity (i.e. potential yield growth, and the other with downward-facing concavity (i.e. the yield approaches saturation. Theoretical results for genotype comparison and genotype selection are illustrated with an example of yield from a non-orthogonal series of experiments with winter rye (Secalecereale L.. We have deleted 10 % of that data at random to show that our meteorology is fully applicable to incomplete data sets, often observed in multi-environment trials.

  7. Team training in obstetric and neonatal emergencies using highly realistic simulation in Mexico: impact on process indicators. (United States)

    Walker, Dilys; Cohen, Susanna; Fritz, Jimena; Olvera, Marisela; Lamadrid-Figueroa, Hector; Cowan, Jessica Greenberg; Hernandez, Dolores Gonzalez; Dettinger, Julia C; Fahey, Jenifer O


    Ineffective management of obstetric emergencies contributes significantly to maternal and neonatal morbidity and mortality in Mexico. PRONTO (Programa de Rescate Obstétrico y Neonatal: Tratamiento Óptimo y Oportuno) is a highly-realistic, low-tech simulation-based obstetric and neonatal emergency training program. A pair-matched hospital-based controlled implementation trial was undertaken in three states in Mexico, with pre/post measurement of process indicators at intervention hospitals. This report assesses the impact of PRONTO simulation training on process indicators from the pre/post study design for process indicators. Data was collected in twelve intervention facilities on process indicators, including pre/post changes in knowledge and self-efficacy of obstetric emergencies and neonatal resuscitation, achievement of strategic planning goals established during training and changes in teamwork scores. Authors performed a longitudinal fixed-effects linear regression model to estimate changes in knowledge and self-efficacy and logistic regression to assess goal achievement. A total of 450 professionals in interprofessional teams were trained. Significant increases in knowledge and self-efficacy were noted for both physicians and nurses (p <0.001- 0.009) in all domains. Teamwork scores improved and were maintained over a three month period. A mean of 58.8% strategic planning goals per team in each hospital were achieved. There was no association between high goal achievement and knowledge, self-efficacy, proportion of doctors or nurses in training, state, or teamwork score. These results suggest that PRONTO's highly realistic, locally appropriate simulation and team training in maternal and neonatal emergency care may be a promising avenue for optimizing emergency response and improving quality of facility-based obstetric and neonatal care in resource-limited settings. NCT01477554.

  8. Randomized comparison of conservative versus aggressive strategy for provisional side branch intervention in coronary bifurcation lesions: results from the SMART-STRATEGY (Smart Angioplasty Research Team-Optimal Strategy for Side Branch Intervention in Coronary Bifurcation Lesions) randomized trial. (United States)

    Song, Young Bin; Hahn, Joo-Yong; Song, Pil-Sang; Yang, Jeong Hoon; Choi, Jin-Ho; Choi, Seung-Hyuk; Lee, Sang Hoon; Gwon, Hyeon-Cheol


    The authors sought to compare conservative and aggressive strategies for provisional side branch (SB) intervention in coronary bifurcation lesions. The optimal provisional approach for coronary bifurcation lesions has not been established. In this prospective randomized trial, 258 patients with a coronary bifurcation lesion treated with drug-eluting stents were randomized to a conservative (n = 128) or aggressive (n = 130) SB intervention strategy. The criteria for SB intervention after main vessel stenting differed between the conservative and aggressive groups; Thrombolysis In Myocardial Infarction flow grade 75% for non-left main bifurcations and diameter stenosis >75% versus diameter stenosis >50% for left main bifurcations. The primary endpoint was target vessel failure (cardiac death, myocardial infarction, or target vessel revascularization) at 12 months. Left main bifurcation lesions were noted in 114 patients (44%) and true bifurcation lesions in 171 patients (66%). SB ballooning after main vessel stenting and SB stenting after SB ballooning were performed less frequently in the conservative group than in the aggressive group (25.8% vs. 68.5%, p strategy was associated with a lower incidence of procedure-related myocardial necrosis compared with the aggressive strategy (5.5% vs. 17.7%, p = 0.002). At 12 months, the incidence of target vessel failure was similar in both groups (9.4% in the conservative group vs. 9.2% in the aggressive group, p = 0.97). Compared with the aggressive strategy, the conservative strategy for provisional SB intervention was associated with similar long-term clinical outcomes and a lower incidence of procedure-related myocardial necrosis. (Optimal Strategy for Side Branch Stenting in Coronary Bifurcation Lesions [SMART-STRATEGY]; NCT00794014). Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  9. Producing The New Regressive Left

    DEFF Research Database (Denmark)

    Crone, Christine

    to be a committed artist, and how that translates into supporting al-Assad’s rule in Syria; the Ramadan programme Harrir Aqlak’s attempt to relaunch an intellectual renaissance and to promote religious pluralism; and finally, al-Mayadeen’s cooperation with the pan-Latin American TV station TeleSur and its ambitions...... becomes clear from the analytical chapters is the emergence of the new cross-ideological alliance of The New Regressive Left. This emerging coalition between Shia Muslims, religious minorities, parts of the Arab Left, secular cultural producers, and the remnants of the political,strategic resistance...

  10. An Evaluation of Ridge Regression. (United States)


    of the parameter estimates, is a decreasing function of k. The idea of ridge regression, as suggested by Hoerl and Kennard (Ref 12:58-63), is to pick...CROSS? 0 CR0553 f.812 CR0554 0 CR0555 4.39? CROSS6 0 ALSO 4.922 KSO 0 NVARSO 4. A5059 .622 CONTFNTS OF CASE NUlIPER 209 SEQHUI 209. SUOILE PEGANAL CASWGT...KSQ .000 NVARSO 9. RSOSO .846 CONTENTS OF CASE NUMBER 55 SEONUN 55. SUfTFILE PEGANAL CASWGI 2.0000 459 .970 RI 76600 K .025 NVA? 3. MSE .177 NS[IS

  11. Diving and Environmental Simulation Team (United States)

    Federal Laboratory Consortium — The Diving and Environmental Simulation Team focuses on ways to optimize the performance and safety of Navy divers. Our goal is to increase mission effectiveness by...

  12. Family, Team or Something Else?

    Directory of Open Access Journals (Sweden)

    John Murtha


    Full Text Available When referring to staff, is the term "family" or "team" most accurate? John Murtha explores the importance of setting a company's core value to create and maintain a positive culture, expectations, and support hiring practices.


    Directory of Open Access Journals (Sweden)

    Raluca C. ZOLTAN


    Full Text Available Today’s organization increasingly utilizes all kind of teams in order to surpass their competitors through flexibility, adaptability and innovation, features which are seen to characterize the teams. For this purpose, the concept of synergy in teams’ activity is often mentioned as the prime reason for which collective work is considered to be superior comparative with individual work. But what exactly does it mean? The present paper aims to shed some light on the concept of synergy in work teams and its positive effects, namely, the social consequences of collective work such as social compensation, social indispensability, social comparison, social identity, but also its negative effects, such as free-riding, social loafing and sucker effect. These are important group phenomena that managers should be aware of because they have a major impact on team performance, and consequently, on organization performance.

  14. Hydrogen Storage Technical Team Roadmap

    Energy Technology Data Exchange (ETDEWEB)



    The mission of the Hydrogen Storage Technical Team is to accelerate research and innovation that will lead to commercially viable hydrogen-storage technologies that meet the U.S. DRIVE Partnership goals.

  15. Fuel Cell Technical Team Roadmap

    Energy Technology Data Exchange (ETDEWEB)



    The Fuel Cell Technical Team promotes the development of a fuel cell power system for an automotive powertrain that meets the U.S. DRIVE Partnership (United States Driving Research and Innovation for Vehicle efficiency and Energy sustainability) goals.

  16. Valuing Gender Diversity in Teams

    DEFF Research Database (Denmark)

    Lauring, Jakob; Villeseche, Florence

    Team gender diversity has been much debated in many different contexts – not least since the search for a main effect of diversity on performance was launched. However, results have so far been inconclusive, and a number of scholars suggest that more attention should be directed at contextual...... factors which could influence the effect of gender diversity on team performance. In this study, we explore the effect of positive diversity attitudes and assess the degree of gender diversity where such group attitudes have greater impact. This is done by using a sample of 1085 leaders of academic...... research teams. Findings show that positive diversity attitude in the form of group openness to diversity is strongly associated with team performance. We also find a moderating effect of gender diversity meaning that the effect of openness to diversity is stronger when gender groups are more balanced...

  17. Personnel Turnover and Team Performance

    National Research Council Canada - National Science Library

    Levine, John M; Moreland, Richard L; Argote, Linda; Carley, Kathleen M


    ...) were employed. Experimental studies using the production task investigated how newcomers affect a team's transactive memory system--a shared mental model about how task competencies are distributed across members...

  18. Conducting HIV research in racial and ethnic minority communities: building a successful interdisciplinary research team. (United States)

    Polanco, Frinny R; Dominguez, Dinora C; Grady, Christine; Stoll, Pamela; Ramos, Catalina; Mican, Joann M; Miranda-Acevedo, Robert; Morgan, Marcela; Aizvera, Jeasmine; Purdie, Lori; Koziol, Deloris; Rivera-Goba, Migdalia V


    HIV infection occurs in disproportionately high rates among racial and ethnic minorities in the United States, making it imperative that individuals from these groups be included in research studies. However, it is often difficult to recruit HIV-infected Hispanics and African Americans in clinical trials, but a skilled interdisciplinary team that includes researchers with racial and ethnic diversity can help. This article describes a successful approach for building an interdisciplinary team that values the participation of racial and ethnic minorities in clinical trials and has the skills to work with these groups. The success of the Adelante (a Spanish word meaning forward) Team can be attributed to team members who actively participate in decision-making, are empowered, and function in a cohesive manner. Successful research teams build relationships with research participants to increase the probability that racial and ethnic minorities will enroll and participate fully in research. Published by Elsevier Inc.

  19. Team Effectiveness and Leadership Roles


    Duygulu, Ethem; Ciraklar, Nurcan


    In this study we aim to explain the patterns of leadership roles for team effectiveness in non economic organizations compared to economic organizations. For this purpose, we studied three successful organization types, i.e the amateur sports clubs (football, basketball), theater companies and, regional folk groups. Our basic hypothesis is that the relationship between the type of organization (specially teams) and the role of leadership is not random. Therefore, we believe that a...

  20. Review of child development teams.


    Zahir, M; Bennett, S


    Since the Court report was published in 1976 there has been a consensus that the needs of children with disabilities are best met by child development teams. This study explored the structure, facilities, and organisational elements of child development teams operating in the South East Thames region by means of a structured interview with senior professionals involved with organising services for children with disabilities in 14 of 15 health districts in the region. Although all districts ha...

  1. Varying-coefficient functional linear regression


    Wu, Yichao; Fan, Jianqing; Müller, Hans-Georg


    Functional linear regression analysis aims to model regression relations which include a functional predictor. The analog of the regression parameter vector or matrix in conventional multivariate or multiple-response linear regression models is a regression parameter function in one or two arguments. If, in addition, one has scalar predictors, as is often the case in applications to longitudinal studies, the question arises how to incorporate these into a functional regression model. We study...

  2. Leading the Team You Inherit. (United States)

    Watkins, Michael D


    Most leaders don't have the luxury of building their teams from scratch. Instead they're put in charge of an existing group, and they need guidance on the best way to take over and improve performance. Watkins, an expert on transitions, suggests a three-step approach: Assess. Act quickly to size up the personnel you've inherited, systematically gathering data from one-on-one chats, team meetings, and other sources. Reflect, too, on the business challenges you face, the kinds of people you want in various roles, and the degree to which they need to collaborate. Reshape. Adjust the makeup of the team by moving people to new positions, shifting their responsibilities, or replacing them. Make sure that everyone is aligned on goals and how to achieve them--you may need to change the team's stated direction. Consider also making changes in the way the team operates (reducing the frequency of meetings, for example, or creating new subteams). Then establish ground rules and processes to sustain desired behaviors, and revisit those periodically. Accelerate team development. Set your people up for some early wins. Initial successes will boost everyone's confidence and reinforce the value of your new operating model, thus paving the way for ongoing growth.

  3. Using Teams to Improve Outcomes and Performance. (United States)

    Ulrich, Beth; Crider, Nancy Manning


    Mastering the use of teams in healthcare organizations can maximize outcomes and optimize the use of resources. Most work in healthcare organizations is done by teams, whether it's the clinical team taking care of patients on a unit, the leadership team accountable for operations of the organization, or a team formed to solve a specific problem, improve quality, or plan an event. Effective teams make organizations successful; ineffective teams can create more problems than they solve. This article describes how to successfully use the power of teams within the healthcare setting, create and develop teams, be a team leader or member, create conditions for team effectiveness and high performance, and provide team training. Copyright© by the American Nephrology Nurses Association.


    National Research Council Canada - National Science Library

    Shlomit Azgad-Tromer


    .... Revisiting team production analysis, this Article redefines the corporate team and argues that while several constituencies indeed form part of the corporate team, others are exogenous to the corporate enterprise...

  5. Embracing transformational leadership: team values and the impact of leader behavior on team performance. (United States)

    Schaubroeck, John; Lam, Simon S K; Cha, Sandra E


    The authors investigated the relationship between transformational leadership behavior and group performance in 218 financial services teams that were branches of a bank in Hong Kong and the United States. Transformational leadership influenced team performance through the mediating effect of team potency. The effect of transformational leadership on team potency was moderated by team power distance and team collectivism, such that higher power distance teams and more collectivistic teams exhibited stronger positive effects of transformational leadership on team potency. The model was supported by data in both Hong Kong and the United States, which suggests a convergence in how teams function in the East and West and highlights the importance of team values.

  6. Promoting High-Quality Cancer Care and Equity Through Disciplinary Diversity in Team Composition. (United States)

    Parsons, Susan K; Fineberg, Iris C; Lin, Mingqian; Singer, Marybeth; Tang, May; Erban, John K


    Disciplinary diversity in team composition is a valuable vehicle for oncology care teams to provide high-quality, person-centered comprehensive care. Such diversity facilitates care that effectively addresses the complex needs (biologic, psychosocial, and spiritual) of the whole person. The concept of professional or disciplinary diversity centers on differences in function, education, and culture, reflecting variety and heterogeneity in the perspectives of team members contributing to care. Thorough understanding of the skills, knowledge, and education related to each team member's professional or lay expertise is critical for members to be able to optimize the team's potential. Furthermore, respect and appreciation for differences and similarities across disciplinary cultures allow team members to create a positive collaboration dynamic that maintains a focus on the care of the person with cancer. We present a case study of one oncology team's provision of care to the patient, a Chinese immigrant woman with breast cancer. The case illuminates the strengths and challenges of disciplinary diversity in team composition in assessing and addressing potential barriers to care. Coordinated sharing of information among the varied team members facilitated understanding and care planning focused on the patient's concerns, needs, and strengths. Importantly, collaboration across the disciplinarily diverse set of team members facilitated high-quality oncology care and promoted equity in access to the full range of care options, including enrollment on a National Cancer Institute-sponsored clinical trial. Further implications of disciplinary diversity in oncology care teams are considered for both clinical practice and research.

  7. Peer Effects in Team Sports: Empirical Evidence from NCAA Relay Teams


    Craig A. Depken, II; Lisa E. Haglund


    This paper investigates whether disparity in team member quality impacts team production using NCAA 4x400m relay teams. The net peer effects are estimated to have both an absolute and relative negative effect on the team performance. Because NCAA relay teams are comprised of unpaid amateurs, we utilize a direct measure of team-member quality rather than indirect measures such as wages. The evidence suggests that a greater disparity in team member quality reduces team performance, that is, it ...

  8. Automation of Flight Software Regression Testing (United States)

    Tashakkor, Scott B.


    NASA is developing the Space Launch System (SLS) to be a heavy lift launch vehicle supporting human and scientific exploration beyond earth orbit. SLS will have a common core stage, an upper stage, and different permutations of boosters and fairings to perform various crewed or cargo missions. Marshall Space Flight Center (MSFC) is writing the Flight Software (FSW) that will operate the SLS launch vehicle. The FSW is developed in an incremental manner based on "Agile" software techniques. As the FSW is incrementally developed, testing the functionality of the code needs to be performed continually to ensure that the integrity of the software is maintained. Manually testing the functionality on an ever-growing set of requirements and features is not an efficient solution and therefore needs to be done automatically to ensure testing is comprehensive. To support test automation, a framework for a regression test harness has been developed and used on SLS FSW. The test harness provides a modular design approach that can compile or read in the required information specified by the developer of the test. The modularity provides independence between groups of tests and the ability to add and remove tests without disturbing others. This provides the SLS FSW team a time saving feature that is essential to meeting SLS Program technical and programmatic requirements. During development of SLS FSW, this technique has proved to be a useful tool to ensure all requirements have been tested, and that desired functionality is maintained, as changes occur. It also provides a mechanism for developers to check functionality of the code that they have developed. With this system, automation of regression testing is accomplished through a scheduling tool and/or commit hooks. Key advantages of this test harness capability includes execution support for multiple independent test cases, the ability for developers to specify precisely what they are testing and how, the ability to add

  9. The bigger they are, the harder they fall: linking team power, team conflict, and performance

    NARCIS (Netherlands)

    Greer, L.L.; Caruso, H.M.; Jehn, K.A.


    Across two field studies, we investigate the impact of team power on team conflict and performance. Team power is based on the control of resources that enables a team to influence others in the company. We find across both studies that low-power teams outperform high-power teams. In both studies,

  10. Process Variables Critical for Team Effectiveness: A Delphi Study of Wraparound Team Members. (United States)

    Fleming, Janetta L.; Monda-Amaya, Lisa E.


    Wraparound team members (n=20) identified as teaming experts rated 109 items that support team effectiveness across six categories: team goals, member roles and membership, communication, cohesion, logistics, and outcomes. Items in the team outcomes, goals, and cohesion categories were ranked most critical to team effectiveness. (Contains…

  11. Enhancing the effectiveness of team science

    National Research Council Canada - National Science Library

    Cooke, Nancy J; Hilton, Margaret L


    ...." Scientific research is increasingly conducted by small teams and larger groups rather than individual investigators, but the challenges of collaboration can slow these teams' progress in achieving...

  12. Nonparametric Regression with Common Shocks

    Directory of Open Access Journals (Sweden)

    Eduardo A. Souza-Rodrigues


    Full Text Available This paper considers a nonparametric regression model for cross-sectional data in the presence of common shocks. Common shocks are allowed to be very general in nature; they do not need to be finite dimensional with a known (small number of factors. I investigate the properties of the Nadaraya-Watson kernel estimator and determine how general the common shocks can be while still obtaining meaningful kernel estimates. Restrictions on the common shocks are necessary because kernel estimators typically manipulate conditional densities, and conditional densities do not necessarily exist in the present case. By appealing to disintegration theory, I provide sufficient conditions for the existence of such conditional densities and show that the estimator converges in probability to the Kolmogorov conditional expectation given the sigma-field generated by the common shocks. I also establish the rate of convergence and the asymptotic distribution of the kernel estimator.

  13. Practical Session: Multiple Linear Regression (United States)

    Clausel, M.; Grégoire, G.


    Three exercises are proposed to illustrate the simple linear regression. In the first one investigates the influence of several factors on atmospheric pollution. It has been proposed by D. Chessel and A.B. Dufour in Lyon 1 (see Sect. 6 of and is based on data coming from 20 cities of U.S. Exercise 2 is an introduction to model selection whereas Exercise 3 provides a first example of analysis of variance. Exercises 2 and 3 have been proposed by A. Dalalyan at ENPC (see Exercises 2 and 3 of

  14. Kernel Multitask Regression for Toxicogenetics. (United States)

    Bernard, Elsa; Jiao, Yunlong; Scornet, Erwan; Stoven, Veronique; Walter, Thomas; Vert, Jean-Philippe


    The development of high-throughput in vitro assays to study quantitatively the toxicity of chemical compounds on genetically characterized human-derived cell lines paves the way to predictive toxicogenetics, where one would be able to predict the toxicity of any particular compound on any particular individual. In this paper we present a machine learning-based approach for that purpose, kernel multitask regression (KMR), which combines chemical characterizations of molecular compounds with genetic and transcriptomic characterizations of cell lines to predict the toxicity of a given compound on a given cell line. We demonstrate the relevance of the method on the recent DREAM8 Toxicogenetics challenge, where it ranked among the best state-of-the-art models, and discuss the importance of choosing good descriptors for cell lines and chemicals. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  15. Lumbar herniated disc: spontaneous regression. (United States)

    Altun, Idiris; Yüksel, Kasım Zafer


    Low back pain is a frequent condition that results in substantial disability and causes admission of patients to neurosurgery clinics. To evaluate and present the therapeutic outcomes in lumbar disc hernia (LDH) patients treated by means of a conservative approach, consisting of bed rest and medical therapy. This retrospective cohort was carried out in the neurosurgery departments of hospitals in Kahramanmaraş city and 23 patients diagnosed with LDH at the levels of L3-L4, L4-L5 or L5-S1 were enrolled. The average age was 38.4 ± 8.0 and the chief complaint was low back pain and sciatica radiating to one or both lower extremities. Conservative treatment was administered. Neurological examination findings, durations of treatment and intervals until symptomatic recovery were recorded. Laségue tests and neurosensory examination revealed that mild neurological deficits existed in 16 of our patients. Previously, 5 patients had received physiotherapy and 7 patients had been on medical treatment. The number of patients with LDH at the level of L3-L4, L4-L5, and L5-S1 were 1, 13, and 9, respectively. All patients reported that they had benefit from medical treatment and bed rest, and radiologic improvement was observed simultaneously on MRI scans. The average duration until symptomatic recovery and/or regression of LDH symptoms was 13.6 ± 5.4 months (range: 5-22). It should be kept in mind that lumbar disc hernias could regress with medical treatment and rest without surgery, and there should be an awareness that these patients could recover radiologically. This condition must be taken into account during decision making for surgical intervention in LDH patients devoid of indications for emergent surgery.

  16. The impact of positive and negative intraoperative surgeons' leadership behaviors on surgical team performance. (United States)

    Barling, Julian; Akers, Amy; Beiko, Darren


    The effects of surgeons' leadership on team performance are not well understood. The purpose of this study was to examine the simultaneous effects of transformational, passive, abusive supervision and over-controlling leadership behaviors by surgeons on surgical team performance. Trained observers attended 150 randomly selected operations at a tertiary care teaching hospital. Observers recorded instances of the four leadership behaviors enacted by the surgeon. Postoperatively, team members completed validated questionnaires rating team cohesion and collective efficacy. Multiple regression analyses were computed. Data were analyzed using the complex modeling function in MPlus. Surgeons' abusive supervision was negatively associated with psychological safety (unstandardized B = -0.352, p leadership (unstandardized B = -0.230, p leadership behaviors on intraoperative team performance. Significant effects only surfaced for negative leadership behaviors; transformational leadership did not positively influence team performance. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Review of child development teams. (United States)

    Zahir, M; Bennett, S


    Since the Court report was published in 1976 there has been a consensus that the needs of children with disabilities are best met by child development teams. This study explored the structure, facilities, and organisational elements of child development teams operating in the South East Thames region by means of a structured interview with senior professionals involved with organising services for children with disabilities in 14 of 15 health districts in the region. Although all districts had a designated child development team, not all core professionals were adequately represented and four of 14 districts had no child development centre. The quality of buildings and facilities was variable. Teams that did not have a physical base in the form of a centre had fewer staff in the service and poorer facilities. There is a need for further consensus work about broad guidelines on the requirements of child development teams. These will help to inform purchasing authorities about the needs of children with disabilities living in their districts.

  18. Team learning center design principles

    Energy Technology Data Exchange (ETDEWEB)

    Daily, B.; Loveland, J.; Whatley, A. [New Mexico State Univ., Las Cruces, NM (United States)] [and others


    This is a preliminary report of a multi-year collaboration of the authors addressing the subject: Can a facility be designed for team learning and would it improve the efficiency and effectiveness of team interactions? Team learning in this context is a broad definition that covers all activities where small to large groups of people come together to work, to learn, and to share through team activities. Multimedia, networking, such as World Wide Web and other tools, are greatly enhancing the capability of individual learning. This paper addresses the application of technology and design to facilitate group or team learning. Many organizational meetings need tens of people to come together to do work as a large group and then divide into smaller subgroups of five to ten to work and then to return and report and interact with the larger group. Current facilities were not, in general, designed for this type of meeting. Problems with current facilities are defined and a preliminary design solution to many of the identified problems is presented.

  19. Using teams and committees effectively. (United States)

    Spilker, B


    In a corporate setting, the term "team" usually refers to members of a group with different responsibilities and/or skills working together to achieve a common goal or objective. The major reason why a company desires group as opposed to individual involvement is to derive sounder decisions. Two essential issues to resolve in establishing teams or committees are 1) who should be a member or representative; and 2) what is the charter or mandate for the group. Representatives join a team or group in numerous ways; four common methods are 1) appointment by the group member's supervisor; 2) recruitment by the team leader; 3) appointment by a senior manager; and 4) volunteering. There are various profiles of how groups can approach a decision, including "groupthink," the "ideal group process" and the "debating society" approach. Group meetings must be structured to ensure that decisions are reached and then implemented. Foresight and planning are essential prerequisites to have efficient teams and committees that work effectively and achieve their goals. (c) 1998 Prous Science. All rights reserved.

  20. Consequences of Team Charter Quality: Teamwork Mental Model Similarity and Team Viability in Engineering Design Student Teams (United States)

    Conway Hughston, Veronica


    Since 1996 ABET has mandated that undergraduate engineering degree granting institutions focus on learning outcomes such as professional skills (i.e. solving unstructured problems and working in teams). As a result, engineering curricula were restructured to include team based learning--including team charters. Team charters were diffused into…

  1. Pedagogical innovation in teacher teams

    DEFF Research Database (Denmark)

    Weitze, Charlotte Lærke


    This paper presents findings from a longitudinal design-based research project examining how to enable reflection and pedagogical innovation in teacher teams. The article identifies and analyses the teachers’ learning trajectories and innovative strategies when working together in the IT-pedagogical...... Think Tank for Teacher Teams (after this: ITP4T) (Weitze, 2014a), a competence development model, which was developed in an earlier phase of the research project. By using theoretical lenses from innovative knowledge development frameworks to examine the teachers’ utterances, interactions and new...... learning designs, the research aims to clarify what kind of knowledge is being developed and shared in the teacher teams, and how this contributes to the organisational learning process. The context is Global Classroom, an innovative synchronous hybrid videoconference concept, where adult students can...

  2. Insulin resistance: regression and clustering.

    Directory of Open Access Journals (Sweden)

    Sangho Yoon

    Full Text Available In this paper we try to define insulin resistance (IR precisely for a group of Chinese women. Our definition deliberately does not depend upon body mass index (BMI or age, although in other studies, with particular random effects models quite different from models used here, BMI accounts for a large part of the variability in IR. We accomplish our goal through application of Gauss mixture vector quantization (GMVQ, a technique for clustering that was developed for application to lossy data compression. Defining data come from measurements that play major roles in medical practice. A precise statement of what the data are is in Section 1. Their family structures are described in detail. They concern levels of lipids and the results of an oral glucose tolerance test (OGTT. We apply GMVQ to residuals obtained from regressions of outcomes of an OGTT and lipids on functions of age and BMI that are inferred from the data. A bootstrap procedure developed for our family data supplemented by insights from other approaches leads us to believe that two clusters are appropriate for defining IR precisely. One cluster consists of women who are IR, and the other of women who seem not to be. Genes and other features are used to predict cluster membership. We argue that prediction with "main effects" is not satisfactory, but prediction that includes interactions may be.

  3. Knowledge and Awareness: Linear Regression

    Directory of Open Access Journals (Sweden)

    Monika Raghuvanshi


    Full Text Available Knowledge and awareness are factors guiding development of an individual. These may seem simple and practicable, but in reality a proper combination of these is a complex task. Economically driven state of development in younger generations is an impediment to the correct manner of development. As youths are at the learning phase, they can be molded to follow a correct lifestyle. Awareness and knowledge are important components of any formal or informal environmental education. The purpose of this study is to evaluate the relationship of these components among students of secondary/ senior secondary schools who have undergone a formal study of environment in their curricula. A suitable instrument is developed in order to measure the elements of Awareness and Knowledge among the participants of the study. Data was collected from various secondary and senior secondary school students in the age group 14 to 20 years using cluster sampling technique from the city of Bikaner, India. Linear regression analysis was performed using IBM SPSS 23 statistical tool. There exists a weak relation between knowledge and awareness about environmental issues, caused due to routine practices mishandling; hence one component can be complemented by other for improvement in both. Knowledge and awareness are crucial factors and can provide huge opportunities in any field. Resource utilization for economic solutions may pave the way for eco-friendly products and practices. If green practices are inculcated at the learning phase, they may become normal routine. This will also help in repletion of the environment.

  4. Estimating equivalence with quantile regression (United States)

    Cade, B.S.


    Equivalence testing and corresponding confidence interval estimates are used to provide more enlightened statistical statements about parameter estimates by relating them to intervals of effect sizes deemed to be of scientific or practical importance rather than just to an effect size of zero. Equivalence tests and confidence interval estimates are based on a null hypothesis that a parameter estimate is either outside (inequivalence hypothesis) or inside (equivalence hypothesis) an equivalence region, depending on the question of interest and assignment of risk. The former approach, often referred to as bioequivalence testing, is often used in regulatory settings because it reverses the burden of proof compared to a standard test of significance, following a precautionary principle for environmental protection. Unfortunately, many applications of equivalence testing focus on establishing average equivalence by estimating differences in means of distributions that do not have homogeneous variances. I discuss how to compare equivalence across quantiles of distributions using confidence intervals on quantile regression estimates that detect differences in heterogeneous distributions missed by focusing on means. I used one-tailed confidence intervals based on inequivalence hypotheses in a two-group treatment-control design for estimating bioequivalence of arsenic concentrations in soils at an old ammunition testing site and bioequivalence of vegetation biomass at a reclaimed mining site. Two-tailed confidence intervals based both on inequivalence and equivalence hypotheses were used to examine quantile equivalence for negligible trends over time for a continuous exponential model of amphibian abundance. ?? 2011 by the Ecological Society of America.

  5. Teams That Work: Preparing Student Teams for the Workplace (United States)

    Galbraith, Diane D.; Webb, Fred L.


    Organizations today often require collaboration in the form of work teams. Many tasks completed within organizations, whether in the workplace or in academia, however, can be beyond the capabilities of individuals alone. Productive teamwork and cooperative activities in business are expected and can begin very early in a person's career. The…

  6. Leader–Member Skill Distance, Team Cooperation, and Team Performance

    DEFF Research Database (Denmark)

    Tian, Longwei; Li, Yuan; Li, Peter Ping


    –member skill distance on team performance. We find the empirical support for our views with a mixed-methods design: a qualitative study interviewing informants in different cultures to clarify the psychological mechanisms, and also a quantitative study analyzing the data from US’s National Basketball...

  7. Extra-team Connections for Knowledge Transfer between Staff Teams (United States)

    Ramanadhan, Shoba; Wiecha, Jean L.; Emmons, Karen M.; Gortmaker, Steven L.; Viswanath, Kasisomayajula


    As organizations implement novel health promotion programs across multiple sites, they face great challenges related to knowledge management. Staff social networks may be a useful medium for transferring program-related knowledge in multi-site implementation efforts. To study this potential, we focused on the role of extra-team connections (ties…

  8. Leadership and Team Dynamics in Senior Executive Leadership Teams (United States)

    Barnett, Kerry; McCormick, John


    As secondary school environments become increasingly complex, shifts are occurring in the way leadership is being practised. New leadership practices emphasize shared or distributed leadership. A senior executive leadership team with responsibility for school leadership is likely to be one of the many, varied forms of new leadership practices…

  9. Changing teams/changing families. (United States)

    de Shazer, S; Molnar, A


    A therapist's view of the nature of change and the processes of changing directly influences what the therapist does clinically. This essay describes how we have moved our clinical practice closer to our epistemological premises about the processes of change. For us, one key element in initiating the processes of therapeutic change is the introduction of randomness into the system. In our view, the system under consideration is the family-system plus the therapist (team)-system, and the random can be introduced anywhere in that suprasystem. Therefore, changing the therapy team can promote changing the family's problematic pattern.

  10. Leading teaming: Evidence from Jazz


    Araújo, Francisco Maria Trigo da Roza Carvalho


    A Work Project, presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA – School of Business and Economics In this research we conducted qualitative analysis to study the team dynamics of jazz combos in order to explore deeper the leadership behaviors in a creative environment where teaming occurs. We found evidence of a dual leader, one that shifts his/her role between ‘leader as leader’ and ‘leader as member’, embracing both leaderfulness an...

  11. Professional Team Foundation Server 2012

    CERN Document Server

    Blankenship, Ed; Holliday, Grant; Keller, Brian


    A comprehensive guide to using Microsoft Team Foundation Server 2012 Team Foundation Server has become the leading Microsoft productivity tool for software management, and this book covers what developers need to know to use it effectively. Fully revised for the new features of TFS 2012, it provides developers and software project managers with step-by-step instructions and even assists those who are studying for the TFS 2012 certification exam. You'll find a broad overview of TFS, thorough coverage of core functions, a look at extensibility options, and more, written by Microsoft ins

  12. Sourcing teams and interdepartmental integration

    DEFF Research Database (Denmark)

    Lidegaard, Nina; Ellegaard, Chris; Møller, Morten Munksgaard


    Internal integration is often mentioned as a prerequisite for conducting strategic sourcing, as multiple functional departments must collaborate on creating value-creating activities amongst them. Though it is one of many possibilities, the use of cross-functional teams is often the most commonly...... proposed solution to ensure internal integration. This paper presents an exploratory case study evaluating the use of internal integration mechanisms in a cross-functional sourcing process. Two commodity categories are examined. One is organised in a cross-functional team, while the other is not. Findings...


    Jahani, Mohammad Ali; Yaminfirooz, Mousa; Siamian, Hasan


    The purpose of this study was to drawing a regression model of organizational climate of central libraries of Iran's universities. This study is an applied research. The statistical population of this study consisted of 96 employees of the central libraries of Iran's public universities selected among the 117 universities affiliated to the Ministry of Health by Stratified Sampling method (510 people). Climate Qual localized questionnaire was used as research tools. For predicting the organizational climate pattern of the libraries is used from the multivariate linear regression and track diagram. of the 9 variables affecting organizational climate, 5 variables of innovation, teamwork, customer service, psychological safety and deep diversity play a major role in prediction of the organizational climate of Iran's libraries. The results also indicate that each of these variables with different coefficient have the power to predict organizational climate but the climate score of psychological safety (0.94) plays a very crucial role in predicting the organizational climate. Track diagram showed that five variables of teamwork, customer service, psychological safety, deep diversity and innovation directly effects on the organizational climate variable that contribution of the team work from this influence is more than any other variables. Of the indicator of the organizational climate of climateQual, the contribution of the team work from this influence is more than any other variables that reinforcement of teamwork in academic libraries can be more effective in improving the organizational climate of this type libraries.

  14. Thinking about ophthalmology teaching team building

    Directory of Open Access Journals (Sweden)

    Yi-Sheng Zhong


    Full Text Available Building high performance teaching team of ophthalmology has a very important role for teachers' professional development and the improvement of the quality of ophthalmology personnel training. In this paper, the situation and existing problems of ophthalmology teaching team, the meaning of building ophthalmology teaching team, and the strategies for building team were considered.

  15. Creating, Invigorating, and Sustaining Effective Teams. (United States)

    Trimble, Susan; Miller, John W.


    Teams can boost creativity, morale, and communication, but they can also unleash disharmony, create tension, and waste time. To maximize teaming benefits, administrators must share authority, cultivate teacher leadership, train all team members, use situational leadership, model effective team leader behaviors, provide incentives, support each…

  16. Team Learning: Building Shared Mental Models (United States)

    Van den Bossche, Piet; Gijselaers, Wim; Segers, Mien; Woltjer, Geert; Kirschner, Paul


    To gain insight in the social processes that underlie knowledge sharing in teams, this article questions which team learning behaviors lead to the construction of a shared mental model. Additionally, it explores how the development of shared mental models mediates the relation between team learning behaviors and team effectiveness. Analyses were…

  17. Thinking about ophthalmology teaching team building


    Yi-Sheng Zhong; Xi Shen


    Building high performance teaching team of ophthalmology has a very important role for teachers' professional development and the improvement of the quality of ophthalmology personnel training. In this paper, the situation and existing problems of ophthalmology teaching team, the meaning of building ophthalmology teaching team, and the strategies for building team were considered.

  18. Establishment of self-governing teams

    DEFF Research Database (Denmark)

    Voxted, Søren

    Paperet har til formål at diskutere former for deltaglse og autonomi ved forkellige typer af teams både som team og for teamets enkeldeltagere......Paperet har til formål at diskutere former for deltaglse og autonomi ved forkellige typer af teams både som team og for teamets enkeldeltagere...

  19. 42 CFR 488.314 - Survey teams. (United States)


    ... 42 Public Health 5 2010-10-01 2010-10-01 false Survey teams. 488.314 Section 488.314 Public Health...-Term Care Facilities § 488.314 Survey teams. (a) Team composition. (1) Surveys must be conducted by an interdisciplinary team of professionals, which must include a registered nurse. (2) Examples of professionals...

  20. A Reflective Look at Reflecting Teams (United States)

    Pender, Rebecca L.; Stinchfield, Tracy


    This article reviewed existing literature and research on the reflecting team process. There is a dearth of empirical research that explores the reflecting team process and the outcome of counseling that uses reflecting teams. Implications of using reflecting teams for counselors, counselor educators, and clients will be discussed. A call for…

  1. Elite Teams Get the Job Done. (United States)

    Labich, Kenneth


    Looks at highly successful, noncorporate teams--U.S. Navy SEALs; the Dallas Cowboys; the Tokyo String Quartet; the University of North Carolina women's soccer team; the Massachusetts General Hospital emergency-trauma team; Boots and Coots, hellfighters; and the Childress NASCAR racing team--and discusses the secrets of their success. (JOW)

  2. Team building: conceptual, methodological, and applied considerations. (United States)

    Beauchamp, Mark R; McEwan, Desmond; Waldhauser, Katrina J


    Team building has been identified as an important method of improving the psychological climate in which teams operate, as well as overall team functioning. Within the context of sports, team building interventions have consistently been found to result in improvements in team effectiveness. In this paper we review the extant literature on team building in sport, and address a range of conceptual, methodological, and applied considerations that have the potential to advance theory, research, and applied intervention initiatives within the field. This involves expanding the scope of team building strategies that have, to date, primarily focused on developing group cohesion. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. [Family planning and demographic regression]. (United States)

    Ferrer Regales, M


    The problem of demographic explosion must be reexamined in the light of what has happened during the last 15-20 years in all industrialized countries, which have all experienced a sharp decrease in fertility rates due to the introduction of modern contraceptive technics, decreased mortality, and the possibility of easily obtaining induced legal abortion. Countries such as West Germany, England, Scotland, and Luxembourg have already reached zero population growth; countries such as Austria, Norway, Finland, Sweden have a growth rate of merely 0.2%. In most western countries average parity is 1.8 children per woman, when 2.18 children are needed to guarantee replacement. The sharpest decrease in fertility rates took place in West Germany and in France; should the tendency in those countries continue West Germany population would go from 60 million inhabitants to 39 million in 2030, and France would go from 53 million to 16 million. Demographic aging is another phenomenon related to fertility decrease; in 1977 in the United States 11% of the population was already over 65. Results of fertility decrease have been so sharp and so rapid that many Eastern European countries have already introduced incentives to reverse the trend, and/or to make abortion more difficult to obtain. This policy of incentives to encourage population growth has reached West Germany where since 1978 very young couples are given monetary help. Beside contraceptive availability population decrease has been fostered by the enormous increase in the rate of divorces and by the very liberal abortion laws. A large number of today's births are illegitimate, due mainly to the practice of trial marriages, without intention of real marriage, among adolescents.

  4. Team Building e a enfermagem Team Building e enfermería Team Building and nursing

    Directory of Open Access Journals (Sweden)

    Filipa Homem


    Full Text Available Num ambiente de insatisfação crescente e de imprevisibilidade como é o da enfermagem, cada vez mais é fundamental motivar as equipas, conferindo-lhes competências pessoais, relacionais, comunicacionais e, acima de tudo, fomentar o trabalho em equipa e consequentemente a produtividade. O Team Building, surge assim como uma estratégia eficaz para obter resultados positivos. Por ser uma estratégia ainda pouco utilizada em Portugal, decidimos realizar este artigo teórico sobre o assunto e refletir sobre a sua pertinência e potencialidades nas equipas de enfermagem, tendo definido como objetivos: aprofundar conhecimentos sobre Team Building, contextualizar o Team Building no âmbito das teorias organizacionais, descrever diferentes modelos de Team Building e refletir sobre a utilidade do Team Building na qualidade da prestação de cuidados de enfermagem. Deste modo, foram pesquisados artigos na plataforma eletrónica de bases de dados EBSCO, assim como consultada literatura relacionada com a psicologia organizacional. Com a presente pesquisa conclui-se que esta estratégia de dinamização de equipas é útil no âmbito da enfermagem, podendo melhorar a comunicação e relações interpessoais, identificar pontos fortes e fracos das equipas, proporcionar maior satisfação no trabalho e, deste modo, aumentar a qualidade dos cuidados de saúde prestados.En un ambiente de creciente descontento y de imprevisibilidad como el de la enfermería, es cada vez más primordial motivar a los equipos, dándoles competencias personales, relacionales, y, sobre todo, fomentar el trabajo en equipo y consecuentemente la productividad. El Team Building surge así como una estrategia eficaz para lograr resultados positivos. Al ser una estrategia aún poco utilizada en Portugal, se decidió realizar este artículo teórico sobre el asunto y reflexionar sobre la pertinencia y el potencial de los equipos de enfermería, para lo que se definieron los objetivos

  5. FMEA team performance in health care: A qualitative analysis of team member perceptions. (United States)

    Wetterneck, Tosha B; Hundt, Ann Schoofs; Carayon, Pascale


    : Failure mode and effects analysis (FMEA) is a commonly used prospective risk assessment approach in health care. Failure mode and effects analyses are time consuming and resource intensive, and team performance is crucial for FMEA success. We evaluate FMEA team members' perceptions of FMEA team performance to provide recommendations to improve the FMEA process in health care organizations. : Structured interviews and survey questionnaires were administered to team members of 2 FMEA teams at a Midwest Hospital to evaluate team member perceptions of FMEA team performance and factors influencing team performance. Interview transcripts underwent content analysis, and descriptive statistics were performed on questionnaire results to identify and quantify FMEA team performance. Theme-based nodes were categorized using the input-process-outcome model for team performance. : Twenty-eight interviews and questionnaires were completed by 24 team members. Four persons participated on both teams. There were significant differences between the 2 teams regarding perceptions of team functioning and overall team effectiveness that are explained by difference in team inputs and process (e.g., leadership/facilitation, team objectives, attendance of process owners). : Evaluation of team members' perceptions of team functioning produced useful insights that can be used to model future team functioning. Guidelines for FMEA team success are provided.

  6. A Taxonomy for Composing Effective Naval Teams (United States)


    ignore individual differences , as well as team-level variables. Consequently, very little is knovA, about the determinants of, or how to train or manage ...8217 -* wnmbeed FILDt GOUP gjg.ROUP Team Perfonrmance;’"Individual Differences ; Ptersonality; I’Mn reerhr aeseultdta-esnlt affects team performance, performance. The second task is to develop a means for clausifying team tasks. Leadership research since the 1950’s illustrates the futility of

  7. Principal component regression analysis with SPSS. (United States)

    Liu, R X; Kuang, J; Gong, Q; Hou, X L


    The paper introduces all indices of multicollinearity diagnoses, the basic principle of principal component regression and determination of 'best' equation method. The paper uses an example to describe how to do principal component regression analysis with SPSS 10.0: including all calculating processes of the principal component regression and all operations of linear regression, factor analysis, descriptives, compute variable and bivariate correlations procedures in SPSS 10.0. The principal component regression analysis can be used to overcome disturbance of the multicollinearity. The simplified, speeded up and accurate statistical effect is reached through the principal component regression analysis with SPSS.

  8. Team dynamics in complex projects

    NARCIS (Netherlands)

    Oeij, P.; Vroome, E.E.M. de; Dhondt, S.; Gaspersz, J.B.R.


    Complexity of projects is hotly debated and a factor which affects innovativeness of team performance. Much attention in the past is paid to technical complexity and many issues are related to natural and physical sciences. A growing awareness of the importance of socioorganisational issues is

  9. USPS – Lean Green Teams

    Energy Technology Data Exchange (ETDEWEB)



    Institutional change case study details the U.S. Postal Service's Lean Green Teams, which collaborate across functions to identify and implement low- and no-cost ways to conserve natural resources, purchase fewer consumable products, and reduce waste.

  10. Productivity in Knowledge Worker Teams


    Moreno Romero, Ana María; Mahou Fernández, Ángel; Varanki, H.


    The use of Information and Communication Technologies in work pro- cesses has not brought the expected productivity improvement. Some studies even suggest that the always-on model decreases productivity. This article proposes work teams as a new unit for knowledge worker productivity analysis in organizations. Organizations? ability to adopt new analysis measures is analyzed in three case studies.

  11. Team Work: Time well Spent (United States)

    Moore Johnson, Susan; Reinhorn, Stefanie K.; Simon, Nicole S.


    Teachers in high-poverty schools often feel stressed and fatigued. We might expect that if we ask these teachers to take on even more work by meeting regularly in collaborative improvement teams, they will respond with skepticism, even resentment. But in a study of 83 teachers in six outstanding high-poverty schools, these researchers found the…

  12. Characterizing mental healthcare service teams. (United States)

    Ferreira-Furegato, Antonia Regina; Aparecida Frari-Galera, Sueli; Pillon, Sandra Cristina; Ferreira-Santos, Jair Licio; Araujo-Pitia, Ana Celeste; Cardoso, Lucilene


    Describing profiles for professional psychiatric service categories in Ribeirão Preto. This was an exploratory study of 8 services (3 hospitals and 5 extra-hospital facilities). Data was collected using questionnaires and semi-structured interviews with professionals who worked for all these services. 74 % of the professionals working for the eight services investigated took part in the study. Doctors and nurses predominated in the hospitals and multidisciplinary teams in extra-hospital facilities. Ages ranged from 24 to 68, females predominating (73 %). 127 (88 %) of the 144 subjects in this study had received specific education after graduating in their respective areas but only 48.5 % had studied mental health. Doctors (42/44) and nurses (36/42) predominated in the teams; 121 (83 %) earned over R$ 1,000 per month as their salary. The teams mainly consisted of doctors and nurses, although it was considered that other professionals were important in constituting such teams. One of the main problems hampering reform in the psychiatric field is how services are provided for the population. No country has been able to make the necessary reforms for overcoming all the barriers. The service network studied met the minimum prerequisites for providing psychiatric care for the community.

  13. Turnaround Team Racing Summer's Clock (United States)

    Maxwell, Lesli A.


    A few weeks before a new team of teachers was to report to the former Shawnee High School in Louisville, Kentucky, Principal Keith Look discovered the master schedule for the 2010-11 school year to be in total disarray. More than 100 Shawnee students--all of them juniors and seniors--had been enrolled in classes with no connection to the credits…

  14. Team Building for Youth Sport (United States)

    Bloom, Gordon A.; Loughead, Todd M.; Newin, Julie


    Participation in youth sport generally begins to decline after the age of 12. Among the reasons for this are personal aspects such as lack of desire, and social aspects including negative experiences with coaches. One way that coaches can improve the sporting environment is through group activities that promote team building. The purpose of this…

  15. Team Foundation Server 2013 customization

    CERN Document Server

    Beeming, Gordon


    This book utilizes a tutorial based approach, focused on the practical customization of key features of the Team Foundation Server for collaborative enterprise software projects.This practical guide is intended for those who want to extend TFS. This book is for intermediate users who have an understanding of TFS, and basic coding skills will be required for the more complex customizations.

  16. Your Heart Failure Healthcare Team (United States)

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Your Heart Failure Healthcare Team Updated:May 9,2017 Patients with ... to the Terms and Conditions and Privacy Policy Heart Failure • Home • About Heart Failure • Causes and Risks for ...

  17. Physiological compliance and team performance. (United States)

    Elkins, Amanda N; Muth, Eric R; Hoover, Adam W; Walker, Alexander D; Carpenter, Thomas L; Switzer, Fred S


    Physiological compliance (PC) refers to the correlation between physiological measures of team members over time. The goals of this study were to examine ways of measuring PC in heart rate variability (HRV) data and the relationship between PC and team performance. Teams were tasked with entering both real and simulated rooms and "shooting" individuals with a weapon and identifying individuals without a weapon. The linear correlation and directional agreement PC methods were shown to be the most sensitive to differences in performance, with greater PC being associated with better performance. The correlation method when applied to a measure of respiratory sinus arrhythmia (RSA) revealed a significant difference between high and low performers (t[8]=-2.31, p=0.03) and the directional agreement applied to inter-beat-intervals and RSA revealed trend-level differences (t[4.62]=-1.86, p=0.06 and t[8]=-1.68, p=0.07). These results suggest that PC may have merit for predicting team performance.

  18. Ambidextrous leadership and team innovation

    NARCIS (Netherlands)

    Zacher, Hannes; Rosing, Kathrin


    Purpose - The purpose of this paper is to report the first empirical test of the recently proposed ambidexterity theory of leadership for innovation (Rosing et al., 2011). This theory proposes that the interaction between two complementary leadership behaviors - opening and closing - predicts team

  19. Team reasoning and group identification

    NARCIS (Netherlands)

    Hindriks, Frank

    The team reasoning approach explains cooperation in terms of group identification, which in turn is explicated in terms of agency transformation and payoff transformation. Empirical research in social psychology is consistent with the significance of agency and payoff transformation. However, it

  20. Developing Trust in Virtual Teams (United States)

    Germain, Marie-Line


    Rapid globalization, advances in technology, flatter organizational structures, synergistic cooperation among firms, and a shift to knowledge work environments have led to the increasing use of virtual teams in organizations. Selecting, training, and socializing employees in virtual teamwork has therefore become an important human resource…

  1. Hydrogen Delivery Technical Team Roadmap

    Energy Technology Data Exchange (ETDEWEB)



    The mission of the Hydrogen Delivery Technical Team (HDTT) is to enable the development of hydrogen delivery technologies, which will allow for fuel cell competitiveness with gasoline and hybrid technologies by achieving an as-produced, delivered, and dispensed hydrogen cost of $2-$4 per gallon of gasoline equivalent of hydrogen.

  2. Building the eye care team

    Directory of Open Access Journals (Sweden)

    Thulasiraj Ravilla


    Full Text Available Eye care services are people intensive. They require the right people (competence, in the right numbers (capacity, in the right mix (team with the right resources and processes (enabling conditions to ensure effective and sustainable delivery of patient care.

  3. Protecting artificial team-mates

    DEFF Research Database (Denmark)

    Merritt, Timothy; McGee, Kevin


    Previous research on conversational, competitive, and cooperative systems suggests that people respond differently to humans and AI agents in terms of perception and evaluation of observed team-mate behavior. However, there has not been research examining the relationship between participants' pr...

  4. Green Team to the Rescue (United States)

    Neeper, Lance S.; Dymond, Stacy K.


    Teachers created an after-school club called The Green Team and implemented an instructional strategy know as service-learning to teach environmental science. This article describes the transformation that occurred over a three-year period and illustrates how service-learning can provide a framework for environmental education. (Contains 1 figure,…

  5. Professionals’ views on interprofessional stroke team functioning

    Directory of Open Access Journals (Sweden)

    Jane Murray Cramm


    Full Text Available Introduction: The quality of integrated stroke care depends on smooth team functioning but professionals may not always work well together. Professionals' perspectives on the factors that influence stroke team functioning remain largely unexamined. Understanding their experiences is critical to indentifying measures to improve team functioning. The aim of this study was to identify the factors that contributed to the success of interprofessional stroke teams as perceived by team members.  Methods: We distributed questionnaires to professionals within 34 integrated stroke care teams at various health care facilities in 9 Dutch regions. 558 respondents (response rate: 39% completed the questionnaire. To account for the hierarchical structure of the study design we fitted a hierarchical random-effects model. The hierarchical structure comprised 558 stroke team members (level 1 nested in 34 teams (level 2.  Results: Analyses showed that personal development, social well-being, interprofessional education, communication, and role understanding significantly contributed to stroke team functioning. Team-level constructs affecting interprofessional stroke team functioning were communication and role understanding. No significant relationships were found with individual-level personal autonomy and team-level cohesion.  Discussion and conclusion: Our findings suggest that interventions to improve team members' social well-being, communication, and role understanding will improve teams' performance. To further advance interprofessional team functioning, healthcare organizations should pay attention to developing professionals' interpersonal skills and interprofessional education.        

  6. Illusions of team working in health care. (United States)

    West, Michael A; Lyubovnikova, Joanne


    The ubiquity and value of teams in healthcare are well acknowledged. However, in practice, healthcare teams vary dramatically in their structures and effectiveness in ways that can damage team processes and patient outcomes. The aim of this paper is to highlight these characteristics and to extrapolate several important aspects of teamwork that have a powerful impact on team effectiveness across healthcare contexts. The paper draws upon the literature from health services management and organisational behaviour to provide an overview of the current science of healthcare teams. Underpinned by the input-process-output framework of team effectiveness, team composition, team task, and organisational support are viewed as critical inputs that influence key team processes including team objectives, leadership and reflexivity, which in turn impact staff and patient outcomes. Team training interventions and care pathways can facilitate more effective interdisciplinary teamwork. The paper argues that the prevalence of the term "team" in healthcare makes the synthesis and advancement of the scientific understanding of healthcare teams a challenge. Future research therefore needs to better define the fundamental characteristics of teams in studies in order to ensure that findings based on real teams, rather than pseudo-like groups, are accumulated.

  7. Initiating and utilizing shared leadership in teams: The role of leader humility, team proactive personality, and team performance capability. (United States)

    Chiu, Chia-Yen Chad; Owens, Bradley P; Tesluk, Paul E


    The present study was designed to produce novel theoretical insight regarding how leader humility and team member characteristics foster the conditions that promote shared leadership and when shared leadership relates to team effectiveness. Drawing on social information processing theory and adaptive leadership theory, we propose that leader humility facilitates shared leadership by promoting leadership-claiming and leadership-granting interactions among team members. We also apply dominance complementary theory to propose that team proactive personality strengthens the impact of leader humility on shared leadership. Finally, we predict that shared leadership will be most strongly related to team performance when team members have high levels of task-related competence. Using a sample composed of 62 Taiwanese professional work teams, we find support for our proposed hypothesized model. The theoretical and practical implications of these results for team leadership, humility, team composition, and shared leadership are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  8. Leading virtual teams: hierarchical leadership, structural supports, and shared team leadership. (United States)

    Hoch, Julia E; Kozlowski, Steve W J


    Using a field sample of 101 virtual teams, this research empirically evaluates the impact of traditional hierarchical leadership, structural supports, and shared team leadership on team performance. Building on Bell and Kozlowski's (2002) work, we expected structural supports and shared team leadership to be more, and hierarchical leadership to be less, strongly related to team performance when teams were more virtual in nature. As predicted, results from moderation analyses indicated that the extent to which teams were more virtual attenuated relations between hierarchical leadership and team performance but strengthened relations for structural supports and team performance. However, shared team leadership was significantly related to team performance regardless of the degree of virtuality. Results are discussed in terms of needed research extensions for understanding leadership processes in virtual teams and practical implications for leading virtual teams. (c) 2014 APA, all rights reserved.

  9. We will be champions: Leaders' confidence in 'us' inspires team members' team confidence and performance. (United States)

    Fransen, K; Steffens, N K; Haslam, S A; Vanbeselaere, N; Vande Broek, G; Boen, F


    The present research examines the impact of leaders' confidence in their team on the team confidence and performance of their teammates. In an experiment involving newly assembled soccer teams, we manipulated the team confidence expressed by the team leader (high vs neutral vs low) and assessed team members' responses and performance as they unfolded during a competition (i.e., in a first baseline session and a second test session). Our findings pointed to team confidence contagion such that when the leader had expressed high (rather than neutral or low) team confidence, team members perceived their team to be more efficacious and were more confident in the team's ability to win. Moreover, leaders' team confidence affected individual and team performance such that teams led by a highly confident leader performed better than those led by a less confident leader. Finally, the results supported a hypothesized mediational model in showing that the effect of leaders' confidence on team members' team confidence and performance was mediated by the leader's perceived identity leadership and members' team identification. In conclusion, the findings of this experiment suggest that leaders' team confidence can enhance members' team confidence and performance by fostering members' identification with the team. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. A Spreadsheet Model for Teaching Regression Analysis. (United States)

    Wood, William C.; O'Hare, Sharon L.


    Presents a spreadsheet model that is useful in introducing students to regression analysis and the computation of regression coefficients. Includes spreadsheet layouts and formulas so that the spreadsheet can be implemented. (Author)

  11. Complete regression of primary malignant melanoma. (United States)

    Emanuel, Patrick O; Mannion, Meghan; Phelps, Robert G


    Over the years, histopathologic studies to determine the nature and significance of regression in malignant melanoma have yielded different results. At least in part, this most likely reflects differences in the definition of what constitutes regression. Although partial regression is relatively common, complete regression is rare. It has been said that complete regression of a primary lesion is associated with metastatic disease, but the evidence for this is largely anecdotal-the literature contains only case reports and small series. We found 2 cases of complete regression in our dermatopathology database. Metastatic disease was identified in both cases; in 1 case, the suspicion of melanoma was raised on the initial biopsy and subsequent workup revealed lymph node metastasis. These cases illustrate the histologic features of a completely regressed primary melanoma and add credence to the theory that completely regressed melanoma is associated with a poor outcome.

  12. Unbalanced Regressions and the Predictive Equation

    DEFF Research Database (Denmark)

    Osterrieder, Daniela; Ventosa-Santaulària, Daniel; Vera-Valdés, J. Eduardo

    Predictive return regressions with persistent regressors are typically plagued by (asymptotically) biased/inconsistent estimates of the slope, non-standard or potentially even spurious statistical inference, and regression unbalancedness. We alleviate the problem of unbalancedness in the theoreti...

  13. Effective healthcare teams require effective team members: defining teamwork competencies


    Leggat Sandra G


    Abstract Background Although effective teamwork has been consistently identified as a requirement for enhanced clinical outcomes in the provision of healthcare, there is limited knowledge of what makes health professionals effective team members, and even less information on how to develop skills for teamwork. This study identified critical teamwork competencies for health service managers. Methods Members of a state branch of the professional association of Australian health service managers...

  14. Role Allocation and Team Structure in Command and Control Teams (United States)


    tankers (FT), search units (S) and rescue units (R). Each unit is represented on the map by a numbered icon. Each type of unit is colour -coded and...experiences from command and control research with the C3Fire microworld. Cognition , Technology & Work, 5(3), 183-190. Hollenbeck, J. R. (2000). A...Alexandria, VA, June 2013. Jobidon, M.-E., Tremblay, S., Lafond, D., & Breton, R. (2006). The role of cognition in team functioning: A matter of

  15. Command and Control Teams: Techniques for Assessing Team Performance (United States)


    when the task re- quires high levels of interdependence among group members - ( Deutsch , 1949; Goldman, Stockbauer, & McAuliffe, 1977; Miller...cooperation, ac(. "nt for some additional variance in predic- ting team effectivness ( Deutsch , 1949; Miller & Hamblin, 1963; Naylor & Briggs, 1965; Steiner...460-475. Daval, R. Psychosociology of decision: Individual decisions and col- "lpctive decision. Bulletin de Psychologie , 1967, 20, 1460-1469. Davis

  16. Team spirit makes the difference: the interactive effects of team work engagement and organizational constraints during a military operation on psychological outcomes afterwards. (United States)

    Boermans, S M; Kamphuis, W; Delahaij, R; van den Berg, C; Euwema, M C


    This article prospectively explores the effects of collective team work engagement and organizational constraints during military deployment on individual-level psychological outcomes afterwards. Participants were 971 Dutch peacekeepers within 93 teams who were deployed between the end of 2008 and beginning of 2010, for an average of 4 months, in the International Security Assistance Force. Surveys were administered 2 months into deployment and 6 months afterwards. Multi-level regression analyses demonstrated that team work engagement during deployment moderated the relation between organizational constraints and post-deployment fatigue symptoms. Team members reported less fatigue symptoms after deployment if they were part of highly engaged teams during deployment, particularly when concerns about organizational constraints during deployment were high. In contrast, low team work engagement was related to more fatigue symptoms, particularly when concerns about organizational constraints were high. Contrary to expectations, no effects for team work engagement or organizational constraints were found for post-traumatic growth. The present study highlights that investing in team work engagement is important for those working in highly demanding jobs. © 2014 John Wiley & Sons, Ltd.

  17. Semiparametric regression during 2003–2007

    KAUST Repository

    Ruppert, David


    Semiparametric regression is a fusion between parametric regression and nonparametric regression that integrates low-rank penalized splines, mixed model and hierarchical Bayesian methodology – thus allowing more streamlined handling of longitudinal and spatial correlation. We review progress in the field over the five-year period between 2003 and 2007. We find semiparametric regression to be a vibrant field with substantial involvement and activity, continual enhancement and widespread application.

  18. Consequences of team charter quality: Teamwork mental model similarity and team viability in engineering design student teams (United States)

    Conway Hughston, Veronica

    Since 1996 ABET has mandated that undergraduate engineering degree granting institutions focus on learning outcomes such as professional skills (i.e. solving unstructured problems and working in teams). As a result, engineering curricula were restructured to include team based learning---including team charters. Team charters were diffused into engineering education as one of many instructional activities to meet the ABET accreditation mandates. However, the implementation and execution of team charters into engineering team based classes has been inconsistent and accepted without empirical evidence of the consequences. The purpose of the current study was to investigate team effectiveness, operationalized as team viability, as an outcome of team charter implementation in an undergraduate engineering team based design course. Two research questions were the focus of the study: a) What is the relationship between team charter quality and viability in engineering student teams, and b) What is the relationship among team charter quality, teamwork mental model similarity, and viability in engineering student teams? Thirty-eight intact teams, 23 treatment and 15 comparison, participated in the investigation. Treatment teams attended a team charter lecture, and completed a team charter homework assignment. Each team charter was assessed and assigned a quality score. Comparison teams did not join the lecture, and were not asked to create a team charter. All teams completed each data collection phase: a) similarity rating pretest; b) similarity posttest; and c) team viability survey. Findings indicate that team viability was higher in teams that attended the lecture and completed the charter assignment. Teams with higher quality team charter scores reported higher levels of team viability than teams with lower quality charter scores. Lastly, no evidence was found to support teamwork mental model similarity as a partial mediator of the team charter quality on team viability

  19. Regression with Sparse Approximations of Data

    DEFF Research Database (Denmark)

    Noorzad, Pardis; Sturm, Bob L.


    We propose sparse approximation weighted regression (SPARROW), a method for local estimation of the regression function that uses sparse approximation with a dictionary of measurements. SPARROW estimates the regression function at a point with a linear combination of a few regressands selected by...... on the sparse approximation process. Our experimental results show the locally constant form of SPARROW performs competitively....

  20. Regression Analysis by Example. 5th Edition (United States)

    Chatterjee, Samprit; Hadi, Ali S.


    Regression analysis is a conceptually simple method for investigating relationships among variables. Carrying out a successful application of regression analysis, however, requires a balance of theoretical results, empirical rules, and subjective judgment. "Regression Analysis by Example, Fifth Edition" has been expanded and thoroughly…