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Sample records for reported improved confidence

  1. Improvement in self-reported confidence in nurses' professional skills in the emergency department.

    Science.gov (United States)

    Rautava, Veli-Pekka; Palomäki, Erika; Innamaa, Tapio; Perttu, Mika; Lehto, Päivi; Palomäki, Ari

    2013-03-05

    The aim of this study was to assess nurses' self-reported confidence in their professional skills before and after an extensive Emergency Department (ED) reform in Kanta-Häme Central Hospital. Emergency nurses participated in transitional training commencing two years before the establishment of the new organization in 2007. Training was followed by weekly practical educational sessions in the new ED. During this process nurses improved their transition skills, defined house rules for the new clinic and improved their knowledge of new technology and instruments. The main processes involving critically ill ED patients were described and modelled with an electronic flow chart software.During the transitional training nurses compiled lists of practical skills and measures needed in the ED. These were updated after feedback from physicians in primary and secondary care and head physicians in Kanta-Häme Central Hospital. The final 189-item list comprised 15 different categories, each containing from 4 to 35 items. Based on the work described above, a questionnaire was developed to reflect ED nurses' skills in clinical measures but also to estimate the need for professional education and practical training. Nurses working in the ED were asked to fill the questionnaire in January 2007 (response rate 97%) and in January 2011 (response rate 98%). Nurses' self-reported confidence in their professional skills improved significally in eight classes out of fifteen. These classes were cannulations, urinary catheterizations, patient monitoring, cardiac patients, equipment, triage and nurse practising, psychiatric patients as well as infection risk. Best results were noted in urinary catheterizations, patient monitoring and infection risk. When studying the group of nurses participating in both surveys in 2007 and 2011, improvements were observed in all fifteen categories. All but two of these changes were significant (pskills of nurses. This improvement was especially

  2. Improvement in self-reported confidence in nurses’ professional skills in the emergency department

    Science.gov (United States)

    2013-01-01

    Background The aim of this study was to assess nurses’ self-reported confidence in their professional skills before and after an extensive Emergency Department (ED) reform in Kanta-Häme Central Hospital. Methods Emergency nurses participated in transitional training commencing two years before the establishment of the new organization in 2007. Training was followed by weekly practical educational sessions in the new ED. During this process nurses improved their transition skills, defined house rules for the new clinic and improved their knowledge of new technology and instruments. The main processes involving critically ill ED patients were described and modelled with an electronic flow chart software. During the transitional training nurses compiled lists of practical skills and measures needed in the ED. These were updated after feedback from physicians in primary and secondary care and head physicians in Kanta-Häme Central Hospital. The final 189-item list comprised 15 different categories, each containing from 4 to 35 items. Based on the work described above, a questionnaire was developed to reflect ED nurses’ skills in clinical measures but also to estimate the need for professional education and practical training. Nurses working in the ED were asked to fill the questionnaire in January 2007 (response rate 97%) and in January 2011 (response rate 98%). Results Nurses’ self-reported confidence in their professional skills improved significally in eight classes out of fifteen. These classes were cannulations, urinary catheterizations, patient monitoring, cardiac patients, equipment, triage and nurse practising, psychiatric patients as well as infection risk. Best results were noted in urinary catheterizations, patient monitoring and infection risk. When studying the group of nurses participating in both surveys in 2007 and 2011, improvements were observed in all fifteen categories. All but two of these changes were significant (pskills of nurses. This

  3. Students who developed logical reasoning skills reported improved confidence in drug dose calculation: Feedback from remedial maths classes.

    Science.gov (United States)

    Shelton, Chris

    2016-06-01

    The safe administration of drugs is a focus of attention in healthcare. It is regarded as acceptable that a formula card or mnemonic can be used to find the correct dose and fill a prescription even though this removes any requirement for performing the underlying computation. Feedback and discussion in class reveal that confidence in arithmetic skills can be low even when students are able to pass the end of semester drug calculation exam. To see if confidence in the understanding and performance of arithmetic for drug calculations can be increased by emphasising student's innate powers of logical reasoning after reflection. Remedial classes offered for students who have declared a dislike or lack of confidence in arithmetic have been developed from student feedback adopting a reasoning by logical step methodology. Students who gave up two hours of their free learning time were observed to engage seriously with the learning methods, focussing on the innate ability to perform logical reasoning necessary for drug calculation problems. Working in small groups allowed some discussion of the route to the answer and this was followed by class discussion and reflection. The results were recorded as weekly self-assessment scores for confidence in calculation. A self-selecting group who successfully completed the end of semester drug calculation exam reported low to moderate confidence in arithmetic. After four weeks focussing on logical skills a significant increase in self-belief was measured. This continued to rise in students who remained in the classes. Many students hold a negative belief regarding their own mathematical abilities. This restricts the learning of arithmetic skills making alternate routes using mnemonics and memorised steps an attractive alternative. Practising stepwise logical reasoning skills consolidated by personal reflection has been effective in developing student's confidence and awareness of their innate powers of deduction supporting an

  4. Improved realism of confidence for an episodic memory event

    Directory of Open Access Journals (Sweden)

    Sandra Buratti

    2012-09-01

    Full Text Available We asked whether people can make their confidence judgments more realistic (accurate by adjusting them, with the aim of improving the relationship between the level of confidence and the correctness of the answer. This adjustment can be considered to include a so-called second-order metacognitive judgment. The participants first gave confidence judgments about their answers to questions about a video clip they had just watched. Next, they attempted to increase their accuracy by identifying confidence judgments in need of adjustment and then modifying them. The participants managed to increase their metacognitive realism, thus decreasing their absolute bias and improving their calibration, although the effects were small. We also examined the relationship between confidence judgments that were adjusted and the retrieval fluency and the phenomenological memory quality participants experienced when first answering the questions; this quality was one of either Remember (associated with concrete, vivid details or Know (associated with a feeling of familiarity. Confidence judgments associated with low retrieval fluency and the memory quality of knowing were modified more often. In brief, our results provide evidence that people can improve the realism of their confidence judgments, mainly by decreasing their confidence for incorrect answers. Thus, this study supports the conclusion that people can perform successful second-order metacognitive judgments.

  5. Two sides of the same coin: Monetary incentives concurrently improve and bias confidence judgments.

    Science.gov (United States)

    Lebreton, Maël; Langdon, Shari; Slieker, Matthijs J; Nooitgedacht, Jip S; Goudriaan, Anna E; Denys, Damiaan; van Holst, Ruth J; Luigjes, Judy

    2018-05-01

    Decisions are accompanied by a feeling of confidence, that is, a belief about the decision being correct. Confidence accuracy is critical, notably in high-stakes situations such as medical or financial decision-making. We investigated how incentive motivation influences confidence accuracy by combining a perceptual task with a confidence incentivization mechanism. By varying the magnitude and valence (gains or losses) of monetary incentives, we orthogonalized their motivational and affective components. Corroborating theories of rational decision-making and motivation, our results first reveal that the motivational value of incentives improves aspects of confidence accuracy. However, in line with a value-confidence interaction hypothesis, we further show that the affective value of incentives concurrently biases confidence reports, thus degrading confidence accuracy. Finally, we demonstrate that the motivational and affective effects of incentives differentially affect how confidence builds on perceptual evidence. Together, these findings may provide new hints about confidence miscalibration in healthy or pathological contexts.

  6. Two sides of the same coin: Monetary incentives concurrently improve and bias confidence judgments

    Science.gov (United States)

    Lebreton, Maël; Slieker, Matthijs J.; Nooitgedacht, Jip S.; van Holst, Ruth J.; Luigjes, Judy

    2018-01-01

    Decisions are accompanied by a feeling of confidence, that is, a belief about the decision being correct. Confidence accuracy is critical, notably in high-stakes situations such as medical or financial decision-making. We investigated how incentive motivation influences confidence accuracy by combining a perceptual task with a confidence incentivization mechanism. By varying the magnitude and valence (gains or losses) of monetary incentives, we orthogonalized their motivational and affective components. Corroborating theories of rational decision-making and motivation, our results first reveal that the motivational value of incentives improves aspects of confidence accuracy. However, in line with a value-confidence interaction hypothesis, we further show that the affective value of incentives concurrently biases confidence reports, thus degrading confidence accuracy. Finally, we demonstrate that the motivational and affective effects of incentives differentially affect how confidence builds on perceptual evidence. Together, these findings may provide new hints about confidence miscalibration in healthy or pathological contexts. PMID:29854944

  7. Building, measuring and improving public confidence in the nuclear regulator

    International Nuclear Information System (INIS)

    2006-01-01

    An important factor for public confidence in the nuclear regulator is the general public trust of the government and its representatives, which is clearly not the same in all countries. Likewise, cultural differences between countries can be considerable, and similar means of communication between government authorities and the public may not be universally effective. Nevertheless, this workshop identified a number of common principles for the communication of nuclear regulatory decisions that can be recommended to all regulators. They have been cited in particular for their ability to help build, measure and/or improve overall public confidence in the nuclear regulator. (author)

  8. IMPROVING SEMI-GLOBAL MATCHING: COST AGGREGATION AND CONFIDENCE MEASURE

    Directory of Open Access Journals (Sweden)

    P. d’Angelo

    2016-06-01

    Full Text Available Digital elevation models are one of the basic products that can be generated from remotely sensed imagery. The Semi Global Matching (SGM algorithm is a robust and practical algorithm for dense image matching. The connection between SGM and Belief Propagation was recently developed, and based on that improvements such as correction of over-counting the data term, and a new confidence measure have been proposed. Later the MGM algorithm has been proposed, it aims at improving the regularization step of SGM, but has only been evaluated on the Middlebury stereo benchmark so far. This paper evaluates these proposed improvements on the ISPRS satellite stereo benchmark, using a Pleiades Triplet and a Cartosat-1 Stereo pair. The over-counting correction slightly improves matching density, at the expense of adding a few outliers. The MGM cost aggregation shows leads to a slight increase of accuracy.

  9. What are effective techniques for improving public confidence or restoring lost confidence in a regulator?

    International Nuclear Information System (INIS)

    Harbitz, O.; Isaksson, R.

    2006-01-01

    The conclusions and recommendations of this session can be summarized this way. The following list contains thoughts related to restoring lost confidence: - hard, long lasting event; - strategy: maximum transparency; - to listen, be open, give phone numbers etc. - ways to rebuild trust: frequent communication, being there, open and transparent; - don't be too defensive; if things could be done better, say it; - technical staff and public affair staff together from the beginning - answer all questions; - classifications, actions, instructions that differ much from the earlier ones must be well explained and motivated - and still cause a lot of problems; - things may turn out to be political; - communicative work in an early stage saves work later; - communication experts must be working shoulder to shoulder with other staff; On handling emergencies in general, some recipes proposed are: - better to over react than to under react; - do not avoid extreme actions: hit hard, hit fast; - base your decisions in strict principles; - first principle: public safety first; - when you are realizing plant A, you must have a plant B in your pocket: - be transparent - from the beginning; - crisis communication: early, frequent etc - people need to see political leaders, someone who is making decisions - technical experts are needed but are not enough. On how to involve stakeholders and the public in decision making, recommendations are: - new kind of thinking -. demanding for a organisation; - go to local level, meet local people, speak language people understand, you have to start from the very beginning - introducing yourself tell who you are and why you are there. (authors)

  10. Can traceability improve consumers' confidence in food quality and safety?

    NARCIS (Netherlands)

    Rijswijk, van W.; Cornelisse-Vermaat, J.R.; Frewer, L.J.

    2006-01-01

    Abstract This paper investigates whether the implementation of traceability systems in line with the European General Food Law as well as food labelling laws related to allergens can impact on consumer confidence in food quality and safety. It aims to give insight into consumer demands regarding

  11. A Pediatric Cardiology Fellowship Boot Camp improves trainee confidence.

    Science.gov (United States)

    Allan, Catherine K; Tannous, Paul; DeWitt, Elizabeth; Farias, Michael; Mansfield, Laura; Ronai, Christina; Schidlow, David; Sanders, Stephen P; Lock, James E; Newburger, Jane W; Brown, David W

    2016-12-01

    Introduction New paediatric cardiology trainees are required to rapidly assimilate knowledge and gain clinical skills to which they have limited or no exposure during residency. The Pediatric Cardiology Fellowship Boot Camp (PCBC) at Boston Children's Hospital was designed to provide incoming fellows with an intensive exposure to congenital cardiac pathology and a broad overview of major areas of paediatric cardiology practice. The PCBC curriculum was designed by core faculty in cardiac pathology, echocardiography, electrophysiology, interventional cardiology, exercise physiology, and cardiac intensive care. Individual faculty contributed learning objectives, which were refined by fellowship directors and used to build a programme of didactics, hands-on/simulation-based activities, and self-guided learning opportunities. A total of 16 incoming fellows participated in the 4-week boot camp, with no concurrent clinical responsibilities, over 2 years. On the basis of pre- and post-PCBC surveys, 80% of trainees strongly agreed that they felt more prepared for clinical responsibilities, and a similar percentage felt that PCBC should be offered to future incoming fellows. Fellows showed significant increase in their confidence in all specific knowledge and skills related to the learning objectives. Fellows rated hands-on learning experiences and simulation-based exercises most highly. We describe a novel 4-week-long boot camp designed to expose incoming paediatric cardiology fellows to the broad spectrum of knowledge and skills required for the practice of paediatric cardiology. The experience increased trainee confidence and sense of preparedness to begin fellowship-related responsibilities. Given that highly interactive activities were rated most highly, boot camps in paediatric cardiology should strongly emphasise these elements.

  12. Interactive case-based learning improves resident knowledge and confidence in reproductive endocrinology and infertility.

    Science.gov (United States)

    Goldman, Kara N; Tiegs, Ashley W; Uquillas, Kristen; Nachtigall, Margaret; Fino, M Elizabeth; Winkel, Abigail F; Lerner, Veronica

    2017-06-01

    Resident physicians' scores on the REI section of the CREOG exam are traditionally low, and nearly 40% of house staff nation-wide perceive their REI knowledge to be poor. We aimed to assess whether an interactive case-based group-learning curriculum would narrow the REI knowledge gap by improving understanding and retention of core REI concepts under the time constraints affecting residents. A three-hour case-based workshop was developed to address four primary CREOG objectives. A multiple-choice test was administered immediately before and after the intervention and 7 weeks post-workshop, to evaluate both knowledge and confidence. Following the intervention, residents self-reported increased confidence with counseling and treatment of PCOS, ovulation induction cycle monitoring, counseling and treatment of POI, and breaking bad news related to infertility (p < 0.05). The multiple-choice exam was re-administered 7 weeks post-intervention, and scores remained significantly improved compared to pre-workshop scores (p < 0.05). At that time, all residents either strongly agreed (91.7%) or agreed (8.3%) that the case-based interactive format was preferable to traditional lecture-based teaching. In conclusion, a nontraditional curriculum aimed at teaching core REI concepts to residents through interactive case-based learning can be successfully integrated into a residency curriculum, and significantly improves knowledge and confidence of critical concepts in REI.

  13. 77 FR 55833 - Announcement of Public Meeting on the Consumer Confidence Report (CCR) Rule Retrospective Review...

    Science.gov (United States)

    2012-09-11

    ... on the Consumer Confidence Report (CCR) Rule Retrospective Review and Request for Public Comment on... potential approaches for providing Consumer Confidence Reports (CCR) via electronic delivery. EPA plans to... meeting to give EPA time to process your request. Background Consumer Confidence Reports are a key part of...

  14. 77 FR 5471 - Announcement of Public Meeting on the Consumer Confidence Report (CCR) Rule Retrospective Review

    Science.gov (United States)

    2012-02-03

    ... Announcement of Public Meeting on the Consumer Confidence Report (CCR) Rule Retrospective Review AGENCY... stakeholder input on the Consumer Confidence Report (CCR) Rule as part of the agency's Retrospective Review of... Safe Drinking Water Act (SDWA, section 1414(c)). The Consumer Confidence Report, or CCR, is an annual...

  15. RN-to-BSN Students' Quality Improvement Knowledge, Skills, Confidence, and Systems Thinking.

    Science.gov (United States)

    Trent, Peggy; Dolansky, Mary A; DeBrew, Jacqueline Kayler; Petty, Gayle M

    2017-12-01

    Little evidence demonstrates that RN-to-baccalaureate nursing (BSN) graduates have met The Essentials of Baccalaureate Education for Professional Nursing Practice-specifically, evidence of the graduates' organizational and systems leadership related to quality care and patient safety. This BSN Essentials reflects the QSEN quality improvement (QI) competency. The purpose of this pilot study was to develop and test an assessment strategy to measure RN-to BSN students' QI competence and their perception of QI knowledge and skills. Students (N = 59) from six RN-to-BSN programs participated in a Qualtrics survey e-mailed during the last semester of their program. The majority of students (60%) reported that they did not experience QI content in their program. Scores on QI knowledge, skills, and systems thinking were low, yet the students self-reported that they were confident in their ability to perform QI. This pilot study provides an assessment strategy to measure students' competence related to QI. Nursing education has an opportunity to integrate and measure QI competence to ensure that nurses have the knowledge and skills to continually improve patient care. [J Nurs Educ. 2017;56(12):737-740.]. Copyright 2017, SLACK Incorporated.

  16. 'Asking the hard questions': Improving midwifery students' confidence with domestic violence screening in pregnancy.

    Science.gov (United States)

    Smith, Rachel; Wight, Raechel; Homer, Caroline S E

    2018-01-01

    Domestic violence is a global public health issue. Midwives are ideally placed to screen for, and respond to, disclosure of domestic violence. Qualified midwives and midwifery students report a lack of preparedness and low levels of confidence in working with women who disclose domestic violence. This paper reports the findings from an education intervention designed to increase midwifery students' confidence in working with pregnant women who disclose domestic violence. An authentic practice video and associated interactive workshop was developed to bring the 'woman' into the classroom and to provide role-modelling of exemplary midwifery practice in screening for and responding to disclosure of domestic violence. The findings demonstrated that students' confidence increased in a number of target areas, such as responding appropriately to disclosure and assisting women with access to support. Students' confidence increased in areas where responses needed to be individualised as opposed to being able to be scripted. Students appreciated visual demonstration (video of authentic practice) and having the opportunity to practise responding to disclosures through experiential learning. Given the general lack of confidence reported by both midwives and students of midwifery in this area of practice, this strategy may be useful in supporting midwives, students and other health professionals in increasing confidence in working with women who are experiencing domestic violence. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Generating capital: improving investor confidence in Ontario's electricity industry to induce new generation investment

    International Nuclear Information System (INIS)

    Van Beers, R.

    2004-01-01

    This paper is a critical discussion on improving investor confidence in Ontario's electricity industry to induce new generation investment. The reason that investor confidence is critical in the electric power industry is due to the fact that the industry is capital intensive, the asset life is long, it is impossible to model political/regulatory risk and political action is virtually inevitable. The paper concludes that ultimately private sector investors will bear little risk, the tax payer will be on the hook for almost all risk

  18. Pediatrics Residents' Confidence and Performance Following a Longitudinal Quality Improvement Curriculum.

    Science.gov (United States)

    Courtlandt, Cheryl; Noonan, Laura; Koricke, Maureen Walsh; Zeskind, Philip Sanford; Mabus, Sarah; Feld, Leonard

    2016-02-01

    Quality improvement (QI) training is an integral part of residents' education. Understanding the educational value of a QI curriculum facilitates understanding of its impact. The purpose of this study was to evaluate the effects of a longitudinal QI curriculum on pediatrics residents' confidence and competence in the acquisition and application of QI knowledge and skills. Three successive cohorts of pediatrics residents (N = 36) participated in a longitudinal curriculum designed to increase resident confidence in QI knowledge and skills. Key components were a succession of progressive experiential projects, QI coaching, and resident team membership culminating in leadership of the project. Residents completed precurricular and postcurricular surveys and demonstrated QI competence by performance on the pediatric QI assessment scenario. Residents participating in the Center for Advancing Pediatric Excellence QI curriculum showed significant increases in pre-post measures of confidence in QI knowledge and skills. Coaching and team leadership were ranked by resident participants as having the most educational value among curriculum components. A pediatric QI assessment scenario, which correlated with resident-perceived confidence in acquisition of QI skills but not QI knowledge, is a tool available to test pediatrics residents' QI knowledge. A 3-year longitudinal, multimodal, experiential QI curriculum increased pediatrics residents' confidence in QI knowledge and skills, was feasible with faculty support, and was well-accepted by residents.

  19. Knee Confidence as it Relates to Self-Reported and Objective Correlates of Knee Osteoarthritis

    DEFF Research Database (Denmark)

    Skou, Søren T; Rasmussen, Sten; Simonsen, Ole

    2015-01-01

    osteoarthritis (OA). Background Lack of knee confidence is a frequent symptom in patients with knee OA, but little is known of associations between knee confidence and other common correlates of knee OA. Methods Baseline data from 220 patients with knee OA were applied in ordinal regression analyses, with knee...... confidence, assessed using item Q3 of the Knee injury and Osteoarthritis Outcome Score, as the dependent variable and self-reported (pain on walking, general health, fear of movement, self-efficacy, function, and previous serious injury) and objective measures (muscle strength, 20-m walk time.......21; 95% CI: 1.09, 1.34), and general health (OR = 0.024; 95% CI: 0.002, 0.259) explained 19% of the variance in knee confidence (Pcommon finding in individuals with knee OA. Pain on walking was confirmed as a correlate of knee confidence, whereas...

  20. Carotid artery dissection on non-contrast CT: Does color improve the diagnostic confidence?

    Energy Technology Data Exchange (ETDEWEB)

    Saba, Luca, E-mail: lucasaba@tiscali.it [Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari – Polo di Monserrato, s.s. 554 Monserrato, Cagliari 09045 (Italy); Argiolas, Giovanni Maria [Department of Radiology, Azienda Ospedaliero Brotzu (A.O.B.), di Cagliari, Cagliari 09100 (Italy); Raz, Eytan [Department of Radiology, New York University School of Medicine, New York (United States); Department of Neurology and Psychiatry, Sapienza University of Rome (Italy); Sannia, Stefano [Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari – Polo di Monserrato, s.s. 554 Monserrato, Cagliari 09045 (Italy); Suri, Jasjit S. [Diagnostic and Monitoring Division, AtheroPointTM LLC, Roseville, CA (United States); Electrical Engineering Department (Aff.), Idaho State University, ID (United States); Siotto, Paolo [Department of Radiology, Azienda Ospedaliero Brotzu (A.O.B.), di Cagliari, Cagliari 09100 (Italy); Sanfilippo, Roberto; Montisci, Roberto [Department of Vascular Surgery, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari – Polo di Monserrato, s.s. 554 Monserrato, Cagliari 09045 (Italy); Piga, Mario [Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari – Polo di Monserrato, s.s. 554 Monserrato, Cagliari 09045 (Italy); Wintermark, Max [Department of Radiology, Neuroradiology Division, University of Virginia, Box 800170, Charlottesville, VA, 22908 (United States)

    2014-12-15

    Highlights: • The use of a color scale to display the non-contrast CT images in lieu of the classic grayscale improves the diagnostic confidence of the readers. • Radiologists should consider the use of a color scale, rather than the conventional grayscale, to assess non-contrast CT studies for possible carotid artery dissection. - Abstract: Purpose: The purpose of this work was to evaluate if the use of color maps, instead of conventional grayscale images, would improve the observer's diagnostic confidence in the non-contrast CT evaluation of internal carotid artery dissection (ICAD). Materials and methods: One hundred patients (61 men, 39 women; mean age, 51 years; range, 25–78 years), 40 with and 60 without ICAD, underwent non-contrast CT and were included in this the retrospective study. In this study, three groups of patients were considered: patients with MR confirmation of ICAD, n = 40; patients with MR confirmation of ICAD absence, n = 20; patients who underwent CT of the carotid arteries because of atherosclerotic disease, n = 40. Four blinded observers with different levels of expertise (expert, intermediate A, intermediate B and trainee) analyzed the non-contrast CT datasets using a cross model (one case grayscale and the following case using the color scale). The presence of ICAD was scored on a 5-point scale in order to assess the observer's diagnostic confidence. After 3 months the four observers evaluated the same datasets by using the same cross-model for the alternate readings (one case color scale and the following case using the grayscale). Statistical analysis included receiver operating characteristics (ROC) curve analysis, the Cohen weighted test and sensitivity, specificity, PPV, NPV, accuracy, LR+ and LR−. Results: The ROC curve analysis showed that, for all observers, the use of color scale resulted in an improved diagnostic confidence with AUC values increasing from 0.896 to 0.936, 0.823 to 0.849, 0.84 to 0.909 and 0

  1. Improved NN-GM(1,1 for Postgraduates’ Employment Confidence Index Forecasting

    Directory of Open Access Journals (Sweden)

    Lu Wang

    2014-01-01

    Full Text Available Postgraduates’ employment confidence index (ECI forecasting can help the university to predict the future trend of postgraduates’ employment. However, the common forecast method based on the grey model (GM has unsatisfactory performance to a certain extent. In order to forecast postgraduates’ ECI efficiently, this paper discusses a novel hybrid forecast model using limited raw samples. Different from previous work, the residual modified GM(1,1 model is combined with the improved neural network (NN in this work. In particullar, the hybrid model reduces the residue of the standard GM(1,1 model as well as accelerating the convergence rate of the standard NN. After numerical studies, the illustrative results are provided to demonstrate the forecast performance of the proposed model. In addition, some strategies for improving the postgraduates’ employment confidence have been discussed.

  2. Pre-simulation orientation for medical trainees: An approach to decrease anxiety and improve confidence and performance.

    Science.gov (United States)

    Bommer, Cassidy; Sullivan, Sarah; Campbell, Krystle; Ahola, Zachary; Agarwal, Suresh; O'Rourke, Ann; Jung, Hee Soo; Gibson, Angela; Leverson, Glen; Liepert, Amy E

    2018-02-01

    We assessed the effect of basic orientation to the simulation environment on anxiety, confidence, and clinical decision making. Twenty-four graduating medical students participated in a two-week surgery preparatory curriculum, including three simulations. Baseline anxiety was assessed pre-course. Scenarios were completed on day 2 and day 9. Prior to the first simulation, participants were randomly divided into two groups. Only one group received a pre-simulation orientation. Before the second simulation, all students received the same orientation. Learner anxiety was reported immediately preceding and following each simulation. Confidence was assessed post-simulation. Performance was evaluated by surgical faculty. The oriented group experienced decreased anxiety following the first simulation (p = 0.003); the control group did not. Compared to the control group, the oriented group reported less anxiety and greater confidence and received higher performance scores following all three simulations (all p simulation orientation reduces anxiety while increasing confidence and improving performance. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. The impact of a structured clinical training course on interns' self-reported confidence with core clinical urology skills.

    Science.gov (United States)

    Browne, C; Norton, S; Nolan, J M; Whelan, C; Sullivan, J F; Quinlan, M; Sheikh, M; Mc Dermott, T E D; Lynch, T H; Manecksha, R P

    2018-02-01

    Undergraduate training in core urology skills is lacking in many Irish training programmes. Our aim was to assess newly qualified doctors' experience and confidence with core urological competencies. A questionnaire survey covering exposure to urology and confidence with core clinical skills was circulated to all candidates. The group then attended a skills course covering male/female catheterisation, insertion of three-way catheters, bladder irrigation and management of long-term suprapubic catheters. The groups were re-surveyed following the course. Forty-five interns completed the pre-course questionnaire (group 1) and 27 interns completed the post-course questionnaire (group 2). 24/45 (53%) had no experience of catheter insertion on a patient during their undergraduate training. 26/45 (58%) were unsupervised during their first catheter insertion. 12/45 (27%) had inserted a female catheter. 18/45 (40%) had inserted a three-way catheter. 12/45 (27%) had changed a suprapubic catheter. 40/45 (89%) in group 1 reported 'good' or 'excellent' confidence with male urinary catheterisation, compared to 25/27 (92.5%) in group 2. 18/45 (40%) in group 1 reported 'none' or 'poor' confidence with female catheterisation, compared to 7/27 (26%) in group 2. 22/45 (49%) in group 1 reported 'none' or 'poor' confidence with insertion of three-way catheters, compared to 2/27 (7%) in group 2. 32/45 (71%) in group 1 reported 'none' or 'poor' confidence in changing long-term suprapubic catheters, falling to 3/27 (11%) in group 2. This study raises concerns about newly qualified doctors' practical experience in urology. We suggest that this course improves knowledge and confidence with practical urology skills and should be incorporated into intern induction.

  4. 77 FR 57566 - Announcement of Public Meeting on the Consumer Confidence Report (CCR) Rule Retrospective Review...

    Science.gov (United States)

    2012-09-18

    ... ENVIRONMENTAL PROTECTION AGENCY [EPA-HQ-OW-2012-0035; FRL-9730-7] Announcement of Public Meeting on the Consumer Confidence Report (CCR) Rule Retrospective Review and Request for Public Comment on Potential Approaches to Electronic Delivery of the CCR; Correction AGENCY: Environmental Protection Agency...

  5. Self-reported confidence and skills of general practitioners in management of mental health disorders.

    Science.gov (United States)

    Oakley Browne, Mark; Lee, Adeline; Prabhu, Radha

    2007-10-01

    To identify the predictors of self-reported confidence and skills of GPs in management of patients with mental health problems. Cross-sectional survey, with questionnaire presented to 246 GPs working in 62 practices throughout Gippsland. Rural general practices in Gippsland. One hundred and thirty-four GPs across Gippsland. GPs completed a questionnaire assessing self-perception of knowledge and skills in recognition and management of common mental health problems. Of 134 GPs, 45% reported that they have a specific interest in mental health, and 39% of GPs reported that they had previous mental health training. Only 22% of GPs describe having both an interest and prior training in mental health care. Age and years since graduation are not significantly related to self-reported confidence and skills. The results of this study highlight that self-professed interest and prior training in mental health are associated. Self-professed interest in mental health care predicts confidence and self-perceived skills in recognition, assessment and management of common mental health disorders. Similarly, prior training in mental health care predicts confidence and self-perceived skills in recognition, assessment and management of common mental health problems. Self-professed interest in mental health issues is also associated with hours of participation in continuing medical education related to mental health care. Unfortunately, only a minority described having both interest and prior training in mental health care.

  6. A clinical nutrition course to improve pharmacy students' skills and confidence in counseling patients.

    Science.gov (United States)

    Chang, Linda; Popovich, Nicholas G; Iramaneerat, Cherdsak; Smith, Everett V; Lutfiyya, M Nawal

    2008-06-15

    To create, implement, and evaluate a PharmD course on primary care nutrition. A 2-credit hour elective course was offered to second- and third-year pharmacy students. It was informed by the Socratic method using a minimum number of formal lecture presentations and featured problem-based learning exercises, case-based scenarios, and scientific literature to fuel informed debate. A single group posttest design with a retrospective pretest was used to assess students' self-efficacy. There was a significant overall improvement in students' self-efficacy in their ability to practice primary care nutrition. Completion of a nutrition course improved students' confidence in providing primary care nutrition and empowered them to speak more comfortably about the role of nutrition in the prevention of chronic diseases.

  7. Wheelchair skills training to improve confidence with using a manual wheelchair among older adults: a pilot study.

    Science.gov (United States)

    Sakakibara, Brodie M; Miller, William C; Souza, Melanie; Nikolova, Viara; Best, Krista L

    2013-06-01

    To examine the effects of wheelchair skills training on confidence in older adults who are inexperienced wheelchair users. Parallel group, single-blind randomized controlled trial. Research laboratory in a rehabilitation hospital. Participants (N=20) who were community-living older adults at least 65 years old (mean age, 70y), 50% women, and who had no experience of using a wheelchair were randomly allocated to an intervention (n=10) or control (n=10) group. The intervention group received two 1-hour training sessions that followed the Wheelchair Skills Training Program (WSTP) protocol. The control group received a single socialization contact. The Wheelchair Use Confidence Scale-Manual (WheelCon-M) was used to evaluate confidence with using a manual wheelchair. The WheelCon-M is a self-report questionnaire that comprises 65 items in 6 conceptual areas. A 1-way between-groups analysis of covariance revealed a significant difference in postintervention WheelCon-M scores between the intervention and control groups (F1,17=10.9, P=.004) after controlling for baseline WheelCon-M scores. A large effect size was also observed (partial η(2)=.39). Secondary analyses revealed that the WSTP had greater effects on confidence in areas related to maneuvering around the physical environment, knowledge and problem solving, advocacy, and managing emotions than in areas related to performing activities and behaving in social situations. Two 1-hour WSTP sessions improve confidence with using a manual wheelchair among older adults who are inexperienced wheelchair users. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  8. Interprofessional Oral Health Education Improves Knowledge, Confidence, and Practice for Pediatric Healthcare Providers

    Directory of Open Access Journals (Sweden)

    Devon Cooper

    2017-08-01

    Full Text Available Dental caries is the most prevalent chronic childhood disease in the United States. Dental caries affects the health of 60–90% of school-aged children worldwide. The prevalence of untreated early childhood dental caries is 19% for children 2–5 years of age in the U.S. Some factors that contribute to the progression of dental caries include socioeconomic status, access to dental care, and lack of anticipatory guidance. The prevalence of dental caries remains highest for children from specific ethnic or racial groups, especially those living in underserved areas where there may be limited access to a dentist. Although researchers have acknowledged the various links between oral health and overall systemic health, oral health care is not usually a component of pediatric primary health care. To address this public health crisis and oral health disparity in children, new collaborative efforts among health professionals is critical for dental disease prevention and optimal oral health. This evaluation study focused on a 10-week interprofessional practice and education (IPE course on children’s oral health involving dental, osteopathic medical, and nurse practitioner students at the University of California, San Francisco. This study’s objective was to evaluate changes in knowledge, confidence, attitude, and clinical practice in children’s oral health of the students completed the course. Thirty-one students participated in the IPE and completed demographic questionnaires and four questionnaires before and after the IPE course: (1 course content knowledge, (2 confidence, (3 attitudes, and (4 clinical practice. Results showed a statistically significant improvement in the overall knowledge of children’s oral health topics, confidence in their ability to provide oral health services, and clinical practice. There was no statistically significant difference in attitude, but there was an upward trend toward positivity. To conclude, this IPE

  9. Two sides of the same coin : Monetary incentives concurrently improve and bias confidence judgments

    NARCIS (Netherlands)

    Lebreton, Maël; Langdon, Shari; Slieker, Matthijs J; Nooitgedacht, Jip S; Goudriaan, Anna E; Denys, D.; van Holst, Ruth J; Luigjes, Judy

    2018-01-01

    Decisions are accompanied by a feeling of confidence, that is, a belief about the decision being correct. Confidence accuracy is critical, notably in high-stakes situations such as medical or financial decision-making. We investigated how incentive motivation influences confidence accuracy by

  10. Improvement of Roller Bearing Diagnosis with Unlabeled Data Using Cut Edge Weight Confidence Based Tritraining

    Directory of Open Access Journals (Sweden)

    Wei-Li Qin

    2016-01-01

    Full Text Available Roller bearings are one of the most commonly used components in rotational machines. The fault diagnosis of roller bearings thus plays an important role in ensuring the safe functioning of the mechanical systems. However, in most cases of bearing fault diagnosis, there are limited number of labeled data to achieve a proper fault diagnosis. Therefore, exploiting unlabeled data plus few labeled data, this paper proposed a roller bearing fault diagnosis method based on tritraining to improve roller bearing diagnosis performance. To overcome the noise brought by wrong labeling into the classifiers training process, the cut edge weight confidence is introduced into the diagnosis framework. Besides a small trick called suspect principle is adopted to avoid overfitting problem. The proposed method is validated in two independent roller bearing fault experiment vibrational signals that both include three types of faults: inner-ring fault, outer-ring fault, and rolling element fault. The results demonstrate the desirable diagnostic performance improvement by the proposed method in the extreme situation where there is only limited number of labeled data.

  11. GPs' confidence in caring for their patients on the autism spectrum: an online self-report study.

    Science.gov (United States)

    Unigwe, Silvana; Buckley, Carole; Crane, Laura; Kenny, Lorcan; Remington, Anna; Pellicano, Elizabeth

    2017-06-01

    In the UK, GPs play a key role in the identification and management of children, young people, and adults on the autism spectrum, but there is a paucity of research on GPs' perceptions of working with these patients. To understand GPs' perceived self-efficacy in identifying and managing their patients on the autism spectrum, and the factors affecting this. An online self-report survey was developed for completion by GPs across the UK. A total of 304 GPs in the UK took part. The survey collected responses on participants' background, training, and experience, both as a GP and with regard to autism, and included a 22-item knowledge of autism questionnaire, a 14-item self-efficacy scale targeting GPs' perceived confidence in identifying and managing their autistic patients, and an open question eliciting participants' experiences of working with autistic people. In total, 39.5% ( n = 120) of GP participants reported never having received formal training in autism. Despite demonstrating good knowledge of its key features, participants reported limited confidence in their abilities to identify and manage autistic patients, with many citing a number of barriers that overwhelmingly focused on perceived failings of the current healthcare system (such as a lack of clarity around referral pathways). There is an urgent need for improved local specialist service provision alongside clearer referral pathways for diagnosis to improve both GPs' confidence in caring for their autistic patients and the healthcare experiences of autistic patients and their families. Local clinical commissioning groups are best served to assist GPs in ensuring that they can reliably detect the condition and make appropriate provisions for support. © British Journal of General Practice 2017.

  12. Improving Nurses' Peripheral Intravenous Catheter Insertion Knowledge, Confidence, and Skills Using a Simulation-Based Blended Learning Program

    Science.gov (United States)

    Keleekai, Nowai L.; Schuster, Catherine A.; Murray, Connie L.; King, Mary Anne; Stahl, Brian R.; Labrozzi, Laura J.; Gallucci, Susan; LeClair, Matthew W.; Glover, Kevin R.

    2016-01-01

    Introduction Peripheral intravenous catheter (PIVC) insertion is one of the most common invasive procedures performed in a hospital, but most nurses receive little formal training in this area. Blended PIVC insertion training programs that incorporate deliberate simulated practice have the potential to improve clinical practice and patient care. Methods The study was a randomized, wait-list control group with crossover using nurses on three medical/surgical units. Baseline PIVC knowledge, confidence, and skills assessments were completed for both groups. The intervention group then received a 2-hour PIVC online course, followed by an 8-hour live training course using a synergistic mix of three simulation tools. Both groups were then reassessed. After crossover, the wait-list group received the same intervention and both groups were reassessed. Results At baseline, both groups were similar for knowledge, confidence, and skills. Compared with the wait-list group, the intervention group had significantly higher scores for knowledge, confidence, and skills upon completing the training program. After crossover, the wait-list group had similarly higher scores for knowledge, confidence, and skills than the intervention group. Between the immediate preintervention and postintervention periods, the intervention group improved scores for knowledge by 31%, skills by 24%, and decreased confidence by 0.5%, whereas the wait-list group improved scores for knowledge by 28%, confidence by 16%, and skills by 15%. Conclusions Results demonstrate significant improvements in nurses' knowledge, confidence, and skills with the use of a simulation-based blended learning program for PIVC insertion. Transferability of these findings from a simulated environment into clinical practice should be further explored. PMID:27504890

  13. Improving TSA’s Public Image: Customer-Focused Initiatives to Encourage Public Trust and Confidence

    Science.gov (United States)

    2013-12-01

    faces, many from the old TSA, but the confidence node in their brains appeared to have been bypassed and hardwired directly to the pain center.”8...Traditions training before starting the job. During this orientation period, the Disney culture is communicated through powerful storytelling .”299 New

  14. Sample Preparation Report of the Fourth OPCW Confidence Building Exercise on Biomedical Sample Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Udey, R. N. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Corzett, T. H. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Alcaraz, A. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2014-07-03

    Following the successful completion of the 3rd biomedical confidence building exercise (February 2013 – March 2013), which included the analysis of plasma and urine samples spiked at low ppb levels as part of the exercise scenario, another confidence building exercise was targeted to be conducted in 2014. In this 4th exercise, it was desired to focus specifically on the analysis of plasma samples. The scenario was designed as an investigation of an alleged use of chemical weapons where plasma samples were collected, as plasma has been reported to contain CWA adducts which remain present in the human body for several weeks (Solano et al. 2008). In the 3rd exercise most participants used the fluoride regeneration method to analyze for the presence of nerve agents in plasma samples. For the 4th biomedical exercise it was decided to evaluate the analysis of human plasma samples for the presence/absence of the VX adducts and aged adducts to blood proteins (e.g., VX-butyrylcholinesterase (BuChE) and aged BuChE adducts using a pepsin digest technique to yield nonapeptides; or equivalent). As the aging of VX-BuChE adducts is relatively slow (t1/2 = 77 hr at 37 °C [Aurbek et al. 2009]), soman (GD), which ages much more quickly (t1/2 = 9 min at 37 °C [Masson et al. 2010]), was used to simulate an aged VX sample. Additional objectives of this exercise included having laboratories assess novel OP-adducted plasma sample preparation techniques and analytical instrumentation methodologies, as well as refining/designating the reporting formats for these new techniques.

  15. Technical Report: Algorithm and Implementation for Quasispecies Abundance Inference with Confidence Intervals from Metagenomic Sequence Data

    Energy Technology Data Exchange (ETDEWEB)

    McLoughlin, Kevin [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2016-01-11

    This report describes the design and implementation of an algorithm for estimating relative microbial abundances, together with confidence limits, using data from metagenomic DNA sequencing. For the background behind this project and a detailed discussion of our modeling approach for metagenomic data, we refer the reader to our earlier technical report, dated March 4, 2014. Briefly, we described a fully Bayesian generative model for paired-end sequence read data, incorporating the effects of the relative abundances, the distribution of sequence fragment lengths, fragment position bias, sequencing errors and variations between the sampled genomes and the nearest reference genomes. A distinctive feature of our modeling approach is the use of a Chinese restaurant process (CRP) to describe the selection of genomes to be sampled, and thus the relative abundances. The CRP component is desirable for fitting abundances to reads that may map ambiguously to multiple targets, because it naturally leads to sparse solutions that select the best representative from each set of nearly equivalent genomes.

  16. Improving medical student toxicology knowledge and self-confidence using mannequin simulation.

    Science.gov (United States)

    Halm, Brunhild M; Lee, Meta T; Franke, Adrian A

    2010-01-01

    Learning medicine without placing patients at increased risk of complications is of utmost importance in the medical profession. High-fidelity patient simulators can potentially achieve this and are therefore increasingly used in the training of medical students. Preclinical medical students have minimal exposure to clinical rotations and commonly feel anxious and apprehensive when starting their clinical years. The objective of this pilot study was to determine if toxicology knowledge and confidence of preclinical second-year medical students could be augmented with simulation training. We designed and implemented a simulation exercise for second-year medical students to enhance learning of Basic Life Support, toxidromes, and management of a semiconscious overdose victim. Groups of 5-6 students were tasked to identify abnormal findings, order tests, and initiate treatment on a mannequin. Faculty observers provided video-assisted feedback immediately afterwards. On-line pre- and posttests were completed in the simulation lab before and after the exercise. This simulation exercise, completed by 52 students, increased test scores on average from 60% to 71% compared to a pre-test. Among the topics tested, students scored worst in identifying normal/abnormal vital signs. Mean confidence increased from 2.0 to 2.6 using a 5-point Likert scale (1-very low to 5-very high). This study suggests that simulation exercises for second-year medical students may be a valuable tool to increase knowledge and student self-confidence at a key transition period prior to beginning clerkship experiences. Further research is needed to prove long-term educational benefits of simulation interventions in the preclinical setting.

  17. Does one workshop on respecting cultural differences increase health professionals' confidence to improve the care of Australian Aboriginal patients with cancer? An evaluation.

    Science.gov (United States)

    Durey, Angela; Halkett, Georgia; Berg, Melissa; Lester, Leanne; Kickett, Marion

    2017-09-15

    Aboriginal Australians have worse cancer survival rates than other Australians. Reasons include fear of a cancer diagnosis, reluctance to attend mainstream health services and discrimination from health professionals. Offering health professionals education in care focusing on Aboriginal patients' needs is important. The aim of this paper was to evaluate whether participating in a workshop improved the confidence of radiation oncology health professionals in their knowledge, communication and ability to offer culturally safe healthcare to Aboriginal Australians with cancer. Mixed methods using pre and post workshop online surveys, and one delivered 2 months later, were evaluated. Statistical analysis determined the relative proportion of participants who changed from not at all/a little confident at baseline to fairly/extremely confident immediately and 2 months after the workshop. Factor analysis identified underlying dimensions in the items and nonparametric tests recorded changes in mean dimension scores over and between times. Qualitative data was analysed for emerging themes. Fifty-nine participants attended the workshops, 39 (66% response rate) completed pre-workshop surveys, 32 (82% of study participants) completed post-workshop surveys and 25 (64% of study participants) completed surveys 2 months later. A significant increase in the proportion of attendees who reported fair/extreme confidence within 2 days of the workshop was found in nine of 14 items, which was sustained for all but one item 2 months later. Two additional items had a significant increase in the proportion of fair/extremely confident attendees 2 months post workshop compared to baseline. An exploratory factor analysis identified three dimensions: communication; relationships; and awareness. All dimensions' mean scores significantly improved within 2 days (p Aboriginal Australians that in some cases resulted in improved care. Single workshops co-delivered by an Aboriginal and non

  18. Multiple Sessions for Information Literacy Instruction are Associated with Improvement in Students’ Research Abilities and Confidence

    Directory of Open Access Journals (Sweden)

    Kelley Wadson

    2017-06-01

    -searching, research, and website analysis skills, and three Likert-type 1-5 rating scale questions measuring comfort levels. ENGL 112 students completed their post-test survey in the spring 2015 semester, which consisted of the same three 1-5 rating scale questions measuring comfort levels, to further test the effectiveness of multiple sessions. Main Results – The ENG 111 pre-test survey had 244 (66.67% female and 33.33% male respondents and the post-test had 150 (72.37% female and 28.69% male respondents. When comparing results, scores increased for pre-searching, specifically understanding of methods for brainstorming search terms (9%, and for all measures of website analysis and research, namely understanding of library databases (7.63%, choosing correct evaluative criteria (4.49%, recognizing reliable top-level domains (TLDs .edu (1.15% and .gov (11.21%, and Google’s advanced search (10.43%. Post-test scores decreased on the measures of understanding of a thesis statement (7% and narrowing a topic if there’s too much information (6%. For comfort levels, neutral responses did not vary much, but there was a shift in responses from “not comfortable” to “somewhat comfortable” and “very comfortable.” Across three measures, namely getting started with a research paper, library research skills, and writing an academic research paper, participants’ “not comfortable” responses decreased and their “comfortable” responses increased. The ENG 112 post-test survey had 29 (60.71% female and 39.29% male respondents and measured the same comfort levels. In addition, responses showed further improvement for all three questions. Within-subject analysis of both surveys showed slight gender variations. On several pre-test and post-test measures, females scored lower than males in understanding of databases, Google’s advanced search, and website analysis. Conclusion – The researchers conclude that expanding IL instruction from a single “one-shot” to four sessions

  19. Balance and Gait Training With Augmented Feedback Improves Balance Confidence in People With Parkinson's Disease: A Randomized Controlled Trial.

    Science.gov (United States)

    Shen, Xia; Mak, Margaret K Y

    2014-07-01

    Background Fear of falling has been identified as an important and independent fall-risk predictor in patients with Parkinson's disease (PD). However, there are inconsistent findings on the effects of balance and gait training on balance confidence. Objective To explore whether balance and gait training with augmented feedback can enhance balance confidence in PD patients immediately after treatment and at 3- and 12-month follow-ups. Methods A total of 51 PD patients were randomly assigned to a balance and gait training (BAL) group or to an active control (CON) group. The BAL group received balance and gait training with augmented feedback, whereas CON participants received lower-limb strength training for 12 weeks. Outcome measures included Activities-Specific Balance Confidence (ABC) Scale, limits-of-stability test, single-leg-stance test, and spatiotemporal gait characteristics. All tests were administered before intervention (Pre), immediately after training (Post), and at 3 months (Post3m) and 12 months (Post12m) after treatment completion. Results The ABC score improved marginally at Post and significantly at Post3m and Post12m only in the BAL group (P point excursion at Post, but only the BAL group maintained the improvement at Post3m. The BAL group maintained significantly longer time-to-loss-of-balance during the single-leg stance test than the CON group at Post3m and Post12m (P balance confidence and balance and gait performance in patients with PD. © The Author(s) 2014.

  20. Basic Disaster Life Support (BDLS) Training Improves First Responder Confidence to Face Mass-Casualty Incidents in Thailand.

    Science.gov (United States)

    Kuhls, Deborah A; Chestovich, Paul J; Coule, Phillip; Carrison, Dale M; Chua, Charleston M; Wora-Urai, Nopadol; Kanchanarin, Tavatchai

    2017-10-01

    Medical response to mass-casualty incidents (MCIs) requires specialized training and preparation. Basic Disaster Life Support (BDLS) is a course designed to prepare health care workers for a MCI. The purpose of this study was to evaluate the confidence of health care professionals in Thailand to face a MCI after participating in a BDLS course. Basic Disaster Life Support was taught to health care professionals in Thailand in July 2008. Demographics and medical experience were recorded, and participants rated their confidence before and after the course using a five-point Likert scale in 11 pertinent MCI categories. Survey results were compiled and compared with PBasic Disaster Life Support significantly improves confidence to respond to MCI situations, but nurses and active duty military benefit the most from the course. Future courses should focus on these groups to prepare for MCIs. Kuhls DA , Chestovich PJ , Coule P , Carrison DM , Chua CM , Wora-Urai N , Kanchanarin T . Basic Disaster Life Support (BDLS) training improves first responder confidence to face mass-casualty incidents in Thailand. Prehosp Disaster Med. 2017;32(5):492-500 .

  1. Confidence-building in the Asia-Pacific region. Report of working group II

    International Nuclear Information System (INIS)

    Cotton, J.

    1992-01-01

    Detailed presentations of South and North Korea offers positive evaluation concerning bilateral agreements, which aim both reconciliation between the two states and denuclearization of the Korean peninsula. Consideration was given to confidence building measures in the Asia-Pacific region as a whole as well as to the progress made in introducing such measures in various Subregions of Asia-Pacific. The concept of confidence building actually implies a two-part agenda, particular procedures and general process

  2. Confidence improvement of disosal safety bydevelopement of a safety case for high-level radioactive waste disposal

    Energy Technology Data Exchange (ETDEWEB)

    Baik, Min Hoon; Ko, Nak Youl; Jeong, Jong Tae; Kim, Kyung Su [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2016-12-15

    Many countries have developed a safety case suitable to their own countries in order to improve the confidence of disposal safety in deep geological disposal of high-level radioactive waste as well as to develop a disposal program and obtain its license. This study introduces and summarizes the meaning, necessity, and development process of the safety case for radioactive waste disposal. The disposal safety is also discussed in various aspects of the safety case. In addition, the status of safety case development in the foreign countries is briefly introduced for Switzerland, Japan, the United States of America, Sweden, and Finland. The strategy for the safety case development that is being developed by KAERI is also briefly introduced. Based on the safety case, we analyze the efforts necessary to improve confidence in disposal safety for high-level radioactive waste. Considering domestic situations, we propose and discuss some implementing methods for the improvement of disposal safety, such as construction of a reliable information database, understanding of processes related to safety, reduction of uncertainties in safety assessment, communication with stakeholders, and ensuring justice and transparency. This study will contribute to the understanding of the safety case for deep geological disposal and to improving confidence in disposal safety through the development of the safety case in Korea for the disposal of high-level radioactive waste.

  3. Cluster chemical ionization for improved confidence level in sample identification by gas chromatography/mass spectrometry.

    Science.gov (United States)

    Fialkov, Alexander B; Amirav, Aviv

    2003-01-01

    Upon the supersonic expansion of helium mixed with vapor from an organic solvent (e.g. methanol), various clusters of the solvent with the sample molecules can be formed. As a result of 70 eV electron ionization of these clusters, cluster chemical ionization (cluster CI) mass spectra are obtained. These spectra are characterized by the combination of EI mass spectra of vibrationally cold molecules in the supersonic molecular beam (cold EI) with CI-like appearance of abundant protonated molecules, together with satellite peaks corresponding to protonated or non-protonated clusters of sample compounds with 1-3 solvent molecules. Like CI, cluster CI preferably occurs for polar compounds with high proton affinity. However, in contrast to conventional CI, for non-polar compounds or those with reduced proton affinity the cluster CI mass spectrum converges to that of cold EI. The appearance of a protonated molecule and its solvent cluster peaks, plus the lack of protonation and cluster satellites for prominent EI fragments, enable the unambiguous identification of the molecular ion. In turn, the insertion of the proper molecular ion into the NIST library search of the cold EI mass spectra eliminates those candidates with incorrect molecular mass and thus significantly increases the confidence level in sample identification. Furthermore, molecular mass identification is of prime importance for the analysis of unknown compounds that are absent in the library. Examples are given with emphasis on the cluster CI analysis of carbamate pesticides, high explosives and unknown samples, to demonstrate the usefulness of Supersonic GC/MS (GC/MS with supersonic molecular beam) in the analysis of these thermally labile compounds. Cluster CI is shown to be a practical ionization method, due to its ease-of-use and fast instrumental conversion between EI and cluster CI, which involves the opening of only one valve located at the make-up gas path. The ease-of-use of cluster CI is analogous

  4. Undergraduate baccalaureate nursing students' self-reported confidence in learning about patient safety in the classroom and clinical settings: an annual cross-sectional study (2010-2013).

    Science.gov (United States)

    Lukewich, Julia; Edge, Dana S; Tranmer, Joan; Raymond, June; Miron, Jennifer; Ginsburg, Liane; VanDenKerkhof, Elizabeth

    2015-05-01

    Given the increasing incidence of adverse events and medication errors in healthcare settings, a greater emphasis is being placed on the integration of patient safety competencies into health professional education. Nurses play an important role in preventing and minimizing harm in the healthcare setting. Although patient safety concepts are generally incorporated within many undergraduate nursing programs, the level of students' confidence in learning about patient safety remains unclear. Self-reported patient safety competence has been operationalized as confidence in learning about various dimensions of patient safety. The present study explores nursing students' self-reported confidence in learning about patient safety during their undergraduate baccalaureate nursing program. Cross-sectional study with a nested cohort component conducted annually from 2010 to 2013. Participants were recruited from one Canadian university with a four-year baccalaureate of nursing science program. All students enrolled in the program were eligible to participate. The Health Professional Education in Patient Safety Survey was administered annually. The Health Professional Education in Patient Safety Survey captures how the six dimensions of the Canadian Patient Safety Institute Safety Competencies Framework and broader patient safety issues are addressed in health professional education, as well as respondents' self-reported comfort in speaking up about patient safety issues. In general, nursing students were relatively confident in what they were learning about the clinical dimensions of patient safety, but they were less confident about the sociocultural aspects of patient safety. Confidence in what they were learning in the clinical setting about working in teams, managing adverse events and responding to adverse events declined in upper years. The majority of students did not feel comfortable speaking up about patient safety issues. The nested cohort analysis confirmed these

  5. Cooking Matters for Adults Improves Food Resource Management Skills and Self-confidence Among Low-Income Participants.

    Science.gov (United States)

    Pooler, Jennifer A; Morgan, Ruth E; Wong, Karen; Wilkin, Margaret K; Blitstein, Jonathan L

    Determine the impact of Cooking Matters for Adults (CM) on food resource management (FRM) skills and self-confidence 6 months after course completion. Quasi-experimental design with nonequivalent comparison group and 6-month follow-up. Cooking Matters for Adults programs in CA, CO, ME, MA, MI, and OR. Participants in CM attending classes in April to July, 2016 (n = 332); comparison group (n = 336). Cooking Matters for Adults educated low-income adults to shop for and prepare healthy meals economically using hands-on meal preparation, facilitated discussion, and an interactive grocery store tour. Classes met for 2 hours, once a week for 6 weeks. Food resource management practices; FRM self-confidence (ie, in shopping for and preparing healthy foods on a budget); worrying that food might run out. Pearson's chi-square test and t tests identified measures associated with outcomes of interest and between-group differences. Repeated-measures linear mixed models with fixed and random effects were used to examine differences in outcomes between participants in CM and nonequivalent comparison group and to estimate the treatment effect of the program at 3 and 6 months after course completion. Six months after course completion, CM participants demonstrated improvements in all outcome measures of interest: Use of FRM practices improved (P = .002) as did FRM confidence (P < .001). Participants also worried less that food would run out before they had money to buy more (P = .03). This study demonstrated a positive impact of including FRM skills and confidence building in a nutrition education program, the effects of which could be seen for 6 months after participation in the program. Equipping low-income families with FRM skills allowed them to access healthier foods even during times of hardship. Copyright © 2017 Society for Nutrition Education and Behavior. All rights reserved.

  6. Two-dimensional sonographic cine imaging improves confidence in the initial evaluation of the fetal heart.

    Science.gov (United States)

    Poole, Patricia Sims; Chung, Romy; Lacoursiere, Yvette; Palmieri, Carolina Rossi; Hull, Andrew; Engelkemier, Dawn; Rochelle, Michele; Trivedi, Neha; Pretorius, Dolores H

    2013-06-01

    Initial screening sonography of the fetal heart with static images is often inadequate, resulting in repeated imaging or failure to detect abnormalities. We hypothesized that the addition of short cine clips would reduce the need for repeated imaging. Two-dimensional (2D) static sonograms and short 2D cine clips of the 4-chamber view and left and right ventricular outflow tracts were obtained from 342 patients with gestational ages of greater than 16 weeks. A diagnostic radiologist and a perinatologist retrospectively reviewed the static and cine images independently and graded them as normal, abnormal, or suboptimal. A statistically significant increase in the number of structures called normal was seen when 2D cine clips were added to static imaging for both observers (P cine images versus 61.9% with static images alone, whereas the perinatologist recorded 68.1% as normal versus 58.8%, respectively. The radiologist called 77.8% of structures normal with cine images only versus 61.9% with static images only (P cine images alone (38.9%) versus static images alone (58.8%). The use of cine loops alone resulted in no significant increase in the ability to clear the heart as normal. The maternal body mass index was inversely associated with the ability to clear structures when 2D cine images were added to static images (P cine clips to standard 2D static imaging of the fetal heart significantly improves the number of structures cleared as normal. Two-dimensional cine clips are easily obtained, add little time to a study, and require minimal archival space.

  7. A Novel Multiplayer Screen-Based Simulation Experience for African Learners Improved Confidence in Management of Postpartum Hemorrhage

    Directory of Open Access Journals (Sweden)

    Jeffrey M. Taekman

    2017-09-01

    Full Text Available IntroductionPostpartum hemorrhage (PPH remains a global challenge, affecting thirteen million women each year. In addition, PPH is a leading cause of maternal mortality in Asia and Africa. In the U.S.A., care of critically ill patients is often practiced using mannequin-based simulation. Mannequin-based simulation presents challenges in global health, particularly in low- or middle-income countries. We developed a novel multiplayer screen-based simulation in a virtual world enabling the practice of team coordination with PPH. We used this simulation with learners in Mulago, Uganda. We hypothesized that a multiplayer screen-based simulation experience would increase learner confidence in their ability to manage PPH.MethodsThe study design was a simple pre- and a post-intervention survey. Forty-eight interprofessional subjects participated in one of nine 1-h simulation sessions using the PPH software. A fifteen-question self-assessment administered before and after the intervention was designed to probe the areas of learning as defined by Bloom and Krathwohl: affective, cognitive, and psychomotor.ResultsCombined confidence scores increased significantly overall following the simulation experience and individually in each of the three categories of Bloom’s Taxonomy: affective, cognitive, and psychomotor.ConclusionWe provide preliminary evidence that multiplayer screen-based simulation represents a scalable, distributable form of learning that may be used effectively in global health education and training. Interestingly, despite our intervention being screen-based, our subjects showed improved confidence in their ability to perform psychomotor tasks. Although there is precedent for mental rehearsal improving performance, further research is needed to understand this finding.

  8. A Novel Multiplayer Screen-Based Simulation Experience for African Learners Improved Confidence in Management of Postpartum Hemorrhage.

    Science.gov (United States)

    Taekman, Jeffrey M; Foureman, Megan F; Bulamba, Fred; Steele, Michael; Comstock, Emily; Kintu, Andrew; Mauritz, Amy; Olufolabi, Adeyemi

    2017-01-01

    Postpartum hemorrhage (PPH) remains a global challenge, affecting thirteen million women each year. In addition, PPH is a leading cause of maternal mortality in Asia and Africa. In the U.S.A., care of critically ill patients is often practiced using mannequin-based simulation. Mannequin-based simulation presents challenges in global health, particularly in low- or middle-income countries. We developed a novel multiplayer screen-based simulation in a virtual world enabling the practice of team coordination with PPH. We used this simulation with learners in Mulago, Uganda. We hypothesized that a multiplayer screen-based simulation experience would increase learner confidence in their ability to manage PPH. The study design was a simple pre- and a post-intervention survey. Forty-eight interprofessional subjects participated in one of nine 1-h simulation sessions using the PPH software. A fifteen-question self-assessment administered before and after the intervention was designed to probe the areas of learning as defined by Bloom and Krathwohl: affective, cognitive, and psychomotor. Combined confidence scores increased significantly overall following the simulation experience and individually in each of the three categories of Bloom's Taxonomy: affective, cognitive, and psychomotor. We provide preliminary evidence that multiplayer screen-based simulation represents a scalable, distributable form of learning that may be used effectively in global health education and training. Interestingly, despite our intervention being screen-based, our subjects showed improved confidence in their ability to perform psychomotor tasks. Although there is precedent for mental rehearsal improving performance, further research is needed to understand this finding.

  9. Emergency radiology elective improves second-year medical students' perceived confidence and knowledge of appropriate imaging utilization.

    Science.gov (United States)

    Leschied, Jessica R; Knoepp, Ursula S; Hoff, Carrie Nicole; Mazza, Michael B; Klein, Katherine A; Mullan, Patricia B; Kelly, Aine M

    2013-09-01

    Given recent advances in and wider availability of complex imaging, physicians are expected to understand imaging appropriateness. We introduced second-year medical students to the American College of Radiology Appropriateness Criteria (ACR-AC) in an interactive case-based elective to demonstrate their use in imaging for common emergency department clinical complaints. Prospective pre- and post-test design assessed second-year medical students' performance on case-based knowledge applications and self-assessed confidence related to ACR-AC guidelines compared to second-year students participating in a different concurrent radiology elective. Students participated in a 3-day elective covering the ACR-AC, comparative effective imaging, and risks associated with imaging radiation exposure, with outcomes of perceived confidence using a 5-point Likert scale and knowledge of ACR-AC using case-based multiple choice questions. Analysis included computing mean scores and assessing effect sizes for changes in knowledge. Before the elective, 24 students scored an average of 3.45 questions correct of 8 (43.1%). On course completion, students scored an average of 5.3 questions correct of the same questions (66.3%) (P .85; effect size = 0.008). Students' confidence in ordering appropriate imaging improved nearly 2-fold from a range of 1.9 to 3.2 (on a scale of 1.0 to 5.0) to a range of 3.7 to 4.5. Following a short radiology elective, second-year medical students improved their knowledge of appropriate image utilization and perceived awareness of the indications, contraindications, and effects of radiation exposure related to medical imaging. Copyright © 2013 AUR. Published by Elsevier Inc. All rights reserved.

  10. Earning public trust and confidence: Requisites for managing radioactive wastes. Final report

    Energy Technology Data Exchange (ETDEWEB)

    1993-11-01

    The Task Force on Radioactive Waste Management was created in April 1991 by former Secretary James D. Watkins, who asked the group to analyze the critical institutional question of how the Department of Energy (DOE) might strengthen public trust and confidence in the civilian radioactive waste management program. The panel met eight times over a period of 27 months and heard formal presentations from nearly 100 representatives of state and local governments, non-governmental organizations, and senior DOE Headquarters and Field Office managers. The group also commissioned a variety of studies from independent experts, contracted with the National Academy of Sciences and the National Academy of Public Administration to hold workshops on designing and leading trust-evoking organizations, and carried out one survey of parties affected by the Department`s radioactive waste management activities and a second one of DOE employees and contractors.

  11. Earning public trust and confidence: Requisites for managing radioactive wastes. Final report

    International Nuclear Information System (INIS)

    1993-11-01

    The Task Force on Radioactive Waste Management was created in April 1991 by former Secretary James D. Watkins, who asked the group to analyze the critical institutional question of how the Department of Energy (DOE) might strengthen public trust and confidence in the civilian radioactive waste management program. The panel met eight times over a period of 27 months and heard formal presentations from nearly 100 representatives of state and local governments, non-governmental organizations, and senior DOE Headquarters and Field Office managers. The group also commissioned a variety of studies from independent experts, contracted with the National Academy of Sciences and the National Academy of Public Administration to hold workshops on designing and leading trust-evoking organizations, and carried out one survey of parties affected by the Department's radioactive waste management activities and a second one of DOE employees and contractors

  12. Cupping Therapy Simulation Course; A Pilot Study Assessing Self Reporting of Confidence, Expectations/Satisfaction and Performance

    OpenAIRE

    Aboushanab, Tamer; Khalil, Mohammed; El-Olemy, Ahmed; Alsanad, Saud

    2017-01-01

    This paper aimed to assess self-reporting of confidence, expectations/satisfaction, and performance of medical students before and after the cupping therapy simulation training course and to validate cupping simulation training evaluation questionnaire (CSTEQ). It was a pilot study to evaluate cupping therapy simulation course provided by National Center for Complementary and Alternative Medicine (NCCAM).  The number of participants was 29/41 (70.7%) (20 females and 9 males) before train...

  13. Knowledge and reported confidence of final year midwifery students regarding giving advice on contraception and sexual health.

    Science.gov (United States)

    Walker, Susan H; Davis, Geraldine

    2014-05-01

    this study explored the views of three cohorts of final year midwifery students, regarding their confidence in giving advice to women on contraception and sexual health in the postnatal period. The project also investigated knowledge of contraception using a factual quiz, based on clinical scenarios regarding contraception and sexual health in the postpartum period. a mixed method design using qualitative data from focus groups, and mixed qualitative and quantitative data from a paper based questionnaire was used. the project was carried out in one higher educational institution in England. findings demonstrate that expressed confidence varies according to contraceptive method, with most confidence being reported when advising on the male condom. The findings of the factual quiz indicate that students applied theoretical knowledge poorly in a practically oriented context. These findings also indicated that most students limited advice to general advice. the paper concludes that midwifery students need more practically oriented education in contraception and sexual health, and that the role of mentors is very important in helping students feel confident when giving advice in this area. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. How Effective is a Dental Workshop at Improving the Knowledge and Confidence of Medical Students in the Management of Dental Emergencies?

    Directory of Open Access Journals (Sweden)

    George R. Deeb

    2016-01-01

    Full Text Available The purpose of this study was to evaluate the effect of a three-hour hands-on workshop for medical students and residents on their pre- and postcourse knowledge and confidence in managing dental emergencies. A 1-hour lecture followed by four 20-minute “hands-on” skill stations on dental mannequins was administered to a group of 30 medical students and residents. Pre- and postworkshop questionnaire surveys were conducted. There was a significant increase in the percent of attendees who responded correctly to three of the four knowledge questions following the workshop ( P -value < 0.005. Confidence, as expressed in various statements, about treating dental emergencies was significantly improved after the lecture for eight of the nine statements. These findings indicate that dental knowledge is generally not provided during medical training. Our interactive workshop appeared to be effective in increasing this knowledge and self-reported confidence in handling dental emergencies. These findings clearly indicate the need for additional dental education during medical school. The use of a hands-on workshop may be one model for achieving this goal.

  15. Mars Rover Curriculum: Teacher Self Reporting of Increased Frequency and Confidence in their Science and Language Arts Instruction

    Science.gov (United States)

    Bering, E. A.; Carlson, C.; Nieser, K.; Slagle, E.

    2013-12-01

    The University of Houston is in the process of developing a flexible program that offers children an in-depth educational experience culminating in the design and construction of their own model Mars rover. The program is called the Mars Rover Model Celebration (MRC). It focuses on students, teachers and parents in grades 3-8. Students design and build a model of a Mars rover to carry out a student selected science mission on the surface of Mars. A total of 65 Mars Rover teachers from the 2012-2013 cohort were invited to complete the Mars Rover Teacher Evaluation Survey. The survey was administered online and could be taken at the convenience of the participant. In total, 29 teachers participated in the survey. Teachers were asked to rate their current level of confidence in their ability to teach specific topics within the Earth and Life Science realms, as well as their confidence in their ability to implement teaching strategies with their students. In addition, they were asked to rate the degree to which they felt their confidence increased in the past year as a result of their participation in the MRC program. The majority of teachers (81-90%) felt somewhat to very confident in their ability to effectively teach concepts related to earth and life sciences to their students. In addition, many of the teachers felt that their confidence in teaching these concepts increased somewhat to quite a bit as a result of their participation in the MRC program (54-88%). The most striking increase in this area was the reported 48% of teachers who felt their confidence in teaching 'Earth and the solar system and universe' increased 'Quite a bit' as a result of their participation in the MRC program. The vast majority of teachers (86-100%) felt somewhat to very confident in their ability to effectively implement all of the listed teaching strategies. In addition, the vast majority reported believing that their confidence increased somewhat to quite a bit as a result of their

  16. Confidant Relations in Italy

    Directory of Open Access Journals (Sweden)

    Jenny Isaacs

    2015-02-01

    Full Text Available Confidants are often described as the individuals with whom we choose to disclose personal, intimate matters. The presence of a confidant is associated with both mental and physical health benefits. In this study, 135 Italian adults responded to a structured questionnaire that asked if they had a confidant, and if so, to describe various features of the relationship. The vast majority of participants (91% reported the presence of a confidant and regarded this relationship as personally important, high in mutuality and trust, and involving minimal lying. Confidants were significantly more likely to be of the opposite sex. Participants overall were significantly more likely to choose a spouse or other family member as their confidant, rather than someone outside of the family network. Familial confidants were generally seen as closer, and of greater value, than non-familial confidants. These findings are discussed within the context of Italian culture.

  17. Student self-reported communication skills, knowledge and confidence across standardised patient, virtual and traditional clinical learning environments.

    Science.gov (United States)

    Quail, Michelle; Brundage, Shelley B; Spitalnick, Josh; Allen, Peter J; Beilby, Janet

    2016-02-27

    Advanced communication skills are vital for allied health professionals, yet students often have limited opportunities in which to develop them. The option of increasing clinical placement hours is unsustainable in a climate of constrained budgets, limited placement availability and increasing student numbers. Consequently, many educators are considering the potentials of alternative training methods, such as simulation. Simulations provide safe, repeatable and standardised learning environments in which students can practice a variety of clinical skills. This study investigated students' self-rated communication skill, knowledge, confidence and empathy across simulated and traditional learning environments. Undergraduate speech pathology students were randomly allocated to one of three communication partners with whom they engaged conversationally for up to 30 min: a patient in a nursing home (n = 21); an elderly trained patient actor (n = 22); or a virtual patient (n = 19). One week prior to, and again following the conversational interaction, participants completed measures of self-reported communication skill, knowledge and confidence (developed by the authors based on the Four Habit Coding Scheme), as well as the Jefferson Scale of Empathy - Health Professionals (student version). All three groups reported significantly higher communication knowledge, skills and confidence post-placement (Median d = .58), while the degree of change did not vary as a function of group membership (Median η (2)  communication skill, knowledge and confidence, though not empathy, following a brief placement in a virtual, standardised or traditional learning environment. The self-reported increases were consistent across the three placement types. It is proposed that the findings from this study provide support for the integration of more sustainable, standardised, virtual patient-based placement models into allied health training programs for the training of

  18. The effectiveness of collaborative problem based physics learning (CPBPL) model to improve student’s self-confidence on physics learning

    Science.gov (United States)

    Prahani, B. K.; Suprapto, N.; Suliyanah; Lestari, N. A.; Jauhariyah, M. N. R.; Admoko, S.; Wahyuni, S.

    2018-03-01

    In the previous research, Collaborative Problem Based Physic Learning (CPBPL) model has been developed to improve student’s science process skills, collaborative problem solving, and self-confidence on physics learning. This research is aimed to analyze the effectiveness of CPBPL model towards the improvement of student’s self-confidence on physics learning. This research implemented quasi experimental design on 140 senior high school students who were divided into 4 groups. Data collection was conducted through questionnaire, observation, and interview. Self-confidence measurement was conducted through Self-Confidence Evaluation Sheet (SCES). The data was analyzed using Wilcoxon test, n-gain, and Kruskal Wallis test. Result shows that: (1) There is a significant score improvement on student’s self-confidence on physics learning (α=5%), (2) n-gain value student’s self-confidence on physics learning is high, and (3) n-gain average student’s self-confidence on physics learning was consistent throughout all groups. It can be concluded that CPBPL model is effective to improve student’s self-confidence on physics learning.

  19. Improving students' confidence levels in communicating with patients and introducing students to the importance of history taking

    International Nuclear Information System (INIS)

    Halkett, Georgia K.B.; McKay, Janice; Shaw, Therese

    2011-01-01

    Background: Radiographers can have a marked impact on the way patients deal with their illness because they are often one of the first health professionals that patients see. Therefore, it is essential that radiographers have effective communication skills and are able to provide patients with the information they require. The purpose of this study was to test whether the introduction of additional education on communication and history taking improved students' communication skills. Methods: A short program on communication skills and history taking was introduced to third year undergraduate students prior to a clinical placements period. Three workshops were run; the third included a role play exercise using professional actors as simulated patients. Students completed questionnaires at baseline, following the three workshops and after their subsequent clinical placement. Descriptive statistics were calculated and logistic regression Generalized Estimating Equations models were fitted to test for differences over time in students' confidence levels. Results: Twenty-seven out of 36 students completed the baseline and final surveys. Students indicated they were highly satisfied with the workshops provided. Statistically significant differences were observed for seven items relating to student's confidence levels in communicating with patients after they had participated in the workshops and their subsequent clinical placement. Conclusion: The use of communication skills workshops involving actor/patients is an effective method of assisting students to develop their communication and history taking skills. This program has now been implemented into the mentioned undergraduate course and it is recommended that radiography students at other institutions be provided with the opportunity to develop their communication and history taking skills.

  20. Improving students' confidence levels in communicating with patients and introducing students to the importance of history taking

    Energy Technology Data Exchange (ETDEWEB)

    Halkett, Georgia K.B., E-mail: g.halkett@curtin.edu.a [WA Centre for Cancer and Palliative Care/Curtin Health Innovation Research Institute, Curtin University of Technology, Perth, Western Australia (Australia); Department of Imaging and Applied Physics, Curtin University of Technology, Perth, Western Australia (Australia); McKay, Janice [Department of Imaging and Applied Physics, Curtin University of Technology, Perth, Western Australia (Australia); Shaw, Therese [Child Health Promotion Research Centre, School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Perth, Western Australia (Australia)

    2011-02-15

    Background: Radiographers can have a marked impact on the way patients deal with their illness because they are often one of the first health professionals that patients see. Therefore, it is essential that radiographers have effective communication skills and are able to provide patients with the information they require. The purpose of this study was to test whether the introduction of additional education on communication and history taking improved students' communication skills. Methods: A short program on communication skills and history taking was introduced to third year undergraduate students prior to a clinical placements period. Three workshops were run; the third included a role play exercise using professional actors as simulated patients. Students completed questionnaires at baseline, following the three workshops and after their subsequent clinical placement. Descriptive statistics were calculated and logistic regression Generalized Estimating Equations models were fitted to test for differences over time in students' confidence levels. Results: Twenty-seven out of 36 students completed the baseline and final surveys. Students indicated they were highly satisfied with the workshops provided. Statistically significant differences were observed for seven items relating to student's confidence levels in communicating with patients after they had participated in the workshops and their subsequent clinical placement. Conclusion: The use of communication skills workshops involving actor/patients is an effective method of assisting students to develop their communication and history taking skills. This program has now been implemented into the mentioned undergraduate course and it is recommended that radiography students at other institutions be provided with the opportunity to develop their communication and history taking skills.

  1. Technical Report: Benchmarking for Quasispecies Abundance Inference with Confidence Intervals from Metagenomic Sequence Data

    Energy Technology Data Exchange (ETDEWEB)

    McLoughlin, K. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2016-01-22

    The software application “MetaQuant” was developed by our group at Lawrence Livermore National Laboratory (LLNL). It is designed to profile microbial populations in a sample using data from whole-genome shotgun (WGS) metagenomic DNA sequencing. Several other metagenomic profiling applications have been described in the literature. We ran a series of benchmark tests to compare the performance of MetaQuant against that of a few existing profiling tools, using real and simulated sequence datasets. This report describes our benchmarking procedure and results.

  2. Cardiopulmonary resuscitation; use, training and self-confidence in skills. A self-report study among hospital personnel

    Directory of Open Access Journals (Sweden)

    Hopstock Laila A

    2008-12-01

    Full Text Available Abstract Background Immediate start of basic cardiopulmonary resuscitation (CPR and early defibrillation have been highlighted as crucial for survival from cardiac arrest, but despite new knowledge, new technology and massive personnel training the survival rates from in-hospital cardiac arrest are still low. National guidelines recommend regular intervals of CPR training to make all hospital personnel able to perform basic CPR till advanced care is available. This study investigates CPR training, resuscitation experience and self-confidence in skills among hospital personnel outside critical care areas. Methods A cross-sectional study was performed at three Norwegian hospitals. Data on CPR training and CPR use were collected by self-reports from 361 hospital personnel. Results A total of 89% reported training in CPR, but only 11% had updated their skills in accordance with the time interval recommended by national guidelines. Real resuscitation experience was reported by one third of the respondents. Both training intervals and use of skills in resuscitation situations differed among the professions. Self-reported confidence decreased only after more than two years since last CPR training. Conclusion There is a gap between recommendations and reality in CPR training among hospital personnel working outside critical care areas.

  3. Consumers report lower confidence in their genetics knowledge following direct-to-consumer personal genomic testing.

    Science.gov (United States)

    Carere, Deanna Alexis; Kraft, Peter; Kaphingst, Kimberly A; Roberts, J Scott; Green, Robert C

    2016-01-01

    The aim of this study was to measure changes to genetics knowledge and self-efficacy following personal genomic testing (PGT). New customers of 23andMe and Pathway Genomics completed a series of online surveys. We measured genetics knowledge (nine true/false items) and genetics self-efficacy (five Likert-scale items) before receipt of results and 6 months after results and used paired methods to evaluate change over time. Correlates of change (e.g., decision regret) were identified using linear regression. 998 PGT customers (59.9% female; 85.8% White; mean age 46.9 ± 15.5 years) were included in our analyses. Mean genetics knowledge score was 8.15 ± 0.95 (out of 9) at baseline and 8.25 ± 0.92 at 6 months (P = 0.0024). Mean self-efficacy score was 29.06 ± 5.59 (out of 35) at baseline and 27.7 ± 5.46 at 6 months (P reported lower self-efficacy following PGT. Change in self-efficacy was positively associated with health-care provider consultation (P = 0.0042), impact of PGT on perceived control over one's health (P consumers in response to receiving complex genetic information.Genet Med 18 1, 65-72.

  4. Loss of confidence in vaccines following media reports of infant deaths after hepatitis B vaccination in China.

    Science.gov (United States)

    Yu, Wenzhou; Liu, Dawei; Zheng, Jingshan; Liu, Yanmin; An, Zhijie; Rodewald, Lance; Zhang, Guomin; Su, Qiru; Li, Keli; Xu, Disha; Wang, Fuzhen; Yuan, Ping; Xia, Wei; Ning, Guijun; Zheng, Hui; Chu, Yaozhu; Cui, Jian; Duan, Mengjuan; Hao, Lixin; Zhou, Yuqing; Wu, Zhenhua; Zhang, Xuan; Cui, Fuqiang; Li, Li; Wang, Huaqing

    2016-04-01

    China reduced hepatitis B virus (HBV) infection by 90% among children under 5 years old with safe and effective hepatitis B vaccines (HepB). In December 2013, this success was threatened by widespread media reports of infant deaths following HepB administration. Seventeen deaths and one case of anaphylactic shock following HBV vaccination had been reported. We conducted a telephone survey to measure parental confidence in HepB in eleven provinces at four points in time; reviewed maternal HBV status and use of HepB for newborns in birth hospitals in eight provinces before and after the event; and monitored coverage with hepatitis B vaccine and other programme vaccines in ten provinces. HepB from the implicated company was suspended during the investigation, which showed that the deaths were not caused by HepB vaccination. Before the event, 85% respondents regarded domestic vaccines as safe, decreasing to 26.7% during the event. During the height of the crisis, 30% of parents reported being hesitant to vaccinate and 18.4% reported they would refuse HepB. Use of HepB in the monitored provinces decreased by 18.6%, from 53 653 doses the week before the event to 43 688 doses during the week that Biokangtai HepB was suspended. Use of HepB within the first day of life decreased by 10% among infants born to HBsAg-negative mothers, and by 6% among infants born to HBsAg-positive mothers. Vaccine refusal and HepB birth dose rates returned to baseline within 2 months; confidence increased, but remained below baseline. The HBV vaccine event resulted in the suspension of a safe vaccine, which was associated with a decline of parental confidence, and refusal of vaccination. Suspension of a vaccine can lead to loss of confidence that is difficult to recover. Timely and credible investigation, accompanied by proactive outreach to stakeholders and the media, may help mitigate negative impact of future coincidental adverse events following immunization. © The Author 2016; all rights

  5. Using the confidence interval confidently.

    Science.gov (United States)

    Hazra, Avijit

    2017-10-01

    Biomedical research is seldom done with entire populations but rather with samples drawn from a population. Although we work with samples, our goal is to describe and draw inferences regarding the underlying population. It is possible to use a sample statistic and estimates of error in the sample to get a fair idea of the population parameter, not as a single value, but as a range of values. This range is the confidence interval (CI) which is estimated on the basis of a desired confidence level. Calculation of the CI of a sample statistic takes the general form: CI = Point estimate ± Margin of error, where the margin of error is given by the product of a critical value (z) derived from the standard normal curve and the standard error of point estimate. Calculation of the standard error varies depending on whether the sample statistic of interest is a mean, proportion, odds ratio (OR), and so on. The factors affecting the width of the CI include the desired confidence level, the sample size and the variability in the sample. Although the 95% CI is most often used in biomedical research, a CI can be calculated for any level of confidence. A 99% CI will be wider than 95% CI for the same sample. Conflict between clinical importance and statistical significance is an important issue in biomedical research. Clinical importance is best inferred by looking at the effect size, that is how much is the actual change or difference. However, statistical significance in terms of P only suggests whether there is any difference in probability terms. Use of the CI supplements the P value by providing an estimate of actual clinical effect. Of late, clinical trials are being designed specifically as superiority, non-inferiority or equivalence studies. The conclusions from these alternative trial designs are based on CI values rather than the P value from intergroup comparison.

  6. Impact of a critical care postgraduate certificate course on nurses' self-reported competence and confidence: A quasi-experimental study.

    Science.gov (United States)

    Baxter, Rebecca; Edvardsson, David

    2018-06-01

    Postgraduate education is said to support the development of nurses' professional competence and confidence, essential to the delivery of safe and effective care. However, there is a shortness of empirical evidence to demonstrate an increase to nurses' self-reported confidence and competence on completion of critical care postgraduate certificate-level education. To explore the impact of a critical care postgraduate certificate course on nurses' self-reported competence and confidence. To explore the psychometric properties and performance of the Critical Care Competence and Confidence Questionnaire. A quasi-experimental pre/post-test design. A total population sample of nurses completing a critical care postgraduate certificate course at an Australian University. The Critical Care Competence and Confidence Questionnaire was developed for this study to measure nurses' self-reported competence and confidence at baseline and follow up. Descriptive and inferential statistics were used to explore sample characteristics and changes between baseline and follow-up. Reliability of the questionnaire was explored using Cronbach's Alpha and item-total correlations. There was a statistically significant increase in competence and confidence between baseline and follow-up across all questionnaire domains. Satisfactory reliability estimates were found for the questionnaire. Completion of a critical care postgraduate certificate course significantly increased nurses' perceived competence and confidence. The Critical Care Competence and Confidence Questionnaire was found to be psychometrically sound for measuring nurses' self-reported competence and confidence. Copyright © 2018 Elsevier Ltd. All rights reserved.

  7. Evaluation of a novel individualised communication-skills training intervention to improve doctors' confidence and skills in end-of-life communication.

    Science.gov (United States)

    Clayton, Josephine M; Butow, Phyllis N; Waters, Amy; Laidsaar-Powell, Rebekah C; O'Brien, Angela; Boyle, Frances; Back, Anthony L; Arnold, Robert M; Tulsky, James A; Tattersall, Martin H N

    2013-03-01

    We developed a novel individualised training program regarding end-of-life communication, designed to be time effective for busy junior-doctors working in hospital settings. We aimed to pilot this brief individualised training program with junior-doctors to explore its acceptability, feasibility and effect on the doctors' confidence, communication skills, attitudes towards psychosocial care and burnout. The content of the training intervention was informed by a systematic literature review and evidence-based clinical practice guidelines regarding end-of-life communication. The intervention was based on sound educational principles and involved three one-hour teaching sessions over a three-week period, including two individual sessions with an expert facilitator and simulated patient/caregiver. In addition, participants received written and audiovisual take-home learning materials. PARTICIPANTS were videotaped consulting with a simulated patient/caregiver pre/post training to assess the impact of the course on their communication behaviours. PARTICIPANTS completed de-identified questionnaires pre/post training, including self-assessed confidence, attitudes to psychosocial care, and the Maslach Burnout inventory. PARTICIPANTS included 22 junior-doctors from a large teaching hospital in Sydney, Australia. All participants reported that the training was useful, had been helpful for their communication with patients and that they would recommend the training to others. Significant improvements were found in participants' communication skills (in seven out of 21 specific and all three global communication behaviours assessed, range P=0.02 to confidence in communicating about relevant topics (P<0.001), attitudes towards psychosocial care (P=0.03) and sense of personal accomplishment (P=0.043). There were no overall differences in participants' burnout levels. This intervention shows promise and warrants further formal evaluation.

  8. Self-reported confidence in patient safety knowledge among Australian undergraduate nursing students: A multi-site cross-sectional survey study.

    Science.gov (United States)

    Usher, Kim; Woods, Cindy; Parmenter, Glenda; Hutchinson, Marie; Mannix, Judy; Power, Tamara; Chaboyer, Wendy; Latimer, Sharon; Mills, Jane; Siegloff, Lesley; Jackson, Debra

    2017-06-01

    , Understanding that reporting adverse events and close calls can lead to change and can reduce recurrence of events, was rated significantly higher by third year students than first and second year students. In order are to achieve meaningful improvements in patient safety, and create harm free environments for patients, it is crucial that nursing students develop confidence communicating with others to improve patient safety, particularly in the areas of challenging poor practice, and recognising, responding to and disclosing adverse events, including errors and near misses. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Improving Nurses' Peripheral Intravenous Catheter Insertion Knowledge, Confidence, and Skills Using a Simulation-Based Blended Learning Program: A Randomized Trial.

    Science.gov (United States)

    Keleekai, Nowai L; Schuster, Catherine A; Murray, Connie L; King, Mary Anne; Stahl, Brian R; Labrozzi, Laura J; Gallucci, Susan; LeClair, Matthew W; Glover, Kevin R

    2016-12-01

    Peripheral intravenous catheter (PIVC) insertion is one of the most common invasive procedures performed in a hospital, but most nurses receive little formal training in this area. Blended PIVC insertion training programs that incorporate deliberate simulated practice have the potential to improve clinical practice and patient care. The study was a randomized, wait-list control group with crossover using nurses on three medical/surgical units. Baseline PIVC knowledge, confidence, and skills assessments were completed for both groups. The intervention group then received a 2-hour PIVC online course, followed by an 8-hour live training course using a synergistic mix of three simulation tools. Both groups were then reassessed. After crossover, the wait-list group received the same intervention and both groups were reassessed. At baseline, both groups were similar for knowledge, confidence, and skills. Compared with the wait-list group, the intervention group had significantly higher scores for knowledge, confidence, and skills upon completing the training program. After crossover, the wait-list group had similarly higher scores for knowledge, confidence, and skills than the intervention group. Between the immediate preintervention and postintervention periods, the intervention group improved scores for knowledge by 31%, skills by 24%, and decreased confidence by 0.5%, whereas the wait-list group improved scores for knowledge by 28%, confidence by 16%, and skills by 15%. Results demonstrate significant improvements in nurses' knowledge, confidence, and skills with the use of a simulation-based blended learning program for PIVC insertion. Transferability of these findings from a simulated environment into clinical practice should be further explored.

  10. Simba Study: Undergraduate module in simulation training and basic life support to improve undergraduate confidence in paediatrics

    LENUS (Irish Health Repository)

    Bruell, H

    2013-08-20

    There are significant differences in resuscitation algorithms for children versus adults. We aimed to enhance confidence of our students in the assessment and management of sick children by developing a simple program with emphasis on Basic Airway management, CPR, and clinical assessment and treatment of children using the A\\/B\\/C\\/D\\/E system. \\r\

  11. Radiating confidence

    International Nuclear Information System (INIS)

    Rush, P.

    1988-01-01

    Radiation monitoring systems for operators handling radioactive wastes are described. These include a personnel monitoring system which is suitable for small groups (ie as few as 50) of personnel. The use of microelectronics enable facilities such as automatic personal dose recording with three accumulative registers and automatic reporting of exceeded dose limits. At a controlled entrance the user is identified with a personal identification number. Exit is then also monitored. The use of pocket dosimeters increase the flexibility of this system. In another system a 'rotary man lock' only allows exit from the radiation controlled zone when satisfactory radiation checks have been made. The radiation and security checks available with this system are described. A 'sack monitor' for low level wastes contained in plastic bags is illustrated. (U.K.)

  12. Improving the Confidence of Pre-Adolescent Girls by Focusing on the Development of Positive Self-Esteem, Body Image, and Assertiveness Skills.

    Science.gov (United States)

    Combes, Alice S.

    This practicum was designed to focus on: (1) the improvement of the confidence of pre-adolescent girls; (2) the establishment of a positive body image; and (3) the strengthening of assertiveness skills. The writer worked in a group of 20 girls over a period of 8 months using exercises designed to facilitate their growth. A curriculum was developed…

  13. Confidence rating of marine eutrophication assessments

    DEFF Research Database (Denmark)

    Murray, Ciarán; Andersen, Jesper Harbo; Kaartokallio, Hermanni

    2011-01-01

    of the 'value' of the indicators on which the primary assessment is made. Such secondary assessment of confidence represents a first step towards linking status classification with information regarding their accuracy and precision and ultimately a tool for improving or targeting actions to improve the health......This report presents the development of a methodology for assessing confidence in eutrophication status classifications. The method can be considered as a secondary assessment, supporting the primary assessment of eutrophication status. The confidence assessment is based on a transparent scoring...

  14. OPSAID improvements and capabilities report.

    Energy Technology Data Exchange (ETDEWEB)

    Halbgewachs, Ronald D.; Chavez, Adrian R.

    2011-08-01

    Process Control System (PCS) and Industrial Control System (ICS) security is critical to our national security. But there are a number of technological, economic, and educational impediments to PCS owners implementing effective security on their systems. Sandia National Laboratories has performed the research and development of the OPSAID (Open PCS Security Architecture for Interoperable Design), a project sponsored by the US Department of Energy Office of Electricity Delivery and Energy Reliability (DOE/OE), to address this issue. OPSAID is an open-source architecture for PCS/ICS security that provides a design basis for vendors to build add-on security devices for legacy systems, while providing a path forward for the development of inherently-secure PCS elements in the future. Using standardized hardware, a proof-of-concept prototype system was also developed. This report describes the improvements and capabilities that have been added to OPSAID since an initial report was released. Testing and validation of this architecture has been conducted in another project, Lemnos Interoperable Security Project, sponsored by DOE/OE and managed by the National Energy Technology Laboratory (NETL).

  15. Online Training in Specific Meditation Practices Improves Gratitude, Well-Being, Self-Compassion, and Confidence in Providing Compassionate Care Among Health Professionals.

    Science.gov (United States)

    Rao, Nisha; Kemper, Kathi J

    2016-04-06

    Mind-body practices that intentionally generate positive emotion could improve health professionals' well-being and compassion. However, the feasibility and impact of clinician training in these practices is unknown. Data were analyzed from 3 online modules offered to health professionals: (a) Gratitude, (b) Positive Word, and (c) Loving-kindness/Compassion meditation. Pairedttests were used to assess pre- to posttraining changes in gratitude (Gratitude Questionnaire), well-being (World Health Organization Well-Being Index), self-compassion (Neff's Self-Compassion Scale), and confidence in providing compassionate care (Confidence in Providing Calm, Compassionate Care Scale). The 177 enrollees included diverse practitioners (nurses, physicians, social workers, and others). Training was associated with statistically significant improvements in gratitude (38.3 ± 4.6 to 39.5 ± 3.3), well-being (16.4 ± 4.0 to 17.9 ± 4.2), self-compassion (39.5 ± 8.1 to 43.1 ± 7.6), and confidence in providing compassionate care (73.3 ± 16.4 to 80.9 ± 13.8;Pgratitude, well-being, self-compassion, and confidence in providing compassionate care. © The Author(s) 2016.

  16. Impact of Balance Confidence on Daily Living Activities of Older People with Knee Osteoarthritis with Regard to Balance, Physical Function, Pain, and Quality of Life - A Preliminary Report.

    Science.gov (United States)

    Bobić Lucić, Lana; Grazio, Simeon

    2018-01-01

    The objective of this study was to explore the impact of balance confidence on different activities of daily living (ADL) in older people with knee osteoarthritis (OA). Forty-seven consecutive participants with knee OA were included in this cross-sectional study. They were divided according to the results of the Activities-specific Balance Confidence (ABC) Scale into a group with a low level of confidence in physical functioning (ABC balance measurements. Older people with knee OA who were less confident in their daily physical activities had more physical difficulties and a greater effect of pain on ADL, lower quality of life, and a higher physician's global assessment, but no differences were obtained in balance tests. In people with knee OA, decreased balance confidence is associated with more physical difficulties, an increased effect of pain on ADL, and lower quality of life. An improved awareness of decreased balance confidence may lead to more effective management of older people with knee OA by improving their mobility and QOL through rehabilitation. Furthermore, future research in that direction is warranted.

  17. Confidence in leadership among the newly qualified.

    Science.gov (United States)

    Bayliss-Pratt, Lisa; Morley, Mary; Bagley, Liz; Alderson, Steven

    2013-10-23

    The Francis report highlighted the importance of strong leadership from health professionals but it is unclear how prepared those who are newly qualified feel to take on a leadership role. We aimed to assess the confidence of newly qualified health professionals working in the West Midlands in the different competencies of the NHS Leadership Framework. Most respondents felt confident in their abilities to demonstrate personal qualities and work with others, but less so at managing or improving services or setting direction.

  18. Can follow-up controls improve the confidence of MR of the breast? A retrospective analysis of follow-up MR images of the breast

    International Nuclear Information System (INIS)

    Betsch, A.; Arndt, E.; Stern, W.; Claussen, C.D.; Mueller-Schimpfle, M.; Wallwiener, D.

    2001-01-01

    Purpose: To assess the change in diagnostic confidence between first and follow-up dynamic MR examination of the breast (MRM). Methods: The reports of a total of 175 MRM in 77 patients (mean age 50 years; 36-76) with 98 follow-up MRM were analyzed. All examinations were performed as a dynamic study (Gd-DTPA, 0.16 mmol/kg; 6-7 repetitive studies). The change in diagnostic confidence was retrospectively classified as follows: Controlled lesion vanished during follow-up (category I); diagnostic confidence increases during follow-up (II), more likely benign (IIa), more suspicious (IIb); no difference in diagnostic confidence (III). Long-term follow-up over an average of four years was obtained for 57 patients with category IIa/III findings. Results: In 98 follow-up examinations, only two lesions vanished (2%). In 77/98 cases a category IIa lesion was diagnosed, in 11 cases a category IIb lesion. In 8 cases (8%) there was no change in diagnostic confidence during follow-up. Lesions in category IIb underwent biopsy in 10/11 cases, in one case long-term follow-up proved a completely regredient inflammatory change. In 8/11 suspicious findings (IIb) a malignant tumor was detected. The mean time interval between first and follow-up MRM was 8 months for I-IIb lesions, and 4 months for category III lesions. In the longterm follow-up two patients with a category II a lesion developed a carcinoma in a different breast area after four and five years. Conclusion: MRM follow up increases the diagnostic confidence if the time interval is adequate (>4 months). A persistently or increasingly suspicious finding warrants biopsy. (orig.) [de

  19. Improved Balance Confidence and Stability for Elderly After 6 Weeks of a Multimodal Self-Administered Balance-Enhancing Exercise Program

    Science.gov (United States)

    Hafström, Anna; Malmström, Eva-Maj; Terdèn, Josefine; Fransson, Per-Anders; Magnusson, Måns

    2016-01-01

    Objective: To develop and assess the efficacy of a multimodal balance-enhancing exercise program (BEEP) designed to be regularly self-administered by community-dwelling elderly. The program aims to promote sensory reweighting, facilitate motor control, improve gaze stabilization, and stimulate continuous improvement by being constantly challenging. Method: Forty participants aged 60 to 80 years performed 6 weeks of BEEP training, on average for 16 min four times weekly, in a randomized one-arm crossover design. Results: One-leg standing time improved 32% with eyes open (EO), 206% with eyes closed (EC) on solid surface, and 54% EO on compliant surface (p balance improvements when perturbed on solid and compliant surfaces with EO and EC (p ≤ .033). Walking, step stool, and Timed Up and Go speeds increased (p ≤ .001), as did scores in Berg Balance and balance confidence scales (p ≤ .018). Discussion: Multimodal balance exercises offer an efficient, cost-effective way to improve balance control and confidence in elderly. PMID:28138495

  20. Improved Balance Confidence and Stability for Elderly After 6 Weeks of a Multimodal Self-Administered Balance-Enhancing Exercise Program

    Directory of Open Access Journals (Sweden)

    Anna Hafström MD, PhD

    2016-04-01

    Full Text Available Objective: To develop and assess the efficacy of a multimodal balance-enhancing exercise program (BEEP designed to be regularly self-administered by community-dwelling elderly. The program aims to promote sensory reweighting, facilitate motor control, improve gaze stabilization, and stimulate continuous improvement by being constantly challenging. Method: Forty participants aged 60 to 80 years performed 6 weeks of BEEP training, on average for 16 min four times weekly, in a randomized one-arm crossover design. Results: One-leg standing time improved 32% with eyes open (EO, 206% with eyes closed (EC on solid surface, and 54% EO on compliant surface ( p < .001. Posturography confirmed balance improvements when perturbed on solid and compliant surfaces with EO and EC ( p  ≤ .033. Walking, step stool, and Timed Up and Go speeds increased ( p  ≤ .001, as did scores in Berg Balance and balance confidence scales ( p  ≤ .018. Discussion: Multimodal balance exercises offer an efficient, cost-effective way to improve balance control and confidence in elderly.

  1. Quality of Life in orthognathic surgery patients: post-surgical improvements in aesthetics and self-confidence.

    Science.gov (United States)

    Rustemeyer, Jan; Gregersen, Johanne

    2012-07-01

    The objective of this prospective study was to assess changes of Quality of Life (QoL) in patients undergoing bimaxillary orthognathic surgery. Questionnaires were based on the Oral Health Impact Profile (OHIP, items OH-1-OH-14) and three additional questions (items AD-1-3), and were completed by patients (n=50; mean age 26.9±9.9 years) on average 9.1±2.4 months before surgery, and 12.1±1.4 months after surgery, using a scoring scale. Item scores describing functional limitation, physical pain, physical disability and chewing function did not change significantly, whereas item scores covering psychological discomfort and social disability domains revealed significant decreases following surgery. AD-2 "dissatisfying aesthetics" revealed the greatest difference between pre- and post-surgical scores (paesthetic improvement of facial features post-surgery, the benefit in QoL was generally high. The significant correlation of the pre- to post-surgical changes of item OH-5 "self conscious" to nearly all other item changes suggested that OH-5 was the most sensitive indicator for post-surgical improvement of QoL. Psychological factors and aesthetics exerted a strong influence on the patients' QoL, and determined major changes more than functional aspects did. Copyright © 2011 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  2. A mentor development program for clinical translational science faculty leads to sustained, improved confidence in mentoring skills.

    Science.gov (United States)

    Feldman, Mitchell D; Steinauer, Jody E; Khalili, Mandana; Huang, Laurence; Kahn, James S; Lee, Kathryn A; Creasman, Jennifer; Brown, Jeanette S

    2012-08-01

    Mentorship is crucial for academic productivity and advancement for clinical and translational (CT) science faculty. However, little is known about the long-term effects of mentor training programs. The University of California, San Francisco (UCSF), Clinical and Translational Science Institute launched a Mentor Development Program (MDP) in 2007 for CT faculty. We report on an evaluation of the first three cohorts of graduates from the MDP. In 2010, all Mentors in Training (MITs) who completed the MDP from 2007 to 2009 (n= 38) were asked to complete an evaluation of their mentoring skills and knowledge; all MITs (100%) completed the evaluation. Two-thirds of MDP graduates reported that they often apply knowledge, attitudes, or skills obtained in the MDP to their mentoring. Nearly all graduates (97%) considered being a mentor important to their career satisfaction. Graduates were also asked about the MDP's impact on specific mentoring skills; 95% agreed that the MDP helped them to become a better mentor and to focus their mentoring goals. We also describe a number of new initiatives to support mentoring at UCSF that have evolved from the MDP. To our knowledge, this is the first evaluation of the long-term impact of a mentor training program for CT researchers. © 2012 Wiley Periodicals, Inc.

  3. Spectral analysis software improves confidence in plant and soil water stable isotope analyses performed by isotope ratio infrared spectroscopy (IRIS).

    Science.gov (United States)

    West, A G; Goldsmith, G R; Matimati, I; Dawson, T E

    2011-08-30

    Previous studies have demonstrated the potential for large errors to occur when analyzing waters containing organic contaminants using isotope ratio infrared spectroscopy (IRIS). In an attempt to address this problem, IRIS manufacturers now provide post-processing spectral analysis software capable of identifying samples with the types of spectral interference that compromises their stable isotope analysis. Here we report two independent tests of this post-processing spectral analysis software on two IRIS systems, OA-ICOS (Los Gatos Research Inc.) and WS-CRDS (Picarro Inc.). Following a similar methodology to a previous study, we cryogenically extracted plant leaf water and soil water and measured the δ(2)H and δ(18)O values of identical samples by isotope ratio mass spectrometry (IRMS) and IRIS. As an additional test, we analyzed plant stem waters and tap waters by IRMS and IRIS in an independent laboratory. For all tests we assumed that the IRMS value represented the "true" value against which we could compare the stable isotope results from the IRIS methods. Samples showing significant deviations from the IRMS value (>2σ) were considered to be contaminated and representative of spectral interference in the IRIS measurement. Over the two studies, 83% of plant species were considered contaminated on OA-ICOS and 58% on WS-CRDS. Post-analysis, spectra were analyzed using the manufacturer's spectral analysis software, in order to see if the software correctly identified contaminated samples. In our tests the software performed well, identifying all the samples with major errors. However, some false negatives indicate that user evaluation and testing of the software are necessary. Repeat sampling of plants showed considerable variation in the discrepancies between IRIS and IRMS. As such, we recommend that spectral analysis of IRIS data must be incorporated into standard post-processing routines. Furthermore, we suggest that the results from spectral analysis be

  4. Training health professionals to recruit into challenging randomized controlled trials improved confidence: the development of the QuinteT randomized controlled trial recruitment training intervention.

    Science.gov (United States)

    Mills, Nicola; Gaunt, Daisy; Blazeby, Jane M; Elliott, Daisy; Husbands, Samantha; Holding, Peter; Rooshenas, Leila; Jepson, Marcus; Young, Bridget; Bower, Peter; Tudur Smith, Catrin; Gamble, Carrol; Donovan, Jenny L

    2018-03-01

    The objective of this study was to describe and evaluate a training intervention for recruiting patients to randomized controlled trials (RCTs), particularly for those anticipated to be difficult for recruitment. One of three training workshops was offered to surgeons and one to research nurses. Self-confidence in recruitment was measured through questionnaires before and up to 3 months after training; perceived impact of training on practice was assessed after. Data were analyzed using two-sample t-tests and supplemented with findings from the content analysis of free-text comments. Sixty-seven surgeons and 32 nurses attended. Self-confidence scores for all 10 questions increased after training [range of mean scores before 5.1-6.9 and after 6.9-8.2 (scale 0-10, all 95% confidence intervals are above 0 and all P-values recruitment following training was high-surgeons' mean score 8.8 [standard deviation (SD), 1.2] and nurses' 8.4 (SD, 1.3) (scale 0-10); 50% (19/38) of surgeons and 40% (10/25) of nurses reported on a 4-point Likert scale that training had made "a lot" of difference to their RCT discussions. Analysis of free text revealed this was mostly in relation to how to convey equipoise, explain randomization, and manage treatment preferences. Surgeons and research nurses reported increased self-confidence in discussing RCTs with patients, a raised awareness of hidden challenges and a positive impact on recruitment practice following QuinteT RCT Recruitment Training. Training will be made more available and evaluated in relation to recruitment rates and informed consent. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  5. Improving knowledge, technical skills, and confidence among pediatric health care providers in the management of chronic tracheostomy using a simulation model.

    Science.gov (United States)

    Agarwal, Amit; Marks, Nancy; Wessel, Valerie; Willis, Denise; Bai, Shasha; Tang, Xinyu; Ward, Wendy L; Schellhase, Dennis E; Carroll, John L

    2016-07-01

    The results from a recent national survey about catastrophic complications following tracheostomy revealed that the majority of events involved a loss of airway. Most of the events due to airway loss involved potentially correctable deficits in caregiver education. Training in a simulated environment allows skill acquisition without compromising patient safety. We assessed the knowledge and confidence level of pediatric health care providers at a large tertiary care children's hospital in routine and emergency tracheostomy care and evaluated the efficacy of a comprehensive simulation-based tracheostomy educational program. The prospective observational study was comprised of 33 subjects including pediatric residents, internal medicine-pediatric residents, pediatric hospitalist faculty physicians, and advanced practice registered nurses who are involved in the care of patients with tracheostomies within a tertiary-care children's hospital. The subjects completed self-assessment questionnaires and objective multiple-choice tests before and after attending a comprehensive educational course that employed patient simulation. The outcome measurements included pre- and post-course questionnaires, pre- and post-course test scores, and observational data from the simulation sessions. Before the education and simulation, the subjects' comfort and confidence levels on a five-point Likert scale in performing routine tracheostomy tube care, routine tracheostomy tube change, and an emergency tracheostomy tube change were as follows (median (Q1, Q3)): 1 (1, 2), 1 (1, 2), and 1 (1, 2), respectively (n = 28). The levels of comfort and confidence after completing the course improved significantly to 4 (4, 5), 4 (4, 5), 4 (4, 5), respectively (P tracheostomy tubes (e.g., cuffed versus uncuffed), physiological significance of the cuff, mechanism of action and physiological significance of the speaking valve, and the importance of the obturator in changing the tracheostomy tube

  6. The idiosyncratic nature of confidence.

    Science.gov (United States)

    Navajas, Joaquin; Hindocha, Chandni; Foda, Hebah; Keramati, Mehdi; Latham, Peter E; Bahrami, Bahador

    2017-11-01

    Confidence is the 'feeling of knowing' that accompanies decision making. Bayesian theory proposes that confidence is a function solely of the perceived probability of being correct. Empirical research has suggested, however, that different individuals may perform different computations to estimate confidence from uncertain evidence. To test this hypothesis, we collected confidence reports in a task where subjects made categorical decisions about the mean of a sequence. We found that for most individuals, confidence did indeed reflect the perceived probability of being correct. However, in approximately half of them, confidence also reflected a different probabilistic quantity: the perceived uncertainty in the estimated variable. We found that the contribution of both quantities was stable over weeks. We also observed that the influence of the perceived probability of being correct was stable across two tasks, one perceptual and one cognitive. Overall, our findings provide a computational interpretation of individual differences in human confidence.

  7. Sildenafil citrate improves self-esteem, confidence, and relationships in men with erectile dysfunction: Results from an international, multi-center, double-blind, placebo-controlled trial.

    Science.gov (United States)

    Althof, Stanley E; O'leary, Michael P; Cappelleri, Joseph C; Hvidsten, Kyle; Stecher, Vera J; Glina, Sidney; King, Rosie; Siegel, Richard L

    2006-05-01

    Erectile dysfunction (ED) can significantly impact a man's relationships and well-being. We assessed changes in self-esteem, confidence, sexual relationship satisfaction, and overall relationship satisfaction in men with ED using the validated Self-Esteem And Relationship questionnaire (SEAR). This was a 12-week, double-blind, placebo-controlled, flexible-dose (25, 50, 100 mg, as needed) international study of sildenafil in men > or =18 years of age in Mexico, Brazil, Australia, and Japan. The primary study outcome was change in self-esteem from baseline to the end of treatment. Secondary study measures were changes in other SEAR components, International Index of Erectile Function (IIEF) domains, percentage of intercourse attempts that were successful, and the response to a global efficacy question at the end of treatment. Patients were well balanced for age and duration of ED (placebo = 149 and sildenafil = 151). Compared with placebo, sildenafil significantly improved self-esteem, confidence, sexual relationship satisfaction, and overall relationship satisfaction (P relationship satisfaction, and overall relationship satisfaction after treatment of ED with sildenafil were consistent among countries. These data suggest a substantial cross-cultural improvement in well-being after successful treatment of ED with sildenafil.

  8. Quantifying reporting timeliness to improve outbreak control

    NARCIS (Netherlands)

    Bonačić Marinović, Axel; Swaan, Corien; van Steenbergen, Jim; Kretzschmar, MEE

    The extent to which reporting delays should be reduced to gain substantial improvement in outbreak control is unclear. We developed a model to quantitatively assess reporting timeliness. Using reporting speed data for 6 infectious diseases in the notification system in the Netherlands, we calculated

  9. Confidence crisis of results in biomechanics research.

    Science.gov (United States)

    Knudson, Duane

    2017-11-01

    Many biomechanics studies have small sample sizes and incorrect statistical analyses, so reporting of inaccurate inferences and inflated magnitude of effects are common in the field. This review examines these issues in biomechanics research and summarises potential solutions from research in other fields to increase the confidence in the experimental effects reported in biomechanics. Authors, reviewers and editors of biomechanics research reports are encouraged to improve sample sizes and the resulting statistical power, improve reporting transparency, improve the rigour of statistical analyses used, and increase the acceptance of replication studies to improve the validity of inferences from data in biomechanics research. The application of sports biomechanics research results would also improve if a larger percentage of unbiased effects and their uncertainty were reported in the literature.

  10. CaPOW! Using Problem Sets in a Capstone Course to Improve Fourth-Year Medical Students' Confidence in Self-Directed Learning.

    Science.gov (United States)

    Clay, Alison S; Ming, David Y; Knudsen, Nancy W; Engle, Deborah L; Grochowski, Colleen O'Connor; Andolsek, Kathryn M; Chudgar, Saumil M

    2017-03-01

    Despite the importance of self-directed learning (SDL) in the field of medicine, individuals are rarely taught how to perform SDL or receive feedback on it. Trainee skill in SDL is limited by difficulties with self-assessment and goal setting. Ninety-two graduating fourth-year medical students from Duke University School of Medicine completed an individualized learning plan (ILP) for a transition-to-residency Capstone course in spring 2015 to help foster their skills in SDL. Students completed the ILP after receiving a personalized report from a designated faculty coach detailing strengths and weaknesses on specific topics (e.g., pulmonary medicine) and clinical skills (e.g., generating a differential diagnosis). These were determined by their performance on 12 Capstone Problem Sets of the Week (CaPOWs) compared with their peers. Students used transitional-year milestones to self-assess their confidence in SDL. SDL was successfully implemented in a Capstone course through the development of required clinically oriented problem sets. Coaches provided guided feedback on students' performance to help them identify knowledge deficits. Students' self-assessment of their confidence in SDL increased following course completion. However, students often chose Capstone didactic sessions according to factors other than their CaPOW performance, including perceived relevance to planned specialty and session timing. Future Capstone curriculum changes may further enhance SDL skills of graduating students. Students will receive increased formative feedback on their CaPOW performance and be incentivized to attend sessions in areas of personal weakness.

  11. Self-reported maternal parenting style and confidence and infant temperament in a multi-ethnic community: results from the Born in Bradford cohort.

    Science.gov (United States)

    Prady, Stephanie L; Kiernan, Kathleen; Fairley, Lesley; Wilson, Sarah; Wright, John

    2014-03-01

    Ethnic minority children in the United Kingdom often experience health disadvantage. Parenting influences children's current and future health, but little is known about whether parenting behaviours and mother's perception of her infant vary by ethnicity. Using the Born in Bradford (BiB) birth cohort, which is located in an ethnically diverse and economically deprived UK city, we conducted a cross-sectional analysis of mother's self-reported parenting confidence, self-efficacy, hostility and warmth, and infant temperament at six months of age. We examined responses from women of Pakistani (N = 554) and White British (N = 439) origin. Pakistani mothers reported feeling more confident about their abilities as a parent. Significantly fewer Pakistani women adopted a hostile approach to parenting, an effect that was attenuated after adjustment for socioeconomic status and mental health. Overall, women with more self-efficacious, warm and less hostile parenting styles reported significantly fewer problems with their infant's temperaments. Of women with higher self-efficacy parenting styles, Pakistani mothers were significantly more likely than White British mothers to report more problematic infant temperaments, although absolute differences were small. It is unlikely that the ethnic variation seen in children's cognitive and behavioural outcomes in childhood is attributable to differences in parenting or infant characteristics reported at six months.

  12. Improving Communication of Diagnostic Radiology Findings through Structured Reporting

    Science.gov (United States)

    Panicek, David M.; Berk, Alexandra R.; Li, Yuelin; Hricak, Hedvig

    2011-01-01

    Purpose: To compare the content, clarity, and clinical usefulness of conventional (ie, free-form) and structured radiology reports of body computed tomographic (CT) scans, as evaluated by referring physicians, attending radiologists, and radiology fellows at a tertiary care cancer center. Materials and Methods: The institutional review board approved the study as a quality improvement initiative; no written consent was required. Three radiologists, three radiology fellows, three surgeons, and two medical oncologists evaluated 330 randomly selected conventional and structured radiology reports of body CT scans. For nonradiologists, reports were randomly selected from patients with diagnoses relevant to the physician’s area of specialization. Each physician read 15 reports in each format and rated both the content and clarity of each report from 1 (very dissatisfied or very confusing) to 10 (very satisfied or very clear). By using a previously published radiology report grading scale, physicians graded each report’s effectiveness in advancing the patient’s position on the clinical spectrum. Mixed-effects models were used to test differences between report types. Results: Mean content satisfaction ratings were 7.61 (95% confidence interval [CI]: 7.12, 8.16) for conventional reports and 8.33 (95% CI: 7.82, 8.86) for structured reports, and the difference was significant (P radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11101913/-/DC1 PMID:21518775

  13. Survey mode matters: adults' self-reported statistical confidence, ability to obtain health information, and perceptions of patient-health-care provider communication.

    Science.gov (United States)

    Wallace, Lorraine S; Chisolm, Deena J; Abdel-Rasoul, Mahmoud; DeVoe, Jennifer E

    2013-08-01

    This study examined adults' self-reported understanding and formatting preferences of medical statistics, confidence in self-care and ability to obtain health advice or information, and perceptions of patient-health-care provider communication measured through dual survey modes (random digital dial and mail). Even while controlling for sociodemographic characteristics, significant differences in regard to adults' responses to survey variables emerged as a function of survey mode. While the analyses do not allow us to pinpoint the underlying causes of the differences observed, they do suggest that mode of administration should be carefully adjusted for and considered.

  14. Benchmarking for Cost Improvement. Final report

    Energy Technology Data Exchange (ETDEWEB)

    1993-09-01

    The US Department of Energy`s (DOE) Office of Environmental Restoration and Waste Management (EM) conducted the Benchmarking for Cost Improvement initiative with three objectives: Pilot test benchmarking as an EM cost improvement tool; identify areas for cost improvement and recommend actions to address these areas; provide a framework for future cost improvement. The benchmarking initiative featured the use of four principal methods (program classification, nationwide cost improvement survey, paired cost comparison and component benchmarking). Interested parties contributed during both the design and execution phases. The benchmarking initiative was conducted on an accelerated basis. Of necessity, it considered only a limited set of data that may not be fully representative of the diverse and complex conditions found at the many DOE installations. The initiative generated preliminary data about cost differences and it found a high degree of convergence on several issues. Based on this convergence, the report recommends cost improvement strategies and actions. This report describes the steps taken as part of the benchmarking initiative and discusses the findings and recommended actions for achieving cost improvement. The results and summary recommendations, reported below, are organized by the study objectives.

  15. Improving Business Investment Confidence in Culture-Aligned Indigenous Economies in Remote Australian Communities: A Business Support Framework to Better Inform Government Programs

    Directory of Open Access Journals (Sweden)

    Ann E. Fleming

    2015-06-01

    Full Text Available There is significant evidence that culture-aligned economies are more effective in engaging remote-living Indigenous Australians in work long-term. Despite this evidence, governments remain resistant to investing substantially in these economies, with the result that low employment rates persist. This article argues that governmental systems of organisation are not designed to support non-mainstream economies and this position is unlikely to change. Similarly, the commercial sector lacks confidence that investing in culture-aligned economies will generate financial returns. This article presents a localised, pragmatic approach to Indigenous business support that works within existing systems of government, business and culture. Most unsuccessful programs fail to recognise the full suite of critical factors for sustained market engagement by both business and Indigenous people. This article reports on work to bring all critical factors together into a business support framework to inform the design and implementation of an aquaculture development program in a remote Indigenous Australian community.

  16. Error review: Can this improve reporting performance?

    International Nuclear Information System (INIS)

    Tudor, Gareth R.; Finlay, David B.

    2001-01-01

    AIM: This study aimed to assess whether error review can improve radiologists' reporting performance. MATERIALS AND METHODS: Ten Consultant Radiologists reported 50 plain radiographs, in which the diagnoses were established. Eighteen of the radiographs were normal, 32 showed an abnormality. The radiologists were shown their errors and then re-reported the series of radiographs after an interval of 4-5 months. The accuracy of the reports to the established diagnoses was assessed. Chi-square test was used to calculate the difference between the viewings. RESULTS: On re-reporting the radiographs, seven radiologists improved their accuracy score, two had a lower score and one radiologist showed no score difference. Mean accuracy pre-education was 82.2%, (range 78-92%) and post-education was 88%, (range 76-96%). Individually, two of the radiologists showed a statistically significant improvement post-education (P < 0.01,P < 0.05). Assessing the group as a whole, there was a trend for improvement post-education but this did not reach statistical significance. Assessing only the radiographs where errors were made on the initial viewing, for the group as a whole there was a 63% improvement post-education. CONCLUSION: We suggest that radiologists benefit from error review, although there was not a statistically significant improvement for the series of radiographs in total. This is partly explained by the fact that some radiologists gave incorrect responses post-education that had initially been correct, thus masking the effect of the educational intervention. Tudor, G.R. and Finlay, D.B. (2001

  17. Raising Confident Kids

    Science.gov (United States)

    ... First Aid & Safety Doctors & Hospitals Videos Recipes for Kids Kids site Sitio para niños How the Body ... Videos for Educators Search English Español Raising Confident Kids KidsHealth / For Parents / Raising Confident Kids What's in ...

  18. Biospecimen Reporting for Improved Study Quality (BRISQ)

    Energy Technology Data Exchange (ETDEWEB)

    National Cancer Institute; Jewell, Ph.D., Scott D.; Seijo, M.S., Edward; Kelly, Ph.D., Andrea; Somiari, Ph.D., Stella; B.Chir., M.B.; McShane, Ph.D., Lisa M.; Clark, M.D., Douglas; Greenspan, M.D., Renata; Hayes, M.D., Daniel F.; Hainaut, Ph.D., M.S., Pierre; Kim, Paula; Mansfield, Ph.D., Elizabeth; Potapova, Ph.D., Olga; Riegman, Ph.D., Peter; Rubinstein, Ph.D., Yaffa; Weier, Ph.D., Heinz-Ulrich; Zhu, Ph.D., Claire; Moore, Ph.D., Helen M.; Vaught, Ph.D., Jim; Watson, Peter

    2010-09-02

    Human biospecimens are subjected to collection, processing, and storage that can significantly alter their molecular composition and consistency. These biospecimen preanalytical factors, in turn, influence experimental outcomes and the ability to reproduce scientific results. Currently, the extent and type of information specific to the biospecimen preanalytical conditions reported in scientific publications and regulatory submissions varies widely. To improve the quality of research that uses human tissues, it is crucial that information on the handling of biospecimens be reported in a thorough, accurate, and standardized manner. The Biospecimen Reporting for Improved Study Quality (BRISQ) recommendations outlined herein are intended to apply to any study in which human biospecimens are used. The purpose of reporting these details is to supply others, from researchers to regulators, with more consistent and standardized information to better evaluate, interpret, compare, and reproduce the experimental results. The BRISQ guidelines are proposed as an important and timely resource tool to strengthen communication and publications on biospecimen-related research and to help reassure patient contributors and the advocacy community that their contributions are valued and respected.

  19. Biospecimen Reporting for Improved Study Quality

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Ph.D., Helen M.; Kelly, Ph.D., Andrea B.; Jewell, Ph.D., Scott D.; McShane, Ph.D., Lisa M.; Clark, M.D., Douglas P.; Greenspan, M.D., Renata; Hayes, M.D., Daniel F.; Hainaut, Ph.D., Pierre; Kim, Paula; Mansfield, Ph.D., Elizabeth A.; Potapova, Ph.D., Olga; Riegman, Ph.D., Peter; Rubinstein, Ph.D., Yaffa; Seijo, M.S., Edward; Somiari, Ph.D., Stella; Chir., B; Weier, Ph.D., Heinz-Ulrich; Zhu, Ph.D., Claire; Vaught, Ph.D., Jim; Watson,M.B., Peter

    2010-12-27

    Human biospecimens are subjected to collection, processing, and storage that can significantly alter their molecular composition and consistency. These biospecimen preanalytical factors, in turn, influence experimental outcomes and the ability to reproduce scientific results. Currently, the extent and type of information specific to the biospecimen preanalytical conditions reported in scientific publications and regulatory submissions varies widely. To improve the quality of research that uses human tissues, it is crucial that information on the handling of biospecimens be reported in a thorough, accurate, and standardized manner. The Biospecimen Reporting for Improved Study Quality (BRISQ) recommendations outlined herein are intended to apply to any study in which human biospecimens are used. The purpose of reporting these details is to supply others, from researchers to regulators, with more consistent and standardized information to better evaluate, interpret, compare, and reproduce the experimental results. The BRISQ guidelines are proposed as an important and timely resource tool to strengthen communication and publications on biospecimen-related research and to help reassure patient contributors and the advocacy community that their contributions are valued and respected.

  20. Biospecimen Reporting for Improved Study Quality (BRISQ)

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Ph.D., Helen M.; Kelly Ph.D., Andrea; Jewell Ph.D., Scott D.; McShane Ph.D., Lisa M.; Clark M.D., Douglas P.; Greenspan M.D., Renata; Hayes M.D., Daniel F.; Hainaut Ph.D.,, Pierre; Kim, Paula; Mansfield Ph.D., Elizabeth; Potapova Ph.D., Olga; Riegman Ph.D., Peter; Rubinstein Ph.D., Yaffa; Seijo M.S., Edward; Somiari Ph.D., Stella; Watson M.B., Peter; Weier Ph.D., Heinz-Ulrich; Zhu Ph.D., Claire; Vaught Ph.D., Jim

    2011-04-26

    Human biospecimens are subject to a number of different collection, processing, and storage factors that can significantly alter their molecular composition and consistency. These biospecimen preanalytical factors, in turn, influence experimental outcomes and the ability to reproduce scientific results. Currently, the extent and type of information specific to the biospecimen preanalytical conditions reported in scientific publications and regulatory submissions varies widely. To improve the quality of research utilizing human tissues it is critical that information regarding the handling of biospecimens be reported in a thorough, accurate, and standardized manner. The Biospecimen Reporting for Improved Study Quality (BRISQ) recommendations outlined herein are intended to apply to any study in which human biospecimens are used. The purpose of reporting these details is to supply others, from researchers to regulators, with more consistent and standardized information to better evaluate, interpret, compare, and reproduce the experimental results. The BRISQ guidelines are proposed as an important and timely resource tool to strengthen communication and publications around biospecimen-related research and help reassure patient contributors and the advocacy community that the contributions are valued and respected.

  1. Improved catalyzed reporter deposition, iCARD.

    Science.gov (United States)

    Lohse, Jesper; Petersen, Kenneth Heesche; Woller, Nina Claire; Pedersen, Hans Christian; Skladtchikova, Galina; Jørgensen, Rikke Malene

    2014-06-18

    Novel reporters have been synthesized with extended hydrophilic linkers that in combination with polymerizing cross-linkers result in very efficient reporter deposition. By utilizing antibodies to stain HER2 proteins in a cell line model it is demonstrated that the method is highly specific and sensitive with virtually no background. The detection of HER2 proteins in tissue was used to visualize individual antigens as small dots visible in a microscope. Image analysis-assisted counting of fluorescent or colored dots allowed assessment of relative protein levels in tissue. Taken together, we have developed novel reporters that improve the CARD method allowing highly sensitive in situ detection of proteins in tissue. Our findings suggest that in situ protein quantification in biological samples can be performed by object recognition and enumeration of dots, rather than intensity-based fluorescent or colorimetric assays.

  2. Effectiveness of adolescent suicide prevention e-learning modules that aim to improve knowledge and self-confidence of gatekeepers: Study protocol of a randomized controlled trial

    NARCIS (Netherlands)

    Ghoncheh, R.; Kerkhof, A.J.F.M.; Koot, H.M.

    2014-01-01

    Background: Providing e-learning modules can be an effective strategy for enhancing gatekeepers' knowledge, self-confidence and skills in adolescent suicide prevention. The aim of this study was to test the effectiveness of an online training program called Mental Health Online which consists of

  3. Improving the Transparency of IAEA Safeguards Reporting

    International Nuclear Information System (INIS)

    Toomey, Christopher; Hayman, Aaron M.; Wyse, Evan T.; Odlaug, Christopher S.

    2011-01-01

    In 2008, the Standing Advisory Group on Safeguards Implementation (SAGSI) indicated that the International Atomic Energy Agency's (IAEA) Safeguards Implementation Report (SIR) has not kept pace with the evolution of safeguards and provided the IAEA with a set of recommendations for improvement. The SIR is the primary mechanism for providing an overview of safeguards implementation in a given year and reporting on the annual safeguards findings and conclusions drawn by the Secretariat. As the IAEA transitions to State-level safeguards approaches, SIR reporting must adapt to reflect these evolutionary changes. This evolved report will better reflect the IAEA's transition to a more qualitative and information-driven approach, based upon State-as-a-whole considerations. This paper applies SAGSI's recommendations to the development of multiple models for an evolved SIR and finds that an SIR repurposed as a 'safeguards portal' could significantly enhance information delivery, clarity, and transparency. In addition, this paper finds that the 'portal concept' also appears to have value as a standardized information presentation and analysis platform for use by Country Officers, for continuity of knowledge purposes, and the IAEA Secretariat in the safeguards conclusion process. Accompanying this paper is a fully functional prototype of the 'portal' concept, built using commercial software and IAEA Annual Report data.

  4. Year End Progress Report on Rattlesnake Improvements

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Yaqi [Idaho National Lab. (INL), Idaho Falls, ID (United States); DeHart, Mark David [Idaho National Lab. (INL), Idaho Falls, ID (United States); Gleicher, Frederick Nathan [Idaho National Lab. (INL), Idaho Falls, ID (United States); Ortensi, Javier [Idaho National Lab. (INL), Idaho Falls, ID (United States); Schunert, Sebastian [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-09-01

    Rattlesnake is a MOOSE-based radiation transport application developed at INL to support modern multi-physics simulations. At the beginning of the last year, Rattlesnake was able to perform steady-state, transient and eigenvalue calculations for the multigroup radiation transport equations. Various discretization schemes, including continuous finite element method (FEM) with discrete ordinates method (SN) and spherical harmonics expansion method (PN) for the self-adjoint angular flux (SAAF) formulation, continuous FEM (CFEM) with SN for the least square (LS) formulation, diffusion approximation with CFEM and discontinuous FEM (DFEM), have been implemented. A separate toolkit, YAKXS, for multigroup cross section management was developed to support Rattlesnake calculations with feedback both from changes in the field variables, such as fuel temperature, coolant density, and etc., and in isotope inventory. The framework for doing nonlinear diffusion acceleration (NDA) within Rattlesnake has been set up, and both NDA calculations with SAAF-SN-CFEM scheme and Monte Carlo with OpenMC have been performed. It was also used for coupling BISON and RELAP-7 for the full-core multiphysics simulations. Within the last fiscal year, significant improvements have been made in Rattlesnake. Rattlesnake development was migrated into our internal GITLAB development environment at the end of year 2014. Since then total 369 merge requests has been accepted into Rattlesnake. It is noted that the MOOSE framework that Rattlesnake is based on is under continuous developments. Improvements made in MOOSE can improve the Rattlesnake. It is acknowledged that MOOSE developers spent efforts on patching Rattlesnake for the improvements made on the framework side. This report will not cover the code restructuring for better readability and modularity and documentation improvements, which we have spent tremendous effort on. It only details some of improvements in the following sections.

  5. Improved confidence in performing nutrition and physical activity behaviours mediates behavioural change in young adults: Mediation results of a randomised controlled mHealth intervention.

    Science.gov (United States)

    Partridge, Stephanie R; McGeechan, Kevin; Bauman, Adrian; Phongsavan, Philayrath; Allman-Farinelli, Margaret

    2017-01-01

    The burden of weight gain disproportionally affects young adults. Understanding the underlying behavioural mechanisms of change in mHealth nutrition and physical activity interventions designed for young adults is important for enhancing and translating effective interventions. First, we hypothesised that knowledge, self-efficacy and stage-of-change for nutrition and physical activity behaviours would improve, and second, that self-efficacy changes in nutrition and physical activity behaviours mediate the behaviour changes observed in an mHealth RCT for prevention of weight gain. Young adults, aged 18-35 years at risk of weight gain (n = 250) were randomly assigned to an mHealth-program, TXT2BFiT, consisting of a three-month intensive phase and six-month maintenance phase or to a control group. Self-reported online surveys at baseline, three- and nine-months assessed nutrition and physical activity behaviours, knowledge, self-efficacy and stage-of-change. The mediating effect of self-efficacy was assessed in multiple PROCESS macro-models for three- and nine-month nutrition and physical activity behaviour change. Young adults randomised to the intervention increased and maintained knowledge of fruit requirements (P = 0.029) compared to controls. Intervention participants' fruit and takeaway behaviours improved to meet recommendations at nine months, with a greater proportion progressing to action or maintenance stage-of-change (P behaviours did not meet recommendations, thereby halting progress to action or maintenance stage-of-change. Indirect effects of improved nutrition and physical activity behaviours at three- and nine-months in the intervention group were explained by changes in self-efficacy, accounting for 8%-37% of the total effect. This provides insights into how the mHealth intervention achieved part of its effects and the importance of improving self-efficacy to facilitate improved eating and physical activity behaviours in young adults

  6. Effectiveness of adolescent suicide prevention e-learning modules that aim to improve knowledge and self-confidence of gatekeepers: study protocol for a randomized controlled trial

    OpenAIRE

    Ghoncheh, Rezvan; Kerkhof, Ad JFM; Koot, Hans M

    2014-01-01

    Background Providing e-learning modules can be an effective strategy for enhancing gatekeepers’ knowledge, self-confidence and skills in adolescent suicide prevention. The aim of this study was to test the effectiveness of an online training program called Mental Health Online which consists of eight short e-learning modules, each capturing an important aspect of the process of recognition, guidance and referral of suicidal adolescents (12–20 years). The primary outcomes of this study are par...

  7. Effectiveness of adolescent suicide prevention e-learning modules that aim to improve knowledge and self-confidence of gatekeepers: Study protocol of a randomized controlled trial

    OpenAIRE

    Ghoncheh, R.; Kerkhof, A.J.F.M.; Koot, H.M.

    2014-01-01

    Background: Providing e-learning modules can be an effective strategy for enhancing gatekeepers' knowledge, self-confidence and skills in adolescent suicide prevention. The aim of this study was to test the effectiveness of an online training program called Mental Health Online which consists of eight short e-learning modules, each capturing an important aspect of the process of recognition, guidance and referral of suicidal adolescents (12-20 years). The primary outcomes of this study are pa...

  8. Assessing public speaking fear with the short form of the Personal Report of Confidence as a Speaker scale: confirmatory factor analyses among a French-speaking community sample.

    Science.gov (United States)

    Heeren, Alexandre; Ceschi, Grazia; Valentiner, David P; Dethier, Vincent; Philippot, Pierre

    2013-01-01

    The main aim of this study was to assess the reliability and structural validity of the French version of the 12-item version of the Personal Report of Confidence as Speaker (PRCS), one of the most promising measurements of public speaking fear. A total of 611 French-speaking volunteers were administered the French versions of the short PRCS, the Liebowitz Social Anxiety Scale, the Fear of Negative Evaluation scale, as well as the Trait version of the Spielberger State-Trait Anxiety Inventory and the Beck Depression Inventory-II, which assess the level of anxious and depressive symptoms, respectively. Regarding its structural validity, confirmatory factor analyses indicated a single-factor solution, as implied by the original version. Good scale reliability (Cronbach's alpha = 0.86) was observed. The item discrimination analysis suggested that all the items contribute to the overall scale score reliability. The French version of the short PRCS showed significant correlations with the Liebowitz Social Anxiety Scale (r = 0.522), the Fear of Negative Evaluation scale (r = 0.414), the Spielberger State-Trait Anxiety Inventory (r = 0.516), and the Beck Depression Inventory-II (r = 0.361). The French version of the short PRCS is a reliable and valid measure for the evaluation of the fear of public speaking among a French-speaking sample. These findings have critical consequences for the measurement of psychological and pharmacological treatment effectiveness in public speaking fear among a French-speaking sample.

  9. The Model Confidence Set

    DEFF Research Database (Denmark)

    Hansen, Peter Reinhard; Lunde, Asger; Nason, James M.

    The paper introduces the model confidence set (MCS) and applies it to the selection of models. A MCS is a set of models that is constructed such that it will contain the best model with a given level of confidence. The MCS is in this sense analogous to a confidence interval for a parameter. The MCS......, beyond the comparison of models. We apply the MCS procedure to two empirical problems. First, we revisit the inflation forecasting problem posed by Stock and Watson (1999), and compute the MCS for their set of inflation forecasts. Second, we compare a number of Taylor rule regressions and determine...... the MCS of the best in terms of in-sample likelihood criteria....

  10. Assessing public speaking fear with the short form of the Personal Report of Confidence as a Speaker scale: confirmatory factor analyses among a French-speaking community sample

    Directory of Open Access Journals (Sweden)

    Heeren A

    2013-05-01

    Full Text Available Alexandre Heeren,1,2 Grazia Ceschi,3 David P Valentiner,4 Vincent Dethier,1 Pierre Philippot11Université Catholique de Louvain, Louvain-la-Neuve, Belgium; 2National Fund for Scientific Research, Brussels, Belgium; 3Department of Psychology, University of Geneva, Geneva, Switzerland; 4Department of Psychology, Northern Illinois University, DeKalb, IL, USABackground: The main aim of this study was to assess the reliability and structural validity of the French version of the 12-item version of the Personal Report of Confidence as Speaker (PRCS, one of the most promising measurements of public speaking fear.Methods: A total of 611 French-speaking volunteers were administered the French versions of the short PRCS, the Liebowitz Social Anxiety Scale, the Fear of Negative Evaluation scale, as well as the Trait version of the Spielberger State-Trait Anxiety Inventory and the Beck Depression Inventory-II, which assess the level of anxious and depressive symptoms, respectively.Results: Regarding its structural validity, confirmatory factor analyses indicated a single-factor solution, as implied by the original version. Good scale reliability (Cronbach’s alpha = 0.86 was observed. The item discrimination analysis suggested that all the items contribute to the overall scale score reliability. The French version of the short PRCS showed significant correlations with the Liebowitz Social Anxiety Scale (r = 0.522, the Fear of Negative Evaluation scale (r = 0.414, the Spielberger State-Trait Anxiety Inventory (r = 0.516, and the Beck Depression Inventory-II (r = 0.361.Conclusion: The French version of the short PRCS is a reliable and valid measure for the evaluation of the fear of public speaking among a French-speaking sample. These findings have critical consequences for the measurement of psychological and pharmacological treatment effectiveness in public speaking fear among a French-speaking sample.Keywords: social phobia, public speaking, confirmatory

  11. Using 18th century storm-surge data from the Dutch Coast to improve the confidence in flood-risk estimates

    Directory of Open Access Journals (Sweden)

    F. Baart

    2011-10-01

    Full Text Available For the design of cost-effective coastal defence a precise estimate is needed of the 1/10 000 per year storm surge. A more precise estimate requires more observations. Therefore, the three greatest storm surges that hit the northern part of the Holland Coast in the 18th century are reconstructed. The reconstructions are based on paintings, drawings, written records and shell deposits that have recently appeared. The storm-surge levels of these storms have been estimated using numerical modelling of the coastal processes. Here we show how these reconstructions can be used in combination with extreme value statistics to give a more confident estimate of low probability events.

  12. Effectiveness of adolescent suicide prevention e-learning modules that aim to improve knowledge and self-confidence of gatekeepers: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Ghoncheh, Rezvan; Kerkhof, Ad J F M; Koot, Hans M

    2014-02-08

    Providing e-learning modules can be an effective strategy for enhancing gatekeepers' knowledge, self-confidence and skills in adolescent suicide prevention. The aim of this study was to test the effectiveness of an online training program called Mental Health Online which consists of eight short e-learning modules, each capturing an important aspect of the process of recognition, guidance and referral of suicidal adolescents (12-20 years). The primary outcomes of this study are participant's ratings on perceived knowledge, perceived self-confidence, and actual knowledge regarding adolescent suicidality. A randomized controlled trial will be carried out among 154 gatekeepers. After completing the first assessment (pre-test), participants will be randomly assigned to either the experimental group or the waitlist control group. One week after completing the first assessment the experimental group will have access to the website Mental Health Online containing the eight e-learning modules and additional information on adolescent suicide prevention. Participants in both conditions will be assessed 4 weeks after completing the first assessment (post-test), and 12 weeks after completing the post-test (follow-up). At post-test, participants from the experimental group are asked to complete an evaluation questionnaire on the modules. The waitlist control group will have access to the modules and additional information on the website after completing the follow-up assessment. Gatekeepers can benefit from e-learning modules on adolescent suicide prevention. This approach allows them to learn about this sensitive subject at their own pace and from any given location, as long as they have access to the Internet. Given the flexible nature of the program, each participant can compose his/her own training creating an instant customized course with the required steps in adolescent suicide prevention. Netherlands Trial Register NTR3625.

  13. Methodology for building confidence measures

    Science.gov (United States)

    Bramson, Aaron L.

    2004-04-01

    This paper presents a generalized methodology for propagating known or estimated levels of individual source document truth reliability to determine the confidence level of a combined output. Initial document certainty levels are augmented by (i) combining the reliability measures of multiply sources, (ii) incorporating the truth reinforcement of related elements, and (iii) incorporating the importance of the individual elements for determining the probability of truth for the whole. The result is a measure of confidence in system output based on the establishing of links among the truth values of inputs. This methodology was developed for application to a multi-component situation awareness tool under development at the Air Force Research Laboratory in Rome, New York. Determining how improvements in data quality and the variety of documents collected affect the probability of a correct situational detection helps optimize the performance of the tool overall.

  14. Reclaim your creative confidence.

    Science.gov (United States)

    Kelley, Tom; Kelley, David

    2012-12-01

    Most people are born creative. But over time, a lot of us learn to stifle those impulses. We become warier of judgment, more cautious more analytical. The world seems to divide into "creatives" and "noncreatives," and too many people resign themselves to the latter category. And yet we know that creativity is essential to success in any discipline or industry. The good news, according to authors Tom Kelley and David Kelley of IDEO, is that we all can rediscover our creative confidence. The trick is to overcome the four big fears that hold most of us back: fear of the messy unknown, fear of judgment, fear of the first step, and fear of losing control. The authors use an approach based on the work of psychologist Albert Bandura in helping patients get over their snake phobias: You break challenges down into small steps and then build confidence by succeeding on one after another. Creativity is something you practice, say the authors, not just a talent you are born with.

  15. Confidence in Numerical Simulations

    International Nuclear Information System (INIS)

    Hemez, Francois M.

    2015-01-01

    This PowerPoint presentation offers a high-level discussion of uncertainty, confidence and credibility in scientific Modeling and Simulation (M&S). It begins by briefly evoking M&S trends in computational physics and engineering. The first thrust of the discussion is to emphasize that the role of M&S in decision-making is either to support reasoning by similarity or to ''forecast,'' that is, make predictions about the future or extrapolate to settings or environments that cannot be tested experimentally. The second thrust is to explain that M&S-aided decision-making is an exercise in uncertainty management. The three broad classes of uncertainty in computational physics and engineering are variability and randomness, numerical uncertainty and model-form uncertainty. The last part of the discussion addresses how scientists ''think.'' This thought process parallels the scientific method where by a hypothesis is formulated, often accompanied by simplifying assumptions, then, physical experiments and numerical simulations are performed to confirm or reject the hypothesis. ''Confidence'' derives, not just from the levels of training and experience of analysts, but also from the rigor with which these assessments are performed, documented and peer-reviewed.

  16. Facilitating SME Financing through Improved Credit Reporting

    OpenAIRE

    International Committee on Credit Reporting

    2014-01-01

    The general principles for credit reporting were issued by the World Bank in September 2011. Since then, the World Bank and the international committee on credit reporting (ICCR) have been leading efforts towards the implementation of the general principles worldwide. This report is one of the concrete outputs of the work following the general principles. It addresses one of the most signi...

  17. A Case Study of Culturally Relevant School-Based Programming for First Nations Youth: Improved Relationships, Confidence and Leadership, and School Success

    Science.gov (United States)

    Crooks, Claire V.; Burleigh, Dawn; Snowshoe, Angela; Lapp, Andrea; Hughes, Ray; Sisco, Ashley

    2015-01-01

    Schools are expected to promote social and emotional learning skills among youth; however, there is a lack of culturally-relevant programming available. The Fourth R: Uniting Our Nations programs for Aboriginal youth include strengths-based programs designed to promote healthy relationships and cultural connectedness, and improve school success…

  18. Evaluating the Effectiveness of Using Peer-Dialogue Assessment (PDA) for Improving Pre-Service Teachers' Perceived Confidence and Competence to Teach Physical Education

    Science.gov (United States)

    Eather, Narelle; Riley, Nick; Miller, Drew; Jones, Bradley

    2017-01-01

    Developing effective methods for improving student learning in higher education is a priority. Recent findings have shown that feedback on student work can effectively facilitate learning if students are engaged as active participants in the feedback cycle; where they seek, generate and use feedback in the form of dialogue. This novel study…

  19. Multimodality Molecular Imaging (FDG-PET/CT, US Elastography, and DWI-MRI) as Complimentary Adjunct for Enhancing Diagnostic Confidence in Reported Intermediate Risk Category Thyroid Nodules on Bethesda Thyroid Cytopathology Reporting System

    International Nuclear Information System (INIS)

    Basu, Sandip; Mahajan, Abhishek; Arya, Supreeta

    2016-01-01

    The potential complimentary role of various molecular imaging modalities [fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT), ultrasound (US)-elastography, and diffusion weighted imaging-magnetic resonance imaging (DWI-MRI)] in characterizing thyroid nodules, which have been designated as “intermediate risk category” on the Bethesda thyroid cytopathology reporting system (BTCRS), is illustrated in this communication. The clinical cases described (category III thyroid nodules on BTCRS) show the imaging features and the final diagnostic impressions rendered by the interpreting physicians with the modalities that have been independently compared in a tabular format at the end; of particular note is the high negative predictive value of these (specifically FDG-PET/CT), which could aid in enhancing the diagnostic confidence in the reported “intermediate risk category” thyroid nodules, a “gray zone” from the patient management viewpoint

  20. Globalization of consumer confidence

    Directory of Open Access Journals (Sweden)

    Çelik Sadullah

    2017-01-01

    Full Text Available The globalization of world economies and the importance of nowcasting analysis have been at the core of the recent literature. Nevertheless, these two strands of research are hardly coupled. This study aims to fill this gap through examining the globalization of the consumer confidence index (CCI by applying conventional and unconventional econometric methods. The US CCI is used as the benchmark in tests of comovement among the CCIs of several developing and developed countries, with the data sets divided into three sub-periods: global liquidity abundance, the Great Recession, and postcrisis. The existence and/or degree of globalization of the CCIs vary according to the period, whereas globalization in the form of coherence and similar paths is observed only during the Great Recession and, surprisingly, stronger in developing/emerging countries.

  1. Interpretation of Confidence Interval Facing the Conflict

    Science.gov (United States)

    Andrade, Luisa; Fernández, Felipe

    2016-01-01

    As literature has reported, it is usual that university students in statistics courses, and even statistics teachers, interpret the confidence level associated with a confidence interval as the probability that the parameter value will be between the lower and upper interval limits. To confront this misconception, class activities have been…

  2. Aging and Confidence Judgments in Item Recognition

    Science.gov (United States)

    Voskuilen, Chelsea; Ratcliff, Roger; McKoon, Gail

    2018-01-01

    We examined the effects of aging on performance in an item-recognition experiment with confidence judgments. A model for confidence judgments and response time (RTs; Ratcliff & Starns, 2013) was used to fit a large amount of data from a new sample of older adults and a previously reported sample of younger adults. This model of confidence…

  3. Student laboratory reports: an approach to improving feedback and quality

    Science.gov (United States)

    Ellingsen, Pål Gunnar; Støvneng, Jon Andreas

    2018-05-01

    We present an ongoing effort in improving the quality of laboratory reports written by first and second year physics students. The effort involves a new approach where students are given the opportunity to submit reports at intermediate deadlines, receive feedback, and then resubmit for the final deadline. In combination with a differential grading system, instead of pass/fail, the improved feedback results in higher quality reports. Improvement in the quality of the reports is visible through the grade statistics.

  4. A strategy for improving public confidence of nuclear energy based on the segmentation of stake holders -Focused on Univ. Students, the Opinion Leader in the Next Generation-

    International Nuclear Information System (INIS)

    Jang, Jenam

    2012-01-01

    Korea Nuclear Energy Promotion Agency(hereafter, referred as KONEPA) is a public institution established in March, 1992 to improve correct understanding of nuclear energy through development and dissemination of objective, scientific knowledge on the peaceful use of nuclear energy. KONEPA divided the targeted group into four large groups? opinion leaders, civil-social group, LOCA governments, general public/next-generation students/teachers? according to the knowledge levels of nuclear power and involvements in nuclear power plants, and implemented 'customized strategy' suited to the own characteristic of each group. Of these four groups, the next generation, focused on the 'Univ. students' will be discussed with their activities and future plans in this paper

  5. Confidence in Numerical Simulations

    Energy Technology Data Exchange (ETDEWEB)

    Hemez, Francois M. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2015-02-23

    This PowerPoint presentation offers a high-level discussion of uncertainty, confidence and credibility in scientific Modeling and Simulation (M&S). It begins by briefly evoking M&S trends in computational physics and engineering. The first thrust of the discussion is to emphasize that the role of M&S in decision-making is either to support reasoning by similarity or to “forecast,” that is, make predictions about the future or extrapolate to settings or environments that cannot be tested experimentally. The second thrust is to explain that M&S-aided decision-making is an exercise in uncertainty management. The three broad classes of uncertainty in computational physics and engineering are variability and randomness, numerical uncertainty and model-form uncertainty. The last part of the discussion addresses how scientists “think.” This thought process parallels the scientific method where by a hypothesis is formulated, often accompanied by simplifying assumptions, then, physical experiments and numerical simulations are performed to confirm or reject the hypothesis. “Confidence” derives, not just from the levels of training and experience of analysts, but also from the rigor with which these assessments are performed, documented and peer-reviewed.

  6. Reporting funding source or conflict of interest in abstracts of randomized controlled trials, no evidence of a large impact on general practitioners' confidence in conclusions, a three-arm randomized controlled trial.

    Science.gov (United States)

    Buffel du Vaure, Céline; Boutron, Isabelle; Perrodeau, Elodie; Ravaud, Philippe

    2014-04-28

    Systematic reporting of funding sources is recommended in the CONSORT Statement for abstracts. However, no specific recommendation is related to the reporting of conflicts of interest (CoI). The objective was to compare physicians' confidence in the conclusions of abstracts of randomized controlled trials of pharmaceutical treatment indexed in PubMed. We planned a three-arm parallel-group randomized trial. French general practitioners (GPs) were invited to participate and were blinded to the study's aim. We used a representative sample of 75 abstracts of pharmaceutical industry-funded randomized controlled trials published in 2010 and indexed in PubMed. Each abstract was standardized and reported in three formats: 1) no mention of the funding source or CoI; 2) reporting the funding source only; and 3) reporting the funding source and CoI. GPs were randomized according to a computerized randomization on a secure Internet system at a 1:1:1 ratio to assess one abstract among the three formats. The primary outcome was GPs' confidence in the abstract conclusions (0, not at all, to 10, completely confident). The study was planned to detect a large difference with an effect size of 0.5. Between October 2012 and June 2013, among 605 GPs contacted, 354 were randomized, 118 for each type of abstract. The mean difference (95% confidence interval) in GPs' confidence in abstract findings was 0.2 (-0.6; 1.0) (P = 0.84) for abstracts reporting the funding source only versus no funding source or CoI; -0.4 (-1.3; 0.4) (P = 0.39) for abstracts reporting the funding source and CoI versus no funding source and CoI; and -0.6 (-1.5; 0.2) (P = 0.15) for abstracts reporting the funding source and CoI versus the funding source only. We found no evidence of a large impact of trial report abstracts mentioning funding sources or CoI on GPs' confidence in the conclusions of the abstracts. ClinicalTrials.gov identifier: NCT01679873.

  7. Technical report for effective estimation and improvement of quality system

    International Nuclear Information System (INIS)

    Kim, Kwan Hyun

    2000-06-01

    This technical report provides the methods on how to improve the Quality System, in R and D part. This report applies on the quality assurance(QA) programmes of the design, fabrication in nuclear projects. The organization having overall responsibility for the nuclear power item design, preservation, fabrication shall be described in this report in each stage of improvement of QA systems

  8. Report focuses on improving resilience to disasters

    Science.gov (United States)

    Showstack, Randy

    2012-08-01

    “Disaster resilience is everyone's business,” states a new report that calls for a series of local and national measures to increase resilience in the face of an increasingly costly toll from natural disasters to human lives and the economy. In 2011 natural disasters were responsible for damages in the United States exceeding $55 billion, and costs could increase with more people and structures located in harm's way and with the effects of extreme events, according to the report, Disaster Resilience: A National Imperative, issued by a committee of the U.S. National Academies on 1 August. Among the recommendations is for federal government agencies to incorporate national resilience as an organizing principle to guide federal government actions and programs. The report defines resilience as “the ability to prepare and plan for, absorb, recover from, and more successfully adapt to adverse events.”

  9. An educational approach to improve outcomes in acute kidney injury (AKI): report of a quality improvement project.

    Science.gov (United States)

    Xu, Gang; Baines, Richard; Westacott, Rachel; Selby, Nick; Carr, Susan

    2014-03-20

    To assess the impact of a quality improvement project that used a multifaceted educational intervention on how to improve clinician's knowledge, confidence and awareness of acute kidney injury (AKI). 2 large acute teaching hospitals in England, serving a combined population of over 1.5 million people. All secondary care clinicians working in the clinical areas were targeted, with a specific focus on clinicians working in acute admission areas. A multifaceted educational intervention consisting of traditional didactic lectures, case-based teaching in small groups and an interactive web-based learning resource. We assessed clinicians' knowledge of AKI and their self-reported clinical behaviour using an interactive questionnaire before and after the educational intervention. Secondary outcome measures included clinical audit of patient notes before and after the intervention. 26% of clinicians reported that they were aware of local AKI guidelines in the preintervention questionnaire compared to 64% in the follow-up questionnaire (χ²=60.2, pquality improvement project utilising a multifaceted educational intervention improved awareness of AKI as demonstrated by changes in the clinician's self-reported management of patients with AKI. Elements of the project have been sustained beyond the project period, and demonstrate the power of quality improvement projects to help initiate changes in practice. Our findings are limited by confounding factors and highlight the need to carry out formal randomised studies to determine the impact of educational initiatives in the clinical setting.

  10. Report of panel 3: Concept improvement

    International Nuclear Information System (INIS)

    Dean, S.O.; Ripin, B.H.; Batchelor, D.; Berkner, K.; Kaye, S.M.; Logan, B.G.; Marmar, E.; Navratil, G.; Ellis, W.R.; Gentle, K.W.

    1992-01-01

    The charge to Panel 3 was to look at the idea of concept improvements in the context of US DOE management of the magnetic fusion program. The panel suggested that if DOE were commited to the idea of concept improvement, it needed to overcome the existing impression it was not receptive to new ideas. In part the long time scale for development of fusion energy, coupled with the rate of change of scientific programs and research based on emerging knowledge, means that in general the program will be much different ten to twenty years in the future. To be able to meet this changing direction, the US program must maintain an openness to look at promising alternative ideas, spend money on developing the ideas, and consider funding some to intermediate development levels. Stellerator research was offered as one alternative to consider in light of present international work. The panel urged supporting the development of new concepts and ideas, as well as continued support for plasma physics basic research

  11. A Report Card on Continuous Quality Improvement

    Science.gov (United States)

    Blumenthal, David; Kilo, Charles M.

    1998-01-01

    Efforts to incorporate the principles of continuous quality improvement (CQI) into health care have been underway for about ten years. In order to understand the lessons of this decade of experience, senior organizational leaders and experts in the field of health care were interviewed. This select group agreed that there have been concrete accomplishments: the tactic of assigning blame for mistakes to individuals is gradually giving way to an emphasis on detecting problems with process; there is a new focus on the health care customer; and many valuable projects have been inaugurated. Nevertheless, the interviews underlined the reality that the movement has not yet made a sizable impact on the U.S. health care system. Until there is a profound, organization-wide recognition of the need for change, universal commitment to CQI principles will not be achieved. PMID:9879305

  12. Establishing and communicating confidence in the safety of deep geologic disposal. Approaches and arguments

    International Nuclear Information System (INIS)

    2002-01-01

    Confidence among both technical experts and the public in the safety of deep geologic repositories for radioactive waste is a key element in the successful development of the repositories. This report presents the approaches and arguments that are currently used in OECD countries to establish and communicate confidence in their safety. It evaluates the state of the art for obtaining, presenting and demonstrating confidence in long-term safety, and makes recommendations on future directions and initiatives to be taken for improving confidence. (author)

  13. Competition and confidence

    International Nuclear Information System (INIS)

    Borloo, J.L.

    2007-01-01

    After a presentation of the new situation of the energy sector with the opening of European energy markets to competition, the author recalls the role of the French government in the organisation and operation of this market: reliable information and protection of consumers, security of supplies with reasonable gas prices, sound relations and partnerships with producing and transit countries. France agrees with the diagnostic of the European Commission about the necessity to improve the operation of the domestic energy markets but differs with the projects of the Commission on the means to be implemented to ensure transparency, non-discrimination, and efficiency in the operation of these markets. (J.S.)

  14. Improved radioimmunotherapy of hematologic malignancies. [Final report

    Energy Technology Data Exchange (ETDEWEB)

    Press, O.W.

    1992-03-24

    This research project proposes to develop novel new approaches of improving the radioimmunodetection and radioimmunotherapy of malignancies by augmenting retention of radioimmunoconjugates by tumor cells. The approaches shown to be effective in these laboratory experiments will subsequently be incorporated into out ongoing clinical trials in patients. Specific project objectives include: to study the rates of endocytosis, intracellular routing, and metabolic degradation of radiolabeled monoclonal antibodies targeting tumor-associated antigens on human leukemia and lymphoma cells; To examine the effects of lysosomotropic amines (e.g. chloroquine, amantadine), carboxylic ionophores (monensin, nigericin), and thioamides (propylthiouracil), on the retention of radiolabeled MoAbs by tumor cells; to examine the impact of newer radioiodination techniques (tyramine cellobiose, paraiodobenzoyl) on the metabolic degradation of radioiodinated antibodies; to compare the endocytosis, intracellular routing, and degradation of radioimmunoconjugates prepared with different radionuclides ({sup 131}Iodine, {sup 111}Indium, {sup 90}Yttrium, {sup 99m}Technetium, {sup 186}Rhenium); and to examine the utility of radioimmunoconjugates targeting oncogene products for the radioimmunotherapy and radioimmunoscintigraphy of cancer.

  15. Communication confidence in persons with aphasia.

    Science.gov (United States)

    Babbitt, Edna M; Cherney, Leora R

    2010-01-01

    Communication confidence is a construct that has not been explored in the aphasia literature. Recently, national and international organizations have endorsed broader assessment methods that address quality of life and include participation, activity, and impairment domains as well as psychosocial areas. Individuals with aphasia encounter difficulties in all these areas on a daily basis in living with a communication disorder. Improvements are often reflected in narratives that are not typically included in standard assessments. This article illustrates how a new instrument measuring communication confidence might fit into a broad assessment framework and discusses the interaction of communication confidence, autonomy, and self-determination for individuals living with aphasia.

  16. The IOM report on improving diagnosis: new concepts.

    Science.gov (United States)

    Graber, Mark L

    2015-12-01

    The IOM report 'Improving Diagnosis in Health Care' represents a major advance in summarizing the problem of diagnostic error. Three new concepts in the report will be helpful in future efforts to understand and improve the diagnostic process: a new definition of diagnostic error, a new framework for understanding the diagnostic process, and a new concept of the diagnostic 'team'. This paper highlights these new concepts and their relevance to improving diagnosis.

  17. Diverse interpretations of confidence building

    International Nuclear Information System (INIS)

    Macintosh, J.

    1998-01-01

    This paper explores the variety of operational understandings associated with the term 'confidence building'. Collectively, these understandings constitute what should be thought of as a 'family' of confidence building approaches. This unacknowledged and generally unappreciated proliferation of operational understandings that function under the rubric of confidence building appears to be an impediment to effective policy. The paper's objective is to analyze these different understandings, stressing the important differences in their underlying assumptions. In the process, the paper underlines the need for the international community to clarify its collective thinking about what it means when it speaks of 'confidence building'. Without enhanced clarity, it will be unnecessarily difficult to employ the confidence building approach effectively due to the lack of consistent objectives and common operating assumptions. Although it is not the intention of this paper to promote a particular account of confidence building, dissecting existing operational understandings should help to identify whether there are fundamental elements that define what might be termed 'authentic' confidence building. Implicit here is the view that some operational understandings of confidence building may diverge too far from consensus models to count as meaningful members of the confidence building family. (author)

  18. Pilot study to train dentists to communicate about oral cancer: the impact on dentists' self-reported behaviour, confidence and beliefs.

    Science.gov (United States)

    Awojobi, O; Newton, J T; Scott, S E

    2016-01-22

    To evaluate the effect of a brief, focused training session on the use of an oral cancer communication guide on dentists' intentions, self-efficacy and beliefs with regards to communicating about oral cancer with patients. Pre-post intervention study. The training session took place in a lecture theatre at King's College London. Dentists working in various settings were trained on the use of the oral cancer communication guide via a structured session that included an update on oral cancer, modelling the use of the guide in practice, and role playing. Dentists (n = 39) completed questionnaires pre-training, immediately post-training (n = 31) and after 2 weeks (n = 23). Questionnaires assessed current practice, self-efficacy and barriers to discussing oral cancer. A significantly higher proportion of dentists reported that they informed patients that they were being screened for oral cancer post-training (44%) than pre-training (16%). Significantly fewer perceived barriers and higher self-efficacy to discuss oral cancer were also reported. Training dentists in the use of the guide showed positive impact by reducing perceived barriers and increasing self-efficacy.

  19. Financing mechanisms for capital improvements : interchanges, final report, March 2010.

    Science.gov (United States)

    2010-03-01

    This report examines the use of alternative local financing mechanisms for interchange and interchange area infrastructure improvements. The financing mechanisms covered include transportation impact fees, tax increment financing, value capture finan...

  20. Financing mechanisms for capital improvements : interchanges : final report.

    Science.gov (United States)

    2010-03-01

    This report examines the use of alternative local financing mechanisms for interchange and interchange area infrastructure improvements. The financing mechanisms covered include transportation impact fees, tax increment financing, value capture finan...

  1. Improving Manufacturing Performance in South Africa : Report of the ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    1995-01-01

    Improving Manufacturing Performance in South Africa : Report of the Industrial Strategy Project. Couverture du livre Improving Manufacturing Performance in South Africa. Author(s):. Avril Joffe, David Kaplan, Raphael Kaplinsky et David Lewis. Publisher(s):. UCT Press, CRDI. January 1, 1995. ISBN: Épuisé. 264 pages.

  2. Increasing Product Confidence-Shifting Paradigms.

    Science.gov (United States)

    Phillips, Marla; Kashyap, Vishal; Cheung, Mee-Shew

    2015-01-01

    Leaders in the pharmaceutical, medical device, and food industries expressed a unilateral concern over product confidence throughout the total product lifecycle, an unsettling fact for these leaders to manage given that their products affect the lives of millions of people each year. Fueled by the heparin incident of intentional adulteration in 2008, initial efforts for increasing product confidence were focused on improving the confidence of incoming materials, with a belief that supplier performance must be the root cause. As in the heparin case, concern over supplier performance extended deep into the supply chain to include suppliers of the suppliers-which is often a blind spot for pharmaceutical, device, and food manufacturers. Resolved to address the perceived lack of supplier performance, these U.S. Food and Drug Administration (FDA)-regulated industries began to adopt the supplier relationship management strategy, developed by the automotive industry, that emphasizes "management" of suppliers for the betterment of the manufacturers. Current product and supplier management strategies, however, have not led to a significant improvement in product confidence. As a result of the enduring concern by industry leaders over the lack of product confidence, Xavier University launched the Integrity of Supply Initiative in 2012 with a team of industry leaders and FDA officials. Through a methodical research approach, data generated by the pharmaceutical, medical device, and food manufacturers surprisingly pointed to themselves as a source of the lack of product confidence, and revealed that manufacturers either unknowingly increase the potential for error or can control/prevent many aspects of product confidence failure. It is only through this paradigm shift that manufacturers can work collaboratively with their suppliers as equal partners, instead of viewing their suppliers as "lesser" entities needing to be controlled. The basis of this shift provides manufacturers

  3. Report: EPA’s Fleet Management Program Needs Improvement

    Science.gov (United States)

    Report #15-P-0001, October 6, 2014. If oversight of the EPA’s fleet is not improved, the $6 million-per-year program could be ineffective and inefficient in supporting the agency’s mission and reporting data to the federal system.

  4. Diagnosing and reporting of occupational diseases: a quality improvement study

    NARCIS (Netherlands)

    Spreeuwers, D.; de Boer, A. G. E. M.; Verbeek, J. H. A. M.; van Beurden, M. M.; van Dijk, F. J. H.

    2008-01-01

    AIM: To assess the need for quality improvement of diagnosing and reporting of noise-induced occupational hearing loss and occupational adjustment disorder. METHODS: Performance indicators and criteria for the quality of diagnosing and reporting were developed. Self-assessment questionnaires were

  5. Improving report writing by peer assessment using Coursera

    DEFF Research Database (Denmark)

    Christiansen, Henrik Lehrmann

    2015-01-01

    report writing. In the case of report writing active learning could include peer evaluation which is what is investigated in this paper. This paper presents a case study from the Technical University of Denmark. A course on mobile communication was redesigned to include peer evaluation as a tool......Report writing is a general engineering competence and it should therefore be part of any university engineering education to learn how to write a good report. Active leaning methods are well-known to be effective in supporting student learning; hence it should preferably also be used for teaching...... for improving report writing skills. The peer evaluation process was automated using the elearning tool Coursera. What was investigated was the improvement in report writing as well as the consistency and quality of the peer assessed grades....

  6. Improving Reports Turnaround Time: An Essential Healthcare Quality Dimension.

    Science.gov (United States)

    Khan, Mustafa; Khalid, Parwaiz; Al-Said, Youssef; Cupler, Edward; Almorsy, Lamia; Khalifa, Mohamed

    2016-01-01

    Turnaround time is one of the most important healthcare performance indicators. King Faisal Specialist Hospital and Research Center in Jeddah, Saudi Arabia worked on reducing the reports turnaround time of the neurophysiology lab from more than two weeks to only five working days for 90% of cases. The main quality improvement methodology used was the FOCUS PDCA. Using root cause analysis, Pareto analysis and qualitative survey methods, the main factors contributing to the delay of turnaround time and the suggested improvement strategies were identified and implemented, through restructuring transcriptionists daily tasks, rescheduling physicians time and alerting for new reports, engaging consultants, consistent coordination and prioritizing critical reports. After implementation; 92% of reports are verified within 5 days compared to only 6% before implementation. 7% of reports were verified in 5 days to 2 weeks and only 1% of reports needed more than 2 weeks compared to 76% before implementation.

  7. Assessing confidence in management adaptation approaches for climate-sensitive ecosystems

    International Nuclear Information System (INIS)

    West, J M; Julius, S H; Weaver, C P

    2012-01-01

    A number of options are available for adapting ecosystem management to improve resilience in the face of climatic changes. However, uncertainty exists as to the effectiveness of these options. A report prepared for the US Climate Change Science Program reviewed adaptation options for a range of federally managed systems in the United States. The report included a qualitative uncertainty analysis of conceptual approaches to adaptation derived from the review. The approaches included reducing anthropogenic stressors, protecting key ecosystem features, maintaining representation, replicating, restoring, identifying refugia and relocating organisms. The results showed that the expert teams had the greatest scientific confidence in adaptation options that reduce anthropogenic stresses. Confidence in other approaches was lower because of gaps in understanding of ecosystem function, climate change impacts on ecosystems, and management effectiveness. This letter discusses insights gained from the confidence exercise and proposes strategies for improving future assessments of confidence for management adaptations to climate change. (letter)

  8. Improving ultrasound for appendicitis through standardized reporting of secondary signs.

    Science.gov (United States)

    Partain, Kristin N; Patel, Adarsh U; Travers, Curtis; Short, Heather L; Braithwaite, Kiery; Loewen, Jonathan; Heiss, Kurt F; Raval, Mehul V

    2017-08-01

    Our aim was to implement a standardized US report that included secondary signs of appendicitis (SS) to facilitate accurate diagnosis of appendicitis and decrease the use of computed tomography (CT) and admissions for observation. A multidisciplinary team implemented a quality improvement (QI) intervention in the form of a standardized US report and provided stakeholders with monthly feedback. Outcomes including report compliance, CT use, and observation admissions were compared pretemplate and posttemplate. We identified 387 patients in the pretemplate period and 483 patients in the posttemplate period. In the posttemplate period, the reporting of SS increased from 5.4% to 79.5% (pappendicitis also improved in the posttemplate period. A focused QI initiative led to high compliance rates of utilizing the standardized US report and resulted in lower CT use and fewer admissions for observation. Study of a Diagnostic Test Level of Evidence: 1. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Report: EPA Improved Its National Security Information Program, but Some Improvements Still Needed

    Science.gov (United States)

    Report #16-P-0196, June 2, 2016. The EPA will continue to improve its national security information program by completing information classification guides that can be used uniformly and consistently throughout the agency.

  10. Nuclear power: restoring public confidence

    International Nuclear Information System (INIS)

    Arnold, L.

    1986-01-01

    The paper concerns a one day conference on nuclear power organised by the Centre for Science Studies and Science Policy, Lancaster, April 1986. Following the Chernobyl reactor accident, the conference concentrated on public confidence in nuclear power. Causes of lack of public confidence, public perceptions of risk, and the effect of Chernobyl in the United Kingdom, were all discussed. A Select Committee on the Environment examined the problems of radioactive waste disposal. (U.K.)

  11. Improving the safety of LWR power plants. Final report

    International Nuclear Information System (INIS)

    1980-04-01

    This report documents the results of the Study to identify current, potential research issues and efforts for improving the safety of Light Water Reactor (LWR) power plants. This final report describes the work accomplished, the results obtained, the problem areas, and the recommended solutions. Specifically, for each of the issues identified in this report for improving the safety of LWR power plants, a description is provided in detail of the safety significance, the current status (including information sources, status of technical knowledge, problem solution and current activities), and the suggestions for further research and development. Further, the issues are ranked for action into high, medium, and low priority with respect to primarily (a) improved safety (e.g. potential reduction in public risk and occupational exposure), and secondly (b) reduction in safety-related costs

  12. Sources of sport confidence, imagery type and performance among competitive athletes: the mediating role of sports confidence.

    Science.gov (United States)

    Levy, A R; Perry, J; Nicholls, A R; Larkin, D; Davies, J

    2015-01-01

    This study explored the mediating role of sport confidence upon (1) sources of sport confidence-performance relationship and (2) imagery-performance relationship. Participants were 157 competitive athletes who completed state measures of confidence level/sources, imagery type and performance within one hour after competition. Among the current sample, confirmatory factor analysis revealed appropriate support for the nine-factor SSCQ and the five-factor SIQ. Mediational analysis revealed that sport confidence had a mediating influence upon the achievement source of confidence-performance relationship. In addition, both cognitive and motivational imagery types were found to be important sources of confidence, as sport confidence mediated imagery type- performance relationship. Findings indicated that athletes who construed confidence from their own achievements and report multiple images on a more frequent basis are likely to benefit from enhanced levels of state sport confidence and subsequent performance.

  13. Improving Autopsy Report Turnaround Times by Implementing Lean Management Principles.

    Science.gov (United States)

    Cromwell, Susan; Chiasson, David A; Cassidy, Debra; Somers, Gino R

    2018-01-01

    The autopsy is an integral part of the service of a large academic pathology department. Timely reporting is central to providing good service and is beneficial for many stakeholders, including the families, the clinical team, the hospital, and the wider community. The current study aimed to improve hospital-consented autopsy reporting times (turnaround time, TAT) by using lean principles modified for a healthcare setting, with an aim of signing out 90% of autopsies in 90 days. An audit of current and historical TATs was performed, and a working group incorporating administrative, technical, and professional staff constructed a value stream map documenting the steps involved in constructing an autopsy report. Two areas of delay were noted: examination of the microscopy and time taken to sign-out the report after the weekly autopsy conference. Several measures were implemented to address these delays, including visual tracking using a whiteboard and individualized tracking sheets, weekly whiteboard huddles, and timelier scheduling of clinicopathologic conference rounds. All measures resulted in an improvement of TATs. In the 30 months prior to the institution of lean, 37% of autopsies (53/144) were signed out in 90 days, with a wide variation in reporting times. In the 30 months following the institution of lean, this improved to 74% (136/185) ( P lean; 63 days post-lean). The application of lean principles to autopsy sign-out workflow can significantly improve TATs and reduce variability, without changing staffing levels or significantly altering scheduling structure.

  14. Understanding Confidence Intervals With Visual Representations

    OpenAIRE

    Navruz, Bilgin; Delen, Erhan

    2014-01-01

    In the present paper, we showed how confidence intervals (CIs) are valuable and useful in research studies when they are used in the correct form with correct interpretations. The sixth edition of the APA (2010) Publication Manual strongly recommended reporting CIs in research studies, and it was described as “the best reporting strategy” (p. 34). Misconceptions and correct interpretations of CIs were presented from several textbooks. In addition, limitations of the null hypothesis statistica...

  15. Errors and Predictors of Confidence in Condom Use amongst Young Australians Attending a Music Festival.

    Science.gov (United States)

    Hall, Karina M; Brieger, Daniel G; De Silva, Sukhita H; Pfister, Benjamin F; Youlden, Daniel J; John-Leader, Franklin; Pit, Sabrina W

    2016-01-01

    Objectives . To determine the confidence and ability to use condoms correctly and consistently and the predictors of confidence in young Australians attending a festival. Methods . 288 young people aged 18 to 29 attending a mixed-genre music festival completed a survey measuring demographics, self-reported confidence using condoms, ability to use condoms, and issues experienced when using condoms in the past 12 months. Results . Self-reported confidence using condoms was high (77%). Multivariate analyses showed confidence was associated with being male ( P < 0.001) and having had five or more lifetime sexual partners ( P = 0.038). Reading packet instructions was associated with increased condom use confidence ( P = 0.011). Amongst participants who had used a condom in the last year, 37% had experienced the condom breaking and 48% had experienced the condom slipping off during intercourse and 51% when withdrawing the penis after sex. Conclusion . This population of young people are experiencing high rates of condom failures and are using them inconsistently or incorrectly, demonstrating the need to improve attitudes, behaviour, and knowledge about correct and consistent condom usage. There is a need to empower young Australians, particularly females, with knowledge and confidence in order to improve condom use self-efficacy.

  16. The use of a proforma improves colorectal cancer pathology reporting.

    Science.gov (United States)

    Rigby, K.; Brown, S. R.; Lakin, G.; Balsitis, M.; Hosie, K. B.

    1999-01-01

    The detail and accuracy of pathological reporting for colorectal cancer is becoming increasingly recognised as important in the overall management of the patient. However, there is criticism of the variable standards of reporting. We assessed how the use of a proforma affected the completeness of reporting within one hospital. Data on all colorectal cancer patients attending one teaching hospital has been collected prospectively over a 15 month period from 1997 to 1998. The Royal College of Surgeons/Association of Coloproctology proforma lists all items considered to be essential for a complete pathological report of colorectal cancer. Its introduction in September 1997 allowed us to compare reporting before the proforma to that after. Of 54 patients, 46 (85%) had one or more items missing from their report before introduction of the proforma compared with only 8/44 (18%) patients after the proforma (P < 0.001). Circumferential resection margins and apical node status were the items most often absent, being significantly more frequently reported after the proforma (P < 0.05 and P < 0.001, respectively). There was no difference in the median number of lymph nodes harvested after proforma introduction. The introduction of the proforma has not only resulted in improvements in reporting, but has increased the dialogue between surgical oncologists and pathologists. These features should result in improved overall management of the colorectal cancer patient. PMID:10655894

  17. Improving Indicators in a Brazilian Hospital Through Quality-Improvement Programs Based on STS Database Reports

    Directory of Open Access Journals (Sweden)

    Pedro Gabriel Melo de Barros e Silva

    2015-12-01

    Full Text Available ABSTRACT OBJECTIVE: To report the initial changes after quality-improvement programs based on STS-database in a Brazilian hospital. METHODS: Since 2011 a Brazilian hospital has joined STS-Database and in 2012 multifaceted actions based on STS reports were implemented aiming reductions in the time of mechanical ventilation and in the intensive care stay and also improvements in evidence-based perioperative therapies among patients who underwent coronary artery bypass graft surgeries. RESULTS: All the 947 patients submitted to coronary artery bypass graft surgeries from July 2011 to June 2014 were analyzed and there was an improvement in all the three target endpoints after the implementation of the quality-improvement program but the reduction in time on mechanical ventilation was not statistically significant after adjusting for prognostic characteristics. CONCLUSION: The initial experience with STS registry in a Brazilian hospital was associated with improvement in most of targeted quality-indicators.

  18. Confidence in critical care nursing.

    Science.gov (United States)

    Evans, Jeanne; Bell, Jennifer L; Sweeney, Annemarie E; Morgan, Jennifer I; Kelly, Helen M

    2010-10-01

    The purpose of the study was to gain an understanding of the nursing phenomenon, confidence, from the experience of nurses in the nursing subculture of critical care. Leininger's theory of cultural care diversity and universality guided this qualitative descriptive study. Questions derived from the sunrise model were used to elicit nurses' perspectives about cultural and social structures that exist within the critical care nursing subculture and the influence that these factors have on confidence. Twenty-eight critical care nurses from a large Canadian healthcare organization participated in semistructured interviews about confidence. Five themes arose from the descriptions provided by the participants. The three themes, tenuously navigating initiation rituals, deliberately developing holistic supportive relationships, and assimilating clinical decision-making rules were identified as social and cultural factors related to confidence. The remaining two themes, preserving a sense of security despite barriers and accommodating to diverse challenges, were identified as environmental factors related to confidence. Practice and research implications within the culture of critical care nursing are discussed in relation to each of the themes.

  19. Professional confidence: a concept analysis.

    Science.gov (United States)

    Holland, Kathlyn; Middleton, Lyn; Uys, Leana

    2012-03-01

    Professional confidence is a concept that is frequently used and or implied in occupational therapy literature, but often without specifying its meaning. Rodgers's Model of Concept Analysis was used to analyse the term "professional confidence". Published research obtained from a federated search in four health sciences databases was used to inform the concept analysis. The definitions, attributes, antecedents, and consequences of professional confidence as evidenced in the literature are discussed. Surrogate terms and related concepts are identified, and a model case of the concept provided. Based on the analysis, professional confidence can be described as a dynamic, maturing personal belief held by a professional or student. This includes an understanding of and a belief in the role, scope of practice, and significance of the profession, and is based on their capacity to competently fulfil these expectations, fostered through a process of affirming experiences. Developing and fostering professional confidence should be nurtured and valued to the same extent as professional competence, as the former underpins the latter, and both are linked to professional identity.

  20. Teachers' confidence in teaching HIV/AIDS and sexuality in South African and Tanzanian schools.

    Science.gov (United States)

    Helleve, Arnfinn; Flisher, Alan J; Onya, Hans; Kaaya, Sylvia; Mukoma, Wanjiru; Swai, Caroline; Klepp, Knut-Inge

    2009-06-01

    This study aimed to investigate how confident and comfortable teachers at Tanzanian and South African urban and rural schools are in teaching HIV/AIDS and sexuality. It also aimed at identifying factors associated with teacher confidence and investigated how reported confidence was associated with the implementation of educational programmes on HIV/AIDS and sexuality. A survey was conducted among South African grade 8 and 9 Life Orientation teachers, and among science teachers for grade 5 to 7 in public primary schools in Tanzania. Teachers' confidence levels were measured on a four-item scale (0-3). A total number of 266 teachers participated in a survey in 86 schools in South Africa and Tanzania. Overall, teachers report to be rather confident in teaching HIV/AIDS and sexuality. Tanzanian teachers reported higher levels of confidence then did their South Africa colleagues (2.1 vs. 1.8; p teaching was significantly associated with the numbers of years teaching HIV/AIDS and sexuality, formal training in these subjects, experience in discussing the topics with others, school policy and priority given to teaching HIV/AIDS and sexuality at school. Finally, confidence in teaching remained positively associated with self-reported successful implementation of school-based programmes after adjusting for gender, age, religion and numbers of years teaching HIV/AIDS and sexuality. Across urban and rural sites in South Africa and Tanzania teachers reported to be fairly confident in teaching HIV/AIDS and sexuality. Further strengthening of their confidence levels could, however, be an important measure for improving the implementation of such programmes.

  1. Targeting Low Career Confidence Using the Career Planning Confidence Scale

    Science.gov (United States)

    McAuliffe, Garrett; Jurgens, Jill C.; Pickering, Worth; Calliotte, James; Macera, Anthony; Zerwas, Steven

    2006-01-01

    The authors describe the development and validation of a test of career planning confidence that makes possible the targeting of specific problem issues in employment counseling. The scale, developed using a rational process and the authors' experience with clients, was tested for criterion-related validity against 2 other measures. The scale…

  2. Structured data quality reports to improve EHR data quality.

    Science.gov (United States)

    Taggart, Jane; Liaw, Siaw-Teng; Yu, Hairong

    2015-12-01

    To examine whether a structured data quality report (SDQR) and feedback sessions with practice principals and managers improve the quality of routinely collected data in EHRs. The intervention was conducted in four general practices participating in the Fairfield neighborhood electronic Practice Based Research Network (ePBRN). Data were extracted from their clinical information systems and summarised as a SDQR to guide feedback to practice principals and managers at 0, 4, 8 and 12 months. Data quality (DQ) metrics included completeness, correctness, consistency and duplication of patient records. Information on data recording practices, data quality improvement, and utility of SDQRs was collected at the feedback sessions at the practices. The main outcome measure was change in the recording of clinical information and level of meeting Royal Australian College of General Practice (RACGP) targets. Birth date was 100% and gender 99% complete at baseline and maintained. DQ of all variables measured improved significantly (pImprovement was greatest with allergies. There was no significant change in duplicate records. SDQRs and feedback sessions support general practitioners and practice managers to focus on improving the recording of patient information. However, improved practice DQ, was not sufficient to meet RACGP targets. Randomised controlled studies are required to evaluate strategies to improve data quality and any associated improved safety and quality of care. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Robust misinterpretation of confidence intervals

    NARCIS (Netherlands)

    Hoekstra, Rink; Morey, Richard; Rouder, Jeffrey N.; Wagenmakers, Eric-Jan

    2014-01-01

    Null hypothesis significance testing (NHST) is undoubtedly the most common inferential technique used to justify claims in the social sciences. However, even staunch defenders of NHST agree that its outcomes are often misinterpreted. Confidence intervals (CIs) have frequently been proposed as a more

  4. Umatilla River Subbasin Fish Habitat Improvement Program, 2005 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    St. Hilaire, Danny R. (Oregon Department of Fish and Wildlife, Pendleton, OR)

    2006-05-01

    This annual report is in fulfillment of contractual obligations with Bonneville Power Administration (BPA), which is the funding source for the Oregon Department of Fish and Wildlife's (ODFW), Umatilla River Subbasin Fish Habitat Improvement Program (Program). The Program works cooperatively with private landowners to develop long-term restoration agreements, under which, passive and active Habitat Improvement Projects are conducted. Historically, projects have included livestock exclusion fencing (passive restoration) to protect riparian habitats, along with the installation of instream structures (active restoration) to address erosion and improve fish habitat conditions. In recent years, the focus of active restoration has shifted to bioengineering treatments and, more recently, to channel re-design and re-construction aimed at improving fish habitat, through the restoration of stable channel function. This report provides a summary of Program activities for the 2005 calendar year (January 1 through December 31, 2005), within each of the four main project phases, including: (1) Implementation--Pre-Work, (2) Implementation--On Site Development, (3) Operation and Maintenance (O&M), and (4) Monitoring and Evaluation (M&E). This report also summarizes activities associated with Program Administration, Interagency Coordination, and Public Education.

  5. Social media sentiment and consumer confidence

    OpenAIRE

    Daas, Piet J.H.; Puts, Marco J.H.

    2014-01-01

    Changes in the sentiment of Dutch public social media messages were compared with changes in monthly consumer confidence over a period of three-and-a-half years, revealing that both were highly correlated (up to r = 0.9) and that both series cointegrated. This phenomenon is predominantly affected by changes in the sentiment of all Dutch public Facebook messages. The inclusion of various selections of public Twitter messages improved this association and the response to changes in sentiment. G...

  6. Umatilla River subbasin fish habitat improvement project. Annual report 1993

    International Nuclear Information System (INIS)

    Bailey, T.D.; Laws, T.S.

    1994-05-01

    This annual report is in fulfillment of contract obligations with Bonneville Power Administration which is the funding source for the Oregon Department of Fish and Wildlife's Umatilla Basin Habitat Improvement Project. Major activities undertaken during this report period included: (1) procurement of one access easement with a private landowner, (2) design, layout, and implementation of 3.36 miles of instream structure maintenance, (3) inspection and routine maintenance of 15.1 miles of fence, (4) revegetation along 3.36 miles of stream, (5) collection and summarization of physical and biological monitoring data, (6) extensive interagency coordination, and (7) environmental education activities with local high school students

  7. Anesthesia report card - a customizable tool for performance improvement.

    Science.gov (United States)

    Peccora, Christian D; Gimlich, Robert; Cornell, Richard P; Vacanti, Charles A; Ehrenfeld, Jesse M; Urman, Richard D

    2014-09-01

    Measuring and providing performance feedback to physicians has gained momentum not only as a way to comply with regulatory requirements, but also as a way to improve patient care. Measurement of structural, process, and outcome metrics in a reliable, evidence-based, specialty-specific manner maximizes the probability of improving physician performance. The manner in which feedback is provided influences whether the measurement tool will be successful in changing behavior. We created an innovative reporting tool template for anesthesiology practitioners designed to provide detailed, continuous feedback covering many aspects of clinical practice. The literature regarding quality metric measurement and feedback strategies was examined to design a reporting tool that could provide high quality information and result in improved performance of clinical and academic tasks. A committee of department leaders and information technology professionals was tasked with determining the measurement criteria and infrastructure needed to generate these reports. Data was collected in a systematic, unbiased manner, and reports were populated with information from multiple databases and software systems. Feedback would be based on frequently updated information and allow for analysis of historical performance as well as comparison amongst peers. A template for an anesthesia report card was created. Categories included compliance, credentialing and qualifications, education, clinical and operating room responsibilities, and academic achievements. Physicians were able to choose to be evaluated in some of the categories and had to meet a minimum number of criteria within each category. This allowed for customization to each practitioner's practice. Criteria were derived from the measures of academic and clinical proficiency, as well as quality metrics. Criteria were objective measures and data gathering was often automated. Reports could be generated that were updated daily and provided

  8. Alan Greenspan, the confidence strategy

    Directory of Open Access Journals (Sweden)

    Edwin Le Heron

    2006-12-01

    Full Text Available To evaluate the Greenspan era, we nevertheless need to address three questions: Is his success due to talent or just luck? Does he have a system of monetary policy or is he himself the system? What will be his legacy? Greenspan was certainly lucky, but he was also clairvoyant. Above all, he has developed a profoundly original monetary policy. His confidence strategy is clearly opposed to the credibility strategy developed in central banks and the academic milieu after 1980, but also inflation targeting, which today constitutes the mainstream monetary policy regime. The question of his legacy seems more nuanced. However, Greenspan will remain 'for a considerable period of time' a highly heterodox and original central banker. His political vision, his perception of an uncertain world, his pragmatism and his openness form the structure of a powerful alternative system, the confidence strategy, which will leave its mark on the history of monetary policy.

  9. Structured reporting platform improves CAD-RADS assessment.

    Science.gov (United States)

    Szilveszter, Bálint; Kolossváry, Márton; Karády, Júlia; Jermendy, Ádám L; Károlyi, Mihály; Panajotu, Alexisz; Bagyura, Zsolt; Vecsey-Nagy, Milán; Cury, Ricardo C; Leipsic, Jonathon A; Merkely, Béla; Maurovich-Horvat, Pál

    2017-11-01

    Structured reporting in cardiac imaging is strongly encouraged to improve quality through consistency. The Coronary Artery Disease - Reporting and Data System (CAD-RADS) was recently introduced to facilitate interdisciplinary communication of coronary CT angiography (CTA) results. We aimed to assess the agreement between manual and automated CAD-RADS classification using a structured reporting platform. Five readers prospectively interpreted 500 coronary CT angiographies using a structured reporting platform that automatically calculates the CAD-RADS score based on stenosis and plaque parameters manually entered by the reader. In addition, all readers manually assessed CAD-RADS blinded to the automatically derived results, which was used as the reference standard. We evaluated factors influencing reader performance including CAD-RADS training, clinical load, time of the day and level of expertise. Total agreement between manual and automated classification was 80.2%. Agreement in stenosis categories was 86.7%, whereas the agreement in modifiers was 95.8% for "N", 96.8% for "S", 95.6% for "V" and 99.4% for "G". Agreement for V improved after CAD-RADS training (p = 0.047). Time of the day and clinical load did not influence reader performance (p > 0.05 both). Less experienced readers had a higher total agreement as compared to more experienced readers (87.0% vs 78.0%, respectively; p = 0.011). Even though automated CAD-RADS classification uses data filled in by the readers, it outperforms manual classification by preventing human errors. Structured reporting platforms with automated calculation of the CAD-RADS score might improve data quality and support standardization of clinical decision making. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  10. The accuracy of meta-metacognitive judgments: regulating the realism of confidence.

    Science.gov (United States)

    Buratti, Sandra; Allwood, Carl Martin

    2012-08-01

    Can people improve the realism of their confidence judgments about the correctness of their episodic memory reports by deselecting the least realistic judgments? An assumption of Koriat and Goldsmith's (Psychol Rev 103:490-517, 1996) model is that confidence judgments regulate the reporting of memory reports. We tested whether this assumption generalizes to the regulation of the realism (accuracy) of confidence judgments. In two experiments, 270 adults in separate conditions answered 50 recognition and recall questions about the contents of a just-seen video. After each answer, they made confidence judgments about the answer's correctness. In Experiment 1, the participants in the recognition conditions significantly increased their absolute bias when they excluded 15 questions. In Experiment 2, the participants in the recall condition significantly improved their calibration. The results indicate that recall, more than recognition, offers valid cues for participants to increase the realism of their report. However, the effects were small with only weak support for the conclusion that people have some ability to regulate the realism in their confidence judgments.

  11. Figures in clinical trial reports: current practice & scope for improvement.

    Science.gov (United States)

    Pocock, Stuart J; Travison, Thomas G; Wruck, Lisa M

    2007-11-19

    Most clinical trial publications include figures, but there is little guidance on what results should be displayed as figures and how. To evaluate the current use of figures in Trial reports, and to make constructive suggestions for future practice. We surveyed all 77 reports of randomised controlled trials in five general medical journals during November 2006 to January 2007. The numbers and types of figures were determined, and then each Figure was assessed for its style, content, clarity and suitability. As a consequence, guidelines are developed for presenting figures, both in general and for each specific common type of Figure. Most trial reports contained one to three figures, mean 2.3 per article. The four main types were flow diagram, Kaplan Meier plot, Forest plot (for subgroup analyses) and repeated measures over time: these accounted for 92% of all figures published. For each type of figure there is a considerable diversity of practice in both style and content which we illustrate with selected examples of both good and bad practice. Some pointers on what to do, and what to avoid, are derived from our critical evaluation of these articles' use of figures. There is considerable scope for authors to improve their use of figures in clinical trial reports, as regards which figures to choose, their style of presentation and labelling, and their specific content. Particular improvements are needed for the four main types of figures commonly used.

  12. Figures in clinical trial reports: current practice & scope for improvement

    Directory of Open Access Journals (Sweden)

    Travison Thomas G

    2007-11-01

    Full Text Available Abstract Background Most clinical trial publications include figures, but there is little guidance on what results should be displayed as figures and how. Purpose To evaluate the current use of figures in Trial reports, and to make constructive suggestions for future practice. Methods We surveyed all 77 reports of randomised controlled trials in five general medical journals during November 2006 to January 2007. The numbers and types of figures were determined, and then each Figure was assessed for its style, content, clarity and suitability. As a consequence, guidelines are developed for presenting figures, both in general and for each specific common type of Figure. Results Most trial reports contained one to three figures, mean 2.3 per article. The four main types were flow diagram, Kaplan Meier plot, Forest plot (for subgroup analyses and repeated measures over time: these accounted for 92% of all figures published. For each type of figure there is a considerable diversity of practice in both style and content which we illustrate with selected examples of both good and bad practice. Some pointers on what to do, and what to avoid, are derived from our critical evaluation of these articles' use of figures. Conclusion There is considerable scope for authors to improve their use of figures in clinical trial reports, as regards which figures to choose, their style of presentation and labelling, and their specific content. Particular improvements are needed for the four main types of figures commonly used.

  13. Improving patient safety in radiotherapy through error reporting and analysis

    International Nuclear Information System (INIS)

    Findlay, Ú.; Best, H.; Ottrey, M.

    2016-01-01

    Aim: To improve patient safety in radiotherapy (RT) through the analysis and publication of radiotherapy errors and near misses (RTE). Materials and methods: RTE are submitted on a voluntary basis by NHS RT departments throughout the UK to the National Reporting and Learning System (NRLS) or directly to Public Health England (PHE). RTE are analysed by PHE staff using frequency trend analysis based on the classification and pathway coding from Towards Safer Radiotherapy (TSRT). PHE in conjunction with the Patient Safety in Radiotherapy Steering Group publish learning from these events, on a triannual and summarised on a biennial basis, so their occurrence might be mitigated. Results: Since the introduction of this initiative in 2010, over 30,000 (RTE) reports have been submitted. The number of RTE reported in each biennial cycle has grown, ranging from 680 (2010) to 12,691 (2016) RTE. The vast majority of the RTE reported are lower level events, thus not affecting the outcome of patient care. Of the level 1 and 2 incidents reported, it is known the majority of them affected only one fraction of a course of treatment. This means that corrective action could be taken over the remaining treatment fractions so the incident did not have a significant impact on the patient or the outcome of their treatment. Analysis of the RTE reports demonstrates that generation of error is not confined to one professional group or to any particular point in the pathway. It also indicates that the pattern of errors is replicated across service providers in the UK. Conclusion: Use of the terminology, classification and coding of TSRT, together with implementation of the national voluntary reporting system described within this report, allows clinical departments to compare their local analysis to the national picture. Further opportunities to improve learning from this dataset must be exploited through development of the analysis and development of proactive risk management strategies

  14. A new safety event reporting system improves physician reporting in the surgical intensive care unit.

    Science.gov (United States)

    Schuerer, Douglas J E; Nast, Patricia A; Harris, Carolyn B; Krauss, Melissa J; Jones, Rebecca M; Boyle, Walter A; Buchman, Timothy G; Coopersmith, Craig M; Dunagan, W Claiborne; Fraser, Victoria J

    2006-06-01

    Medical errors are common, and physicians have notably been poor medical error reporters. In the SICU, reporting was generally poor and reporting by physicians was virtually nonexistent. This study was designed to observe changes in error reporting in an SICU when a new card-based system (SAFE) was introduced. Before implementation of the SAFE reporting system, education was given to all SICU healthcare providers. The SAFE system was introduced into the SICU for a 9-month period from March 2003 through November 2003, to replace an underused online system. Data were collected from the SAFE card reports and the online reporting systems during introduction, removal, and reimplementation of these cards. Reporting rates were calculated as number of reported events per 1,000 patient days. Reporting rates increased from 19 to 51 reports per 1,000 patient days after the SAFE cards were introduced into the ICU (preporting increased most, rising from 0.3 to 5.8 reports per 1,000 patient days; nursing reporting also increased from 18 to 39 reports per 1,000 patient days (both preporting declined to 0 reports per 1,000 patient days (p=0.01) and rose to 8.1 (p=0.001) when the cards were returned, similar to nursing results. A higher proportion of physician reports were events that caused harm compared with no effect (p reporting system, combined with appropriate education, improved overall reporting in the SICU, especially among physician providers. Nurses were more likely to use reporting systems than were physicians. Physician reports were more likely to be of events that caused harm.

  15. Can technology improve intershift report? What the research reveals.

    Science.gov (United States)

    Strople, Bernadette; Ottani, Patricia

    2006-01-01

    Shift report is a multifaceted process that serves to provide nurses with vital patient information to facilitate clinical decisions and patient care planning. A shift report also provides nurses with a forum for functions, such as patient problem solving and collaboration. The authors conducted a literature review, which indicates that current methodologies used to collect and convey patient information are ineffective and may contribute to negative patient outcomes. Data incongruence, legal implications, time constraints augmented by the nursing shortage, and the financial impact of shift report are also addressed. The literature reveals significant rationale for pioneering new and innovative methods of shift-to-shift communication. In the report To Err is Human: Building a Safe Health System, the Institute of Medicine attributes the deaths of up to 98,000 hospitalized Americans to medical errors, including communication failures [Institute of Medicine. (1999). To err is human: Building a safe health system. Report by the Committee on Quality of Health Care in America. Washington, DC: National Academy Press]. As a result, government policy makers and health care agencies have focused their attention on determining the root cause of errors to identify preventative measures, including the use of information technology [Institute of Medicine. (2004). Keeping patients safe: Transforming the work environment of nurses. Report by the Committee on Quality of Health Care in America. Washington, DC: National Academy Press]. Under these premises, the authors examined the process of nursing shift report and how it impacts patient outcomes. The use of computer technology and wireless modes of communication is explored as a means of improving the shift report process and, subsequently, health care outcomes and patient safety.

  16. Improving plant bioaccumulation science through consistent reporting of experimental data.

    Science.gov (United States)

    Fantke, Peter; Arnot, Jon A; Doucette, William J

    2016-10-01

    Experimental data and models for plant bioaccumulation of organic contaminants play a crucial role for assessing the potential human and ecological risks associated with chemical use. Plants are receptor organisms and direct or indirect vectors for chemical exposures to all other organisms. As new experimental data are generated they are used to improve our understanding of plant-chemical interactions that in turn allows for the development of better scientific knowledge and conceptual and predictive models. The interrelationship between experimental data and model development is an ongoing, never-ending process needed to advance our ability to provide reliable quality information that can be used in various contexts including regulatory risk assessment. However, relatively few standard experimental protocols for generating plant bioaccumulation data are currently available and because of inconsistent data collection and reporting requirements, the information generated is often less useful than it could be for direct applications in chemical assessments and for model development and refinement. We review existing testing guidelines, common data reporting practices, and provide recommendations for revising testing guidelines and reporting requirements to improve bioaccumulation knowledge and models. This analysis provides a list of experimental parameters that will help to develop high quality datasets and support modeling tools for assessing bioaccumulation of organic chemicals in plants and ultimately addressing uncertainty in ecological and human health risk assessments. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Leadership by Confidence in Teams

    OpenAIRE

    Kobayashi, Hajime; Suehiro, Hideo

    2008-01-01

    We study endogenous signaling by analyzing a team production problem with endogenous timing. Each agent of the team is privately endowed with some level of confidence about team productivity. Each of them must then commit a level of effort in one of two periods. At the end of each period, each agent observes his partner' s move in this period. Both agents are rewarded by a team output determined by team productivity and total invested effort. Each agent must personally incur the cost of effor...

  18. Towards confidence in transport safety

    International Nuclear Information System (INIS)

    Robison, R.W.

    1992-01-01

    The U.S. Department of Energy (US DOE) plans to demonstrate to the public that high-level waste can be transported safely to the proposed repository. The author argues US DOE should begin now to demonstrate its commitment to safety by developing an extraordinary safety program for nuclear cargo it is now shipping. The program for current shipments should be developed with State, Tribal, and local officials. Social scientists should be involved in evaluating the effect of the safety program on public confidence. The safety program developed in cooperation with western states for shipments to the Waste Isolation Pilot plant is a good basis for designing that extraordinary safety program

  19. Special report. New products that improve officer performance, safety.

    Science.gov (United States)

    1991-12-01

    The need for products that improve performance of security officers is counterbalanced these days by budgetary constraints. While this may limit major investments in security systems and personnel, less costly improvements or innovations might be worth considering. In this report, we will discuss four advances that may be valuable not only in hospital security, but in other industries as well. One of them, a smoke filter, was originally developed for the hotel industry. Another, a drug detection device, may replace the use of undercover agents or drug-sniffing' dogs in certain circumstances. The third new product is an economical patrol vehicle for parking facilities which might replace more costly vehicles such as golf carts or cars. The fourth product, a roving CCTV camera, is actually being tested at a Midwest medical center and may allow you to monitor areas of parking garages with cameras instead of officers on patrol.

  20. Efficiency improvements in pipeline transportation systems. Technical report, Task 3

    Energy Technology Data Exchange (ETDEWEB)

    Banks, W. F.; Horton, J. H.

    1977-01-01

    This report identifies those potential energy-conservative pipeline innovations that are most energy- and cost-effective, and formulates recommendations for the R, D, and D programs needed to exploit those opportunities. From a candidate field of over twenty classes of efficiency improvements, eight systems are recommended for pursuit. Most of these possess two highly important attributes: large potential energy savings and broad applicability outside the pipeline industry. The R, D, and D program for each improvement and the recommended immediate next step are described. The eight programs recommended for pursuit are: gas-fired combined-cycle compressor station; internally cooled internal combustion engine; methanol-coal slurry pipeline; methanol-coal slurry-fired and coal-fired engines; indirect-fired coal-burning combined-cycle pump station; fuel-cycle pump station; internal coatings in pipelines; and drag-reducing additives in liquid pipelines.

  1. Experiential Education Builds Student Self-Confidence in Delivering Medication Therapy Management

    Directory of Open Access Journals (Sweden)

    Wendy M. Parker

    2017-07-01

    Full Text Available To determine the impact of advanced pharmacy practice experiences (APPE on student self-confidence related to medication therapy management (MTM, fourth-year pharmacy students were surveyed pre/post APPE to: identify exposure to MTM learning opportunities, assess knowledge of the MTM core components, and assess self-confidence performing MTM services. An anonymous electronic questionnaire administered pre/post APPE captured demographics, factors predicted to impact student self-confidence (Grade point average (GPA, work experience, exposure to MTM learning opportunities, MTM knowledge and self-confidence conducting MTM using a 5-point Likert scale (1 = Not at all Confident; 5 = Extremely Confident. Sixty-two students (26% response rate responded to the pre-APPE questionnaire and n = 44 (18% to the post-APPE. Over 90% demonstrated MTM knowledge and 68.2% completed MTM learning activities. APPE experiences significantly improved students’ overall self-confidence (pre-APPE = 3.27 (0.85 SD, post-APPE = 4.02 (0.88, p < 0.001. Students engaging in MTM learning opportunities had higher self-confidence post-APPE (4.20 (0.71 vs. those not reporting MTM learning opportunities (3.64 (1.08, p = 0.05. Post-APPE, fewer students reported MTM was patient-centric or anticipated engaging in MTM post-graduation. APPE learning opportunities increased student self-confidence to provide MTM services. However, the reduction in anticipated engagement in MTM post-graduation and reduction in sensing the patient-centric nature of MTM practice, may reveal a gap between practice expectations and reality.

  2. Final report on improved N15 analyser NOI-6e

    International Nuclear Information System (INIS)

    Meier, G.; Hollenthoner, S.

    1985-05-01

    This report gives a general view of the computerized NOI-6e nitrogen analyzer. The construction of the new prototype is described. The new version of the N15 analyzer together with the microcomputer program which has been developed improves the convenience of operation and also has high reliability. Many practical test measurements have been made. The most important result is the remarkable reduction of the standard deviation σsub(x): a standard deviation of less than 0.5% is achieved. We have not found such a low standard deviation in descriptions of similar analyzers which use emission spectroscopy

  3. DTU International Energy Report 2012: Energy efficiency improvements

    DEFF Research Database (Denmark)

    Increased energy efficiency can reduce global CO2 emissions over the period to 2050 with up to 25%. On the top of that large profits can be gained for very little investment. Energy efficiency improvements can save investment in new energy infrastructure, cut fuel costs, increase competitiveness...... and increase consumer welfare. Thus, it is natural for DTU International Energy Report 2012 to take up this issue and analyze the global, regional and national challenges in exploiting energy efficiency and promote research and development in energy efficiency....

  4. Improving cancer treatment with cyclotron produced radionuclides. Progress report

    Energy Technology Data Exchange (ETDEWEB)

    Larson, S.M.; Finn, R.D.

    1993-11-01

    This report describes our continuing long term goal of promoting nuclear medicine applications by improving the scientific basis for tumor diagnosis, treatment and treatment follow-up based on the use of cyclotron produced radiotracers in oncology. The program includes 3 interactive components: Radiochemistry/Cyclotron; Pharmacology; and Immunology. An essential strategy is as follows: novel radionuclides and radiotracers developed in the Radiochemistry/Cyclotron section will be employed in the Pharmacology and Immunology sections during the next year. The development of novel radionuclides and tracers is of course useful in and of itself, but their utility is greatly enhanced by the interaction with the immunology and pharmacology components of the program.

  5. Workshop on confidence limits. Proceedings

    International Nuclear Information System (INIS)

    James, F.; Lyons, L.; Perrin, Y.

    2000-01-01

    The First Workshop on Confidence Limits was held at CERN on 17-18 January 2000. It was devoted to the problem of setting confidence limits in difficult cases: number of observed events is small or zero, background is larger than signal, background not well known, and measurements near a physical boundary. Among the many examples in high-energy physics are searches for the Higgs, searches for neutrino oscillations, B s mixing, SUSY, compositeness, neutrino masses, and dark matter. Several different methods are on the market: the CL s methods used by the LEP Higgs searches; Bayesian methods; Feldman-Cousins and modifications thereof; empirical and combined methods. The Workshop generated considerable interest, and attendance was finally limited by the seating capacity of the CERN Council Chamber where all the sessions took place. These proceedings contain all the papers presented, as well as the full text of the discussions after each paper and of course the last session which was a discussion session. The list of participants and the 'required reading', which was expected to be part of the prior knowledge of all participants, are also included. (orig.)

  6. The Great Recession and confidence in homeownership

    OpenAIRE

    Anat Bracha; Julian Jamison

    2013-01-01

    Confidence in homeownership shifts for those who personally experienced real estate loss during the Great Recession. Older Americans are confident in the value of homeownership. Younger Americans are less confident.

  7. To protect and serve: Restoring public confidence in the SAPS ...

    African Journals Online (AJOL)

    Persistent incidents of brutality, criminal behaviour and abuse of authority by members of South Africa's police agencies have serious implications for public trust and confidence in the police. A decline in trust and confidence in the police is inevitably harmful to the ability of the government to reduce crime and improve public ...

  8. Confidence-Based Learning in Investment Analysis

    Science.gov (United States)

    Serradell-Lopez, Enric; Lara-Navarra, Pablo; Castillo-Merino, David; González-González, Inés

    The aim of this study is to determine the effectiveness of using multiple choice tests in subjects related to the administration and business management. To this end we used a multiple-choice test with specific questions to verify the extent of knowledge gained and the confidence and trust in the answers. The tests were performed in a group of 200 students at the bachelor's degree in Business Administration and Management. The analysis made have been implemented in one subject of the scope of investment analysis and measured the level of knowledge gained and the degree of trust and security in the responses at two different times of the course. The measurements have been taken into account different levels of difficulty in the questions asked and the time spent by students to complete the test. The results confirm that students are generally able to obtain more knowledge along the way and get increases in the degree of trust and confidence in the answers. It is confirmed as the difficulty level of the questions set a priori by the heads of the subjects are related to levels of security and confidence in the answers. It is estimated that the improvement in the skills learned is viewed favourably by businesses and are especially important for job placement of students.

  9. Confidence with and Barriers to Serious Illness Communication: A National Survey of Hospitalists.

    Science.gov (United States)

    Rosenberg, Leah B; Greenwald, Jeff; Caponi, Bartho; Doshi, Ami; Epstein, Howard; Frank, Jeff; Lindenberger, Elizabeth; Marzano, Nick; Mills, Lynnea M; Razzak, Rab; Risser, James; Anderson, Wendy G

    2017-09-01

    To describe the concerns, confidence, and barriers of practicing hospitalists around serious illness communication. Hospitalist physicians are optimally positioned to provide primary palliative care, yet their experiences in serious illness communication are not well described. Web-based survey, conducted in May 2016. The survey link was distributed via email to 4000 members of the Society of Hospital Medicine. The 39-item survey assessed frequency of concerns about serious illness communication, confidence for common tasks, and barriers using Likert-type scales. It was developed by the authors based on prior work, a focus group, and feedback from pilot respondents. We received 332 completed surveys. On most or every shift, many participants reported having concerns about a patient's or family's understanding of prognosis (53%) or the patient's code status (63%). Most participants were either confident or very confident in discussing goals of care (93%) and prognosis (87%). Fewer were confident or very confident in responding to patients or families who had not accepted the seriousness of an illness (59%) or in managing conflict (50%). Other frequently cited barriers were lack of time, lack of prior discussions in the outpatient setting, unrealistic prognostic expectations from other physicians, limited institutional support, and difficulty finding records of previous discussions. Our results suggest opportunities to improve hospitalists' ability to lead serious illness communication by increasing the time hospitalists have for discussions, improving documentation systems and communication between inpatient and outpatient clinicians, and targeted training on challenging communication scenarios.

  10. 2003 Stewardship progress report : committed to continuous improvement

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2003-12-01

    The stewardship initiative is a mandatory requirement for members of the Canadian Association of Petroleum Producers (CAPP). It involves performance management and benchmarking, voluntary audits and verification, as well as training and improved communication inside and outside the industry. This fourth annual progress report describes the environment, health, safety and socio-economic stewardship initiative. This report presents an aggregate of industry performance. Stewardship of Excellence awards were presented in 2003, celebrating outstanding performance by members who demonstrated their commitment to responsible development and continuous improvement within a business framework. The awards were presented in three categories, namely environment, health and safety, and socio-economic. Northrock Resources was presented with the award in the environment category for its voluntary waste gas reduction. The health and safety recognition went to Burlington Resources Canada Ltd. for superior office ergonomics, while the award in the socio-economic category was presented to Suncor Energy Inc. for Aboriginal business development. A brief overview of the achievements of each of these three companies was presented. tabs., figs.

  11. Using Patient-Reported Information to Improve Clinical Practice.

    Science.gov (United States)

    Schlesinger, Mark; Grob, Rachel; Shaller, Dale

    2015-12-01

    To assess what is known about the relationship between patient experience measures and incentives designed to improve care, and to identify how public policy and medical practices can promote patient-valued outcomes in health systems with strong financial incentives. Existing literature (gray and peer-reviewed) on measuring patient experience and patient-reported outcomes, identified from Medline and Cochrane databases; evaluations of pay-for-performance programs in the United States, Europe, and the Commonwealth countries. We analyzed (1) studies of pay-for-performance, to identify those including metrics for patient experience, and (2) studies of patient experience and of patient-reported outcomes to identify evidence of influence on clinical practice, whether through public reporting or private reporting to clinicians. First, we identify four forms of "patient-reported information" (PRI), each with distinctive roles shaping clinical practice: (1) patient-reported outcomes measuring self-assessed physical and mental well-being, (2) surveys of patient experience with clinicians and staff, (3) narrative accounts describing encounters with clinicians in patients' own words, and (4) complaints/grievances signaling patients' distress when treatment or outcomes fall short of expectations. Because these forms vary in crucial ways, each must be distinctively measured, deployed, and linked with financial incentives. Second, although the literature linking incentives to patients experience is limited, implementing pay-for-performance systems appears to threaten certain patient-valued aspects of health care. But incentives can be made compatible with the outcomes patients value if: (a) a sufficient portion of incentives is tied to patient-reported outcomes and experiences, (b) incentivized forms of PRI are complemented by other forms of patient feedback, and (c) health care organizations assist clinicians to interpret and respond to PRI. Finally, we identify roles for the

  12. Public confidence and nuclear energy

    International Nuclear Information System (INIS)

    Chaussade, J.P.

    1990-01-01

    Today in France there are 54 nuclear power units in operation at 18 sites. They supply 75% of all electricity produced, 12% of which is exported to neighbouring countries, and play an important role in the French economy. For the French, nuclear power is a fact of life, and most accept it. However, the accident of Chernobyl has made public opinion more sensitive, and the public relations work has had to be reconsidered carefully with a view to increase the confidence of the French public in nuclear power, anticipating media crises and being equipped to deal with such crises. The three main approaches are the following: keeping the public better informed, providing clear information at time of crisis and international activities

  13. Knowledge, Self Confidence and Courage

    DEFF Research Database (Denmark)

    Selberg, Hanne; Steenberg Holtzmann, Jette; Hovedskov, Jette

    . Results The students identified their major learning outcomes as transfer of operational skills, experiencing self-efficacy and enhanced understanding of the patients' perspective.Involving simulated patients in the training of technical skills contributed to the development of the students' communication......Knowledge, self confidence and courage – long lasting learning outcomes through simulation in a clinical context. Hanne Selberg1, Jette Hovedskov2, Jette Steenberg Holtzmann2 The significance and methodology of the researchThe study focuses on simulation alongside the clinical practice and linked...... Development, Clinical Lecturer, Metropolitan University College, Faculty of Nursing, Email: hase@phoe.dk, phone: +45-72282830. 2. Jette Hovedskov, RN, Development Consultant, Glostrup University Hospital, Department of Development Email : jeho@glo.regionh.dk ,phone: +45- 43232090 3. Jette Holtzmann Steenberg...

  14. Impact of a reengineered electronic error-reporting system on medication event reporting and care process improvements at an urban medical center.

    Science.gov (United States)

    McKaig, Donald; Collins, Christine; Elsaid, Khaled A

    2014-09-01

    A study was conducted to evaluate the impact of a reengineered approach to electronic error reporting at a 719-bed multidisciplinary urban medical center. The main outcome of interest was the monthly reported medication errors during the preimplementation (20 months) and postimplementation (26 months) phases. An interrupted time series analysis was used to describe baseline errors, immediate change following implementation of the current electronic error-reporting system (e-ERS), and trend of error reporting during postimplementation. Errors were categorized according to severity using the National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) Medication Error Index classifications. Reported errors were further analyzed by reporter and error site. During preimplementation, the monthly reported errors mean was 40.0 (95% confidence interval [CI]: 36.3-43.7). Immediately following e-ERS implementation, monthly reported errors significantly increased by 19.4 errors (95% CI: 8.4-30.5). The change in slope of reported errors trend was estimated at 0.76 (95% CI: 0.07-1.22). Near misses and no-patient-harm errors accounted for 90% of all errors, while errors that caused increased patient monitoring or temporary harm accounted for 9% and 1%, respectively. Nurses were the most frequent reporters, while physicians were more likely to report high-severity errors. Medical care units accounted for approximately half of all reported errors. Following the intervention, there was a significant increase in reporting of prevented errors and errors that reached the patient with no resultant harm. This improvement in reporting was sustained for 26 months and has contributed to designing and implementing quality improvement initiatives to enhance the safety of the medication use process.

  15. A simultaneous confidence band for sparse longitudinal regression

    KAUST Repository

    Ma, Shujie; Yang, Lijian; Carroll, Raymond J.

    2012-01-01

    Functional data analysis has received considerable recent attention and a number of successful applications have been reported. In this paper, asymptotically simultaneous confidence bands are obtained for the mean function of the functional regression model, using piecewise constant spline estimation. Simulation experiments corroborate the asymptotic theory. The confidence band procedure is illustrated by analyzing CD4 cell counts of HIV infected patients.

  16. Inter-Korean military confidence building after 2003.

    Energy Technology Data Exchange (ETDEWEB)

    Tae-woo, Kim (Korea Institute for Defense Analyses, Seoul, Republic of Korea); Littlefield, Adriane C.; Vannoni, Michael Geoffrey; Sang-beom, Kim (Korea Institute for Defense Analyses, Seoul, Republic of Korea); Koelm, Jennifer Gay; Olsen, John Norman; Myong-jin, Kim (Korea Institute for Defense Analyses, Seoul, Republic of Korea); Sung-tack, Shin (Korea Institute for Defense Analyses, Seoul, Republic of Korea)

    2003-08-01

    Tensions on the Korean Peninsula remain high despite a long-term strategy by South Korea to increase inter-Korean exchanges in economics, culture, sports, and other topics. This is because the process of reconciliation has rarely extended to military and security topics and those initiatives that were negotiated have been ineffective. Bilateral interactions must include actions to reduce threats and improve confidence associated with conventional military forces (land, sea, and air) as well as nuclear, chemical, and biological activities that are applicable to developing and producing weapons of mass destruction (WMD). The purpose of this project is to develop concepts for inter-Korean confidence building measures (CBMs) for military and WMD topics that South Korea could propose to the North when conditions are right. This report describes the historical and policy context for developing security-related CBMs and presents an array of bilateral options for conventional military and WMD topics within a consistent framework. The conceptual CBMs address two scenarios: (1) improved relations where construction of a peace regime becomes a full agenda item in inter-Korean dialogue, and (2) continued tense inter-Korean relations. Some measures could be proposed in the short term under current conditions, others might be implemented in a series of steps, while some require a higher level of cooperation than currently exists. To support decision making by political leaders, this research focuses on strategies and policy options and does not include technical details.

  17. INTERIM REPORT IMPROVED METHODS FOR INCORPORATING RISK IN DECISION MAKING

    Energy Technology Data Exchange (ETDEWEB)

    Clausen, M. J.; Fraley, D. W.; Denning, R. S.

    1980-08-01

    This paper reports observations and preliminary investigations in the first phase of a research program covering methodologies for making safety-related decisions. The objective has been to gain insight into NRC perceptions of the value of formal decision methods, their possible applications, and how risk is, or may be, incorporated in decision making. The perception of formal decision making techniques, held by various decision makers, and what may be done to improve them, were explored through interviews with NRC staff. An initial survey of decision making methods, an assessment of the applicability of formal methods vis-a-vis the available information, and a review of methods of incorporating risk and uncertainty have also been conducted.

  18. Organising a manuscript reporting quality improvement or patient safety research.

    Science.gov (United States)

    Holzmueller, Christine G; Pronovost, Peter J

    2013-09-01

    Peer-reviewed publication plays important roles in disseminating research findings, developing generalisable knowledge and garnering recognition for authors and institutions. Nonetheless, many bemoan the whole manuscript writing process, intimidated by the arbitrary and somewhat opaque conventions. This paper offers practical advice about organising and writing a manuscript reporting quality improvement or patient safety research for submission to a peer-reviewed journal. Each section of the paper discusses a specific manuscript component-from title, abstract and each section of the manuscript body, through to reference list and tables and figures-explaining key principles, offering content organisation tips and providing an example of how this section may read. The paper also offers a checklist of common mistakes to avoid in a manuscript.

  19. Doubly Bayesian Analysis of Confidence in Perceptual Decision-Making.

    Science.gov (United States)

    Aitchison, Laurence; Bang, Dan; Bahrami, Bahador; Latham, Peter E

    2015-10-01

    Humans stand out from other animals in that they are able to explicitly report on the reliability of their internal operations. This ability, which is known as metacognition, is typically studied by asking people to report their confidence in the correctness of some decision. However, the computations underlying confidence reports remain unclear. In this paper, we present a fully Bayesian method for directly comparing models of confidence. Using a visual two-interval forced-choice task, we tested whether confidence reports reflect heuristic computations (e.g. the magnitude of sensory data) or Bayes optimal ones (i.e. how likely a decision is to be correct given the sensory data). In a standard design in which subjects were first asked to make a decision, and only then gave their confidence, subjects were mostly Bayes optimal. In contrast, in a less-commonly used design in which subjects indicated their confidence and decision simultaneously, they were roughly equally likely to use the Bayes optimal strategy or to use a heuristic but suboptimal strategy. Our results suggest that, while people's confidence reports can reflect Bayes optimal computations, even a small unusual twist or additional element of complexity can prevent optimality.

  20. Confidence building in safety assessments

    International Nuclear Information System (INIS)

    Grundfelt, Bertil

    1999-01-01

    Future generations should be adequately protected from damage caused by the present disposal of radioactive waste. This presentation discusses the core of safety and performance assessment: The demonstration and building of confidence that the disposal system meets the safety requirements stipulated by society. The major difficulty is to deal with risks in the very long time perspective of the thousands of years during which the waste is hazardous. Concern about these problems has stimulated the development of the safety assessment discipline. The presentation concentrates on two of the elements of safety assessment: (1) Uncertainty and sensitivity analysis, and (2) validation and review. Uncertainty is associated both with respect to what is the proper conceptual model and with respect to parameter values for a given model. A special kind of uncertainty derives from the variation of a property in space. Geostatistics is one approach to handling spatial variability. The simplest way of doing a sensitivity analysis is to offset the model parameters one by one and observe how the model output changes. The validity of the models and data used to make predictions is central to the credibility of safety assessments for radioactive waste repositories. There are several definitions of model validation. The presentation discusses it as a process and highlights some aspects of validation methodologies

  1. Robust misinterpretation of confidence intervals.

    Science.gov (United States)

    Hoekstra, Rink; Morey, Richard D; Rouder, Jeffrey N; Wagenmakers, Eric-Jan

    2014-10-01

    Null hypothesis significance testing (NHST) is undoubtedly the most common inferential technique used to justify claims in the social sciences. However, even staunch defenders of NHST agree that its outcomes are often misinterpreted. Confidence intervals (CIs) have frequently been proposed as a more useful alternative to NHST, and their use is strongly encouraged in the APA Manual. Nevertheless, little is known about how researchers interpret CIs. In this study, 120 researchers and 442 students-all in the field of psychology-were asked to assess the truth value of six particular statements involving different interpretations of a CI. Although all six statements were false, both researchers and students endorsed, on average, more than three statements, indicating a gross misunderstanding of CIs. Self-declared experience with statistics was not related to researchers' performance, and, even more surprisingly, researchers hardly outperformed the students, even though the students had not received any education on statistical inference whatsoever. Our findings suggest that many researchers do not know the correct interpretation of a CI. The misunderstandings surrounding p-values and CIs are particularly unfortunate because they constitute the main tools by which psychologists draw conclusions from data.

  2. Innovative improvements of thermal response tests - Final report

    Energy Technology Data Exchange (ETDEWEB)

    Poppei, J.; Schwarz, R. [AF-Colenco Ltd, Baden (Switzerland); Peron, H.; Silvani, C; Steinmann, G.; Laloui, L. [Swiss Federal Institute of Technology, Laboratoire de Mecanique des Sols, Lausanne (Switzerland); Wagner, R.; Lochbuehler, T.; Rohner, E. [Geowatt AG, Zuerich (Switzerland)

    2008-12-15

    This illustrated final report for Swiss Federal Office of Energy (SFOE) takes a look at innovative improvements to thermal response tests that are used to investigate the thermo-physical properties of the ground for the purpose of dimensioning borehole heat exchangers. Recent technical developments in the borehole investigation tools area provide a promising prerequisite for improved estimates of thermal conductivity. A mini-module developed at the Swiss Federal Institute of Technology EPFL which is suitable for fast and flexible thermal response testing is discussed as is a wireless miniature data logger for continuous temperature recordings in borehole heat exchangers up to a depth of 350 m. This allows high-resolution vertical temperature profiling in boreholes. International state-of-the-art methods are reviewed. The adaptations to the analytical methods necessary for the effective application of these tools are discussed and numerical methods available are looked at. The testing of the methods developed and their results are discussed, as is the influence of ground-water flow.

  3. Multivoxel neurofeedback selectively modulates confidence without changing perceptual performance

    Science.gov (United States)

    Cortese, Aurelio; Amano, Kaoru; Koizumi, Ai; Kawato, Mitsuo; Lau, Hakwan

    2016-01-01

    A central controversy in metacognition studies concerns whether subjective confidence directly reflects the reliability of perceptual or cognitive processes, as suggested by normative models based on the assumption that neural computations are generally optimal. This view enjoys popularity in the computational and animal literatures, but it has also been suggested that confidence may depend on a late-stage estimation dissociable from perceptual processes. Yet, at least in humans, experimental tools have lacked the power to resolve these issues convincingly. Here, we overcome this difficulty by using the recently developed method of decoded neurofeedback (DecNef) to systematically manipulate multivoxel correlates of confidence in a frontoparietal network. Here we report that bi-directional changes in confidence do not affect perceptual accuracy. Further psychophysical analyses rule out accounts based on simple shifts in reporting strategy. Our results provide clear neuroscientific evidence for the systematic dissociation between confidence and perceptual performance, and thereby challenge current theoretical thinking. PMID:27976739

  4. Improving global environmental management with standard corporate reporting

    Science.gov (United States)

    Kareiva, Peter M.; McNally, Brynn W.; McCormick, Steve; Miller, Tom; Ruckelshaus, Mary

    2015-01-01

    Multinational corporations play a prominent role in shaping the environmental trajectory of the planet. The integration of environmental costs and benefits into corporate decision-making has enormous, but as yet unfulfilled, potential to promote sustainable development. To help steer business decisions toward better environmental outcomes, corporate reporting frameworks need to develop scientifically informed standards that consistently consider land use and land conversion, clean air (including greenhouse gas emissions), availability and quality of freshwater, degradation of coastal and marine habitats, and sustainable use of renewable resources such as soil, timber, and fisheries. Standardization by itself will not be enough—also required are advances in ecosystem modeling and in our understanding of critical ecological thresholds. With improving ecosystem science, the opportunity for realizing a major breakthrough in reporting corporate environmental impacts and dependencies has never been greater. Now is the time for ecologists to take advantage of an explosion of sustainability commitments from business leaders and expanding pressure for sustainable practices from shareholders, financial institutions, and consumers. PMID:26082543

  5. Improving global environmental management with standard corporate reporting.

    Science.gov (United States)

    Kareiva, Peter M; McNally, Brynn W; McCormick, Steve; Miller, Tom; Ruckelshaus, Mary

    2015-06-16

    Multinational corporations play a prominent role in shaping the environmental trajectory of the planet. The integration of environmental costs and benefits into corporate decision-making has enormous, but as yet unfulfilled, potential to promote sustainable development. To help steer business decisions toward better environmental outcomes, corporate reporting frameworks need to develop scientifically informed standards that consistently consider land use and land conversion, clean air (including greenhouse gas emissions), availability and quality of freshwater, degradation of coastal and marine habitats, and sustainable use of renewable resources such as soil, timber, and fisheries. Standardization by itself will not be enough--also required are advances in ecosystem modeling and in our understanding of critical ecological thresholds. With improving ecosystem science, the opportunity for realizing a major breakthrough in reporting corporate environmental impacts and dependencies has never been greater. Now is the time for ecologists to take advantage of an explosion of sustainability commitments from business leaders and expanding pressure for sustainable practices from shareholders, financial institutions, and consumers.

  6. Statistical reviewers improve reporting in biomedical articles: a randomized trial.

    Directory of Open Access Journals (Sweden)

    Erik Cobo

    2007-03-01

    Full Text Available Although peer review is widely considered to be the most credible way of selecting manuscripts and improving the quality of accepted papers in scientific journals, there is little evidence to support its use. Our aim was to estimate the effects on manuscript quality of either adding a statistical peer reviewer or suggesting the use of checklists such as CONSORT or STARD to clinical reviewers or both.Interventions were defined as 1 the addition of a statistical reviewer to the clinical peer review process, and 2 suggesting reporting guidelines to reviewers; with "no statistical expert" and "no checklist" as controls. The two interventions were crossed in a 2x2 balanced factorial design including original research articles consecutively selected, between May 2004 and March 2005, by the Medicina Clinica (Barc editorial committee. We randomized manuscripts to minimize differences in terms of baseline quality and type of study (intervention, longitudinal, cross-sectional, others. Sample-size calculations indicated that 100 papers provide an 80% power to test a 55% standardized difference. We specified the main outcome as the increment in quality of papers as measured on the Goodman Scale. Two blinded evaluators rated the quality of manuscripts at initial submission and final post peer review version. Of the 327 manuscripts submitted to the journal, 131 were accepted for further review, and 129 were randomized. Of those, 14 that were lost to follow-up showed no differences in initial quality to the followed-up papers. Hence, 115 were included in the main analysis, with 16 rejected for publication after peer review. 21 (18.3% of the 115 included papers were interventions, 46 (40.0% were longitudinal designs, 28 (24.3% cross-sectional and 20 (17.4% others. The 16 (13.9% rejected papers had a significantly lower initial score on the overall Goodman scale than accepted papers (difference 15.0, 95% CI: 4.6-24.4. The effect of suggesting a guideline to the

  7. CERN confident of LHC start-up in 2007

    CERN Document Server

    2007-01-01

    "Delegates attending the 140th meeting of CERN Council heard a confident report from the Laboratory about the scheduled start-up of the world's highest energy particle accelerator, the Large Hadron Collier (LHC), in 2007." (1 page)

  8. Using crowdsourcing to prioritize bicycle network improvements : final report.

    Science.gov (United States)

    2016-04-01

    Effort to improve the bicycle route network using crowdsourced data is a powerful means : of incorporating citizens in infrastructure improvement decisions, which will improve : livability by maximizing the benefit of the bicycle infrastructure fundi...

  9. The influence of situation awareness training on nurses' confidence about patient safety skills: A prospective cohort study.

    Science.gov (United States)

    Stomski, Norman; Gluyas, Heather; Andrus, Prue; Williams, Anne; Hopkins, Martin; Walters, Jennifer; Sandy, Martinique; Morrison, Paul

    2018-04-01

    Several studies report that patient safety skills, especially non-technical skills, receive scant attention in nursing curricula. Hence, there is a compelling reason to incorporate material that enhances non-technical skills, such as situation awareness, in nursing curricula in order to assist in the reduction of healthcare related adverse events. The objectives of this study were to: 1) understand final year nursing students' confidence in their patient safety skills; and 2) examine the impact of situation awareness training on final year nursing students' confidence in their patient safety skills. Participants were enrolled from a convenience sample comprising final year nursing students at a Western Australia university. Self-reported confidence in patient safety skills was assessed with the Health Professional in Patient Safety Survey before and after the delivery of a situation awareness educational intervention. Pre/post educational intervention differences were examined by repeated measures ANOVA. No significant differences in confidence about patient safety skills were identified within settings (class/clinical). However, confidence in patient safety skills significantly decreased between settings i.e. nursing students lost confidence after clinical placements. The educational intervention delivered in this study did not seem to improve confidence in patient safety skills, but substantial ceiling effects may have confounded the identification of such improvement. Further studies are required to establish whether the findings of this study can be generalised to other university nursing cohorts. Copyright © 2018 Elsevier Ltd. All rights reserved.

  10. Constructivist-Based Asynchronous Tutorial to Improve Transfer between Math and Chemistry Domains: Design, Implementation, and Analysis of the Impact of ReMATCH on General Chemistry Course Performance and Confidence

    Science.gov (United States)

    Barker, M. Danielle

    2011-07-01

    The two-year implementation of ReMATCH, a web-based math and problem-solving tutorial, in a traditionally arranged general chemistry classroom at the University of Kansas examined the impact of a designed intervention to assist students with the transfer of their mathematical knowledge to a chemistry context where it could be readily used for quantitative problem solving. The ReMATCH intervention, designed on constructivist-based pedagogies, focused on illuminating the expert-processes of problem solving and transferring knowledge across domains to the novice chemistry. The two implementations of ReMATCH -- once as lab assignments and once lecture assignments -- resulted in very different student responses to the intervention. However, within both, the beneficial effects of sustained ReMATCH-use were visible. In 2006, students who attempted all of the ReMATCH homework assignments were predicted to earn ˜5% higher on their total exam points. The 2007 implementation of ReMATCH demonstrated that students who attempted all of the homework problems and visited at least half of the ReMATCH tutorial pages were predicted to earn ˜8.5% higher on their total exam points. Additionally, use of ReMATCH in 2006 also resulted in increased confidence (as measured by comfort-level) with some of the math-related chemistry topics covered in ReMATCH. In 2007, when only students who attempted all of the ReMATCH problems were considered, it became clear that individuals who were initially less confident in their math-related chemistry skills were more likely to view more of the ReMATCH tutorial pages. When students with lower initial comfort-levels on these topics viewed at least half of the ReMATCH tutorial pages, they were able to compensate for their initially lower levels of confidence and were equally comfortable with most of the math-related chemistry topics by the final survey. Student interactions with and perceptions of ReMATCH showed that student attitudes towards Re

  11. Improving energy audit process and report outcomes through planning initiatives

    Science.gov (United States)

    Sprau Coulter, Tabitha L.

    Energy audits and energy models are an important aspect of the retrofit design process, as they provide project teams with an opportunity to evaluate a facilities current building systems' and energy performance. The information collected during an energy audit is typically used to develop an energy model and an energy audit report that are both used to assist in making decisions about the design and implementation of energy conservation measures in a facility. The current lack of energy auditing standards results in a high degree of variability in energy audit outcomes depending on the individual performing the audit. The research presented is based on the conviction that performing an energy audit and producing a value adding energy model for retrofit buildings can benefit from a revised approach. The research was divided into four phases, with the initial three phases consisting of: 1.) process mapping activity - aimed at reducing variability in the energy auditing and energy modeling process. 2.) survey analysis -- To examine the misalignment between how industry members use the top energy modeling tools compared to their intended use as defined by software representatives. 3.) sensitivity analysis -- analysis of the affect key energy modeling inputs are having on energy modeling analysis results. The initial three phases helped define the need for an improved energy audit approach that better aligns data collection with facility owners' needs and priorities. The initial three phases also assisted in the development of a multi-criteria decision support tool that incorporates a House of Quality approach to guide a pre-audit planning activity. For the fourth and final research phase explored the impacts and evaluation methods of a pre-audit planning activity using two comparative energy audits as case studies. In each case, an energy audit professionals was asked to complete an audit using their traditional methods along with an audit which involved them first

  12. Structured reporting of MRI of the shoulder - improvement of report quality?

    Energy Technology Data Exchange (ETDEWEB)

    Gassenmaier, Sebastian; Armbruster, Marco; Sommer, Wieland H.; Sommer, Nora N. [Ludwig-Maximilians-University (LMU), Department of Clinical Radiology, Munich (Germany); Haasters, Florian [Schoen Klinik Muenchen Harlaching, Department of Knee, Hip and Shoulder Surgery, Munich (Germany); Ludwig-Maximilians-University (LMU), Department of General, Trauma and Reconstructive Surgery, Munich (Germany); Helfen, Tobias [Ludwig-Maximilians-University (LMU), Department of General, Trauma and Reconstructive Surgery, Munich (Germany); Henzler, Thomas [University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University, Institute of Clinical Radiology and Nuclear Medicine, Heidelberg (Germany); Alibek, Sedat [Ambulatory Health Care Center Radiology and Nuclear Medicine, Fuerth (Germany); Friedrich-Alexander University, Department of Diagnostic Radiology, Erlangen-Nuremberg (Germany); Pfoerringer, Dominik [Klinikum rechts der Isar, Technical University of Munich, Department of Trauma Surgery, Munich (Germany)

    2017-10-15

    To evaluate the effect of structured reports (SRs) in comparison to non-structured narrative free text (NRs) shoulder MRI reports and potential effects of both types of reporting on completeness, readability, linguistic quality and referring surgeons' satisfaction. Thirty patients after trauma or with suspected degenerative changes of the shoulder were included in this study (2012-2015). All patients underwent shoulder MRI for further assessment and possible surgical planning. NRs were generated during clinical routine. Corresponding SRs were created using a dedicated template. All 60 reports were evaluated by two experienced orthopaedic shoulder surgeons using a questionnaire that included eight questions. Eighty per cent of the SRs were fully complete without any missing key features whereas only 45% of the NRs were fully complete (p < 0.001). The extraction of information was regarded to be easy in 92% of the SRs and 63% of the NRs. The overall quality of the SRs was rated better than that of the NRs (p < 0.001). Structured reporting of shoulder MRI improves the readability as well as the linguistic quality of radiological reports, and potentially leads to a higher satisfaction of referring physicians. (orig.)

  13. Structured reporting of MRI of the shoulder - improvement of report quality?

    International Nuclear Information System (INIS)

    Gassenmaier, Sebastian; Armbruster, Marco; Sommer, Wieland H.; Sommer, Nora N.; Haasters, Florian; Helfen, Tobias; Henzler, Thomas; Alibek, Sedat; Pfoerringer, Dominik

    2017-01-01

    To evaluate the effect of structured reports (SRs) in comparison to non-structured narrative free text (NRs) shoulder MRI reports and potential effects of both types of reporting on completeness, readability, linguistic quality and referring surgeons' satisfaction. Thirty patients after trauma or with suspected degenerative changes of the shoulder were included in this study (2012-2015). All patients underwent shoulder MRI for further assessment and possible surgical planning. NRs were generated during clinical routine. Corresponding SRs were created using a dedicated template. All 60 reports were evaluated by two experienced orthopaedic shoulder surgeons using a questionnaire that included eight questions. Eighty per cent of the SRs were fully complete without any missing key features whereas only 45% of the NRs were fully complete (p < 0.001). The extraction of information was regarded to be easy in 92% of the SRs and 63% of the NRs. The overall quality of the SRs was rated better than that of the NRs (p < 0.001). Structured reporting of shoulder MRI improves the readability as well as the linguistic quality of radiological reports, and potentially leads to a higher satisfaction of referring physicians. (orig.)

  14. Conceptual design report -- Gasification Product Improvement Facility (GPIF)

    Energy Technology Data Exchange (ETDEWEB)

    Sadowski, R.S.; Skinner, W.H.; House, L.S.; Duck, R.R. [CRS Sirrine Engineers, Inc., Greenville, SC (United States); Lisauskas, R.A.; Dixit, V.J. [Riley Stoker Corp., Worcester, MA (United States); Morgan, M.E.; Johnson, S.A. [PSI Technology Co., Andover, MA (United States). PowerServe Div.; Boni, A.A. [PSI-Environmental Instruments Corp., Andover, MA (United States)

    1994-09-01

    The problems heretofore with coal gasification and IGCC concepts have been their high cost and historical poor performance of fixed-bed gasifiers, particularly on caking coals. The Gasification Product Improvement Facility (GPIF) project is being developed to solve these problems through the development of a novel coal gasification invention which incorporates pyrolysis (carbonization) with gasification (fixed-bed). It employs a pyrolyzer (carbonizer) to avoid sticky coal agglomeration caused in the conventional process of gradually heating coal through the 400 F to 900 F range. In so doing, the coal is rapidly heated sufficiently such that the coal tar exists in gaseous form rather than as a liquid. Gaseous tars are then thermally cracked prior to the completion of the gasification process. During the subsequent endothermic gasification reactions, volatilized alkali can become chemically bound to aluminosilicates in (or added to) the ash. To reduce NH{sub 3} and HCN from fuel born nitrogen, steam injection is minimized, and residual nitrogen compounds are partially chemically reduced in the cracking stage in the upper gasifier region. Assuming testing confirms successful deployment of all these integrated processes, future IGCC applications will be much simplified, require significantly less mechanical components, and will likely achieve the $1,000/kWe commercialized system cost goal of the GPIF project. This report describes the process and its operation, design of the plant and equipment, site requirements, and the cost and schedule. 23 refs., 45 figs., 23 tabs.

  15. Provider confidence in opioid prescribing and chronic pain management: results of the Opioid Therapy Provider Survey

    Science.gov (United States)

    Pearson, Amy CS; Moman, Rajat N; Moeschler, Susan M; Eldrige, Jason S; Hooten, W Michael

    2017-01-01

    Introduction Many providers report lack of confidence in managing patients with chronic pain. Thus, the primary aim of this study was to investigate the associations of provider confidence in managing chronic pain with their practice behaviors and demographics. Materials and methods The primary outcome measure was the results of the Opioid Therapy Provider Survey, which was administered to clinicians attending a pain-focused continuing medical education conference. Nonparametric correlations were assessed using Spearman’s rho. Results Of the respondents, 55.0% were women, 92.8% were white, and 56.5% were physicians. Primary care providers accounted for 56.5% of the total respondents. The majority of respondents (60.8%) did not feel confident managing patients with chronic pain. Provider confidence in managing chronic pain was positively correlated with 1) following an opioid therapy protocol (P=0.001), 2) the perceived ability to identify patients at risk for opioid misuse (P=0.006), and 3) using a consistent practice-based approach to improve their comfort level with prescribing opioids (Pcorrelated with the perception that treating pain patients was a “problem in my practice” (P=0.005). Conclusion In this study, the majority of providers did not feel confident managing chronic pain. However, provider confidence was associated with a protocolized and consistent practice-based approach toward managing opioids and the perceived ability to identify patients at risk for opioid misuse. Future studies should investigate whether provider confidence is associated with measurable competence in managing chronic pain and explore approaches to enhance appropriate levels of confidence in caring for patients with chronic pain. PMID:28652805

  16. High Confidence Software and Systems Research Needs

    Data.gov (United States)

    Networking and Information Technology Research and Development, Executive Office of the President — This White Paper presents a survey of high confidence software and systems research needs. It has been prepared by the High Confidence Software and Systems...

  17. Trust, confidence, and the 2008 global financial crisis.

    Science.gov (United States)

    Earle, Timothy C

    2009-06-01

    The 2008 global financial crisis has been compared to a "once-in-a-century credit tsunami," a disaster in which the loss of trust and confidence played key precipitating roles and the recovery from which will require the restoration of these crucial factors. Drawing on the analogy between the financial crisis and environmental and technological hazards, recent research on the role of trust and confidence in the latter is used to provide a perspective on the former. Whereas "trust" and "confidence" are used interchangeably and without explicit definition in most discussions of the financial crisis, this perspective uses the TCC model of cooperation to clearly distinguish between the two and to demonstrate how this distinction can lead to an improved understanding of the crisis. The roles of trust and confidence-both in precipitation and in possible recovery-are discussed for each of the three major sets of actors in the crisis, the regulators, the banks, and the public. The roles of trust and confidence in the larger context of risk management are also examined; trust being associated with political approaches, confidence with technical. Finally, the various stances that government can take with regard to trust-such as supportive or skeptical-are considered. Overall, it is argued that a clear understanding of trust and confidence and a close examination of the specific, concrete circumstances of a crisis-revealing when either trust or confidence is appropriate-can lead to useful insights for both recovery and prevention of future occurrences.

  18. On-line confidence monitoring during decision making.

    Science.gov (United States)

    Dotan, Dror; Meyniel, Florent; Dehaene, Stanislas

    2018-02-01

    Humans can readily assess their degree of confidence in their decisions. Two models of confidence computation have been proposed: post hoc computation using post-decision variables and heuristics, versus online computation using continuous assessment of evidence throughout the decision-making process. Here, we arbitrate between these theories by continuously monitoring finger movements during a manual sequential decision-making task. Analysis of finger kinematics indicated that subjects kept separate online records of evidence and confidence: finger deviation continuously reflected the ongoing accumulation of evidence, whereas finger speed continuously reflected the momentary degree of confidence. Furthermore, end-of-trial finger speed predicted the post-decisional subjective confidence rating. These data indicate that confidence is computed on-line, throughout the decision process. Speed-confidence correlations were previously interpreted as a post-decision heuristics, whereby slow decisions decrease subjective confidence, but our results suggest an adaptive mechanism that involves the opposite causality: by slowing down when unconfident, participants gain time to improve their decisions. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Accounting for failures may improve precision: evidence supporting improved validity of self-reported condom use.

    Science.gov (United States)

    Crosby, Richard; Salazar, Laura F; DiClemente, Ralph J; Yarber, William L; Caliendo, Angela M; Staples-Horne, Michelle

    2005-08-01

    To determine whether a measure of unprotected vaginal sex that is adjusted for condom failures would produce improved accuracy in predicting biologically confirmed STDs (chlamydia and gonorrhea) among female teens. Self-reported measures were collected using audio-computer-assisted self-interviewing. DNA amplification for the presence of Chlamydia trachomatis and Neisseria gonorrhoeae was conducted. The unadjusted measure of unprotected vaginal sex was not significantly associated with biologically confirmed prevalence of STDs (prevalence ratio [PR] = 1.51; 95% CI = 0.71-3.21; P = 0.28). Alternatively, the adjusted measure achieved significance (PR = 3.59; 95% CI = 1.13-11.38; P = 0.014). More than one quarter (25.6%) of teens using condoms inconsistently and/or incorrectly tested positive for an STD compared to 7.1% among those reporting the consistent and correct use of condoms. Findings demonstrate that studies of condom effectiveness should use an adjusted measure of condom use to achieve precision and rigor.

  20. Considering public confidence in developing regulatory programs

    International Nuclear Information System (INIS)

    Collins, S.J.

    2001-01-01

    In the area of public trust and in any investment, planning and strategy are important. While it is accepted in the United States that an essential part of our mission is to leverage our resources to improving Public Confidence this performance goal must be planned for, managed and measured. Similar to our premier performance goal of Maintaining Safety, a strategy must be developed and integrated with our external stake holders but with internal regulatory staff as well. In order to do that, business is to be conducted in an open environment, the basis for regulatory decisions has to be available through public documents and public meetings, communication must be done in clear and consistent terms. (N.C.)

  1. Effect of immersive workplace experience on undergraduate nurses' mental health clinical confidence.

    Science.gov (United States)

    Patterson, Christopher; Moxham, Lorna; Taylor, Ellie K; Perlman, Dana; Brighton, Renee; Sumskis, Susan; Heffernan, Tim; Lee-Bates, Benjamin

    2017-12-01

    Preregistration education needs to ensure that student nurses are properly trained with the required skills and knowledge, and have the confidence to work with people who have a mental illness. With increased attention on non-traditional mental health clinical placements, further research is required to determine the effects of non-traditional mental health clinical placements on mental health clinical confidence. The aim of the present study was to investigate the impact of a non-traditional mental health clinical placement on mental health nursing clinical confidence compared to nursing students undergoing traditional clinical placements. Using the Mental Health Nursing Clinical Confidence Scale, the study investigated the relative effects of two placement programmes on the mental health clinical confidence of 79 nursing students. The two placement programmes included a non-traditional clinical placement of Recovery Camp and a comparison group that attended traditional clinical placements. Overall, the results indicated that, for both groups, mental health placement had a significant effect on improving mean mental health clinical confidence, both immediately upon conclusion of placement and at the 3-month follow up. Students who attended Recovery Camp reported a significant positive difference, compared to the comparison group, for ratings related to communicating effectively with clients with a mental illness, having a basic knowledge of antipsychotic medications and their side-effects, and providing client education regarding the effects and side-effects of medications. The findings suggest that a unique clinical placement, such as Recovery Camp, can improve and maintain facets of mental health clinical confidence for students of nursing. © 2017 Australian College of Mental Health Nurses Inc.

  2. Physiotherapy improves patient reported shoulder function and health status in patients with subacromial impingement syndrome

    DEFF Research Database (Denmark)

    Storgaard, Filip Holst; Pedersen, Christina Gravgaard; Jensen, Majbritt Lykke

    Physiotherapy improves patient reported shoulder function and health status in patients with subacromial impingement syndrome.......Physiotherapy improves patient reported shoulder function and health status in patients with subacromial impingement syndrome....

  3. Confidence Building Strategies in the Public Schools.

    Science.gov (United States)

    Achilles, C. M.; And Others

    1985-01-01

    Data from the Phi Delta Kappa Commission on Public Confidence in Education indicate that "high-confidence" schools make greater use of marketing and public relations strategies. Teacher attitudes were ranked first and administrator attitudes second by 409 respondents for both gain and loss of confidence in schools. (MLF)

  4. Strengthening Social Ties to Increase Confidence and Self-Esteem Among Sexual and Gender Minority Youth.

    Science.gov (United States)

    Romijnders, Kim A; Wilkerson, J Michael; Crutzen, Rik; Kok, Gerjo; Bauldry, Jessica; Lawler, Sylvia M

    2017-05-01

    Sexual and gender minority (SGM) youth too often live in nonsupportive environments. This study reports the influence of social support from primary and secondary social ties on confidence and self-esteem among participants in Hatch Youth, a drop-in group-level intervention for SGM youth. Each 3-hour Hatch Youth meeting consists of a social, educational, and youth-led support hour. Over 14 weeks, these meetings were randomly observed and individual interviews with participating youth ( n = 12) and staff and volunteers ( n = 12) were conducted; data underwent a content analysis. Participants perceived an increase in confidence and self-esteem through enhanced bonding with family and friends, a sense of belonging, and community empowerment because of their involvement with Hatch Youth, suggesting drop-in centers can strengthen secondary social ties and improve confidence and self-esteem.

  5. Disconnections Between Teacher Expectations and Student Confidence in Bioethics

    Science.gov (United States)

    Hanegan, Nikki L.; Price, Laura; Peterson, Jeremy

    2008-09-01

    This study examines how student practice of scientific argumentation using socioscientific bioethics issues affects both teacher expectations of students’ general performance and student confidence in their own work. When teachers use bioethical issues in the classroom students can gain not only biology content knowledge but also important decision-making skills. Learning bioethics through scientific argumentation gives students opportunities to express their ideas, formulate educated opinions and value others’ viewpoints. Research has shown that science teachers’ expectations of student success and knowledge directly influence student achievement and confidence levels. Our study analyzes pre-course and post-course surveys completed by students enrolled in a university level bioethics course ( n = 111) and by faculty in the College of Biology and Agriculture faculty ( n = 34) based on their perceptions of student confidence. Additionally, student data were collected from classroom observations and interviews. Data analysis showed a disconnect between faculty and students perceptions of confidence for both knowledge and the use of science argumentation. Student reports of their confidence levels regarding various bioethical issues were higher than faculty reports. A further disconnect showed up between students’ preferred learning styles and the general faculty’s common teaching methods; students learned more by practicing scientific argumentation than listening to traditional lectures. Students who completed a bioethics course that included practice in scientific argumentation, significantly increased their confidence levels. This study suggests that professors’ expectations and teaching styles influence student confidence levels in both knowledge and scientific argumentation.

  6. Building confidence: PETROBRAS plus community

    Energy Technology Data Exchange (ETDEWEB)

    Mascarenhas, Carina R.; Galluci, Alice Vianna [TELSAN - Engenharia Telecomunicacoes e Saneamento, Belo Horizonte, MG (Brazil). ; Costa Filho, Mario Duarte [Petroleo Brasileiro S.A. (PETROBRAS), Rio de Janeiro, RJ (Brazil)

    2009-07-01

    In accordance with Brazilian Secretary of Mines and Energy goal of spreading the share of natural gas in the country's energetic system, there is a project of enlarging the pipeline network for natural gas, including northeast Brazil, with the construction of about 1,000 miles of pipelines, through 250 counties. The construction is guided by actions of Social and Environmental Responsibility and Sustainability. IENE, engineering group in charge of construction and erection of pipelines and plants for natural gas and renewable energy in northeast Brazil, develops Social and Environmental actions, projects and programs in the direct influence area (440 yards left and right from the pipeline axis). This history case is about the community of Mapele, 20 miles from the capital of Bahia, Brazil, with social and environmental problems due to the construction and operation of pipelines - gas and oil - that was a challenge to empower a good relationship with the community, creating an improvement of actions in the same community. So, this paper intends to share our experience in building a good relationship of PETROBRAS with Mapele's community. (author)

  7. Using Organization Development To Improve School Climate. Report No. 17.

    Science.gov (United States)

    Gottfredson, Gary D.; Gottfredson, Denise C.

    This paper presents and illustrates some principles for organizational development approaches to improving school climate. It discusses a specific structure for facilitating school improvement entitled Program Development Evaluation, and it illustrates the use of school climate assessments for school diagnosis and the evaluation of improvement…

  8. Case Report: Improved Homonymous Hemianopia with Hyperbaric Oxygen Therapy

    Science.gov (United States)

    2017-06-29

    in the visual fields was noted at 13 treatments, but approximately 50% improvement was demonstrated in the right eye after 30 treatments with less...significant objective improvement of a fixed neurologic deficit following an ischemic brain injury. Various hypotheses exist regarding the recovery of

  9. AEL Continuous School Improvement Questionnaire. User Manual and Technical Report.

    Science.gov (United States)

    Meehan, Merrill L.; Cowley, Kimberly S.; Craig, James R.; Balow, Nancy; Childers, Robert D.

    The Continuous School Improvement Questionnaire (CSIQ) developed by the AEL helps a school staff gauge its performance on six dimensions related to continuous school improvement. Each member of the staff responds to the CSIQ individually. Although results might be used at the district or regional level, the most widely intended unit for applying…

  10. Food skills confidence and household gatekeepers' dietary practices.

    Science.gov (United States)

    Burton, Melissa; Reid, Mike; Worsley, Anthony; Mavondo, Felix

    2017-01-01

    Household food gatekeepers have the potential to influence the food attitudes and behaviours of family members, as they are mainly responsible for food-related tasks in the home. The aim of this study was to determine the role of gatekeepers' confidence in food-related skills and nutrition knowledge on food practices in the home. An online survey was completed by 1059 Australian dietary gatekeepers selected from the Global Market Insite (GMI) research database. Participants responded to questions about food acquisition and preparation behaviours, the home eating environment, perceptions and attitudes towards food, and demographics. Two-step cluster analysis was used to identify groups based on confidence regarding food skills and nutrition knowledge. Chi-square tests and one-way ANOVAs were used to compare the groups on the dependent variables. Three groups were identified: low confidence, moderate confidence and high confidence. Gatekeepers in the highest confidence group were significantly more likely to report lower body mass index (BMI), and indicate higher importance of fresh food products, vegetable prominence in meals, product information use, meal planning, perceived behavioural control and overall diet satisfaction. Gatekeepers in the lowest confidence group were significantly more likely to indicate more perceived barriers to healthy eating, report more time constraints and more impulse purchasing practices, and higher convenience ingredient use. Other smaller associations were also found. Household food gatekeepers with high food skills confidence were more likely to engage in several healthy food practices, while those with low food skills confidence were more likely to engage in unhealthy food practices. Food education strategies aimed at building food-skills and nutrition knowledge will enable current and future gatekeepers to make healthier food decisions for themselves and for their families. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Regional Competition for Confidence: Features of Formation

    Directory of Open Access Journals (Sweden)

    Irina Svyatoslavovna Vazhenina

    2016-09-01

    Full Text Available The increase in economic independence of the regions inevitably leads to an increase in the quality requirements of the regional economic policy. The key to successful regional policy, both during its development and implementation, is the understanding of the necessity of gaining confidence (at all levels, and the inevitable participation in the competition for confidence. The importance of confidence in the region is determined by its value as a competitive advantage in the struggle for partners, resources and tourists, and attracting investments. In today’s environment the focus of governments, regions and companies on long-term cooperation is clearly expressed, which is impossible without a high level of confidence between partners. Therefore, the most important competitive advantages of territories are intangible assets such as an attractive image and a good reputation, which builds up confidence of the population and partners. The higher the confidence in the region is, the broader is the range of potential partners, the larger is the planning horizon of long-term concerted action, the better are the chances of acquiring investment, the higher is the level of competitive immunity of the territories. The article defines competition for confidence as purposeful behavior of a market participant in economic environment, aimed at acquiring specific intangible competitive advantage – the confidence of the largest possible number of other market actors. The article also highlights the specifics of confidence as a competitive goal, presents factors contributing to the destruction of confidence, proposes a strategy to fight for confidence as a program of four steps, considers the factors which integrate regional confidence and offers several recommendations for the establishment of effective regional competition for confidence

  12. Matrix Summaries Improve Research Reports: Secondary Analyses Using Published Literature

    Science.gov (United States)

    Zientek, Linda Reichwein; Thompson, Bruce

    2009-01-01

    Correlation matrices and standard deviations are the building blocks of many of the commonly conducted analyses in published research, and AERA and APA reporting standards recommend their inclusion when reporting research results. The authors argue that the inclusion of correlation/covariance matrices, standard deviations, and means can enhance…

  13. Psychometric properties of the communication Confidence Rating Scale for Aphasia (CCRSA): phase 1.

    Science.gov (United States)

    Cherney, Leora R; Babbitt, Edna M; Semik, Patrick; Heinemann, Allen W

    2011-01-01

    Confidence is a construct that has not been explored previously in aphasia research. We developed the Communication Confidence Rating Scale for Aphasia (CCRSA) to assess confidence in communicating in a variety of activities and evaluated its psychometric properties using rating scale (Rasch) analysis. The CCRSA was administered to 21 individuals with aphasia before and after participation in a computer-based language therapy study. Person reliability of the 8-item CCRSA was .77. The 5-category rating scale demonstrated monotonic increases in average measures from low to high ratings. However, one item ("I follow news, sports, stories on TV/movies") misfit the construct defined by the other items (mean square infit = 1.69, item-measure correlation = .41). Deleting this item improved reliability to .79; the 7 remaining items demonstrated excellent fit to the underlying construct, although there was a modest ceiling effect in this sample. Pre- to posttreatment changes on the 7-item CCRSA measure were statistically significant using a paired samples t test. Findings support the reliability and sensitivity of the CCRSA in assessing participants' self-report of communication confidence. Further evaluation of communication confidence is required with larger and more diverse samples.

  14. Dissociating Perceptual Confidence from Discrimination Accuracy Reveals No Influence of Metacognitive Awareness on Working Memory.

    Science.gov (United States)

    Samaha, Jason; Barrett, John J; Sheldon, Andrew D; LaRocque, Joshua J; Postle, Bradley R

    2016-01-01

    Visual awareness is hypothesized to be intimately related to visual working memory (WM), such that information present in WM is thought to have necessarily been represented consciously. Recent work has challenged this longstanding view by demonstrating that visual stimuli rated by observers as unseen can nevertheless be maintained over a delay period. These experiments have been criticized, however, on the basis that subjective awareness ratings may contain response bias (e.g., an observer may report no awareness when in fact they had partial awareness). We mitigated this issue by investigating WM for visual stimuli that were matched for perceptual discrimination capacity (d'), yet which varied in subjective confidence ratings (so-called relative blindsight). If the degree of initial subjective awareness of a stimulus facilitates later maintenance of that information, WM performance should improve for stimuli encoded with higher confidence. In contrast, we found that WM performance did not benefit from higher visual discrimination confidence. This relationship was observed regardless of WM load (1 or 3). Insofar as metacognitive ratings (e.g., confidence, visibility) reflect visual awareness, these results challenge a strong relationship between conscious perception and WM using a paradigm that controls for discrimination accuracy and is less subject to response bias (since confidence is manipulated within subjects). Methodologically, we replicate prior efforts to induce relative blindsight using similar stimulus displays, providing a general framework for isolating metacognitive awareness in order to examine the function of consciousness.

  15. Dissociating perceptual confidence from discrimination accuracy reveals no influence of metacognitive awareness on working memory

    Directory of Open Access Journals (Sweden)

    Jason eSamaha

    2016-06-01

    Full Text Available Visual awareness is hypothesized to be intimately related to visual working memory (WM, such that information present in WM is thought to have necessarily been represented consciously. Recent work has challenged this longstanding view by demonstrating that visual stimuli rated by observers as unseen can nevertheless be maintained over a delay period. These experiments have been criticized, however, on the basis that subjective awareness ratings may contain response bias (e.g., an observer may report no awareness when in fact they had partial awareness. We mitigated this issue by investigating WM for visual stimuli that were matched for perceptual discrimination capacity (d’, yet which varied in subjective confidence ratings (so called relative blindsight. If the degree of initial subjective awareness of a stimulus facilitates later maintenance of that information, WM performance should improve for stimuli encoded with higher confidence. In contrast, we found that WM performance did not benefit from higher visual discrimination confidence. This relationship was observed regardless of WM load (1 or 3. Insofar as metacognitive ratings (e.g., confidence, visibility reflect visual awareness, these results challenge a strong relationship between conscious perception and WM using a paradigm that controls for discrimination accuracy and is less subject to response bias (since confidence is manipulated within subjects. Methodologically, we replicate prior efforts to induce relative blindsight using similar stimulus displays, providing a general framework for isolating metacognitive awareness in order to examine the function of consciousness.

  16. Improving Numeracy and Literacy: Evaluation Report and Executive Summary

    Science.gov (United States)

    Worth, Jack; Sizmur, Juliet; Ager, Rob; Styles, Ben

    2015-01-01

    The project, "Oxford Improving Numeracy and Literacy Programme," was delivered by Oxford University Department of Education. This evaluation tested two different initiatives with Year 2 children: "Mathematics and Reasoning" and "Literacy and Morphemes." The "Mathematics and Reasoning" programme aimed to…

  17. Sex differences in confidence influence patterns of conformity.

    Science.gov (United States)

    Cross, Catharine P; Brown, Gillian R; Morgan, Thomas J H; Laland, Kevin N

    2017-11-01

    Lack of confidence in one's own ability can increase the likelihood of relying on social information. Sex differences in confidence have been extensively investigated in cognitive tasks, but implications for conformity have not been directly tested. Here, we tested the hypothesis that, in a task that shows sex differences in confidence, an indirect effect of sex on social information use will also be evident. Participants (N = 168) were administered a mental rotation (MR) task or a letter transformation (LT) task. After providing an answer, participants reported their confidence before seeing the responses of demonstrators and being allowed to change their initial answer. In the MR, but not the LT, task, women showed lower levels of confidence than men, and confidence mediated an indirect effect of sex on the likelihood of switching answers. These results provide novel, experimental evidence that confidence is a general explanatory mechanism underpinning susceptibility to social influences. Our results have implications for the interpretation of the wider literature on sex differences in conformity. © 2016 The British Psychological Society.

  18. BWR Servicing and Refueling Improvement Program: Phase I summary report

    Energy Technology Data Exchange (ETDEWEB)

    Perry, D.R.

    1978-09-01

    Under the U.S. Department of Energy sponsorship, General Electric Co. (GE) undertook a study of boiling water reactor (BWR) refueling outages for the purpose of recommending the development and demonstration of critical path time savings improvements. The Tennessee Valley Authority (TVA) joined the study as a subcontractor, providing monitoring assistance and making the Browns Ferry Site available for improvement demonstrations. Agreement was also reached with Georgia Power Co., Power Authority of the State of New York, and Commonwealth Edison Co. for monitoring and data collection at Hatch 1, FitzPatrick, and Quad Cities 1 nuclear plants, respectively. The objective was to identify, develop, and demonstrate improved refueling, maintenance, and inspection procedures and equipment. The improvements recommended in this study are applicable to BWR nuclear plants currently in operation as well as those in the design and construction phases. The recommendations and outage information can be used as a basis to plan and conduct the first outages of new plants and to improve the planning and facilities of currently operating plants. Many of the recommendations can readily be incorporated in plants currently in the design and construction phases as well as in the design of future plants. Many of these recommended improvements can be implemented immediately by utilities without further technical development.

  19. BWR Servicing and Refueling Improvement Program: Phase I summary report

    International Nuclear Information System (INIS)

    Perry, D.R.

    1978-09-01

    Under the U.S. Department of Energy sponsorship, General Electric Co. (GE) undertook a study of boiling water reactor (BWR) refueling outages for the purpose of recommending the development and demonstration of critical path time savings improvements. The Tennessee Valley Authority (TVA) joined the study as a subcontractor, providing monitoring assistance and making the Browns Ferry Site available for improvement demonstrations. Agreement was also reached with Georgia Power Co., Power Authority of the State of New York, and Commonwealth Edison Co. for monitoring and data collection at Hatch 1, FitzPatrick, and Quad Cities 1 nuclear plants, respectively. The objective was to identify, develop, and demonstrate improved refueling, maintenance, and inspection procedures and equipment. The improvements recommended in this study are applicable to BWR nuclear plants currently in operation as well as those in the design and construction phases. The recommendations and outage information can be used as a basis to plan and conduct the first outages of new plants and to improve the planning and facilities of currently operating plants. Many of the recommendations can readily be incorporated in plants currently in the design and construction phases as well as in the design of future plants. Many of these recommended improvements can be implemented immediately by utilities without further technical development

  20. A Novel Reporting System to Improve Accuracy in Appendicitis Imaging

    Science.gov (United States)

    Godwin, Benjamin D.; Drake, Frederick T.; Simianu, Vlad V.; Shriki, Jabi E.; Hippe, Daniel S.; Dighe, Manjiri; Bastawrous, Sarah; Cuevas, Carlos; Flum, David; Bhargava, Puneet

    2015-01-01

    OBJECTIVE The purpose of this study was to ascertain if standardized radiologic reporting for appendicitis imaging increases diagnostic accuracy. MATERIALS AND METHODS We developed a standardized appendicitis reporting system that includes objective imaging findings common in appendicitis and a certainty score ranging from 1 (definitely not appendicitis) through 5 (definitely appendicitis). Four radiologists retrospectively reviewed the preoperative CT scans of 96 appendectomy patients using our reporting system. The presence of appendicitis-specific imaging findings and certainty scores were compared with final pathology. These comparisons were summarized using odds ratios (ORs) and the AUC. RESULTS The appendix was visualized on CT in 89 patients, of whom 71 (80%) had pathologically proven appendicitis. Imaging findings associated with appendicitis included appendiceal diameter (odds ratio [OR] = 14 [> 10 vs appendicitis. In this initially indeterminate group, using the standardized reporting system, radiologists assigned higher certainty scores (4 or 5) in 21 of the 28 patients with appendicitis (75%) and lower scores (1 or 2) in five of the seven patients without appendicitis (71%) (AUC = 0.90; p = 0.001). CONCLUSION Standardized reporting and grading of objective imaging findings correlated well with postoperative pathology and may decrease the number of CT findings reported as indeterminate for appendicitis. Prospective evaluation of this reporting system on a cohort of patients with clinically suspected appendicitis is currently under way. PMID:26001230

  1. Improved Barriers to Turbine Engine Fragments: Final Annual Report

    National Research Council Canada - National Science Library

    Shockey, Donald

    2002-01-01

    This final annual technical report describes the progress rnade during year 4 of the SPI International Phase II effort to develop a computational capability for designing lightweight fragment barriers...

  2. Chemical Weapons Improved Response Program. 2000 Summary Report

    National Research Council Canada - National Science Library

    2000-01-01

    The purpose of this summary report is to inform members of the first responder and emergency management communities about the on-going activities, initiatives, and lessons learned from the Chemical...

  3. Report: Improvements Needed in Key EPA Information System Security Practices

    Science.gov (United States)

    Report #10-P-0146, June 15, 2010. Williams Adley found that EPA program offices lacked evidence that they planned and executed tests of information system security controls as required by federal requirements.

  4. Report: EPA Needs to Improve Continuity of Operations Planning

    Science.gov (United States)

    Report #10-P-0017, October 27, 2009. EPA has limited assurance that it can successfully maintain continuity of operations and execute its mission essential functions during a significant national event such as a pandemic influenza outbreak.

  5. Agencies Need Improved Financial Data Reporting for Private Security Contractors

    National Research Council Canada - National Science Library

    Warren, David R; Bianco, Michael A; Nasser, Waheed; Kusman, Richard R; Shafer, James; Venner, Jason; Walls, Lovell Q; Wright, Samson J

    2008-01-01

    .... The objective of this report was to determine the extent to which federal agencies have systematically captured financial data for private security services in Iraq since 2003, and to identify...

  6. Improving user-insurance communication on accident reports

    OpenAIRE

    Fardoun, Habib Moussa; Alghazzawi, Daniyal M.; Paules Ciprés, Antonio

    2014-01-01

    This paper presents an easy to use methodology and system for insurance companies targeting at managing traffic accidents reports process. The main objective is to facilitate and accelerate the process of creating and finalizing the necessary accident reports in cases without mortal victims involved. The diverse entities participating in the process from the moment an accident occurs until the related final actions needed are included. Nowadays, this market is limited to the consulting platfo...

  7. Simulation experience enhances physical therapist student confidence in managing a patient in the critical care environment.

    Science.gov (United States)

    Ohtake, Patricia J; Lazarus, Marcilene; Schillo, Rebecca; Rosen, Michael

    2013-02-01

    Rehabilitation of patients in critical care environments improves functional outcomes. This finding has led to increased implementation of intensive care unit (ICU) rehabilitation programs, including early mobility, and an associated increased demand for physical therapists practicing in ICUs. Unfortunately, many physical therapists report being inadequately prepared to work in this high-risk environment. Simulation provides focused, deliberate practice in safe, controlled learning environments and may be a method to initiate academic preparation of physical therapists for ICU practice. The purpose of this study was to examine the effect of participation in simulation-based management of a patient with critical illness in an ICU setting on levels of confidence and satisfaction in physical therapist students. A one-group, pretest-posttest, quasi-experimental design was used. Physical therapist students (N=43) participated in a critical care simulation experience requiring technical (assessing bed mobility and pulmonary status), behavioral (patient and interprofessional communication), and cognitive (recognizing a patient status change and initiating appropriate responses) skill performance. Student confidence and satisfaction were surveyed before and after the simulation experience. Students' confidence in their technical, behavioral, and cognitive skill performance increased from "somewhat confident" to "confident" following the critical care simulation experience. Student satisfaction was highly positive, with strong agreement the simulation experience was valuable, reinforced course content, and was a useful educational tool. Limitations of the study were the small sample from one university and a control group was not included. Incorporating a simulated, interprofessional critical care experience into a required clinical course improved physical therapist student confidence in technical, behavioral, and cognitive performance measures and was associated with high

  8. Talking about cancer with confidence: evaluation of cancer awareness training for community-based health workers.

    Science.gov (United States)

    Grimmett, Chloe; Macherianakis, Alexis; Rendell, Helen; George, Helen; Kaplan, Gwen; Kilgour, Gillian; Power, Emily

    2014-09-01

    To examine the impact of cancer awareness training for community-based health workers on confidence to talk about cancer, and knowledge of cancer risk factors and signs and symptoms. Community-based health workers from Sandwell, Birmingham and Solihull were invited to take part in one of 14 one-day training workshops. Trainees completed questionnaires at the beginning of the workshop and were followed up one month later. Confidence in talking about cancer was examined. Knowledge of cancer risk factors and signs and symptoms was assessed. Trainees were asked to rate the usefulness of the workshop, whether they would recommend it to others and whether they had put what they had learnt into practice. A total of 187 community-based health workers took part in the workshops, and 167 (89%) completed the one-month follow-up. Considerable improvements were observed in confidence to discuss cancer. For example, the proportion of participants reporting feeling 'very confident'/'fairly confident' in discussing signs and symptoms of cancer increased from 32% to 96% (p cancer at one month compared with 21% before training (p cancer signs and symptoms also increased from 2.3 (± 1.6) to 2.7 (± 1.5), (p = .02). Most trainees (83%) rated the workshop as 'very useful', and 89% said they would 'definitely' recommend the workshop. The cancer awareness training was reviewed positively by community-based health workers and led to improvements in confidence to talk about cancer, and knowledge of risk factors and warning signs of cancer. It is hoped that raising awareness among this group will help them to communicate and drive behaviour change in the at-risk populations with whom they work. © Royal Society for Public Health 2014.

  9. Confidence Measurement in the Light of Signal Detection Theory

    Directory of Open Access Journals (Sweden)

    Sébastien eMassoni

    2014-12-01

    Full Text Available We compare three alternative methods for eliciting retrospective confidence in the context of a simple perceptual task: the Simple Confidence Rating (a direct report on a numerical scale, the Quadratic Scoring Rule (a post-wagering procedure and the Matching Probability (a generalization of the no-loss gambling method. We systematically compare the results obtained with these three rules to the theoretical confidence levels that can be inferred from performance in the perceptual task using Signal Detection Theory. We find that the Matching Probability provides better results in that respect. We conclude that Matching Probability is particularly well suited for studies of confidence that use Signal Detection Theory as a theoretical framework.

  10. Improved patient-reported health impact of multiple sclerosis

    DEFF Research Database (Denmark)

    Macdonell, Richard; Nagels, Guy; Laplaud, David-Axel

    2016-01-01

    BACKGROUND: Multiple sclerosis (MS) is a debilitating disease that negatively impacts patients' lives. OBJECTIVE: ENABLE assessed the effect of long-term prolonged-release (PR) fampridine (dalfampridine extended release in the United States) treatment on patient-perceived health impact in patients...... with MS with walking impairment. METHODS: ENABLE was a 48-week, open-label, Phase 4 study of PR-fampridine 10 mg twice daily. Patients who showed any improvement in Timed 25-Foot Walk walking speed at weeks 2 and 4 and any improvement in 12-item MS Walking Scale score at week 4 remained on treatment....... The primary endpoint was change from baseline in 36-Item Short-Form Health Survey (SF-36) physical component summary (PCS) score. RESULTS: At week 4, 707/901 (78.5%) patients met the criteria to remain on treatment. Patients on treatment demonstrated significant and clinically meaningful improvements in SF-36...

  11. Development of free statistical software enabling researchers to calculate confidence levels, clinical significance curves and risk-benefit contours

    International Nuclear Information System (INIS)

    Shakespeare, T.P.; Mukherjee, R.K.; Gebski, V.J.

    2003-01-01

    Confidence levels, clinical significance curves, and risk-benefit contours are tools improving analysis of clinical studies and minimizing misinterpretation of published results, however no software has been available for their calculation. The objective was to develop software to help clinicians utilize these tools. Excel 2000 spreadsheets were designed using only built-in functions, without macros. The workbook was protected and encrypted so that users can modify only input cells. The workbook has 4 spreadsheets for use in studies comparing two patient groups. Sheet 1 comprises instructions and graphic examples for use. Sheet 2 allows the user to input the main study results (e.g. survival rates) into a 2-by-2 table. Confidence intervals (95%), p-value and the confidence level for Treatment A being better than Treatment B are automatically generated. An additional input cell allows the user to determine the confidence associated with a specified level of benefit. For example if the user wishes to know the confidence that Treatment A is at least 10% better than B, 10% is entered. Sheet 2 automatically displays clinical significance curves, graphically illustrating confidence levels for all possible benefits of one treatment over the other. Sheet 3 allows input of toxicity data, and calculates the confidence that one treatment is more toxic than the other. It also determines the confidence that the relative toxicity of the most effective arm does not exceed user-defined tolerability. Sheet 4 automatically calculates risk-benefit contours, displaying the confidence associated with a specified scenario of minimum benefit and maximum risk of one treatment arm over the other. The spreadsheet is freely downloadable at www.ontumor.com/professional/statistics.htm A simple, self-explanatory, freely available spreadsheet calculator was developed using Excel 2000. The incorporated decision-making tools can be used for data analysis and improve the reporting of results of any

  12. Anatomy-Specific Virtual Reality Simulation in Temporal Bone Dissection: Perceived Utility and Impact on Surgeon Confidence.

    Science.gov (United States)

    Locketz, Garrett D; Lui, Justin T; Chan, Sonny; Salisbury, Kenneth; Dort, Joseph C; Youngblood, Patricia; Blevins, Nikolas H

    2017-06-01

    Objective To evaluate the effect of anatomy-specific virtual reality (VR) surgical rehearsal on surgeon confidence and temporal bone dissection performance. Study Design Prospective pre- and poststudy of a novel virtual surgical rehearsal platform. Setting Academic otolaryngology-head and neck surgery residency training programs. Subjects and Methods Sixteen otolaryngology-head and neck surgery residents from 2 North American training institutions were recruited. Surveys were administered to assess subjects' baseline confidence in performing 12 subtasks of cortical mastoidectomy with facial recess. A cadaver temporal bone was randomly assigned to each subject. Cadaver specimens were scanned with a clinical computed tomography protocol, allowing the creation of anatomy-specific models for use in a VR surgical rehearsal platform. Subjects then rehearsed a virtual mastoidectomy on data sets derived from their specimens. Surgical confidence surveys were administered again. Subjects then dissected assigned cadaver specimens, which were blindly graded with a modified Welling scale. A final survey assessed the perceived utility of rehearsal on dissection performance. Results Of 16 subjects, 14 (87.5%) reported a significant increase in overall confidence after conducting an anatomy-specific VR rehearsal. A significant correlation existed between perceived utility of rehearsal and confidence improvement. The effect of rehearsal on confidence was dependent on trainee experience and the inherent difficulty of the surgical subtask. Postrehearsal confidence correlated strongly with graded dissection performance. Subjects rated anatomy-specific rehearsal as having a moderate to high contribution to their dissection performance. Conclusion Anatomy-specific virtual rehearsal improves surgeon confidence in performing mastoid dissection, dependent on surgeon experience and task difficulty. The subjective confidence gained through rehearsal correlates positively with subsequent

  13. Confidence in Alternative Dispute Resolution: Experience from Switzerland

    Directory of Open Access Journals (Sweden)

    Christof Schwenkel

    2014-06-01

    Full Text Available Alternative Dispute Resolution plays a crucial role in the justice system of Switzerland. With the unified Swiss Code of Civil Procedure, it is required that each litigation session shall be preceded by an attempt at conciliation before a conciliation authority. However, there has been little research on conciliation authorities and the public's perception of the authorities. This paper looks at public confidence in conciliation authorities and provides results of a survey conducted with more than 3,400 participants. This study found that public confidence in Swiss conciliation authorities is generally high, exceeds the ratings for confidence in cantonal governments and parliaments, but is lower than confidence in courts.Since the institutional models of the conciliation authorities (meaning the organization of the authorities and the selection of the conciliators differ widely between the 26 Swiss cantons, the influence of the institutional models on public confidence is analyzed. Contrary to assumptions based on New Institutional-ism approaches, this study reports that the institutional models do not impact public confidence. Also, the relationship between a participation in an election of justices of the peace or conciliators and public confidence in these authorities is found to be at most very limited (and negative. Similar to common findings on courts, the results show that general contacts with conciliation authorities decrease public confidence in these institutions whereas a positive experience with a conciliation authority leads to more confidence.The Study was completed as part of the research project 'Basic Research into Court Management in Switzerland', supported by the Swiss National Science Foundation (SNSF. Christof Schwenkel is a PhD student at the University of Lucerne and a research associate and project manager at Interface Policy Studies. A first version of this article was presented at the 2013 European Group for Public

  14. Determining the confidence levels of sensor outputs using neural networks

    Energy Technology Data Exchange (ETDEWEB)

    Broten, G S; Wood, H C [Saskatchewan Univ., Saskatoon, SK (Canada). Dept. of Electrical Engineering

    1996-12-31

    This paper describes an approach for determining the confidence level of a sensor output using multi-sensor arrays, sensor fusion and artificial neural networks. The authors have shown in previous work that sensor fusion and artificial neural networks can be used to learn the relationships between the outputs of an array of simulated partially selective sensors and the individual analyte concentrations in a mixture of analyses. Other researchers have shown that an array of partially selective sensors can be used to determine the individual gas concentrations in a gaseous mixture. The research reported in this paper shows that it is possible to extract confidence level information from an array of partially selective sensors using artificial neural networks. The confidence level of a sensor output is defined as a numeric value, ranging from 0% to 100%, that indicates the confidence associated with a output of a given sensor. A three layer back-propagation neural network was trained on a subset of the sensor confidence level space, and was tested for its ability to generalize, where the confidence level space is defined as all possible deviations from the correct sensor output. A learning rate of 0.1 was used and no momentum terms were used in the neural network. This research has shown that an artificial neural network can accurately estimate the confidence level of individual sensors in an array of partially selective sensors. This research has also shown that the neural network`s ability to determine the confidence level is influenced by the complexity of the sensor`s response and that the neural network is able to estimate the confidence levels even if more than one sensor is in error. The fundamentals behind this research could be applied to other configurations besides arrays of partially selective sensors, such as an array of sensors separated spatially. An example of such a configuration could be an array of temperature sensors in a tank that is not in

  15. Improvement of diagnostic confidence for detection of multiple myeloma involvement of the ribs by a new CT software generating rib unfolded images: Comparison with 5- and 1-mm axial images

    Energy Technology Data Exchange (ETDEWEB)

    Homann, Georg; Mustafa, Deedar Farhad; Nikolaou, Konstantin; Horger, Marius [Eberhard Karls University Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany); Weisel, Katja [Eberhard Karls University Tuebingen, Department of Internal Medicine II, Tuebingen (Germany); Ditt, Hendrik [Healthcare Sector Imaging and Therapy Division, Siemens AG, Forchheim (Germany)

    2015-04-02

    To investigate the performance of a new CT software generating rib unfolded images for improved detection of rib osteolyses in patients with multiple myeloma. One hundred sixteen patients who underwent whole-body reduced-dose multidetector computed tomography (WBRD-MDCT) for multiple myeloma diagnosis and during follow-up were retrospectively evaluated. Nonenhanced CT scans with 5- and 1-mm slice thickness were interpreted by two readers with focus on detection of rib involvement (location, number, fracture). Image analysis of ''unfolded,'' 1-mm-based CT rib images was subsequently undertaken. We classified the number of lytic bone lesions into 0, 1, 2, <5, <10 and ≥10. For all three data sets the reading time was registered. An approximated sum of 6,727 myeloma-related rib lesions was found. On a patient-based analysis, CT (5 mm), CT (1 mm) and CT (1 mm ''unfolded rib'') yielded a sensitivity, specificity and accuracy of 79.7/94.7/87.1, 88.1/93/90.5 and 98.3/96.5/97.4, respectively. In a lesion-based analysis, the sensitivity, specificity and accuracy of the three evaluations were 69.7/87.2/70.5, 79.8/55.9/78 and 96.5/89.7/96.1. Mean reading time for 5 mm/1 mm axial images and unfolded images was 178.7/215.1/90.8 s, respectively. The generation of ''unfolded rib'' images improves detection of rib involvement in patients with multiple myeloma and significantly reduces reading time. (orig.)

  16. Errors and Predictors of Confidence in Condom Use amongst Young Australians Attending a Music Festival

    OpenAIRE

    Hall, Karina M.; Brieger, Daniel G.; De Silva, Sukhita H.; Pfister, Benjamin F.; Youlden, Daniel J.; John-Leader, Franklin; Pit, Sabrina W.

    2016-01-01

    Objectives. To determine the confidence and ability to use condoms correctly and consistently and the predictors of confidence in young Australians attending a festival. Methods. 288 young people aged 18 to 29 attending a mixed-genre music festival completed a survey measuring demographics, self-reported confidence using condoms, ability to use condoms, and issues experienced when using condoms in the past 12 months. Results. Self-reported confidence using condoms was high (77%). Multivariate...

  17. The Sense of Confidence during Probabilistic Learning: A Normative Account.

    Directory of Open Access Journals (Sweden)

    Florent Meyniel

    2015-06-01

    Full Text Available Learning in a stochastic environment consists of estimating a model from a limited amount of noisy data, and is therefore inherently uncertain. However, many classical models reduce the learning process to the updating of parameter estimates and neglect the fact that learning is also frequently accompanied by a variable "feeling of knowing" or confidence. The characteristics and the origin of these subjective confidence estimates thus remain largely unknown. Here we investigate whether, during learning, humans not only infer a model of their environment, but also derive an accurate sense of confidence from their inferences. In our experiment, humans estimated the transition probabilities between two visual or auditory stimuli in a changing environment, and reported their mean estimate and their confidence in this report. To formalize the link between both kinds of estimate and assess their accuracy in comparison to a normative reference, we derive the optimal inference strategy for our task. Our results indicate that subjects accurately track the likelihood that their inferences are correct. Learning and estimating confidence in what has been learned appear to be two intimately related abilities, suggesting that they arise from a single inference process. We show that human performance matches several properties of the optimal probabilistic inference. In particular, subjective confidence is impacted by environmental uncertainty, both at the first level (uncertainty in stimulus occurrence given the inferred stochastic characteristics and at the second level (uncertainty due to unexpected changes in these stochastic characteristics. Confidence also increases appropriately with the number of observations within stable periods. Our results support the idea that humans possess a quantitative sense of confidence in their inferences about abstract non-sensory parameters of the environment. This ability cannot be reduced to simple heuristics, it seems

  18. IMPROVING TACONITE PROCESSING PLANT EFFICIENCY BY COMPUTER SIMULATION, Final Report

    Energy Technology Data Exchange (ETDEWEB)

    William M. Bond; Salih Ersayin

    2007-03-30

    This project involved industrial scale testing of a mineral processing simulator to improve the efficiency of a taconite processing plant, namely the Minorca mine. The Concentrator Modeling Center at the Coleraine Minerals Research Laboratory, University of Minnesota Duluth, enhanced the capabilities of available software, Usim Pac, by developing mathematical models needed for accurate simulation of taconite plants. This project provided funding for this technology to prove itself in the industrial environment. As the first step, data representing existing plant conditions were collected by sampling and sample analysis. Data were then balanced and provided a basis for assessing the efficiency of individual devices and the plant, and also for performing simulations aimed at improving plant efficiency. Performance evaluation served as a guide in developing alternative process strategies for more efficient production. A large number of computer simulations were then performed to quantify the benefits and effects of implementing these alternative schemes. Modification of makeup ball size was selected as the most feasible option for the target performance improvement. This was combined with replacement of existing hydrocyclones with more efficient ones. After plant implementation of these modifications, plant sampling surveys were carried out to validate findings of the simulation-based study. Plant data showed very good agreement with the simulated data, confirming results of simulation. After the implementation of modifications in the plant, several upstream bottlenecks became visible. Despite these bottlenecks limiting full capacity, concentrator energy improvement of 7% was obtained. Further improvements in energy efficiency are expected in the near future. The success of this project demonstrated the feasibility of a simulation-based approach. Currently, the Center provides simulation-based service to all the iron ore mining companies operating in northern

  19. Confidence amongst Multidisciplinary Professionals in Managing Paediatric Rheumatic Disease in Australia

    Directory of Open Access Journals (Sweden)

    Samuel Cassidy

    2018-01-01

    Full Text Available Objective. Interprofessional collaboration is a crucial component of care for children with rheumatic disease. Interprofessional care, when delivered appropriately, prevents disability and improves long-term prognosis in this vulnerable group. Methods. The aim of this survey was to explore allied health professionals’ and nurses’ confidence in treating paediatric rheumatology patients. Results. Overall, 117 participants were recruited, 77.9% of participants reported being “not confident at all,” “not confident,” or “neutral” in treating children with rheumatic diseases (RD despite 65.1% of participants reporting having treated >1 paediatric rheumatology case in the past month. Furthermore, 67.2% of participants felt their undergraduate education in paediatric rheumatology was inadequate. “Journals” or “texts books” were used by 49.3% of participants as their primary source of continuing professional development (CPD and 39.3% of participants indicated that they did not undertake any CPD related to paediatric rheumatology. Small group and online education were perceived to be potentially of “great benefit” for CPD. Conclusion. This paper highlights allied health professionals’ and nurses’ perceived inadequacy of their undergraduate education in paediatric RD and their low confidence in recognising and treating RD. Undergraduate and postgraduate education opportunities focusing on interprofessional collaboration should be developed to address this workforce deficiency.

  20. Examining Belief and Confidence in Schizophrenia

    Science.gov (United States)

    Joyce, Dan W.; Averbeck, Bruno B.; Frith, Chris D.; Shergill, Sukhwinder S.

    2018-01-01

    Background People with psychoses often report fixed, delusional beliefs that are sustained even in the presence of unequivocal contrary evidence. Such delusional beliefs are the result of integrating new and old evidence inappropriately in forming a cognitive model. We propose and test a cognitive model of belief formation using experimental data from an interactive “Rock Paper Scissors” game. Methods Participants (33 controls and 27 people with schizophrenia) played a competitive, time-pressured interactive two-player game (Rock, Paper, Scissors). Participant’s behavior was modeled by a generative computational model using leaky-integrator and temporal difference methods. This model describes how new and old evidence is integrated to form both a playing strategy to beat the opponent and provide a mechanism for reporting confidence in one’s playing strategy to win against the opponent Results People with schizophrenia fail to appropriately model their opponent’s play despite consistent (rather than random) patterns that can be exploited in the simulated opponent’s play. This is manifest as a failure to weigh existing evidence appropriately against new evidence. Further, participants with schizophrenia show a ‘jumping to conclusions’ bias, reporting successful discovery of a winning strategy with insufficient evidence. Conclusions The model presented suggests two tentative mechanisms in delusional belief formation – i) one for modeling patterns in other’s behavior, where people with schizophrenia fail to use old evidence appropriately and ii) a meta-cognitive mechanism for ‘confidence’ in such beliefs where people with schizophrenia overweight recent reward history in deciding on the value of beliefs about the opponent. PMID:23521846

  1. Self-Confidence in the Hospitality Industry

    Directory of Open Access Journals (Sweden)

    Michael Oshins

    2014-02-01

    Full Text Available Few industries rely on self-confidence to the extent that the hospitality industry does because guests must feel welcome and that they are in capable hands. This article examines the results of hundreds of student interviews with industry professionals at all levels to determine where the majority of the hospitality industry gets their self-confidence.

  2. Consumer confidence or the business cycle

    DEFF Research Database (Denmark)

    Møller, Stig Vinther; Nørholm, Henrik; Rangvid, Jesper

    2014-01-01

    Answer: The business cycle. We show that consumer confidence and the output gap both excess returns on stocks in many European countries: When the output gap is positive (the economy is doing well), expected returns are low, and when consumer confidence is high, expected returns are also low...

  3. Financial Literacy, Confidence and Financial Advice Seeking

    NARCIS (Netherlands)

    Kramer, Marc M.

    2016-01-01

    We find that people with higher confidence in their own financial literacy are less likely to seek financial advice, but no relation between objective measures of literacy and advice seeking. The negative association between confidence and advice seeking is more pronounced among wealthy households.

  4. Confidence Interval Approximation For Treatment Variance In ...

    African Journals Online (AJOL)

    In a random effects model with a single factor, variation is partitioned into two as residual error variance and treatment variance. While a confidence interval can be imposed on the residual error variance, it is not possible to construct an exact confidence interval for the treatment variance. This is because the treatment ...

  5. Organic labbeling systems and consumer confidence

    OpenAIRE

    Sønderskov, Kim Mannemar; Daugbjerg, Carsten

    2009-01-01

    A research analysis suggests that a state certification and labelling system creates confidence in organic labelling systems and consequently green consumerism. Danish consumers have higher levels of confidence in the labelling system than consumers in countries where the state plays a minor role in labelling and certification.

  6. Improving Employability Skills, Enriching Our Economy. Case Study Report

    Science.gov (United States)

    National Foundation for Educational Research, 2015

    2015-01-01

    This report has been produced by four organisations--the National Foundation for Educational Research, South East Strategic Leaders, London Councils and the London Enterprise Panel. It is based on research into how secondary schools, colleges, SMEs (small and medium-sized enterprises) and micro-businesses in London and the South East work together…

  7. Self-confidence and metacognitive processes

    Directory of Open Access Journals (Sweden)

    Kleitman Sabina

    2005-01-01

    Full Text Available This paper examines the status of Self-confidence trait. Two studies strongly suggest that Self-confidence is a component of metacognition. In the first study, participants (N=132 were administered measures of Self-concept, a newly devised Memory and Reasoning Competence Inventory (MARCI, and a Verbal Reasoning Test (VRT. The results indicate a significant relationship between confidence ratings on the VRT and the Reasoning component of MARCI. The second study (N=296 employed an extensive battery of cognitive tests and several metacognitive measures. Results indicate the presence of robust Self-confidence and Metacognitive Awareness factors, and a significant correlation between them. Self-confidence taps not only processes linked to performance on items that have correct answers, but also beliefs about events that may never occur.

  8. Trust versus confidence: Microprocessors and personnel monitoring

    International Nuclear Information System (INIS)

    Chiaro, P.J. Jr.

    1993-01-01

    Due to recent technological advances, substantial improvements have been made in personnel contamination monitoring. In all likelihood, these advances will close out the days of manually frisking personnel for radioactive contamination. Unfortunately, as microprocessor-based monitors become more widely used, not only at commercial power reactors but also at government facilities, questions concerning their trustworthiness arise. Algorithms make decisions that were previously made by technicians. Trust is placed not in technicians but in machines. In doing this it is assumed that the machine never misses. Inevitably, this trust drops, due largely to open-quotes false alarms.close quotes This is especially true when monitoring for alpha contamination. What is a open-quotes false alarm?close quotes Do these machines and their algorithms that we put our trust in make mistakes? An analysis was performed on half-body and hand-and-foot monitors at Oak Ridge National Laboratory (ORNL) in order to justify the suggested confidence level used for alarm point determination. Sources used in this analysis had activities approximating ORNL's contamination limits

  9. Trust versus confidence: Microprocessors and personnel monitoring

    International Nuclear Information System (INIS)

    Chiaro, P.J. Jr.

    1993-01-01

    Due to recent technological advances, substantial improvements have been made in personnel contamination monitoring. In all likelihood, these advances will close out the days of manually frisking personnel for radioactive contamination. Unfortunately, as microprocessor-based monitors become more widely used, not only at commercial power reactors but also at government facilities, questions concerning their trustworthiness arise. Algorithms make decisions that were previously made by technicians. Trust is placed not in technicians but in machines. In doing this it is assumed that the machine never misses. Inevitably, this trust drops, due largely to ''false alarms''. This is especially true when monitoring for alpha contamination. What is a ''false alarm''? Do these machines and their algorithms that we put our trust in make mistakes? An analysis was performed on half-body and hand-and-foot monitors at Oak Ridge National Laboratory (ORNL) in order to justify the suggested confidence level used for alarm point determination. Sources used in this analysis had activities approximating ORNL's contamination limits

  10. Trust versus confidence: Microprocessors and personnel monitoring

    International Nuclear Information System (INIS)

    Chiaro, P.J. Jr.

    1994-01-01

    Due to recent technological advances, substantial improvements have been made in personnel contamination monitoring. In all likelihood, these advances will close out the days of manually frisking personnel for radioactive contamination. Unfortunately, as microprocessor-based monitors become more widely used, not only at commercial power reactors but also at government facilities, questions concerning their trustworthiness arise. Algorithms make decisions that were previously made by technicians. Trust is placed not in technicians but in machines. In doing this it is assumed that the machine never misses. Inevitably, this trust drops, due largely to ''false alarms''. This is especially true when monitoring for alpha contamination. What is a ''false alarm''? Do these machines and their algorithms that they put their trust in make mistakes? An analysis was performed on half-body and hand-and-foot monitors at Oak Ridge National Laboratory (ORNL) in order to justify the suggested confidence level used for alarm point determination. Sources used in this analysis had activities approximating ORNL's contamination limits

  11. Stability in the metamemory realism of eyewitness confidence judgments.

    Science.gov (United States)

    Buratti, Sandra; Allwood, Carl Martin; Johansson, Marcus

    2014-02-01

    The stability of eyewitness confidence judgments over time in regard to their reported memory and accuracy of these judgments is of interest in forensic contexts because witnesses are often interviewed many times. The present study investigated the stability of the confidence judgments of memory reports of a witnessed event and of the accuracy of these judgments over three occasions, each separated by 1 week. Three age groups were studied: younger children (8-9 years), older children (10-11 years), and adults (19-31 years). A total of 93 participants viewed a short film clip and were asked to answer directed two-alternative forced-choice questions about the film clip and to confidence judge each answer. Different questions about details in the film clip were used on each of the three test occasions. Confidence as such did not exhibit stability over time on an individual basis. However, the difference between confidence and proportion correct did exhibit stability across time, in terms of both over/underconfidence and calibration. With respect to age, the adults and older children exhibited more stability than the younger children for calibration. Furthermore, some support for instability was found with respect to the difference between the average confidence level for correct and incorrect answers (slope). Unexpectedly, however, the younger children's slope was found to be more stable than the adults. Compared to the previous research, the present study's use of more advanced statistical methods provides a more nuanced understanding of the stability of confidence judgments in the eyewitness reports of children and adults.

  12. The effect of the SQUIRE (Standards of QUality Improvement Reporting Excellence) guidelines on reporting standards in the quality improvement literature: a before-and-after study.

    Science.gov (United States)

    Howell, Victoria; Schwartz, Amanda Eva; O'Leary, James Daniel; Mc Donnell, Conor

    2015-06-01

    The SQUIRE (Standards of QUality Improvement Reporting Excellence) guidelines were developed to improve the reporting of quality improvement (QI) projects. The effect of the guidelines on the completeness of reporting in the QI literature is unknown. Our primary objective was to determine if the completeness of reporting in the QI literature has been improved[OUP_CE13] since the introduction of the SQUIRE guidelines. We performed a before-and-after evaluation of QI articles selected from four prominent journals of healthcare quality. Twenty-five articles published in each of two time periods (2006-2008 and 2010-2011) were confirmed to be QI projects using a standardised definition and were independently evaluated by two investigators as an interim evaluation of a planned larger sample. Articles were assessed using 50 statements of the SQUIRE guidelines, and the overall change in the completeness of reporting between the two groups was determined. The value of pimprovement observed in the completeness of reporting of QI projects after the publication of the SQUIRE guidelines, and the study was stopped early. There is potential for improvement in reporting standards, particularly for those guideline items or statements specific to QI projects. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  13. Government policy, research and stakeholder confidence - Current Trends in Canada

    International Nuclear Information System (INIS)

    Letourneau, Carmel

    2006-01-01

    The author addressed the topic of government Policy, research and stakeholder Confidence from the perspective of government policy makers in Canada. The presentation reviewed the question: why carry out more research into methods of long-term management of nuclear fuel waste? In addressing this question, the author provided some perspectives that were expressed by the Canadian public, since reflected in the Final Study of management approaches led by the Nuclear Waste Management Organization (NWMO), an organization set up by the nuclear industry to study options for the long-term management of nuclear fuel waste. The Final Study was submitted to the federal Minister of Natural Resources in November 2005 as required under the Nuclear Fuel Waste Act. The NWMO's Final Study emphasized the important role of continuous learning, a key element in the NWMO's recommendation of Adaptive Phased Management. It was reported that the NWMO work had identified many reasons to carry out further research. Regardless of the management approach adopted, activities to manage radioactive waste will continue for a very long time. Any management program could be expected to apply the best practice available at the time. A program that will evolve over a long period of time will have many opportunities for improvements to increase performance, enhance effectiveness, and address rising societal concerns. It was suggested that, to realize these benefits, there needs to be a vibrant and robust research and development effort during management program development and execution, a period that will last many generations, and enable implementers to adapt to a changing environment. Among the reasons put forward for continuing research were, to: - Embody the principles of continuous learning which encourages standards of excellence and integrity; - Prepare for facility siting, design, licensing, development and operations to improve designs, minimize costs, enhance schedules, and reduce

  14. Fort St. Vrain improvement program plan. Draft final report

    International Nuclear Information System (INIS)

    1980-03-01

    The restraints are described which inhibit the Fort St. Vrain (FSV) Nuclear Power Station, a high temperature gas cooled reactor (HTGR) plant, from achieving full power operation with high availability. The actions necessary to overcome these restraints are outlined. The restraints originated from problems in both hardware related and institutional areas. The report summarizes what has been accomplished, what is currently being done, and what should be done to resolve the problems

  15. Improving the Efficient of Ernie Turner Center. Final Progress Report

    Energy Technology Data Exchange (ETDEWEB)

    Fredeen, Amy

    2011-03-21

    The objective of this project was to complete the specifications and drawings for a variable speed kitchen exhaust system and the boiler heating system which when implemented will improve the heating efficiency of the building. The design work was focused in two key areas: kitchen ventilation and heating for the Ernie Turner Center building (ETC). RSA completed design work and issued a set of 100% drawings. RSA also worked with a cost estimator to put together a detailed cost estimate for the project. The design components are summarized.

  16. [Financial incentives in improving healthcare quality. SESPAS Report 2012].

    Science.gov (United States)

    Eirea Eiras, Carlos; Ortún Rubio, Vicente

    2012-03-01

    We address the contribution of financial incentives linked to pay for performance (P4P) to improving the quality of care. The situation of P4P is analyzed internationally and in the distinct health services in Spain. The participation of P4P in wage compensation and the effects of the current economic crisis on these incentives is discussed. We review the results of recent studies to clarify the role of these incentive models and assess possible orientations and new proposals. Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.

  17. Natural Propagation and Habitat Improvement, Volume 1, Oregon, 1986 Final and Annual Reports.

    Energy Technology Data Exchange (ETDEWEB)

    Stuart, Amy

    1987-01-01

    This report describes activities implemented for fisheries habitat improvement work on priority drainages in the Clackamas and Hood River sub-basins. Separate abstracts have been prepared for the reports on individual projects. (ACR)

  18. Management Report: Improvements Needed in IRS's Accounting Procedures and Internal Controls

    National Research Council Canada - National Science Library

    2002-01-01

    ... with requirements of the Federal Financial Management Improvement Act of 1996. A separate report on the implementation status of recommendations from our prior IRS financial audits and related financial management reports will be issued shortly...

  19. Kangaroo Care Education Effects on Nurses' Knowledge and Skills Confidence.

    Science.gov (United States)

    Almutairi, Wedad Matar; Ludington-Hoe, Susan M

    2016-11-01

    Less than 20% of the 996 NICUs in the United States routinely practice kangaroo care, due in part to the inadequate knowledge and skills confidence of nurses. Continuing education improves knowledge and skills acquisition, but the effects of a kangaroo care certification course on nurses' knowledge and skills confidence are unknown. A pretest-posttest quasi-experiment was conducted. The Kangaroo Care Knowledge and Skills Confidence Tool was administered to 68 RNs at a 2.5-day course about kangaroo care evidence and skills. Measures of central tendency, dispersion, and paired t tests were conducted on 57 questionnaires. The nurses' characteristics were varied. The mean posttest Knowledge score (M = 88.54, SD = 6.13) was significantly higher than the pretest score (M = 78.7, SD = 8.30), t [54] = -9.1, p = .000), as was the posttest Skills Confidence score (pretest M = 32.06, SD = 3.49; posttest M = 26.80, SD = 5.22), t [53] = -8.459, p = .000). The nurses' knowledge and skills confidence of kangaroo care improved following continuing education, suggesting a need for continuing education in this area. J Contin Educ Nurs. 2016;47(11):518-524. Copyright 2016, SLACK Incorporated.

  20. IMPROVING THE REPORTING OF THERAPEUTIC EXERCISE INTERVENTIONS IN REHABILITATION RESEARCH.

    Science.gov (United States)

    Page, Phil; Hoogenboom, Barb; Voight, Michael

    2017-04-01

    The foundation of evidence-based practice lies in clinical research, which is based on the utilization of the scientific method. The scientific method requires that all details of the experiment be provided in publications to support replication of the study in order to evaluate and validate the results. More importantly, clinical research can only be translated into practice when researchers provide explicit details of the study. Too often, rehabilitation exercise intervention studies lack the appropriate detail to allow clinicians to replicate the exercise protocol in their patient populations. Therefore, the purpose of this clinical commentary is to provide guidelines for optimal reporting of therapeutic exercise interventions in rehabilitation research. 5.

  1. Improved nuclear gage development - phase i and ii. Interim report

    International Nuclear Information System (INIS)

    Chan, E.L.; Champion, F.C.; Castanon, D.R.; Chang, J.C.; Hannon, J.B.

    1976-09-01

    This report contains Phase I and II of an investigation covering the design and construction of a prototype nuclear-moisture-density backscatter gage. Gage development was based upon the analysis of several factors which affect gage performance. This research indicated that the prototype gage measurements are approximately equivalent to measurements obtained by a commercial transmission gage. The implication of this research finding concerns the qualification of the backscatter test method as a valid, reliable, and expedient procedure for determining in-situ soil conditions

  2. Research work for improving LWR safety. 1991 annual report

    International Nuclear Information System (INIS)

    1992-08-01

    The work performed in 1991 for the PNS project centers on various phenomena of severe fuel damage and on selected aspects of a core meltdown accident, relating to aerosol behaviour and filter engineering, and to methods of assessing and minimizing the radiological impacts of a reactor accident. One paper included in this annual report summarizes the evaluation of experiments carried out in 1990 at the Wuerenlingen PROTEUS reactor. The 1991 task programme of the project for the first time included research into extreme load conditions affecting the containment in a core meltdown accident; first results are given of the experiments performed. (orig./DG) [de

  3. Confidence Intervals: From tests of statistical significance to confidence intervals, range hypotheses and substantial effects

    Directory of Open Access Journals (Sweden)

    Dominic Beaulieu-Prévost

    2006-03-01

    Full Text Available For the last 50 years of research in quantitative social sciences, the empirical evaluation of scientific hypotheses has been based on the rejection or not of the null hypothesis. However, more than 300 articles demonstrated that this method was problematic. In summary, null hypothesis testing (NHT is unfalsifiable, its results depend directly on sample size and the null hypothesis is both improbable and not plausible. Consequently, alternatives to NHT such as confidence intervals (CI and measures of effect size are starting to be used in scientific publications. The purpose of this article is, first, to provide the conceptual tools necessary to implement an approach based on confidence intervals, and second, to briefly demonstrate why such an approach is an interesting alternative to an approach based on NHT. As demonstrated in the article, the proposed CI approach avoids most problems related to a NHT approach and can often improve the scientific and contextual relevance of the statistical interpretations by testing range hypotheses instead of a point hypothesis and by defining the minimal value of a substantial effect. The main advantage of such a CI approach is that it replaces the notion of statistical power by an easily interpretable three-value logic (probable presence of a substantial effect, probable absence of a substantial effect and probabilistic undetermination. The demonstration includes a complete example.

  4. We will be champions: Leaders' confidence in 'us' inspires team members' team confidence and performance.

    Science.gov (United States)

    Fransen, K; Steffens, N K; Haslam, S A; Vanbeselaere, N; Vande Broek, G; Boen, F

    2016-12-01

    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.

  5. Confidence building in implementation of geological disposal

    International Nuclear Information System (INIS)

    Umeki, Hiroyuki

    2004-01-01

    Long-term safety of the disposal system should be demonstrated to the satisfaction of the stakeholders. Convincing arguments are therefore required that instil in the stakeholders confidence in the safety of a particular concept for the siting and design of a geological disposal, given the uncertainties that inevitably exist in its a priori description and in its evolution. The step-wise approach associated with making safety case at each stage is a key to building confidence in the repository development programme. This paper discusses aspects and issues on confidence building in the implementation of HLW disposal in Japan. (author)

  6. Improved Controls for Fusion RF Systems. Final technical report

    International Nuclear Information System (INIS)

    Casey, Jeffrey A.

    2011-01-01

    We have addressed the specific requirements for the integrated systems controlling an array of klystrons used for Lower Hybrid Current Drive (LHCD). The immediate goal for our design was to modernize the transmitter protection system (TPS) for LHCD on the Alcator C-Mod tokamak at the MIT Plasma Science and Fusion Center (MIT-PSFC). Working with the Alcator C-Mod team, we have upgraded the design of these controls to retrofit for improvements in performance and safety, as well as to facilitate the upcoming expansion from 12 to 16 klystrons. The longer range goals to generalize the designs in such a way that they will be of benefit to other programs within the international fusion effort was met by designing a system which was flexible enough to address all the MIT system requirements, and modular enough to adapt to a large variety of other requirements with minimal reconfiguration

  7. Improving plant bioaccumulation science through consistent reporting of experimental data

    DEFF Research Database (Denmark)

    Fantke, Peter; Arnot, Jon A.; Doucette, William J.

    2016-01-01

    Experimental data and models for plant bioaccumulation of organic contaminants play a crucial role for assessing the potential human and ecological risks associated with chemical use. Plants are receptor organisms and direct or indirect vectors for chemical exposures to all other organisms. As new...... experimental data are generated they are used to improve our understanding of plant-chemical interactions that in turn allows for the development of better scientific knowledge and conceptual and predictive models. The interrelationship between experimental data and model development is an ongoing, never......-ending process needed to advance our ability to provide reliable quality information that can be used in various contexts including regulatory risk assessment. However, relatively few standard experimental protocols for generating plant bioaccumulation data are currently available and because of inconsistent...

  8. Improved Controls for Fusion RF Systems. Final technical report

    Energy Technology Data Exchange (ETDEWEB)

    Casey, Jeffrey A. [Rockfield Research Inc., Las Vegas, NV (United States)

    2011-11-08

    We have addressed the specific requirements for the integrated systems controlling an array of klystrons used for Lower Hybrid Current Drive (LHCD). The immediate goal for our design was to modernize the transmitter protection system (TPS) for LHCD on the Alcator C-Mod tokamak at the MIT Plasma Science and Fusion Center (MIT-PSFC). Working with the Alcator C-Mod team, we have upgraded the design of these controls to retrofit for improvements in performance and safety, as well as to facilitate the upcoming expansion from 12 to 16 klystrons. The longer range goals to generalize the designs in such a way that they will be of benefit to other programs within the international fusion effort was met by designing a system which was flexible enough to address all the MIT system requirements, and modular enough to adapt to a large variety of other requirements with minimal reconfiguration.

  9. Valve-stem-packing improvement study. Final report

    International Nuclear Information System (INIS)

    Adey, C.W.; Klein, J.J.

    1982-08-01

    By employing questionnaires and face-to-face interviews with valve and valve packing manufacturers, as well as nuclear plant personnel, an understanding of valve stem packing leakage problems from each of the three viewpoints was developed. This information, in-house experience, and available technical literature were used to develop specific recommendations for valve manufacturers, valve packing manufacturers, and nuclear plant valve users. It was generally recommended that each these groups make better use of graphite packing. The questionnaires and interviews indicated that increased usage of graphite packing over the last few years has reduced the incidence of valve packing problems. To confirm this, a survey of Licensee Event Reports (LERs) from 1972 to 1980 was undertaken using the keywords Valve and Packing. A statistical analysis of the LER data confirms that the adoption of graphite packing has significantly reduced valve stem leakage

  10. Medical students' perceptions regarding the importance of nutritional knowledge and their confidence in providing competent nutrition practice.

    Science.gov (United States)

    Perlstein, R; McCoombe, S; Shaw, C; Nowson, C

    2016-11-01

    The objective of this study was to examine the perceived importance, knowledge and confidence in nutritional management in a sample of Australian medical students undertaking a 4-year postgraduate medical degree. In 2015, students in years 1-4 were anonymously surveyed to assess students' perceived importance of nutrition, and knowledge and confidence in nutritional management. A total of 131 first and second year (preclinical/yr 1-2) medical students (46% response rate) and 66 third and fourth year (clinical/yr 3-4) students (24% response rate) completed the questionnaire. Most preclinical students agreed that medical graduates should understand nutritional issues in managing cardiovascular disease (99%), type 2 diabetes (93%), coeliac disease (95%), and renal impairment (97%). However, students were limited in their confidence to demonstrate this knowledge (range of confidence: 26%-41%) for individual medical conditions. This improved for students in the clinical context of years 3 and 4, although it was still not optimal (range 26%-81%). Few year 3 and 4 students reported confidence in knowledge related to medicolegal issues, respiratory disease, nutritional guidelines and nutrition assessment (all 80%) reported confidence in the dietary management of type 2 diabetes, cardiovascular disease and coeliac disease and >60% indicated they would refer onto nutrition professionals. This cohort of postgraduate medical students recognize the importance of nutrition in disease. The number of students reporting increased confidence in nutritional management of a few select diseases where dietary management is one of the cornerstones of treatment (e.g. type 2 diabetes) rises throughout the course. However, students reported lower levels of knowledge in diseases where diet is secondary to other treatments and preventative strategies (e.g. respiratory disease). Filling the gap by integrating the nutritional management into the range of common chronic diseases during training

  11. Confidence assessment. Site-descriptive modelling SDM-Site Laxemar

    International Nuclear Information System (INIS)

    2009-06-01

    The objective of this report is to assess the confidence that can be placed in the Laxemar site descriptive model, based on the information available at the conclusion of the surface-based investigations (SDM-Site Laxemar). In this exploration, an overriding question is whether remaining uncertainties are significant for repository engineering design or long-term safety assessment and could successfully be further reduced by more surface-based investigations or more usefully by explorations underground made during construction of the repository. Procedures for this assessment have been progressively refined during the course of the site descriptive modelling, and applied to all previous versions of the Forsmark and Laxemar site descriptive models. They include assessment of whether all relevant data have been considered and understood, identification of the main uncertainties and their causes, possible alternative models and their handling, and consistency between disciplines. The assessment then forms the basis for an overall confidence statement. The confidence in the Laxemar site descriptive model, based on the data available at the conclusion of the surface based site investigations, has been assessed by exploring: - Confidence in the site characterization data base, - remaining issues and their handling, - handling of alternatives, - consistency between disciplines and - main reasons for confidence and lack of confidence in the model. Generally, the site investigation database is of high quality, as assured by the quality procedures applied. It is judged that the Laxemar site descriptive model has an overall high level of confidence. Because of the relatively robust geological model that describes the site, the overall confidence in the Laxemar Site Descriptive model is judged to be high, even though details of the spatial variability remain unknown. The overall reason for this confidence is the wide spatial distribution of the data and the consistency between

  12. Confidence assessment. Site-descriptive modelling SDM-Site Laxemar

    Energy Technology Data Exchange (ETDEWEB)

    2008-12-15

    The objective of this report is to assess the confidence that can be placed in the Laxemar site descriptive model, based on the information available at the conclusion of the surface-based investigations (SDM-Site Laxemar). In this exploration, an overriding question is whether remaining uncertainties are significant for repository engineering design or long-term safety assessment and could successfully be further reduced by more surface-based investigations or more usefully by explorations underground made during construction of the repository. Procedures for this assessment have been progressively refined during the course of the site descriptive modelling, and applied to all previous versions of the Forsmark and Laxemar site descriptive models. They include assessment of whether all relevant data have been considered and understood, identification of the main uncertainties and their causes, possible alternative models and their handling, and consistency between disciplines. The assessment then forms the basis for an overall confidence statement. The confidence in the Laxemar site descriptive model, based on the data available at the conclusion of the surface based site investigations, has been assessed by exploring: - Confidence in the site characterization data base, - remaining issues and their handling, - handling of alternatives, - consistency between disciplines and - main reasons for confidence and lack of confidence in the model. Generally, the site investigation database is of high quality, as assured by the quality procedures applied. It is judged that the Laxemar site descriptive model has an overall high level of confidence. Because of the relatively robust geological model that describes the site, the overall confidence in the Laxemar Site Descriptive model is judged to be high, even though details of the spatial variability remain unknown. The overall reason for this confidence is the wide spatial distribution of the data and the consistency between

  13. An Exact Confidence Region in Multivariate Calibration

    OpenAIRE

    Mathew, Thomas; Kasala, Subramanyam

    1994-01-01

    In the multivariate calibration problem using a multivariate linear model, an exact confidence region is constructed. It is shown that the region is always nonempty and is invariant under nonsingular transformations.

  14. Weighting Mean and Variability during Confidence Judgments

    Science.gov (United States)

    de Gardelle, Vincent; Mamassian, Pascal

    2015-01-01

    Humans can not only perform some visual tasks with great precision, they can also judge how good they are in these tasks. However, it remains unclear how observers produce such metacognitive evaluations, and how these evaluations might be dissociated from the performance in the visual task. Here, we hypothesized that some stimulus variables could affect confidence judgments above and beyond their impact on performance. In a motion categorization task on moving dots, we manipulated the mean and the variance of the motion directions, to obtain a low-mean low-variance condition and a high-mean high-variance condition with matched performances. Critically, in terms of confidence, observers were not indifferent between these two conditions. Observers exhibited marked preferences, which were heterogeneous across individuals, but stable within each observer when assessed one week later. Thus, confidence and performance are dissociable and observers’ confidence judgments put different weights on the stimulus variables that limit performance. PMID:25793275

  15. Confidence bands for inverse regression models

    International Nuclear Information System (INIS)

    Birke, Melanie; Bissantz, Nicolai; Holzmann, Hajo

    2010-01-01

    We construct uniform confidence bands for the regression function in inverse, homoscedastic regression models with convolution-type operators. Here, the convolution is between two non-periodic functions on the whole real line rather than between two periodic functions on a compact interval, since the former situation arguably arises more often in applications. First, following Bickel and Rosenblatt (1973 Ann. Stat. 1 1071–95) we construct asymptotic confidence bands which are based on strong approximations and on a limit theorem for the supremum of a stationary Gaussian process. Further, we propose bootstrap confidence bands based on the residual bootstrap and prove consistency of the bootstrap procedure. A simulation study shows that the bootstrap confidence bands perform reasonably well for moderate sample sizes. Finally, we apply our method to data from a gel electrophoresis experiment with genetically engineered neuronal receptor subunits incubated with rat brain extract

  16. Quality improvement in depression care in the Netherlands: the Depression Breakthrough Collaborative. A quality improvement report.

    NARCIS (Netherlands)

    Franx, G.C.; Meeuwissen, J.A.; Sinnema, H.; Spijker, J.; Huyser, J.; Wensing, M.J.P.; Lange, J.

    2009-01-01

    BACKGROUND: Improving the healthcare for patients with depression is a priority health policy across the world. Roughly, two major problems can be identified in daily practice: (1) the content of care is often not completely consistent with recommendations in guidelines and (2) the organization of

  17. CERN confident of LHC start-up in 2007

    CERN Document Server

    Vanden Broeck, Renilde

    2007-01-01

    "Delegates attending the 140th meeting of CERN Council today heard a confident report from the Laboratory about the scheduled start-up of the world's highest energy particle accelerator, the Large Hadron Collier (LHC) in 2007. (1/2 page)

  18. CERN confident of LHC start-up in 2007

    CERN Multimedia

    2006-01-01

    "Delegates attending the 140th meeting of CERN Council today heard a confident report from the Laboratory about the scheduled start-up of the world's highest energy particle accelerator, the Large Hadron Collider (LHC) in 2007." (1/2 page)

  19. Confidence Intervals for Assessing Heterogeneity in Generalized Linear Mixed Models

    Science.gov (United States)

    Wagler, Amy E.

    2014-01-01

    Generalized linear mixed models are frequently applied to data with clustered categorical outcomes. The effect of clustering on the response is often difficult to practically assess partly because it is reported on a scale on which comparisons with regression parameters are difficult to make. This article proposes confidence intervals for…

  20. North Dakota Leadership Training Boosts Confidence and Involvement

    Science.gov (United States)

    Flage, Lynette; Hvidsten, Marie; Vettern, Rachelle

    2012-01-01

    Effective leadership is critical for communities as they work to maintain their vitality and sustainability for years to come. The purpose of the study reported here was to assess confidence levels and community engagement of community leadership program participants in North Dakota State University Extension programs. Through a survey…

  1. Distinguishing highly confident accurate and inaccurate memory: insights about relevant and irrelevant influences on memory confidence

    OpenAIRE

    Chua, Elizabeth F.; Hannula, Deborah E.; Ranganath, Charan

    2012-01-01

    It is generally believed that accuracy and confidence in one’s memory are related, but there are many instances when they diverge. Accordingly, it is important to disentangle the factors which contribute to memory accuracy and confidence, especially those factors that contribute to confidence, but not accuracy. We used eye movements to separately measure fluent cue processing, the target recognition experience, and relative evidence assessment on recognition confidence and accuracy. Eye movem...

  2. Final Scientific Report - "Improved Fuel Efficiency from Nanocomposite Tire Tread"

    Energy Technology Data Exchange (ETDEWEB)

    Dr. Andrew Myers

    2005-12-30

    Rolling resistance, a measure of the energy lost as a tire rotates while moving, is a significant source of power and fuel loss. Recently, low rolling resistant tires have been formulated by adding silica to tire tread. These "Green Tires" (so named from the environmental advantages of lower emissions and improved fuel economy) have seen some commercial success in Europe, where high fuel prices and performance drive tire selection. Unfortunately, the higher costs of the silica and a more complicated manufacturing process have prevented significant commercialization - and the resulting fuel savings - in the U.S. In this project, TDA Research, Inc. (TDA) prepared an inexpensive alternative to silica that leads to tire components with lower rolling resistance. These new tire composite materials were processed with traditional rubber processing equipment. We prepared specially designed nanoparticle additives, based on a high purity, inorganic mineral whose surface can be easily modified for compatibility with tire tread formulations. Our nanocomposites decreased energy losses to hysteresis, the loss of energy from the compression and relaxation of an elastic material, by nearly 20% compared to a blank SBR sample. We also demonstrated better performance than a leading silica product, with easier production of our final rubber nanocomposite.

  3. Foundations for Improvements to Passive Detection Systems - Final Report

    International Nuclear Information System (INIS)

    Labov, S E; Pleasance, L; Sokkappa, P; Craig, W; Chapline, G; Frank, M; Gronberg, J; Jernigan, J G; Johnson, S; Kammeraad, J; Lange, D; Meyer, A; Nelson, K; Pohl, B; Wright, D; Wurtz, R

    2004-01-01

    This project explores the scientific foundation and approach for improving passive detection systems for plutonium and highly enriched uranium in real applications. Sources of gamma-ray radiation of interest were chosen to represent a range of national security threats, naturally occurring radioactive materials, industrial and medical radiation sources, and natural background radiation. The gamma-ray flux emerging from these sources, which include unclassified criticality experiment configurations as surrogates for nuclear weapons, were modeled in detail. The performance of several types of gamma-ray imaging systems using Compton scattering were modeled and compared. A mechanism was created to model the combine sources and background emissions and have the simulated radiation ''scene'' impinge on a model of a detector. These modeling tools are now being used in various projects to optimize detector performance and model detector sensitivity in complex measuring environments. This study also developed several automated algorithms for isotope identification from gamma-ray spectra and compared these to each other and to algorithms already in use. Verification testing indicates that these alternative isotope identification algorithms produced less false positive and false negative results than the ''GADRAS'' algorithms currently in use. In addition to these algorithms that used binned spectra, a new approach to isotope identification using ''event mode'' analysis was developed. Finally, a technique using muons to detect nuclear material was explored

  4. Yakima Habitat Improvement Project Master Plan, Technical Report 2003.

    Energy Technology Data Exchange (ETDEWEB)

    Golder Associates, Inc.

    2003-04-22

    The Yakima Urban Growth Area (UGA) is a developing and growing urban area in south-central Washington. Despite increased development, the Yakima River and its tributaries within the UGA continue to support threatened populations of summer steelhead and bull trout as well as a variety of non-listed salmonid species. In order to provide for the maintenance and recovery of these species, while successfully planning for the continued growth and development within the UGA, the City of Yakima has undertaken the Yakima Habitat Improvement Project. The overall goal of the project is to maintain, preserve, and restore functioning fish and wildlife habitat within and immediately surrounding the Yakima UGA over the long term. Acquisition and protection of the fish and wildlife habitat associated with key properties in the UGA will prevent future subdivision along riparian corridors, reduce further degradation or removal of riparian habitat, and maintain or enhance the long term condition of aquatic habitat. By placing these properties in long-term protection, the threat of development from continued growth in the urban area will be removed. To most effectively implement the multi-year habitat acquisition and protection effort, the City has developed this Master Plan. The Master Plan provides the structure and guidance for future habitat acquisition and restoration activities to be performed within the Yakima Urban Area. The development of this Master Plan also supports several Reasonable and Prudent Alternatives (RPAs) of the NOAA Fisheries 2000 Biological Opinion (BiOp), as well as the Water Investment Action Agenda for the Yakima Basin, local planning efforts, and the Columbia Basin Fish and Wildlife Authority's 2000 Fish and Wildlife Program. This Master Plan also provides the framework for coordination of the Yakima Habitat Improvement Project with other fish and wildlife habitat acquisition and protection activities currently being implemented in the area. As a

  5. Global hydrobelts: improved reporting scale for water-related issues?

    Science.gov (United States)

    Meybeck, M.; Kummu, M.; Dürr, H. H.

    2012-08-01

    Questions related to water such as its availability, water needs or stress, or management, are mapped at various resolutions at the global scale. They are reported at many scales, mostly along political or continental boundaries. As such, they ignore the fundamental heterogeneity of the hydroclimate and the natural boundaries of the river basins. Here, we describe the continental landmasses according to eight global-scale hydrobelts strictly limited by river basins, defined at a 30' (0.5°) resolution. The belts were defined and delineated, based primarily on the annual average temperature (T) and runoff (q), to maximise interbelt differences and minimise intrabelt variability. The belts were further divided into 29 hydroregions based on continental limits. This new global puzzle defines homogeneous and near-contiguous entities with similar hydrological and thermal regimes, glacial and postglacial basin histories, endorheism distribution and sensitivity to climate variations. The Mid-Latitude, Dry and Subtropical belts have northern and southern analogues and a general symmetry can be observed for T and q between them. The Boreal and Equatorial belts are unique. The hydroregions (median size 4.7 Mkm2) contrast strongly, with the average q ranging between 6 and 1393 mm yr-1 and the average T between -9.7 and +26.3 °C. Unlike the hydroclimate, the population density between the North and South belts and between the continents varies greatly, resulting in pronounced differences between the belts with analogues in both hemispheres. The population density ranges from 0.7 to 0.8 p km-2 for the North American Boreal and some Australian hydroregions to 280 p km-2 for the Asian part of the Northern Mid-Latitude belt. The combination of population densities and hydroclimate features results in very specific expressions of water-related characteristics in each of the 29 hydroregions. Our initial tests suggest that hydrobelt and hydroregion divisions are often more

  6. How do regulators measure public confidence?

    International Nuclear Information System (INIS)

    Schmitt, A.; Besenyei, E.

    2006-01-01

    The conclusions and recommendations of this session can be summarized this way. - There are some important elements of confidence: visibility, satisfaction, credibility and reputation. The latter can consist of trust, positive image and knowledge of the role the organisation plays. A good reputation is hard to achieve but easy to lose. - There is a need to define what public confidence is and what to measure. The difficulty is that confidence is a matter of perception of the public, so what we try to measure is the perception. - It is controversial how to take into account the results of confidence measurement because of the influence of the context. It is not an exact science, results should be examined cautiously and surveys should be conducted frequently, at least every two years. - Different experiences were explained: - Quantitative surveys - among the general public or more specific groups like the media; - Qualitative research - with test groups and small panels; - Semi-quantitative studies - among stakeholders who have regular contracts with the regulatory body. It is not clear if the results should be shared with the public or just with other authorities and governmental organisations. - Efforts are needed to increase visibility, which is a prerequisite for confidence. - A practical example of organizing an emergency exercise and an information campaign without taking into account the real concerns of the people was given to show how public confidence can be decreased. - We learned about a new method - the so-called socio-drama - which addresses another issue also connected to confidence - the notion of understanding between stakeholders around a nuclear site. It is another way of looking at confidence in a more restricted group. (authors)

  7. Nutrition Report Cards: an opportunity to improve school lunch selection.

    Directory of Open Access Journals (Sweden)

    Brian Wansink

    Full Text Available OBJECTIVE: To explore the feasibility and implementation efficiency of Nutritional Report Cards (NRCs in helping children make healthier food choices at school. METHODS: Pilot testing was conducted in a rural New York school district (K-12. Over a five-week period, 27 parents received a weekly e-mail containing a NRC listing how many meal components (fruits, vegetables, starches, milk, snacks, and a-la-carte foods their child selected. We analyzed choices of students in the NRC group vs. the control group, both prior to and during the intervention period. Point-of-sale system data for a-la-carte items was analyzed using Generalized Least Squares regressions with clustered standard errors. RESULTS: NRCs encouraged more home conversations about nutrition and more awareness of food selections. Despite the small sample, the NRC was associated with reduced selection of some items, such as the percentage of those selecting cookies which decreased from 14.3 to 6.5 percent. Additionally, despite requiring new keys on the check-out registers to generate the NRC, checkout times increased by only 0.16 seconds per transaction, and compiling and sending the NRCs required a total weekly investment of 30 minutes of staff time. CONCLUSIONS: This test of concept suggests that NRCs are a feasible and inexpensive tool to guide children towards healthier choices.

  8. [Sources of leader's confidence in organizations].

    Science.gov (United States)

    Ikeda, Hiroshi; Furukawa, Hisataka

    2006-04-01

    The purpose of this study was to examine the sources of confidence that organization leaders had. As potential sources of the confidence, we focused on fulfillment of expectations made by self and others, reflection on good as well as bad job experiences, and awareness of job experiences in terms of commonality, differentiation, and multiple viewpoints. A questionnaire was administered to 170 managers of Japanese companies. Results were as follows: First, confidence in leaders was more strongly related to fulfillment of expectations made by self and others than reflection on and awareness of job experiences. Second, the confidence was weakly related to internal processing of job experiences, in the form of commonality awareness and reflection on good job experiences. And finally, years of managerial experiences had almost no relation to the confidence. These findings suggested that confidence in leaders was directly acquired from fulfillment of expectations made by self and others, rather than indirectly through internal processing of job experiences. Implications of the findings for leadership training were also discussed.

  9. Quantify and improve PEM fuel cell durability. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Grahl-Madsen, L.; Odgaard, M.; Munksgaard Nielsen, R. (IRD Fuel Cell A/S, Svendborg (Denmark)); Li, Q.; Jensen, Jens Oluf (Technical Univ. of Denmark, Dept. of Chemistry, Kgs. Lyngby (Denmark)); Andersen, Shuang Ma; Speder, J.; Skou, E. (Syddansk Univ. (SDU), Odense (Denmark))

    2010-07-01

    The aim of the present project is to systematically quantify and improve the durability of the PEM FC including the following three PEM FC variants: LT PEM FC, DMFC, and HT PEM FC. Different factors influencing dissolution properties of noble metal catalyst platinum and platinum-ruthenium alloy has been studied. The dissolution was found to increase by increasing the CV cycle upper potential limit, number of potential cycles, solution acidity, oxygen partial pressure, involvement of chloride, and temperature. Ruthenium was found to deteriorate ten (10) times faster than platinum catalyst; and carbon supported catalyst (Pt: 20%, Ru: up to 100%) deteriorate ten (10) times faster than non-supported catalyst (Pt: 2%, Ru: 30%) at the same condition. Loss of sulphonic acid groups and fluoride from perfluorinated sulfonic acid membrane was confirmed by different techniques, which locally leads to loss of acidity, and consequently enhances dissolution of noble metal catalyst. Degradation of Nafion ionomer in the electrode was enhanced by noble metal catalyst and the thermal decomposition properties has synergetic effect with carbon degradation. Hydrophobicity of GDL and electrode on GDL were found to degrade e.g. radical attack, oxidation, and physical wear out. The very top micro surface structure turned out to be responsible for wetting property after chemical ageing. Optimal catalyst and ionomer ratio is also reflected in contact angle value, which can be understood in terms of catalyst/carbon - ionomer affinity and layered structure. Long-term tested and 'virgin' LT PEM MEAs have been characterised with respect to SEM, TEM, EDS, and XRD. Both failed and well-functioning MEAs have been characterised. The Post Mortem analysis has shown and quantified degradation mechanisms like catalyst growth and carbon corrosion. Furthermore, the effect of fuel starvation was shown by pronounced Ru-catalyst band within the membrane. The catalyst coarsening observed after

  10. Using Strategy Instruction and Confidence Judgments to Improve Metacognitive Monitoring

    Science.gov (United States)

    Huff, Jessica D.; Nietfeld, John L.

    2009-01-01

    Current models of self-regulated learning emphasize the pervasive need for metacognitive monitoring skills at all phases of the learning process (Winne and Hadwin in "Studying as self-regulated learning." In D. J. Hacker, J. Dunlosky, & A. C. Graesser (Eds.), "Metacognition in educational theory and practice" (pp. 227-304). Mahwah, NJ: Erlbaum,…

  11. A National Radiation Oncology Medical Student Clerkship Survey: Didactic Curricular Components Increase Confidence in Clinical Competency

    Energy Technology Data Exchange (ETDEWEB)

    Jagadeesan, Vikrant S. [Department of Radiation and Cellular Oncology, Pritzker School of Medicine, University of Chicago, Chicago, Illinois (United States); Raleigh, David R. [Department of Radiation Oncology, School of Medicine, University of California–San Francisco, San Francisco, California (United States); Koshy, Matthew; Howard, Andrew R.; Chmura, Steven J. [Department of Radiation and Cellular Oncology, Pritzker School of Medicine, University of Chicago, Chicago, Illinois (United States); Golden, Daniel W., E-mail: dgolden@radonc.uchicago.edu [Department of Radiation and Cellular Oncology, Pritzker School of Medicine, University of Chicago, Chicago, Illinois (United States)

    2014-01-01

    Purpose: Students applying to radiation oncology residency programs complete 1 or more radiation oncology clerkships. This study assesses student experiences and perspectives during radiation oncology clerkships. The impact of didactic components and number of clerkship experiences in relation to confidence in clinical competency and preparation to function as a first-year radiation oncology resident are evaluated. Methods and Materials: An anonymous, Internet-based survey was sent via direct e-mail to all applicants to a single radiation oncology residency program during the 2012-2013 academic year. The survey was composed of 3 main sections including questions regarding baseline demographic information and prior radiation oncology experience, rotation experiences, and ideal clerkship curriculum content. Results: The survey response rate was 37% (70 of 188). Respondents reported 191 unique clerkship experiences. Of the respondents, 27% (19 of 70) completed at least 1 clerkship with a didactic component geared towards their level of training. Completing a clerkship with a didactic component was significantly associated with a respondent's confidence to function as a first-year radiation oncology resident (Wilcoxon rank–sum P=.03). However, the total number of clerkships completed did not correlate with confidence to pursue radiation oncology as a specialty (Spearman ρ P=.48) or confidence to function as a first year resident (Spearman ρ P=.43). Conclusions: Based on responses to this survey, rotating students perceive that the majority of radiation oncology clerkships do not have formal didactic curricula. Survey respondents who completed a clerkship with a didactic curriculum reported feeling more prepared to function as a radiation oncology resident. However, completing an increasing number of clerkships does not appear to improve confidence in the decision to pursue radiation oncology as a career or to function as a radiation oncology resident. These

  12. A national radiation oncology medical student clerkship survey: didactic curricular components increase confidence in clinical competency.

    Science.gov (United States)

    Jagadeesan, Vikrant S; Raleigh, David R; Koshy, Matthew; Howard, Andrew R; Chmura, Steven J; Golden, Daniel W

    2014-01-01

    Students applying to radiation oncology residency programs complete 1 or more radiation oncology clerkships. This study assesses student experiences and perspectives during radiation oncology clerkships. The impact of didactic components and number of clerkship experiences in relation to confidence in clinical competency and preparation to function as a first-year radiation oncology resident are evaluated. An anonymous, Internet-based survey was sent via direct e-mail to all applicants to a single radiation oncology residency program during the 2012-2013 academic year. The survey was composed of 3 main sections including questions regarding baseline demographic information and prior radiation oncology experience, rotation experiences, and ideal clerkship curriculum content. The survey response rate was 37% (70 of 188). Respondents reported 191 unique clerkship experiences. Of the respondents, 27% (19 of 70) completed at least 1 clerkship with a didactic component geared towards their level of training. Completing a clerkship with a didactic component was significantly associated with a respondent's confidence to function as a first-year radiation oncology resident (Wilcoxon rank-sum P=.03). However, the total number of clerkships completed did not correlate with confidence to pursue radiation oncology as a specialty (Spearman ρ P=.48) or confidence to function as a first year resident (Spearman ρ P=.43). Based on responses to this survey, rotating students perceive that the majority of radiation oncology clerkships do not have formal didactic curricula. Survey respondents who completed a clerkship with a didactic curriculum reported feeling more prepared to function as a radiation oncology resident. However, completing an increasing number of clerkships does not appear to improve confidence in the decision to pursue radiation oncology as a career or to function as a radiation oncology resident. These results support further development of structured didactic

  13. A National Radiation Oncology Medical Student Clerkship Survey: Didactic Curricular Components Increase Confidence in Clinical Competency

    International Nuclear Information System (INIS)

    Jagadeesan, Vikrant S.; Raleigh, David R.; Koshy, Matthew; Howard, Andrew R.; Chmura, Steven J.; Golden, Daniel W.

    2014-01-01

    Purpose: Students applying to radiation oncology residency programs complete 1 or more radiation oncology clerkships. This study assesses student experiences and perspectives during radiation oncology clerkships. The impact of didactic components and number of clerkship experiences in relation to confidence in clinical competency and preparation to function as a first-year radiation oncology resident are evaluated. Methods and Materials: An anonymous, Internet-based survey was sent via direct e-mail to all applicants to a single radiation oncology residency program during the 2012-2013 academic year. The survey was composed of 3 main sections including questions regarding baseline demographic information and prior radiation oncology experience, rotation experiences, and ideal clerkship curriculum content. Results: The survey response rate was 37% (70 of 188). Respondents reported 191 unique clerkship experiences. Of the respondents, 27% (19 of 70) completed at least 1 clerkship with a didactic component geared towards their level of training. Completing a clerkship with a didactic component was significantly associated with a respondent's confidence to function as a first-year radiation oncology resident (Wilcoxon rank–sum P=.03). However, the total number of clerkships completed did not correlate with confidence to pursue radiation oncology as a specialty (Spearman ρ P=.48) or confidence to function as a first year resident (Spearman ρ P=.43). Conclusions: Based on responses to this survey, rotating students perceive that the majority of radiation oncology clerkships do not have formal didactic curricula. Survey respondents who completed a clerkship with a didactic curriculum reported feeling more prepared to function as a radiation oncology resident. However, completing an increasing number of clerkships does not appear to improve confidence in the decision to pursue radiation oncology as a career or to function as a radiation oncology resident. These results

  14. Market Confidence Predicts Stock Price: Beyond Supply and Demand.

    Science.gov (United States)

    Sun, Xiao-Qian; Shen, Hua-Wei; Cheng, Xue-Qi; Zhang, Yuqing

    2016-01-01

    Stock price prediction is an important and challenging problem in stock market analysis. Existing prediction methods either exploit autocorrelation of stock price and its correlation with the supply and demand of stock, or explore predictive indictors exogenous to stock market. In this paper, using transaction record of stocks with identifier of traders, we introduce an index to characterize market confidence, i.e., the ratio of the number of traders who is active in two successive trading days to the number of active traders in a certain trading day. Strong Granger causality is found between the index of market confidence and stock price. We further predict stock price by incorporating the index of market confidence into a neural network based on time series of stock price. Experimental results on 50 stocks in two Chinese Stock Exchanges demonstrate that the accuracy of stock price prediction is significantly improved by the inclusion of the market confidence index. This study sheds light on using cross-day trading behavior to characterize market confidence and to predict stock price.

  15. Market Confidence Predicts Stock Price: Beyond Supply and Demand.

    Directory of Open Access Journals (Sweden)

    Xiao-Qian Sun

    Full Text Available Stock price prediction is an important and challenging problem in stock market analysis. Existing prediction methods either exploit autocorrelation of stock price and its correlation with the supply and demand of stock, or explore predictive indictors exogenous to stock market. In this paper, using transaction record of stocks with identifier of traders, we introduce an index to characterize market confidence, i.e., the ratio of the number of traders who is active in two successive trading days to the number of active traders in a certain trading day. Strong Granger causality is found between the index of market confidence and stock price. We further predict stock price by incorporating the index of market confidence into a neural network based on time series of stock price. Experimental results on 50 stocks in two Chinese Stock Exchanges demonstrate that the accuracy of stock price prediction is significantly improved by the inclusion of the market confidence index. This study sheds light on using cross-day trading behavior to characterize market confidence and to predict stock price.

  16. Nurses' training and confidence on deep venous catheterization.

    Science.gov (United States)

    Liachopoulou, A P; Synodinou-Kamilou, E E; Deligiannidi, P G; Giannakopoulou, M; Birbas, K N

    2008-01-01

    The rough estimation of the education and the self-confidence of nurses, both students and professionals, regarding deep venous catheterization in adult patients, the evaluation of the change in self-confidence of one team of students who were trained with a simulator on deep venous catheterization and the correlation of their self-confidence with their performance recorded by the simulator. Seventy-six nurses and one hundred twenty-four undergraduate students participated in the study. Fourty-four University students took part in a two-day educational seminar and were trained on subclavian and femoral vein paracentesis with a simulator and an anatomical model. Three questionnaires were filled in by the participants: one from nurses, one from students of Technological institutions, while the University students filled in the previous questionnaire before their attendance of the seminar, and another questionnaire after having attended it. Impressive results in improving the participants' self-confidence were recorded. However, the weak correlation of their self-confidence with the score automatically provided by the simulator after each user's training obligates us to be particularly cautious about the ability of the users to repeat the action successfully in a clinical environment. Educational courses and simulators are useful educational tools that are likely to shorten but in no case can efface the early phase of the learning curve in clinical setting, substituting the clinical training of inexperienced users.

  17. Power, effects, confidence, and significance: an investigation of statistical practices in nursing research.

    Science.gov (United States)

    Gaskin, Cadeyrn J; Happell, Brenda

    2014-05-01

    improvement. Most importantly, researchers should abandon the misleading practice of interpreting the results from inferential tests based solely on whether they are statistically significant (or not) and, instead, focus on reporting and interpreting effect sizes, confidence intervals, and significance levels. Nursing researchers also need to conduct and report a priori power analyses, and to address the issue of Type I experiment-wise error inflation in their studies. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  18. Supporting Aboriginal Women to Quit Smoking: Antenatal and Postnatal Care Providers' Confidence, Attitudes, and Practices.

    Science.gov (United States)

    Tzelepis, Flora; Daly, Justine; Dowe, Sarah; Bourke, Alex; Gillham, Karen; Freund, Megan

    2017-05-01

    Tobacco use during pregnancy is substantially higher among Aboriginal women compared to non-Aboriginal women in Australia. However, no studies have investigated the amount or type of smoking cessation care that staff from Aboriginal antenatal and postnatal services provide to clients who smoke or staff confidence to do so. This study examined Aboriginal antenatal and postnatal staff confidence, perceived role and delivery of smoking cessation care to Aboriginal women and characteristics associated with provision of such care. Staff from 11 Aboriginal Maternal and Infant Health Services and eight Aboriginal Child and Family Health services in the Hunter New England Local Health District in Australia completed a cross-sectional self-reported survey (n = 67, response rate = 97.1%). Most staff reported they assessed clients' smoking status most or all of the time (92.2%). However, only a minority reported they offered a quitline referral (42.2%), provided follow-up support (28.6%) or provided nicotine replacement therapy (4.7%) to most or all clients who smoked. Few staff felt confident in motivating clients to quit smoking (19.7%) and advising clients about using nicotine replacement therapy (15.6%). Staff confident with talking to clients about how smoking affected their health had significantly higher odds of offering a quitline referral [OR = 4.9 (1.7-14.5)] and quitting assistance [OR = 3.9 (1.3-11.6)] to clients who smoke. Antenatal and postnatal staff delivery of smoking cessation care to pregnant Aboriginal women or mothers with young Aboriginal children could be improved. Programs that support Aboriginal antenatal and postnatal providers to deliver smoking cessation care to clients are needed. Aboriginal antenatal and postnatal service staff have multiple opportunities to assist Aboriginal women to quit smoking during pregnancy and postpartum. However, staff confidence and practices of offering various forms of smoking cessation support to pregnant Aboriginal

  19. Confidence-building and Canadian leadership

    Energy Technology Data Exchange (ETDEWEB)

    Cleminson, F.R. [Dept. of Foreign Affairs and International Trade, Verification, Non-Proliferation, Arms Control and Disarmament Div (IDA), Ottawa, Ontario (Canada)

    1998-07-01

    Confidence-building has come into its own as a 'tool of choice' in facilitating the non-proliferation, arms control and disarmament (NACD) agenda, whether regional or global. From the Middle East Peace Process (MEPP) to the ASEAN Intersessional Group on Confidence-Building (ARF ISG on CBMS), confidence-building has assumed a central profile in regional terms. In the Four Power Talks begun in Geneva on December 9, 1997, the United States identified confidence-building as one of two subject areas for initial discussion as part of a structured peace process between North and South Korea. Thus, with CBMs assuming such a high profile internationally, it seems prudent for Canadians to pause and take stock of the significant role which Canada has already played in the conceptual development of the process over the last two decades. Since the Helsinki accords of 1975, Canada has developed a significant expertise in this area through an unbroken series of original, basic research projects. These have contributed to defining the process internationally from concept to implementation. Today, these studies represent a solid and unique Departmental investment in basic research from which to draw in meeting Canada's current commitments to multilateral initiatives in the area of confidence-building and to provide a 'step up' in terms of future-oriented leadership. (author)

  20. Confidence Leak in Perceptual Decision Making.

    Science.gov (United States)

    Rahnev, Dobromir; Koizumi, Ai; McCurdy, Li Yan; D'Esposito, Mark; Lau, Hakwan

    2015-11-01

    People live in a continuous environment in which the visual scene changes on a slow timescale. It has been shown that to exploit such environmental stability, the brain creates a continuity field in which objects seen seconds ago influence the perception of current objects. What is unknown is whether a similar mechanism exists at the level of metacognitive representations. In three experiments, we demonstrated a robust intertask confidence leak-that is, confidence in one's response on a given task or trial influencing confidence on the following task or trial. This confidence leak could not be explained by response priming or attentional fluctuations. Better ability to modulate confidence leak predicted higher capacity for metacognition as well as greater gray matter volume in the prefrontal cortex. A model based on normative principles from Bayesian inference explained the results by postulating that observers subjectively estimate the perceptual signal strength in a stable environment. These results point to the existence of a novel metacognitive mechanism mediated by regions in the prefrontal cortex. © The Author(s) 2015.

  1. ADAM SMITH: THE INVISIBLE HAND OR CONFIDENCE

    Directory of Open Access Journals (Sweden)

    Fernando Luis, Gache

    2010-01-01

    Full Text Available In 1776 Adam Smith raised the matter that an invisible hand was the one which moved the markets to obtain its efficiency. Despite in the present paper we are going to raise the hypothesis, that this invisible hand is in fact the confidence that each person feels when he is going to do business. That in addition it is unique, because it is different from the confidence of the others and that is a variable nonlinear that essentially is ligatured to respective personal histories. For that we are going to take as its bases the paper by Leopoldo Abadía (2009, with respect to the financial economy crisis that happened in 2007-2008, to evidence the form in which confidence operates. Therefore the contribution that we hope to do with this paper is to emphasize that, the level of confidence of the different actors, is the one which really moves the markets, (therefore the economy and that the crisis of the subprime mortgages is a confidence crisis at world-wide level.

  2. Confidence-building and Canadian leadership

    International Nuclear Information System (INIS)

    Cleminson, F.R.

    1998-01-01

    Confidence-building has come into its own as a 'tool of choice' in facilitating the non-proliferation, arms control and disarmament (NACD) agenda, whether regional or global. From the Middle East Peace Process (MEPP) to the ASEAN Intersessional Group on Confidence-Building (ARF ISG on CBMS), confidence-building has assumed a central profile in regional terms. In the Four Power Talks begun in Geneva on December 9, 1997, the United States identified confidence-building as one of two subject areas for initial discussion as part of a structured peace process between North and South Korea. Thus, with CBMs assuming such a high profile internationally, it seems prudent for Canadians to pause and take stock of the significant role which Canada has already played in the conceptual development of the process over the last two decades. Since the Helsinki accords of 1975, Canada has developed a significant expertise in this area through an unbroken series of original, basic research projects. These have contributed to defining the process internationally from concept to implementation. Today, these studies represent a solid and unique Departmental investment in basic research from which to draw in meeting Canada's current commitments to multilateral initiatives in the area of confidence-building and to provide a 'step up' in terms of future-oriented leadership. (author)

  3. Innovation in diabetes care: improving consumption of healthy food through a "chef coaching" program: a case report.

    Science.gov (United States)

    Polak, Rani; Dill, Diana; Abrahamson, Martin J; Pojednic, Rachele M; Phillips, Edward M

    2014-11-01

    Nutrition therapy as part of lifestyle care is recommended for people with type 2 diabetes. However, most people with diabetes do not follow this guideline. Changing eating habits involves obtaining knowledge and building practical skills such as shopping, meal preparation, and food storage. Just as fitness coaches use their specific knowledge base in fitness to enhance the effectiveness of their coaching, credentialed chefs trained as health coaches might combine their culinary expertise with coaching in order to improve clients' food choices and lifestyles. This report documents the case of a 55-year-old white male physician, single and living alone, who was recently diagnosed with type 2 diabetes and reported chronic stress, sedentary behavior, and unhealthy eating habits. He participated in a chef coaching program of 8 weekly one-on-one 30-minute coaching sessions via Skype delivered by a chef trained as a health coach. During the first five meetings, the patient's goals were primarily culinary; however, with his success in accomplishing these goals, the patient progressed and expanded his goals to include other lifestyle domains, specifically exercise and work-life balance. At the end of the program, the patient had improved both his nutritional and exercise habits, his confidence in further self-care improvement, and his health parameters such as HgA1c (8.8% to 6.7%; normal implement them so that they eat better and, further, has the potential to help them improve their overall self-care. We intend to further develop chef coaching and assess its potential as we learn from its implementation.

  4. Counterfeit Parts: DOD Needs to Improve Reporting and Oversight to Reduce Supply Chain Risk

    Science.gov (United States)

    2016-02-01

    agencies and contractors we met with stated that they have encountered counterfeit parts less frequently in the DOD supply chain , in part, because...the DOD supply chain as a method to prevent further counterfeiting.22 DOD and industry officials noted that timely reporting of...COUNTERFEIT PARTS DOD Needs to Improve Reporting and Oversight to Reduce Supply Chain Risk Report to Congressional Committees

  5. Self-confidence of anglers in identification of freshwater sport fish

    Science.gov (United States)

    Chizinski, C.J.; Martin, D. R.; Pope, Kevin L.

    2014-01-01

    Although several studies have focused on how well anglers identify species using replicas and pictures, there has been no study assessing the confidence that can be placed in angler's ability to identify recreationally important fish. Understanding factors associated with low self-confidence will be useful in tailoring education programmes to improve self-confidence in identifying common species. The purposes of this assessment were to quantify the confidence of recreational anglers to identify 13 commonly encountered warm water fish species and to relate self-confidence to species availability and angler experience. Significant variation was observed in anglers self-confidence among species and levels of self-declared skill, with greater confidence associated with greater skill and with greater exposure. This study of angler self-confidence strongly highlights the need for educational programmes that target lower skilled anglers and the importance of teaching all anglers about less common species, regardless of skill level.

  6. High confidence in falsely recognizing prototypical faces.

    Science.gov (United States)

    Sampaio, Cristina; Reinke, Victoria; Mathews, Jeffrey; Swart, Alexandra; Wallinger, Stephen

    2018-06-01

    We applied a metacognitive approach to investigate confidence in recognition of prototypical faces. Participants were presented with sets of faces constructed digitally as deviations from prototype/base faces. Participants were then tested with a simple recognition task (Experiment 1) or a multiple-choice task (Experiment 2) for old and new items plus new prototypes, and they showed a high rate of confident false alarms to the prototypes. Confidence and accuracy relationship in this face recognition paradigm was found to be positive for standard items but negative for the prototypes; thus, it was contingent on the nature of the items used. The data have implications for lineups that employ match-to-suspect strategies.

  7. A systematic review of maternal confidence for physiologic birth: characteristics of prenatal care and confidence measurement.

    Science.gov (United States)

    Avery, Melissa D; Saftner, Melissa A; Larson, Bridget; Weinfurter, Elizabeth V

    2014-01-01

    Because a focus on physiologic labor and birth has reemerged in recent years, care providers have the opportunity in the prenatal period to help women increase confidence in their ability to give birth without unnecessary interventions. However, most research has only examined support for women during labor. The purpose of this systematic review was to examine the research literature for information about prenatal care approaches that increase women's confidence for physiologic labor and birth and tools to measure that confidence. Studies were reviewed that explored any element of a pregnant woman's interaction with her prenatal care provider that helped build confidence in her ability to labor and give birth. Timing of interaction with pregnant women included during pregnancy, labor and birth, and the postpartum period. In addition, we looked for studies that developed a measure of women's confidence related to labor and birth. Outcome measures included confidence or similar concepts, descriptions of components of prenatal care contributing to maternal confidence for birth, and reliability and validity of tools measuring confidence. The search of MEDLINE, CINAHL, PsycINFO, and Scopus databases provided a total of 893 citations. After removing duplicates and articles that did not meet inclusion criteria, 6 articles were included in the review. Three relate to women's confidence for labor during the prenatal period, and 3 describe tools to measure women's confidence for birth. Research about enhancing women's confidence for labor and birth was limited to qualitative studies. Results suggest that women desire information during pregnancy and want to use that information to participate in care decisions in a relationship with a trusted provider. Further research is needed to develop interventions to help midwives and physicians enhance women's confidence in their ability to give birth and to develop a tool to measure confidence for use during prenatal care. © 2014 by

  8. Impact of an Advanced Cardiac Life Support Simulation Laboratory Experience on Pharmacy Student Confidence and Knowledge.

    Science.gov (United States)

    Maxwell, Whitney D; Mohorn, Phillip L; Haney, Jason S; Phillips, Cynthia M; Lu, Z Kevin; Clark, Kimberly; Corboy, Alex; Ragucci, Kelly R

    2016-10-25

    Objective. To assess the impact of an advanced cardiac life support (ACLS) simulation on pharmacy student confidence and knowledge. Design. Third-year pharmacy students participated in a simulation experience that consisted of team roles training, high-fidelity ACLS simulations, and debriefing. Students completed a pre/postsimulation confidence and knowledge assessment. Assessment. Overall, student knowledge assessment scores and student confidence scores improved significantly. Student confidence and knowledge changes from baseline were not significantly correlated. Conversely, a significant, weak positive correlation between presimulation studying and both presimulation confidence and presimulation knowledge was discovered. Conclusions. Overall, student confidence and knowledge assessment scores in ACLS significantly improved from baseline; however, student confidence and knowledge were not significantly correlated.

  9. Confidence building - is science the only approach

    International Nuclear Information System (INIS)

    Bragg, K.

    1990-01-01

    The Atomic Energy Control Board (AECB) has begun to develop some simplified methods to determine if it is possible to provide confidence that dose, risk and environmental criteria can be respected without undue reliance on detailed scientific models. The progress to date will be outlined and the merits of this new approach will be compared to the more complex, traditional approach. Stress will be given to generating confidence in both technical and non-technical communities as well as the need to enhance communication between them. 3 refs., 1 tab

  10. Self Confidence Spillovers and Motivated Beliefs

    DEFF Research Database (Denmark)

    Banerjee, Ritwik; Gupta, Nabanita Datta; Villeval, Marie Claire

    that success when competing in a task increases the performers’ self-confidence and competitiveness in the subsequent task. We also find that such spillovers affect the self-confidence of low-status individuals more than that of high-status individuals. Receiving good news under Affirmative Action, however......Is success in a task used strategically by individuals to motivate their beliefs prior to taking action in a subsequent, unrelated, task? Also, is the distortion of beliefs reinforced for individuals who have lower status in society? Conducting an artefactual field experiment in India, we show...

  11. Registered nurse leadership style and confidence in delegation.

    Science.gov (United States)

    Saccomano, Scott J; Pinto-Zipp, Genevieve

    2011-05-01

      Leadership and confidence in delegation are two important explanatory constructs of nursing practice. The relationship between these constructs, however, is not clearly understood. To be successful in their roles as leaders, regardless of their experience, registered nurses (RNs) need to understand how to best delegate. The present study explored and described the relationship between RN leadership styles, demographic variables and confidence in delegation in a community teaching hospital. Utilizing a cross-sectional survey design, RNs employed in one acute care hospital completed questionnaires that measured leadership style [Path-Goal Leadership Questionnaire (PGLQ)] and confidence in delegating patient care tasks [Confidence and Intent to Delegate Scale (CIDS)]. Contrary to expectations, the data did not confirm a relationship between confidence in delegating tasks to unlicensed assistive personnel (UAPs) and leadership style. Nurses who were diploma or associate degree prepared were initially less confident in delegating tasks to UAPs as compared with RNs holding a bachelor's degree or higher. Further, after 5 years of clinical nursing experience, nurses with less educational experience reported more confidence in delegating tasks as compared with RNs with more educational experience. The lack of a relationship between leadership style and confidence in delegating patient care tasks were discussed in terms of the PGLQ classification criteria and hospital unit differences. As suggested by the significant two-way interaction between educational preparation and clinical nursing experience, changes in the nurse's confidence in delegating patient care tasks to UAPs was a dynamic changing variable that resulted from the interplay between amount of educational preparation and years of clinical nursing experience in this population of nurses. Clearly, generalizability of these findings to nurses outside the US is questionable, thus nurse managers must be familiar

  12. Determining the confidence levels of sensor outputs using neural networks

    International Nuclear Information System (INIS)

    Broten, G.S.; Wood, H.C.

    1995-01-01

    This paper describes an approach for determining the confidence level of a sensor output using multi-sensor arrays, sensor fusion and artificial neural networks. The authors have shown in previous work that sensor fusion and artificial neural networks can be used to learn the relationships between the outputs of an array of simulated partially selective sensors and the individual analyte concentrations in a mixture of analyses. Other researchers have shown that an array of partially selective sensors can be used to determine the individual gas concentrations in a gaseous mixture. The research reported in this paper shows that it is possible to extract confidence level information from an array of partially selective sensors using artificial neural networks. The confidence level of a sensor output is defined as a numeric value, ranging from 0% to 100%, that indicates the confidence associated with a output of a given sensor. A three layer back-propagation neural network was trained on a subset of the sensor confidence level space, and was tested for its ability to generalize, where the confidence level space is defined as all possible deviations from the correct sensor output. A learning rate of 0.1 was used and no momentum terms were used in the neural network. This research has shown that an artificial neural network can accurately estimate the confidence level of individual sensors in an array of partially selective sensors. This research has also shown that the neural network's ability to determine the confidence level is influenced by the complexity of the sensor's response and that the neural network is able to estimate the confidence levels even if more than one sensor is in error. The fundamentals behind this research could be applied to other configurations besides arrays of partially selective sensors, such as an array of sensors separated spatially. An example of such a configuration could be an array of temperature sensors in a tank that is not in

  13. Reporting Guidelines and Checklists Improve the Reliability and Rigor of Research Reports.

    Science.gov (United States)

    Abbott, J Haxby

    2016-03-01

    The Journal of Orthopaedic & Sports Physical Therapy (JOSPT) requires the use of robust research reporting guidelines for all research report submissions, including the newly adopted RECORD (REporting of studies Conducted using Observational Routinely-collected health Data) statement. We remind authors submitting research to JOSPT to identify the appropriate guideline and checklist for their study design, and to submit a completely and accurately completed checklist with their manuscript. J Orthop Sports Phys Ther 2016;46(3):130. doi:10.2519/jospt.2016.0105.

  14. Effects of pediatric asthma care coordination in underserved communities on parent perceptions of care and asthma-management confidence.

    Science.gov (United States)

    Janevic, Mary R; Baptist, Alan P; Bryant-Stephens, Tyra; Lara, Marielena; Persky, Victoria; Ramos-Valencia, Gilberto; Uyeda, Kimberly; Hazan, Rebecca; Garrity, Ashley; Malveaux, Floyd J

    2017-06-01

    Disparities by race and socioeconomic status persist in pediatric asthma morbidity, mortality, and treatment. Improving parent/provider communication and parents' asthma-management confidence may result in better asthma control in vulnerable populations. The Merck Childhood Asthma Network, Inc. funded an initiative to implement medical-social care coordination to improve asthma outcomes at sites in four low-income, urban communities (Los Angeles, CA; Philadelphia, PA; Chicago, IL; and San Juan, PR.) As part of a cross-site evaluation of this effort, pre- post-program changes in parents' reports of asthma care and management were assessed. Across sites, 805 parents or other caregivers responded to a baseline survey that was repeated one year later following their child's participation in care coordination. Parents' asthma-management confidence, as well as their perceptions of provider access, trust, and communication, were measured with Likert scales. Linear mixed models were used to assess improvement in these variables, across and within sites, adjusting for sociodemographics. Pooled across sites, the adjusted mean estimate for all outcomes showed a significant improvement (p asthma care coordination, as implemented variously in diverse settings, was associated with improvement in parents' perceptions of asthma care and self-reported asthma-management knowledge and confidence. This positive impact on parents may help sustain care coordination's impact on children.

  15. Confident Communication: Speaking Tips for Educators.

    Science.gov (United States)

    Parker, Douglas A.

    This resource book seeks to provide the building blocks needed for public speaking while eliminating the fear factor. The book explains how educators can perfect their oratorical capabilities as well as enjoy the security, confidence, and support needed to create and deliver dynamic speeches. Following an Introduction: A Message for Teachers,…

  16. Principles of psychological confidence of NPP operators

    International Nuclear Information System (INIS)

    Alpeev, A.S.

    1994-01-01

    The problems of operator interaction with subsystems supporting his activity are discussed from the point of view of formation of his psychological confidence on the basis of the automation intellectual means capabilities. The functions of operator activity supporting subsystems, which realization will provide to decrease greatly the portion of accidents at NPPs connected with mistakes in operator actions, are derived. 6 refs

  17. Growing confidence, building skills | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    In 2012 Rashid explored the influence of think tanks on policy in Bangladesh, as well as their relationships with international donors and media. In 2014, he explored two-way student exchanges between Canadian and ... his IDRC experience “gave me the confidence to conduct high quality research in social sciences.”.

  18. Detecting Disease in Radiographs with Intuitive Confidence

    Directory of Open Access Journals (Sweden)

    Stefan Jaeger

    2015-01-01

    Full Text Available This paper argues in favor of a specific type of confidence for use in computer-aided diagnosis and disease classification, namely, sine/cosine values of angles represented by points on the unit circle. The paper shows how this confidence is motivated by Chinese medicine and how sine/cosine values are directly related with the two forces Yin and Yang. The angle for which sine and cosine are equal (45° represents the state of equilibrium between Yin and Yang, which is a state of nonduality that indicates neither normality nor abnormality in terms of disease classification. The paper claims that the proposed confidence is intuitive and can be readily understood by physicians. The paper underpins this thesis with theoretical results in neural signal processing, stating that a sine/cosine relationship between the actual input signal and the perceived (learned input is key to neural learning processes. As a practical example, the paper shows how to use the proposed confidence values to highlight manifestations of tuberculosis in frontal chest X-rays.

  19. Current Developments in Measuring Academic Behavioural Confidence

    Science.gov (United States)

    Sander, Paul

    2009-01-01

    Using published findings and by further analyses of existing data, the structure, validity and utility of the Academic Behavioural Confidence scale (ABC) is critically considered. Validity is primarily assessed through the scale's relationship with other existing scales as well as by looking for predicted differences. The utility of the ABC scale…

  20. Coefficient Omega Bootstrap Confidence Intervals: Nonnormal Distributions

    Science.gov (United States)

    Padilla, Miguel A.; Divers, Jasmin

    2013-01-01

    The performance of the normal theory bootstrap (NTB), the percentile bootstrap (PB), and the bias-corrected and accelerated (BCa) bootstrap confidence intervals (CIs) for coefficient omega was assessed through a Monte Carlo simulation under conditions not previously investigated. Of particular interests were nonnormal Likert-type and binary items.…

  1. Evaluating Measures of Optimism and Sport Confidence

    Science.gov (United States)

    Fogarty, Gerard J.; Perera, Harsha N.; Furst, Andrea J.; Thomas, Patrick R.

    2016-01-01

    The psychometric properties of the Life Orientation Test-Revised (LOT-R), the Sport Confidence Inventory (SCI), and the Carolina SCI (CSCI) were examined in a study involving 260 athletes. The study aimed to test the dimensional structure, convergent and divergent validity, and invariance over competition level of scores generated by these…

  2. Distinguishing highly confident accurate and inaccurate memory: insights about relevant and irrelevant influences on memory confidence.

    Science.gov (United States)

    Chua, Elizabeth F; Hannula, Deborah E; Ranganath, Charan

    2012-01-01

    It is generally believed that accuracy and confidence in one's memory are related, but there are many instances when they diverge. Accordingly it is important to disentangle the factors that contribute to memory accuracy and confidence, especially those factors that contribute to confidence, but not accuracy. We used eye movements to separately measure fluent cue processing, the target recognition experience, and relative evidence assessment on recognition confidence and accuracy. Eye movements were monitored during a face-scene associative recognition task, in which participants first saw a scene cue, followed by a forced-choice recognition test for the associated face, with confidence ratings. Eye movement indices of the target recognition experience were largely indicative of accuracy, and showed a relationship to confidence for accurate decisions. In contrast, eye movements during the scene cue raised the possibility that more fluent cue processing was related to higher confidence for both accurate and inaccurate recognition decisions. In a second experiment we manipulated cue familiarity, and therefore cue fluency. Participants showed higher confidence for cue-target associations for when the cue was more familiar, especially for incorrect responses. These results suggest that over-reliance on cue familiarity and under-reliance on the target recognition experience may lead to erroneous confidence.

  3. The P Value Problem in Otolaryngology: Shifting to Effect Sizes and Confidence Intervals.

    Science.gov (United States)

    Vila, Peter M; Townsend, Melanie Elizabeth; Bhatt, Neel K; Kao, W Katherine; Sinha, Parul; Neely, J Gail

    2017-06-01

    There is a lack of reporting effect sizes and confidence intervals in the current biomedical literature. The objective of this article is to present a discussion of the recent paradigm shift encouraging the use of reporting effect sizes and confidence intervals. Although P values help to inform us about whether an effect exists due to chance, effect sizes inform us about the magnitude of the effect (clinical significance), and confidence intervals inform us about the range of plausible estimates for the general population mean (precision). Reporting effect sizes and confidence intervals is a necessary addition to the biomedical literature, and these concepts are reviewed in this article.

  4. Graphing within-subjects confidence intervals using SPSS and S-Plus.

    Science.gov (United States)

    Wright, Daniel B

    2007-02-01

    Within-subjects confidence intervals are often appropriate to report and to display. Loftus and Masson (1994) have reported methods to calculate these, and their use is becoming common. In the present article, procedures for calculating within-subjects confidence intervals in SPSS and S-Plus are presented (an R version is on the accompanying Web site). The procedure in S-Plus allows the user to report the bias corrected and adjusted bootstrap confidence intervals as well as the standard confidence intervals based on traditional methods. The presented code can be easily altered to fit the individual user's needs.

  5. Using Facebook to enhance commencing student confidence in clinical skill development: A phenomenological hermeneutic study.

    Science.gov (United States)

    Watson, Bernadette; Cooke, Marie; Walker, Rachel

    2016-01-01

    The purpose of this study was to explore commencing nursing students' experience of Facebook as an adjunct to on-campus course delivery to determine its impact as a learning strategy for improving confidence in clinical skill development. Approaches supporting nursing students in the development of clinical skills have relied on 'real-life' clinical placements and simulated on-campus clinical laboratories. However students continue to report a lack of confidence in their clinical skills for practice. Social networking sites including Facebook are being used as a learning strategy to stimulate active and collaborative learning approaches. A hermeneutic phenomenological approach was used to provide an understanding of the experience of confidence in clinical skills development for nursing students. Data were collected through in-depth interviews with commencing students about their experience as learners using Facebook and their perceptions of the impact on their clinical skill development. Ten first-year student nurses at one university in south-east Queensland, Australia. Four themes emerged from the data including: 'We're all in this together'; 'I can do this'; 'This is about my future goals and success'; and, 'Real time is not fast enough!'. These themes provide new meaningful insights demonstrating students' sense of confidence in clinical skills was increased through engagement with a dedicated Facebook page. The findings of this study have relevance to academics in the design of learning strategies for clinical courses to further support student confidence and engagement through peer collaboration and active learning processes. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  6. Building Public Confidence in Nuclear Activities

    International Nuclear Information System (INIS)

    Isaacs, T

    2002-01-01

    Achieving public acceptance has become a central issue in discussions regarding the future of nuclear power and associated nuclear activities. Effective public communication and public participation are often put forward as the key building blocks in garnering public acceptance. A recent international workshop in Finland provided insights into other features that might also be important to building and sustaining public confidence in nuclear activities. The workshop was held in Finland in close cooperation with Finnish stakeholders. This was most appropriate because of the recent successes in achieving positive decisions at the municipal, governmental, and Parliamentary levels, allowing the Finnish high-level radioactive waste repository program to proceed, including the identification and approval of a proposed candidate repository site. Much of the workshop discussion appropriately focused on the roles of public participation and public communications in building public confidence. It was clear that well constructed and implemented programs of public involvement and communication and a sense of fairness were essential in building the extent of public confidence needed to allow the repository program in Finland to proceed. It was also clear that there were a number of other elements beyond public involvement that contributed substantially to the success in Finland to date. And, in fact, it appeared that these other factors were also necessary to achieving the Finnish public acceptance. In other words, successful public participation and communication were necessary but not sufficient. What else was important? Culture, politics, and history vary from country to country, providing differing contexts for establishing and maintaining public confidence. What works in one country will not necessarily be effective in another. Nonetheless, there appear to be certain elements that might be common to programs that are successful in sustaining public confidence and some of

  7. Building Public Confidence in Nuclear Activities

    International Nuclear Information System (INIS)

    Isaacs, T

    2002-01-01

    Achieving public acceptance has become a central issue in discussions regarding the future of nuclear power and associated nuclear activities. Effective public communication and public participation are often put forward as the key building blocks in garnering public acceptance. A recent international workshop in Finland provided insights into other features that might also be important to building and sustaining public confidence in nuclear activities. The workshop was held in Finland in close cooperation with Finnish stakeholders. This was most appropriate because of the recent successes in achieving positive decisions at the municipal, governmental, and Parliamentary levels, allowing the Finnish high-level radioactive waste repository program to proceed, including the identification and approval of a proposed candidate repository site Much of the workshop discussion appropriately focused on the roles of public participation and public communications in building public confidence. It was clear that well constructed and implemented programs of public involvement and communication and a sense of fairness were essential in building the extent of public confidence needed to allow the repository program in Finland to proceed. It was also clear that there were a number of other elements beyond public involvement that contributed substantially to the success in Finland to date. And, in fact, it appeared that these other factors were also necessary to achieving the Finnish public acceptance. In other words, successful public participation and communication were necessary but not sufficient. What else was important? Culture, politics, and history vary from country to country, providing differing contexts for establishing and maintaining public confidence. What works in one country will not necessarily be effective in another. Nonetheless, there appear to be certain elements that might be common to programs that are successful in sustaining public confidence, and some of

  8. Confidence and Use of Communication Skills in Medical Students

    OpenAIRE

    Mahnaz Jalalvandi; Akhtar Jamali; Ali Taghipoor-Zahir; Mohammad-Reza Sohrabi

    2014-01-01

    Background: Well-designed interventions can improve the communication skills of physicians. Since the understanding of the current situation is essential for designing effective interventions, this study was performed to determine medical interns’ confidence and use of communication skills.Materials and Methods: This descriptive-analytical study was performed in spring 2013 within 3 branches of Islamic Azad University (Tehran, Mashhad, and Yazd), on 327 randomly selected interns. Data gatheri...

  9. Natural Propagation and Habitat Improvement, Volume I, Oregon, 1984 Final and Annual Reports.

    Energy Technology Data Exchange (ETDEWEB)

    Miller, Rod

    1986-02-01

    This volume contains reports on habitat improvement and fisheries enhancement projects conducted in the following subbasins: (1) Clackamas River; (2) Hood River; :(3) Deschutes River; (4) John Day River; (5) Umatilla River; and (6) Grande Ronde River. (ACR)

  10. Report: Agency-Wide Application of Region 7 NPDES Program Process Improvements Could Increase EPA Efficiency

    Science.gov (United States)

    Report #11-P-0315, July 6, 2011. Although Region 7 NPDES Kaizen event participants continued to follow up on the commitments and action items identified, no single authority was responsible for tracking the process improvement outcomes.

  11. Report: EPA Needs to Improve Management Practices to Ensure a Successful Customer Technology Solutions Project

    Science.gov (United States)

    Report #10-P-0194, August 23, 2010. Although EPA indicated it could avoid spending more than $115.4 million over 8.5 years by consolidating the desktop computing environment, improved management practices are needed.

  12. Report: Improved Management Practices Needed to Increase Use of Exchange Network

    Science.gov (United States)

    Report #2007-P-00030, August 20, 2007. EPA established a partnership with the Exchange Network’s governance bodies to assist them with accomplishing Network initiatives, more improvements are needed to ensure Network partners fully utilize the Network.

  13. Motivators and barriers to using patient experience reports for performance improvement

    NARCIS (Netherlands)

    Geissler, K.H.; Friedberg, M.W.; SteelFisher, G.K.; Schneider, E.C.

    2013-01-01

    Increasingly, patient experience surveys are available to provide performance feedback to physician groups. However, limited published literature addresses factors influencing use of these reports for performance improvement. To address this gap, we conducted semistructured interviews with leaders

  14. Report: Office of Research and Development Needs to Improve Its Method of Measuring Administrative Savings

    Science.gov (United States)

    Report #11-P-0333, July 14, 2011. ORD’s efforts to reduce its administrative costs are noteworthy, but ORD needs to improve its measurement mechanism for assessing the effectiveness of its initiatives to reduce administrative costs.

  15. Event (error and near-miss) reporting and learning system for process improvement in radiation oncology.

    Science.gov (United States)

    Mutic, Sasa; Brame, R Scott; Oddiraju, Swetha; Parikh, Parag; Westfall, Melisa A; Hopkins, Merilee L; Medina, Angel D; Danieley, Jonathan C; Michalski, Jeff M; El Naqa, Issam M; Low, Daniel A; Wu, Bin

    2010-09-01

    The value of near-miss and error reporting processes in many industries is well appreciated and typically can be supported with data that have been collected over time. While it is generally accepted that such processes are important in the radiation therapy (RT) setting, studies analyzing the effects of organized reporting and process improvement systems on operation and patient safety in individual clinics remain scarce. The purpose of this work is to report on the design and long-term use of an electronic reporting system in a RT department and compare it to the paper-based reporting system it replaced. A specifically designed web-based system was designed for reporting of individual events in RT and clinically implemented in 2007. An event was defined as any occurrence that could have, or had, resulted in a deviation in the delivery of patient care. The aim of the system was to support process improvement in patient care and safety. The reporting tool was designed so individual events could be quickly and easily reported without disrupting clinical work. This was very important because the system use was voluntary. The spectrum of reported deviations extended from minor workflow issues (e.g., scheduling) to errors in treatment delivery. Reports were categorized based on functional area, type, and severity of an event. The events were processed and analyzed by a formal process improvement group that used the data and the statistics collected through the web-based tool for guidance in reengineering clinical processes. The reporting trends for the first 24 months with the electronic system were compared to the events that were reported in the same clinic with a paper-based system over a seven-year period. The reporting system and the process improvement structure resulted in increased event reporting, improved event communication, and improved identification of clinical areas which needed process and safety improvements. The reported data were also useful for the

  16. Using the Nintendo Wii Fit and body weight support to improve aerobic capacity, balance, gait ability, and fear of falling: two case reports.

    Science.gov (United States)

    Miller, Carol A; Hayes, Dawn M; Dye, Kelli; Johnson, Courtney; Meyers, Jennifer

    2012-01-01

    Lower limb amputation in older adults has a significant impact on balance, gait, and cardiovascular fitness, resulting in diminished community participation. The purpose of this case study was to describe the effects of a balance training program utilizing the Nintendo Wii™ Fit (Nintendo of America, Inc, Redmond, Washington) balance board and body-weight supported gait training on aerobic capacity, balance, gait, and fear of falling in two persons with transfemoral amputation. Participant A, a 62 year-old male 32 months post traumatic transfemoral amputation, reported fear of falling and restrictions in community activity. Participant B, a 58 year-old male 9 years post transfemoral amputation, reported limited energy and balance deficits during advanced gait activities. 6-weeks, 2 supervised sessions per week included 20 minutes of Nintendo™ Wii Fit Balance gaming and 20 minutes of gait training using Body Weight Support. Measures included oxygen uptake efficiency slope (OUES), economy of movement, dynamic balance (Biodex platform system), Activities-Specific Balance Confidence (ABC) Scale, and spatial-temporal parameters of gait (GAITRite). Both participants demonstrated improvement in dynamic balance, balance confidence, economy of movement, and spatial-temporal parameters of gait. Participant A reduced the need for an assistive device during community ambulation. Participant B improved his aerobic capacity, indicated by an increase in OUES. This case study illustrated that the use of Nintendo Wii™ Fit training and Body Weight Support were effective interventions to achieve functional goals for improving balance confidence, reducing use of assistive devices, and increasing energy efficiency when ambulating with a transfemoral prosthesis.

  17. Inferring high-confidence human protein-protein interactions

    Directory of Open Access Journals (Sweden)

    Yu Xueping

    2012-05-01

    Full Text Available Abstract Background As numerous experimental factors drive the acquisition, identification, and interpretation of protein-protein interactions (PPIs, aggregated assemblies of human PPI data invariably contain experiment-dependent noise. Ascertaining the reliability of PPIs collected from these diverse studies and scoring them to infer high-confidence networks is a non-trivial task. Moreover, a large number of PPIs share the same number of reported occurrences, making it impossible to distinguish the reliability of these PPIs and rank-order them. For example, for the data analyzed here, we found that the majority (>83% of currently available human PPIs have been reported only once. Results In this work, we proposed an unsupervised statistical approach to score a set of diverse, experimentally identified PPIs from nine primary databases to create subsets of high-confidence human PPI networks. We evaluated this ranking method by comparing it with other methods and assessing their ability to retrieve protein associations from a number of diverse and independent reference sets. These reference sets contain known biological data that are either directly or indirectly linked to interactions between proteins. We quantified the average effect of using ranked protein interaction data to retrieve this information and showed that, when compared to randomly ranked interaction data sets, the proposed method created a larger enrichment (~134% than either ranking based on the hypergeometric test (~109% or occurrence ranking (~46%. Conclusions From our evaluations, it was clear that ranked interactions were always of value because higher-ranked PPIs had a higher likelihood of retrieving high-confidence experimental data. Reducing the noise inherent in aggregated experimental PPIs via our ranking scheme further increased the accuracy and enrichment of PPIs derived from a number of biologically relevant data sets. These results suggest that using our high-confidence

  18. Biased but in Doubt: Conflict and Decision Confidence

    Science.gov (United States)

    De Neys, Wim; Cromheeke, Sofie; Osman, Magda

    2011-01-01

    Human reasoning is often biased by intuitive heuristics. A central question is whether the bias results from a failure to detect that the intuitions conflict with traditional normative considerations or from a failure to discard the tempting intuitions. The present study addressed this unresolved debate by using people's decision confidence as a nonverbal index of conflict detection. Participants were asked to indicate how confident they were after solving classic base-rate (Experiment 1) and conjunction fallacy (Experiment 2) problems in which a cued intuitive response could be inconsistent or consistent with the traditional correct response. Results indicated that reasoners showed a clear confidence decrease when they gave an intuitive response that conflicted with the normative response. Contrary to popular belief, this establishes that people seem to acknowledge that their intuitive answers are not fully warranted. Experiment 3 established that younger reasoners did not yet show the confidence decrease, which points to the role of improved bias awareness in our reasoning development. Implications for the long standing debate on human rationality are discussed. PMID:21283574

  19. A general model of confidence building: analysis and implications

    International Nuclear Information System (INIS)

    Kilgour, D.M.

    1998-01-01

    For more than two decades, security approaches in Europe have included confidence building. Many have argued that Confidence-Building Measures (CBMS) played an essential role in the enormous transformations that took place there. Thus, it is hardly,surprising that CBMs have been proposed as measures to reduce tensions and transform security relationships elsewhere in the world. The move toward wider application of CBMs has strengthened recently, as conventional military, diplomatic, and humanitarian approaches seem to have failed to address problems associated with peace-building and peace support operations. There is, however, a serious problem. We don't really know why, or even how, CBMs work. Consequently, we have no reliable way to design CBMs that would be appropriate in substance, form, and timing for regions culturally, geographically, and militarily different from Europe. Lacking a solid understanding of confidence building, we are handicapped in our efforts to extend its successes to the domain of peace building and peace support. To paraphrase Macintosh, if we don't know how CBMs succeeded in the past, then we are unlikely to be good at maintaining, improving, or extending them. The specific aim of this project is to step into this gap, using the methods of game theory to clarify some aspects of the underlying logic of confidence building. Formal decision models will be shown to contribute new and valuable insights that will assist in the design of CBMs to contribute to new problems and in new arenas. (author)

  20. An Introduction to Confidence Intervals for Both Statistical Estimates and Effect Sizes.

    Science.gov (United States)

    Capraro, Mary Margaret

    This paper summarizes methods of estimating confidence intervals, including classical intervals and intervals for effect sizes. The recent American Psychological Association (APA) Task Force on Statistical Inference report suggested that confidence intervals should always be reported, and the fifth edition of the APA "Publication Manual"…

  1. Effects of parental divorce on marital commitment and confidence.

    Science.gov (United States)

    Whitton, Sarah W; Rhoades, Galena K; Stanley, Scott M; Markman, Howard J

    2008-10-01

    Research on the intergenerational transmission of divorce has demonstrated that compared with offspring of nondivorced parents, those of divorced parents generally have more negative attitudes toward marriage as an institution and are less optimistic about the feasibility of a long-lasting, healthy marriage. It is also possible that when entering marriage themselves, adults whose parents divorced have less personal relationship commitment to their own marriages and less confidence in their own ability to maintain a happy marriage with their spouse. However, this prediction has not been tested. In the current study, we assessed relationship commitment and relationship confidence, as well as parental divorce and retrospectively reported interparental conflict, in a sample of 265 engaged couples prior to their first marriage. Results demonstrated that women's, but not men's, parental divorce was associated with lower relationship commitment and lower relationship confidence. These effects persisted when controlling for the influence of recalled interparental conflict and premarital relationship adjustment. The current findings suggest that women whose parents divorced are more likely to enter marriage with relatively lower commitment to, and confidence in, the future of those marriages, potentially raising their risk for divorce. Copyright 2008 APA, all rights reserved.

  2. Challenge for reconstruction of public confidence

    International Nuclear Information System (INIS)

    Matsuura, S.

    2001-01-01

    Past incidents and scandals that have had a large influence on damaging public confidence in nuclear energy safety are presented. Radiation leak on nuclear-powered ship 'Mutsu' (1974), the T.M.I. incident in 1979, Chernobyl accident (1986), the sodium leak at the Monju reactor (1995), fire and explosion at a low level waste asphalt solidification facility (1997), J.C.O. incident (Tokai- MURA, 1999), are so many examples that have created feelings of distrust and anxiety in society. In order to restore public confidence there is no other course but to be prepared for difficulty and work honestly to our fullest ability, with all steps made openly and accountably. (N.C.)

  3. Tables of Confidence Limits for Proportions

    Science.gov (United States)

    1990-09-01

    0.972 180 49 0.319 0.332 0,357 175 165 0.964 0.969 0.976 ISO 50 0.325 0.338 0.363 175 166 0.969 0.973 0.980 180 51 0.331 0.344 0.368 175 167 0.973 0.977...0.528 180 18 0.135 0 145 0.164 180 19 0.141 0.151 0.171 ISO 80 0.495 0,508 0.534 347 UPPER CONFIDENCE LIMIT FOR PROPORTIONS CONFIDENCE LEVEL...500 409 0.8401 0.8459 0.8565 500 355 0.7364 0.7434 0.7564 500 356 0.7383 0.7453 0.7582 500 410 0.8420 0.8478 0 8583 500 357 0.7402 0.7472 0.7602 500

  4. Nuclear Weapons Sustainment: Improvements Made to Budget Estimates Report, but Opportunities Remain to Further Enhance Transparency

    Science.gov (United States)

    2015-12-01

    Enhance Transparency Report to Congressional Committees December 2015 GAO-16-23 United States Government Accountability Office United...SUSTAINMENT Improvements Made to Budget Estimates Report, but Opportunities Remain to Further Enhance Transparency Why GAO Did This Study DOD and DOE are...modernization plans and (2) complete, transparent information on the methodologies used to develop those estimates. GAO analyzed the departments

  5. Improving Bioscience Research Reporting: The ARRIVE Guidelines for Reporting Animal Research

    Directory of Open Access Journals (Sweden)

    Carol Kilkenny

    2014-02-01

    Full Text Available In the last decade the number of bioscience journals has increased enormously, with many filling specialised niches reflecting new disciplines and technologies. The emergence of open-access journals has revolutionised the publication process, maximising the availability of research data. Nevertheless, a wealth of evidence shows that across many areas, the reporting of biomedical research is often inadequate, leading to the view that even if the science is sound, in many cases the publications themselves are not “fit for purpose”, meaning that incomplete reporting of relevant information effectively renders many publications of limited value as instruments to inform policy or clinical and scientific practice [1–21]. A recent review of clinical research showed that there is considerable cumulative waste of financial resources at all stages of the research process, including as a result of publications that are unusable due to poor reporting [22]. It is unlikely that this issue is confined to clinical research [2–14,16–20].

  6. Confidence, Visual Research, and the Aesthetic Function

    Directory of Open Access Journals (Sweden)

    Stan Ruecker

    2007-05-01

    Full Text Available The goal of this article is to identify and describe one of the primary purposes of aesthetic quality in the design of computer interfaces and visualization tools. We suggest that humanists can derive advantages in visual research by acknowledging by their efforts to advance aesthetic quality that a significant function of aesthetics in this context is to inspire the user’s confidence. This confidence typically serves to create a sense of trust in the provider of the interface or tool. In turn, this increased trust may result in an increased willingness to engage with the object, on the basis that it demonstrates an attention to detail that promises to reward increased engagement. In addition to confidence, the aesthetic may also contribute to a heightened degree of satisfaction with having spent time using or investigating the object. In the realm of interface design and visualization research, we propose that these aesthetic functions have implications not only for the quality of interactions, but also for the results of the standard measures of performance and preference.

  7. Report from SG 1.1: improving the performance of existing gas storages

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-07-01

    This report aims to identify underlying trends for improvements in the underground gas storage (UGS) industry. It highlights best practices and state-of-the-art technology used in operating gas storages. The core conclusions of this report are based on a survey, which was sent out to the member countries. A reply was received from 15 countries, represented by 22 companies/institutions, including more than 100 gas storage sites. This response represents some 30% of the total estimated world storage working volume. In the survey operators were asked to report on the following issues: - measures implemented to improve the performance, - current priorities for improvements, - most important drivers for improvement, - techniques used to analyze performance, - techniques used to optimize storage performance, - software packages used, - technology used for reservoir management, wells and surface facilities, - safety and environment. (author)

  8. Does enhanced regulation improve EIA report quality? Lessons from South Africa

    Energy Technology Data Exchange (ETDEWEB)

    Sandham, L.A., E-mail: luke.sandham@nwu.ac.za [Environmental Assessment Research Group, School of Geo and Spatial Sciences, North-West University, Private Bag X6001, Potchefstroom, 2520 (South Africa); Heerden, A.J. van [Environmental Assessment Research Group, School of Geo and Spatial Sciences, North-West University, Private Bag X6001, Potchefstroom, 2520 (South Africa); Jones, C.E. [School of Environment and Development, University of Manchester, Oxford Road, Manchester, M13 9PL (United Kingdom); Retief, F.P.; Morrison-Saunders, A.N. [Environmental Assessment Research Group, School of Geo and Spatial Sciences, North-West University, Private Bag X6001, Potchefstroom, 2520 (South Africa)

    2013-01-15

    Recently, various EIA systems have been subjected to system review processes with a view to improve performance. Many of these reviews resulted in some form of legislative reform. The South African Environmental Impact Assessment (EIA) regulations were modified in 2006 with the express intent to improve EIA effectiveness. In order to evaluate to what extent the desired outcome was achieved, the quality of EIA reports produced under the 2006 regulations was investigated for comparative analysis with the preceding regime. A sample of EIA reports from the two legislative regimes was reviewed using an adapted version of a well established method known colloquially as the 'Lee and Colley' review package. Despite some improvements in certain aspects, overall report quality has decreased slightly from the 1997 EIA regime. It therefore appears that the modifications to the regulations, often heralded as the solution to improvements in performance have not resulted in improved quality of EIA reports. - Highlights: Black-Right-Pointing-Pointer EIA regulations in South Africa were revised and became more comprehensive in 2006. Black-Right-Pointing-Pointer The report quality of a sample of EIAs was reviewed using the Lee and Colley review package. Black-Right-Pointing-Pointer Report quality showed a slight decline from the previous regulatory regime. Black-Right-Pointing-Pointer EIA good practice needs flexibility rather than over-detailed regulation.

  9. Does enhanced regulation improve EIA report quality? Lessons from South Africa

    International Nuclear Information System (INIS)

    Sandham, L.A.; Heerden, A.J. van; Jones, C.E.; Retief, F.P.; Morrison-Saunders, A.N.

    2013-01-01

    Recently, various EIA systems have been subjected to system review processes with a view to improve performance. Many of these reviews resulted in some form of legislative reform. The South African Environmental Impact Assessment (EIA) regulations were modified in 2006 with the express intent to improve EIA effectiveness. In order to evaluate to what extent the desired outcome was achieved, the quality of EIA reports produced under the 2006 regulations was investigated for comparative analysis with the preceding regime. A sample of EIA reports from the two legislative regimes was reviewed using an adapted version of a well established method known colloquially as the “Lee and Colley” review package. Despite some improvements in certain aspects, overall report quality has decreased slightly from the 1997 EIA regime. It therefore appears that the modifications to the regulations, often heralded as the solution to improvements in performance have not resulted in improved quality of EIA reports. - Highlights: ► EIA regulations in South Africa were revised and became more comprehensive in 2006. ► The report quality of a sample of EIAs was reviewed using the Lee and Colley review package. ► Report quality showed a slight decline from the previous regulatory regime. ► EIA good practice needs flexibility rather than over-detailed regulation.

  10. Diabetes technology: improving care, improving patient-reported outcomes and preventing complications in young people with Type 1 diabetes.

    Science.gov (United States)

    Prahalad, P; Tanenbaum, M; Hood, K; Maahs, D M

    2018-04-01

    With the evolution of diabetes technology, those living with Type 1 diabetes are given a wider arsenal of tools with which to achieve glycaemic control and improve patient-reported outcomes. Furthermore, the use of these technologies may help reduce the risk of acute complications, such as severe hypoglycaemia and diabetic ketoacidosis, as well as long-term macro- and microvascular complications. In addition, diabetes technology can have a beneficial impact on psychosocial health by reducing the burden of diabetes. Unfortunately, diabetes goals are often unmet and people with Type 1 diabetes too frequently experience acute and long-term complications of this condition, in addition to often having less than ideal psychosocial outcomes. Increasing realization of the importance of patient-reported outcomes is leading to diabetes care delivery becoming more patient-centred. Diabetes technology in the form of medical devices, digital health and big data analytics have the potential to improve clinical care and psychosocial support, resulting in lower rates of acute and chronic complications, decreased burden of diabetes care, and improved quality of life. © 2018 Diabetes UK.

  11. A longitudinal study of well-being, confidence and competence in junior doctors and the impact of emergency medicine placements.

    Science.gov (United States)

    Mason, Suzanne; O'Keeffe, Colin; Carter, Angela; Stride, Chris

    2016-02-01

    To measure levels of, and change in junior doctor well-being, confidence and self-reported competence over their second postgraduate training year and the impact of emergency department (ED) placements on these outcomes. A longitudinal study using an online survey administered at four time points (2010-2011). 28 Acute Hospital Trusts, drawn from nine participating Postgraduate Deaneries in England. Junior doctors who had a placement in an ED as part of their second postgraduate training year. Levels of anxiety, depression, motivation, job satisfaction, confidence and self-reported competence, collected at four time points spread over the period of the doctor's second training year (F2). 217 junior doctors were recruited to the study. Over the year there was a significant increase in their overall job satisfaction, confidence and self-reported competence. Junior doctors also reported significantly increased levels of motivation and anxiety, and significantly decreased levels of extrinsic job satisfaction when working in ED compared with other specialties. There were also significant increases in both junior doctor confidence and self-reported competence after their placement in ED relative to other specialties. While elements of junior doctor well-being worsened in their ED placement compared with their time spent in other specialties, the increased levels of anxiety and reduced extrinsic job satisfaction were within the normal range for other healthcare workers. These deficits were also balanced by greater improvements in motivation, confidence in managing common acute clinical conditions and perceived competence in performing acute procedures compared with benefits offered by placements in other specialties. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  12. Re-thinking accountability: trust versus confidence in medical practice.

    Science.gov (United States)

    Checkland, K; Marshall, M; Harrison, S

    2004-04-01

    In seeking to prevent a reoccurrence of scandals such as that involving cardiac surgery in Bristol, the UK government has adopted a model of regulation that uses rules and surveillance as a way of both improving the quality of care delivered and increasing confidence in healthcare institutions. However, this approach may actually act to reduce confidence and trust while also reducing the moral motivation of practitioners. Accountability in health care is discussed, and it is suggested that openness about the difficult dilemmas that arise when practitioners have a duty to be accountable to more than one audience may be an alternative means of restoring trust. A greater emphasis on the sharing of information between individual health professionals and their patients would increase trust and would allow patients to hold their doctors to account for the quality of care they receive. Concentrating more on developing trust by the sharing of information and less on the futile search for complete confidence in systems and rules may improve the quality of care delivered while also nurturing the moral motivation of professionals upon which the delivery of high quality health care depends.

  13. Incorporating Reporting Efforts to Manage and Improve Health and Wellness Programs.

    Science.gov (United States)

    Wells, Timothy S; Ozminkowski, Ronald J; McGinn, Michael P; Hawkins, Kevin; Bhattarai, Gandhi R; Serxner, Seth A; Greame, Chris

    2017-06-01

    Wellness programs are designed to help individuals maintain or improve their health. This article describes how a reporting process can be used to help manage and improve a wellness program. Beginning in 2014, a wellness pilot program became available in New Jersey for individuals with an AARP Medicare Supplement Insurance plan insured by UnitedHealthcare Insurance Company. The program has since expanded to include Missouri, Texas, Alabama, and Washington. This wellness program includes an online health portal, one-on-one telephonic coaching, gym membership discounts, and local health events. To assure smooth program operations and alignment with program objectives, weekly and monthly reports are produced. The weekly report includes metrics on member engagement and utilization for the aforementioned 4 program offerings and reports on the last 4 weeks, as well as for the current month and the current year to date. The monthly report includes separate worksheets for each state and a summary worksheet that includes all states combined, and provides metrics on overall engagement as well as utilization of the 4 program components. Although the monthly reports were used to better manage the 4 program offerings, the weekly reports help management to gauge response to program marketing. Reporting can be a data-driven management tool to help manage wellness programs. Reports provide rapid feedback regarding program performance. In contrast, in-depth program evaluations serve a different purpose, such as to report program-related savings, return on investment, or to report other longer term program-related outcomes.

  14. Self-assessment on the competencies and reported improvement priorities for pediatrics residents.

    Science.gov (United States)

    Li, Su-Ting T; Tancredi, Daniel J; Burke, Ann E; Guillot, Ann; Guralnick, Susan; Trimm, R Franklin; Mahan, John D

    2012-12-01

    Self-assessment and self-directed learning are essential to becoming an effective physician. To identify factors associated with resident self-assessment on the competencies, and to determine whether residents chose areas of self-assessed relative weakness as areas for improvement in their Individualized Learning Plan (ILP). We performed a cross-sectional analysis of the American Academy of Pediatrics' PediaLink ILP database. Pediatrics residents self-assessed their competency in the 6 Accreditation Council for Graduate Medical Education competencies using a color-coded slider scale with end anchors "novice" and "proficient" (0-100), and then chose at least 1 competency to improve. Multivariate regression explored the relationship between overall confidence in core competencies, sex, level of training, and degree (MD or DO) status. Correlation examined whether residents chose to improve competencies in which they rated themselves as lower. A total of 4167 residents completed an ILP in academic year 2009-2010, with residents' ratings improving from advanced beginner (48 on a 0-100 scale) in postgraduate year-1 residents (PGY-1s) to competent (75) in PGY-3s. Residents rated themselves as most competent in professionalism (mean, 75.3) and least competent in medical knowledge (mean, 55.8) and systems-based practice (mean, 55.2). In the adjusted regression model, residents' competency ratings increased by level of training and whether they were men. In PGY-3s, there was no difference between men and women. Residents selected areas for improvement that correlated to competencies where they had rated themselves lower (P knowledge and systems-based practice, even as PGY-3s. Residents tended to choose subcompetencies, which they rated as lower to focus on improving.

  15. Peer-Assisted Analysis of Resident Feedback Improves Clinical Teaching: A Case Report.

    Science.gov (United States)

    Mai, Christine L; Baker, Keith

    2017-07-01

    Anesthesiologists play an important role in educating future clinicians. Yet few residency programs incorporate teaching skills into faculty development. Consequently, many anesthesiologists have limited training to supervise and educate residents. In turn, these attendings may receive negative feedback and poor evaluations from residents without a means to effectively improve. Peer-assisted teaching between faculty members may serve as a strategy to improve teaching skills. We report a case of peer-assisted analysis of resident feedback to identify specific areas of concern that were targeted for improvement. This approach resulted in improved teaching scores and feedback for the faculty member.

  16. Structured pathology reporting improves the macroscopic assessment of rectal tumour resection specimens.

    Science.gov (United States)

    King, Simon; Dimech, Margaret; Johnstone, Susan

    2016-06-01

    We examined whether introduction of a structured macroscopic reporting template for rectal tumour resection specimens improved the completeness and efficiency in collecting key macroscopic data elements. Fifty free text (narrative) macroscopic reports retrieved from 2012 to 2014 were compared with 50 structured macroscopic reports from 2013 to 2015, all of which were generated at John Hunter Hospital, Newcastle, NSW. The six standard macroscopic data elements examined in this study were reported in all 50 anatomical pathology reports using a structured macroscopic reporting dictation template. Free text reports demonstrated significantly impaired data collection when recording intactness of mesorectum (p<0.001), relationship to anterior peritoneal reflection (p=0.028) and distance of tumour to the non-peritonealised circumferential margin (p<0.001). The number of words used was also significantly (p<0.001) reduced using pre-formatted structured reports compared to free text reports. The introduction of a structured reporting dictation template improves data collection and may reduce the subsequent administrative burden when macroscopically evaluating rectal resections. Copyright © 2016 Royal College of Pathologists of Australasia. Published by Elsevier B.V. All rights reserved.

  17. Transparency as an element of public confidence

    International Nuclear Information System (INIS)

    Kim, H.K.

    2007-01-01

    In the modern society, there is increasing demands for greater transparency. It has been discussed with respect to corruption or ethics issues in social science. The need for greater openness and transparency in nuclear regulation is widely recognised as public expectations on regulator grow. It is also related to the digital and information technology that enables disclosures of every activity and information of individual and organisation, characterised by numerous 'small brothers'. Transparency has become a key word in this ubiquitous era. Transparency in regulatory activities needs to be understood in following contexts. First, transparency is one of elements to build public confidence in regulator and eventually to achieve regulatory goal of providing the public with satisfaction at nuclear safety. Transparent bases of competence, independence, ethics and integrity of working process of regulatory body would enhance public confidence. Second, activities transmitting information on nuclear safety and preparedness to be accessed are different types of transparency. Communication is an active method of transparency. With increasing use of web-sites, 'digital transparency' is also discussed as passive one. Transparency in regulatory process may be more important than that of contents. Simply providing more information is of little value and specific information may need to be protected for security reason. Third, transparency should be discussed in international, national and organizational perspectives. It has been demanded through international instruments. for each country, transparency is demanded by residents, public, NGOs, media and other stakeholders. Employees also demand more transparency in operating and regulatory organisations. Whistle-blower may appear unless they are satisfied. Fourth, pursuing transparency may cause undue social cost or adverse effects. Over-transparency may decrease public confidence and the process for transparency may also hinder

  18. Asymptotically Honest Confidence Regions for High Dimensional

    DEFF Research Database (Denmark)

    Caner, Mehmet; Kock, Anders Bredahl

    While variable selection and oracle inequalities for the estimation and prediction error have received considerable attention in the literature on high-dimensional models, very little work has been done in the area of testing and construction of confidence bands in high-dimensional models. However...... develop an oracle inequality for the conservative Lasso only assuming the existence of a certain number of moments. This is done by means of the Marcinkiewicz-Zygmund inequality which in our context provides sharper bounds than Nemirovski's inequality. As opposed to van de Geer et al. (2014) we allow...

  19. National Debate and Public Confidence in Sweden

    International Nuclear Information System (INIS)

    Lindquist, Ted

    2014-01-01

    Ted Lindquist, coordinator of the Association of Swedish Municipalities with Nuclear Facilities (KSO), closed the first day of conferences. He showed what the nuclear landscape was in Sweden, and in particular that through time there has been a rather good support from the population. He explained that the reason could be the confidence of the public in the national debate. On a more local scale, Ted Lindquist showed how overwhelmingly strong the support was in towns where the industry would like to operate long-term storage facilities

  20. False memories and memory confidence in borderline patients.

    Science.gov (United States)

    Schilling, Lisa; Wingenfeld, Katja; Spitzer, Carsten; Nagel, Matthias; Moritz, Steffen

    2013-12-01

    Mixed results have been obtained regarding memory in patients with borderline personality disorder (BPD). Prior reports and anecdotal evidence suggests that patients with BPD are prone to false memories but this assumption has to been put to firm empirical test, yet. Memory accuracy and confidence was assessed in 20 BPD patients and 22 healthy controls using a visual variant of the false memory (Deese-Roediger-McDermott) paradigm which involved a negative and a positive-valenced picture. Groups did not differ regarding veridical item recognition. Importantly, patients did not display more false memories than controls. At trend level, borderline patients rated more items as new with high confidence compared to healthy controls. The results tentatively suggest that borderline patients show uncompromised visual memory functions and display no increased susceptibility for distorted memories. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. Critical evaluation as an aid to improved report writing: a case study

    Science.gov (United States)

    Walker, Mirabelle; Williams, Judith

    2014-05-01

    Report writing is an important employability skill for Engineers and Technologists, and this case study describes how a Technology degree module took a novel approach to developing students' report writing skills. Students learned how to use a criterion-referenced critical evaluation framework for reports and other technological documents. They were given opportunities to practise using the framework both through exemplars and through evaluating the work of their peers. They also carried out self-assessment. The authors' analysis of this novel approach shows that most students responded well to it and benefited from it. Lessons are drawn from this work for others who wish to improve their students' report writing skills.

  2. Perceived confidence, competence and training in evidence-based treatments for eating disorders: a survey of clinicians in an Australian regional health service.

    Science.gov (United States)

    Lakeman, Richard; McIntosh, Christine

    2018-03-01

    Eating disorders (EDs) are challenging to treat and contribute to considerable morbidity and mortality. This study sought to identify the educational preparedness, competence and confidence of clinicians to work with people with EDs; and to identify how services might be improved. Clinicians who worked in the emergency department, medical, paediatric wards and mental health services were invited to complete an online survey. From the 136 surveys returned, 73% of respondents reported little or no confidence working with EDs. There was a strong linear correlation between perceived confidence and competence and hours of education. Those with 70 or more hours of self-reported training were 2.7 times more likely to rate themselves as both confident and competent. Improving services for people with eating disorders included the provision of appropriate training, improving access to services including psychotherapy, and facilitating consistency in and continuity of care. To increase the confidence and competence of the workforce, regular training around EDs should be undertaken. The establishment of a specialist team to provide services across the continuum of care for people with severe or complex EDs appears warranted in a regional health service.

  3. Effect of an educational intervention to improve adverse drug reaction reporting in physicians: a cluster randomized controlled trial.

    Science.gov (United States)

    Lopez-Gonzalez, Elena; Herdeiro, Maria T; Piñeiro-Lamas, María; Figueiras, Adolfo

    2015-02-01

    The yellow-card scheme continues to be one of the principal methods for signal generation in pharmacovigilance. Nevertheless, under-reporting, one of its disadvantages, delays alert signals and has a negative influence on public health. Educational interventions in pharmacovigilance may have a positive impact on the spontaneous reporting of adverse drug reactions (ADRs). To assess the duration of the effect and effectiveness of an educational intervention in pharmacovigilance designed to improve ADR reporting in a robust pharmacovigilance system. A spatial, cluster randomized controlled trial was conducted covering all National Health System physicians in the northwest of Spain and targeting those who were actively engaged in clinical practice (n = 7,498). Of these, 2,120 were assigned in three spatial clusters to the intervention group (six hospitals and 138 primary care centers) and 3,614 in four clusters to the control group (seven hospitals and 267 primary care centers). The educational intervention consisted of two complementary approaches--one active (group sessions), the other passive (educational material, reporting form)-implemented from November 2007 to December 2008, with a follow-up period of 8 months. Intervention participation was 53.7 % in a hospital setting and 60.5 % in primary care settings. ADR reporting in the intervention group increased by 65.4 % (95 % confidence interval [CI]: 8.2-153.4) across the follow-up. The ADR reporting rate per 1,000 physicians/year in the intervention group rose from 28.1 to 39.6 following the intervention (51.7 and 27.4 in the first and second 4-month period, respectively). For the intervention group, relative risk (RR) was 2.31 (95 % CI: 1.46-3.68) and 1.04 (95 % CI: 0.61-1.77) in the first and second 4-month period, respectively adjusted to baseline values. There was an increase in unexpected ADR reporting (RR 2.06, 95 % CI 1.19-3.55). Pharmacovigilance educational interventions that have proved effective can be

  4. Self-confidence of medical students in performing clinical skills acquired during their surgical rotation. Assessing clinical skills education in Kuwait.

    Science.gov (United States)

    Karim, Jumanah A; Marwan, Yousef A; Dawas, Ahmed M; Akhtar, Saeed

    2012-12-01

    To assess the self-confidence of clinical years` medical students in performing clinical skills/procedures. A cross-sectional study was conducted in April 2011 at the Department of Surgery, Faculty of Medicine, Health Sciences Center, Kuwait University, Safat, Kuwait. A questionnaire was used to collect data from students who had completed their surgical rotation of their first clinical year. The students reported their level of self-confidence in performing specific skills/procedures related to that rotation. Data were presented using frequencies and percentages. A total score of confidence was calculated for each student. The Mann-Whitney and Kruskal-Wallis tests were used to assess the association between the students` sociodemographic characteristics and confidence score. Of the 122 students invited to participate in the study, only 15 (12.3%) declined to comply. Most students reported high confidence level (more than 75%) in performing 7 of the 13 history taking/physical examination skills, and 2 of the 39 diagnostic/treatment procedure skills. The highest confidence level was in performing abdominal examination, while the lowest level was in care of Jackson-Pratt drain site and emptying the drain bulb. The total confidence score was significantly higher among males (p=0.021), and students with higher monthly income (p=0.002). Medical students appeared to have poor self-confidence in performing clinical skills/procedures. Curriculum planners should explore potential reasons, and methods for the improvement of confidence level among medical students in performing skills/procedures they were expected to learn during their surgical rotation.

  5. Diagnosing Anomalous Network Performance with Confidence

    Energy Technology Data Exchange (ETDEWEB)

    Settlemyer, Bradley W [ORNL; Hodson, Stephen W [ORNL; Kuehn, Jeffery A [ORNL; Poole, Stephen W [ORNL

    2011-04-01

    Variability in network performance is a major obstacle in effectively analyzing the throughput of modern high performance computer systems. High performance interconnec- tion networks offer excellent best-case network latencies; how- ever, highly parallel applications running on parallel machines typically require consistently high levels of performance to adequately leverage the massive amounts of available computing power. Performance analysts have usually quantified network performance using traditional summary statistics that assume the observational data is sampled from a normal distribution. In our examinations of network performance, we have found this method of analysis often provides too little data to under- stand anomalous network performance. Our tool, Confidence, instead uses an empirically derived probability distribution to characterize network performance. In this paper we describe several instances where the Confidence toolkit allowed us to understand and diagnose network performance anomalies that we could not adequately explore with the simple summary statis- tics provided by traditional measurement tools. In particular, we examine a multi-modal performance scenario encountered with an Infiniband interconnection network and we explore the performance repeatability on the custom Cray SeaStar2 interconnection network after a set of software and driver updates.

  6. Confidence intervals for the lognormal probability distribution

    International Nuclear Information System (INIS)

    Smith, D.L.; Naberejnev, D.G.

    2004-01-01

    The present communication addresses the topic of symmetric confidence intervals for the lognormal probability distribution. This distribution is frequently utilized to characterize inherently positive, continuous random variables that are selected to represent many physical quantities in applied nuclear science and technology. The basic formalism is outlined herein and a conjured numerical example is provided for illustration. It is demonstrated that when the uncertainty reflected in a lognormal probability distribution is large, the use of a confidence interval provides much more useful information about the variable used to represent a particular physical quantity than can be had by adhering to the notion that the mean value and standard deviation of the distribution ought to be interpreted as best value and corresponding error, respectively. Furthermore, it is shown that if the uncertainty is very large a disturbing anomaly can arise when one insists on interpreting the mean value and standard deviation as the best value and corresponding error, respectively. Reliance on using the mode and median as alternative parameters to represent the best available knowledge of a variable with large uncertainties is also shown to entail limitations. Finally, a realistic physical example involving the decay of radioactivity over a time period that spans many half-lives is presented and analyzed to further illustrate the concepts discussed in this communication

  7. The relationship between confidence in charitable organizations and volunteering revisited

    NARCIS (Netherlands)

    Bekkers, René H.F.P.; Bowman, Woods

    2009-01-01

    Confidence in charitable organizations (charitable confidence) would seem to be an important prerequisite for philanthropic behavior. Previous research relying on cross-sectional data has suggested that volunteering promotes charitable confidence and vice versa. This research note, using new

  8. How do aggregated patient-reported outcome measures data stimulate health care improvement? A realist synthesis

    Science.gov (United States)

    Dalkin, Sonia; Gibbons, Elizabeth; Wright, Judy; Valderas, Jose Maria; Meads, David; Black, Nick

    2017-01-01

    Objectives Internationally, there has been considerable debate about the role of data in supporting quality improvement in health care. Our objective was to understand how, why and in what circumstances the feedback of aggregated patient-reported outcome measures data improved patient care. Methods We conducted a realist synthesis. We identified three main programme theories underlying the use of patient-reported outcome measures as a quality improvement strategy and expressed them as nine ‘if then’ propositions. We identified international evidence to test these propositions through searches of electronic databases and citation tracking, and supplemented our synthesis with evidence from similar forms of performance data. We synthesized this evidence through comparing the mechanisms and impact of patient-reported outcome measures and other performance data on quality improvement in different contexts. Results Three programme theories were identified: supporting patient choice, improving accountability and enabling providers to compare their performance with others. Relevant contextual factors were extent of public disclosure, use of financial incentives, perceived credibility of the data and the practicality of the results. Available evidence suggests that patients or their agents rarely use any published performance data when selecting a provider. The perceived motivation behind public reporting is an important determinant of how providers respond. When clinicians perceived that performance indicators were not credible but were incentivized to collect them, gaming or manipulation of data occurred. Outcome data do not provide information on the cause of poor care: providers needed to integrate and interpret patient-reported outcome measures and other outcome data in the context of other data. Lack of timeliness of performance data constrains their impact. Conclusions Although there is only limited research evidence to support some widely held theories of how

  9. Development and Evaluation of a Confidence-Weighting Computerized Adaptive Testing

    Science.gov (United States)

    Yen, Yung-Chin; Ho, Rong-Guey; Chen, Li-Ju; Chou, Kun-Yi; Chen, Yan-Lin

    2010-01-01

    The purpose of this study was to examine whether the efficiency, precision, and validity of computerized adaptive testing (CAT) could be improved by assessing confidence differences in knowledge that examinees possessed. We proposed a novel polytomous CAT model called the confidence-weighting computerized adaptive testing (CWCAT), which combined a…

  10. Training and Confidence Level of Junior Anaesthetists in CPR- Experience in A Developing Country

    Directory of Open Access Journals (Sweden)

    Desalu Ibironke

    2008-01-01

    There is low confidence among junior anaesthetists in Nigeria in performance of CPR, poor knowledge of ECG interpretation of cardiac arrest rhythm and little practice in defibrillation. The establishment of a Resuscitation council would ensure adequate and frequent training which would improve knowledge, boost confidence and result in better patient care.

  11. The Effects of a Site-Based Mentoring Program on Teacher Confidence and Effectiveness

    Science.gov (United States)

    Dos Santos, Kimberley G.

    2012-01-01

    This dissertation was designed to examine the effects of a site-based teacher mentoring program on teacher confidence and effectiveness in an elementary school in Florida. Based on preliminary data, there was a need for system organizational change to improve teacher confidence and performance with the district's Document Based Question (DBQ)…

  12. Peer pressure and public reporting within healthcare setting: improving accountability and health care quality in hospitals.

    Science.gov (United States)

    Specchia, Maria Lucia; Veneziano, Maria Assunta; Cadeddu, Chiara; Ferriero, Anna Maria; Capizzi, Silvio; Ricciardi, Walter

    2012-01-01

    In the last few years, the need of public reporting of health outcomes has acquired a great importance. The public release of performance results could be a tool for improving health care quality and many attempts have been made in order to introduce public reporting programs within the health care context at different levels. It would be necessary to promote the introduction of a standardized set of outcome and performance measures in order to improve quality of health care services and to make health care providers aware of the importance of transparency and accountability.

  13. Model-driven approach to data collection and reporting for quality improvement.

    Science.gov (United States)

    Curcin, Vasa; Woodcock, Thomas; Poots, Alan J; Majeed, Azeem; Bell, Derek

    2014-12-01

    Continuous data collection and analysis have been shown essential to achieving improvement in healthcare. However, the data required for local improvement initiatives are often not readily available from hospital Electronic Health Record (EHR) systems or not routinely collected. Furthermore, improvement teams are often restricted in time and funding thus requiring inexpensive and rapid tools to support their work. Hence, the informatics challenge in healthcare local improvement initiatives consists of providing a mechanism for rapid modelling of the local domain by non-informatics experts, including performance metric definitions, and grounded in established improvement techniques. We investigate the feasibility of a model-driven software approach to address this challenge, whereby an improvement model designed by a team is used to automatically generate required electronic data collection instruments and reporting tools. To that goal, we have designed a generic Improvement Data Model (IDM) to capture the data items and quality measures relevant to the project, and constructed Web Improvement Support in Healthcare (WISH), a prototype tool that takes user-generated IDM models and creates a data schema, data collection web interfaces, and a set of live reports, based on Statistical Process Control (SPC) for use by improvement teams. The software has been successfully used in over 50 improvement projects, with more than 700 users. We present in detail the experiences of one of those initiatives, Chronic Obstructive Pulmonary Disease project in Northwest London hospitals. The specific challenges of improvement in healthcare are analysed and the benefits and limitations of the approach are discussed. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

  14. Promoting skill building and confidence in freshman nursing students with a "Skills-a-Thon".

    Science.gov (United States)

    Roberts, Susan T; Vignato, Julie A; Moore, Joan L; Madden, Carol A

    2009-08-01

    Freshman nursing students returning for their second semester after summer break benefited by reviewing previously learned clinical skills presented in a Skills-a-Thon. Skills stations were established and facilitated by faculty and senior students. Senior students were first trained in mentoring and specific steps in skills competencies. Freshman students demonstrated skills in various mock clinical situations including catheter insertion, sterile dressings, medications, and physical assessment. The strategy reinforced learning and provided an opportunity for students to experience risk-free skills performance among peers. Freshman students gained proficiency and appreciated guidance by senior students without the pressures of testing. Seniors benefited from a condensed version of the program to review their own skills prior to the event. Responses were positive, with students reporting improved performance and confidence with hands-on application in a non-threatening environment. Nursing faculty observed improvement in skill performance and competence, and plan to offer future events. Copyright 2009, SLACK Incorporated.

  15. The application of deep confidence network in the problem of image recognition

    Directory of Open Access Journals (Sweden)

    Chumachenko О.І.

    2016-12-01

    Full Text Available In order to study the concept of deep learning, in particular the substitution of multilayer perceptron on the corresponding network of deep confidence, computer simulations of the learning process to test voters was carried out. Multi-layer perceptron has been replaced by a network of deep confidence, consisting of successive limited Boltzmann machines. After training of a network of deep confidence algorithm of layer-wise training it was found that the use of networks of deep confidence greatly improves the accuracy of multilayer perceptron training by method of reverse distribution errors.

  16. Design report on SCDAP/RELAP5 model improvements - debris bed and molten pool behavior

    International Nuclear Information System (INIS)

    Allison, C.M.; Rempe, J.L.; Chavez, S.A.

    1994-11-01

    The SCDAP/RELAP5/MOD3 computer code is designed to describe the overall reactor coolant system thermal-hydraulic response, core damage progression, and in combination with VICTORIA, fission product release and transport during severe accidents. Improvements for existing debris bed and molten pool models in the SCDAP/RELAP5/MOD3.1 code are described in this report. Model improvements to address (a) debris bed formation, heating, and melting; (b) molten pool formation and growth; and (c) molten pool crust failure are discussed. Relevant data, existing models, proposed modeling changes, and the anticipated impact of the changes are discussed. Recommendations for the assessment of improved models are provided

  17. Using Primary Care Parenting Interventions to Improve Outcomes in Children with Developmental Disabilities: A Case Report

    Directory of Open Access Journals (Sweden)

    Cassandra L. Tellegen

    2012-01-01

    Full Text Available Parenting is central to the health and well-being of children. Children with developmental disabilities have been shown to be at increased risk of developing emotional and behavioral problems. Parent training programs are effective interventions for improving child behavior and family functioning. This paper describes the outcomes of a brief 4-session parenting intervention (Primary Care Stepping Stones Triple P targeting compliance and cooperative play skills in an 8-year-old girl with Asperger’s disorder and ADHD combined type. The intervention was associated with decreases in child behavior problems, increases in parenting confidence, and decreases in dysfunctional parenting styles. This paper demonstrates that low-intensity parenting interventions can lead to significant improvements in child behavior and family functioning. Such brief interventions are cost effective, can be widely disseminated, and have been designed to be delivered within primary health care settings. Pediatricians can play a key role in identifying parents in need of assistance and in helping them access evidence-based parenting interventions.

  18. Self-confidence in financial analysis: a study of younger and older male professional analysts.

    Science.gov (United States)

    Webster, R L; Ellis, T S

    2001-06-01

    Measures of reported self-confidence in performing financial analysis by 59 professional male analysts, 31 born between 1946 and 1964 and 28 born between 1965 and 1976, were investigated and reported. Self-confidence in one's ability is important in the securities industry because it affects recommendations and decisions to buy, sell, and hold securities. The respondents analyzed a set of multiyear corporate financial statements and reported their self-confidence in six separate financial areas. Data from the 59 male financial analysts were tallied and analyzed using both univariate and multivariate statistical tests. Rated self-confidence was not significantly different for the younger and the older men. These results are not consistent with a similar prior study of female analysts in which younger women showed significantly higher self-confidence than older women.

  19. Technology in a crisis of confidence

    Energy Technology Data Exchange (ETDEWEB)

    Damodaran, G R

    1979-04-01

    The power that technological progress has given to engineers is examined to see if there has been a corresponding growth in human happiness. A credit/debit approach is discussed, whereby technological advancement is measured against the criteria of social good. The credit side includes medicine, agriculture, and energy use, while the debit side lists pollution, unequal distribution of technology and welfare, modern weaponry, resource depletion, and a possible decline in the quality of life. The present anti-technologists claim the debit side is now predominant, but the author challenges this position by examining the role of technology and the engineer in the society. He sees a need for renewed self-confidence and a sense of direction among engineers, but is generally optimistic that technology and civilization will continue to be intertwined. (DCK)

  20. Quantifying uncertainty on sediment loads using bootstrap confidence intervals

    Science.gov (United States)

    Slaets, Johanna I. F.; Piepho, Hans-Peter; Schmitter, Petra; Hilger, Thomas; Cadisch, Georg

    2017-01-01

    Load estimates are more informative than constituent concentrations alone, as they allow quantification of on- and off-site impacts of environmental processes concerning pollutants, nutrients and sediment, such as soil fertility loss, reservoir sedimentation and irrigation channel siltation. While statistical models used to predict constituent concentrations have been developed considerably over the last few years, measures of uncertainty on constituent loads are rarely reported. Loads are the product of two predictions, constituent concentration and discharge, integrated over a time period, which does not make it straightforward to produce a standard error or a confidence interval. In this paper, a linear mixed model is used to estimate sediment concentrations. A bootstrap method is then developed that accounts for the uncertainty in the concentration and discharge predictions, allowing temporal correlation in the constituent data, and can be used when data transformations are required. The method was tested for a small watershed in Northwest Vietnam for the period 2010-2011. The results showed that confidence intervals were asymmetric, with the highest uncertainty in the upper limit, and that a load of 6262 Mg year-1 had a 95 % confidence interval of (4331, 12 267) in 2010 and a load of 5543 Mg an interval of (3593, 8975) in 2011. Additionally, the approach demonstrated that direct estimates from the data were biased downwards compared to bootstrap median estimates. These results imply that constituent loads predicted from regression-type water quality models could frequently be underestimating sediment yields and their environmental impact.

  1. Effect size, confidence intervals and statistical power in psychological research.

    Directory of Open Access Journals (Sweden)

    Téllez A.

    2015-07-01

    Full Text Available Quantitative psychological research is focused on detecting the occurrence of certain population phenomena by analyzing data from a sample, and statistics is a particularly helpful mathematical tool that is used by researchers to evaluate hypotheses and make decisions to accept or reject such hypotheses. In this paper, the various statistical tools in psychological research are reviewed. The limitations of null hypothesis significance testing (NHST and the advantages of using effect size and its respective confidence intervals are explained, as the latter two measurements can provide important information about the results of a study. These measurements also can facilitate data interpretation and easily detect trivial effects, enabling researchers to make decisions in a more clinically relevant fashion. Moreover, it is recommended to establish an appropriate sample size by calculating the optimum statistical power at the moment that the research is designed. Psychological journal editors are encouraged to follow APA recommendations strictly and ask authors of original research studies to report the effect size, its confidence intervals, statistical power and, when required, any measure of clinical significance. Additionally, we must account for the teaching of statistics at the graduate level. At that level, students do not receive sufficient information concerning the importance of using different types of effect sizes and their confidence intervals according to the different types of research designs; instead, most of the information is focused on the various tools of NHST.

  2. Communicating the Improvements Developed from Critical Incident Reports is an Essential Part of CIRS.

    Science.gov (United States)

    Hubertus, J; Piehlmeier, W; Heinrich, M

    2016-09-01

    The Critical Incident Reporting System (CIRS) is a tool for employees to report anonymously of near misses. Its efficiency and improvement of safety is proved by many studies. Our department introduced CIRS in 2009 and it is used frequently. As the number of reports decreased over time we asked for factors responsible for the reduced use. All employees had access to CIRS and have been trained in several courses of instruction. Accomplished results and consequences were published in biannual newsletters. In 2014 we initiated an anonymous employee attitude survey to ask for their experience and satisfaction with CIRS. 88 near misses were reported since 2009. 44 (50%) reports were classified as RS1, 34 (38.6%) as RS2, and 10 (11.4%) as RS3. No RS4 reports were notified. Most reports concerned problems with administration of medication (n=26; 29.5%) and problems with technical devices (n=18; 20.5%). 75 (83%) of our employees participated in the survey. 64 (86.5%) discerned that CIRS is anonymous. 31 (41.9%) reported already a near miss. Of note, two-third didn't realize an improvement following their report. On the other hand, only half of the pollees stated to read the newsletter. Even if efficiency and advantages of CIRS are proved and undeniable, sufficient and perpetual feedback of results and improvements developed by the CIRS team and regular trainings of the employees are mandatory for the success of CIRS. © Georg Thieme Verlag KG Stuttgart · New York.

  3. CONSORT-EHEALTH: Improving and Standardizing Evaluation Reports of Web-based and Mobile Health Interventions

    Science.gov (United States)

    2011-01-01

    Background Web-based and mobile health interventions (also called “Internet interventions” or "eHealth/mHealth interventions") are tools or treatments, typically behaviorally based, that are operationalized and transformed for delivery via the Internet or mobile platforms. These include electronic tools for patients, informal caregivers, healthy consumers, and health care providers. The Consolidated Standards of Reporting Trials (CONSORT) statement was developed to improve the suboptimal reporting of randomized controlled trials (RCTs). While the CONSORT statement can be applied to provide broad guidance on how eHealth and mHealth trials should be reported, RCTs of web-based interventions pose very specific issues and challenges, in particular related to reporting sufficient details of the intervention to allow replication and theory-building. Objective To develop a checklist, dubbed CONSORT-EHEALTH (Consolidated Standards of Reporting Trials of Electronic and Mobile HEalth Applications and onLine TeleHealth), as an extension of the CONSORT statement that provides guidance for authors of eHealth and mHealth interventions. Methods A literature review was conducted, followed by a survey among eHealth experts and a workshop. Results A checklist instrument was constructed as an extension of the CONSORT statement. The instrument has been adopted by the Journal of Medical Internet Research (JMIR) and authors of eHealth RCTs are required to submit an electronic checklist explaining how they addressed each subitem. Conclusions CONSORT-EHEALTH has the potential to improve reporting and provides a basis for evaluating the validity and applicability of eHealth trials. Subitems describing how the intervention should be reported can also be used for non-RCT evaluation reports. As part of the development process, an evaluation component is essential; therefore, feedback from authors will be solicited, and a before-after study will evaluate whether reporting has been improved

  4. Teaching Evolution to Students with Compromised Backgrounds & Lack of Confidence about Evolution--Is It Possible?

    Science.gov (United States)

    Schauer, Alexandria; Cotner, Sehoya; Moore, Randy

    2014-01-01

    Students regard evolutionary theory differently than science in general. Students' reported confidence in their ability to understand science in general (e.g., posing scientific questions, interpreting tables and graphs, and understanding the content of their biology course) significantly outweighed their confidence in understanding evolution. We…

  5. Does Classroom Management Coursework Influence Pre-service Teachers' Perceived Preparedness or Confidence?

    Science.gov (United States)

    O'Neill, Sue; Stephenson, Jennifer

    2012-01-01

    There has been conjecture that completing focused coursework units on classroom management during pre-service teacher preparation might lead to increased feelings of preparedness and confidence. This study reports the preparedness in managing specific problem behaviours, familiarity, and confidence in using management strategies and models of…

  6. The Relationship between a Women's Leadership Development Program and Participant Self-Confidence

    Science.gov (United States)

    Jennings, Janelle Perron

    2009-01-01

    According to Lundeberg, Fox, and Punccohar (1994), the reason that there are fewer women in certain professions is because of a lack of self-confidence. In a review of the literature, they found studies reporting a lack of self-confidence in sixth-grade girls, high school students, and women in undergraduate and graduate school. In her work on…

  7. Risk of Bias in Reports of In Vivo Research: A Focus for Improvement.

    Directory of Open Access Journals (Sweden)

    Malcolm R Macleod

    2015-10-01

    Full Text Available The reliability of experimental findings depends on the rigour of experimental design. Here we show limited reporting of measures to reduce the risk of bias in a random sample of life sciences publications, significantly lower reporting of randomisation in work published in journals of high impact, and very limited reporting of measures to reduce the risk of bias in publications from leading United Kingdom institutions. Ascertainment of differences between institutions might serve both as a measure of research quality and as a tool for institutional efforts to improve research quality.

  8. The Effects of Game-Based Learning on Mathematical Confidence and Performance: High Ability vs. Low Ability

    Science.gov (United States)

    Ku, Oskar; Chen, Sherry Y.; Wu, Denise H.; Lao, Andrew C. C.; Chan, Tak-Wai

    2014-01-01

    Many students possess low confidence toward learning mathematics, which, in turn, may lead them to give up pursuing more mathematics knowledge. Recently, game-based learning (GBL) is regarded as a potential means in improving students' confidence. Thus, this study tried to promote students' confidence toward mathematics by using GBL. In addition,…

  9. Reporting Data with "Over-the-Counter" Data Analysis Supports Improves Educators' Data Analyses

    Science.gov (United States)

    Rankin, Jenny Grant

    2014-01-01

    The benefits of making data-informed decisions to improve learning rely on educators correctly interpreting given data. Many educators routinely misinterpret data, even at districts with proactive support for data use. The tool most educators use for data analyses, which is an information technology data system or its reports, typically reports…

  10. Incomplete reporting of enhanced recovery elements and its impact on achieving quality improvement

    DEFF Research Database (Denmark)

    Day, R W; Fielder, S; Calhoun, J

    2015-01-01

    per cent), length of stay (47, 94 per cent) and mortality (45, 90 per cent). CONCLUSION: The current standard of reporting is frequently incomplete. To transfer knowledge and facilitate implementation of pathways that demonstrate improvements in perioperative care and recovery, a consistent structured...

  11. Improving a newly developed patient-reported outcome for thyroid patients, using cognitive interviewing

    DEFF Research Database (Denmark)

    Watt, Torquil; Rasmussen, Ase Krogh; Groenvold, Mogens

    2008-01-01

    Objective To improve a newly developed patient-reported outcome measure for thyroid patients using cognitive interviewing. Methods Thirty-one interviews using immediate retrospective and expansive probing were conducted among patients with non-toxic goiter (n = 4), nodular toxic goiter (n = 5) Gr...

  12. The Graduation Cliff: Improving the Post-School Outcomes of Students with Disabilities. Summary Report

    Science.gov (United States)

    McFadden, Erica Skogebo; Daugherty, David B.; Lee, Sang Eun; Fisher, Kim W.; Hack, Anthony; Spyra, Ed

    2015-01-01

    There is a federal movement to improve student outcomes targeting some of these predictors in several recently launched initiatives, but where does Arizona stand? What are we currently doing to move the needle, and what do we still need to do? This report prepared for the Arizona Developmental Disabilities Planning Council has two objectives: (1)…

  13. Confidence assessment. Site descriptive modelling SDM-Site Forsmark

    International Nuclear Information System (INIS)

    2008-09-01

    The objective of this report is to assess the confidence that can be placed in the Forsmark site descriptive model, based on the information available at the conclusion of the surface-based investigations (SDM-Site Forsmark). In this exploration, an overriding question is whether remaining uncertainties are significant for repository engineering design or long-term safety assessment and could successfully be further reduced by more surface based investigations or more usefully by explorations underground made during construction of the repository. The confidence in the Forsmark site descriptive model, based on the data available at the conclusion of the surface-based site investigations, have been assessed by exploring: Confidence in the site characterisation data base; Key remaining issues and their handling; Handling of alternative models; Consistency between disciplines; and, Main reasons for confidence and lack of confidence in the model. It is generally found that the key aspects of importance for safety assessment and repository engineering of the Forsmark site descriptive model are associated with a high degree of confidence. Because of the robust geological model that describes the site, the overall confidence in Forsmark site descriptive model is judged to be high. While some aspects have lower confidence this lack of confidence is handled by providing wider uncertainty ranges, bounding estimates and/or alternative models. Most, but not all, of the low confidence aspects have little impact on repository engineering design or for long-term safety. Poor precision in the measured data are judged to have limited impact on uncertainties on the site descriptive model, with the exceptions of inaccuracy in determining the position of some boreholes at depth in 3-D space, as well as the poor precision of the orientation of BIPS images in some boreholes, and the poor precision of stress data determined by overcoring at the locations where the pre

  14. Chinese Management Research Needs Self-Confidence but not Over-confidence

    DEFF Research Database (Denmark)

    Li, Xin; Ma, Li

    2018-01-01

    Chinese management research aims to contribute to global management knowledge by offering rigorous and innovative theories and practical recommendations both for managing in China and outside. However, two seemingly opposite directions that researchers are taking could prove detrimental......-confidence, limiting theoretical innovation and practical relevance. Yet going in the other direction of overly indigenous research reflects over-confidence, often isolating the Chinese management research from the mainstream academia and at times, even becoming anti-science. A more integrated approach of conducting...... to the healthy development of Chinese management research. We argue that the two directions share a common ground that lies in the mindset regarding the confidence in the work on and from China. One direction of simply following the American mainstream on academic rigor demonstrates a lack of self...

  15. Thought confidence as a determinant of persuasion: the self-validation hypothesis.

    Science.gov (United States)

    Petty, Richard E; Briñol, Pablo; Tormala, Zakary L

    2002-05-01

    Previous research in the domain of attitude change has described 2 primary dimensions of thinking that impact persuasion processes and outcomes: the extent (amount) of thinking and the direction (valence) of issue-relevant thought. The authors examined the possibility that another, more meta-cognitive aspect of thinking is also important-the degree of confidence people have in their own thoughts. Four studies test the notion that thought confidence affects the extent of persuasion. When positive thoughts dominate in response to a message, increasing confidence in those thoughts increases persuasion, but when negative thoughts dominate, increasing confidence decreases persuasion. In addition, using self-reported and manipulated thought confidence in separate studies, the authors provide evidence that the magnitude of the attitude-thought relationship depends on the confidence people have in their thoughts. Finally, the authors also show that these self-validation effects are most likely in situations that foster high amounts of information processing activity.

  16. Licensee Event Report System. Evaluation of first year results, and recommendations for improvements. Supplement No. 2

    International Nuclear Information System (INIS)

    1985-09-01

    This report describes an evaluation of an industry-wide sample of Licensee Event Reports (LERs) that was conducted to determine whether or not these LERs were prepared in accordance with the requirements set forth in 10 CFR 50.73. The study was performed at the Idaho National Engineering Laboratory (INEL), by EG and G, Inc. This evaluation (NUREG/CR-4178) indicated that although the overall quality of the LERs was good, many LERs failed to meet all of the requirements. This report presents the methodology that was used to evaluate the LERs, the conclusions reached concerning problem areas in the reports, and suggestions as to how the overall quality and completeness of reports can be improved

  17. A Comparative Study of Self-Confidence from the Perspectives of Quran, Ahadith and Psychology

    Directory of Open Access Journals (Sweden)

    Sayyed Ali Mostajaboldavati

    2017-03-01

    Full Text Available Background and Objectives: Self-confidence, referring to relying on and exploiting individual abilities and talents for realizing spiritual and material prosperity, not only contradicts but is in agreement with and a prerequisite for faith in God. Practically, the greater faith in God one has, the more potent self-confidence he /she possess. Investigating the subject of self-confidence from the perspectives of Quran, Ahadith and psychology, this study explores the meaning of self (soul in self-confidence and its levels, the prerequisites for development and enhancement of self-confidence, the association of self-concept and self-esteem with self-confidence, and the approaches to develop and enhance positive self-concept as well as to boost self-confidence. Methods: The data of this descriptive review article were gathered from library and digital references. Results: Although it appears that self-confidence contradicts Islamic teachings, it can be clearly understood that this teaching subject is confirmed and emphasized in Islamic teachings by discovery of its true meaning. Conclusion: If having self-confidence is meant to rely on and exploiting individual abilities and talents to reach material and spiritual prosperity, it not only does not contradict but is in agreement with and a prerequisite for faith in God. Self in self- confidence indeed means human as a combination of the body and the spirit which is fully consistent with indices of self-confidence. According to psychologists, improving self-esteem and positive self-concept affects self-confidence directly. From perspective of religion, paying attention to venerability and God-given dignity of human, recognizing the superb purpose in life, etc. are approaches to develop and enhance positive self-concept and self-esteem, and to boost self-confidence.

  18. Dementia post-radiotherapy: improvement with acetylcholinesterase inhibitor A case report

    Directory of Open Access Journals (Sweden)

    Antonio Eduardo Damin

    Full Text Available Abstract Cognitive decline associated with radiotherapy is a progressive complication that affects many patients submitted to this form of treatment. The lack of an effective treatment drives research for new treatment options to improve the quality of life of patients with this disorder. We report the case of a 64 year-old man who developed a severe dementia of the frontal subcortical type, which was associated with subcortical frontal lesions and appeared as a late complication of radiotherapy used to treat a pituitary tumor. After many pharmacological attempts to improve his cognitive and behavioral problems, the patient showed a significant improvement in the cognitive, functional and behavioral impairments after treatment with an acetylcholinesterase inhibitor. This report discusses hypotheses for the positive effect of this treatment.

  19. Augmenting the impact of technology adoption with financial incentive to improve radiology report signature times.

    Science.gov (United States)

    Andriole, Katherine P; Prevedello, Luciano M; Dufault, Allen; Pezeshk, Parham; Bransfield, Robert; Hanson, Richard; Doubilet, Peter M; Seltzer, Steven E; Khorasani, Ramin

    2010-03-01

    Radiology report signature time (ST) can be a substantial component of total report turnaround time. Poor turnaround time resulting from lengthy ST can adversely affect patient care. The combination of technology adoption with financial incentive was evaluated to determine if ST improvement can be augmented and sustained. This prospective study was performed at a 751-bed, urban, tertiary care adult teaching hospital. Test-site imaging volume approximated 48,000 examinations per month. The radiology department has 100 trainees and 124 attending radiologists serving multiple institutions. Over a study period of 4 years and 4 months, three interventions focused on radiologist signature performance were implemented: 1) a notification paging application that alerted radiologists when reports were ready for signature, 2) a picture archiving and communications systems (PACS)-integrated speech recognition report generation system, and 3) a departmental financial incentive to reward radiologists semiannually for ST performance. Signature time was compared before and after the interventions. Wilcoxon and linear regression statistical analyses were used to assess the significance of trends. Technology adoption (paging plus speech recognition) reduced median ST from >5 to 24 to 15 to 18 hours (P financial incentive further improved 80th-percentile ST to 4 to 8 hours (P Technology interventions coupled with financial incentive can result in synergistic and sustainable improvement in radiologist report-signing behavior. The addition of a financial incentive leads to better performance than that achievable through technology alone.

  20. Improvement in the incident reporting and investigation procedures using process excellence (DMAI2C) methodology

    International Nuclear Information System (INIS)

    Miles, Elizabeth N.

    2006-01-01

    In 1996, Health and Safety introduced an incident investigation process called Learning to Look ( C) to Johnson and Johnson. This process provides a systematic way of analyzing work-related injuries and illness, uncovers root cause that leads to system defects, and points to viable solutions. The process analyzed involves three steps: investigation and reporting of the incident, determination of root cause, and development and implementation of a corrective action plan. The process requires the investigators to provide an initial communication for work-related serious injuries and illness as well as lost workday cases to Corporate Headquarters within 72h of the incident with a full investigative report to follow within 10 days. A full investigation requires a written report, a cause-result logic diagram (CRLD), a corrective action plan (CAP) and a report of incident costs (SafeCost) all due to be filed electronically. It is incumbent on the principal investigator and his or her investigative teams to assemble the various parts of the investigation and to follow up with the relevant parties to ensure corrective actions are implemented, and a full report submitted to Corporate executives. Initial review of the system revealed that the process was not working as designed. A number of reports were late, not signed by the business leaders, and in some instances, all cause were not identified. Process excellence was the process used to study the issue. The team used six sigma DMAI 2 C methodologies to identify and implement system improvements. The project examined the breakdown of the critical aspects of the reporting and investigation process that lead to system errors. This report will discuss the study findings, recommended improvements, and methods used to monitor the new improved process

  1. Identification of quality improvement areas in pediatric MRI from analysis of patient safety reports

    International Nuclear Information System (INIS)

    Jaimes, Camilo; Murcia, Diana J.; Miguel, Karen; DeFuria, Cathryn; Sagar, Pallavi; Gee, Michael S.

    2018-01-01

    Analysis of safety reports has been utilized to guide practice improvement efforts in adult magnetic resonance imaging (MRI). Data specific to pediatric MRI could help target areas of improvement in this population. To estimate the incidence of safety reports in pediatric MRI and to determine associated risk factors. In a retrospective HIPAA-compliant, institutional review board-approved study, a single-institution Radiology Information System was queried to identify MRI studies performed in pediatric patients (0-18 years old) from 1/1/2010 to 12/31/2015. The safety report database was queried for events matching the same demographic and dates. Data on patient age, gender, location (inpatient, outpatient, emergency room [ER]), and the use of sedation/general anesthesia were recorded. Safety reports were grouped into categories based on the cause and their severity. Descriptive statistics were used to summarize continuous variables. Chi-square analyses were performed for univariate determination of statistical significance of variables associated with safety report rates. A multivariate logistic regression was used to control for possible confounding effects. A total of 16,749 pediatric MRI studies and 88 safety reports were analyzed, yielding a rate of 0.52%. There were significant differences in the rate of safety reports between patients younger than 6 years (0.89%) and those older (0.41%) (P<0.01), sedated (0.8%) and awake children (0.45%) (P<0.01), and inpatients (1.1%) and outpatients (0.4%) (P<0.01). The use of sedation/general anesthesia is an independent risk factor for a safety report (P=0.02). The most common causes for safety reports were service coordination (34%), drug reactions (19%), and diagnostic test and ordering errors (11%). The overall rate of safety reports in pediatric MRI is 0.52%. Interventions should focus on vulnerable populations, such as younger patients, those requiring sedation, and those in need of acute medical attention. (orig.)

  2. Identification of quality improvement areas in pediatric MRI from analysis of patient safety reports

    Energy Technology Data Exchange (ETDEWEB)

    Jaimes, Camilo [Massachusetts General Hospital, Harvard Medical School, Division of Neuroradiology, Department of Radiology, Boston, MA (United States); Murcia, Diana J. [Massachusetts General Hospital, Harvard Medical School, Division of Abdominal Imaging, Department of Radiology, Boston, MA (United States); Miguel, Karen; DeFuria, Cathryn [Massachusetts General Hospital, Harvard Medical School, Quality and Safety Office, Department of Radiology, Boston, MA (United States); Sagar, Pallavi; Gee, Michael S. [Massachusetts General Hospital for Children, Harvard Medical School, Division of Pediatric Imaging, Department of Radiology, Boston, MA (United States)

    2018-01-15

    Analysis of safety reports has been utilized to guide practice improvement efforts in adult magnetic resonance imaging (MRI). Data specific to pediatric MRI could help target areas of improvement in this population. To estimate the incidence of safety reports in pediatric MRI and to determine associated risk factors. In a retrospective HIPAA-compliant, institutional review board-approved study, a single-institution Radiology Information System was queried to identify MRI studies performed in pediatric patients (0-18 years old) from 1/1/2010 to 12/31/2015. The safety report database was queried for events matching the same demographic and dates. Data on patient age, gender, location (inpatient, outpatient, emergency room [ER]), and the use of sedation/general anesthesia were recorded. Safety reports were grouped into categories based on the cause and their severity. Descriptive statistics were used to summarize continuous variables. Chi-square analyses were performed for univariate determination of statistical significance of variables associated with safety report rates. A multivariate logistic regression was used to control for possible confounding effects. A total of 16,749 pediatric MRI studies and 88 safety reports were analyzed, yielding a rate of 0.52%. There were significant differences in the rate of safety reports between patients younger than 6 years (0.89%) and those older (0.41%) (P<0.01), sedated (0.8%) and awake children (0.45%) (P<0.01), and inpatients (1.1%) and outpatients (0.4%) (P<0.01). The use of sedation/general anesthesia is an independent risk factor for a safety report (P=0.02). The most common causes for safety reports were service coordination (34%), drug reactions (19%), and diagnostic test and ordering errors (11%). The overall rate of safety reports in pediatric MRI is 0.52%. Interventions should focus on vulnerable populations, such as younger patients, those requiring sedation, and those in need of acute medical attention. (orig.)

  3. The Role of Residential Early Parenting Services in Increasing Parenting Confidence in Mothers with A History of Infertility

    Directory of Open Access Journals (Sweden)

    Marjan Lynette

    2016-07-01

    Full Text Available Background Mothers with a history of infertility may experience parenting difficulties and challenges. This study was conducted to investigate the role of residential early parenting services in increasing parenting confidence in mothers with a history of infertility. Materials and Methods This was a retrospective chart review study using the quantitative data from the clients attending the Karitane Residential Units and Parenting Services (known as Karitane RUs during 2013. Parenting confidence (using Karitane Parenting Confidence Scale-KPCS, depression, demographics, reproductive and medical history, as well as child’s information were assessed from a sample of 27 mothers who had a history of infertility and who attended the Karitane RUs for support and assistance. The data were analyzed using SPSS version 19. Results More than half of the women (59.3% reported a relatively low level of parenting confidence on the day of admission. The rate of low parenting confidence, however, dropped to 22.2% after receiving 4-5 days support and training in the Karitane RUs. The mean score of the KPCS increased from 36.9 ± 5.6 before the intervention to 41.1 ± 3.4 after the intervention, indicating an improvement in the parenting confidence of the mothers after attending the Karitane RUs (P<0.0001. No statistically significant association was found between maternal low parenting confidence with parental demographics (including age, country of birth, and employment status, a history of help-seeking, symptoms of depression, as well as child’s information [including gender, age, siblings, diagnosis of gastroesophageal reflux disease (GORD and use of medication]. Conclusion Having a child after a period of infertility can be a stressful experience for some mothers. This can result in low parenting confidence and affect parent-child attachment. Our findings emphasized on the role of the residential early parenting services in promoting the level of

  4. Support for reporting guidelines in surgical journals needs improvement: A systematic review.

    Science.gov (United States)

    Agha, Riaz A; Barai, Ishani; Rajmohan, Shivanchan; Lee, Seon; Anwar, Mohammed O; Fowler, Alexander J; Orgill, Dennis P; Altman, Douglas G

    2017-09-01

    Evidence-based medicine works best if the evidence is reported well. Past studies have shown reporting quality to be lacking in the field of surgery. Reporting guidelines are an important tool for authors to optimize the reporting of their research. The objective of this study was to analyse the frequency and strength of recommendation for such reporting guidelines within surgical journals. A systematic review of the 198 journals within the Journal Citation Report 2014 (surgery category) published by Thomson Reuters was undertaken. The online guide for authors for each journal was screened by two independent groups and results compared. Data regarding the presence and strength of recommendation to use reporting guidelines was extracted. 193 journals were included (as five appeared twice having changed their name). These had a median impact factor of 1.526 (range 0.047-8.327), with a median of 145 articles published per journal (range 29-659), with 34,036 articles published in total over the two-year window 2012-2013. The majority (62%) of surgical journals made no mention of reporting guidelines within their guidelines for authors. Of the 73 (38%) that did mention them, only 14% (10/73) required the use of all relevant reporting guidelines. The most frequently mentioned reporting guideline was CONSORT (46 journals). The mention of reporting guidelines within the guide for authors of surgical journals needs improvement. Authors, reviewers and editors should work to ensure that research is reported in line with the relevant reporting guidelines. Journals should consider hard-wiring adherence to them. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  5. Patient Drug Safety Reporting: Diabetes Patients' Perceptions of Drug Safety and How to Improve Reporting of Adverse Events and Product Complaints.

    Science.gov (United States)

    Patel, Puja; Spears, David; Eriksen, Betina Østergaard; Lollike, Karsten; Sacco, Michael

    2018-03-01

    Global health care manufacturer Novo Nordisk commissioned research regarding awareness of drug safety department activities and potential to increase patient feedback. Objectives were to examine patients' knowledge of pharmaceutical manufacturers' responsibilities and efforts regarding drug safety, their perceptions and experiences related to these efforts, and how these factors influence their thoughts and behaviors. Data were collected before and after respondents read a description of a drug safety department and its practices. We conducted quantitative survey research across 608 health care consumers receiving treatment for diabetes in the United States, Germany, United Kingdom, and Italy. This research validated initial, exploratory qualitative research (across 40 comparable consumers from the same countries) which served to guide design of the larger study. Before reading a drug safety department description, 55% of respondents were unaware these departments collect safety information on products and patients. After reading the description, 34% reported the department does more than they expected to ensure drug safety, and 56% reported "more confidence" in the industry as a whole. Further, 66% reported themselves more likely to report an adverse event or product complaint, and 60% reported that they were more likely to contact a drug safety department with questions. The most preferred communication methods were websites/online forums (39%), email (27%), and telephone (25%). Learning about drug safety departments elevates consumers' confidence in manufacturers' safety efforts and establishes potential for patients to engage in increased self-monitoring and reporting. Study results reveal potentially actionable insights for the industry across patient and physician programs and communications.

  6. A Quantitative Assessment of the Reporting Quality of Herbal Medicine Research: The Road to Improvement.

    Science.gov (United States)

    Naumann, Ken

    2018-02-01

    To quantify different aspects of the quality of reporting of herbal medicine clinical trials, to determine how that quality is affecting the conclusions of meta-analyses, and to target areas for improvement in future herbal medicine research reporting. The Electronic databases PubMed, Academic Search Premier, ScienceDirect, and Alt HealthWatch were searched for meta-analyses of herbal medicines in refereed journals and Cochrane Reviews in the years 2000-2004 and 2010-2014. The search was limited to meta-analyses of randomized controlled trials involving humans and published in English. Judgments and descriptions within the meta-analyses were used to report on risks of bias in the included clinical trials and the meta-analyses themselves. Out of 3264 citations, 9 journal-published meta-analyses were selected from 2000 to 2004, 116 from 2010 to 2014, and 44 Cochrane Reviews from 2010 to 2014. Across both time frames and categories of publication, herbal medicines include a significant number of clinical trials that do not meet the recommended standards for clinical trial reporting. This quantitative assessment identified significant publication bias and other bias risks that may be due to inadequate trial design or incomplete reporting of outcomes. Suggested improvements to herbal medicine clinical trial reporting are discussed.

  7. The theory of confidence-building measures

    International Nuclear Information System (INIS)

    Darilek, R.E.

    1992-01-01

    This paper discusses the theory of Confidence-Building Measures (CBMs) in two ways. First, it employs a top-down, deductively oriented approach to explain CBM theory in terms of the arms control goals and objectives to be achieved, the types of measures to be employed, and the problems or limitations likely to be encountered when applying CBMs to conventional or nuclear forces. The chapter as a whole asks how various types of CBMs might function during a political - military escalation from peacetime to a crisis and beyond (i.e. including conflict), as well as how they might operate in a de-escalatory environment. In pursuit of these overarching issues, the second section of the chapter raises a fundamental but complicating question: how might the next all-out war actually come aoubt - by unpremeditated escalation resulting from misunderstanding or miscalculation, or by premeditation resulting in a surprise attack? The second section of the paper addresses this question, explores its various implications for CBMs, and suggests the potential contribution of different types of CBMs toward successful resolution of the issues involved

  8. Umatilla River Subbasin Fish Habitat Improvement Program, 2004-2005 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    St. Hilaire, Danny R. (Oregon Department of Fish and Wildlife, Pendleton, OR)

    2006-02-01

    This annual report is in fulfillment of contractual obligations with Bonneville Power Administration (BPA), which is the funding source for the Oregon Department of Fish and Wildlife's (ODFW), Umatilla River Subbasin Fish Habitat Improvement Program (Program). The Program works cooperatively with private landowners to develop long-term restoration, under which, passive and active Habitat Improvement Projects are conducted. Historically, projects have included livestock exclusion fencing (passive restoration) to protect riparian habitats, along with the installation of instream structures (active restoration) to address erosion and improve fish habitat. In recent years, the focus of active restoration has shifted to bioengineering treatments and, more recently, to channel re-design and reconstruction aimed at improving fish habitat, by restoring stable channel function. This report provides a summary of Program activities for the 2004 calendar year (January 1 through December 31, 2004), within each of the four main project phases, including: (1) Implementation--Pre-Work, (2) Implementation--On Site Development, (3) Operation and Maintenance, and (4) Monitoring and Evaluation. This report also summarizes Program Administrative, Interagency Coordination, and Public Education activities.

  9. Making Residents Part of the Safety Culture: Improving Error Reporting and Reducing Harms.

    Science.gov (United States)

    Fox, Michael D; Bump, Gregory M; Butler, Gabriella A; Chen, Ling-Wan; Buchert, Andrew R

    2017-01-30

    Reporting medical errors is a focus of the patient safety movement. As frontline physicians, residents are optimally positioned to recognize errors and flaws in systems of care. Previous work highlights the difficulty of engaging residents in identification and/or reduction of medical errors and in integrating these trainees into their institutions' cultures of safety. The authors describe the implementation of a longitudinal, discipline-based, multifaceted curriculum to enhance the reporting of errors by pediatric residents at Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center. The key elements of this curriculum included providing the necessary education to identify medical errors with an emphasis on systems-based causes, modeling of error reporting by faculty, and integrating error reporting and discussion into the residents' daily activities. The authors tracked monthly error reporting rates by residents and other health care professionals, in addition to serious harm event rates at the institution. The interventions resulted in significant increases in error reports filed by residents, from 3.6 to 37.8 per month over 4 years (P error reporting correlated with a decline in serious harm events, from 15.0 to 8.1 per month over 4 years (P = 0.01). Integrating patient safety into the everyday resident responsibilities encourages frequent reporting and discussion of medical errors and leads to improvements in patient care. Multiple simultaneous interventions are essential to making residents part of the safety culture of their training hospitals.

  10. Integrated approach towards the application of horizontal wells to improve waterflooding performance. Annual report

    Energy Technology Data Exchange (ETDEWEB)

    Kelkar, M.; Liner, C.; Kerr, D.

    1995-05-01

    This annual report describes the progress during the second year of the project on Integrated Approach Towards the Application of Horizontal Wells to Improve Waterflooding Performance. This project is funded under the Department of Energy`s Class I program which is targeted towards improving the reservoir performance of mature oil fields located in fluvial-dominated deltaic deposits. The project involves an integrated approach to characterize the reservoir followed by the drilling of horizontal injection wells to improve production performance. The type of data we have integrated include cross bore hole seismic surveys, geological interpretation based on logs and cores, and engineering information. This report covers the second phase of the project which includes a detailed reservoir description of the field by integrating all the available information, followed by flow simulation of the Self Unit under various operating conditions. Based on an examination of the various operating parameters, we observed that the best possible solution to improve the Self Unit performance is to recomplete and stimulate most of the wells followed by an increase in the water injection rate. Drilling of horizontal injection well, although helpful in improving the performance, was not found to be economically feasible. The proposed reservoir management plan will be implemented shortly.

  11. Balance confidence is related to features of balance and gait in individuals with chronic stroke

    Science.gov (United States)

    Schinkel-Ivy, Alison; Wong, Jennifer S.; Mansfield, Avril

    2016-01-01

    Reduced balance confidence is associated with impairments in features of balance and gait in individuals with sub-acute stroke. However, an understanding of these relationships in individuals at the chronic stage of stroke recovery is lacking. This study aimed to quantify relationships between balance confidence and specific features of balance and gait in individuals with chronic stroke. Participants completed a balance confidence questionnaire and clinical balance assessment (quiet standing, walking, and reactive stepping) at 6 months post-discharge from inpatient stroke rehabilitation. Regression analyses were performed using balance confidence as a predictor variable and quiet standing, walking, and reactive stepping outcome measures as the dependent variables. Walking velocity was positively correlated with balance confidence, while medio-lateral centre of pressure excursion (quiet standing) and double support time, step width variability, and step time variability (walking) were negatively correlated with balance confidence. This study provides insight into the relationships between balance confidence and balance and gait measures in individuals with chronic stroke, suggesting that individuals with low balance confidence exhibited impaired control of quiet standing as well as walking characteristics associated with cautious gait strategies. Future work should identify the direction of these relationships to inform community-based stroke rehabilitation programs for individuals with chronic stroke, and determine the potential utility of incorporating interventions to improve balance confidence into these programs. PMID:27955809

  12. AFSC/RACE/GAP/Orr: Gulf of Alaska and Aleutian Islands groundfish surveys Identification Confidence

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This report includes an identification confidence matrix for all fishes and invertebrates identified from the GOA and AI surveys from 1980 through 2011. The matrix...

  13. AFSC/RACE/GAP/Orr: Bering Sea Slope groundfish surveys Identification Confidence

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This report includes an identification confidence matrix for all fishes and invertebrates identified from the EBS slope triennial and biennial surveys from 1976...

  14. Improving gross motor function and postural control with hippotherapy in children with Down syndrome: case reports.

    Science.gov (United States)

    Champagne, Danielle; Dugas, Claude

    2010-11-01

    The purpose of this case report is to describe the impact of an 11-week hippotherapy program on the gross motor functions of two children (respectively 28 and 37 months old) diagnosed with Down syndrome. Hippotherapy is a strategy that uses the horse's motion to stimulate and enhance muscle contraction and postural control. The children were assessed by the Gross Motor Function Measure (GMFM) and accelerometry. The results indicate that both children improved on many dimensions of the GMFM. Power spectral analysis of the acceleration signals showed improvement in postural control of either the head or trunk, because the children adopted two different adaptative strategies to perturbation induced by the moving horse.

  15. Fuel utilization improvements in a once-through PWR fuel cycle. Final report on Task 6

    International Nuclear Information System (INIS)

    Dabby, D.

    1979-06-01

    In studying the position of the United States Department of Energy, Non-proliferation Alternative Systems Assessment Program, this report determines the uranium saving associated with various improvement concepts applicable to a once-through fuel cycle of a standard four-loop Westinghouse Pressurized Water Reactor. Increased discharged fuel burnup from 33,000 to 45,000 MWD/MTM could achieve a 12% U 3 O 8 saving by 1990. Improved fuel management schemes combined with coastdown to 60% power, could result in U 3 O 8 savings of 6%

  16. Fuel performance improvement program. Quarterly/annual progress report, October 1977--September 1978

    International Nuclear Information System (INIS)

    Crouthamel, C.E.

    1978-10-01

    This quarterly/annual report reviews and summarizes the activities performed in support of the Fuel Performance Improvement Program (FPIP) during Fiscal Year 1978 with emphasis on those activities that transpired during the quarter ending September 30, 1978. Significant progress has been made in achieving the primary objectives of the program, i.e., to demonstrate commercially viable fuel concepts with improved fuel - cladding interaction (FCI) behavior. This includes out-of-reactor experiments to support the fuel concepts being evaluated, initiation of instrumented test rod experiments in the Halden Boiling Water Reactor (HBWR), and fabrication of the first series of demonstration rods for irradiation in the Big Rock Point Reactor

  17. Conflicting race/ethnicity reports: lessons for improvement in data quality.

    Science.gov (United States)

    Webster, Pamela S; Fulton, John P; Sampangi, Swathi

    2013-01-01

    To learn the frequency of conflicting race/ethnicity reports, to examine patterns of conflicting reports, and to identify possible avenues for data quality improvement. As part of the Data Improvement Project on Patient Ethnicity and Race (DIPPER), an analysis of conflicting race/ethnicity reports for cancer cases was conducted. Using matched hospital discharge data and central cancer registry data from 2009, the race/ethnicity of patients in the 2 datasets were compared. Those with conflicting reports ("mismatched") were examined more closely. From a sample of 2,356 patients, 187 had conflicting reports for their race (7.9%) and 357 had conflicting reports for their ethnicity (15% was thus developed). In the 2009 hospital discharge data, an unknown response occurred nearly twice as often for Hispanic ethnicity as for race. Almost 85% of the mismatched race cases were classified as non-white in the hospital discharge data and white in the central cancer registry data. The most common ethnicity mismatch was coded unknown by the hospital but non-Hispanic by the registry. Hospital cancer registrars occasionally lack easy access to race and, more often, ethnicity data. More attention should be given to discrepancies (including allowing staff to flag and verify existing data), and staff training should improve both perceived and real data accuracy. In the future, hospitals and registries would be better served by pairing race and ethnicity together in the electronic medical record. This would ensure quick, easy access for cancer registrars. Perhaps standard setters should add ethnicity to the gold standard criteria for registries.

  18. Improving Hospital Reporting of Patient Race and Ethnicity--Approaches to Data Auditing.

    Science.gov (United States)

    Zingmond, David S; Parikh, Punam; Louie, Rachel; Lichtensztajn, Daphne Y; Ponce, Ninez; Hasnain-Wynia, Romana; Gomez, Scarlett Lin

    2015-08-01

    To investigate new metrics to improve the reporting of patient race and ethnicity (R/E) by hospitals. California Patient Discharge Database (PDD) and birth registry, 2008-2009, Healthcare and Cost Utilization Project's State Inpatient Database, 2008-2011, cancer registry 2000-2008, and 2010 US Census Summary File 2. We examined agreement between hospital reported R/E versus self-report among mothers delivering babies and a cancer cohort in California. Metrics were created to measure root mean squared differences (RMSD) by hospital between reported R/E distribution and R/E estimates using R/E distribution within each patient's zip code of residence. RMSD comparisons were made to corresponding "gold standard" facility-level measures within the maternal cohort for California and six comparison states. Maternal birth hospitalization (linked to the state birth registry) and cancer cohort records linked to preceding and subsequent hospitalizations. Hospital discharges were linked to the corresponding Census zip code tabulation area using patient zip code. Overall agreement between the PDD and the gold standard for the maternal cohort was 86 percent for the combined R/E measure and 71 percent for race alone. The RMSD measure is modestly correlated with the summary level gold standard measure for R/E (r = 0.44). The RMSD metric revealed general improvement in data agreement and completeness across states. "Other" and "unknown" categories were inconsistently applied within inpatient databases. Comparison between reported R/E and R/E estimates using zip code level data may be a reasonable first approach to evaluate and track hospital R/E reporting. Further work should focus on using more granular geocoded data for estimates and tracking data to improve hospital collection of R/E data. © Health Research and Educational Trust.

  19. An assessment of the precision and confidence of aquatic eddy correlation measurements

    DEFF Research Database (Denmark)

    Donis, Daphne; Holtappels, Moritz; Noss, Christian

    2015-01-01

    facility with well-constrained hydrodynamics. These observations are used to review data processing procedures and to recommend improved deployment methods, thus improving the precision, reliability, and confidence of EC measurements. Specifically, this study demonstrates that 1) the alignment of the time...... series based on maximum cross correlation improved the precision of EC flux estimations; 2) an oxygen sensor with a response time of

  20. Feedback from incident reporting: information and action to improve patient safety.

    Science.gov (United States)

    Benn, J; Koutantji, M; Wallace, L; Spurgeon, P; Rejman, M; Healey, A; Vincent, C

    2009-02-01

    Effective feedback from incident reporting systems in healthcare is essential if organisations are to learn from failures in the delivery of care. Despite the wide-scale development and implementation of incident reporting in healthcare, studies in the UK suggest that information concerning system vulnerabilities could be better applied to improve operational safety within organisations. In this article, the findings and implications of research to identify forms of effective feedback from incident reporting are discussed, to promote best practices in this area. The research comprised a mixed methods review to investigate mechanisms of effective feedback for healthcare, drawing upon experience within established reporting programmes in high-risk industry and transport domains. Systematic searches of published literature were undertaken, and 23 case studies describing incident reporting programmes with feedback were identified for analysis from the international healthcare literature. Semistructured interviews were undertaken with 19 subject matter experts across a range of domains, including: civil aviation, maritime, energy, rail, offshore production and healthcare. In analysis, qualitative information from several sources was synthesised into practical requirements for developing effective feedback in healthcare. Both action and information feedback mechanisms were identified, serving safety awareness, improvement and motivational functions. The provision of actionable feedback that visibly improved systems was highlighted as important in promoting future reporting. Fifteen requirements for the design of effective feedback systems were identified, concerning: the role of leadership, the credibility and content of information, effective dissemination channels, the capacity for rapid action and the need for feedback at all levels of the organisation, among others. Above all, the safety-feedback cycle must be closed by ensuring that reporting, analysis and

  1. Graduating general surgery resident operative confidence: perspective from a national survey.

    Science.gov (United States)

    Fonseca, Annabelle L; Reddy, Vikram; Longo, Walter E; Gusberg, Richard J

    2014-08-01

    General surgical training has changed significantly over the last decade with work hour restrictions, increasing subspecialization, the expanding use of minimally invasive techniques, and nonoperative management for solid organ trauma. Given these changes, this study was undertaken to assess the confidence of graduating general surgery residents in performing open surgical operations and to determine factors associated with increased confidence. A survey was developed and sent to general surgery residents nationally. We queried them regarding demographics and program characteristics, asked them to rate their confidence (rated 1-5 on a Likert scale) in performing open surgical procedures and compared those who indicated confidence with those who did not. We received 653 responses from the fifth year (postgraduate year 5) surgical residents: 69% male, 68% from university programs, and 51% from programs affiliated with a Veterans Affairs hospital; 22% from small programs, 34% from medium programs, and 44% from large programs. Anticipated postresidency operative confidence was 72%. More than 25% of residents reported a lack of confidence in performing eight of the 13 operations they were queried about. Training at a university program, a large program, dedicated research years, future fellowship plans, and training at a program that performed a large percentage of operations laparoscopically was associated with decreased confidence in performing a number of open surgical procedures. Increased surgical volume was associated with increased operative confidence. Confidence in performing open surgery also varied regionally. Graduating surgical residents indicated a significant lack of confidence in performing a variety of open surgical procedures. This decreased confidence was associated with age, operative volume as well as type, and location of training program. Analyzing and addressing this confidence deficit merits further study. Copyright © 2014 Elsevier Inc. All

  2. Breast calcifications. A standardized mammographic reporting and data system to improve positive predictive value

    International Nuclear Information System (INIS)

    Perugini, G.; Bonzanini, B.; Valentino, C.

    1999-01-01

    The purpose of this work is to investigate the usefulness of a standardized reporting and data system in improving the positive predictive value of mammography in breast calcifications. Using the Breast Imaging Reporting and Data System lexicon developed by the American College of Radiology, it is defined 5 descriptive categories of breast calcifications and classified diagnostic suspicion of malignancy on a 3-grade scale (low, intermediate and high). Two radiologists reviewed 117 mammographic studies selected from those of the patients submitted to surgical biopsy for mammographically detected calcifications from January 1993 to December 1997, and classified them according to the above criteria. The positive predictive value was calculated for all examinations and for the stratified groups. Defining a standardized system for assessing and describing breast calcifications helps improve the diagnostic accuracy of mammography in clinical practice [it

  3. Improvement of a portable high-energy radiographic inspection system: Final report

    International Nuclear Information System (INIS)

    Owen, R.D.

    1987-02-01

    This report describes the development of miniaturized linear accelerator (MINAC) technology, including descriptions of all major developments sponsored by EPRI subsequent to previously sponsored work. In addition, this report describes MINAC-related developments in both real-time x-ray imaging and radiographic image data processing systems which were sponsored by EPRI concurrently. The objectives of this program have been to achieve modifications identified as desirable improvements to the basic ''MINAC 3'' equipment; to expand the range and effectiveness of MINAC applications through design improvements, achievement of wider energy/output capabilities, and the development of suitable imaging and digital processing technologies; and to provide technical information on high-energy radiographic equipment useful to scientists, educators, institutions, NDE technicians and others who may benefit from detailed information on the special equipment. Program, equipment and technical descriptions are followed by conclusions and recommendations for future work

  4. Programme Reporting Standards (PRS for improving the reporting of sexual, reproductive, maternal, newborn, child and adolescent health programmes

    Directory of Open Access Journals (Sweden)

    Anna E. Kågesten

    2017-08-01

    Full Text Available Abstract Background Information about design, implementation, monitoring and evaluation is central to understand the impact of programmes within the field of sexual, reproductive, maternal, newborn, child and adolescent health (SRMNCAH. Existing reporting guidelines do not orient on reporting of contextual and implementation issues in sufficient detail. We therefore developed Programme Reporting Standards (PRS to be used by SRMNCAH programme implementers and researchers. Methods Building on the first step of the PRS development (a systematic review to identify reporting items, we conducted a three-round online Delphi consensus survey with experts. Consensus was defined a-priori as 80% agreement of items as essential. This was followed by a technical consultation with a group of experts to refine the items, definitions and their structuring. The revised PRS was piloted to assess its relevance to current SRMNCAH programme reports and identify key issues regarding the use of the PRS. Results Of the 81 participants invited to the Delphi survey, 20 responded to all three rounds. In the final round, 27 items received consensus as essential; three items were ranked as “borderline” essential; 20 items as supplementary. The items were subsequently revised, followed by a technical consultation with 29 experts to further review and refine the PRS. The feedback resulted in substantial changes to the structure and content of the PRS into 24 items across five domains: Programme overview; Programme components and implementation; Monitoring of Implementation; Evaluation and Results; and Synthesis. This version was used in a piloting exercise, where questions regarding how much information to report and how to comment on the quality of the information reported were addressed. All items were kept in the PRS following the pilot although minor changes were made to the flow and description of items. Conclusions The PRS 1.0 is the result of a structured

  5. Measuring the Success of Changes to Existing Business Intelligence Solutions to Improve Business Intelligence Reporting

    OpenAIRE

    Dedić, Nedim; Stanier, Clare

    2016-01-01

    Evaluating the success of changes to an existing Business Intelligence (BI) environment means that there is a need to compare the level of user satisfaction with the original and amended versions of the application. The focus of this paper is on producing an evaluation tool, which can be used to measure the success of changes to existing BI solutions to support improved BI reporting. The paper identifies the users involved in the BI process and investigates what is meant by satisfaction in th...

  6. Peer Helpers: Encouraging Kids to Confide.

    Science.gov (United States)

    Tanaka, Gail; Reid, Kelley

    1997-01-01

    In peer-helping programs, a professional counselor or teacher trains a group of students who then help other students by listening, providing information, and referring them to others with the necessary expertise. Peer helpers can help improve the school climate by contributing to its health and security. Since 1979, Seattle's Natural Helpers…

  7. Predicting Manual Therapy Treatment Success in Patients With Chronic Ankle Instability: Improving Self-Reported Function.

    Science.gov (United States)

    Wikstrom, Erik A; McKeon, Patrick O

    2017-04-01

      Therapeutic modalities that stimulate sensory receptors around the foot-ankle complex improve chronic ankle instability (CAI)-associated impairments. However, not all patients have equal responses to these modalities. Identifying predictors of treatment success could improve clinician efficiency when treating patients with CAI.   To conduct a response analysis on existing data to identify predictors of improved self-reported function in patients with CAI.   Secondary analysis of a randomized controlled clinical trial.   Sports medicine research laboratories.   Fifty-nine patients with CAI, which was defined in accordance with the International Ankle Consortium recommendations.   Participants were randomized into 3 treatment groups (plantar massage [PM], ankle-joint mobilization [AJM], or calf stretching [CS]) that received six 5-minute treatments over 2 weeks.   Treatment success, defined as a patient exceeding the minimally clinically important difference of the Foot and Ankle Ability Measure-Sport (FAAM-S).   Patients with ≤5 recurrent sprains and ≤82.73% on the Foot and Ankle Ability Measure had a 98% probability of having a meaningful FAAM-S improvement after AJM. As well, ≥5 balance errors demonstrated 98% probability of meaningful FAAM-S improvements from AJM. Patients <22 years old and with ≤9.9 cm of dorsiflexion had a 99% probability of a meaningful FAAM-S improvement after PM. Also, those who made ≥2 single-limb-stance errors had a 98% probability of a meaningful FAAM-S improvement from PM. Patients with ≤53.1% on the FAAM-S had an 83% probability of a meaningful FAAM-S improvement after CS.   Each sensory-targeted ankle-rehabilitation strategy resulted in a unique combination of predictors of success for patients with CAI. Specific indicators of success with AJM were deficits in self-reported function, single-limb balance, and <5 previous sprains. Age, weight-bearing-dorsiflexion restrictions, and single-limb balance

  8. Summary report of the consultants' meeting on improvement of the standard cross sections for light elements

    International Nuclear Information System (INIS)

    Carlson, A.D.; Muir, D.W.; Pronyaev, V.G.

    2001-06-01

    This report summarizes the results of the Consultants' Meeting on Improvement of the Standard Cross Sections for Light Elements. The approaches and computer programs used for evaluation of neutron standard cross sections and their uncertainties were presented by the participants. Special attention was paid to the reasons for strong uncertainty reduction observed in the model fits. The meeting participants discussed the plan of the INDC recommended Co-ordinated Research Project (CRP) on 'Improvement of the Standard Cross Sections for Light Elements'. This CRP will address the problem of uncertainty reduction along with other methodological improvements needed in order to produce a new, and internationally accepted, evaluation of neutron standard cross sections for light elements. (author)

  9. A Nephrology Fellows' Communication Skills Course: An Educational Quality Improvement Report.

    Science.gov (United States)

    Cohen, Robert A; Jackson, Vicki A; Norwich, Diana; Schell, Jane O; Schaefer, Kristen; Ship, Amy N; Sullivan, Amy M

    2016-08-01

    Nephrology fellows need expertise navigating challenging conversations with patients throughout the course of advanced kidney disease. However, evidence shows that nephrologists receive inadequate training in this area. This study assessed the effectiveness of an educational quality improvement intervention designed to enhance fellows' communication with patients who have advanced kidney disease. Quality improvement project. Full-day annual workshops (2013-2014) using didactics, discussion, and practice with simulated patients. Content focused on delivering bad news, acknowledging emotion, discussing care goals in dialysis decision making when prognosis is uncertain, and addressing dialysis therapy withdrawal and end of life. Participants were first-year nephrology fellows from 2 Harvard-affiliated training programs (N=26). Study assessed the effectiveness of an intervention designed to enhance fellows' communication skills. Primary outcomes were changes in self-reported patient communication skills, attitudes, and behaviors related to discussing disease progression, prognostic uncertainty, dialysis therapy withdrawal, treatments not indicated, and end of life; responding to emotion; eliciting patient goals and values; and incorporating patient goals into recommendations. Surveys measured prior training, pre- and postcourse perceived changes in skills and values, and reported longer term (3-month) changes in communication behaviors, using both closed- and open-ended items. Response rates were 100% (pre- and postsurveys) and 68% (follow-up). Participants reported improvement in all domains, with an overall mean increase of 1.1 (summed average scores: precourse, 2.8; postcourse, 3.9 [1-5 scale; 5 = "extremely well prepared"]; Pskills taught, such as "Ask-Tell-Ask" and using open-ended questions. Self-reported data may overestimate actual changes; small sample size and the programs' affiliation with a single medical school may limit generalizability. A day

  10. Improving knowledge management through the support of image examination and data annotation using DICOM structured reporting.

    Science.gov (United States)

    Torres, José Salavert; Damian Segrelles Quilis, J; Espert, Ignacio Blanquer; García, Vicente Hernandez

    2012-12-01

    An important effort has been invested on improving the image diagnosis process in different medical areas using information technologies. The field of medical imaging involves two main data types: medical imaging and reports. Developments based on the DICOM standard have demonstrated to be a convenient and widespread solution among the medical community. The main objective of this work is to design a Web application prototype that will be able to improve diagnosis and follow-on of breast cancer patients. It is based on TRENCADIS middleware, which provides a knowledge-oriented storage model composed by federated repositories of DICOM image studies and DICOM-SR medical reports. The full structure and contents of the diagnosis reports are used as metadata for indexing images. The TRENCADIS infrastructure takes full advantage of Grid technologies by deploying multi-resource grid services that enable multiple views (reports schemes) of the knowledge database. The paper presents a real deployment of such Web application prototype in the Dr. Peset Hospital providing radiologists with a tool to create, store and search diagnostic reports based on breast cancer explorations (mammography, magnetic resonance, ultrasound, pre-surgery biopsy and post-surgery biopsy), improving support for diagnostics decisions. A technical details for use cases (outlining enhanced multi-resource grid services communication and processing steps) and interactions between actors and the deployed prototype are described. As a result, information is more structured, the logic is clearer, network messages have been reduced and, in general, the system is more resistant to failures. Copyright © 2012 Elsevier Inc. All rights reserved.

  11. Learning about confidence intervals with software R

    Directory of Open Access Journals (Sweden)

    Gariela Gonçalves

    2013-08-01

    Full Text Available 0 0 1 202 1111 USAL 9 2 1311 14.0 Normal 0 21 false false false ES JA X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabla 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:0cm 5.4pt 0cm 5.4pt; mso-para-margin-top:0cm; mso-para-margin-right:0cm; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0cm; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:Calibri; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-ansi-language:ES; mso-fareast-language:EN-US;} This work was to study the feasibility of implementing a teaching method that employs software, in a Computational Mathematics course, involving students and teachers through the use of the statistical software R in carrying out practical work, such as strengthening the traditional teaching. The statistical inference, namely the determination of confidence intervals, was the content selected for this experience. It was intended show, first of all, that it is possible to promote, through the proposal methodology, the acquisition of basic skills in statistical inference and to promote the positive relationships between teachers and students. It presents also a comparative study between the methodologies used and their quantitative and qualitative results on two consecutive school years, in several indicators. The data used in the study were obtained from the students to the exam questions in the years 2010/2011 and 2011/2012, from the achievement of a working group in 2011/2012 and via the responses to a questionnaire (optional and anonymous also applied in 2011 / 2012. In terms of results, we emphasize a better performance of students in the examination questions in 2011/2012, the year that students used the software R, and a very favorable student’s perspective about

  12. Study of amended reports to evaluate and improve surgical pathology processes.

    Science.gov (United States)

    Meier, Frederick A; Varney, Ruan C; Zarbo, Richard J

    2011-09-01

    : Amended surgical pathology reports record defects in the process of transforming tissue specimens into diagnostic information. : Systematic study of amended reports tests 2 hypotheses: (a) that tracking amendment frequencies and the distribution of amendment types reveals relevant aspects of quality in surgical pathology's daily transformation of specimens into diagnoses and (b) that such tracking measures the effect, or lack of effect, of efforts to improve surgical pathology processes. : We applied a binary definition of altered reports as either amendments or addenda and a taxonomy of defects that caused amendments as misidentifications, specimen defects, misinterpretations, and report defects. During the introduction of a LEAN process improvement approach-the Henry Ford Productions System-we followed trends in amendment rates and defect fractions to (a) evaluate specific interventions, (b) sort case-by-case root causes of misidentifications, specimen defects, and misinterpretations, and (c) audit the ongoing accuracy of the classification of changed reports. LEAN is the management and production system of the Toyota Motor Corporation that promotes continuous improvement; it considers wasted resources expended for purposes other than creating value for end customers and targets such expenditures for elimination. : Introduction of real-time editing of amendments saw annual amendment rates increase from 4.8/1000 to 10.1/1000 and then decrease in an incremental manner to 5.6/1000 as Henry Ford Productions System-specific interventions were introduced. Before introduction of HFPS interventions, about a fifth of the amendments were due to misidentifications, a 10th were due to specimen defects, a quarter due to misinterpretation, and almost half were due to report defects. During the period of the initial application of HFPS, the fraction of amendments due to misidentifications decreased as those due to report defects increased, in a statistically linked manner. As

  13. Confidence Intervals from Normalized Data: A correction to Cousineau (2005

    Directory of Open Access Journals (Sweden)

    Richard D. Morey

    2008-09-01

    Full Text Available Presenting confidence intervals around means is a common method of expressing uncertainty in data. Loftus and Masson (1994 describe confidence intervals for means in within-subjects designs. These confidence intervals are based on the ANOVA mean squared error. Cousineau (2005 presents an alternative to the Loftus and Masson method, but his method produces confidence intervals that are smaller than those of Loftus and Masson. I show why this is the case and offer a simple correction that makes the expected size of Cousineau confidence intervals the same as that of Loftus and Masson confidence intervals.

  14. Building confidence: an exploration of nurses undertaking a postgraduate biological science course.

    Science.gov (United States)

    Van Wissen, Kim; McBride-Henry, Karen

    2010-01-01

    This study aimed to explore the impact of studying biological science at a postgraduate level and how this impacted on nursing practice. The term biological sciences in this research encompasses elements of physiology, genetics, biochemistry and pathophysiology. A qualitative research study was designed, that involved the dissemination of a pre- and post-course semi-structured questionnaire for a biological science course, as part of a Master of Nursing programme at a New Zealand University, thus exploring the impact of undertaking a postgraduate biological sciences course. The responses were analysed into themes, based on interpretive concepts. The primary themes revealed improvement in confidence as: confidence in communication, confidence in linking nursing theoretical knowledge to practice and confidence in clinical nursing knowledge. This study highlights the need to privilege clinically-derived nursing knowledge, and that confidence in this nursing knowledge and clinical practice can be instilled through employing the model of theory-guided practice.

  15. Does Consumer Confidence Forecast Household Saving and Borrowing Behavior? Evidence for Poland.

    Science.gov (United States)

    Kłopocka, Aneta Maria

    2017-01-01

    Consumer confidence plays an important role in households' decision-making processes. This study investigates the effects of consumer confidence on household saving and borrowing behavior that are unsatisfactorily considered in previous discussions. The questions of interest are first, whether indexes of consumer confidence have any predictive power on their own for future household saving and borrowing rates, and second, whether they contain information about future household saving and borrowing rates aside from the information contained in other available indicators. In addition to aggregate confidence indicators, their components are used to provide more precise information. Overall, the multiple linear regression analysis (OLS technique) of Polish time-series data gives positive answers to both questions. This finding supports the recommendation of combining the strengths of objective indicators (such as economic fundamentals) and subjective indicators (such as consumer confidence) to improve household financial behavior forecasts.

  16. Evaluating an undergraduate interprofessional simulation-based educational module: communication, teamwork, and confidence performing cardiac resuscitation skills

    Directory of Open Access Journals (Sweden)

    Marian Luctkar-Flude

    2010-11-01

    Full Text Available Marian Luctkar-Flude1, Cynthia Baker1, Cheryl Pulling1, Robert McGraw2, Damon Dagnone2, Jennifer Medves1, Carly Turner-Kelly11School of Nursing, Queen’s University, Kingston, Ontario, Canada; 2School of Medicine, Queen’s University, Kingston, Ontario, CanadaPurpose: Interprofessional (IP collaboration during cardiac resuscitation is essential and contributes to patient wellbeing. The purpose of this study is to evaluate an innovative simulation-based IP educational module for undergraduate nursing and medical students on cardiac resuscitation skills.Methods: Nursing and medical trainees participated in a new cardiac resuscitation curriculum involving a 2-hour IP foundational cardiac resuscitation skills lab, followed by three 2-hour IP simulation sessions. Control group participants attended the existing two 2-hour IP simulation sessions. Study respondents (N = 71 completed a survey regarding their confidence performing cardiac resuscitation skills and their perceptions of IP collaboration.Results: Despite a consistent positive trend, only one out of 17 quantitative survey items were significantly improved for learners in the new curriculum. They were more likely to report feeling confident managing the airway during cardiac resuscitation (P = 0.001. Overall, quantitative results suggest that senior nursing and medical students were comfortable with IP communication and teamwork and confident with cardiac resuscitation skills. There were no significant differences between nursing students’ and medical students’ results. Through qualitative feedback, participants reported feeling comfortable learning with students from other professions and found value in the IP simulation sessions.Conclusion: Results from this study will inform ongoing restructuring of the IP cardiac resuscitation skills simulation module as defined by the action research process. Specific improvements that are suggested by these findings include strengthening the team

  17. The Precision of Effect Size Estimation From Published Psychological Research: Surveying Confidence Intervals.

    Science.gov (United States)

    Brand, Andrew; Bradley, Michael T

    2016-02-01

    Confidence interval ( CI) widths were calculated for reported Cohen's d standardized effect sizes and examined in two automated surveys of published psychological literature. The first survey reviewed 1,902 articles from Psychological Science. The second survey reviewed a total of 5,169 articles from across the following four APA journals: Journal of Abnormal Psychology, Journal of Applied Psychology, Journal of Experimental Psychology: Human Perception and Performance, and Developmental Psychology. The median CI width for d was greater than 1 in both surveys. Hence, CI widths were, as Cohen (1994) speculated, embarrassingly large. Additional exploratory analyses revealed that CI widths varied across psychological research areas and that CI widths were not discernably decreasing over time. The theoretical implications of these findings are discussed along with ways of reducing the CI widths and thus improving precision of effect size estimation.

  18. A call to improve sampling methodology and reporting in young novice driver research.

    Science.gov (United States)

    Scott-Parker, B; Senserrick, T

    2017-02-01

    Young drivers continue to be over-represented in road crash fatalities despite a multitude of research, communication and intervention. Evidence-based improvement depends to a great extent upon research methodology quality and its reporting, with known limitations in the peer-review process. The aim of the current research was to review the scope of research methodologies applied in 'young driver' and 'teen driver' research and their reporting in four peer-review journals in the field between January 2006 and December 2013. In total, 806 articles were identified and assessed. Reporting omissions included participant gender (11% of papers), response rates (49%), retention rates (39%) and information regarding incentives (44%). Greater breadth and specific improvements in study designs and reporting are thereby identified as a means to further advance the field. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  19. Report: EPA Is Taking Steps to Improve State Drinking Water Program Reviews and Public Water Systems Compliance Data

    Science.gov (United States)

    Report #17-P-0326, July 18, 2017. The EPA is taking action to improve oversight tools used to determine whether public water systems are monitoring and reporting drinking water quality in accordance with the Safe Drinking Water Act.

  20. Leader's opinion priority bounded confidence model for network opinion evolution

    Science.gov (United States)

    Zhu, Meixia; Xie, Guangqiang

    2017-08-01

    Aiming at the weight of trust someone given to participate in the interaction in Hegselmann-Krause's type consensus model is the same and virtual social networks among individuals with different level of education, personal influence, etc. For differences between agents, a novelty bounded confidence model was proposed with leader's opinion considered priority. Interaction neighbors can be divided into two kinds. The first kind is made up of "opinion leaders" group, another kind is made up of ordinary people. For different groups to give different weights of trust. We also analyzed the related characteristics of the new model under the symmetrical bounded confidence parameters and combined with the classical HK model were analyzed. Simulation experiment results show that no matter the network size and initial view is subject to uniform distribution or discrete distribution. We can control the "opinion-leader" good change the number of views and values, and even improve the convergence speed. Experiment also found that the choice of "opinion leaders" is not the more the better, the model well explain how the "opinion leader" in the process of the evolution of the public opinion play the role of the leader.

  1. Technical specification improvements to containment heat removal and emergency core cooling systems: Final report

    International Nuclear Information System (INIS)

    Sullivan, W.P.; Ha, C.; Pentzien, D.C.; Visweswaran, S.

    1988-07-01

    This report presents the results of an analysis for technical specification improvements to the emergency core cooling systems (ECCS) and containment heat removal systems (EPRI Research Project 2142-3). The objective of this project is to further develop a reliability- and risk-based methodology to provide improvements by considering groups of surveillance test intervals and allowed out-of-service times jointly. This was done for the technical specifications for the ECCS, containment heat removal equipment, and supporting systems of a boiling water reactor plant. The project (1) developed a methodology for optimizing groups of surveillance test intervals and allowed out-of-service times jointly, (2) applied the methodology in a case study of a specific operating plant, Hatch-2, and (3) evaluated benefits of the application. The results of the case study demonstrate that beneficial technical specification improvements can be realized with application of the methodology. By tightening a small group of sensitive surveillance test intervals (STIs) and allowed out-of-service times (AOTs), a larger group of less sensitive STIs and AOTs can be extended resulting in an overall plant operating cost improvement without reducing the plant safety. The reliability- and risk-based methodology and results from this project can be effectively applied for technical specification improvements at other operating plants

  2. An SPSS Macro to Compute Confidence Intervals for Pearson’s Correlation

    Directory of Open Access Journals (Sweden)

    Bruce Weaver

    2014-04-01

    Full Text Available In many disciplines, including psychology, medical research, epidemiology and public health, authors are required, or at least encouraged to report confidence intervals (CIs along with effect size estimates. Many students and researchers in these areas use IBM-SPSS for statistical analysis. Unfortunately, the CORRELATIONS procedure in SPSS does not provide CIs in the output. Various work-around solutions have been suggested for obtaining CIs for rhowith SPSS, but most of them have been sub-optimal. Since release 18, it has been possible to compute bootstrap CIs, but only if users have the optional bootstrap module. The !rhoCI macro described in this article is accessible to all SPSS users with release 14 or later. It directs output from the CORRELATIONS procedure to another dataset, restructures that dataset to have one row per correlation, computes a CI for each correlation, and displays the results in a single table. Because the macro uses the CORRELATIONS procedure, it allows users to specify a list of two or more variables to include in the correlation matrix, to choose a confidence level, and to select either listwise or pairwise deletion. Thus, it offers substantial improvements over previous solutions to theproblem of how to compute CIs for rho with SPSS.

  3. Mandatory Reporting? Issues to consider when developing legislation and policy to improve discovery of child abuse

    Directory of Open Access Journals (Sweden)

    Emma Davies

    2014-10-01

    Full Text Available Article by Dr Emma Davies (School of Law, Liverpool John Moores University, Associate Professor Ben Mathews (School of Law, Queensland University of Technology and Professor John Read (Institute of Psychology, Health and Society, University of Liverpool. In the United Kingdom, recent investigations into child sexual abuse occurring within schools, the Catholic Church and the British Broadcasting Corporation, have intensified debate on ways to improve the discovery of child sexual abuse, and child maltreatment generally. One approach adopted in other jurisdictions to better identify cases of severe child maltreatment is the introduction of some form of legislative mandatory reporting to require designated persons to report known and suspected cases. The debate in England has raised the prospect of whether adopting a strategy of some kind of mandatory reporting law is advisable. The purpose of this article is to add to this debate by identifying fundamental principles, issues and complexities underpinning policy and even legislative developments in the interests of children and society. The article will first highlight the data on the hidden nature of child maltreatment and the background to the debate. Secondly, it will identify some significant gaps in knowledge that need to be filled. Thirdly, the article will summarise the barriers to reporting abuse and neglect. Fourthly, we will identify a range of options for, and clarify the dilemmas in developing, legislative mandatory reporting, addressing two key issues: who should be mandated to report, and what types of child maltreatment should they be required to report? Finally, we draw attention to some inherently different goals and competing interests, both between and within the various institutions involved in the safeguarding of children and the criminal prosecution of some offenders. Based on this analysis we offer some concluding observations that we hope contribute to informed and careful

  4. Breakaway technique training as a means of increasing confidence in managing aggression in neuroscience nursing.

    Science.gov (United States)

    Lamont, Scott; Brunero, Scott; Bailey, Alanah; Woods, Karen

    2012-08-01

    The objective of this paper was to evaluate breakaway technique training with neuroscience nursing staff as a measure of increased confidence and safety in managing aggression. A quasi experimental design was used in a sample of neuroscience nursing staff (n=31), participating in 2×1h breakaway technique workshops. The workshops consisted of supervised skills training in safe breakaway techniques. A pre- and postintervention-matched questionnaire measuring confidence and safety around managing aggressive patients, and exposure to and confidence in dealing with breakaways, was self administered. Statistically significant increases in confidence and safety in working with aggressive patients, and confidence levels for safe breakaways were reported. Qualitative comments demonstrated a desire for ongoing skills workshops. This study provides early evidence of the importance of incorporating breakaway training into existing training programs which aim to minimise and manage aggression and violence in generalist settings.

  5. Peer teaching and information retrieval: the role of the NICE Evidence search student champion scheme in enhancing students' confidence.

    Science.gov (United States)

    Sbaffi, Laura; Hallsworth, Elaine; Weist, Anne

    2018-03-01

    This research reports on the NICE Evidence search (ES) student champion scheme (SCS) first five years of activity (2011-2016) in terms of its impact on health care undergraduate students' information search skills and search confidence. A review of students' evaluation of the scheme was carried out to chart the changes in attitude towards NICE Evidence search as an online health care information source and to monitor students' approach to information seeking. This study is based on the results of questionnaires distributed to students before and after attending a training session on NICE Evidence search delivered by their own peers. The exercise was implemented in health related universities in England over a period of five consecutive academic years. (i) Students' search confidence improved considerably after the training; (ii) ES was perceived as being an increasingly useful resource of evidence based information for their studies; (iii) the training helped students develop discerning search skills and use evidence based information sources more consistently and critically. The NICE SCS improves confidence in approaching information tasks amongst health care undergraduate students. Future developments could involve offering the training at the onset of a course of study and adopting online delivery formats to expand its geographical reach. © 2018 Health Libraries Group.

  6. Physician Confidence in Dental Trauma Treatment and the Introduction of a Dental Trauma Decision-Making Pathway for the Pediatric Emergency Department.

    Science.gov (United States)

    Cully, Matthew; Cully, Jennifer; Nietert, Paul J; Titus, M Olivia

    2018-04-24

    The objectives of this study were to (1) survey and report the awareness and confidence of pediatric emergency medicine physicians in the management of dental trauma and (2) determine the prevalence of dental trauma decision-making pathway utilization in the pediatric emergency department. A survey was distributed through e-mail to the pediatric emergency medicine discussion list via Brown University LISTSERV. The survey study included 10 questions and was multiple-choice. The survey contained questions about physician confidence and their use of a dental trauma decision-making pathway. A total of 285 individuals responded to the survey. Somewhat confident was the most common response (61%) followed by not confident (20%) and confident (19%) by respondents in treating dental trauma. Forty-one percent of respondents felt comfortable, 39% somewhat comfortable, 19% not comfortable, and 1% not sure in replanting an avulsed tooth. Only 6% of respondents reported that their pediatric emergency department always or sometimes uses a dental trauma decision-making pathway, whereas 78% of pediatric emergency departments do not. We believe that the adoption of a decision-making pathway will provide timely management, improve emergency physician comfort, and enhance outcomes for pediatric patients presenting with a dental trauma. A future multicenter review will aim to evaluate these goals based on the utilization of our dental trauma decision-making pathway.

  7. Protein Correlation Profiles Identify Lipid Droplet Proteins with High Confidence*

    Science.gov (United States)

    Krahmer, Natalie; Hilger, Maximiliane; Kory, Nora; Wilfling, Florian; Stoehr, Gabriele; Mann, Matthias; Farese, Robert V.; Walther, Tobias C.

    2013-01-01

    Lipid droplets (LDs) are important organelles in energy metabolism and lipid storage. Their cores are composed of neutral lipids that form a hydrophobic phase and are surrounded by a phospholipid monolayer that harbors specific proteins. Most well-established LD proteins perform important functions, particularly in cellular lipid metabolism. Morphological studies show LDs in close proximity to and interacting with membrane-bound cellular organelles, including the endoplasmic reticulum, mitochondria, peroxisomes, and endosomes. Because of these close associations, it is difficult to purify LDs to homogeneity. Consequently, the confident identification of bona fide LD proteins via proteomics has been challenging. Here, we report a methodology for LD protein identification based on mass spectrometry and protein correlation profiles. Using LD purification and quantitative, high-resolution mass spectrometry, we identified LD proteins by correlating their purification profiles to those of known LD proteins. Application of the protein correlation profile strategy to LDs isolated from Drosophila S2 cells led to the identification of 111 LD proteins in a cellular LD fraction in which 1481 proteins were detected. LD localization was confirmed in a subset of identified proteins via microscopy of the expressed proteins, thereby validating the approach. Among the identified LD proteins were both well-characterized LD proteins and proteins not previously known to be localized to LDs. Our method provides a high-confidence LD proteome of Drosophila cells and a novel approach that can be applied to identify LD proteins of other cell types and tissues. PMID:23319140

  8. Curling for Confidence: Psychophysical Benefits of Curling for Older Adults.

    Science.gov (United States)

    Stone, Rachael C; Rakhamilova, Zina; Gage, William H; Baker, Joseph

    2018-04-01

    While physical activity is increasingly promoted for older adults, there is a paucity of sport promotion, which has distinct benefits from exercise and remains stereotypically associated with younger age. Curling is a moderately intense and safe sport that continues to gain popularity; however, no research has investigated psychophysical benefits of curling for older adults. The present study compares high-experience (20+ years; n = 63) and low-experience (<20 years; n = 53) curlers (aged 60+ years) with older adult noncurlers (n = 44) on measures of daily functionality, balance confidence, and perceptions of the aging process. While no significant differences were found between high- and low-experience curlers, any level of experience reported significantly better functionality, physical confidence, and aging attitudes compared to noncurlers (p ≤ .05). Although further research is necessary, the results suggest that any level of curling experience can enhance older adult psychophysical well-being, and warrants consideration for physical activity promotion and falls prevention programs.

  9. Alternative confidence measure for local matching stereo algorithms

    CSIR Research Space (South Africa)

    Ndhlovu, T

    2009-11-01

    Full Text Available The authors present a confidence measure applied to individual disparity estimates in local matching stereo correspondence algorithms. It aims at identifying textureless areas, where most local matching algorithms fail. The confidence measure works...

  10. nigerian students' self-confidence in responding to statements

    African Journals Online (AJOL)

    Temechegn

    Altogether the test is made up of 40 items covering students' ability to recall definition ... confidence interval within which student have confidence in their choice of the .... is mentioned these equilibrium systems come to memory of the learner.

  11. Simultaneous confidence bands for the integrated hazard function

    OpenAIRE

    Dudek, Anna; Gocwin, Maciej; Leskow, Jacek

    2006-01-01

    The construction of the simultaneous confidence bands for the integrated hazard function is considered. The Nelson--Aalen estimator is used. The simultaneous confidence bands based on bootstrap methods are presented. Two methods of construction of such confidence bands are proposed. The weird bootstrap method is used for resampling. Simulations are made to compare the actual coverage probability of the bootstrap and the asymptotic simultaneous confidence bands. It is shown that the equal--tai...

  12. Final Report on the Operation and Maintenance Improvement Program for Concentrating Solar Power Plants

    International Nuclear Information System (INIS)

    Cohen, Gilbert E.; Kearney, David W.; Kolb, Gregory J.

    1999-01-01

    This report describes the results of a six-year, $6.3 million project to reduce operation and maintenance (O ampersand M) costs at power plants employing concentrating solar power (CSP) technology. Sandia National Laboratories teamed with KJC Operating Company to implement the O ampersand M Improvement Program. O ampersand M technologies developed during the course of the program were demonstrated at the 150-MW Kramer Junction solar power park located in Boron, California. Improvements were made in the following areas: (a) efficiency of solar energy collection, (b) O ampersand M information management, (c) reliability of solar field flow loop hardware, (d) plant operating strategy, and (e) cost reduction associated with environmental issues. A 37% reduction in annual O ampersand M costs was achieved. Based on the lessons learned, an optimum solar- field O ampersand M plan for future CSP plants is presented. Parabolic trough solar technology is employed at Kramer Junction. However, many of the O ampersand M improvements described in the report are also applicable to CSP plants based on solar power tower or dish/engine concepts

  13. Final Report on the Operation and Maintenance Improvement Program for Concentrating Solar Power Plants

    Energy Technology Data Exchange (ETDEWEB)

    Cohen Gilbert E.; Kearney, David W.; Kolb, Gregory J.

    1999-06-01

    This report describes the results of a six-year, $6.3 million project to reduce operation and maintenance (O&M) costs at power plants employing concentrating solar power (CSP) technology. Sandia National Laboratories teamed with KJC Operating Company to implement the O&M Improvement Program. O&M technologies developed during the course of the program were demonstrated at the 150-MW Kramer Junction solar power park located in Boron, California. Improvements were made in the following areas: (a) efficiency of solar energy collection, (b) O&M information management, (c) reliability of solar field flow loop hardware, (d) plant operating strategy, and (e) cost reduction associated with environmental issues. A 37% reduction in annual O&M costs was achieved. Based on the lessons learned, an optimum solar- field O&M plan for future CSP plants is presented. Parabolic trough solar technology is employed at Kramer Junction. However, many of the O&M improvements described in the report are also applicable to CSP plants based on solar power tower or dish/engine concepts.

  14. Bootstrap-based confidence estimation in PCA and multivariate statistical process control

    DEFF Research Database (Denmark)

    Babamoradi, Hamid

    be used to detect outliers in the data since the outliers can distort the bootstrap estimates. Bootstrap-based confidence limits were suggested as alternative to the asymptotic limits for control charts and contribution plots in MSPC (Paper II). The results showed that in case of the Q-statistic......Traditional/Asymptotic confidence estimation has limited applicability since it needs statistical theories to estimate the confidences, which are not available for all indicators/parameters. Furthermore, in case the theories are available for a specific indicator/parameter, the theories are based....... The goal was to improve process monitoring by improving the quality of MSPC charts and contribution plots. Bootstrapping algorithm to build confidence limits was illustrated in a case study format (Paper I). The main steps in the algorithm were discussed where a set of sensible choices (plus...

  15. 49 CFR 1103.23 - Confidences of a client.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 8 2010-10-01 2010-10-01 false Confidences of a client. 1103.23 Section 1103.23... Responsibilities Toward A Client § 1103.23 Confidences of a client. (a) The practitioner's duty to preserve his client's confidence outlasts the practitioner's employment by the client, and this duty extends to the...

  16. Contrasting Academic Behavioural Confidence in Mexican and European Psychology Students

    Science.gov (United States)

    Ochoa, Alma Rosa Aguila; Sander, Paul

    2012-01-01

    Introduction: Research with the Academic Behavioural Confidence scale using European students has shown that students have high levels of confidence in their academic abilities. It is generally accepted that people in more collectivist cultures have more realistic confidence levels in contrast to the overconfidence seen in individualistic European…

  17. Reported care giver strategies for improving drinking water for young children.

    Science.gov (United States)

    McLennan, John D; Farrelly, Ashley

    2010-11-01

    Care givers may engage in a variety of strategies to try and improve drinking water for children. However, the pattern of these efforts is not well known, particularly for young children in high-risk situations. The objective of this study was to determine care giver-reported strategies for young children with (1) undernutrition and (2) living in an unplanned poor peri-urban community in the Dominican Republic. Practices reported by care givers of young children from a community and clinic group were extracted from interviews conducted between 2004 and 2008 (n = 563). These results were compared to two previous similar samples interviewed in 1997 (n = 341). Bottled water is currently the most prevalent reported strategy for improving drinking water for young children. Its use increased from 6% to 69% in the community samples over the last decade and from 13% to 79% in the clinic samples. Boiling water continues to be a common strategy, particularly for the youngest children, though its overall use has decreased over time. Household-level chlorination is infrequently used and has dropped over time. Care givers are increasingly turning to bottled water in an attempt to provide safe drinking water for their children. While this may represent a positive trend for protecting children from water-transmitted diseases, it may represent an inefficient approach to safe drinking water provision that may place a financial burden on low-income families.

  18. Australian midwives and provision of nutrition education during pregnancy: A cross sectional survey of nutrition knowledge, attitudes, and confidence.

    Science.gov (United States)

    Arrish, Jamila; Yeatman, Heather; Williamson, Moira

    2016-10-01

    Maternal nutrition during pregnancy affects the health of the mother and the baby. Midwives are ideally placed to provide nutrition education to pregnant women. There is limited published research evidence of Australian midwives' nutrition knowledge, attitudes and confidence. To investigate Australian midwives' nutrition knowledge, attitudes and confidence in providing nutrition education during pregnancy. Members of the Australian College of Midwives (n=4770) were sent an invitation email to participate in a web-based survey, followed by two reminders. The completion rate was 6.9% (329 of 4770). The majority (86.6% and 75.7%, respectively) highly rated the importance of nutrition during pregnancy and the significance of their role in nutrition education. Midwives' nutrition knowledge was inadequate in several areas such as weight gain, dairy serves and iodine requirements (73.3%, 73.2% and 79.9% incorrect responses, respectively). The level of confidence in discussing general and specific nutrition issues ranged mostly from moderate to low. The majority of the midwives (93%) provided nutrition advice to pregnant women. This advice was mostly described as 'general' and focused on general nutrition topics. Only half of the midwives reported receiving nutrition education during midwifery education (51.1%) or after registration (54.1%). Australian midwives' attitudes towards nutrition during pregnancy and their role in educating pregnant women about it were positive but their knowledge and confidence did not align with these attitudes. This could be due to minimal nutrition education during midwifery education or during practice. Continued education to improve midwives' nutrition knowledge and confidence is essential. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  19. Three success factors for continual improvement in healthcare: an analysis of the reports of improvement team members.

    Science.gov (United States)

    Brandrud, Aleidis Skard; Schreiner, Ada; Hjortdahl, Per; Helljesen, Gro Sævil; Nyen, Bjørnar; Nelson, Eugene C

    2011-03-01

    The objectives of the Breakthrough Series Collaborative are to close the gap between what we know and what we do, and to contribute to continuous quality improvement (CQI) of healthcare through collaborative learning. The improvement efforts are guided by a systematic approach, combining professional and improvement knowledge. To explore what the improvement teams have learnt from participating in the collaborative and from dealing with promoting and inhibiting factors encountered. Qualitative interviews with 19 team members were conducted in four focus groups, using the Critical Incident Technique. A critical incident is one that makes significant contributions, either positively or negatively, to an activity. The elements of a culture of improvement are revealed by the critical incidents, and reflect the eight domains of knowledge, as a product of collaborative learning. The improvement knowledge and skills of individuals are important elements, but not enough to achieve sustainable changes. 90% of the material reflects the need for a system of CQI to solve the problems that organisations experience in trying to make lasting improvements. A pattern of three success factors for CQI emerges: (1) continuous and reliable information, including measurement, about best and current practice; (2) engagement of everybody in all phases of the improvement work: the patient and family, the leadership, the professional environment and the staff; and (3) an infrastructure based on improvement knowledge, with multidisciplinary teams, available coaching, learning systems and sustainability systems.

  20. Using Surgeon-Specific Outcome Reports and Positive Deviance for Continuous Quality Improvement.

    Science.gov (United States)

    Ivanovic, Jelena; Anstee, Caitlin; Ramsay, Tim; Gilbert, Sebastien; Maziak, Donna E; Shamji, Farid M; Sundaresan, R Sudhir; Villeneuve, P James; Seely, Andrew J E

    2015-10-01

    Using the thoracic morbidity and mortality classification to document all postoperative adverse events between October 2012 and February 2014, we created surgeon-specific outcome reports (SSORs) to promote self-assessment and to implement a divisional continuous quality improvement (CQI) program, on the construct of positive deviance, to improve individual surgeon's clinical performance. Mixed-methods study within a division of six thoracic surgeons, involving (1) development of real-time, Web-based, risk-adjusted SSORs; (2) implementation of CQI seminars (n = 6; September 2013 to June 2014) for evaluation of results, collegial discussion on quality improvement based on identification of positive outliers, and selection of quality indicators for future discussion; and (3) in-person interviews to identify facilitators and barriers to using SSORs and CQI. Interview transcripts were analyzed using thematic analysis. Interviews revealed enthusiastic support for SSORs as a means to improve patient care through awareness of personal outcomes with blinded divisional comparison for similar operations and diseases, and apply the learning objectives to continuous professional development and maintenance of certification. Perceived limitations of SSORs included difficulty measuring surgeon expertise, limited understanding of risk adjustment, resistance to change, and belief that knowledge of sensitive data could lead to punitive actions. All surgeons believed CQI seminars led to collegial discussions, whereas perceived limitations included quorum participation and failing to circle back on actionable items. Real-time performance feedback using SSORs can motivate surgeons to improve their practice, and CQI seminars offer the opportunity to review and interpret results and address issues in a supportive environment. Whether SSORs and CQI can lead to improvements in rates of postoperative adverse events is a matter of ongoing research. Copyright © 2015 The Society of Thoracic

  1. The Forum on Stakeholder Confidence celebrates a decade of work

    International Nuclear Information System (INIS)

    Pescatore, C.; Mays, C.; Diaconu, D.

    2010-01-01

    Since its foundation in 2000, the NEA Radioactive Waste Management Committee (RWMC) Forum on Stakeholder Confidence (FSC) has fostered constructive dialogues and interactions with hundreds of interested parties in radioactive waste management, ranging from specialists and academic researchers, national and local politicians to local stakeholders and associations. Many of those partners came to Paris in September 2010 to participate in the colloquium 'Looking Back, Looking Forward in Stakeholder Engagement'. This Ten- year Anniversary Colloquium as well as the FSC's eleventh regular meeting on the following two days were open to all interested parties. This article describes the Forum and the online reports in which learning is shared. It highlights the two major topics discussed at the Colloquium and reviews the joint evaluation made there of FSC achievements. Finally, it points to the directions selected for a new decade of work

  2. Final priority; technical assistance to improve state data capacity--National Technical Assistance Center to improve state capacity to accurately collect and report IDEA data. Final priority.

    Science.gov (United States)

    2013-05-20

    The Assistant Secretary for Special Education and Rehabilitative Services announces a priority under the Technical Assistance to Improve State Data Capacity program. The Assistant Secretary may use this priority for competitions in fiscal year (FY) 2013 and later years. We take this action to focus attention on an identified national need to provide technical assistance (TA) to States to improve their capacity to meet the data collection and reporting requirements of the Individuals with Disabilities Education Act (IDEA). We intend this priority to establish a TA center to improve State capacity to accurately collect and report IDEA data (Data Center).

  3. Powerplant productivity improvement study: policy analysis and incentive assessment. Final report

    Energy Technology Data Exchange (ETDEWEB)

    None

    1979-05-01

    Policy options that the Illinois Commerce Commission might adopt in order to promote improved power plant productivity for existing units in Illinois are identified and analyzed. These policy options would generally involve either removing existing disincentives and/or adding direct incentives through the regulatory process. The following activities are reported: in-depth review of existing theoretical and empirical literature in the areas of power plant reliability, regulatory utility efficiency and performance incentives, and impacts of various regulatory mechanisms such as the Fuel Adjustment Clauses on productivity; contacts with other state public utility commissions known to be investigating or implementing productivity improvement incentive mechanisms; documentation and analysis of incentive mechanisms adopted or under consideration in other states; analysis of current regulatory practice in Illinois as it relates to power plant productivity incentives and disincentives; identification of candidate incentive mechanisms for consideration by the Illinois Commerce Commission; and analysis and evaluation of these candidates. 72 references, 8 figures.

  4. Improvement of post-hypoxic action myoclonus with levetiracetam add-on therapy: A case report

    Directory of Open Access Journals (Sweden)

    Božić Ksenija

    2014-01-01

    Full Text Available Introduction. Chronic post-anoxic myoclonus, also known as Lance-Adams syndrome, may develop following hypoxic brain injury, and is resistant to pharmacological therapy. Case report. The patient we presented developed post-anoxic action myoclonus with severe, completely incapacitating myoclonic jerks. Myoclonus did not respond to the treatment with commonly used agents, i.e. valproate and clonazepam alone or in combination. Improvement of the action myoclonus was observed only after adding levetiracetam. Conclusion. Although Lance-Adams syndrome may not be fully curable at this point, levetiracetam appears to be a promising agent that can significantly improve functional level and overall quality of life of patients with this disorder.

  5. Improved vacuum sealing drainage in the treatment of gas gangrene: a case report.

    Science.gov (United States)

    Liu, Zhaofa; Zhao, Dewei; Wang, Benjie

    2015-01-01

    In this case, improved vacuum sealing drainage was used for gas gangrene treatment, which is different from traditional therapies of gas gangrene and this is the first report of using improved vacuum sealing drainage to treat gas gangrene. The patient was a 12-year-old Asian Male who was presented to the Emergency Department with a one-day history of left femoral progressing swelling, paining and fevering. Four days ago, rusty iron bars were plugged into the muscle of the left femoral when he played. Then he was taken to the local clinic and injected with tetanus antitoxin. A diagnosis of gas gangrene was made and modified vacuum sealing drainage device was used after thorough debridement. After two weeks' treatment, left femoral was kept and gas gangrene was cured successfully.

  6. Clinician perceptions of personal safety and confidence to manage inpatient aggression in a forensic psychiatric setting.

    Science.gov (United States)

    Martin, T; Daffern, M

    2006-02-01

    Inpatient mental health clinicians need to feel safe in the workplace. They also require confidence in their ability to work with aggressive patients, allowing the provision of therapeutic care while protecting themselves and other patients from psychological and physical harm. The authors initiated this study with the predetermined belief that a comprehensive and integrated organizational approach to inpatient aggression was required to support clinicians and that this approach increased confidence and staff perceptions of personal safety. To assess perceptions of personal safety and confidence, clinicians in a forensic psychiatric hospital were surveyed using an adapted version of the Confidence in Coping With Patient Aggression Instrument. In this study clinicians reported the hospital as safe. They reported confidence in their work with aggressive patients. The factors that most impacted on clinicians' confidence to manage aggression were colleagues' knowledge, experience and skill, management of aggression training, use of prevention and intervention strategies, teamwork and the staff profile. These results are considered with reference to an expanding literature on inpatient aggression. It is concluded that organizational resources, policies and frameworks support clinician perceptions of safety and confidence to manage inpatient aggression. However, how these are valued by clinicians and translated into practice at unit level needs ongoing attention.

  7. Turning is an important marker of balance confidence and walking limitation in persons with multiple sclerosis.

    Directory of Open Access Journals (Sweden)

    Gautam Adusumilli

    Full Text Available The standard functional tool for gait assessment in multiple sclerosis (MS clinical trials has been the 25-Foot Timed Walk Test, a measure of gait speed. Straight-line gait assessment may not reflect adequately upon balance and coordination. Walking tests with turns may add additional information towards understanding gait and balance status, and be more reflective of ambulation in the community. Understanding the impact of turn parameters on patient-reported outcomes of balance and walking would help MS clinicians better formulate treatment plans for persons with gait limitations. In this study, ninety-one persons with MS (Expanded Disability Status Score; EDSS, range: 0-6.5 were enrolled in an initial cross-sectional study. Twenty-four subjects (EDSS, range:1.0-6.0 completed a follow-up visit an average of 12 months later. Spatiotemporal gait analysis was collected at both visits using APDM Opal wireless body-worn sensors while performing the Timed-Up-and-Go (TUG and 6-Minute Walk Test (6MWT. For both cross-sectional and longitudinal data, regression analyses determined the impact on the addition of turning parameters to stride velocity (SV, in the prediction of self-reported balance confidence (Activities-Specific Balance Confidence Scale (ABC and walking limitation (12-item Multiple Sclerosis Walking Scale (MSWS-12. The addition of 6MWT peak turn velocity (PTV to 6MWT SV increased the predictive power of the 6MWT for the ABC from 20% to 33%, and increased the predictive power from 28% to 41% for the MSWS-12. TUG PTV added to TUG SV also strengthened the relationship of the TUG for the ABC from 19% to 28%, and 27% to 36% for the MSWS-12. For those with 1 year follow-up, percent change in turn number of steps (TNS%Δ during the 6MWT added to 6MWT SV%Δ improved the modeling of ABC%Δ from 24% to 33%. 6MWT PTV%Δ added to 6MWT SV%Δ increased the predictive power of MSWS-12%Δ from 8% to 27%. Conclusively, turn parameters improved modeling of

  8. Comprehensive Plan for Public Confidence in Nuclear Regulator

    International Nuclear Information System (INIS)

    Choi, Kwang Sik; Choi, Young Sung; Kim, Ho ki

    2008-01-01

    Public confidence in nuclear regulator has been discussed internationally. Public trust or confidence is needed for achieving regulatory goal of assuring nuclear safety to the level that is acceptable by the public or providing public ease for nuclear safety. In Korea, public ease or public confidence has been suggested as major policy goal in the 'Nuclear regulatory policy direction' annually announced. This paper reviews theory of trust, its definitions and defines nuclear safety regulation, elements of public trust or public confidence developed based on the study conducted so far. Public ease model developed and 10 measures for ensuring public confidence are also presented and future study directions are suggested

  9. Report on a programme of testing and improving the geosphere models used within SYVAC

    International Nuclear Information System (INIS)

    Broyd, T.W.; Deaves, D.M.; Gibson, A.E.; Rutledge, K.W.

    1985-03-01

    A number of geosphere models for use with the SYVAC (System Variability Analysis Code) computer program have been developed, and are described in various previous reports. The SYVAC computer program provides an assessment of the dose effect to man resulting from buried wastes, using a series of submodels to represent transport processes in the vault, geosphere and biosphere. The work reported herein describes a programme of testing and improvements carried out on these models. It is concluded that the individual solution methods work well within stated parametric limits, and that further development studies should await a commitment to use SYVAC for the radiological assessment of specific named sites. The exception to this general rule may be the consideration of overall time scales and time stepping methods used within SYVAC. (author)

  10. The utility of including pathology reports in improving the computational identification of patients

    Directory of Open Access Journals (Sweden)

    Wei Chen

    2016-01-01

    Full Text Available Background: Celiac disease (CD is a common autoimmune disorder. Efficient identification of patients may improve chronic management of the disease. Prior studies have shown searching International Classification of Diseases-9 (ICD-9 codes alone is inaccurate for identifying patients with CD. In this study, we developed automated classification algorithms leveraging pathology reports and other clinical data in Electronic Health Records (EHRs to refine the subset population preselected using ICD-9 code (579.0. Materials and Methods: EHRs were searched for established ICD-9 code (579.0 suggesting CD, based on which an initial identification of cases was obtained. In addition, laboratory results for tissue transglutaminse were extracted. Using natural language processing we analyzed pathology reports from upper endoscopy. Twelve machine learning classifiers using different combinations of variables related to ICD-9 CD status, laboratory result status, and pathology reports were experimented to find the best possible CD classifier. Ten-fold cross-validation was used to assess the results. Results: A total of 1498 patient records were used including 363 confirmed cases and 1135 false positive cases that served as controls. Logistic model based on both clinical and pathology report features produced the best results: Kappa of 0.78, F1 of 0.92, and area under the curve (AUC of 0.94, whereas in contrast using ICD-9 only generated poor results: Kappa of 0.28, F1 of 0.75, and AUC of 0.63. Conclusion: Our automated classification system presented an efficient and reliable way to improve the performance of CD patient identification.

  11. Improving the Reporting of Clinical Trials of Infertility Treatments (IMPRINT): modifying the CONSORT statement.

    Science.gov (United States)

    2014-10-01

    Clinical trials testing infertility treatments often do not report on the major outcomes of interest to patients and clinicians and the public (such as live birth) nor on the harms, including maternal risks during pregnancy and fetal anomalies. This is complicated by the multiple participants in infertility trials which may include a woman (mother), a man (father), and a third individual if successful, their offspring (child), who is also the desired outcome of treatment. The primary outcome of interest and many adverse events occur after cessation of infertility treatment and during pregnancy and the puerperium, which creates a unique burden of follow-up for clinical trial investigators and participants. In 2013, because of the inconsistencies in trial reporting and the unique aspects of infertility trials not adequately addressed by existing Consolidated Standards of Reporting Trials (CONSORT) statements, we convened a consensus conference in Harbin, China, with the aim of planning modifications to the CONSORT checklist to improve the quality of reporting of clinical trials testing infertility treatment. The consensus group recommended that the preferred primary outcome of all infertility trials is live birth (defined as any delivery of a live infant after ≥20 weeks' gestation) or cumulative live birth, defined as the live birth per women over a defined time period (or number of treatment cycles). In addition, harms to all participants should be systematically collected and reported, including during the intervention, any resulting pregnancy, and the neonatal period. Routine information should be collected and reported on both male and female participants in the trial. We propose to track the change in quality that these guidelines may produce in published trials testing infertility treatments. Our ultimate goal is to increase the transparency of benefits and risks of infertility treatments to provide better medical care to affected individuals and couples

  12. The Space Situational Assessment Report to Improve Public Awareness in China

    Science.gov (United States)

    Li, Hongbo; Zhang, Qi; Xie, Zebing; Wei, Xiangwang; Wang, Tao

    For improvement of public awareness of the impact of space activities in China, a Space Situational Assessment Report 2013 will be issued in March 2014. More than ten Chinese main medium are invited for a special press conference. The Space Situational Assessment Report aims to introduce international space activities to Chinese public, and provide a common, comprehensive knowledge base to support the development of national policies and international security cooperation of outer space. The full report organizes international space activities until 2013 according to three parts those are Foundations, Strategies and Environment, including nine chapters, such as Space laws and policies; Space facility and equipment; Institutions and Human Resource; Military space, Civil space and Commercial space; Natural space environment; Space situational awareness, etc. A kind of Space Situational Assessment Index System is presented as a globally-focused analytic framework that defines, measures, and ranks national space activity. To use for a variety of public themes, different assessment indexes are constituted by scores of individual qualitative and quantitative metrics based on the Index System. Three research organizaitons of space sciences and technologies collaborated on the Space Situational Assessment Report. It is a scholarly and ungovernmental work.

  13. Effects of postidentification feedback on eyewitness identification and nonidentification confidence.

    Science.gov (United States)

    Semmler, Carolyn; Brewer, Neil; Wells, Gary L

    2004-04-01

    Two experiments investigated new dimensions of the effect of confirming feedback on eyewitness identification confidence using target-absent and target-present lineups and (previously unused) unbiased witness instructions (i.e., "offender not present" option highlighted). In Experiment 1, participants viewed a crime video and were later asked to try to identify the thief from an 8-person target-absent photo array. Feedback inflated witness confidence for both mistaken identifications and correct lineup rejections. With target-present lineups in Experiment 2, feedback inflated confidence for correct and mistaken identifications and lineup rejections. Although feedback had no influence on the confidence-accuracy correlation, it produced clear overconfidence. Confidence inflation varied with the confidence measure reference point (i.e., retrospective vs. current confidence) and identification response latency.

  14. Effects of confidence and anxiety on flow state in competition.

    Science.gov (United States)

    Koehn, Stefan

    2013-01-01

    Confidence and anxiety are important variables that underlie the experience of flow in sport. Specifically, research has indicated that confidence displays a positive relationship and anxiety a negative relationship with flow. The aim of this study was to assess potential direct and indirect effects of confidence and anxiety dimensions on flow state in tennis competition. A sample of 59 junior tennis players completed measures of Competitive State Anxiety Inventory-2d and Flow State Scale-2. Following predictive analysis, results showed significant positive correlations between confidence (intensity and direction) and anxiety symptoms (only directional perceptions) with flow state. Standard multiple regression analysis indicated confidence as the only significant predictor of flow. The results confirmed a protective function of confidence against debilitating anxiety interpretations, but there were no significant interaction effects between confidence and anxiety on flow state.

  15. Sustainable nuclear development and public confidence

    International Nuclear Information System (INIS)

    Gagarinski, A.

    2000-01-01

    This report discusses the objective preconditions, which would lead the world community to acceptance of nuclear energy. The following conditions deserve special emphasis: (a) Demographic growth, resulting in the increase of energy demand and promoting the understanding of the fact, that the world energy resources are limited and all possible energy sources, including nuclear ones, should be used. (b) Development of the 'third-world' countries, creating additional energy demand, which cannot be met without nuclear power. (c) Global (and influencing the plans of each country) need of availability and acceptable costs together with reliability and safety of energy supply, and, consequently, the interest to energy sources diversification in order to eliminate the dependence of fossil fuels import. The paper considers the ways to solve this strategic task. Its solution could take a long time (several decades) and should be properly perceived by the generation of specialists now starting their career in nuclear science and industry. Now it is a good time for the new generation of nuclear specialists to solve this problem - the large-scale NPP development is not yet needed, there is a large accumulated experience and perspective ideas, and there is enough time to analyze the problems in detail, propose and prepare the solutions and convince the general public, that these solutions are correct. And then the next phase of nuclear energy development would be based not only on correct technical solutions, but also on a favourable social environment. (authors)

  16. Confidence intervals for effect sizes: compliance and clinical significance in the Journal of Consulting and clinical Psychology.

    Science.gov (United States)

    Odgaard, Eric C; Fowler, Robert L

    2010-06-01

    In 2005, the Journal of Consulting and Clinical Psychology (JCCP) became the first American Psychological Association (APA) journal to require statistical measures of clinical significance, plus effect sizes (ESs) and associated confidence intervals (CIs), for primary outcomes (La Greca, 2005). As this represents the single largest editorial effort to improve statistical reporting practices in any APA journal in at least a decade, in this article we investigate the efficacy of that change. All intervention studies published in JCCP in 2003, 2004, 2007, and 2008 were reviewed. Each article was coded for method of clinical significance, type of ES, and type of associated CI, broken down by statistical test (F, t, chi-square, r/R(2), and multivariate modeling). By 2008, clinical significance compliance was 75% (up from 31%), with 94% of studies reporting some measure of ES (reporting improved for individual statistical tests ranging from eta(2) = .05 to .17, with reasonable CIs). Reporting of CIs for ESs also improved, although only to 40%. Also, the vast majority of reported CIs used approximations, which become progressively less accurate for smaller sample sizes and larger ESs (cf. Algina & Kessleman, 2003). Changes are near asymptote for ESs and clinical significance, but CIs lag behind. As CIs for ESs are required for primary outcomes, we show how to compute CIs for the vast majority of ESs reported in JCCP, with an example of how to use CIs for ESs as a method to assess clinical significance.

  17. Might ART Adherence Estimates Be Improved by Combining Biomarker and Self-Report Data?

    Directory of Open Access Journals (Sweden)

    Rebecca Rhead

    Full Text Available As we endeavour to examine rates of viral suppression in PLHIV, reliable data on ART adherence are needed to distinguish between the respective contributions of poor adherence and treatment failure on high viral load. Self-reported data are susceptible to response bias and although biomarker data on drug presence and concentration can provide a superior, alternative method of measurement, complications due to drug-drug interactions and genetic variations can cause some inaccuracies. We investigate the feasibility of combining both biomarker and self-report data to produce a potentially more accurate measure of ART adherence.Data were taken from a large general-population survey in the Manicaland province, Zimbabwe, conducted in 2009-2011. HIV-infected adults who had initiated ART (N = 560 provided self-report data on adherence and dried blood spot samples that were analysed for traces of ART medication. A new three-category measure of ART adherence was constructed, based on biomarker data but using self-report data to adjust for cases with abnormally low and high drug concentrations due to possible drug-drug interactions and genetic factors, and was assessed for plausibility using survey data on socio-demographic correlates.94.3% (528/560 and 92.7% (519/560 of the sample reported faithful adherence to their medication and had traces of ART medication, respectively. The combined measure estimated good evidence of ART adherence at 69% and excellent evidence of adherence at 53%. The regression analysis results showed plausible patterns of ART adherence by socio-demographic status with men and younger participants being more likely to adhere poorly to medication, and higher socio-economic status individuals and those living in more urban locations being more likely to adhere well.Biomarker and self-reported measures of adherence can be combined in a meaningful way to produce a potentially more accurate measure of ART adherence. Results indicate that

  18. Might ART Adherence Estimates Be Improved by Combining Biomarker and Self-Report Data?

    Science.gov (United States)

    Rhead, Rebecca; Masimirembwa, Collen; Cooke, Graham; Takaruza, Albert; Nyamukapa, Constance; Mutsimhi, Cosmas; Gregson, Simon

    2016-01-01

    As we endeavour to examine rates of viral suppression in PLHIV, reliable data on ART adherence are needed to distinguish between the respective contributions of poor adherence and treatment failure on high viral load. Self-reported data are susceptible to response bias and although biomarker data on drug presence and concentration can provide a superior, alternative method of measurement, complications due to drug-drug interactions and genetic variations can cause some inaccuracies. We investigate the feasibility of combining both biomarker and self-report data to produce a potentially more accurate measure of ART adherence. Data were taken from a large general-population survey in the Manicaland province, Zimbabwe, conducted in 2009-2011. HIV-infected adults who had initiated ART (N = 560) provided self-report data on adherence and dried blood spot samples that were analysed for traces of ART medication. A new three-category measure of ART adherence was constructed, based on biomarker data but using self-report data to adjust for cases with abnormally low and high drug concentrations due to possible drug-drug interactions and genetic factors, and was assessed for plausibility using survey data on socio-demographic correlates. 94.3% (528/560) and 92.7% (519/560) of the sample reported faithful adherence to their medication and had traces of ART medication, respectively. The combined measure estimated good evidence of ART adherence at 69% and excellent evidence of adherence at 53%. The regression analysis results showed plausible patterns of ART adherence by socio-demographic status with men and younger participants being more likely to adhere poorly to medication, and higher socio-economic status individuals and those living in more urban locations being more likely to adhere well. Biomarker and self-reported measures of adherence can be combined in a meaningful way to produce a potentially more accurate measure of ART adherence. Results indicate that ART adherence

  19. Decision time and confidence predict choosers' identification performance in photographic showups

    Science.gov (United States)

    Sagana, Anna; Sporer, Siegfried L.; Wixted, John T.

    2018-01-01

    In vast contrast to the multitude of lineup studies that report on the link between decision time, confidence, and identification accuracy, only a few studies looked at these associations for showups, with results varying widely across studies. We therefore set out to test the individual and combined value of decision time and post-decision confidence for diagnosing the accuracy of positive showup decisions using confidence-accuracy characteristic curves and Bayesian analyses. Three-hundred-eighty-four participants viewed a stimulus event and were subsequently presented with two showups which could be target-present or target-absent. As expected, we found a negative decision time-accuracy and a positive post-decision confidence-accuracy correlation for showup selections. Confidence-accuracy characteristic curves demonstrated the expected additive effect of combining both postdictors. Likewise, Bayesian analyses, taking into account all possible target-presence base rate values showed that fast and confident identification decisions were more diagnostic than slow or less confident decisions, with the combination of both being most diagnostic for postdicting accurate and inaccurate decisions. The postdictive value of decision time and post-decision confidence was higher when the prior probability that the suspect is the perpetrator was high compared to when the prior probability that the suspect is the perpetrator was low. The frequent use of showups in practice emphasizes the importance of these findings for court proceedings. Overall, these findings support the idea that courts should have most trust in showup identifications that were made fast and confidently, and least in showup identifications that were made slowly and with low confidence. PMID:29346394

  20. Aggregate analysis of regulatory authority assessors' comments to improve the quality of periodic safety update reports.

    Science.gov (United States)

    Jullian, Sandra; Jaskiewicz, Lukasz; Pfannkuche, Hans-Jürgen; Parker, Jeremy; Lalande-Luesink, Isabelle; Lewis, David J; Close, Philippe

    2015-09-01

    Marketing authorization holders (MAHs) are expected to provide high-quality periodic safety update reports (PSURs) on their pharmaceutical products to health authorities (HAs). We present a novel instrument aiming at improving quality of PSURs based on standardized analysis of PSUR assessment reports (ARs) received from the European Union HAs across products and therapeutic areas. All HA comments were classified into one of three categories: "Request for regulatory actions," "Request for medical and scientific information," or "Data deficiencies." The comments were graded according to their impact on patients' safety, the drug's benefit-risk profile, and the MAH's pharmacovigilance system. A total of 476 comments were identified through the analysis of 63 PSUR HA ARs received in 2013 and 2014; 47 (10%) were classified as "Requests for regulatory actions," 309 (65%) as "Requests for medical and scientific information," and 118 (25%) comments were related to "Data deficiencies." The most frequent comments were requests for labeling changes (35 HA comments in 19 ARs). The aggregate analysis revealed commonly raised issues and prompted changes of the MAH's procedures related to the preparation of PSURs. The authors believe that this novel instrument based on the evaluation of PSUR HA ARs serves as a valuable mechanism to enhance the quality of PSURs and decisions about optimization of the use of the products and, therefore, contributes to improve further the MAH's pharmacovigilance system and patient safety. Copyright © 2015 John Wiley & Sons, Ltd.