Preparing School Leaders for a Changing World: Case Studies of Exemplary Programs. School Leadership Study. Case Study Summaries

ERIC Educational Resources Information Center

LaPointe, Michelle, Ed.; Darling-Hammond, Linda, Ed.; Meyerson, Debra, Ed.

2007-01-01

In 2003, with funding from The Wallace Foundation, a national team of researchers organized by Stanford University and The Finance Project set out to find and examine a set of exemplary pre- and in-service professional development programs for principals, along with the policy contexts in which they operate. The purpose of the study was to…

Highly Efficient Design-of-Experiments Methods for Combining CFD Analysis and Experimental Data

NASA Technical Reports Server (NTRS)

Anderson, Bernhard H.; Haller, Harold S.

2009-01-01

It is the purpose of this study to examine the impact of "highly efficient" Design-of-Experiments (DOE) methods for combining sets of CFD generated analysis data with smaller sets of Experimental test data in order to accurately predict performance results where experimental test data were not obtained. The study examines the impact of micro-ramp flow control on the shock wave boundary layer (SWBL) interaction where a complete paired set of data exist from both CFD analysis and Experimental measurements By combining the complete set of CFD analysis data composed of fifteen (15) cases with a smaller subset of experimental test data containing four/five (4/5) cases, compound data sets (CFD/EXP) were generated which allows the prediction of the complete set of Experimental results No statistical difference were found to exist between the combined (CFD/EXP) generated data sets and the complete Experimental data set composed of fifteen (15) cases. The same optimal micro-ramp configuration was obtained using the (CFD/EXP) generated data as obtained with the complete set of Experimental data, and the DOE response surfaces generated by the two data sets were also not statistically different.

The influence of power and actor relations on priority setting and resource allocation practices at the hospital level in Kenya: a case study.

PubMed

Barasa, Edwine W; Cleary, Susan; English, Mike; Molyneux, Sassy

2016-09-30

Priority setting and resource allocation in healthcare organizations often involves the balancing of competing interests and values in the context of hierarchical and politically complex settings with multiple interacting actor relationships. Despite this, few studies have examined the influence of actor and power dynamics on priority setting practices in healthcare organizations. This paper examines the influence of power relations among different actors on the implementation of priority setting and resource allocation processes in public hospitals in Kenya. We used a qualitative case study approach to examine priority setting and resource allocation practices in two public hospitals in coastal Kenya. We collected data by a combination of in-depth interviews of national level policy makers, hospital managers, and frontline practitioners in the case study hospitals (n = 72), review of documents such as hospital plans and budgets, minutes of meetings and accounting records, and non-participant observations in case study hospitals over a period of 7 months. We applied a combination of two frameworks, Norman Long's actor interface analysis and VeneKlasen and Miller's expressions of power framework to examine and interpret our findings RESULTS: The interactions of actors in the case study hospitals resulted in socially constructed interfaces between: 1) senior managers and middle level managers 2) non-clinical managers and clinicians, and 3) hospital managers and the community. Power imbalances resulted in the exclusion of middle level managers (in one of the hospitals) and clinicians and the community (in both hospitals) from decision making processes. This resulted in, amongst others, perceptions of unfairness, and reduced motivation in hospital staff. It also puts to question the legitimacy of priority setting processes in these hospitals. Designing hospital decision making structures to strengthen participation and inclusion of relevant stakeholders could improve priority setting practices. This should however, be accompanied by measures to empower stakeholders to contribute to decision making. Strengthening soft leadership skills of hospital managers could also contribute to managing the power dynamics among actors in hospital priority setting processes.

E-Learning Teams and Their Adult Learning Efforts in Corporate Settings: A Cross Analysis of Four Case Studies

ERIC Educational Resources Information Center

Stewart, Barbara; Waight, Consuelo

2008-01-01

Four cases relating to the efforts of e-learning teams in valuing adult learners in their e-learning solutions were examined to better understand how e-learning teams value their adult learners within corporate settings. Two questions guided the analysis of the cases, they are: (1) What is the nature of the e-learning solutions in these cases? (2)…

Online Learning and Teaching with Technology: Case Studies, Experience and Practice. Case Studies of Teaching in Higher Education.

ERIC Educational Resources Information Center

Murphy, David, Ed.; Walker, Rob, Ed.; Webb, Graham, Ed.

This book contains case studies that look at using technology in a wide range of situations, from fully online courses to more traditional face-to-face settings. The case studies deal with issues related to student interaction, teaching and assessment, planning and development, and policy. The following case studies are included: (1) "Flame…

Tech-Prep in New York State: Profiles of Four Diverse Programs.

ERIC Educational Resources Information Center

Frenkel, Michael W.; Brodsky, Stanley M.

These case studies highlight the diversity of four tech programs that responded with a unique set of organizational policies and procedures to a unique set of challenges. The case study on City Tech Tech-Prep Consortium in Brooklyn focuses on three strategies: transition to City Tech program, postsecondary component, and program evaluation. The…

Determinants in the development of advanced nursing practice: a case study of primary-care settings in Hong Kong.

PubMed

Twinn, Sheila; Thompson, David R; Lopez, Violeta; Lee, Diana T F; Shiu, Ann T Y

2005-01-01

Different factors have been shown to influence the development of models of advanced nursing practice (ANP) in primary-care settings. Although ANP is being developed in hospitals in Hong Kong, China, it remains undeveloped in primary care and little is known about the factors determining the development of such a model. The aims of the present study were to investigate the contribution of different models of nursing practice to the care provided in primary-care settings in Hong Kong, and to examine the determinants influencing the development of a model of ANP in such settings. A multiple case study design was selected using both qualitative and quantitative methods of data collection. Sampling methods reflected the population groups and stage of the case study. Sampling included a total population of 41 nurses from whom a secondary volunteer sample was drawn for face-to-face interviews. In each case study, a convenience sample of 70 patients were recruited, from whom 10 were selected purposively for a semi-structured telephone interview. An opportunistic sample of healthcare professionals was also selected. The within-case and cross-case analysis demonstrated four major determinants influencing the development of ANP: (1) current models of nursing practice; (2) the use of skills mix; (3) the perceived contribution of ANP to patient care; and (4) patients' expectations of care. The level of autonomy of individual nurses was considered particularly important. These determinants were used to develop a model of ANP for a primary-care setting. In conclusion, although the findings highlight the complexity determining the development and implementation of ANP in primary care, the proposed model suggests that definitions of advanced practice are appropriate to a range of practice models and cultural settings. However, the findings highlight the importance of assessing the effectiveness of such models in terms of cost and long-term patient outcomes.

Extending the boundaries of the Declaration of Helsinki: a case study of an unethical experiment in a non-medical setting

PubMed Central

Richter, E.; Barach, P.; Berman, T.; Ben-David, G; Weinberger, Z.

2001-01-01

To examine the ethical issues involved in governmental decisions with potential health risks, we review the history of the decision to raise the interurban speed limit in Israel in light of its impact on road death and injury. In 1993, the Israeli Ministry of Transportation initiated an "experiment" to raise the interurban speed limit from 90 to 100 kph. The "experiment" did not include a protocol and did not specify cut-off points for early termination in the case of adverse results. After the raise in the speed limit, the death toll on interurban roads rose as a result of a sudden increase in speeds and case fatality rates. The committee's decision is a case study in unfettered human experimentation and public health risks when the setting is non-medical and lacks a defined ethical framework. The case study states the case for extending Helsinki type safeguards to experimentation in non-medical settings. Key Words: Declaration of Helsinki • human experimentation • speed limit PMID:11314157

Measles: effect of a two-dose vaccination programme in Catalonia, Spain.

PubMed Central

Godoy, P.; Domínguez, A.; Salleras, L.

1999-01-01

The study reports incidences of measles in Catalonia, Spain, as detected by surveillance, and analyses the specific characteristics of the outbreaks reported for the period 1986-95. Incidences per 100,000 inhabitants were calculated for the period 1971-95. The following variables were studied: year of presentation, number of cases, median age, transmission setting, cases with a record of vaccination and preventable cases. Associations between variables were determined using odds ratios (OR). The incidence of measles declined from 306.3 cases in 1971 to 30.9 in 1995. A total of 50 outbreaks were investigated. The outbreaks that occurred in the last two years of the study had a higher likelihood of having a transmission setting other than primary school (OR = 3.9); a median case age > 10 years (OR = 7.2); and fewer than 6 cases (OR = 2.3). The characteristics of recent outbreaks, marked by a rise both in transmission outside the primary-school setting and in median age, indicate the need for the introduction of a specific vaccination programme at the end of adolescence in addition to control of school-related outbreaks. PMID:10083711

Nurse case management: negotiating care together within a developing relationship.

PubMed

Yamashita, Mineko; Forchuk, Cheryl; Mound, Bronwyn

2005-01-01

TOPIC/PROBLEM: The purpose of this study was to explicate the process of nurse case management involving clients afflicted with chronic mental illness. Grounded theory was the method of choice. Interviews were conducted with nurses in inpatient, transitional, and community settings in four cities in southern Ontario, Canada. Negotiating care together within a developing relationship emerged as the basic social process. "Building a trusting relationship" was identified as the foundation of case management. Salient differences were found between the three settings, yet the basic social process was consistent across settings. This underscores the therapeutic relationship as the basis for nurse psychiatric case management.

The Quality of Life of a Child with Asperger's Disorder in a General Education Setting: A Pilot Case Study

ERIC Educational Resources Information Center

Mayton, Michael R.

2005-01-01

This pilot qualitative case study was designed to investigate how the quality of life (QOL) of a child with Asperger's Disorder was impacted by her placement in an inclusive education setting which provided no specialized social skills instruction. Direct and indirect data were gathered and examined regarding themes that centered around QOL…

Naturally-Emerging Technology-Based Leadership Roles in Three Independent Schools: A Social Network-Based Case Study Using Fuzzy Set Qualitative Comparative Analysis

ERIC Educational Resources Information Center

Velastegui, Pamela J.

2013-01-01

This hypothesis-generating case study investigates the naturally emerging roles of technology brokers and technology leaders in three independent schools in New York involving 92 school educators. A multiple and mixed method design utilizing Social Network Analysis (SNA) and fuzzy set Qualitative Comparative Analysis (FSQCA) involved gathering…

Polymorphisms in Stromal Genes and Susceptibility to Serous Epithelial Ovarian Cancer: A Report from the Ovarian Cancer Association Consortium

PubMed Central

Amankwah, Ernest K.; Wang, Qinggang; Schildkraut, Joellen M.; Tsai, Ya-Yu; Ramus, Susan J.; Fridley, Brooke L.; Beesley, Jonathan; Johnatty, Sharon E.; Webb, Penelope M.; Chenevix-Trench, Georgia; Dale, Laura C.; Lambrechts, Diether; Amant, Frederic; Despierre, Evelyn; Vergote, Ignace; Gayther, Simon A.; Gentry-Maharaj, Aleksandra; Menon, Usha; Chang-Claude, Jenny; Wang-Gohrke, Shan; Anton-Culver, Hoda; Ziogas, Argyrios; Dörk, Thilo; Dürst, Matthias; Antonenkova, Natalia; Bogdanova, Natalia; Brown, Robert; Flanagan, James M.; Kaye, Stanley B.; Paul, James; Bützow, Ralf; Nevanlinna, Heli; Campbell, Ian; Eccles, Diana M.; Karlan, Beth Y.; Gross, Jenny; Walsh, Christine; Pharoah, Paul D. P.; Song, Honglin; Krüger Kjær, Susanne; Høgdall, Estrid; Høgdall, Claus; Lundvall, Lene; Nedergaard, Lotte; Kiemeney, Lambertus A. L. M.; Massuger, Leon F. A. G.; van Altena, Anne M.; Vermeulen, Sita H. H. M.; Le, Nhu D.; Brooks-Wilson, Angela; Cook, Linda S.; Phelan, Catherine M.; Cunningham, Julie M.; Vachon, Celine M.; Vierkant, Robert A.; Iversen, Edwin S.; Berchuck, Andrew; Goode, Ellen L.; Sellers, Thomas A.; Kelemen, Linda E.

2011-01-01

Alterations in stromal tissue components can inhibit or promote epithelial tumorigenesis. Decorin (DCN) and lumican (LUM) show reduced stromal expression in serous epithelial ovarian cancer (sEOC). We hypothesized that common variants in these genes associate with risk. Associations with sEOC among Caucasians were estimated with odds ratios (OR) among 397 cases and 920 controls in two U.S.-based studies (discovery set), 436 cases and 1,098 controls in Australia (replication set 1) and a consortium of 15 studies comprising 1,668 cases and 4,249 controls (replication set 2). The discovery set and replication set 1 (833 cases and 2,013 controls) showed statistically homogeneous (Pheterogeneity≥0.48) decreased risks of sEOC at four variants: DCN rs3138165, rs13312816 and rs516115, and LUM rs17018765 (OR = 0.6 to 0.9; Ptrend = 0.001 to 0.03). Results from replication set 2 were statistically homogeneous (Pheterogeneity≥0.13) and associated with increased risks at DCN rs3138165 and rs13312816, and LUM rs17018765: all ORs = 1.2; Ptrend≤0.02. The ORs at the four variants were statistically heterogeneous across all 18 studies (Pheterogeneity≤0.03), which precluded combining. In post-hoc analyses, interactions were observed between each variant and recruitment period (Pinteraction≤0.003), age at diagnosis (Pinteraction = 0.04), and year of diagnosis (Pinteraction = 0.05) in the five studies with available information (1,044 cases, 2,469 controls). We conclude that variants in DCN and LUM are not directly associated with sEOC, and that confirmation of possible effect modification of the variants by non-genetic factors is required. PMID:21637745

Case Studies for Effective Business Instruction.

ERIC Educational Resources Information Center

McAlister-Kizzier, Donna

This book is designed as a resource for educators who teach business content in a variety of instructional settings. It contains case studies representing all functional areas of business, including corporate training, for grades 7 through graduate education. Chapter 1 provides an overview of the case study method. The history of the case method,…

Teaching Business French through Case Studies: Presentation of a Marketing Case.

ERIC Educational Resources Information Center

Federico, Salvatore; Moore, Catherine

The use of case studies as a means for teaching business French is discussed. The approach is advocated because of the realism of case studies, which are based on actual occurrences. Characteristics of a good case are noted: it tells a story, focuses on interest-arousing issues, is set in the past 10 years, permits empathy with the main…

Environmental contaminants in food. Volume II-part a: working papers. I. Priority setting of toxic substances for guiding monitoring programs. II. Five case studies of environmental food contamination

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

This volume contains working papers written for Office of Technology Assessment (OTA) to assist in preparation of the report Environmental Contaminants in Food. The contents include: (1) Priority setting of toxic substances for guiding monitoring programs; and (2) Five case studies of environmental food contamination.

A Critique of Kenneth M. Coffey and S. John Obringer's: "A Case Study on Autism: School Accommodations and Inclusive Settings"

ERIC Educational Resources Information Center

Coutinho, Colin

2008-01-01

This paper provides a review, followed by a critique, of Kenneth M. Coffey and S. John Obringer's article entitled "A Case Study on Autism: School Accommodations and Inclusive Settings." Coffey and Obringer's intriguing and informative article provides new insights regarding the effects of autism socializing disorder (ASD) and its impact on a…

Undergraduate Psychology Students' Experiences with Creative Drama: A Multi-Case Study

ERIC Educational Resources Information Center

Wilcox, Ruth A.

2015-01-01

This qualitative multi-case study explored undergraduate psychology students' experiences participating in creative drama activities the instructor/researcher developed to teach psychological concepts. The study was conducted in three introductory and developmental courses in a mid-western community college setting. Participants (cases) included…

The Analysis of a Murder, a Case Study

ERIC Educational Resources Information Center

Dinan, Frank J.; Szczepankiewicz, Steven H.; Carnaham, Melinda; Colvin, Michael T.

2007-01-01

The analysis of a Murder case study can be used in general chemistry or nonscience major chemistry courses to teach data handling and analysis in a non-laboratory context. This case study will help students to respond more enthusiastically and with more interest to a set of material placed before them related to a real case rather than…

Standard setting: the crucial issues. A case study of accounting & auditing.

PubMed

Nowakowski, J R

1982-01-01

A study of standard-setting efforts in accounting and auditing is reported. The study reveals four major areas of concern in a professional standard-setting effort: (1) issues related to the rationale for setting standards, (2) issues related to the standard-setting board and its support structure, (3) issues related to the content of standards and rules for generating them, and (4) issues that deal with how standards are put to use. Principles derived from the study of accounting and auditing are provided to illuminate and assess standard-setting efforts in evaluation.

Leadership and organisational effectiveness--lessons to be drawn from education?

PubMed

Joyce, Pauline

2009-05-01

The aim of this paper is to present findings of a case study on organisational effectiveness in an education setting and draw similarities with a healthcare setting, focusing on the school principal and nurse leader. The study was carried out in a primary school setting and focuses on a principal (as leader). The school, which will be named St Senan's for the case study, is a typical tall structure, has a staff of 30 (teachers and special needs' assistants) and a student number of 117. A case study methodology was used. Data was collected by interviewing the principal, two teachers, two students and a parent, in this order. In addition, a Parents' Council meeting was observed and document analysis was carried out on measurements which reflected some critical success factors for the school. Interviews from students and teachers in addition to observation notes indicate that the principal's leadership impacts on organisational effectiveness in the school. The findings are located in the context of education with similarities being drawn from nursing. It is how the leader leads in the context of the organisation setting which is paramount. In other words it is not possible to take a set of general critical success factors for a school or healthcare setting and apply these widely. The paper concludes by proposing the use of a quality framework to contextualise the findings of the case and promote further discussion in the context of nurse leaders. The paper suggests that comparisons can be made between school principals and nurse leaders.

What Factors Influence States' Capacity to Report Children's Health Care Quality Measures? A Multiple-Case Study.

PubMed

Christensen, Anna L; Petersen, Dana M; Burton, Rachel A; Forsberg, Vanessa C; Devers, Kelly J

2017-01-01

Objectives The objective of this study was to describe factors that influence the ability of state Medicaid agencies to report the Centers for Medicare & Medicaid Services' (CMS) core set of children's health care quality measures (Child Core Set). Methods We conducted a multiple-case study of four high-performing states participating in the Children's Health Insurance Program Reauthorization Act (CHIPRA) Quality Demonstration Grant Program: Illinois, Maine, Pennsylvania, and Oregon. Cases were purposively selected for their diverse measurement approaches and used data from 2010 to 2015, including 154 interviews, semiannual grant progress reports, and annual public reports on Child Core Set measures. We followed Yin's multiple-case study methodology to describe how and why each state increased the number of measures reported to CMS. Results All four states increased the number of Child Core Set measures reported to CMS during the grant period. Each took a different approach to reporting, depending on the available technical, organizational, and behavioral inputs in the state. Reporting capacity was influenced by a state's Medicaid data availability, ability to link to other state data systems, past experience with quality measurement, staff time and technical expertise, and demand for the measures. These factors were enhanced by CHIPRA Quality Demonstration grant funding and other federal capacity building activities, as hypothesized in our conceptual framework. These and other states have made progress reporting the Child Core Set since 2010. Conclusion With financial support and investment in state data systems and organizational factors, states can overcome challenges to reporting most of the Child Core Set measures.

A case study on the application of International Classification of Functioning, Disability and Health (ICF)-based tools for vocational rehabilitation in spinal cord injury.

PubMed

Glässel, Andrea; Rauch, Alexandra; Selb, Melissa; Emmenegger, Karl; Lückenkemper, Miriam; Escorpizo, Reuben

2012-01-01

Vocational rehabilitation (VR) plays a key role in bringing persons with acquired disabilities back to work, while encouraging employment participation. The purpose of this case study is to illustrate the systematic application of International Classification of Functioning, Disability, and Health (ICF)-based documentation tools by using ICF Core Sets in VR shown with a case example of a client with traumatic spinal cord injury (SCI). The client was a 26-year-old male with paraplegia (7th thoracic level), working in the past as a mover. This case study describes the integration of the ICF Core Sets for VR into an interdisciplinary rehabilitation program by using ICF-based documentation tools. Improvements in the client's impairments, activity limitations, and participation restrictions were observed following rehabilitation. Goals in different areas of functioning were achieved. The use of the ICF Core Sets in VR allows a comprehensive assessment of the client's level of functioning and intervention planning. Specifically, the Brief ICF Core Set in VR can provide domains for intervention relevant to each member of an interdisciplinary team and hence, can facilitate the VR management process in a SCI center in Switzerland.

Development and Formative Evaluation of Multimedia Case Studies for Instructional Design and Technology Students

ERIC Educational Resources Information Center

Sugar, William

2014-01-01

This study describes the development of three case studies that included a combination of multimedia production and instructional design skills within a particular setting. These case studies incorporated real-life incidents from 47 professional instructional designers. These instructional designers described a total of 146 activities involving…

A Case Example of the Implementation of Schoolwide Positive Behavior Support in a High School Setting Using Change Point Test Analysis

ERIC Educational Resources Information Center

Bohanon, Hank; Fenning, Pamela; Hicks, Kira; Weber, Stacey; Thier, Kimberly; Aikins, Brigit; Morrissey, Kelly; Briggs, Alissa; Bartucci, Gina; McArdle, Lauren; Hoeper, Lisa; Irvin, Larry

2012-01-01

The purpose of this case study was to expand the literature base regarding the application of high school schoolwide positive behavior support in an urban setting for practitioners and policymakers to address behavior issues. In addition, the study describes the use of the Change Point Test as a method for analyzing time series data that are…

Health-related quality of life of irritable bowel syndrome patients in different cultural settings.

PubMed

Faresjö, Ashild; Anastasiou, Foteini; Lionis, Christos; Johansson, Saga; Wallander, Mari-Ann; Faresjö, Tomas

2006-03-27

Persons with Irritable bowel syndrome (IBS) are seriously affected in their everyday life. The effect across different cultural settings of IBS on their quality of life has been little studied. The aim was to compare health-related quality of life (HRQOL) of individuals suffering from IBS in two different cultural settings; Crete, Greece and Linköping, Sweden. This study is a sex and age-matched case-control study, with n = 30 Cretan IBS cases and n = 90 Swedish IBS cases and a Swedish control group (n = 300) randomly selected from the general population. Health-related quality of life, measured by SF-36 and demographics, life style indicators and co-morbidity, was measured. Cretan IBS cases reported lower HRQOL on most dimensions of SF-36 in comparison to the Swedish IBS cases. Significant differences were found for the dimensions mental health (p < 0.0001) and general health (p = 0.05) even after adjustments for educational level and co-morbidity. Women from Crete with IBS scored especially low on the dimensions general health (p = 0.009) and mental health (p < 0.0001) in comparison with Swedish women with IBS. The IBS cases, from both sites, reported significantly lower scores on all HRQOL dimensions in comparison with the Swedish control group. The results from this study tentatively support that the claim that similar individuals having the same disease, e.g. IBS, but living in different cultural environments could perceive their disease differently and that the disease might affect their everyday life and quality of life in a different way. The Cretan population, and especially women, are more seriously affected mentally by their disease than Swedish IBS cases. Coping with IBS in everyday life might be more problematic in the Cretan environment than in the Swedish setting.

Development and validation of a registry-based definition of eosinophilic esophagitis in Denmark

PubMed Central

Dellon, Evan S; Erichsen, Rune; Pedersen, Lars; Shaheen, Nicholas J; Baron, John A; Sørensen, Henrik T; Vyberg, Mogens

2013-01-01

AIM: To develop and validate a case definition of eosinophilic esophagitis (EoE) in the linked Danish health registries. METHODS: For case definition development, we queried the Danish medical registries from 2006-2007 to identify candidate cases of EoE in Northern Denmark. All International Classification of Diseases-10 (ICD-10) and prescription codes were obtained, and archived pathology slides were obtained and re-reviewed to determine case status. We used an iterative process to select inclusion/exclusion codes, refine the case definition, and optimize sensitivity and specificity. We then re-queried the registries from 2008-2009 to yield a validation set. The case definition algorithm was applied, and sensitivity and specificity were calculated. RESULTS: Of the 51 and 49 candidate cases identified in both the development and validation sets, 21 and 24 had EoE, respectively. Characteristics of EoE cases in the development set [mean age 35 years; 76% male; 86% dysphagia; 103 eosinophils per high-power field (eos/hpf)] were similar to those in the validation set (mean age 42 years; 83% male; 67% dysphagia; 77 eos/hpf). Re-review of archived slides confirmed that the pathology coding for esophageal eosinophilia was correct in greater than 90% of cases. Two registry-based case algorithms based on pathology, ICD-10, and pharmacy codes were successfully generated in the development set, one that was sensitive (90%) and one that was specific (97%). When these algorithms were applied to the validation set, they remained sensitive (88%) and specific (96%). CONCLUSION: Two registry-based definitions, one highly sensitive and one highly specific, were developed and validated for the linked Danish national health databases, making future population-based studies feasible. PMID:23382628

Universal ethical principles in a diverse universe: a commentary on Monshi and Zieglmayer's case study.

PubMed

DuBois, James M

2004-01-01

Monshi and Zieglmayer's case study presents Sri Lankan participants as having views on the privacy of health information that differ radically from those commonly found in Western nations. This article explores 2 questions that their case study raises for the ethical review of research in international settings: First, are allegedly universal ethical principles--of the sort promulgated in the Belmont Report (National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, 1978)--useful in international settings?, and second, how should research oversight bodies address the challenges that arise in international behavioral and social science research?

Mining Hierarchies and Similarity Clusters from Value Set Repositories.

PubMed

Peterson, Kevin J; Jiang, Guoqian; Brue, Scott M; Shen, Feichen; Liu, Hongfang

2017-01-01

A value set is a collection of permissible values used to describe a specific conceptual domain for a given purpose. By helping to establish a shared semantic understanding across use cases, these artifacts are important enablers of interoperability and data standardization. As the size of repositories cataloging these value sets expand, knowledge management challenges become more pronounced. Specifically, discovering value sets applicable to a given use case may be challenging in a large repository. In this study, we describe methods to extract implicit relationships between value sets, and utilize these relationships to overlay organizational structure onto value set repositories. We successfully extract two different structurings, hierarchy and clustering, and show how tooling can leverage these structures to enable more effective value set discovery.

On the Analysis of Case-Control Studies in Cluster-correlated Data Settings.

PubMed

Haneuse, Sebastien; Rivera-Rodriguez, Claudia

2018-01-01

In resource-limited settings, long-term evaluation of national antiretroviral treatment (ART) programs often relies on aggregated data, the analysis of which may be subject to ecological bias. As researchers and policy makers consider evaluating individual-level outcomes such as treatment adherence or mortality, the well-known case-control design is appealing in that it provides efficiency gains over random sampling. In the context that motivates this article, valid estimation and inference requires acknowledging any clustering, although, to our knowledge, no statistical methods have been published for the analysis of case-control data for which the underlying population exhibits clustering. Furthermore, in the specific context of an ongoing collaboration in Malawi, rather than performing case-control sampling across all clinics, case-control sampling within clinics has been suggested as a more practical strategy. To our knowledge, although similar outcome-dependent sampling schemes have been described in the literature, a case-control design specific to correlated data settings is new. In this article, we describe this design, discuss balanced versus unbalanced sampling techniques, and provide a general approach to analyzing case-control studies in cluster-correlated settings based on inverse probability-weighted generalized estimating equations. Inference is based on a robust sandwich estimator with correlation parameters estimated to ensure appropriate accounting of the outcome-dependent sampling scheme. We conduct comprehensive simulations, based in part on real data on a sample of N = 78,155 program registrants in Malawi between 2005 and 2007, to evaluate small-sample operating characteristics and potential trade-offs associated with standard case-control sampling or when case-control sampling is performed within clusters.

Validating the WHO maternal near miss tool: comparing high- and low-resource settings.

PubMed

Witteveen, Tom; Bezstarosti, Hans; de Koning, Ilona; Nelissen, Ellen; Bloemenkamp, Kitty W; van Roosmalen, Jos; van den Akker, Thomas

2017-06-19

WHO proposed the WHO Maternal Near Miss (MNM) tool, classifying women according to several (potentially) life-threatening conditions, to monitor and improve quality of obstetric care. The objective of this study is to analyse merged data of one high- and two low-resource settings where this tool was applied and test whether the tool may be suitable for comparing severe maternal outcome (SMO) between these settings. Using three cohort studies that included SMO cases, during two-year time frames in the Netherlands, Tanzania and Malawi we reassessed all SMO cases (as defined by the original studies) with the WHO MNM tool (five disease-, four intervention- and seven organ dysfunction-based criteria). Main outcome measures were prevalence of MNM criteria and case fatality rates (CFR). A total of 3172 women were studied; 2538 (80.0%) from the Netherlands, 248 (7.8%) from Tanzania and 386 (12.2%) from Malawi. Total SMO detection was 2767 (87.2%) for disease-based criteria, 2504 (78.9%) for intervention-based criteria and 1211 (38.2%) for organ dysfunction-based criteria. Including every woman who received ≥1 unit of blood in low-resource settings as life-threatening, as defined by organ dysfunction criteria, led to more equally distributed populations. In one third of all Dutch and Malawian maternal death cases, organ dysfunction criteria could not be identified from medical records. Applying solely organ dysfunction-based criteria may lead to underreporting of SMO. Therefore, a tool based on defining MNM only upon establishing organ failure is of limited use for comparing settings with varying resources. In low-resource settings, lowering the threshold of transfused units of blood leads to a higher detection rate of MNM. We recommend refined disease-based criteria, accompanied by a limited set of intervention- and organ dysfunction-based criteria to set a measure of severity.

Piloting a programme tool to evaluate malaria case investigation and reactive case detection activities: results from 3 settings in the Asia Pacific.

PubMed

Cotter, Chris; Sudathip, Prayuth; Herdiana, Herdiana; Cao, Yuanyuan; Liu, Yaobao; Luo, Alex; Ranasinghe, Neil; Bennett, Adam; Cao, Jun; Gosling, Roly D

2017-08-22

Case investigation and reactive case detection (RACD) activities are widely-used in low transmission settings to determine the suspected origin of infection and identify and treat malaria infections nearby to the index patient household. Case investigation and RACD activities are time and resource intensive, include methodologies that vary across eliminating settings, and have no standardized metrics or tools available to monitor and evaluate them. In response to this gap, a simple programme tool was developed for monitoring and evaluating (M&E) RACD activities and piloted by national malaria programmes. During the development phase, four modules of the RACD M&E tool were created to assess and evaluate key case investigation and RACD activities and costs. A pilot phase was then carried out by programme implementers between 2013 and 2015, during which malaria surveillance teams in three different settings (China, Indonesia, Thailand) piloted the tool over a period of 3 months each. This study describes summary results of the pilots and feasibility and impact of the tool on programmes. All three study areas implemented the RACD M&E tool modules, and pilot users reported the tool and evaluation process were helpful to identify gaps in RACD programme activities. In the 45 health facilities evaluated, 71.8% (97/135; min 35.3-max 100.0%) of the proper notification and reporting forms and 20.0% (27/135; min 0.0-max 100.0%) of standard operating procedures (SOPs) were available to support malaria elimination activities. The tool highlighted gaps in reporting key data indicators on the completeness for malaria case reporting (98.8%; min 93.3-max 100.0%), case investigations (65.6%; min 61.8-max 78.4%) and RACD activities (70.0%; min 64.7-max 100.0%). Evaluation of the SOPs showed that knowledge and practices of malaria personnel varied within and between study areas. Average monthly costs for conducting case investigation and RACD activities showed variation between study areas (min USD $844.80-max USD $2038.00) for the malaria personnel, commodities, services and other costs required to carry out the activities. The RACD M&E tool was implemented in the three pilot areas, identifying key gaps that led to impacts on programme decision making. Study findings support the need for routine M&E of malaria case reporting, case investigation and RACD activities. Scale-up of the RACD M&E tool in malaria-eliminating settings will contribute to improved programme performance to the high level that is required to reach elimination.

Towards a Science of Community Stakeholder Engagement in Biomedical HIV Prevention Trials: An Embedded Four-Country Case Study.

PubMed

Newman, Peter A; Rubincam, Clara; Slack, Catherine; Essack, Zaynab; Chakrapani, Venkatesan; Chuang, Deng-Min; Tepjan, Suchon; Shunmugam, Murali; Roungprakhon, Surachet; Logie, Carmen; Koen, Jennifer; Lindegger, Graham

2015-01-01

Broad international guidelines and studies in the context of individual clinical trials highlight the centrality of community stakeholder engagement in conducting ethically rigorous HIV prevention trials. We explored and identified challenges and facilitators for community stakeholder engagement in biomedical HIV prevention trials in diverse global settings. Our aim was to assess and deepen the empirical foundation for priorities included in the GPP guidelines and to highlight challenges in implementation that may merit further attention in subsequent GPP iterations. From 2008-2012 we conducted an embedded, multiple case study centered in Thailand, India, South Africa and Canada. We conducted in-depth interviews and focus groups with respondents from different trial-related subsystems: civil society organization representatives, community advocates, service providers, clinical trialists/researchers, former trial participants, and key HIV risk populations. Interviews/focus groups were recorded, and coded using thematic content analysis. After intra-case analyses, we conducted cross-case analysis to contrast and synthesize themes and sub-themes across cases. Lastly, we applied the case study findings to explore and assess UNAIDS/AVAC GPP guidelines and the GPP Blueprint for Stakeholder Engagement. Across settings, we identified three cross-cutting themes as essential to community stakeholder engagement: trial literacy, including lexicon challenges and misconceptions that imperil sound communication; mistrust due to historical exploitation; and participatory processes: engaging early; considering the breadth of "community"; and, developing appropriate stakeholder roles. Site-specific challenges arose in resource-limited settings and settings where trials were halted. This multiple case study revealed common themes underlying community stakeholder engagement across four country settings that largely mirror GPP goals and the GPP Blueprint, as well as highlighting challenges in the implementation of important guidelines. GPP guidance documents could be strengthened through greater focus on: identifying and addressing the community-specific roots of mistrust and its impact on trial literacy activities; achieving and evaluating representativeness in community stakeholder groups; and addressing the impact of power and funding streams on meaningful engagement and independent decision-making.

Towards a Science of Community Stakeholder Engagement in Biomedical HIV Prevention Trials: An Embedded Four-Country Case Study

PubMed Central

Newman, Peter A.; Rubincam, Clara; Slack, Catherine; Essack, Zaynab; Chakrapani, Venkatesan; Chuang, Deng-Min; Tepjan, Suchon; Shunmugam, Murali; Roungprakhon, Surachet; Logie, Carmen; Koen, Jennifer; Lindegger, Graham

2015-01-01

Objectives Broad international guidelines and studies in the context of individual clinical trials highlight the centrality of community stakeholder engagement in conducting ethically rigorous HIV prevention trials. We explored and identified challenges and facilitators for community stakeholder engagement in biomedical HIV prevention trials in diverse global settings. Our aim was to assess and deepen the empirical foundation for priorities included in the GPP guidelines and to highlight challenges in implementation that may merit further attention in subsequent GPP iterations. Methods From 2008–2012 we conducted an embedded, multiple case study centered in Thailand, India, South Africa and Canada. We conducted in-depth interviews and focus groups with respondents from different trial-related subsystems: civil society organization representatives, community advocates, service providers, clinical trialists/researchers, former trial participants, and key HIV risk populations. Interviews/focus groups were recorded, and coded using thematic content analysis. After intra-case analyses, we conducted cross-case analysis to contrast and synthesize themes and sub-themes across cases. Lastly, we applied the case study findings to explore and assess UNAIDS/AVAC GPP guidelines and the GPP Blueprint for Stakeholder Engagement. Results Across settings, we identified three cross-cutting themes as essential to community stakeholder engagement: trial literacy, including lexicon challenges and misconceptions that imperil sound communication; mistrust due to historical exploitation; and participatory processes: engaging early; considering the breadth of “community”; and, developing appropriate stakeholder roles. Site-specific challenges arose in resource-limited settings and settings where trials were halted. Conclusions This multiple case study revealed common themes underlying community stakeholder engagement across four country settings that largely mirror GPP goals and the GPP Blueprint, as well as highlighting challenges in the implementation of important guidelines. GPP guidance documents could be strengthened through greater focus on: identifying and addressing the community-specific roots of mistrust and its impact on trial literacy activities; achieving and evaluating representativeness in community stakeholder groups; and addressing the impact of power and funding streams on meaningful engagement and independent decision-making. PMID:26295159

Use of genomic data in risk assessment case study: I. Evaluation of the dibutyl phthalate male reproductive development toxicity data set

DOE Office of Scientific and Technical Information (OSTI.GOV)

Makris, Susan L., E-mail: makris.susan@epa.gov; Euling, Susan Y.; Gray, L. Earl

2013-09-15

A case study was conducted, using dibutyl phthalate (DBP), to explore an approach to using toxicogenomic data in risk assessment. The toxicity and toxicogenomic data sets relative to DBP-related male reproductive developmental outcomes were considered conjointly to derive information about mode and mechanism of action. In this manuscript, we describe the case study evaluation of the toxicological database for DBP, focusing on identifying the full spectrum of male reproductive developmental effects. The data were assessed to 1) evaluate low dose and low incidence findings and 2) identify male reproductive toxicity endpoints without well-established modes of action (MOAs). These efforts ledmore » to the characterization of data gaps and research needs for the toxicity and toxicogenomic studies in a risk assessment context. Further, the identification of endpoints with unexplained MOAs in the toxicity data set was useful in the subsequent evaluation of the mechanistic information that the toxicogenomic data set evaluation could provide. The extensive analysis of the toxicology data set within the MOA context provided a resource of information for DBP in attempts to hypothesize MOAs (for endpoints without a well-established MOA) and to phenotypically anchor toxicogenomic and other mechanistic data both to toxicity endpoints and to available toxicogenomic data. This case study serves as an example of the steps that can be taken to develop a toxicological data source for a risk assessment, both in general and especially for risk assessments that include toxicogenomic data.« less

Performable Case Studies in Ethics Education.

PubMed

Robeson, Richard; King, Nancy M P

2017-09-12

Bioethics education often includes the study of short stories, novels, plays, and films, because such materials present case examples that can highlight relevant issues and questions especially vividly for a wide range of students. In addition, creative writing is widely used in the education of health professional students and in continuing education settings for health professionals. There are very few academic or professional disciplines that do not use case studies, but the case study in dialogic form has not been standard practice for thousands of years. Dramatic arts casuistry-the creation and performance of short case studies designed specifically to raise bioethics issues for discussion-represents an application of literature and the medical humanities that is both unique and uniquely valuable. This essay describes the development and history of a course that has been successfully taught to medical students and graduate bioethics students, in which the class researches, writes, and performs a case study designed to elicit reflection and discussion about a topic and set of bioethics issues of current interest to both academic and general audiences. The model is also suited to the presentation and discussion of existing case studies, both live and via on-demand audio.

Performable Case Studies in Ethics Education

PubMed Central

Robeson, Richard; King, Nancy M. P.

2017-01-01

Bioethics education often includes the study of short stories, novels, plays, and films, because such materials present case examples that can highlight relevant issues and questions especially vividly for a wide range of students. In addition, creative writing is widely used in the education of health professional students and in continuing education settings for health professionals. There are very few academic or professional disciplines that do not use case studies, but the case study in dialogic form has not been standard practice for thousands of years. Dramatic arts casuistry—the creation and performance of short case studies designed specifically to raise bioethics issues for discussion—represents an application of literature and the medical humanities that is both unique and uniquely valuable. This essay describes the development and history of a course that has been successfully taught to medical students and graduate bioethics students, in which the class researches, writes, and performs a case study designed to elicit reflection and discussion about a topic and set of bioethics issues of current interest to both academic and general audiences. The model is also suited to the presentation and discussion of existing case studies, both live and via on-demand audio. PMID:28895903

Patient participation as dialogue: setting research agendas

PubMed Central

Abma, Tineke A.; Broerse, Jacqueline E. W.

2010-01-01

Abstract Background  Collaboration with patients in healthcare and medical research is an emerging development. We aimed to develop a methodology for health research agenda setting processes grounded in the notion of participation as dialogue. Methods  We conducted seven case studies between 2003 and 2007 to develop and validate a Dialogue Model for patient participation in health research agenda setting. The case studies related to spinal cord injury, neuromuscular diseases, renal failure, asthma/chronic obstructive pulmonary disease, burns, diabetes and intellectual disabilities. Results  The Dialogue Model is grounded in participatory and interactive approaches and has been adjusted on the basis of pilot work. It has six phases: exploration; consultation; prioritization; integration; programming; and implementation. These phases are discussed and illustrated with a case description of research agenda setting relating to burns. Conclusions  The dialogue model appeared relevant and feasible to structure the process of collaboration between stakeholders in several research agenda setting processes. The phase of consultation enables patients to develop their own voice and agenda, and prepares them for the broader collaboration with other stakeholder groups. Challenges include the stimulation of more permanent changes in research, and institutional transitions. PMID:20536537

R&D on dental implants breakage

NASA Astrophysics Data System (ADS)

Croitoru, Sorin Mihai; Popovici, Ion Alexandru

2017-09-01

Most used dental implants for human dental prostheses are of two steps type: first step means implantation and, after several months healing and osseointegration, second step is prosthesis fixture. For sure, dental implants and prostheses are meant to last for a lifetime. Still, there are unfortunate cases when dental implants break. This paper studies two steps dental implants breakage and proposes a set of instruments for replacement and restoration of the broken implant. First part of the paper sets the input data of the study: structure of the studied two steps dental implants based on two Romanian patents and values of the loading forces found in practice and specialty papers. In the second part of the paper, using DEFORM 2D™ FEM simulation software, worst case scenarios of loading dental implants are studied in order to determine which zones and components of the dental implant set are affected (broken). Last part of the paper is dedicated to design and presentation of a set for extracting and cutting tools used to restore the broken implant set.

The current status of emergent laparoscopic colectomy: a population-based study of clinical and financial outcomes.

PubMed

Keller, Deborah S; Pedraza, Rodrigo; Flores-Gonzalez, Juan Ramon; LeFave, Jean Paul; Mahmood, Ali; Haas, Eric M

2016-08-01

Population-based studies evaluating laparoscopic colectomy and outcomes compared with open surgery have concentrated on elective resections. As such, data assessing non-elective laparoscopic colectomies are limited. Our goal was to evaluate the current usage and outcomes of laparoscopic in the urgent and emergent setting in the USA. A national inpatient database was reviewed from 2008 to 2011 for right, left, and sigmoid colectomies in the non-elective setting. Cases were stratified by approach into open or laparoscopic groups. Demographics, perioperative clinical variables, and financial outcomes were compared across each group. A total of 22,719 non-elective colectomies were analyzed. The vast majority (95.8 %) was open. Most cases were performed in an urban setting at non-teaching hospitals by general surgeons. Colorectal surgeons were significantly more likely to perform a case laparoscopic than general surgeons (p < 0.001). Demographics were similar between open and laparoscopic groups; however, the disease distribution by approach varied, with significantly more severe cases in the open colectomy arm (p < 0.001). Cases performed laparoscopically had significantly better mortality and complication rates. Laparoscopic cases also had significantly improved outcomes, including shorter length of stay and hospital costs (all p < 0.001). Our analysis revealed less than 5 % of urgent and emergent colectomies in the USA are performed laparoscopically. Colorectal surgeons were more likely to approach a case laparoscopically than general surgeons. Outcomes following laparoscopic colectomy in this setting resulted in reduced length of stay, lower complication rates, and lower costs. Increased adoption of laparoscopy in the non-elective setting should be considered.

Tests of a Semi-Analytical Case 1 and Gelbstoff Case 2 SeaWiFS Algorithm with a Global Data Set

NASA Technical Reports Server (NTRS)

Carder, Kendall L.; Hawes, Steve K.; Lee, Zhongping

1997-01-01

A semi-analytical algorithm was tested with a total of 733 points of either unpackaged or packaged-pigment data, with corresponding algorithm parameters for each data type. The 'unpackaged' type consisted of data sets that were generally consistent with the Case 1 CZCS algorithm and other well calibrated data sets. The 'packaged' type consisted of data sets apparently containing somewhat more packaged pigments, requiring modification of the absorption parameters of the model consistent with the CalCOFI study area. This resulted in two equally divided data sets. A more thorough scrutiny of these and other data sets using a semianalytical model requires improved knowledge of the phytoplankton and gelbstoff of the specific environment studied. Since the semi-analytical algorithm is dependent upon 4 spectral channels including the 412 nm channel, while most other algorithms are not, a means of testing data sets for consistency was sought. A numerical filter was developed to classify data sets into the above classes. The filter uses reflectance ratios, which can be determined from space. The sensitivity of such numerical filters to measurement resulting from atmospheric correction and sensor noise errors requires further study. The semi-analytical algorithm performed superbly on each of the data sets after classification, resulting in RMS1 errors of 0.107 and 0.121, respectively, for the unpackaged and packaged data-set classes, with little bias and slopes near 1.0. In combination, the RMS1 performance was 0.114. While these numbers appear rather sterling, one must bear in mind what mis-classification does to the results. Using an average or compromise parameterization on the modified global data set yielded an RMS1 error of 0.171, while using the unpackaged parameterization on the global evaluation data set yielded an RMS1 error of 0.284. So, without classification, the algorithm performs better globally using the average parameters than it does using the unpackaged parameters. Finally, the effects of even more extreme pigment packaging must be examined in order to improve algorithm performance at high latitudes. Note, however, that the North Sea and Mississippi River plume studies contributed data to the packaged and unpackaged classess, respectively, with little effect on algorithm performance. This suggests that gelbstoff-rich Case 2 waters do not seriously degrade performance of the semi-analytical algorithm.

Priority-setting and hospital strategic planning: a qualitative case study.

PubMed

Martin, Douglas; Shulman, Ken; Santiago-Sorrell, Patricia; Singer, Peter

2003-10-01

To describe and evaluate the priority-setting element of a hospital's strategic planning process. Qualitative case study and evaluation against the conditions of 'accountability for reasonableness' of a strategic planning process at a large urban university-affiliated hospital. The hospital's strategic planning process met the conditions of 'accountability for reasonableness' in large part. Specifically: the hospital based its decisions on reasons (both information and criteria) that the participants felt were relevant to the hospital; the number and type of participants were very extensive; the process, decisions and reasons were well communicated throughout the organization, using multiple communication vehicles; and the process included an ethical framework linked to an effort to evaluate and improve the process. However, there were opportunities to improve the process, particularly by giving participants more time to absorb the information relevant to priority-setting decisions, more time to take difficult decisions and some means to appeal or revise decisions. A case study linked to an evaluation using 'accountability for reasonableness' can serve to improve priority-setting in the context of hospital strategic planning.

Long-term Evaluation of Landuse Changes On Landscape Water Balance - A Case Study From North-east Germany

NASA Astrophysics Data System (ADS)

Wegehenkel, M.

In this paper, long-term effects of different afforestation scenarios on landscape wa- ter balance will be analyzed taking into account the results of a regional case study. This analysis is based on using a GIS-coupled simulation model for the the spatially distributed calculation of water balance.For this purpose, the modelling system THE- SEUS with a simple GIS-interface will be used. To take into account the special case of change in forest cover proportion, THESEUS was enhanced with a simple for- est growth model. In the regional case study, model runs will be performed using a detailed spatial data set from North-East Germany. This data set covers a mesoscale catchment located at the moraine landscape of North-East Germany. Based on this data set, the influence of the actual landuse and of different landuse change scenarios on water balance dynamics will be investigated taking into account the spatial distributed modelling results from THESEUS. The model was tested using different experimen- tal data sets from field plots as well as obsverded catchment discharge. Additionally to such convential validation techniques, remote sensing data were used to check the simulated regional distribution of water balance components like evapotranspiration in the catchment.

Impact of Export Control and Technology Transfer Regimes: International Perspectives

DTIC Science & Technology

2012-01-07

major national security and public policy issue. Exploring the ITAR environment through a set of case studies was the central idea in a project...cover) was based on a survey of UK stakeholders. The results were unambiguous and striking. Our British partners conclude ITAR is a good idea gone...ITAR) regime is a major national security and public policy issue. Exploring the ITAR environment through a set of case studies was the central idea

Mining pathway associations for disease-related pathway activity analysis based on gene expression and methylation data.

PubMed

Lee, Hyeonjeong; Shin, Miyoung

2017-01-01

The problem of discovering genetic markers as disease signatures is of great significance for the successful diagnosis, treatment, and prognosis of complex diseases. Even if many earlier studies worked on identifying disease markers from a variety of biological resources, they mostly focused on the markers of genes or gene-sets (i.e., pathways). However, these markers may not be enough to explain biological interactions between genetic variables that are related to diseases. Thus, in this study, our aim is to investigate distinctive associations among active pathways (i.e., pathway-sets) shown each in case and control samples which can be observed from gene expression and/or methylation data. The pathway-sets are obtained by identifying a set of associated pathways that are often active together over a significant number of class samples. For this purpose, gene expression or methylation profiles are first analyzed to identify significant (active) pathways via gene-set enrichment analysis. Then, regarding these active pathways, an association rule mining approach is applied to examine interesting pathway-sets in each class of samples (case or control). By doing so, the sets of associated pathways often working together in activity profiles are finally chosen as our distinctive signature of each class. The identified pathway-sets are aggregated into a pathway activity network (PAN), which facilitates the visualization of differential pathway associations between case and control samples. From our experiments with two publicly available datasets, we could find interesting PAN structures as the distinctive signatures of breast cancer and uterine leiomyoma cancer, respectively. Our pathway-set markers were shown to be superior or very comparable to other genetic markers (such as genes or gene-sets) in disease classification. Furthermore, the PAN structure, which can be constructed from the identified markers of pathway-sets, could provide deeper insights into distinctive associations between pathway activities in case and control samples.

A complementary graphical method for reducing and analyzing large data sets. Case studies demonstrating thresholds setting and selection.

PubMed

Jing, X; Cimino, J J

2014-01-01

Graphical displays can make data more understandable; however, large graphs can challenge human comprehension. We have previously described a filtering method to provide high-level summary views of large data sets. In this paper we demonstrate our method for setting and selecting thresholds to limit graph size while retaining important information by applying it to large single and paired data sets, taken from patient and bibliographic databases. Four case studies are used to illustrate our method. The data are either patient discharge diagnoses (coded using the International Classification of Diseases, Clinical Modifications [ICD9-CM]) or Medline citations (coded using the Medical Subject Headings [MeSH]). We use combinations of different thresholds to obtain filtered graphs for detailed analysis. The thresholds setting and selection, such as thresholds for node counts, class counts, ratio values, p values (for diff data sets), and percentiles of selected class count thresholds, are demonstrated with details in case studies. The main steps include: data preparation, data manipulation, computation, and threshold selection and visualization. We also describe the data models for different types of thresholds and the considerations for thresholds selection. The filtered graphs are 1%-3% of the size of the original graphs. For our case studies, the graphs provide 1) the most heavily used ICD9-CM codes, 2) the codes with most patients in a research hospital in 2011, 3) a profile of publications on "heavily represented topics" in MEDLINE in 2011, and 4) validated knowledge about adverse effects of the medication of rosiglitazone and new interesting areas in the ICD9-CM hierarchy associated with patients taking the medication of pioglitazone. Our filtering method reduces large graphs to a manageable size by removing relatively unimportant nodes. The graphical method provides summary views based on computation of usage frequency and semantic context of hierarchical terminology. The method is applicable to large data sets (such as a hundred thousand records or more) and can be used to generate new hypotheses from data sets coded with hierarchical terminologies.

Military Hydrology. Report 12. Case Study Evaluation of Alternative Dam-Breach Flood Wave Methods. Volume 1. Main Report.

DTIC Science & Technology

1986-11-01

Report Organization. .................... 7 *PART 11: CASE STUDIES .......................... 9 Teton Dam Failure Flood. ...................... 9...channel, (3) Laurel Run Dam , and (4) Stillhouse Hollow Dam . The Laurel Run and Teton case studies involved field data sets from actual dam failures. The...hypothetical prismatic channel case study used the Teton reservoir and dam data but replaced the complex Teton Valley geometry with a prismatic channel

Perspectives on Distance Education. Quality Assurance in Higher Education: Selected Case Studies.

ERIC Educational Resources Information Center

Tait, Alan, Ed.

This publication consists of a set of case studies of quality assurance practices in distance teaching universities. The case studies are particularly relevant at a time when universities in many parts of the world, both new and established distance teaching universities, are placing great emphasis on reviewing and revising what they do in…

Introducing a Compendium of Psychological Literacy Case Studies: Reflections on Psychological Literacy in Practice

ERIC Educational Resources Information Center

Taylor, Jacqui; Hulme, Julie

2015-01-01

This article introduces a set of case studies that were submitted to us following requests in psychology conferences and publications, and through professional networks. The full versions of the case studies make up the first version of a Psychological Literacy Compendium of Practice that is available online at www.psychologicalliteracy.com. The…

A Case Study on Autism: School Accommodations and Inclusive Settings

ERIC Educational Resources Information Center

Coffey, Kenneth M.; Obringer, S. John

2004-01-01

Semi-structured interviews were conducted with a mother and father raising their two children with autism. This single case study revealed the supports involved in educating and socializing school-aged children with autism spectrum disorder. The case study indicated that the parents agreed on a majority of issues and clearly pointed out that their…

RecutClub.com: An Open Source, Whole Slide Image-based Pathology Education System

PubMed Central

Christensen, Paul A.; Lee, Nathan E.; Thrall, Michael J.; Powell, Suzanne Z.; Chevez-Barrios, Patricia; Long, S. Wesley

2017-01-01

Background: Our institution's pathology unknown conferences provide educational cases for our residents. However, the cases have not been previously available digitally, have not been collated for postconference review, and were not accessible to a wider audience. Our objective was to create an inexpensive whole slide image (WSI) education suite to address these limitations and improve the education of pathology trainees. Materials and Methods: We surveyed residents regarding their preference between four unique WSI systems. We then scanned weekly unknown conference cases and study set cases and uploaded them to our custom built WSI viewer located at RecutClub.com. We measured site utilization and conference participation. Results: Residents preferred our OpenLayers WSI implementation to Ventana Virtuoso, Google Maps API, and OpenSlide. Over 16 months, we uploaded 1366 cases from 77 conferences and ten study sets, occupying 793.5 GB of cloud storage. Based on resident evaluations, the interface was easy to use and demonstrated minimal latency. Residents are able to review cases from home and from their mobile devices. Worldwide, 955 unique IP addresses from 52 countries have viewed cases in our site. Conclusions: We implemented a low-cost, publicly available repository of WSI slides for resident education. Our trainees are very satisfied with the freedom to preview either the glass slides or WSI and review the WSI postconference. Both local users and worldwide users actively and repeatedly view cases in our study set. PMID:28382224

Feasibility of reusing time-matched controls in an overlapping cohort.

PubMed

Delcoigne, Bénédicte; Hagenbuch, Niels; Schelin, Maria Ec; Salim, Agus; Lindström, Linda S; Bergh, Jonas; Czene, Kamila; Reilly, Marie

2018-06-01

The methods developed for secondary analysis of nested case-control data have been illustrated only in simplified settings in a common cohort and have not found their way into biostatistical practice. This paper demonstrates the feasibility of reusing prior nested case-control data in a realistic setting where a new outcome is available in an overlapping cohort where no new controls were gathered and where all data have been anonymised. Using basic information about the background cohort and sampling criteria, the new cases and prior data are "aligned" to identify the common underlying study base. With this study base, a Kaplan-Meier table of the prior outcome extracts the risk sets required to calculate the weights to assign to the controls to remove the sampling bias. A weighted Cox regression, implemented in standard statistical software, provides unbiased hazard ratios. Using the method to compare cases of contralateral breast cancer to available controls from a prior study of metastases, we identified a multifocal tumor as a risk factor that has not been reported previously. We examine the sensitivity of the method to an imperfect weighting scheme and discuss its merits and pitfalls to provide guidance for its use in medical research studies.

Seasat-A ASVT: Commercial demonstration experiments. Results analysis methodology for the Seasat-A case studies

NASA Technical Reports Server (NTRS)

1979-01-01

The SEASAT-A commercial demonstration program ASVT is described. The program consists of a set of experiments involving the evaluation of a real time data distributions system, the SEASAT-A user data distribution system, that provides the capability for near real time dissemination of ocean conditions and weather data products from the U.S. Navy Fleet Numerical Weather Central to a selected set of commercial and industrial users and case studies, performed by commercial and industrial users, using the data gathered by SEASAT-A during its operational life. The impact of the SEASAT-A data on business operations is evaluated by the commercial and industrial users. The approach followed in the performance of the case studies, and the methodology used in the analysis and integration of the case study results to estimate the actual and potential economic benefits of improved ocean condition and weather forecast data are described.

Quantifying human decomposition in an indoor setting and implications for postmortem interval estimation.

PubMed

Ceciliason, Ann-Sofie; Andersson, M Gunnar; Lindström, Anders; Sandler, Håkan

2018-02-01

This study's objective is to obtain accuracy and precision in estimating the postmortem interval (PMI) for decomposing human remains discovered in indoor settings. Data were collected prospectively from 140 forensic cases with a known date of death, scored according to the Total Body Score (TBS) scale at the post-mortem examination. In our model setting, it is estimated that, in cases with or without the presence of blowfly larvae, approximately 45% or 66% respectively, of the variance in TBS can be derived from Accumulated Degree-Days (ADD). The precision in estimating ADD/PMI from TBS is, in our setting, moderate to low. However, dividing the cases into defined subgroups suggests the possibility to increase the precision of the model. Our findings also suggest a significant seasonal difference with concomitant influence on TBS in the complete data set, possibly initiated by the presence of insect activity mainly during summer. PMI may be underestimated in cases with presence of desiccation. Likewise, there is a need for evaluating the effect of insect activity, to avoid overestimating the PMI. Our data sample indicates that the scoring method might need to be slightly modified to better reflect indoor decomposition, especially in cases with insect infestations or/and extensive desiccation. When applying TBS in an indoor setting, the model requires distinct inclusion criteria and a defined population. Copyright © 2017 Elsevier B.V. All rights reserved.

Employing Case Study Methodology in Special Educational Settings

ERIC Educational Resources Information Center

Rouse, Angelise M.

2016-01-01

In general, case studies are a preferred strategy when "how" or "why" questions are being posed, when the investigator has little control over events, and when the focus is on a contemporary phenomenon within some real-life context (Yin, 2009). This article will examine the advantages and disadvantages of employing case study…

Moderation of effects of AAC based on setting and types of aided AAC on outcome variables: an aggregate study of single-case research with individuals with ASD.

PubMed

Ganz, Jennifer B; Rispoli, Mandy J; Mason, Rose Ann; Hong, Ee Rea

2014-06-01

The purpose of this meta-analysis was to evaluate the potential moderating effects of intervention setting and type of aided augmentative and alternative communication (AAC) on outcome variables for students with autism spectrum disorders. Improvement rate difference, an effect size measure, was used to calculate aggregate effects across 35 single-case research studies. Results indicated that the largest effects for aided AAC were observed in general education settings. With respect to communication outcomes, both speech generating devices (SGDs) and the Picture Exchange Communication System (PECS) were associated with larger effects than other picture-based systems. With respect to challenging behaviour outcomes, SGDs produced larger effects than PECS. This aggregate study highlights the importance of considering intervention setting, choice of AAC system and target outcomes when designing and planning an aided AAC intervention.

Case Studies Comparing System Advisor Model (SAM) Results to Real Performance Data: Preprint

DOE Office of Scientific and Technical Information (OSTI.GOV)

Blair, N.; Dobos, A.; Sather, N.

2012-06-01

NREL has completed a series of detailed case studies comparing the simulations of the System Advisor Model (SAM) and measured performance data or published performance expectations. These case studies compare PV measured performance data with simulated performance data using appropriate weather data. The measured data sets were primarily taken from NREL onsite PV systems and weather monitoring stations.

Health-related quality of life of irritable bowel syndrome patients in different cultural settings

PubMed Central

Faresjö, Åshild; Anastasiou, Foteini; Lionis, Christos; Johansson, Saga; Wallander, Mari-Ann; Faresjö, Tomas

2006-01-01

Background Persons with Irritable bowel syndrome (IBS) are seriously affected in their everyday life. The effect across different cultural settings of IBS on their quality of life has been little studied. The aim was to compare health-related quality of life (HRQOL) of individuals suffering from IBS in two different cultural settings; Crete, Greece and Linköping, Sweden. Methods This study is a sex and age-matched case-control study, with n = 30 Cretan IBS cases and n = 90 Swedish IBS cases and a Swedish control group (n = 300) randomly selected from the general population. Health-related quality of life, measured by SF-36 and demographics, life style indicators and co-morbidity, was measured. Results Cretan IBS cases reported lower HRQOL on most dimensions of SF-36 in comparison to the Swedish IBS cases. Significant differences were found for the dimensions mental health (p < 0.0001) and general health (p = 0.05) even after adjustments for educational level and co-morbidity. Women from Crete with IBS scored especially low on the dimensions general health (p = 0.009) and mental health (p < 0.0001) in comparison with Swedish women with IBS. The IBS cases, from both sites, reported significantly lower scores on all HRQOL dimensions in comparison with the Swedish control group. Conclusion The results from this study tentatively support that the claim that similar individuals having the same disease, e.g. IBS, but living in different cultural environments could perceive their disease differently and that the disease might affect their everyday life and quality of life in a different way. The Cretan population, and especially women, are more seriously affected mentally by their disease than Swedish IBS cases. Coping with IBS in everyday life might be more problematic in the Cretan environment than in the Swedish setting. PMID:16566821

The evaluation of complex interventions in palliative care: an exploration of the potential of case study research strategies.

PubMed

Walshe, Catherine

2011-12-01

Complex, incrementally changing, context dependent and variable palliative care services are difficult to evaluate. Case study research strategies may have potential to contribute to evaluating such complex interventions, and to develop this field of evaluation research. This paper explores definitions of case study (as a unit of study, a process, and a product) and examines the features of case study research strategies which are thought to confer benefits for the evaluation of complex interventions in palliative care settings. Ten features of case study that are thought to be beneficial in evaluating complex interventions in palliative care are discussed, drawing from exemplars of research in this field. Important features are related to a longitudinal approach, triangulation, purposive instance selection, comprehensive approach, multiple data sources, flexibility, concurrent data collection and analysis, search for proving-disproving evidence, pattern matching techniques and an engaging narrative. The limitations of case study approaches are discussed including the potential for subjectivity and their complex, time consuming and potentially expensive nature. Case study research strategies have great potential in evaluating complex interventions in palliative care settings. Three key features need to be exploited to develop this field: case selection, longitudinal designs, and the use of rival hypotheses. In particular, case study should be used in situations where there is interplay and interdependency between the intervention and its context, such that it is difficult to define or find relevant comparisons.

Revisioning the Process: A Case Study in Feminist Program Evaluation.

ERIC Educational Resources Information Center

Beardsley, Rebecca M.; Miller, Michelle Hughes

2002-01-01

Conducted a case study of the evaluation of a women's substance abuse prevention program and identified three key aspects of negotiated evaluation. Discusses the processes involved in feminist evaluation, including collaborative agenda setting and cooperative teamwork. (SLD)

Interval ridge regression (iRR) as a fast and robust method for quantitative prediction and variable selection applied to edible oil adulteration.

PubMed

Jović, Ozren; Smrečki, Neven; Popović, Zora

2016-04-01

A novel quantitative prediction and variable selection method called interval ridge regression (iRR) is studied in this work. The method is performed on six data sets of FTIR, two data sets of UV-vis and one data set of DSC. The obtained results show that models built with ridge regression on optimal variables selected with iRR significantly outperfom models built with ridge regression on all variables in both calibration (6 out of 9 cases) and validation (2 out of 9 cases). In this study, iRR is also compared with interval partial least squares regression (iPLS). iRR outperfomed iPLS in validation (insignificantly in 6 out of 9 cases and significantly in one out of 9 cases for p<0.05). Also, iRR can be a fast alternative to iPLS, especially in case of unknown degree of complexity of analyzed system, i.e. if upper limit of number of latent variables is not easily estimated for iPLS. Adulteration of hempseed (H) oil, a well known health beneficial nutrient, is studied in this work by mixing it with cheap and widely used oils such as soybean (So) oil, rapeseed (R) oil and sunflower (Su) oil. Binary mixture sets of hempseed oil with these three oils (HSo, HR and HSu) and a ternary mixture set of H oil, R oil and Su oil (HRSu) were considered. The obtained accuracy indicates that using iRR on FTIR and UV-vis data, each particular oil can be very successfully quantified (in all 8 cases RMSEP<1.2%). This means that FTIR-ATR coupled with iRR can very rapidly and effectively determine the level of adulteration in the adulterated hempseed oil (R(2)>0.99). Copyright © 2015 Elsevier B.V. All rights reserved.

The effect of class imbalance on case selection for case-based classifiers: An empirical study in the context of medical decision support

PubMed Central

Malof, Jordan M.; Mazurowski, Maciej A.; Tourassi, Georgia D.

2013-01-01

Case selection is a useful approach for increasing the efficiency and performance of case-based classifiers. Multiple techniques have been designed to perform case selection. This paper empirically investigates how class imbalance in the available set of training cases can impact the performance of the resulting classifier as well as properties of the selected set. In this study, the experiments are performed using a dataset for the problem of detecting breast masses in screening mammograms. The classification problem was binary and we used a k-nearest neighbor classifier. The classifier’s performance was evaluated using the Receiver Operating Characteristic (ROC) area under the curve (AUC) measure. The experimental results indicate that although class imbalance reduces the performance of the derived classifier and the effectiveness of selection at improving overall classifier performance, case selection can still be beneficial, regardless of the level of class imbalance. PMID:21820273

A jazz-based approach for optimal setting of pressure reducing valves in water distribution networks

NASA Astrophysics Data System (ADS)

De Paola, Francesco; Galdiero, Enzo; Giugni, Maurizio

2016-05-01

This study presents a model for valve setting in water distribution networks (WDNs), with the aim of reducing the level of leakage. The approach is based on the harmony search (HS) optimization algorithm. The HS mimics a jazz improvisation process able to find the best solutions, in this case corresponding to valve settings in a WDN. The model also interfaces with the improved version of a popular hydraulic simulator, EPANET 2.0, to check the hydraulic constraints and to evaluate the performances of the solutions. Penalties are introduced in the objective function in case of violation of the hydraulic constraints. The model is applied to two case studies, and the obtained results in terms of pressure reductions are comparable with those of competitive metaheuristic algorithms (e.g. genetic algorithms). The results demonstrate the suitability of the HS algorithm for water network management and optimization.

75 FR 74024 - Notice of Submission for OMB Review

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-30

... purpose of the Study of School Turnaround is to document over time the intervention models, approaches... with school principals, district administrators and state officials; site visits to case study schools... study team will conduct in-depth case studies over three years, and two sets of 10 ``special topics...

Characteristics of the group of radiologists that benefits the most using Breast Screen Reader Assessment Strategy (BREAST)

NASA Astrophysics Data System (ADS)

Ganesan, A.; Alakhras, M.; Brennan, P. C.; Lee, W.; Tapia, K.; Mello-Thoms, C.

2018-03-01

Purpose: To determine the impact of Breast Screen Reader Assessment Strategy (BREAST) over time in improving radiologists' breast cancer detection performance, and to identify the group of radiologists that benefit the most by using BREAST as a training tool. Materials and Methods: Thirty-six radiologists who completed three case-sets offered by BREAST were included in this study. The case-sets were arranged in radiologists' chronological order of completion and five performance measures (sensitivity, specificity, location sensitivity, receiver operating characteristics area under the curve (ROC AUC) and jackknife alternative free-response receiver operating characteristic (JAFROC) figure-of-merit (FOM)), available from BREAST, were compared between case-sets to determine the level of improvement achieved. The radiologists were then grouped based on their characteristics and the above performance measures between the case-sets were compared. Paired t-tests or Wilcoxon signed-rank tests with statistical significance set at p < 0.05 were used to compare the performance measures. Results: Significant improvement was demonstrated in radiologists' case-set performance in terms of location sensitivity and JAFROC FOM over the years, and radiologists' location sensitivity and JAFROC FOM showed significant improvement irrespective of their characteristics. In terms of ROC AUC, significant improvement was shown for radiologists who were reading screen mammograms for more than 7 years and spent more than 9 hours per week reading mammograms. Conclusion: Engaging with case-sets appears to enhance radiologists' performance suggesting the important value of initiatives such as BREAST. However, such performance enhancement was not shown for everyone, highlighting the need to tailor the BREAST platform to benefit all radiologists.

Paediatric case mix in a rural clinical school is relevant to future practice.

PubMed

Wright, Helen M; Maley, Moira A L; Playford, Denese E; Nicol, Pam; Evans, Sharon F

2017-11-29

Exposure to a representative case mix is essential for clinical learning, with logbooks established as a way of demonstrating patient contacts. Few studies have reported the paediatric case mix available to geographically distributed students within the same medical school. Given international interest in expanding medical teaching locations to rural contexts, equitable case exposure in rural relative to urban settings is topical. The Rural Clinical School of Western Australia locates students up to 3500 km from the urban university for an academic year. There is particular need to examine paediatric case mix as a study reported Australian graduates felt unprepared for paediatric rotations. We asked: Does a rural clinical school provide a paediatric case mix relevant to future practice? How does the paediatric case mix as logged by rural students compare with that by urban students? The 3745 logs of 76 urban and 76 rural consenting medical students were categorised by presenting symptoms and compared to the Australian Institute of Health and Welfare (AIHW) database Major Diagnostic Categories (MDCs). Rural and urban students logged core paediatric cases, in similar order, despite the striking difference in geographic locations. The pattern of overall presenting problems closely corresponded to Australian paediatric hospital admissions. Rural students logged 91% of cases in secondary healthcare settings; urban students logged 90% of cases in tertiary settings. The top four presenting problems were ENT/respiratory, gastrointestinal/urogenital, neurodevelopmental and musculoskeletal; these made up 60% of all cases. Rural and urban students logged similar proportions of infants, children and adolescents, with a variety of case morbidity. Rural clinical school students logged a mix of core paediatric cases relevant to illnesses of Australian children admitted to public hospitals, with similar order and pattern by age group to urban students, despite major differences in clinical settings. Logged cases met the curriculum learning outcomes of graduates. Minor variations were readily addressed via recommendations about logging. This paper provides evidence of the legitimacy of student logs as useful tools in affirming appropriate paediatric case mix. It validates the rural clinical school context as appropriate for medical students to prepare for future clinical paediatric practice.

Association of Long Runs of Homozygosity With Alzheimer Disease Among African American Individuals

PubMed Central

Ghani, Mahdi; Reitz, Christiane; Cheng, Rong; Vardarajan, Badri Narayan; Jun, Gyungah; Sato, Christine; Naj, Adam; Rajbhandary, Ruchita; Wang, Li-San; Valladares, Otto; Lin, Chiao-Feng; Larson, Eric B.; Graff-Radford, Neill R.; Evans, Denis; De Jager, Philip L.; Crane, Paul K.; Buxbaum, Joseph D.; Murrell, Jill R.; Raj, Towfique; Ertekin-Taner, Nilufer; Logue, Mark; Baldwin, Clinton T.; Green, Robert C.; Barnes, Lisa L.; Cantwell, Laura B.; Fallin, M. Daniele; Go, Rodney C. P.; Griffith, Patrick A.; Obisesan, Thomas O.; Manly, Jennifer J.; Lunetta, Kathryn L.; Kamboh, M. Ilyas; Lopez, Oscar L.; Bennett, David A.; Hendrie, Hugh; Hall, Kathleen S.; Goate, Alison M.; Byrd, Goldie S.; Kukull, Walter A.; Foroud, Tatiana M.; Haines, Jonathan L.; Farrer, Lindsay A.; Pericak-Vance, Margaret A.; Lee, Joseph H.; Schellenberg, Gerard D.; St. George-Hyslop, Peter; Mayeux, Richard; Rogaeva, Ekaterina

2015-01-01

IMPORTANCE Mutations in known causal Alzheimer disease (AD) genes account for only 1% to 3% of patients and almost all are dominantly inherited. Recessive inheritance of complex phenotypes can be linked to long (>1-megabase [Mb]) runs of homozygosity (ROHs) detectable by single-nucleotide polymorphism (SNP) arrays. OBJECTIVE To evaluate the association between ROHs and AD in an African American population known to have a risk for AD up to 3 times higher than white individuals. DESIGN, SETTING, AND PARTICIPANTS Case-control study of a large African American data set previously genotyped on different genome-wide SNP arrays conducted from December 2013 to January 2015. Global and locus-based ROH measurements were analyzed using raw or imputed genotype data. We studied the raw genotypes from 2 case-control subsets grouped based on SNP array: Alzheimer’s Disease Genetics Consortium data set (871 cases and 1620 control individuals) and Chicago Health and Aging Project–Indianapolis Ibadan Dementia Study data set (279 cases and 1367 control individuals). We then examined the entire data set using imputed genotypes from 1917 cases and 3858 control individuals. MAIN OUTCOMES AND MEASURES The ROHs larger than 1 Mb, 2 Mb, or 3 Mb were investigated separately for global burden evaluation, consensus regions, and gene-based analyses. RESULTS The African American cohort had a low degree of inbreeding (F ~ 0.006). In the Alzheimer’s Disease Genetics Consortium data set, we detected a significantly higher proportion of cases with ROHs greater than 2 Mb (P = .004) or greater than 3 Mb (P = .02), as well as a significant 114-kilobase consensus region on chr4q31.3 (empirical P value 2 = .04; ROHs >2 Mb). In the Chicago Health and Aging Project–Indianapolis Ibadan Dementia Study data set, we identified a significant 202-kilobase consensus region on Chr15q24.1 (empirical P value 2 = .02; ROHs >1 Mb) and a cluster of 13 significant genes on Chr3p21.31 (empirical P value 2 = .03; ROHs >3 Mb). A total of 43 of 49 nominally significant genes common for both data sets also mapped to Chr3p21.31. Analyses of imputed SNP data from the entire data set confirmed the association of AD with global ROH measurements (12.38 ROHs >1 Mb in cases vs 12.11 in controls; 2.986 Mb average size of ROHs >2 Mb in cases vs 2.889 Mb in controls; and 22% of cases with ROHs >3 Mb vs 19% of controls) and a gene-cluster on Chr3p21.31 (empirical P value 2 = .006-.04; ROHs >3 Mb). Also, we detected a significant association between AD and CLDN17 (empirical P value 2 = .01; ROHs >1 Mb), encoding a protein from the Claudin family, members of which were previously suggested as AD biomarkers. CONCLUSIONS AND RELEVANCE To our knowledge, we discovered the first evidence of increased burden of ROHs among patients with AD from an outbred African American population, which could reflect either the cumulative effect of multiple ROHs to AD or the contribution of specific loci harboring recessive mutations and risk haplotypes in a subset of patients. Sequencing is required to uncover AD variants in these individuals. PMID:26366463

Ayahuasca, dimethyltryptamine, and psychosis: a systematic review of human studies.

PubMed

Dos Santos, Rafael G; Bouso, José Carlos; Hallak, Jaime E C

2017-04-01

Ayahuasca is a hallucinogen brew traditionally used for ritual and therapeutic purposes in Northwestern Amazon. It is rich in the tryptamine hallucinogens dimethyltryptamine (DMT), which acts as a serotonin 5-HT 2A agonist. This mechanism of action is similar to other compounds such as lysergic acid diethylamide (LSD) and psilocybin. The controlled use of LSD and psilocybin in experimental settings is associated with a low incidence of psychotic episodes, and population studies corroborate these findings. Both the controlled use of DMT in experimental settings and the use of ayahuasca in experimental and ritual settings are not usually associated with psychotic episodes, but little is known regarding ayahuasca or DMT use outside these controlled contexts. Thus, we performed a systematic review of the published case reports describing psychotic episodes associated with ayahuasca and DMT intake. We found three case series and two case reports describing psychotic episodes associated with ayahuasca intake, and three case reports describing psychotic episodes associated with DMT. Several reports describe subjects with a personal and possibly a family history of psychosis (including schizophrenia, schizophreniform disorders, psychotic mania, psychotic depression), nonpsychotic mania, or concomitant use of other drugs. However, some cases also described psychotic episodes in subjects without these previous characteristics. Overall, the incidence of such episodes appears to be rare in both the ritual and the recreational/noncontrolled settings. Performance of a psychiatric screening before administration of these drugs, and other hallucinogens, in controlled settings seems to significantly reduce the possibility of adverse reactions with psychotic symptomatology. Individuals with a personal or family history of any psychotic illness or nonpsychotic mania should avoid hallucinogen intake.

Collaborative knowledge acquisition for the design of context-aware alert systems.

PubMed

Joffe, Erel; Havakuk, Ofer; Herskovic, Jorge R; Patel, Vimla L; Bernstam, Elmer Victor

2012-01-01

To present a framework for combining implicit knowledge acquisition from multiple experts with machine learning and to evaluate this framework in the context of anemia alerts. Five internal medicine residents reviewed 18 anemia alerts, while 'talking aloud'. They identified features that were reviewed by two or more physicians to determine appropriate alert level, etiology and treatment recommendation. Based on these features, data were extracted from 100 randomly-selected anemia cases for a training set and an additional 82 cases for a test set. Two staff internists assigned an alert level, etiology and treatment recommendation before and after reviewing the entire electronic medical record. The training set of 118 cases (100 plus 18) and the test set of 82 cases were explored using RIDOR and JRip algorithms. The feature set was sufficient to assess 93% of anemia cases (intraclass correlation for alert level before and after review of the records by internists 1 and 2 were 0.92 and 0.95, respectively). High-precision classifiers were constructed to identify low-level alerts (precision p=0.87, recall R=0.4), iron deficiency (p=1.0, R=0.73), and anemia associated with kidney disease (p=0.87, R=0.77). It was possible to identify low-level alerts and several conditions commonly associated with chronic anemia. This approach may reduce the number of clinically unimportant alerts. The study was limited to anemia alerts. Furthermore, clinicians were aware of the study hypotheses potentially biasing their evaluation. Implicit knowledge acquisition, collaborative filtering and machine learning were combined automatically to induce clinically meaningful and precise decision rules.

A genome-wide association study of anorexia nervosa.

PubMed

Boraska, V; Franklin, C S; Floyd, J A B; Thornton, L M; Huckins, L M; Southam, L; Rayner, N W; Tachmazidou, I; Klump, K L; Treasure, J; Lewis, C M; Schmidt, U; Tozzi, F; Kiezebrink, K; Hebebrand, J; Gorwood, P; Adan, R A H; Kas, M J H; Favaro, A; Santonastaso, P; Fernández-Aranda, F; Gratacos, M; Rybakowski, F; Dmitrzak-Weglarz, M; Kaprio, J; Keski-Rahkonen, A; Raevuori, A; Van Furth, E F; Slof-Op 't Landt, M C T; Hudson, J I; Reichborn-Kjennerud, T; Knudsen, G P S; Monteleone, P; Kaplan, A S; Karwautz, A; Hakonarson, H; Berrettini, W H; Guo, Y; Li, D; Schork, N J; Komaki, G; Ando, T; Inoko, H; Esko, T; Fischer, K; Männik, K; Metspalu, A; Baker, J H; Cone, R D; Dackor, J; DeSocio, J E; Hilliard, C E; O'Toole, J K; Pantel, J; Szatkiewicz, J P; Taico, C; Zerwas, S; Trace, S E; Davis, O S P; Helder, S; Bühren, K; Burghardt, R; de Zwaan, M; Egberts, K; Ehrlich, S; Herpertz-Dahlmann, B; Herzog, W; Imgart, H; Scherag, A; Scherag, S; Zipfel, S; Boni, C; Ramoz, N; Versini, A; Brandys, M K; Danner, U N; de Kovel, C; Hendriks, J; Koeleman, B P C; Ophoff, R A; Strengman, E; van Elburg, A A; Bruson, A; Clementi, M; Degortes, D; Forzan, M; Tenconi, E; Docampo, E; Escaramís, G; Jiménez-Murcia, S; Lissowska, J; Rajewski, A; Szeszenia-Dabrowska, N; Slopien, A; Hauser, J; Karhunen, L; Meulenbelt, I; Slagboom, P E; Tortorella, A; Maj, M; Dedoussis, G; Dikeos, D; Gonidakis, F; Tziouvas, K; Tsitsika, A; Papezova, H; Slachtova, L; Martaskova, D; Kennedy, J L; Levitan, R D; Yilmaz, Z; Huemer, J; Koubek, D; Merl, E; Wagner, G; Lichtenstein, P; Breen, G; Cohen-Woods, S; Farmer, A; McGuffin, P; Cichon, S; Giegling, I; Herms, S; Rujescu, D; Schreiber, S; Wichmann, H-E; Dina, C; Sladek, R; Gambaro, G; Soranzo, N; Julia, A; Marsal, S; Rabionet, R; Gaborieau, V; Dick, D M; Palotie, A; Ripatti, S; Widén, E; Andreassen, O A; Espeseth, T; Lundervold, A; Reinvang, I; Steen, V M; Le Hellard, S; Mattingsdal, M; Ntalla, I; Bencko, V; Foretova, L; Janout, V; Navratilova, M; Gallinger, S; Pinto, D; Scherer, S W; Aschauer, H; Carlberg, L; Schosser, A; Alfredsson, L; Ding, B; Klareskog, L; Padyukov, L; Courtet, P; Guillaume, S; Jaussent, I; Finan, C; Kalsi, G; Roberts, M; Logan, D W; Peltonen, L; Ritchie, G R S; Barrett, J C; Estivill, X; Hinney, A; Sullivan, P F; Collier, D A; Zeggini, E; Bulik, C M

2014-10-01

Anorexia nervosa (AN) is a complex and heritable eating disorder characterized by dangerously low body weight. Neither candidate gene studies nor an initial genome-wide association study (GWAS) have yielded significant and replicated results. We performed a GWAS in 2907 cases with AN from 14 countries (15 sites) and 14 860 ancestrally matched controls as part of the Genetic Consortium for AN (GCAN) and the Wellcome Trust Case Control Consortium 3 (WTCCC3). Individual association analyses were conducted in each stratum and meta-analyzed across all 15 discovery data sets. Seventy-six (72 independent) single nucleotide polymorphisms were taken forward for in silico (two data sets) or de novo (13 data sets) replication genotyping in 2677 independent AN cases and 8629 European ancestry controls along with 458 AN cases and 421 controls from Japan. The final global meta-analysis across discovery and replication data sets comprised 5551 AN cases and 21 080 controls. AN subtype analyses (1606 AN restricting; 1445 AN binge-purge) were performed. No findings reached genome-wide significance. Two intronic variants were suggestively associated: rs9839776 (P=3.01 × 10(-7)) in SOX2OT and rs17030795 (P=5.84 × 10(-6)) in PPP3CA. Two additional signals were specific to Europeans: rs1523921 (P=5.76 × 10(-)(6)) between CUL3 and FAM124B and rs1886797 (P=8.05 × 10(-)(6)) near SPATA13. Comparing discovery with replication results, 76% of the effects were in the same direction, an observation highly unlikely to be due to chance (P=4 × 10(-6)), strongly suggesting that true findings exist but our sample, the largest yet reported, was underpowered for their detection. The accrual of large genotyped AN case-control samples should be an immediate priority for the field.

Single case design studies in music therapy: resurrecting experimental evidence in small group and individual music therapy clinical settings.

PubMed

Geist, Kamile; Hitchcock, John H

2014-01-01

The profession would benefit from greater and routine generation of causal evidence pertaining to the impact of music therapy interventions on client outcomes. One way to meet this goal is to revisit the use of Single Case Designs (SCDs) in clinical practice and research endeavors in music therapy. Given the appropriate setting and goals, this design can be accomplished with small sample sizes and it is often appropriate for studying music therapy interventions. In this article, we promote and discuss implementation of SCD studies in music therapy settings, review the meaning of internal study validity and by extension the notion of causality, and describe two of the most commonly used SCDs to demonstrate how they can help generate causal evidence to inform the field. In closing, we describe the need for replication and future meta-analysis of SCD studies completed in music therapy settings. SCD studies are both feasible and appropriate for use in music therapy clinical practice settings, particularly for testing effectiveness of interventions for individuals or small groups. © the American Music Therapy Association 2014. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Test set readings predict clinical performance to a limited extent: preliminary findings

NASA Astrophysics Data System (ADS)

Soh, BaoLin P.; Lee, Warwick M.; Kench, Peter L.; Reed, Warren M.; McEntee, Mark F.; Brennan, Patrick C.

2013-03-01

Aim: To investigate the level of agreement between test sets and actual clinical reading Background: The performance of screen readers in detecting breast cancer is being assessed in some countries by using mammographic test sets. However, previous studies have provided little evidence that performance assessed by test sets strongly correlate to performance in clinical reading. Methods: Five clinicians from BreastScreen New South Wales participated in this study. Each clinician was asked to read 200 de-identified mammographic examinations gathered from their own case history within the BreastScreen NSW Digital Imaging Library. All test sets were designed with specific proportions of true positive, true negative, false positive and false negative examinations from the previous actual clinical reads of each reader. A prior mammogram examination for comparison (when available) was also provided for each case. Results: Preliminary analyses have shown that there is a moderate level of agreement (Kappa 0.42-0.56, p < 0.001) between laboratory test sets and actual clinical reading. In addition, a mean increase of 38% in sensitivity in the laboratory test sets as compared to their actual clinical readings was demonstrated. Specificity is similar between the laboratory test sets and actual clinical reading. Conclusion: This study demonstrated a moderate level of agreement between actual clinical reading and test set reading, which suggests that test sets have a role in reflecting clinical performance.

Servant Leadership through Distance Learning: A Case Study

ERIC Educational Resources Information Center

Russell, Eric James

2013-01-01

This qualitative study explored the influence a distance learning servant leadership course had on the emergency service students' understanding of leadership. The research study utilized a case study design in order to tell the story of the lived experiences of the participants. The setting for the study was a state university in Utah, with the…

Value of hemoglobin A1c in diagnosing diabetes mellitus within a chronic disease management system illustrated by the receiver operating characteristic curve.

PubMed

Eid, Wael E; Pottala, James V

2010-01-01

To develop a receiver operating characteristic (ROC) curve of glycosylated hemoglobin (HbA1c) for diagnosing diabetes mellitus within a chronic disease management system. A case-control study including medical records from January 1, 1997, to December 31, 2005, was conducted at the Sioux Falls Veterans Affairs Medical Center. Medical records for the case group (patients with diabetes) were selected based on 1 of 3 criteria: International Classification of Diseases, Ninth Revision, Clinical Modification or Current Procedural Terminology codes specific for type 1 and type 2 diabetes; patients' use of medications (oral hypoglycemic agents, antidiabetes agents, or insulin); or results from random blood or plasma glucose tests (at least 2 measurements of blood glucose > or = 200 mg/dL). Records for the control group were selected based on patients having HbA1c measured, but not meeting the above diagnostic criteria for diabetes during the study period. Records for cases and controls were randomly frequency-matched, one-to-one. The control group was randomly divided into 5 sets of an equal number of records. Five sets of an equal number of cases were then randomly selected from the total number of cases. Each test data set included 1 case group and 1 control group, resulting in 5 independent data sets. In total, 5040 patient records met the case definition in the diabetes registry. Records of 15 patients who were prescribed metformin only, but did not meet any other case criteria, were reviewed and excluded after determining the patients were not diabetic. The control group consisted of 5 sets of 616 records each (totaling 3080 records), and the case group consisted of 5 sets of 616 records each (totaling 3080 records). Thus, each of the 5 independent data sets of 1 case group and 1 control group contained 1232 records. The case group was predominantly composed of white men (mean age, 69 years; mean body mass index, 31 kg/m2). Demographic data were similar for control patients. The ROC curve revealed that a HbA1c > or = 6.3% (mean + 1 SD) offered the most accurate cutoff value for diagnosing type 2 diabetes mellitus, with the following statistical values: C statistic, 0.78; sensitivity, 70%; specificity, 85%; and positive likelihood ratio, 4.6 (95% confidence interval, 4.2-5.0). A HbA1c value > or = 6.3% may be a useful benchmark for diagnosing diabetes mellitus within a chronic disease management system and may be a useful tool for monitoring high-risk populations.

Cost-Effectiveness of Case Management in Substance Abuse Treatment

ERIC Educational Resources Information Center

Saleh, Shadi S.; Vaughn, Thomas; Levey, Samuel; Fuortes, Laurence; Uden-Holmen, Tanya; Hall, James A.

2006-01-01

Objective: The purpose of this study, which is part of a larger clinical trial, was to examine the cost-effectiveness of case management for individuals treated for substance abuse in a residential setting. Method: Clients who agreed to participate were randomly assigned to one of four study groups. Two groups received face-to-face case management…

Case Studies in 21st Century School Administration: Addressing Challenges for Educational Leadership

ERIC Educational Resources Information Center

Gray, David L.; Smith, Agnes

2007-01-01

Authors David L. Gray and Agnes E. Smith have written a book of cases to give prospective school leaders opportunities to resolve complex issues in K-12 school settings through reflective questions, activities, and authentic assessment tools for skill development. "Case Studies in 21st Century School Administration" presents thought-provoking case…

Peer Support in Full-Service Partnerships: A Multiple Case Study Analysis.

PubMed

Siantz, Elizabeth; Henwood, Benjamin; Gilmer, Todd

2017-07-01

Peer providers are integral to Full Service Partnerships (FSPs), which are team-based mental health service models. Peer providers use principles of recovery to engage clients, but FSPs can vary in their recovery orientation. Whether and how peer recovery orientation reflects the organizational environments of FSPs is unclear. This qualitative study explored peer provider attitudes towards recovery within the organizational contexts of FSPs where they are employed. Case study analysis was conducted on eight purposively sampled FSPs using qualitative interviews with peer providers and program directors. In two cases, peer recovery attitudes diverged from those of their organizational context. In these cases, peer providers were champions for recovery, and used practice-based strategies to promote client autonomy despite working in settings with lower recovery orientation. Peer providers could be uniquely positioned to promote client autonomy in settings where organizational factors limit consumer choice.

Case definitions for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): a systematic review

PubMed Central

Brurberg, Kjetil Gundro; Fønhus, Marita Sporstøl; Larun, Lillebeth; Flottorp, Signe; Malterud, Kirsti

2014-01-01

Objective To identify case definitions for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), and explore how the validity of case definitions can be evaluated in the absence of a reference standard. Design Systematic review. Setting International. Participants A literature search, updated as of November 2013, led to the identification of 20 case definitions and inclusion of 38 validation studies. Primary and secondary outcome measure Validation studies were assessed for risk of bias and categorised according to three validation models: (1) independent application of several case definitions on the same population, (2) sequential application of different case definitions on patients diagnosed with CFS/ME with one set of diagnostic criteria or (3) comparison of prevalence estimates from different case definitions applied on different populations. Results A total of 38 studies contributed data of sufficient quality and consistency for evaluation of validity, with CDC-1994/Fukuda as the most frequently applied case definition. No study rigorously assessed the reproducibility or feasibility of case definitions. Validation studies were small with methodological weaknesses and inconsistent results. No empirical data indicated that any case definition specifically identified patients with a neuroimmunological condition. Conclusions Classification of patients according to severity and symptom patterns, aiming to predict prognosis or effectiveness of therapy, seems useful. Development of further case definitions of CFS/ME should be given a low priority. Consistency in research can be achieved by applying diagnostic criteria that have been subjected to systematic evaluation. PMID:24508851

Strengthening healthcare delivery in Haiti through nursing continuing education.

PubMed

Clark, M; Julmisse, M; Marcelin, N; Merry, L; Tuck, J; Gagnon, A J

2015-03-01

The aim of this paper was to (1) highlight nursing continuing education as a key initiative for strengthening healthcare delivery in low-resource settings, and (2) provide an example of a nursing continuing education programme in Haiti. Haiti and other low-resource settings face extreme challenges including severe shortages of healthcare workers, high rates of nurse out-migration and variations in nurse competency at entry-to-practice. Nursing continuing education has the potential to address these challenges and improve healthcare delivery through enhanced nurse performance and retention; however, it is underutilized in low-resource settings. A case study is presented from the Hôpital Universitaire de Mirebalais in Mirebalais, Haiti of a new nursing continuing education programme called the Beyond Expert Program. The case study highlights eight key dimensions of nursing continuing education in low-resource settings: (1) involving local stakeholders in planning process, (2) targeting programme to nurse participant level and area of care, (3) basing course content on local context, (4) including diverse range of nursing topics, (5) using participatory teaching methods, (6) addressing resource constraints in time and scheduling, (7) evaluating and monitoring outcomes, and (8) establishing partnerships. The case study provides guidance for others wishing to develop programmes in similar settings. Creating a nursing continuing education programme in a low-resource setting is possible when there is commitment and engagement for nursing continuing education at all levels of the organization. Our report suggests a need for policy-makers in resource-limited settings to make greater investments in nursing continuing education as a focus of human resources for health, as it is an important strategy for promoting nurse retention, building the knowledge and skill of the existing nursing workforce, and raising the image of nursing in low-resource settings. © 2015 International Council of Nurses.

Effectiveness of reactive case detection for malaria elimination in three archetypical transmission settings: a modelling study.

PubMed

Gerardin, Jaline; Bever, Caitlin A; Bridenbecker, Daniel; Hamainza, Busiku; Silumbe, Kafula; Miller, John M; Eisele, Thomas P; Eckhoff, Philip A; Wenger, Edward A

2017-06-12

Reactive case detection could be a powerful tool in malaria elimination, as it selectively targets transmission pockets. However, field operations have yet to demonstrate under which conditions, if any, reactive case detection is best poised to push a region to elimination. This study uses mathematical modelling to assess how baseline transmission intensity and local interconnectedness affect the impact of reactive activities in the context of other possible intervention packages. Communities in Southern Province, Zambia, where elimination operations are currently underway, were used as representatives of three archetypes of malaria transmission: low-transmission, high household density; high-transmission, low household density; and high-transmission, high household density. Transmission at the spatially-connected household level was simulated with a dynamical model of malaria transmission, and local variation in vectorial capacity and intervention coverage were parameterized according to data collected from the area. Various potential intervention packages were imposed on each of the archetypical settings and the resulting likelihoods of elimination by the end of 2020 were compared. Simulations predict that success of elimination campaigns in both low- and high-transmission areas is strongly dependent on stemming the flow of imported infections, underscoring the need for regional-scale strategies capable of reducing transmission concurrently across many connected areas. In historically low-transmission areas, treatment of clinical malaria should form the cornerstone of elimination operations, as most malaria infections in these areas are symptomatic and onward transmission would be mitigated through health system strengthening; reactive case detection has minimal impact in these settings. In historically high-transmission areas, vector control and case management are crucial for limiting outbreak size, and the asymptomatic reservoir must be addressed through reactive case detection or mass drug campaigns. Reactive case detection is recommended only for settings where transmission has recently been reduced rather than all low-transmission settings. This is demonstrated in a modelling framework with strong out-of-sample accuracy across a range of transmission settings while including methodologies for understanding the most resource-effective allocations of health workers. This approach generalizes to providing a platform for planning rational scale-up of health systems based on locally-optimized impact according to simplified stratification.

Patterns of public participation.

PubMed

Slutsky, Jean; Tumilty, Emma; Max, Catherine; Lu, Lanting; Tantivess, Sripen; Hauegen, Renata Curi; Whitty, Jennifer A; Weale, Albert; Pearson, Steven D; Tugendhaft, Aviva; Wang, Hufeng; Staniszewska, Sophie; Weerasuriya, Krisantha; Ahn, Jeonghoon; Cubillos, Leonardo

2016-08-15

Purpose - The paper summarizes data from 12 countries, chosen to exhibit wide variation, on the role and place of public participation in the setting of priorities. The purpose of this paper is to exhibit cross-national patterns in respect of public participation, linking those differences to institutional features of the countries concerned. Design/methodology/approach - The approach is an example of case-orientated qualitative assessment of participation practices. It derives its data from the presentation of country case studies by experts on each system. The country cases are located within the historical development of democracy in each country. Findings - Patterns of participation are widely variable. Participation that is effective through routinized institutional processes appears to be inversely related to contestatory participation that uses political mobilization to challenge the legitimacy of the priority setting process. No system has resolved the conceptual ambiguities that are implicit in the idea of public participation. Originality/value - The paper draws on a unique collection of country case studies in participatory practice in prioritization, supplementing existing published sources. In showing that contestatory participation plays an important role in a sub-set of these countries it makes an important contribution to the field because it broadens the debate about public participation in priority setting beyond the use of minipublics and the observation of public representatives on decision-making bodies.

Maori Children's Biliteracy Experiences Moving from a Kohanga Reo Setting to a Kura Kaupapa Maori, Bilingual, and Mainstream Education Setting: An Exploratory Study

ERIC Educational Resources Information Center

Rona, Sarika; McLachlan, Claire J.

2018-01-01

This research explored the biliteracy experiences of three kohanga reo children as they started school in one of three school settings: a bilingual unit, a mainstream classroom, and kura kaupapa Maori. A Kaupapa Maori approach underpinned this research and guided the case study methodology employed. The children's literacy experiences were…

Multimodal Behavior Therapy: Case Study of a High School Student.

ERIC Educational Resources Information Center

Seligman, Linda

1981-01-01

A case study of a high school student concerned with weight problems illustrates multimodal behavior therapy and its use in a high school setting. Multimodal therapy allows the school counselor to maximize referral sources while emphasizing growth and actualization. (JAC)

Campus Crisis Response at Viberg College

ERIC Educational Resources Information Center

Eaker, Rachel; Viars, Jamie

2014-01-01

This fictional case study examines crisis response in higher education settings. Information about current crisis response procedures, plans, and trends was gathered from informational interviews, current crisis management literature, and multiple college and university websites. The information was synthesized into a fictional case study using…

A Framework for Reviewing EPA's State Administrative Cost Estimates: A Case Study (2007)

EPA Pesticide Factsheets

This report contains the findings of the set of case studies that look at EPA’s and the states’ information and methods used to estimate the costs to states charged with administering a selection of EPA regulations.

Working Together with Children and Families: Case Studies in Early Intervention.

ERIC Educational Resources Information Center

McWilliam, P. J., Ed.; Bailey, Donald B., Jr., Ed.

This book presents 21 case studies of young children with disabilities in a variety of family situations and settings, for early interventionists to study in planning and applying recommended practices. Section I, "Defining and Delivering Quality Services in Early Intervention," provides two introductory chapters: "The Search for Quality…

Development of a diagnostic test set to assess agreement in breast pathology: practical application of the Guidelines for Reporting Reliability and Agreement Studies (GRRAS).

PubMed

Oster, Natalia V; Carney, Patricia A; Allison, Kimberly H; Weaver, Donald L; Reisch, Lisa M; Longton, Gary; Onega, Tracy; Pepe, Margaret; Geller, Berta M; Nelson, Heidi D; Ross, Tyler R; Tosteson, Aanna N A; Elmore, Joann G

2013-02-05

Diagnostic test sets are a valuable research tool that contributes importantly to the validity and reliability of studies that assess agreement in breast pathology. In order to fully understand the strengths and weaknesses of any agreement and reliability study, however, the methods should be fully reported. In this paper we provide a step-by-step description of the methods used to create four complex test sets for a study of diagnostic agreement among pathologists interpreting breast biopsy specimens. We use the newly developed Guidelines for Reporting Reliability and Agreement Studies (GRRAS) as a basis to report these methods. Breast tissue biopsies were selected from the National Cancer Institute-funded Breast Cancer Surveillance Consortium sites. We used a random sampling stratified according to woman's age (40-49 vs. ≥50), parenchymal breast density (low vs. high) and interpretation of the original pathologist. A 3-member panel of expert breast pathologists first independently interpreted each case using five primary diagnostic categories (non-proliferative changes, proliferative changes without atypia, atypical ductal hyperplasia, ductal carcinoma in situ, and invasive carcinoma). When the experts did not unanimously agree on a case diagnosis a modified Delphi method was used to determine the reference standard consensus diagnosis. The final test cases were stratified and randomly assigned into one of four unique test sets. We found GRRAS recommendations to be very useful in reporting diagnostic test set development and recommend inclusion of two additional criteria: 1) characterizing the study population and 2) describing the methods for reference diagnosis, when applicable.

A preliminary study of EAT and BITE scores for one school year in Bermuda: increased early anorexic measures related to socio-economic factors.

PubMed

Marlowe, Karl

2005-03-01

Bermuda is a unique heterogeneous ethnic population in which it is possible to study the interaction of ethnicity, culture, gender and economic factors that influence abnormal eating attitudes. A cross-sectional survey of 836 adolescents, one total school year in Bermuda. The BITE and EAT self-report questionnaires were administered in a classroom setting. The analysis was for caseness and for total scores. Caseness represents possible developing anorexic or bulimic eating disorder pathology for this non-adult population. 7.3% fulfilled EAT caseness, 0.24% fulfilled BITE caseness. There was no gender or ethnic difference for caseness. Multivariate analysis for EAT caseness found Odds Ratios of 2.89 (95% CI 1.37, 6.11) for Manual maternal job status. Despite the limitation of a questionnaire analysis, lower socioeconomic status increases the risk of possible eating disorder pathology in this adolescent population. Developing anorexic eating attitudes were more prevalent compared to bulimic attitudes for schoolchildren in this unique cultural setting.

Professional relationships and power dynamics between urban community-based nurses and social work case managers: advocacy in action.

PubMed

Young, Staci

2009-01-01

The purpose of this study was to explore how community-based case managers interface with their clients' healthcare providers and other community organizations as a function within their advocacy efforts. Case managers previously defined advocacy as occurring at individual, organizational, and community levels. The relationships they attempt to develop and maintain are consistent with case management ideology, yet this is a complex process to ensure care for vulnerable populations with many medical and socioeconomic needs. Community-based case management settings. In-depth qualitative interviews with a total of 20 nurse and social work case managers working in public housing, university-affiliated community nursing centers, local parishes, and community ministry. The case managers in this study reflected on how they interface with their clients, other healthcare providers, and community organizations on behalf of their clients. They reflect on the importance of trust and communication to facilitate this process. The advocacy work of case managers is influenced by the setting, others' perceptions of their knowledge and expertise, and power dynamics. Their ability to effectively advocate is greatly influenced by the strength of the relationships they forge. Advocacy for vulnerable clients is influenced by the existing relationship between case managers and their clients' healthcare providers. Case managers need to be persistent in their interactions with other providers to ensure that their clients have access to valuable community resources. Clear lines of communication should be established between case managers so that there is clarity around roles and expectations in service provision. Case managers should also participate in the mentoring of future health professions students so they may learn the application of advocacy work in community settings.

An Investigation of GeoBase Mission Data Set Design, Implementation, and Usage Within Air Force Civil Engineer Electrical and Utilities Work Centers

DTIC Science & Technology

2005-03-01

ethnography , grounded theory , phenomenological , case study , and content analysis. As ethnography is based upon a longitudinal study in...a qualitative methodology consisting of a case study strategy is warranted for this research project. Yin (2003) lists five components of research ...systems. Journal of End User Computing, 12(3), 14. Yin, R. K. (2003). Case Study Research : Design and

Ways and Means of Adapting Culture and Structure: Case Studies. Support Document 1

ERIC Educational Resources Information Center

Clayton, Berwyn; Fisher, Thea; Harris, Roger; Bateman, Andrea; Brown, Mike

2008-01-01

The resource in this support document is a set of small case studies, offering insights into how a range of organisations have gone about adapting their organisational structure and/or culture to enhance their capability. Key elements of each case are presented with a particular emphasis on: (1) the principles that have underpinned each approach…

Case Study: Teaching Nature of Science through Scientific Models--The Geocentric vs. Heliocentric Cosmology

ERIC Educational Resources Information Center

Price, Matthew; Rogers, Michael

2016-01-01

In the nonmajor science classroom, case studies--when used as learning tools--should help students build the necessary framework to understand the nature of science. For most students, the nonmajor science course (in this case, Astronomy 101) may be the last time that they interact with science in a formal learning setting. A National Science…

Making Sense of Clinical Practice: Order Set Design Strategies in CPOE

PubMed Central

Novak, Laurie L.

2007-01-01

A case study was conducted during the customization phase of a commercial CPOE system at a multi-hospital, academic health system. The study focused on the development of order sets. Three distinct approaches to order set development were observed: Empirical, Local Consensus and Departmental. The three approaches are first described and then examined using the framework of sensemaking. Different approaches to sensemaking in the context of order set development reflect variations in sources of knowledge related to the standardization of care. PMID:18693900

Development and testing of a tool for assessing and resolving medication-related problems in older adults in an ambulatory care setting: the individualized medication assessment and planning (iMAP) tool.

PubMed

Crisp, Ginny D; Burkhart, Jena Ivey; Esserman, Denise A; Weinberger, Morris; Roth, Mary T

2011-12-01

Medication is one of the most important interventions for improving the health of older adults, yet it has great potential for causing harm. Clinical pharmacists are well positioned to engage in medication assessment and planning. The Individualized Medication Assessment and Planning (iMAP) tool was developed to aid clinical pharmacists in documenting medication-related problems (MRPs) and associated recommendations. The purpose of our study was to assess the reliability and usability of the iMAP tool in classifying MRPs and associated recommendations in older adults in the ambulatory care setting. Three cases, representative of older adults seen in an outpatient setting, were developed. Pilot testing was conducted and a "gold standard" key developed. Eight eligible pharmacists consented to participate in the study. They were instructed to read each case, make an assessment of MRPs, formulate a plan, and document the information using the iMAP tool. Inter-rater reliability was assessed for each case, comparing the pharmacists' identified MRPs and recommendations to the gold standard. Consistency of categorization across reviewers was assessed using the κ statistic or percent agreement. The mean κ across the 8 pharmacists in classifying MRPs compared with the gold standard was 0.74 (range, 0.54-1.00) for case 1 and 0.68 (range, 0.36-1.00) for case 2, indicating substantial agreement. For case 3, percent agreement was 63% (range, 40%-100%). The mean κ across the 8 pharmacists when classifying recommendations compared with the gold standard was 0.87 (range, 0.58-1.00) for case 1 and 0.88 (range, 0.75-1.00) for case 2, indicating almost perfect agreement. For case 3, percent agreement was 68% (range, 40%-100%). Clinical pharmacists found the iMAP tool easy to use. The iMAP tool provides a reliable and standardized approach for clinical pharmacists to use in the ambulatory care setting to classify MRPs and associated recommendations. Future studies will explore the predictive validity of the tool on clinical outcomes such as health care utilization. Copyright © 2011 Elsevier HS Journals, Inc. All rights reserved.

Frequency, probability, and prediction: easy solutions to cognitive illusions?

PubMed

Griffin, D; Buehler, R

1999-02-01

Many errors in probabilistic judgment have been attributed to people's inability to think in statistical terms when faced with information about a single case. Prior theoretical analyses and empirical results imply that the errors associated with case-specific reasoning may be reduced when people make frequentistic predictions about a set of cases. In studies of three previously identified cognitive biases, we find that frequency-based predictions are different from-but no better than-case-specific judgments of probability. First, in studies of the "planning fallacy, " we compare the accuracy of aggregate frequency and case-specific probability judgments in predictions of students' real-life projects. When aggregate and single-case predictions are collected from different respondents, there is little difference between the two: Both are overly optimistic and show little predictive validity. However, in within-subject comparisons, the aggregate judgments are significantly more conservative than the single-case predictions, though still optimistically biased. Results from studies of overconfidence in general knowledge and base rate neglect in categorical prediction underline a general conclusion. Frequentistic predictions made for sets of events are no more statistically sophisticated, nor more accurate, than predictions made for individual events using subjective probability. Copyright 1999 Academic Press.

Coherence, Contradiction, and the Development of School Science Identities

ERIC Educational Resources Information Center

Olitsky, Stacy; Flohr, Linda Loman; Gardner, Jessica; Billups, Markita

2010-01-01

This study demonstrates the potential for collaborative research among participants in local settings to effect positive change in urban settings characterized by diversity. It describes an interpretive case study of a racially, ethnically, and socioeconomically diverse eighth grade science classroom in an urban magnet school in order to explore…

Histological features associated with diagnostic agreement in atypical ductal hyperplasia of the breast: illustrative cases from the B-Path study.

PubMed

Allison, Kimberly H; Rendi, Mara H; Peacock, Sue; Morgan, Tom; Elmore, Joann G; Weaver, Donald L

2016-12-01

This study examined the case-specific characteristics associated with interobserver diagnostic agreement in atypical ductal hyperplasia (ADH) of the breast. Seventy-two test set cases with a consensus diagnosis of ADH from the B-Path study were evaluated. Cases were scored for 17 histological features, which were then correlated with the participant agreement with the consensus ADH diagnosis. Participating pathologists' perceptions of case difficulty, borderline features or whether they would obtain a second opinion were also examined for associations with agreement. Of the 2070 participant interpretations of the 72 consensus ADH cases, 48% were scored by participants as difficult and 45% as borderline between two diagnoses; the presence of both of these features was significantly associated with increased agreement (P < 0.001). A second opinion would have been obtained in 80% of interpretations, and this was associated with increased agreement (P < 0.001). Diagnostic agreement ranged from 10% to 89% on a case-by-case basis. Cases with papillary lesions, cribriform architecture and obvious cytological monotony were associated with higher agreement. Lower agreement rates were associated with solid or micropapillary architecture, borderline cytological monotony, or cases without a diagnostic area that was obvious on low power. The results of this study suggest that pathologists frequently recognize the challenge of ADH cases, with some cases being more prone to diagnostic variability. In addition, there are specific histological features associated with diagnostic agreement on ADH cases. Multiple example images from cases in this test set are provided to serve as educational illustrations of these challenges. © 2016 John Wiley & Sons Ltd.

PCMO L01-Setting Specifications for Biological Investigational Medicinal Products.

PubMed

Krause, Stephan O

2015-01-01

This paper provides overall guidance and best practices for the setting of specifications for clinical biological drug substances and drug products within the framework of ICH guidelines on pharmaceutical development [Q8(R2) and Q11], quality risk management (Q9), and quality systems (Q10). A review is provided of the current regulatory expectations for the specification setting process as part of a control strategy during product development, pointing to existing challenges for the investigational new drug/investigational medicinal product dossier (IND/IMPD) sponsor. A case study illustrates how the investigational medicinal product specification revision process can be managed within a flexible quality system, and how specifications can be set and justified for early and late development stages. This paper provides an overview for the setting of product specifications for investigational medicinal products used in clinical trials. A case study illustrates how product specifications of investigational medicinal products can be justified and managed within a modern product quality system. © PDA, Inc. 2015.

Leadership Analysis in K-12 Case Study: "Divided Loyalties"

ERIC Educational Resources Information Center

Alsubaie, Merfat Ayesh

2016-01-01

This report mainly aims to provide a critical and in-depth analysis of the K-12 Case, "Divided Loyalty" by Holy and Tartar (2004). The case recounts how the manifestation of inadequate leadership skills in a school setting could affect negatively the performance of students.

Ayahuasca, dimethyltryptamine, and psychosis: a systematic review of human studies

PubMed Central

dos Santos, Rafael G.; Bouso, José Carlos; Hallak, Jaime E. C.

2017-01-01

Ayahuasca is a hallucinogen brew traditionally used for ritual and therapeutic purposes in Northwestern Amazon. It is rich in the tryptamine hallucinogens dimethyltryptamine (DMT), which acts as a serotonin 5-HT2A agonist. This mechanism of action is similar to other compounds such as lysergic acid diethylamide (LSD) and psilocybin. The controlled use of LSD and psilocybin in experimental settings is associated with a low incidence of psychotic episodes, and population studies corroborate these findings. Both the controlled use of DMT in experimental settings and the use of ayahuasca in experimental and ritual settings are not usually associated with psychotic episodes, but little is known regarding ayahuasca or DMT use outside these controlled contexts. Thus, we performed a systematic review of the published case reports describing psychotic episodes associated with ayahuasca and DMT intake. We found three case series and two case reports describing psychotic episodes associated with ayahuasca intake, and three case reports describing psychotic episodes associated with DMT. Several reports describe subjects with a personal and possibly a family history of psychosis (including schizophrenia, schizophreniform disorders, psychotic mania, psychotic depression), nonpsychotic mania, or concomitant use of other drugs. However, some cases also described psychotic episodes in subjects without these previous characteristics. Overall, the incidence of such episodes appears to be rare in both the ritual and the recreational/noncontrolled settings. Performance of a psychiatric screening before administration of these drugs, and other hallucinogens, in controlled settings seems to significantly reduce the possibility of adverse reactions with psychotic symptomatology. Individuals with a personal or family history of any psychotic illness or nonpsychotic mania should avoid hallucinogen intake. PMID:28540034

Collaborative knowledge acquisition for the design of context-aware alert systems

PubMed Central

Joffe, Erel; Havakuk, Ofer; Herskovic, Jorge R; Patel, Vimla L

2012-01-01

Objective To present a framework for combining implicit knowledge acquisition from multiple experts with machine learning and to evaluate this framework in the context of anemia alerts. Materials and Methods Five internal medicine residents reviewed 18 anemia alerts, while ‘talking aloud’. They identified features that were reviewed by two or more physicians to determine appropriate alert level, etiology and treatment recommendation. Based on these features, data were extracted from 100 randomly-selected anemia cases for a training set and an additional 82 cases for a test set. Two staff internists assigned an alert level, etiology and treatment recommendation before and after reviewing the entire electronic medical record. The training set of 118 cases (100 plus 18) and the test set of 82 cases were explored using RIDOR and JRip algorithms. Results The feature set was sufficient to assess 93% of anemia cases (intraclass correlation for alert level before and after review of the records by internists 1 and 2 were 0.92 and 0.95, respectively). High-precision classifiers were constructed to identify low-level alerts (precision p=0.87, recall R=0.4), iron deficiency (p=1.0, R=0.73), and anemia associated with kidney disease (p=0.87, R=0.77). Discussion It was possible to identify low-level alerts and several conditions commonly associated with chronic anemia. This approach may reduce the number of clinically unimportant alerts. The study was limited to anemia alerts. Furthermore, clinicians were aware of the study hypotheses potentially biasing their evaluation. Conclusion Implicit knowledge acquisition, collaborative filtering and machine learning were combined automatically to induce clinically meaningful and precise decision rules. PMID:22744961

Comparison of cost determination of both resource consumption accounting and time-driven activity-based costing systems in a healthcare setting.

PubMed

Özyapıcı, Hasan; Tanış, Veyis Naci

2017-05-01

Objective The aim of the present study was to explore the differences between resource consumption accounting (RCA) and time-driven activity-based costing (TDABC) systems in determining the costs of services of a healthcare setting. Methods A case study was conducted to calculate the unit costs of open and laparoscopic gall bladder surgeries using TDABC and RCA. Results The RCA system assigns a higher cost both to open and laparoscopic gall bladder surgeries than TDABC. The total cost of unused capacity under the TDABC system is also double that in RCA. Conclusion Unlike TDABC, RCA calculates lower costs for unused capacities but higher costs for products or services in a healthcare setting in which fixed costs make up a high proportion of total costs. What is known about the topic? TDABC is a revision of the activity-based costing (ABC) system. RCA is also a new costing system that includes both the theoretical advantages of ABC and the practical advantages of German costing. However, little is known about the differences arising from application of TDABC and RCA. What does this paper add? There is no study comparing both TDABC and RCA in a single case study based on a real-world healthcare setting. Thus, the present study fills this gap in the literature and it is unique in the sense that it is the first case study comparing TDABC and RCA for open and laparoscopic gall bladder surgeries in a healthcare setting. What are the implications for practitioners? This study provides several interesting results for managers and cost accounting researchers. Thus, it will contribute to the spread of RCA studies in healthcare settings. It will also help the implementers of TDABC to revise data concerning the cost of unused capacity. In addition, by separating costs into fixed and variable, the paper will help managers to create a blended (combined) system that can improve both short- and long-term decisions.

[Case-control study on bone setting manipulation for the treatment of over degree II supination-eversion fractures of ankle joint].

PubMed

Qi, Yue-Feng; Chen, Fa-Lin; Bao, Shu-Ren; Li, Cheng-Huan; Zhao, Xing-Wei; Liu, Shi-Ming; Chen, Wen-Xue; Li, Ye; Wang, Peng

2012-08-01

To explore therapeutic effects of bone setting manipulation for the treatment of over degree II supination-eversion fractures of ankle,and analyze manipulative reduction mechanism. From 2005 to 2008, 95 patients with over degree II supination-eversion fractures of ankle were treated respectively by manipulation and operation. There were 43 cases [11 males and 32 females with an average age of (44.95 +/- 12.65) years] in manipulation group, and 2 cases were degree II, 11 cases were degree III, and 30 cases were degree IV. There were 52 cases [21 males and 31 females with an average age of (39.96 +/- 13.28) years] in operative group,and 6 cases were degree II, 18 cases were degree III, and 28 cases were degree IV. Bone setting manipulation and hard splint external fixation were applied to manipulative group. Operative reduction internal fixation was performed in operative group. X-ray was used to evaluate reduction of fracture before and after treatment, 2 months after treatment. Ankle joint function was evaluated according to Olerud-Molander scoring system after 6 months treatment. All patients were followed up with good reduction. Three cases occurred wound complication in operative group, but not in manipulative group. In manipulation group, 19 cases got excellent results, 20 cases good and 4 cases fair; while in operative group, 30 cases got excellent results, 20 cases good and 2 cases poor. There were no significant differences in fracture reduction and ankle joint function recovery between two groups (P > 0.05). Efficacy of operative treatment was better than that of manipulative treatment at degree IV fracture (P < 0.05). Bone setting manipulation is a good method for treating supination-eversion ankle joint fractures, which has advantages of simple and safe operation, reliable efficacy. For ankle join fracture at degree IV, manipulative reduction should be adopted earlier, and operative treatment also necessary

Implementing iPads in the Inclusive Classroom Setting

ERIC Educational Resources Information Center

Maich, Kimberly; Hall, Carmen

2016-01-01

This column provides practical suggestions to help guide teachers in utilizing classroom sets of iPads. Following a brief introduction to tablet technology in inclusive classrooms and the origin of these recommendations from a case study focus group, important elements of setting up classroom iPad use, from finding funding to teaching apps, are…

Coproducing Aboriginal patient journey mapping tools for improved quality and coordination of care.

PubMed

Kelly, Janet; Dwyer, Judith; Mackean, Tamara; O'Donnell, Kim; Willis, Eileen

2016-12-08

This paper describes the rationale and process for developing a set of Aboriginal patient journey mapping tools with Aboriginal patients, health professionals, support workers, educators and researchers in the Managing Two Worlds Together project between 2008 and 2015. Aboriginal patients and their families from rural and remote areas, and healthcare providers in urban, rural and remote settings, shared their perceptions of the barriers and enablers to quality care in interviews and focus groups, and individual patient journey case studies were documented. Data were thematically analysed. In the absence of suitable existing tools, a new analytical framework and mapping approach was developed. The utility of the tools in other settings was then tested with health professionals, and the tools were further modified for use in quality improvement in health and education settings in South Australia and the Northern Territory. A central set of patient journey mapping tools with flexible adaptations, a workbook, and five sets of case studies describing how staff adapted and used the tools at different sites are available for wider use.

Hospitals as complex adaptive systems: A case study of factors influencing priority setting practices at the hospital level in Kenya.

PubMed

Barasa, Edwine W; Molyneux, Sassy; English, Mike; Cleary, Susan

2017-02-01

There is a dearth of literature on priority setting and resource allocation (PSRA) practices in hospitals, particularly in low and middle income countries (LMICs). Using a case study approach, we examined PSRA practices in 2 public hospitals in coastal Kenya. We collected data through a combination of in-depth interviews of national level policy makers, hospital managers, and frontline practitioners in the case study hospitals (n = 72), review of documents such as hospital plans and budgets, minutes of meetings and accounting records, and non-participant observations of PSRA practices in case study hospitals over a period of 7 months. In this paper, we apply complex adaptive system (CAS) theory to examine the factors that influence PSRA practices. We found that PSRA practices in the case hospitals were influenced by, 1) inadequate financing level and poorly designed financing arrangements, 2) limited hospital autonomy and decision space, and 3) inadequate management and leadership capacity in the hospital. The case study hospitals exhibited properties of complex adaptive systems (CASs) that exist in a dynamic state with multiple interacting agents. Weaknesses in system 'hardware' (resource scarcity) and 'software' (including PSRA guidelines that reduced hospitals decision space, and poor leadership skills) led to the emergence of undesired properties. The capacity of hospitals to set priorities should be improved across these interacting aspects of the hospital organizational system. Interventions should however recognize that hospitals are CAS. Rather than rectifying isolated aspects of the system, they should endeavor to create conditions for productive emergence. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Triggering Transformative Possibilities: A Case Study of Leaders' Quest in China

ERIC Educational Resources Information Center

Lau-Kwong, Kenzie

2012-01-01

This study explored the nature of transformative learning experiences among global executives who participated in Quest program, a learning journey program designed to facilitate shifting mind-sets and worldviews through 1-week intensives in countries such as China. A mixed methods, multiple case study approach was employed. First, a secondary…

Dealing with Gender in the Classroom: A Portrayed Case Study of Four Teachers

ERIC Educational Resources Information Center

Giraldo, Elida; Colyar, Julia

2012-01-01

This paper emerges from a qualitative case study that takes place in a US preschool setting and explores teachers' influences on the construction of children's gender identities. According to postmodern theories of gender, identity is constructed and constituted through social interactions and performances. This study focuses on the gender…

Enhancing Children's Outdoor Learning Experiences with a Mobile Application

ERIC Educational Resources Information Center

Rikala, Jenni

2015-01-01

This paper examines how a mobile learning application can enhance children's outdoor learning experiences. The study draws upon empirical evidence gathered in one case study conducted in a Finnish primary school setting in the fall of 2012. The data were collected with student and teacher surveys. The case study indicated that the mobile…

Case Studies of Action Research in Various Adult Education Settings.

ERIC Educational Resources Information Center

Kuhne, Gary W.; Weirauch, Drucie; Fetterman, David J.; Mearns, Raiana M.; Kalinosky, Kathy; Cegles, Kathleen A.; Ritchey, Linda

1997-01-01

Six case studies illustrate action research in adult education: faculty development in a museum, participation in a church congregation, retention of literacy volunteers in a corrections center, learner participation in a homeless shelter, technology innovation in a university, and infection control in a hospital. (SK)

Can cognitive exercises help treat anorexia nervosa?

PubMed

Tchanturia, K; Whitney, J; Treasure, J

2006-12-01

Cognitive remediation therapy (CRT) is used as an intervention for people with brain lesions and psychosis. This case report demonstrates the possible benefits of introducing CRT into treatment packages for anorexia nervosa (AN). In our previous work, we reported that people with AN demonstrate inflexibility in cognitive set-shifting tasks. Weight gain alone does not improve the neuropsychological profile in set-shifting tasks. This case report illustrates how training programmes can address problems in cognitive rigidity. We acknowledge the limitations of case studies, however, this is a starting point in exploring the possibilities of introducing CRT as part of the treatment of AN.

Lightning forecasting studies using LDAR, LLP, field mill, surface mesonet, and Doppler radar data

NASA Technical Reports Server (NTRS)

Forbes, Gregory S.; Hoffert, Steven G.

1995-01-01

The ultimate goal of this research is to develop rules, algorithms, display software, and training materials that can be used by the operational forecasters who issue weather advisories for daily ground operations and launches by NASA and the United States Air Force to improve real-time forecasts of lightning. Doppler radar, Lightning Detection and Ranging (LDAR), Lightning Location and Protection (LLP), field mill (Launch Pad Lightning Warning System -- LPLWS), wind tower (surface mesonet) and additional data sets have been utilized in 10 case studies of thunderstorms in the vicinity of KSC during the summers of 1994 and 1995. These case studies reveal many intriguing aspects of cloud-to-ground, cloud-to-cloud, in-cloud, and cloud-to-air lightning discharges in relation to radar thunderstorm structure and evolution. They also enable the formulation of some preliminary working rules of potential use in the forecasting of initial and final ground strike threat. In addition, LDAR and LLP data sets from 1993 have been used to quantify the lightning threat relative to the center and edges of LDAR discharge patterns. Software has been written to overlay and display the various data sets as color imagery. However, human intervention is required to configure the data sets for proper intercomparison. Future efforts will involve additional software development to automate the data set intercomparisons, to display multiple overlay combinations in a windows format, and to allow for animation of the imagery. The software package will then be used as a tool to examine more fully the current cases and to explore additional cases in a timely manner. This will enable the formulation of more general and reliable forecasting guidelines and rules.

The rate of sputum smear-positive tuberculosis after treatment default in a high-burden setting: a retrospective cohort study.

PubMed

Marx, Florian M; Dunbar, Rory; Enarson, Donald A; Beyers, Nulda

2012-01-01

High rates of recurrent tuberculosis after successful treatment have been reported from different high burden settings in Sub-Saharan Africa. However, little is known about the rate of smear-positive tuberculosis after treatment default. In particular, it is not known whether or not treatment defaulters continue to be or become again smear-positive and thus pose a potential for transmission of infection to others. To investigate, in a high tuberculosis burden setting, the rate of re-treatment for smear-positive tuberculosis among cases defaulting from standardized treatment compared to successfully treated cases. Retrospective cohort study among smear-positive tuberculosis cases treated between 1996 and 2008 in two urban communities in Cape Town, South Africa. Episodes of re-treatment for smear-positive tuberculosis were ascertained via probabilistic record linkage. Survival analysis and Poisson regression were used to compare the rate of smear-positive tuberculosis after treatment default to that after successful treatment. A total of 2,136 smear-positive tuberculosis cases were included in the study. After treatment default, the rate of re-treatment for smear-positive tuberculosis was 6.86 (95% confidence interval [CI]: 5.59-8.41) per 100 person-years compared to 2.09 (95% CI: 1.81-2.41) after cure (adjusted Hazard Ratio [aHR]: 3.97; 95% CI: 3.00-5.26). Among defaulters, the rate was inversely associated with treatment duration and sputum conversion prior to defaulting. Smear grade at start of the index treatment episode (Smear3+: aHR 1.61; 95%CI 1.11-2.33) was independently associated with smear-positive tuberculosis re-treatment, regardless of treatment outcome. In this high-burden setting, there is a high rate of subsequent smear-positive tuberculosis after treatment default. Treatment defaulters are therefore likely to contribute to the pool of infectious source cases in the community. Our findings underscore the importance of preventing treatment default, as a means of successful tuberculosis control in high-burden settings.

SU-E-T-131: Artificial Neural Networks Applied to Overall Survival Prediction for Patients with Periampullary Carcinoma

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gong, Y; Yu, J; Yeung, V

Purpose: Artificial neural networks (ANN) can be used to discover complex relations within datasets to help with medical decision making. This study aimed to develop an ANN method to predict two-year overall survival of patients with peri-ampullary cancer (PAC) following resection. Methods: Data were collected from 334 patients with PAC following resection treated in our institutional pancreatic tumor registry between 2006 and 2012. The dataset contains 14 variables including age, gender, T-stage, tumor differentiation, positive-lymph-node ratio, positive resection margins, chemotherapy, radiation therapy, and tumor histology.After censoring for two-year survival analysis, 309 patients were left, of which 44 patients (∼15%) weremore » randomly selected to form testing set. The remaining 265 cases were randomly divided into training set (211 cases, ∼80% of 265) and validation set (54 cases, ∼20% of 265) for 20 times to build 20 ANN models. Each ANN has one hidden layer with 5 units. The 20 ANN models were ranked according to their concordance index (c-index) of prediction on validation sets. To further improve prediction, the top 10% of ANN models were selected, and their outputs averaged for prediction on testing set. Results: By random division, 44 cases in testing set and the remaining 265 cases have approximately equal two-year survival rates, 36.4% and 35.5% respectively. The 20 ANN models, which were trained and validated on the 265 cases, yielded mean c-indexes as 0.59 and 0.63 on validation sets and the testing set, respectively. C-index was 0.72 when the two best ANN models (top 10%) were used in prediction on testing set. The c-index of Cox regression analysis was 0.63. Conclusion: ANN improved survival prediction for patients with PAC. More patient data and further analysis of additional factors may be needed for a more robust model, which will help guide physicians in providing optimal post-operative care. This project was supported by PA CURE Grant.« less

Assessing risk for imminent violence in the elderly: the Brøset Violence Checklist.

PubMed

Almvik, Roger; Woods, Phil; Rasmussen, Kirsten

2007-09-01

The Brøset Violence Checklist (BVC) assesses confusion, irritability, boisterousness, verbal threats, physical threats and attacks on objects as either present or absent. It is hypothesised that an individual displaying two or more of these behaviours is more likely to be violent in the next twenty-four hour period. This study aims to test the validity of the instrument in geriatric settings and to report on the predictive value of an easy-to-use risk assessment instrument. Eight thousand eight hundred and thirty-five BVC observations were completed in two psychogeriatric wards (n = 42 patients) and two special care units for patients with dementia (n = 40 residents). To measure violent incidents the study group was monitored using the Staff Observation Aggression Scale-Revised (SOAS-R). This study disclosed that patients in geriatric wards and residents in nursing homes who are aggressive have higher BVC scores than the non-violent subjects indicating that the BVC does predict violent episodes in these settings. From a clinical perspective, it is most important that a prediction aid has good sensitivity, so that most cases are detected and have a high negative predictive value so that most non-cases on the measure are indeed non-cases. Our results indicate that the BVC was able to achieve this goal.

Application of correspondence analysis in the assessment of mine tailings dam breakage risk in the Mediterranean region.

PubMed

Salgueiro, Ana Rita; Pereira, Henrique Garcia; Rico, Maria-Teresa; Benito, Gerado; Díez-Herreo, Andrés

2008-02-01

A new statistical approach for preliminary risk evaluation of breakage in tailings dam is presented and illustrated by a case study regarding the Mediterranean region. The objective of the proposed method is to establish an empirical scale of risk, from which guidelines for prioritizing the collection of further specific information can be derived. The method relies on a historical database containing, in essence, two sets of qualitative data: the first set concerns the variables that are observable before the disaster (e.g., type and size of the dam, its location, and state of activity), and the second refers to the consequences of the disaster (e.g., failure type, sludge characteristics, fatalities categorization, and downstream range of damage). Based on a modified form of correspondence analysis, where the second set of attributes are projected as "supplementary variables" onto the axes provided by the eigenvalue decomposition of the matrix referring to the first set, a "qualitative regression" is performed, relating the variables to be predicted (contained in the second set) with the "predictors" (the observable variables). On the grounds of the previously derived relationship, the risk of breakage in a new case can be evaluated, given observable variables. The method was applied in a case study regarding a set of 13 test sites where the ranking of risk obtained was validated by expert knowledge. Once validated, the procedure was included in the final output of the e-EcoRisk UE project (A Regional Enterprise Network Decision-Support System for Environmental Risk and Disaster Management of Large-Scale Industrial Spills), allowing for a dynamic historical database updating and providing a prompt rough risk evaluation for a new case. The aim of this section of the global project is to provide a quantified context where failure cases occurred in the past for supporting analogue reasoning in preventing similar situations.

The Impact of Introducing Malaria Rapid Diagnostic Tests on Fever Case Management: A Synthesis of Ten Studies from the ACT Consortium.

PubMed

Bruxvoort, Katia J; Leurent, Baptiste; Chandler, Clare I R; Ansah, Evelyn K; Baiden, Frank; Björkman, Anders; Burchett, Helen E D; Clarke, Siân E; Cundill, Bonnie; DiLiberto, Debora D; Elfving, Kristina; Goodman, Catherine; Hansen, Kristian S; Kachur, S Patrick; Lal, Sham; Lalloo, David G; Leslie, Toby; Magnussen, Pascal; Mangham-Jefferies, Lindsay; Mårtensson, Andreas; Mayan, Ismail; Mbonye, Anthony K; Msellem, Mwinyi I; Onwujekwe, Obinna E; Owusu-Agyei, Seth; Rowland, Mark W; Shakely, Delér; Staedke, Sarah G; Vestergaard, Lasse S; Webster, Jayne; Whitty, Christopher J M; Wiseman, Virginia L; Yeung, Shunmay; Schellenberg, David; Hopkins, Heidi

2017-10-01

Since 2010, the World Health Organization has been recommending that all suspected cases of malaria be confirmed with parasite-based diagnosis before treatment. These guidelines represent a paradigm shift away from presumptive antimalarial treatment of fever. Malaria rapid diagnostic tests (mRDTs) are central to implementing this policy, intended to target artemisinin-based combination therapies (ACT) to patients with confirmed malaria and to improve management of patients with nonmalarial fevers. The ACT Consortium conducted ten linked studies, eight in sub-Saharan Africa and two in Afghanistan, to evaluate the impact of mRDT introduction on case management across settings that vary in malaria endemicity and healthcare provider type. This synthesis includes 562,368 outpatient encounters (study size range 2,400-432,513). mRDTs were associated with significantly lower ACT prescription (range 8-69% versus 20-100%). Prescribing did not always adhere to malaria test results; in several settings, ACTs were prescribed to more than 30% of test-negative patients or to fewer than 80% of test-positive patients. Either an antimalarial or an antibiotic was prescribed for more than 75% of patients across most settings; lower antimalarial prescription for malaria test-negative patients was partly offset by higher antibiotic prescription. Symptomatic management with antipyretics alone was prescribed for fewer than 25% of patients across all scenarios. In community health worker and private retailer settings, mRDTs increased referral of patients to other providers. This synthesis provides an overview of shifts in case management that may be expected with mRDT introduction and highlights areas of focus to improve design and implementation of future case management programs.

The Impact of Introducing Malaria Rapid Diagnostic Tests on Fever Case Management: A Synthesis of Ten Studies from the ACT Consortium

PubMed Central

Bruxvoort, Katia J.; Leurent, Baptiste; Chandler, Clare I. R.; Ansah, Evelyn K.; Baiden, Frank; Björkman, Anders; Burchett, Helen E. D.; Clarke, Siân E.; Cundill, Bonnie; DiLiberto, Debora D.; Elfving, Kristina; Goodman, Catherine; Hansen, Kristian S.; Kachur, S. Patrick; Lal, Sham; Lalloo, David G.; Leslie, Toby; Magnussen, Pascal; Mangham-Jefferies, Lindsay; Mårtensson, Andreas; Mayan, Ismail; Mbonye, Anthony K.; Msellem, Mwinyi I.; Onwujekwe, Obinna E.; Owusu-Agyei, Seth; Rowland, Mark W.; Shakely, Delér; Staedke, Sarah G.; Vestergaard, Lasse S.; Webster, Jayne; Whitty, Christopher J. M.; Wiseman, Virginia L.; Yeung, Shunmay; Schellenberg, David; Hopkins, Heidi

2017-01-01

Abstract. Since 2010, the World Health Organization has been recommending that all suspected cases of malaria be confirmed with parasite-based diagnosis before treatment. These guidelines represent a paradigm shift away from presumptive antimalarial treatment of fever. Malaria rapid diagnostic tests (mRDTs) are central to implementing this policy, intended to target artemisinin-based combination therapies (ACT) to patients with confirmed malaria and to improve management of patients with nonmalarial fevers. The ACT Consortium conducted ten linked studies, eight in sub-Saharan Africa and two in Afghanistan, to evaluate the impact of mRDT introduction on case management across settings that vary in malaria endemicity and healthcare provider type. This synthesis includes 562,368 outpatient encounters (study size range 2,400–432,513). mRDTs were associated with significantly lower ACT prescription (range 8–69% versus 20–100%). Prescribing did not always adhere to malaria test results; in several settings, ACTs were prescribed to more than 30% of test-negative patients or to fewer than 80% of test-positive patients. Either an antimalarial or an antibiotic was prescribed for more than 75% of patients across most settings; lower antimalarial prescription for malaria test-negative patients was partly offset by higher antibiotic prescription. Symptomatic management with antipyretics alone was prescribed for fewer than 25% of patients across all scenarios. In community health worker and private retailer settings, mRDTs increased referral of patients to other providers. This synthesis provides an overview of shifts in case management that may be expected with mRDT introduction and highlights areas of focus to improve design and implementation of future case management programs. PMID:28820705

Systematic review of discharge coding accuracy

PubMed Central

Burns, E.M.; Rigby, E.; Mamidanna, R.; Bottle, A.; Aylin, P.; Ziprin, P.; Faiz, O.D.

2012-01-01

Introduction Routinely collected data sets are increasingly used for research, financial reimbursement and health service planning. High quality data are necessary for reliable analysis. This study aims to assess the published accuracy of routinely collected data sets in Great Britain. Methods Systematic searches of the EMBASE, PUBMED, OVID and Cochrane databases were performed from 1989 to present using defined search terms. Included studies were those that compared routinely collected data sets with case or operative note review and those that compared routinely collected data with clinical registries. Results Thirty-two studies were included. Twenty-five studies compared routinely collected data with case or operation notes. Seven studies compared routinely collected data with clinical registries. The overall median accuracy (routinely collected data sets versus case notes) was 83.2% (IQR: 67.3–92.1%). The median diagnostic accuracy was 80.3% (IQR: 63.3–94.1%) with a median procedure accuracy of 84.2% (IQR: 68.7–88.7%). There was considerable variation in accuracy rates between studies (50.5–97.8%). Since the 2002 introduction of Payment by Results, accuracy has improved in some respects, for example primary diagnoses accuracy has improved from 73.8% (IQR: 59.3–92.1%) to 96.0% (IQR: 89.3–96.3), P= 0.020. Conclusion Accuracy rates are improving. Current levels of reported accuracy suggest that routinely collected data are sufficiently robust to support their use for research and managerial decision-making. PMID:21795302

What Case Managers Should Know About Their Roles and Functions: A National Study From the Commission for Case Manager Certification: Part 1.

PubMed

Tahan, Hussein M; Watson, Annette C; Sminkey, Patrice V

2015-01-01

The purpose of this national role and function study was to identify the essential activities and necessary knowledge areas for effective case manager practice from the perspective of those currently functioning in various care settings and across diverse professional disciplines. The national study covered all case management practices and/or work settings across the full continuum of health care. This cross-sectional descriptive study used the practice analysis method and online survey research design. It employed a purposive sample of case managers, in which 52,370 individuals received an invitation to participate. Data collection completed over a 4-week period, resulting in 7,668 useable survey responses (nearly a 15% response rate). The study identified the common activities and knowledge areas necessary for competent and effective performance of case managers, as is highlighted in this article, which is the first of a 2-part series on the role and function study. The results informed the needed update of the test specifications for the Certified Case Manager (CCM) certification examination, as will be delineated in Part 2 of the article series, to ensure that it continues to be substantiated in current practice. Of special note are the emergence of specific activity and knowledge domains in the area of case management ethical, legal, and practice standards, and an increase in the number of employers requiring certified case managers to fill vacant positions and compensating them financially for such qualifications. This study helps keep the CCM credentialing examination evidence-based and maintain its validity for evaluating competency of case managers. Specifically, the study identified essential activities and knowledge domains that define competent case management practice. Findings can be used for developing programs and curricula for the training and development of case managers. The study instrument also can be used for further research of case management practice.

Grade One: Math Computation. Case Study #1

ERIC Educational Resources Information Center

Powell, Sarah R.; Seethaler, Pamela M.

2007-01-01

The purpose of this case study is to highlight the integral role that progress monitoring (PM) plays throughout any Response to Intervention (RTI) process. This example uses a three-level, responsiveness-to-intervention (RTI) method for identifying students with learning difficulties. Using a fictional first-grade classroom as the setting for…

Transnational Education: A Case Study of One Professional Doctorate

ERIC Educational Resources Information Center

O'Neill, Marnie

2012-01-01

This case study of a Doctor of Education program in a transnational setting is contextualized in Australian national policies for international higher education and influences of regionalization and globalization. The doctorate was designed to meet aspirations of professional practitioners in Australia and South East Asia where the School had…

Mediating Meaning for Individuals with Down Syndrome: A Phenomenological Case Study

ERIC Educational Resources Information Center

McCullough, Michelle J.

2012-01-01

The current phenomenological case study, based in part on Vygotsky's sociocultural theory, set out to examine the lived experiences of individuals sharing and mediating meaningful communication with individuals who have Down syndrome. To accomplish this, the researcher interviewed several categories of caregivers who regularly interact with…

ICT to Support Ideation via General Education

ERIC Educational Resources Information Center

Thorsteinsson, Gisli

2014-01-01

This paper reports a case study series of four related case study lessons, set up as a course using a Virtual Reality Learning Environment (VRLE) to support the students' ideation skills in Innovation Education (IE) in Icelandic conventional classroom. The IE course content and preparation is described. Overall aims, objectives and research…

Blended and Online Learning: Student Perceptions and Performance

ERIC Educational Resources Information Center

Adam, Stewart; Nel, Deon

2009-01-01

Purpose: The purpose of this paper is to improve educator knowledge of the antecedents and consequences of blended learning in higher education. Design/methodology/approach: A longitudinal case study approach is adopted. Three case studies each involve tracking a student evaluations of teaching (SET) measure (willingness to recommend) and grade…

Using the Internship as a Tool for Assessment: A Case Study.

ERIC Educational Resources Information Center

Graham, Beverly; Bourland-Davis, Pamela G.; Fulmer, Hal W.

1997-01-01

States communication programs are expected to operate in some harmony with communication activities of organizations outside the university in professional settings. Describes one possible activity in this matrix: use of student internships as a means of assessing the communication program. Presents a case study involving public relations…

Where Learners' Questions Meet Modes of Teaching: A Study of Cases

ERIC Educational Resources Information Center

de Jesus, Helena Pedrosa; Almeida, Patricia; Teixeira-Dias, Jose J.; Watts, Mike

2007-01-01

This paper is concerned with "match-mismatch" problems. In particular it seeks to match students' questioning to different modes of teaching in undergraduate chemistry. Kolb's theory of experiential learning is used to bridge between learners' questioning and teaching formats. Three case studies illuminate both sets of characteristics, the…

Co-Teaching: The Importance of Professional Development

ERIC Educational Resources Information Center

Barnes, Greg

2017-01-01

Purpose: The purpose of this qualitative case study was to determine the impact co-teaching professional development has had on teacher attitude and classroom practices in a secondary, middle school setting. Methodology: This qualitative case study design included the use of best practice checklists and personal interviews. Educators from a middle…

Definition of periprosthetic joint infection: is there a consensus?

PubMed

Parvizi, Javad; Jacovides, Christina; Zmistowski, Benjamin; Jung, Kwang Am

2011-11-01

The diagnosis of periprosthetic joint infection (PJI) continues to pose a challenge. While many diagnostic criteria have been proposed, a gold standard for diagnosis is lacking. Use of multiple diagnostic criteria within the joint arthroplasty community raises concerns in patient treatment and comparison of research pertaining to PJI. We (1) determined the variation in existing diagnostic criteria, (2) compared the existing criteria to a proposed new set of criteria that incorporates aspirate cell count analysis, and (3) investigated the variations between the existing criteria and the proposed criteria. We retrospectively identified 182 patients undergoing 192 revision knee arthroplasties who had a preoperative joint aspiration analysis at our institution between April 2002 and November 2009. We excluded 20 cases due to insufficient laboratory parameters, leaving 172 cases for analysis. We applied six previously published sets of diagnostic criteria for PJI to determine the variation in its incidence using each set of criteria. We then compared these diagnostic criteria to our proposed new criteria and investigated cases where disagreement occurred. We identified 41 cases (24%) in which at least one established criteria set classified the case as infected while at least one other criteria set classified the case as uninfected. With our proposed criteria, the infected/uninfected ratio was 92/80. The proposed criteria had a large variance in sensitivity (54%-100%), specificity (39%-100%), and accuracy (53%-100%) when using each of the established criteria sets as the reference standard. The discrepancy between definitions of infection complicates interpretation of the literature and the treatment of failed TKAs owing to PJI. Based on our findings, we suggest establishing a common set of diagnostic criteria utilizing aspirate analysis to improve the treatment of PJI and facilitate interpretation of the literature. Level III, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.

Qualitative case study data analysis: an example from practice.

PubMed

Houghton, Catherine; Murphy, Kathy; Shaw, David; Casey, Dympna

2015-05-01

To illustrate an approach to data analysis in qualitative case study methodology. There is often little detail in case study research about how data were analysed. However, it is important that comprehensive analysis procedures are used because there are often large sets of data from multiple sources of evidence. Furthermore, the ability to describe in detail how the analysis was conducted ensures rigour in reporting qualitative research. The research example used is a multiple case study that explored the role of the clinical skills laboratory in preparing students for the real world of practice. Data analysis was conducted using a framework guided by the four stages of analysis outlined by Morse ( 1994 ): comprehending, synthesising, theorising and recontextualising. The specific strategies for analysis in these stages centred on the work of Miles and Huberman ( 1994 ), which has been successfully used in case study research. The data were managed using NVivo software. Literature examining qualitative data analysis was reviewed and strategies illustrated by the case study example provided. Discussion Each stage of the analysis framework is described with illustration from the research example for the purpose of highlighting the benefits of a systematic approach to handling large data sets from multiple sources. By providing an example of how each stage of the analysis was conducted, it is hoped that researchers will be able to consider the benefits of such an approach to their own case study analysis. This paper illustrates specific strategies that can be employed when conducting data analysis in case study research and other qualitative research designs.

Use of Genomic Data in Risk Assessment Caes Study: II. Evaluation of the Dibutyl Phthalate Toxicogenomic Dataset

EPA Science Inventory

An evaluation of the toxicogenomic data set for dibutyl phthalate (DBP) and male reproductive developmental effects was performed as part of a larger case study to test an approach for incorporating genomic data in risk assessment. The DBP toxicogenomic data set is composed of ni...

Teaching Australian Aboriginal Higher Education Students: What Should Universities Do?

ERIC Educational Resources Information Center

Rochecouste, Judith; Oliver, Rhonda; Bennell, Debra; Anderson, Roz; Cooper, Inala; Forrest, Simon

2017-01-01

This paper reports findings from a recent study of Australian Aboriginal higher education student experience. Reported here are extracts from a set of case studies of staff, specifically those working in Indigenous Centres, involved with these students in both teaching and support capacities. These participants provided a rich set of qualitative…

Estimating Local Child Abuse.

ERIC Educational Resources Information Center

Ards, Sheila

1989-01-01

Three conceptual approaches to estimating local child abuse rates using the National Incidence Study of Child Abuse and Neglect data set are evaluated. All three approaches yield estimates of actual abuse cases that exceed the number of reported cases. (SLD)

Empirical evaluation demonstrated importance of validating biomarkers for early detection of cancer in screening settings to limit the number of false-positive findings.

PubMed

Chen, Hongda; Knebel, Phillip; Brenner, Hermann

2016-07-01

Search for biomarkers for early detection of cancer is a very active area of research, but most studies are done in clinical rather than screening settings. We aimed to empirically evaluate the role of study setting for early detection marker identification and validation. A panel of 92 candidate cancer protein markers was measured in 35 clinically identified colorectal cancer patients and 35 colorectal cancer patients identified at screening colonoscopy. For each case group, we selected 38 controls without colorectal neoplasms at screening colonoscopy. Single-, two- and three-marker combinations discriminating cases and controls were identified in each setting and subsequently validated in the alternative setting. In all scenarios, a higher number of predictive biomarkers were initially detected in the clinical setting, but a substantially lower proportion of identified biomarkers could subsequently be confirmed in the screening setting. Confirmation rates were 50.0%, 84.5%, and 74.2% for one-, two-, and three-marker algorithms identified in the screening setting and were 42.9%, 18.6%, and 25.7% for algorithms identified in the clinical setting. Validation of early detection markers of cancer in a true screening setting is important to limit the number of false-positive findings. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Are we prepared for Affordable Care Act provisions of care coordination? Case managers' self-assessments and views on physicians' roles.

PubMed

Moreo, Kathleen; Moreo, Natalie; Urbano, Frank L; Weeks, Matthew; Greene, Laurence

2014-01-01

Care coordination, traditionally the purview of the case management field, is recognized as a national priority for improving health care delivery and patient outcomes. With reforms of the Affordable Care Act (ACA) of 2010, case managers face new challenges and opportunities in providing care coordination services. The evolving roles of case managers as members of interprofessional care teams will be influenced by new policies that enable physicians to be reimbursed for care coordination. This qualitative study aimed to evaluate case managers' self-assessed readiness for ACA reforms of care coordination and their perceptions of physicians' understanding of case management and ability to lead care coordination efforts in evolving models. Provisions of care coordination in the ACA affect case managers in all practice settings. The majority of this study's participants represented hospital and managed care settings. An invitation to complete an 11-item online survey was sent by e-mail to 8,110 case managers in an opt-in database maintained by a health care continuing education company. Survey questions were designed to assess respondents' (1) self-reported levels of knowledge and preparation for ACA care coordination provisions and (2) beliefs about the readiness and abilities of physicians to administer care coordination services. In addition, demographic data and open-ended comments regarding physicians' roles in conducting care coordination were collected. Over a restricted 9-day period, 834 case managers representing various health care settings responded to the survey. The majority of respondents (63%) indicated that more than 50% of their day is dedicated to performing care coordination activities. However, 80% of all respondents reported being "not at all knowledgeable" or only "somewhat knowledgeable" about the new care coordination provisions in the ACA. Only 8% admitted to being "very prepared" to implement ACA changes. The majority of respondents (68%) perceive their case management departments to be at least "somewhat prepared" to implement necessary changes. Whereas 67% of respondents expect physicians to have at least a "moderate role" in implementing care coordination services, only 12% believe that physicians have more than "some" understanding of the processes of care coordination and case managers' roles. These qualitative study findings suggest that case managers from multiple practice settings perceive a lack of preparedness, knowledge, and understanding among themselves and physicians regarding ACA reforms that may significantly affect the delivery of care coordination services. The findings call for new initiatives in interprofessional education to address the knowledge gaps and enhance understanding of the collaborative roles among case managers and physicians.

Why mistreatment of medical students is not reported in clinical settings: perspectives of trainees.

PubMed

Ahmadipour, Habibeh; Vafadar, Reza

2016-01-01

Mistreatment of medical students is a major source of stress for them. Studies indicate a high incidence of such mistreatment, especially in clinical settings. In most cases, students who have been mistreated do not report it to the authorities. This study investigated factors related to the failure to report mistreatment. This was a cross-sectional study carried out in Kerman Medical School, Iran. All students in the internship and clerkship stages, as well as residents, were selected through the census method. Experiences of mistreatment and the reasons for not reporting them were evaluated using a questionnaire. The data were analysed with SPSS 19. Ninety-three per cent of the participants experienced mistreatment, but less than half of them reported it. Residents and interns reported emotional and academic mistreatment, respectively, more than other groups. The most common reason for not reporting mistreatment was that the students did not think reporting would accomplish anything. Our study showed that the experience of mistreatment in the clinical setting is common, but the cases reported to the authorities are far fewer than the actual number of cases. Educational systems should make extensive efforts to detect and prevent mistreatment to improve the teaching-learning environment.

[Multiple sclerosis epidemiological situation update: pertinence and set-up of a population based registry of new cases in Catalonia].

PubMed

Otero, S; Batlle, J; Bonaventura, I; Brieva, Ll; Bufill, E; Cano, A; Carmona, O; Escartín, A; Marco, M; Moral, E; Munteis, E; Nos, C; Pericot, I; Perkal, H; Ramió-Torrentà, Ll; Ramo-Tello, C; Saiz, A; Sastre-Garriga, J; Tintoré, M; Vaqué, J; Montalban, X

2010-05-16

The first epidemiological studies on multiple sclerosis (MS) around the world pictured a north to south latitudinal gradient that led to the first genetic and environmental pathogenic hypothesis. MS incidence seems to be increasing during the past 20 years based on recent data from prospective studies performed in Europe, America and Asia. This phenomenon could be explained by a better case ascertainment as well as a change in causal factors. The few prospective studies in our area together with the increase in the disease in other regions, justifies an epidemiological MS project in order to describe the incidence and temporal trends of MS. A prospective multicenter MS registry has been established according to the actual requirements of an epidemiological surveillance system. Case definition is based on the fulfillment of the McDonald diagnostic criteria. The registry setting is the geographical area of Cataluna (northeastern Spain), using a wide network of hospitals specialized in MS management. Recent epidemiological studies have described an increase in MS incidence. In order to contrast this finding in our area, we consider appropriate to set up a population based registry.

Generative Text Sets: Tools for Negotiating Critically Inclusive Early Childhood Teacher Education Pedagogical Practices

ERIC Educational Resources Information Center

Souto-Manning, Mariana

2017-01-01

Through a case study, this article sheds light onto generative text sets as tools for developing and enacting critically inclusive early childhood teacher education pedagogies. In doing so, it positions teaching and learning processes as sociocultural, historical, and political acts as it inquires into the use of generative text sets in one early…

Using Mobile Technologies for Assessment and Learning in Practice Settings: Outcomes of Five Case Studies

ERIC Educational Resources Information Center

Dearnley, Christine; Taylor, Jill; Hennessy, Scott; Parks, Maria; Coates, Catherine; Haigh, Jackie; Fairhall, John; Riley, Kevin; Dransfield, Mark

2009-01-01

This article presents the outcomes of the Mobile Technologies Pilot Project for the Assessment and Learning in Practice Settings (ALPS) Centre for Excellence in Teaching and Learning (CETL). ALPS is a partnership of five Higher Education Institutions (HEI) that aims to develop and improve assessment, and thereby learning, in practice settings for…

Using Text Sets to Facilitate Critical Thinking in Sixth Graders

ERIC Educational Resources Information Center

Scales, Roya Q.; Tracy, Kelly N.

2017-01-01

This case study examines features and processes of a sixth grade teacher (Jane) utilizing text sets as a tool for facilitating critical thinking. Jane's strong vision and student-centered beliefs informed her use of various texts to teach language arts as she worked to address demands of the Common Core State Standards. Text sets promoted multiple…

Scalable problems and memory bounded speedup

NASA Technical Reports Server (NTRS)

Sun, Xian-He; Ni, Lionel M.

1992-01-01

In this paper three models of parallel speedup are studied. They are fixed-size speedup, fixed-time speedup and memory-bounded speedup. The latter two consider the relationship between speedup and problem scalability. Two sets of speedup formulations are derived for these three models. One set considers uneven workload allocation and communication overhead and gives more accurate estimation. Another set considers a simplified case and provides a clear picture on the impact of the sequential portion of an application on the possible performance gain from parallel processing. The simplified fixed-size speedup is Amdahl's law. The simplified fixed-time speedup is Gustafson's scaled speedup. The simplified memory-bounded speedup contains both Amdahl's law and Gustafson's scaled speedup as special cases. This study leads to a better understanding of parallel processing.

Computerized N-acetylcysteine physician order entry by template protocol for acetaminophen toxicity.

PubMed

Thompson, Trevonne M; Lu, Jenny J; Blackwood, Louisa; Leikin, Jerrold B

2011-01-01

Some medication dosing protocols are logistically complex for traditional physician ordering. The use of computerized physician order entry (CPOE) with templates, or order sets, may be useful to reduce medication administration errors. This study evaluated the rate of medication administration errors using CPOE order sets for N-acetylcysteine (NAC) use in treating acetaminophen poisoning. An 18-month retrospective review of computerized inpatient pharmacy records for NAC use was performed. All patients who received NAC for the treatment of acetaminophen poisoning were included. Each record was analyzed to determine the form of NAC given and whether an administration error occurred. In the 82 cases of acetaminophen poisoning in which NAC was given, no medication administration errors were identified. Oral NAC was given in 31 (38%) cases; intravenous NAC was given in 51 (62%) cases. In this retrospective analysis of N-acetylcysteine administration using computerized physician order entry and order sets, no medication administration errors occurred. CPOE is an effective tool in safely executing complicated protocols in an inpatient setting.

Debriefing a Health-Related Educational Game: A Case Study

ERIC Educational Resources Information Center

Lennon, Jeffrey L.

2010-01-01

This study sought to evaluate the utility of a Web-based game on the topic of immunity, based upon the work of Nobel Prize winner Ileya Mechnikov. This was accomplished through postgame written debriefing with an oral debriefing follow-up. A qualitative case study was conducted in a nonformal home setting. The participant learned new information,…

Examining Education Leadership Communication Practices around Basic and Advanced Skill Sets: A Multiple Case Study

ERIC Educational Resources Information Center

Minger, Leslie

2017-01-01

The purpose of this multiple case study was to explore and describe the leadership communication practices of school principals in Southern California schools with demonstrated high levels of academic performance in order to identify practices that might be replicated in other schools. Communication practices were studied in relation to two…

Social Skills Training for Adolescents with Asperger's Syndrome Using a Consultation Model

ERIC Educational Resources Information Center

Minihan, Aileen; Kinsella, William; Honan, Rita

2011-01-01

A case study design was used to evaluate the effectiveness of behavioural consultation as a method for improving the social skills of adolescents with Asperger's syndrome. Two case studies were conducted. In each study, two teachers implemented a social skills programme with two to three adolescents with Asperger's syndrome in a group setting with…

Knowledge Transfer: A Case Study of a Community Nutrition Education Program at a Land-Grant University

ERIC Educational Resources Information Center

Hurtado, Ghaffar Ali

2014-01-01

The purpose of this study was to investigate the process of knowledge transfer. The setting is a health and nutrition educational program at University of Minnesota Extension. The main research question was how is Knowledge Transfer being implemented in Extension, specifically Educational Supplemental Nutrition Assistance Program? A case study,…

Academic Staff's Perspectives upon Student Plagiarism: A Case Study at a University in Hong Kong

ERIC Educational Resources Information Center

Li, Yongyan

2015-01-01

Much of the previous research concerning student plagiarism has been conducted in Anglo-American settings. The present paper reports a case study of academic staff's perspectives upon student plagiarism at a university in Hong Kong. Based on interviews with 16 instructors, the study focused on the teachers' views and pedagogical practices,…

The Role of Reflection in Developing Eupraxis in Learning to Teach English

ERIC Educational Resources Information Center

Smagorinsky, Peter; Shelton, Stephanie Anne; Moore, Cynthia

2015-01-01

This case study focuses on one beginning English teacher's work toward eupraxia, i.e., good practice informed by reflection in a setting in which a degree of free choice is available. The study uses a Vygotskian framework for studying concept development that focuses on the settings of human activity and how ambiguous social concepts are developed…

A Hamiltonian approach to the planar optimization of mid-course corrections

NASA Astrophysics Data System (ADS)

Iorfida, E.; Palmer, P. L.; Roberts, M.

2016-04-01

Lawden's primer vector theory gives a set of necessary conditions that characterize the optimality of a transfer orbit, defined accordingly to the possibility of adding mid-course corrections. In this paper a novel approach is proposed where, through a polar coordinates transformation, the primer vector components decouple. Furthermore, the case when transfer, departure and arrival orbits are coplanar is analyzed using a Hamiltonian approach. This procedure leads to approximate analytic solutions for the in-plane components of the primer vector. Moreover, the solution for the circular transfer case is proven to be the Hill's solution. The novel procedure reduces the mathematical and computational complexity of the original case study. It is shown that the primer vector is independent of the semi-major axis of the transfer orbit. The case with a fixed transfer trajectory and variable initial and final thrust impulses is studied. The acquired related optimality maps are presented and analyzed and they express the likelihood of a set of trajectories to be optimal. Furthermore, it is presented which kind of requirements have to be fulfilled by a set of departure and arrival orbits to have the same profile of primer vector.

Learning from Multiple Cases: A New Paradigm for Investigating the Effects of Clinical Experience on Knowledge Restructuring and Knowledge Acquisition.

ERIC Educational Resources Information Center

Boshuizen, Henny P. A.; Bongaerts, Maureen Machiels; van de Wiel, Margaretha W. J.; Schmidt, Henk G.

The effects of experience with a series of similar cases on the knowledge restructuring and learning from text were studied in a longitudinal design. Two groups of fourth-year medical students were confronted with a series of cases, part of them having the same underlying disease. The cases were interspersed with fillers, and each set of cases had…

Meta-analysis of screening and case finding tools for depression in cancer: evidence based recommendations for clinical practice on behalf of the Depression in Cancer Care consensus group.

PubMed

Mitchell, Alex J; Meader, Nick; Davies, Evan; Clover, Kerrie; Carter, Gregory L; Loscalzo, Matthew J; Linden, Wolfgang; Grassi, Luigi; Johansen, Christoffer; Carlson, Linda E; Zabora, James

2012-10-01

To examine the validity of screening and case-finding tools used in the identification of depression as defined by an ICD10/DSM-IV criterion standard. We identified 63 studies involving 19 tools (in 33 publications) designed to help clinicians identify depression in cancer settings. We used a standardized rating system. We excluded 11 tools without at least two independent studies, leaving 8 tools for comparison. Across all cancer stages there were 56 diagnostic validity studies (n=10,009). For case-finding, one stem question, two stem questions and the BDI-II all had level 2 evidence (2a, 2b and 2c respectively) and given their better acceptability we gave the stem questions a grade B recommendation. For screening, two stem questions had level 1b evidence (with high acceptability) and the BDI-II had level 2c evidence. For every 100 people screened in advanced cancer, the two questions would accurately detect 18 cases, while missing only 1 and correctly reassure 74 with 7 falsely identified. For every 100 people screened in non-palliative settings the BDI-II would accurately detect 17 cases, missing 2 and correctly re-assure 70, with 11 falsely identified as cases. The main cautions are the reliance on DSM-IV definitions of major depression, the large number of small studies and the paucity of data for many tools in specific settings. Although no single tool could be offered unqualified support, several tools are likely to improve upon unassisted clinical recognition. In clinical practice, all tools should form part of an integrated approach involving further follow-up, clinical assessment and evidence based therapy. Copyright © 2012 Elsevier B.V. All rights reserved.

Benefits and limitations of fine needle aspiration cytology in the diagnosis and classification of leprosy in primary and secondary healthcare settings.

PubMed

Ray, R; Mondal, R K; Pathak, S

2015-08-01

The goal of the World Health Organization (WHO) is to eliminate leprosy as a public health problem. This will only be possible when all patients are detected and cured using multidrug therapy, which requires accurate diagnosis prior to treatment. The objective of this study was to evaluate the possibility of the diagnosis of leprosy lesions by fine needle aspiration cytology according to a modification of the Ridley-Jopling scale, as it can be used in primary and secondary healthcare centres, especially in low-resource settings in which leprosy is prevalent. A prospective study comprising 54 cases with cardinal features of leprosy was performed. Among the 54 cases, 27 patients consented to a histopathological biopsy procedure. The slides were stained with Giemsa, modified Ziehl-Neelsen, Papanicolaou and haematoxylin and eosin methods. Among the 54 cases, 34 were reported as tuberculoid leprosy, five as mid-borderline (BB), three as borderline lepromatous (BL) and eight as lepromatous leprosy (LL); four were unsatisfactory. Histopathological study was performed in 27 cases, which showed cyto-histological correlation in 21 cases (78%). Agreement between histological and cytological diagnosis was achieved in 12 of the 15 tuberculoid cases, one of the three BB cases, one of the two BL cases and all seven LL cases. With the implementation of the WHO classification based on patch counting, there is the possibility of the over-treatment of paucibacillary cases and under-treatment of multibacillary cases. Cytology in terms of cellular type morphology and bacteriological study can complement the WHO classification. © 2014 John Wiley & Sons Ltd.

A machine learning approach to triaging patients with chronic obstructive pulmonary disease

PubMed Central

Qirko, Klajdi; Smith, Ted; Corcoran, Ethan; Wysham, Nicholas G.; Bazaz, Gaurav; Kappel, George; Gerber, Anthony N.

2017-01-01

COPD patients are burdened with a daily risk of acute exacerbation and loss of control, which could be mitigated by effective, on-demand decision support tools. In this study, we present a machine learning-based strategy for early detection of exacerbations and subsequent triage. Our application uses physician opinion in a statistically and clinically comprehensive set of patient cases to train a supervised prediction algorithm. The accuracy of the model is assessed against a panel of physicians each triaging identical cases in a representative patient validation set. Our results show that algorithm accuracy and safety indicators surpass all individual pulmonologists in both identifying exacerbations and predicting the consensus triage in a 101 case validation set. The algorithm is also the top performer in sensitivity, specificity, and ppv when predicting a patient’s need for emergency care. PMID:29166411

Histologic Features associated with Diagnostic Agreement in Atypical Ductal Hyperplasia of the Breast: Illustrative Cases from the B-Path Study

PubMed Central

Allison, Kimberly H.; Rendi, Mara H.; Peacock, Sue; Morgan, Tom; Elmore, Joann G.; Weaver, Donald L.

2016-01-01

Background Case specific characteristics associated with interobserver diagnostic agreement in atypical ductal hyperplasia (ADH) of the breast are poorly understood. Methods Seventy-two test set cases with a consensus diagnosis of ADH from the B-Path study were evaluated. Cases were scored for 17 histologic features which were then correlated with the participant agreement with the consensus ADH diagnosis. Participating pathologists’ perceptions of case difficulty, borderline features, or if they would obtain a second opinion were also examined for associations with agreement. Results Of the 2,070 participant interpretations on the 72 consensus ADH cases, 48% were scored by participants as difficult and 45% as borderline between two diagnoses; the presence of both of these features was significantly associated with increased agreement (p < 0.001). A second opinion would have been obtained in 80% of interpretations, and this was associated with increased agreement (p < 0.001). Diagnostic agreement ranged from 10–89% on a case-by-case basis. Cases with papillary lesions, cribriform architecture and obvious cytologic monotony were associated with higher agreement. Lower agreement rates were associated with solid or micro-papillary architecture, borderline cytologic monotony or cases without a diagnostic area that was obvious on low power. Conclusions The results of this study suggest that pathologists frequently recognize the challenge of ADH cases with some cases more prone to diagnostic variability. In addition, there are specific histologic features associated with diagnostic agreement on ADH cases. Multiple example images from cases in this test set are provided to serve as educational illustrations of these challenges. PMID:27398812

Effectiveness and implementation of enhanced recovery after surgery programmes: a rapid evidence synthesis.

PubMed

Paton, Fiona; Chambers, Duncan; Wilson, Paul; Eastwood, Alison; Craig, Dawn; Fox, Dave; Jayne, David; McGinnes, Erika

2014-07-22

To assess the evidence on the impact of enhanced recovery programmes for patients undergoing elective surgery in acute hospital settings in the UK. Rapid evidence synthesis. Eight databases were searched from 1990 to March 2013 without language restrictions. Relevant reports and guidelines, websites and reference lists of retrieved articles were scanned to identify additional studies. Systematic reviews, RCTs not included in the systematic reviews, economic evaluations and UK NHS cost analysis, implementation case studies and surveys of patient experience in a UK setting were eligible for inclusion. We assessed the impact of enhanced recovery programmes on health or cost-related outcomes, and assessed implementation case studies and patient experience in UK settings. Studies were quality assessed where appropriate using the Centre for Reviews and Dissemination Database of Abstracts of Reviews of Effects critical appraisal process. 17 systematic reviews and 12 additional RCTs were included. Ten relevant economic evaluations were included. No cost analysis studies were identified. Most of the evidence focused on colorectal surgery. 14 innovation case studies and 15 implementation case studies undertaken in National Health Service settings described factors critical to the success of an enhanced recovery programme. Evidence for colorectal surgery suggests that enhanced recovery programmes may reduce hospital stays by 0.5-3.5 days compared with conventional care. There were no significant differences in reported readmission rates. Other surgical specialties showed greater variation in reductions in length of stay reflecting the limited evidence identified. Findings relating to other outcomes were hampered by a lack of robust evidence and poor reporting. There is consistent, albeit limited, evidence that enhanced recovery programmes can reduce length of patient hospital stay without increasing readmission rates. The extent to which managers and clinicians considering implementing enhanced recovery programmes in UK settings can realise savings will depend on length of stay achieved under their existing care pathway. 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.

Effective Writing Content Conferences in a Sixth Grade Classroom: A Cross-Case Analysis

ERIC Educational Resources Information Center

Ricks, Paul H.; Morrison, Timothy G.; Wilcox, Brad; Cutri, Ramona

2017-01-01

Conferencing gives teachers and students opportunities to discuss student writing and provide feedback in individual settings. Practitioner guides offer suggestions on how conferences can be conducted, but little is known about what types of interactions occur. Two case studies, including a cross-case analysis, were conducted to describe key…

Helping Crisis Managers Protect Reputational Assets: Initial Tests of the Situational Crisis Communication Theory.

ERIC Educational Resources Information Center

Coombs, W. Timothy; Holladay, Sherry J.

2002-01-01

Explains a comprehensive, prescriptive, situational approach for responding to crises and protecting organizational reputation: the situational crisis communication theory (SCCT). Notes undergraduate students read two crisis case studies from a set of 13 cases and responded to questions following the case. Validates a key assumption in SCCT and…

Measles burden in urban settings: characteristics of measles cases in Addis Ababa city administration, Ethiopia, 2004-2014.

PubMed

Mersha, Amare Mengistu; Braka, Fiona; Gallagher, Kathleen; Tegegne, Aysheshim Ademe; Argay, Aron Kassahun; Mekonnen, Mekonnen Admassu; Aragaw, Merawi; Abegaz, Debritu Mengesha; Worku, Etsehiwot Zeamlak; Baynesagn, Mekonen Getahun

2017-01-01

In developing countries, measles was a major cause of morbidity and mortality before the wide spread use of measles vaccine. The purpose of this study was to describe measles burden in an urban setting, Addis Ababa- since the implementation of measles case-based surveillance in Ethiopia. We analyzed measles surveillance data for 2004 -2014. Incidence of measles was described by sub city, by year and by age groups. Age specific incidence rate were calculated. Logistic regression was used to identify the predictors of confirmed measles cases. Of 4220 suspected measles cases 39% were confirmed cases. Males and females were equally affected. The mean affected age was 7.59 years. Measles cases peaked in 2010 and 2013-2014. Incidence of measles is higher among children less than five years old. Outer sub cities were more affected by measles in all years. Sub cities bordering with Oromia Regional State were more affected by measles. Older age groups were more affected than younger age groups (age ≤ five years old). Efforts to close immunity gaps against measles and further strengthen surveillance in urban settings, particularly among children below five years old, should be prioritized.

Measles burden in urban settings: characteristics of measles cases in Addis Ababa city administration, Ethiopia, 2004-2014

PubMed Central

Mersha, Amare Mengistu; Braka, Fiona; Gallagher, Kathleen; Tegegne, Aysheshim Ademe; Argay, Aron Kassahun; Mekonnen, Mekonnen Admassu; Aragaw, Merawi; Abegaz, Debritu Mengesha; Worku, Etsehiwot Zeamlak; Baynesagn, Mekonen Getahun

2017-01-01

Introduction In developing countries, measles was a major cause of morbidity and mortality before the wide spread use of measles vaccine. The purpose of this study was to describe measles burden in an urban setting, Addis Ababa- since the implementation of measles case-based surveillance in Ethiopia. We analyzed measles surveillance data for 2004 -2014. Methods Incidence of measles was described by sub city, by year and by age groups. Age specific incidence rate were calculated. Logistic regression was used to identify the predictors of confirmed measles cases. Results Of 4220 suspected measles cases 39% were confirmed cases. Males and females were equally affected. The mean affected age was 7.59 years. Measles cases peaked in 2010 and 2013-2014. Incidence of measles is higher among children less than five years old. Outer sub cities were more affected by measles in all years. Conclusion Sub cities bordering with Oromia Regional State were more affected by measles. Older age groups were more affected than younger age groups (age ≤ five years old). Efforts to close immunity gaps against measles and further strengthen surveillance in urban settings, particularly among children below five years old, should be prioritized. PMID:28890752

Case Study Research Methodology in Nursing Research.

PubMed

Cope, Diane G

2015-11-01

Through data collection methods using a holistic approach that focuses on variables in a natural setting, qualitative research methods seek to understand participants' perceptions and interpretations. Common qualitative research methods include ethnography, phenomenology, grounded theory, and historic research. Another type of methodology that has a similar qualitative approach is case study research, which seeks to understand a phenomenon or case from multiple perspectives within a given real-world context.

Sudden aortic death-proposal for a comprehensive diagnostic approach in forensic and in clinical pathology practice.

PubMed

de Boer, Hans H; Dedouit, Fabrice; Chappex, Nina; van der Wal, Allard C; Michaud, Katarzyna

2017-11-01

Aortic rupture or dissection as immediate cause of sudden death is encountered in forensic and clinical autopsy practice. Despite a common denominator of 'sudden aortic death' (SAD), we expect that in both settings the diagnostic workup, being either primarily legal or primarily disease related, differs substantially, which may affect the eventual diagnoses. We retrospectively reviewed case records of deceased persons who fitted a diagnosis of SAD in the continuous autopsy cohorts in a forensic (Suisse) and a clinical setting (The Netherlands). Clinical characteristics, data from post-mortem imaging, tissue blocks for histological analysis and results of ancillary studies were reviewed for its presence and outcome. SAD was found in 7.7% in the forensic versus 2.2% in the clinical autopsies. In the forensic setting, autopsy was always combined with post-mortem imaging, showing variable outcome on detection of aortic disruption and/or pericardial bleeding. Histology of aorta was performed in 12/35 cases, mostly in the natural deaths. In the clinical setting, histology of the aorta was available in all cases, but post-mortem imaging in none. In both settings, underlying aortic disease was mostly cystic medial degeneration, atherosclerosis or a combination of both, with occasional rare unexpected diagnosis. Also in both, a genetic cause of aortic dissection was revealed in a minority (three cases). Sudden aortic death (SAD) is more commonly encountered in a forensic than in a clinical setting. Major differences in the approach of SAD between these settings coincide with similarities in causes of death and underlying diseases. To ensure a correct diagnosis, we recommend that the investigation of SAD includes a study of the medical history, a full autopsy with histology of major organs including aorta, and storage of material for toxicological and genetic testing. Post-mortem radiological examination, useful for documentation and screening purposes, is feasible as non-invasive alternative when autopsy is not possible, but cannot substitute a full autopsy.

On the use of an Arduino-based controller to control the charging process of a wind turbine

NASA Astrophysics Data System (ADS)

Mahmuddin, Faisal; Yusran, Ahmad Muhtam; Klara, Syerly

2017-02-01

In order to avoid an excessive charging voltage which can damage power storage when converting wind energy using a turbine, it is necessary to control the charging voltage of the turbine generator. In the present study, a charging controller which uses an Arduino microcontroller, is designed. 3 (three) indicator lights are installed to indicate the battery charging process, power diversion to dummy load and battery power level. The performance of the designed controller is evaluated by simulating 3 cases. In this simulation, a battery with maximum voltage of 12.4 V is used. Case 1 is performed with input voltage equals the one set in Arduino which is 10 V. In this case, the battery is charged up to 10.8 V. In case 2, the input voltage is 13 V while the maximum voltage set in Arduino is also 13 V. In this case, the battery is charged up to maximum voltage of the battery. Moreover, the dummy load indicator is ON and charging indicator is OFF after the maximum charging voltage is reached because the electricity is flowed to the dummy load. In the final case, the input voltage is set to be 16 V while the maximum voltage set in Arduino is 13 V. In this case, the charging indicator is OFF and dummy load indicator is ON which means that the Arduino has successfully switched the power to be flowed to dummy load. From the 3 (three) cases, it can be concluded that the designed controller works perfectly to control the charging process of the wind turbine. Moreover, the charging time needed in each case can also be determined.

Uncovering the hidden risk architecture of the schizophrenias: confirmation in three independent genome-wide association studies.

PubMed

Arnedo, Javier; Svrakic, Dragan M; Del Val, Coral; Romero-Zaliz, Rocío; Hernández-Cuervo, Helena; Fanous, Ayman H; Pato, Michele T; Pato, Carlos N; de Erausquin, Gabriel A; Cloninger, C Robert; Zwir, Igor

2015-02-01

The authors sought to demonstrate that schizophrenia is a heterogeneous group of heritable disorders caused by different genotypic networks that cause distinct clinical syndromes. In a large genome-wide association study of cases with schizophrenia and controls, the authors first identified sets of interacting single-nucleotide polymorphisms (SNPs) that cluster within particular individuals (SNP sets) regardless of clinical status. Second, they examined the risk of schizophrenia for each SNP set and tested replicability in two independent samples. Third, they identified genotypic networks composed of SNP sets sharing SNPs or subjects. Fourth, they identified sets of distinct clinical features that cluster in particular cases (phenotypic sets or clinical syndromes) without regard for their genetic background. Fifth, they tested whether SNP sets were associated with distinct phenotypic sets in a replicable manner across the three studies. The authors identified 42 SNP sets associated with a 70% or greater risk of schizophrenia, and confirmed 34 (81%) or more with similar high risk of schizophrenia in two independent samples. Seventeen networks of SNP sets did not share any SNP or subject. These disjoint genotypic networks were associated with distinct gene products and clinical syndromes (i.e., the schizophrenias) varying in symptoms and severity. Associations between genotypic networks and clinical syndromes were complex, showing multifinality and equifinality. The interactive networks explained the risk of schizophrenia more than the average effects of all SNPs (24%). Schizophrenia is a group of heritable disorders caused by a moderate number of separate genotypic networks associated with several distinct clinical syndromes.

[Case finding in early prevention networks - a heuristic for ambulatory care settings].

PubMed

Barth, Michael; Belzer, Florian

2016-06-01

One goal of early prevention is the support of families with small children up to three years who are exposed to psychosocial risks. The identification of these cases is often complex and not well-directed, especially in the ambulatory care setting. Development of a model of a feasible and empirical based strategy for case finding in ambulatory care. Based on the risk factors of postpartal depression, lack of maternal responsiveness, parental stress with regulation disorders and poverty a lexicographic and non-compensatory heuristic model with simple decision rules, will be constructed and empirically tested. Therefore the original data set from an evaluation of the pediatric documentary form on psychosocial issues of families with small children in well-child visits will be used and reanalyzed. The first diagnostic step in the non-compensatory and hierarchical classification process is the assessment of postpartal depression followed by maternal responsiveness, parental stress and poverty. The classification model identifies 89.0 % cases from the original study. Compared to the original study the decision process becomes clearer and more concise. The evidence-based and data-driven model exemplifies a strategy for the assessment of psychosocial risk factors in ambulatory care settings. It is based on four evidence-based risk factors and offers a quick and reliable classification. A further advantage of this model is that after a risk factor is identified the diagnostic procedure will be stopped and the counselling process can commence. For further validation of the model studies, in well suited early prevention networks are needed.

Computer-aided detection of bladder masses in CT urography (CTU)

NASA Astrophysics Data System (ADS)

Cha, Kenny H.; Hadjiiski, Lubomir M.; Chan, Heang-Ping; Caoili, Elaine M.; Cohan, Richard H.; Weizer, Alon; Samala, Ravi K.

2017-03-01

We are developing a computer-aided detection system for bladder cancer in CT urography (CTU). We have previously developed methods for detection of bladder masses within the contrast-enhanced and the non-contrastenhanced regions of the bladder individually. In this study, we investigated methods for detection of bladder masses within the entire bladder. The bladder was segmented using our method that combined deep-learning convolutional neural network with level sets. The non-contrast-enhanced region was separated from the contrast-enhanced region with a maximum-intensity-projection-based method. The non-contrast region was smoothed and gray level threshold was applied to the contrast and non-contrast regions separately to extract the bladder wall and potential masses. The bladder wall was transformed into a straightened thickness profile, which was analyzed to identify lesion candidates in a prescreening step. The candidates were mapped back to the 3D CT volume and segmented using our auto-initialized cascaded level set (AI-CALS) segmentation method. Twenty-seven morphological features were extracted for each candidate. A data set of 57 patients with 71 biopsy-proven bladder lesions was used, which was split into independent training and test sets: 42 training cases with 52 lesions, and 15 test cases with 19 lesions. Using the training set, feature selection was performed and a linear discriminant (LDA) classifier was designed to merge the selected features for classification of bladder lesions and false positives. The trained classifier was evaluated with the test set. FROC analysis showed that the system achieved a sensitivity of 86.5% at 3.3 FPs/case for the training set, and 84.2% at 3.7 FPs/case for the test set.

Practice and Policy to Enhance Student Induction and Transition: A Case Study of Institution-Wide Change

ERIC Educational Resources Information Center

Alsford, Sally; Rose, Christine

2014-01-01

This case study gives an analytical account of institutional development in induction provision. Driven by student experience concerns, a London post-1992 University set up an "enhanced induction project" to provide a more integrated, personalised approach through more coordinated processes. In a large, diverse context, university-wide…

Epistemological Syncretism in a Biology Classroom: A Case Study

ERIC Educational Resources Information Center

Bennett, William D.; Park, Soonhye

2011-01-01

In teaching science, the beliefs of teachers may come into conflict and inhibit the implementation of reformed teaching practice. An experienced biology teacher, Mr. Hobbs, was found to have two different sets of epistemological beliefs while his classroom practice was predominantly teacher-centered. A case study was then performed in order to…

Ethnicity and Schooling: A Caribbean Case Study.

ERIC Educational Resources Information Center

Gibson, Margaret A.

What is the relationship of ethnicity to students' experiences in and responses to schooling? How is success in school related to ethnicity? In this dissertation the schools and community of St. Croix, U.S. Virgin Islands, provide the setting for a multi-ethnic comparative case study in educational anthropology which addresses these questions.…

An Exploration of Infant and Toddler Child Care Consultation: A Multiple Case Study

ERIC Educational Resources Information Center

John, Christine Marie

2015-01-01

This qualitative, multiple case study was an exploration of the professional development (PD) experience of consultation as it occurred within infant and toddler child care settings. Consultation is dependent upon the establishment of a relationship between the consultant and the consultee and offers opportunities for professional growth and…

Online Software Applications for Learning: Observations from an Elementary School

ERIC Educational Resources Information Center

Tay, Lee Yong; Lim, Cher Ping; Nair, Shanthi Suraj; Lim, Siew Khiaw

2014-01-01

This exploratory case study research describes the integration of Information Communication Technology (ICT) into the teaching and learning of English, mathematics and science in an elementary school in Singapore. The school in this case study research is one of the first primary-level future schools that was set up under the…

Using Multimedia Case Studies to Advance Pre-Service Teacher Knowing

ERIC Educational Resources Information Center

Pfister, Christina C.; White, Daniel L.; Masingila, Joanna O.

2006-01-01

This paper uses Baxter Magolda's (1992) framework on ways of knowing to examine the effects of using multimedia case studies with beginning pre-service teachers (PSTs). Baxter Magolda referred to these ways of thinking as absolute, transitional, independent, and contextual. The written responses to two sets of tasks were analysed for 36 PSTs…

Case Study Application of Determining End of Physical Life Using Survival Analysis (WERF Report INFR2R11b)

EPA Science Inventory

Abstract: This case study application provides discussion on a selected application of advanced concepts, included in the End of Asset Life Reinvestment decision-making process tool, using Milwaukee Metropolitan Sewer District (MMSD) pump and motor data sets. The tool provides s...

Comparing the Lifetimes of Two Brands of Batteries

ERIC Educational Resources Information Center

Dunn, Peter K.

2013-01-01

In this paper, we report a case study that illustrates the importance in interpreting the results from statistical tests, and shows the difference between practical importance and statistical significance. This case study presents three sets of data concerning the performance of two brands of batteries. The data are easy to describe and…

A Case Study of Conflict in an Educational Workplace: Managing Personal and Cultural Differences

ERIC Educational Resources Information Center

Torpey, Michael John

2006-01-01

This article is about conflict in an educational workplace setting. It reports on a case study investigating the emergence, development, and management of conflict among diverse native English speakers working as language instructors within a Japanese university. The example of conflict presented, which deals with divergent assumptions about the…

Household Resources and Their Changing Relationships: Case Studies in Gujarat, India. International Agriculture Publications General Series Number 3.

ERIC Educational Resources Information Center

Magrabi, Frances M., Ed.; Verma, Amita, Ed.

This publication contains case studies based on rural life in northern India. The titles include: (1) "Profiles of Two Indian Rural Settings"; (2) "Visitors View a Village"; (3) "Village Households"; (4) "Agriculture"; (5) "Women's Needs: Health and Nutrition"; (6) "Meal Pattern, Nutrient…

Improvisational Theatre as Public Pedagogy: A Case Study of "Aesthetic" Pedagogy in Leadership Development

ERIC Educational Resources Information Center

Katz-Buonincontro, Jen

2011-01-01

How does improvisational theatre promote aesthetic learning in leaders, emphasizing emotion and somatic, or sensory, knowledge? While improvisational theatre has been used in organizational settings, there is little empirical research describing the aesthetic learning process geared towards preparing educational leaders. Based on a case study of…

Infusing Technology Driven Design Thinking in Industrial Design Education: A Case Study

ERIC Educational Resources Information Center

Mubin, Omar; Novoa, Mauricio; Al Mahmud, Abdullah

2017-01-01

Purpose: This paper narrates a case study on design thinking-based education work in an industrial design honours program. Student projects were developed in a multi-disciplinary setting across a Computing and Engineering faculty that allowed promoting technologically and user-driven innovation strategies. Design/methodology/approach: A renewed…

An approach for integrating toxicogenomic data in risk assessment: The dibutyl phthalate case study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Euling, Susan Y., E-mail: euling.susan@epa.gov; Thompson, Chad M.; Chiu, Weihsueh A.

An approach for evaluating and integrating genomic data in chemical risk assessment was developed based on the lessons learned from performing a case study for the chemical dibutyl phthalate. A case study prototype approach was first developed in accordance with EPA guidance and recommendations of the scientific community. Dibutyl phthalate (DBP) was selected for the case study exercise. The scoping phase of the dibutyl phthalate case study was conducted by considering the available DBP genomic data, taken together with the entire data set, for whether they could inform various risk assessment aspects, such as toxicodynamics, toxicokinetics, and dose–response. A descriptionmore » of weighing the available dibutyl phthalate data set for utility in risk assessment provides an example for considering genomic data for future chemical assessments. As a result of conducting the scoping process, two questions—Do the DBP toxicogenomic data inform 1) the mechanisms or modes of action?, and 2) the interspecies differences in toxicodynamics?—were selected to focus the case study exercise. Principles of the general approach include considering the genomics data in conjunction with all other data to determine their ability to inform the various qualitative and/or quantitative aspects of risk assessment, and evaluating the relationship between the available genomic and toxicity outcome data with respect to study comparability and phenotypic anchoring. Based on experience from the DBP case study, recommendations and a general approach for integrating genomic data in chemical assessment were developed to advance the broader effort to utilize 21st century data in risk assessment. - Highlights: • Performed DBP case study for integrating genomic data in risk assessment • Present approach for considering genomic data in chemical risk assessment • Present recommendations for use of genomic data in chemical risk assessment.« less

The Play of Children with Special Needs in Mainstream and Special Education Settings

ERIC Educational Resources Information Center

Bray, Paula; Cooper, Rodney

2007-01-01

Educators and occupational therapists regard play as a primary occupation of childhood, which in the case of children with special needs has not been well studied. The aim of this descriptive study was to observe the free-play behaviour of children with special needs in both special education and mainstream education settings. The Revised…

The Emergence of Student Creativity in Classroom Settings: A Case Study of Elementary Schools in Korea

ERIC Educational Resources Information Center

Cho, Younsoon; Chung, Hye Young; Choi, Kyoulee; Seo, Choyoung; Baek, Eunjoo

2013-01-01

This research explores the emergence of student creativity in classroom settings, specifically within two content areas: science and social studies. Fourteen classrooms in three elementary schools in Korea were observed, and the teachers and students were interviewed. The three types of student creativity emerging in the teaching and learning…

A Visual Narrative Inquiry into Children's Sense of Agency in Preschool and First Grade

ERIC Educational Resources Information Center

Sairanen, Heidi; Kumpulainen, Kristiina

2014-01-01

This socioculturally framed case study focuses on children's sense of agency in educational settings. The study has two objectives: (a) to portray the modalities of children's sense of agency in preschool and first grade settings, and (b) to identify the sociocultural resources that mediate children's sense of agency in these two activity…

The Effect of Interactive Technology on Informal Learning and Performance in a Social Setting

ERIC Educational Resources Information Center

Boileau, Timothy

2011-01-01

This study is based on a qualitative multiple case study research design using a mixed methods approach to provide insight into the effect of interactive technology on informal learning and performance in a social business setting inhabited by knowledge workers. The central phenomenon examined is the variance in behavioral intention towards…

Exploring Students' Perceptions of Academic Disengagement and Reengagement in a Dropout Recovery Charter School Setting

ERIC Educational Resources Information Center

Iachini, Aidyn L.; Buettner, Cynthia; Anderson-Butcher, Dawn; Reno, Rebecca

2013-01-01

The purpose of this exploratory case study was to understand the academic disengagement and reengagement process from the perspective of students enrolled in a dropout recovery charter school. Specifically, this study focused on students' perceptions of the factors that influenced their lack of success in the traditional school setting, the…

Successful adaptation of three-dimensional inversion methodologies for archaeological-scale, total-field magnetic data sets

NASA Astrophysics Data System (ADS)

Cheyney, S.; Fishwick, S.; Hill, I. A.; Linford, N. T.

2015-08-01

Despite the development of advanced processing and interpretation tools for magnetic data sets in the fields of mineral and hydrocarbon industries, these methods have not achieved similar levels of adoption for archaeological or very near surface surveys. Using a synthetic data set we demonstrate that certain methodologies and assumptions used to successfully invert more regional-scale data can lead to large discrepancies between the true and recovered depths when applied to archaeological-type anomalies. We propose variations to the current approach, analysing the choice of the depth-weighting function, mesh design and parameter constraints, to develop an appropriate technique for the 3-D inversion of archaeological-scale data sets. The results show a successful recovery of a synthetic scenario, as well as a case study of a Romano-Celtic temple in the UK. For the case study, the final susceptibility model is compared with two coincident ground penetrating radar surveys, showing a high correlation with the comparative depth slices. The new approach takes interpretation of archaeological data sets beyond a simple 2-D visual interpretation based on pattern recognition.

Sacrificial Girls: A Case Study of the Impact of Streaming and Setting on Gender Reform

ERIC Educational Resources Information Center

Charlton, Emma; Mills, Martin; Martino, Wayne; Beckett, Lori

2007-01-01

This article reports on research funded by the Australian Research Council to investigate school responses to gender equity. It addresses the efforts of a disadvantaged school to tackle what they perceived to be gender inequalities, but in the process of constructing a top-set and bottom-set/stream class they are developing new forms of old…

Three Case Studies in Making Fair Choices on the Path to Universal Health Coverage.

PubMed

Voorhoeve, Alex; Edejer, Tessa T T; Kapiriri, Lydia; Norheim, Ole F; Snowden, James; Basenya, Olivier; Bayarsaikhan, Dorjsuren; Chentaf, Ikram; Eyal, Nir; Folsom, Amanda; Tun Hussein, Rozita Halina; Morales, Cristian; Ostmann, Florian; Ottersen, Trygve; Prakongsai, Phusit; Saenz, Carla; Saleh, Karima; Sommanustweechai, Angkana; Wikler, Daniel; Zakariah, Afisah

2016-12-01

The goal of achieving Universal Health Coverage (UHC) can generally be realized only in stages. Moreover, resource, capacity, and political constraints mean governments often face difficult trade-offs on the path to UHC. In a 2014 report, Making fair choices on the path to UHC , the WHO Consultative Group on Equity and Universal Health Coverage articulated principles for making such trade-offs in an equitable manner. We present three case studies which illustrate how these principles can guide practical decision-making. These case studies show how progressive realization of the right to health can be effectively guided by priority-setting principles, including generating the greatest total health gain, priority for those who are worse off in a number of dimensions (including health, access to health services, and social and economic status), and financial risk protection. They also demonstrate the value of a fair and accountable process of priority setting.

Three Case Studies in Making Fair Choices on the Path to Universal Health Coverage

PubMed Central

Edejer, Tessa T.T.; Kapiriri, Lydia; Norheim, Ole F.; Snowden, James; Basenya, Olivier; Bayarsaikhan, Dorjsuren; Chentaf, Ikram; Eyal, Nir; Folsom, Amanda; Tun Hussein, Rozita Halina; Morales, Cristian; Ostmann, Florian; Ottersen, Trygve; Prakongsai, Phusit; Saenz, Carla; Saleh, Karima; Sommanustweechai, Angkana; Wikler, Daniel; Zakariah, Afisah

2016-01-01

Abstract The goal of achieving Universal Health Coverage (UHC) can generally be realized only in stages. Moreover, resource, capacity, and political constraints mean governments often face difficult trade-offs on the path to UHC. In a 2014 report, Making fair choices on the path to UHC, the WHO Consultative Group on Equity and Universal Health Coverage articulated principles for making such trade-offs in an equitable manner. We present three case studies which illustrate how these principles can guide practical decision-making. These case studies show how progressive realization of the right to health can be effectively guided by priority-setting principles, including generating the greatest total health gain, priority for those who are worse off in a number of dimensions (including health, access to health services, and social and economic status), and financial risk protection. They also demonstrate the value of a fair and accountable process of priority setting. PMID:28559673

Narratives of the Leadership Development of Adults Who Served as Summer Camp Staff in the Mennonite Setting: A Multiple Case Study

ERIC Educational Resources Information Center

Harrison, Jason

2013-01-01

Problem: Leaders today need a new set of knowledge and skills to be effective in collaborative environments. The focus of this study was to investigate how collaborative environments can contribute to leadership development. The purpose of this study was to describe how the collaborative environment of summer camp helped shape emerging adults as…

Knowledge Contribution in a Non-Formal Virtual Setting through a Social Constructionist Approach: A Case Study of an Online Learning Community

ERIC Educational Resources Information Center

Moses, Myra Gail

2012-01-01

This study explored an online learning community in a non-formal educational setting and the process participants used in order to share, create, and construct knowledge through their interactions in the online community. Participants in the study were college interns who were part of a grant that focused on providing professional development for…

Direct Marketing Alternatives in an Urban Setting: A Case Study of Seattle Youth Garden Works

ERIC Educational Resources Information Center

Taylor, Mykel; Young, Doug; Miles, Carol

2010-01-01

The focus of this study is direct marketing of produce from an urban market garden. Rather than discussing broad issues of direct marketing, we use a case study to frame the decisions a market gardener is likely to face in developing both production and marketing plans. The garden featured in this study is located in Seattle, Washington, a city…

Spatio-temporal Bayesian model selection for disease mapping

PubMed Central

Carroll, R; Lawson, AB; Faes, C; Kirby, RS; Aregay, M; Watjou, K

2016-01-01

Spatio-temporal analysis of small area health data often involves choosing a fixed set of predictors prior to the final model fit. In this paper, we propose a spatio-temporal approach of Bayesian model selection to implement model selection for certain areas of the study region as well as certain years in the study time line. Here, we examine the usefulness of this approach by way of a large-scale simulation study accompanied by a case study. Our results suggest that a special case of the model selection methods, a mixture model allowing a weight parameter to indicate if the appropriate linear predictor is spatial, spatio-temporal, or a mixture of the two, offers the best option to fitting these spatio-temporal models. In addition, the case study illustrates the effectiveness of this mixture model within the model selection setting by easily accommodating lifestyle, socio-economic, and physical environmental variables to select a predominantly spatio-temporal linear predictor. PMID:28070156

Using Dynamic Geometry Software To Add Contrast to Geometric Situations--A Case Study.

ERIC Educational Resources Information Center

Holzl, Reinhard

2001-01-01

Uses of Dynamic Geometry Software (DGS) are often limited purely to a verifying role. Presents a case study that emerged from a project in which DGS formed an integral part of the pedagogical arrangement. The study demonstrates how the contrasting power of DGS might be utilized in a guided discovery setting. (Contains 17 references.) (Author/ASK)

The Subtlety of Age, Gender, and Race Barriers: A Case Study of Early Career African American Female Principals

ERIC Educational Resources Information Center

Jean-Marie, Gaetane

2013-01-01

While all educational leaders face challenges in achieving success, African American female principals often face a unique set of challenges associated with the complexity of their gender, race, and, as examined in this study, age. This case study investigates the experiences of two highly visible, early career African American female principals…

School and Community, Community and School: A Case Study of a Rural Missouri Setting

ERIC Educational Resources Information Center

Franklin, Melia K.

2011-01-01

How do a school and a community interact? This question guided this dissertation examining one rural school and community. The purpose of this case study was to investigate the relationship between the rural Marceline R-V School District (a K-12 school system) and its community, Marceline, Missouri. The framework for this study included the…

Cases on Interdisciplinary Research Trends in Science, Technology, Engineering, and Mathematics: Studies on Urban Classrooms. Advances in Educational Technologies and Instructional Design

ERIC Educational Resources Information Center

Lansiquot, Reneta D.

2013-01-01

Involving two or more academic subjects, interdisciplinary studies aim to blend together broad perspectives, knowledge, skills, and epistemology in an educational setting. By focusing on topics or questions too broad for a single discipline to cover, these studies strive to draw connections between seemingly different fields. Cases on…

Hybrid-Wing-Body Vehicle Composite Fuselage Analysis and Case Study

NASA Technical Reports Server (NTRS)

Mukhopadhyay, Vivek

2014-01-01

Recent progress in the structural analysis of a Hybrid Wing-Body (HWB) fuselage concept is presented with the objective of structural weight reduction under a set of critical design loads. This pressurized efficient HWB fuselage design is presently being investigated by the NASA Environmentally Responsible Aviation (ERA) project in collaboration with the Boeing Company, Huntington Beach. The Pultruded Rod-Stiffened Efficient Unitized Structure (PRSEUS) composite concept, developed at the Boeing Company, is approximately modeled for an analytical study and finite element analysis. Stiffened plate linear theories are employed for a parametric case study. Maximum deflection and stress levels are obtained with appropriate assumptions for a set of feasible stiffened panel configurations. An analytical parametric case study is presented to examine the effects of discrete stiffener spacing and skin thickness on structural weight, deflection and stress. A finite-element model (FEM) of an integrated fuselage section with bulkhead is developed for an independent assessment. Stress analysis and scenario based case studies are conducted for design improvement. The FEM model specific weight of the improved fuselage concept is computed and compared to previous studies, in order to assess the relative weight/strength advantages of this advanced composite airframe technology

Directed Design of Experiments for Validating Probability of Detection Capability of a Testing System

NASA Technical Reports Server (NTRS)

Generazio, Edward R. (Inventor)

2012-01-01

A method of validating a probability of detection (POD) testing system using directed design of experiments (DOE) includes recording an input data set of observed hit and miss or analog data for sample components as a function of size of a flaw in the components. The method also includes processing the input data set to generate an output data set having an optimal class width, assigning a case number to the output data set, and generating validation instructions based on the assigned case number. An apparatus includes a host machine for receiving the input data set from the testing system and an algorithm for executing DOE to validate the test system. The algorithm applies DOE to the input data set to determine a data set having an optimal class width, assigns a case number to that data set, and generates validation instructions based on the case number.

The quality and impact of computer supported collaborative learning (CSCL) in radiology case-based learning.

PubMed

Kourdioukova, Elena V; Verstraete, Koenraad L; Valcke, Martin

2011-06-01

The aim of this research was to explore (1) clinical years students' perceptions about radiology case-based learning within a computer supported collaborative learning (CSCL) setting, (2) an analysis of the collaborative learning process, and (3) the learning impact of collaborative work on the radiology cases. The first part of this study focuses on a more detailed analysis of a survey study about CSCL based case-based learning, set up in the context of a broader radiology curriculum innovation. The second part centers on a qualitative and quantitative analysis of 52 online collaborative learning discussions from 5th year and nearly graduating medical students. The collaborative work was based on 26 radiology cases regarding musculoskeletal radiology. The analysis of perceptions about collaborative learning on radiology cases reflects a rather neutral attitude that also does not differ significantly in students of different grade levels. Less advanced students are more positive about CSCL as compared to last year students. Outcome evaluation shows a significantly higher level of accuracy in identification of radiology key structures and in radiology diagnosis as well as in linking the radiological signs with available clinical information in nearly graduated students. No significant differences between different grade levels were found in accuracy of using medical terminology. Students appreciate computer supported collaborative learning settings when tackling radiology case-based learning. Scripted computer supported collaborative learning groups proved to be useful for both 5th and 7th year students in view of developing components of their radiology diagnostic approaches. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

The emergency data set for the German Electronic Health Card--which benefits can be expected?

PubMed

Born, Judith; Albert, Jürgen; Butz, Norbert; Loos, Stefan; Schenkel, Johannes; Gipp, Christoph; Juhra, Christian

2015-01-01

In order to improve access to pre-existing patient information in case of emergency, the German Electronic Health Card (EHC) is supposed to hold emergency data. As a basis, the German Medical Association developed an emergency data set, which provides the possibility to store information on prior diagnoses, medications, allergies and other emergency-relevant information. One main objective of the study is to evaluate the usefulness of the emergency data in specific emergency situations. Within a two-phase exploratory study, a total of 64 paper-based emergency data sets were completed by primary care physicians, and then were evaluated by clinicians, emergency physicians, and paramedics. Clinicians, emergency physicians as well as paramedics rated the emergency data set in more than 70% of the reviewed cases as very useful or useful. The greatest benefit was attributed to the information on diagnoses and medication. The implementation of an emergency data on the EHC has the potential to improve safety, quality and efficiency of emergency care.

Sustainability at the local scale: defining highly aggregated indices for assessing environmental performance. The province of Reggio Emilia (Italy) as a case study.

PubMed

Clerici, Nicola; Bodini, Antonio; Ferrarini, Alessandro

2004-10-01

In order to achieve improved sustainability, local authorities need to use tools that adequately describe and synthesize environmental information. This article illustrates a methodological approach that organizes a wide suite of environmental indicators into few aggregated indices, making use of correlation, principal component analysis, and fuzzy sets. Furthermore, a weighting system, which includes stakeholders' priorities and ambitions, is applied. As a case study, the described methodology is applied to the Reggio Emilia Province in Italy, by considering environmental information from 45 municipalities. Principal component analysis is used to condense an initial set of 19 indicators into 6 fundamental dimensions that highlight patterns of environmental conditions at the provincial scale. These dimensions are further aggregated in two indices of environmental performance through fuzzy sets. The simple form of these indices makes them particularly suitable for public communication, as they condensate a wide set of heterogeneous indicators. The main outcomes of the analysis and the potential applications of the method are discussed.

Identification of facilitators and barriers to residents' use of a clinical reasoning tool.

PubMed

DiNardo, Deborah; Tilstra, Sarah; McNeil, Melissa; Follansbee, William; Zimmer, Shanta; Farris, Coreen; Barnato, Amber E

2018-03-28

While there is some experimental evidence to support the use of cognitive forcing strategies to reduce diagnostic error in residents, the potential usability of such strategies in the clinical setting has not been explored. We sought to test the effect of a clinical reasoning tool on diagnostic accuracy and to obtain feedback on its usability and acceptability. We conducted a randomized behavioral experiment testing the effect of this tool on diagnostic accuracy on written cases among post-graduate 3 (PGY-3) residents at a single internal medical residency program in 2014. Residents completed written clinical cases in a proctored setting with and without prompts to use the tool. The tool encouraged reflection on concordant and discordant aspects of each case. We used random effects regression to assess the effect of the tool on diagnostic accuracy of the independent case sets, controlling for case complexity. We then conducted audiotaped structured focus group debriefing sessions and reviewed the tapes for facilitators and barriers to use of the tool. Of 51 eligible PGY-3 residents, 34 (67%) participated in the study. The average diagnostic accuracy increased from 52% to 60% with the tool, a difference that just met the test for statistical significance in adjusted analyses (p=0.05). Residents reported that the tool was generally acceptable and understandable but did not recognize its utility for use with simple cases, suggesting the presence of overconfidence bias. A clinical reasoning tool improved residents' diagnostic accuracy on written cases. Overconfidence bias is a potential barrier to its use in the clinical setting.

A case report of evaluating a large-scale health systems improvement project in an uncontrolled setting: a quality improvement initiative in KwaZulu-Natal, South Africa.

PubMed

Mate, Kedar S; Ngidi, Wilbroda Hlolisile; Reddy, Jennifer; Mphatswe, Wendy; Rollins, Nigel; Barker, Pierre

2013-11-01

New approaches are needed to evaluate quality improvement (QI) within large-scale public health efforts. This case report details challenges to large-scale QI evaluation, and proposes solutions relying on adaptive study design. We used two sequential evaluative methods to study a QI effort to improve delivery of HIV preventive care in public health facilities in three districts in KwaZulu-Natal, South Africa, over a 3-year period. We initially used a cluster randomised controlled trial (RCT) design. During the RCT study period, tensions arose between intervention implementation and evaluation design due to loss of integrity of the randomisation unit over time, pressure to implement changes across the randomisation unit boundaries, and use of administrative rather than functional structures for the randomisation. In response to this loss of design integrity, we switched to a more flexible intervention design and a mixed-methods quasiexperimental evaluation relying on both a qualitative analysis and an interrupted time series quantitative analysis. Cluster RCT designs may not be optimal for evaluating complex interventions to improve implementation in uncontrolled 'real world' settings. More flexible, context-sensitive evaluation designs offer a better balance of the need to adjust the intervention during the evaluation to meet implementation challenges while providing the data required to evaluate effectiveness. Our case study involved HIV care in a resource-limited setting, but these issues likely apply to complex improvement interventions in other settings.

Leadership Effectiveness and Instructional Supervision: The Case of the Failing Twin

ERIC Educational Resources Information Center

Bloom, Collette Madeleine

2011-01-01

This case study examines the leadership practices of an effective versus an ineffective elementary school principal. The background of this case involves two fourth grade teachers, each teaching one of a set of identical twins. Discrepancies in teaching and grading practices result in one twin failing. The decision-making choices of the principal…

A Practice Concepts Symposium on Drug Misuse in the Elderly: Examination of a Case History.

ERIC Educational Resources Information Center

Silverstone, Barbara; And Others

1986-01-01

Set of articles consisting of an introduction (Barbara Silverstone, et al.) and case study concerning drug misuse in the elderly, and six papers examining the case from the perspectives of clinical pharmacology (William Simonson); pharmacology (Peter Lamy); psychiatry (Charles Gaitz and Nancy Wilson); nursing (Delores Alford); social work (Janet…

A time-and-motion approach to micro-costing of high-throughput genomic assays

PubMed Central

Costa, S.; Regier, D.A.; Meissner, B.; Cromwell, I.; Ben-Neriah, S.; Chavez, E.; Hung, S.; Steidl, C.; Scott, D.W.; Marra, M.A.; Peacock, S.J.; Connors, J.M.

2016-01-01

Background Genomic technologies are increasingly used to guide clinical decision-making in cancer control. Economic evidence about the cost-effectiveness of genomic technologies is limited, in part because of a lack of published comprehensive cost estimates. In the present micro-costing study, we used a time-and-motion approach to derive cost estimates for 3 genomic assays and processes—digital gene expression profiling (gep), fluorescence in situ hybridization (fish), and targeted capture sequencing, including bioinformatics analysis—in the context of lymphoma patient management. Methods The setting for the study was the Department of Lymphoid Cancer Research laboratory at the BC Cancer Agency in Vancouver, British Columbia. Mean per-case hands-on time and resource measurements were determined from a series of direct observations of each assay. Per-case cost estimates were calculated using a bottom-up costing approach, with labour, capital and equipment, supplies and reagents, and overhead costs included. Results The most labour-intensive assay was found to be fish at 258.2 minutes per case, followed by targeted capture sequencing (124.1 minutes per case) and digital gep (14.9 minutes per case). Based on a historical case throughput of 180 cases annually, the mean per-case cost (2014 Canadian dollars) was estimated to be $1,029.16 for targeted capture sequencing and bioinformatics analysis, $596.60 for fish, and $898.35 for digital gep with an 807-gene code set. Conclusions With the growing emphasis on personalized approaches to cancer management, the need for economic evaluations of high-throughput genomic assays is increasing. Through economic modelling and budget-impact analyses, the cost estimates presented here can be used to inform priority-setting decisions about the implementation of such assays in clinical practice. PMID:27803594

Case Report: Activity Diagrams for Integrating Electronic Prescribing Tools into Clinical Workflow

PubMed Central

Johnson, Kevin B.; FitzHenry, Fern

2006-01-01

To facilitate the future implementation of an electronic prescribing system, this case study modeled prescription management processes in various primary care settings. The Vanderbilt e-prescribing design team conducted initial interviews with clinic managers, physicians and nurses, and then represented the sequences of steps carried out to complete prescriptions in activity diagrams. The diagrams covered outpatient prescribing for patients during a clinic visit and between clinic visits. Practice size, practice setting, and practice specialty type influenced the prescribing processes used. The model developed may be useful to others engaged in building or tailoring an e-prescribing system to meet the specific workflows of various clinic settings. PMID:16622168

Optimal selection of markers for validation or replication from genome-wide association studies.

PubMed

Greenwood, Celia M T; Rangrej, Jagadish; Sun, Lei

2007-07-01

With reductions in genotyping costs and the fast pace of improvements in genotyping technology, it is not uncommon for the individuals in a single study to undergo genotyping using several different platforms, where each platform may contain different numbers of markers selected via different criteria. For example, a set of cases and controls may be genotyped at markers in a small set of carefully selected candidate genes, and shortly thereafter, the same cases and controls may be used for a genome-wide single nucleotide polymorphism (SNP) association study. After such initial investigations, often, a subset of "interesting" markers is selected for validation or replication. Specifically, by validation, we refer to the investigation of associations between the selected subset of markers and the disease in independent data. However, it is not obvious how to choose the best set of markers for this validation. There may be a prior expectation that some sets of genotyping data are more likely to contain real associations. For example, it may be more likely for markers in plausible candidate genes to show disease associations than markers in a genome-wide scan. Hence, it would be desirable to select proportionally more markers from the candidate gene set. When a fixed number of markers are selected for validation, we propose an approach for identifying an optimal marker-selection configuration by basing the approach on minimizing the stratified false discovery rate. We illustrate this approach using a case-control study of colorectal cancer from Ontario, Canada, and we show that this approach leads to substantial reductions in the estimated false discovery rates in the Ontario dataset for the selected markers, as well as reductions in the expected false discovery rates for the proposed validation dataset. Copyright 2007 Wiley-Liss, Inc.

Use of Xpert MTB/RIF in Decentralized Public Health Settings and Its Effect on Pulmonary TB and DR-TB Case Finding in India.

PubMed

Sachdeva, Kuldeep Singh; Raizada, Neeraj; Sreenivas, Achuthan; Van't Hoog, Anna H; van den Hof, Susan; Dewan, Puneet K; Thakur, Rahul; Gupta, R S; Kulsange, Shubhangi; Vadera, Bhavin; Babre, Ameet; Gray, Christen; Parmar, Malik; Ghedia, Mayank; Ramachandran, Ranjani; Alavadi, Umesh; Arinaminpathy, Nimalan; Denkinger, Claudia; Boehme, Catharina; Paramasivan, C N

2015-01-01

Xpert MTB/RIF, the first automated molecular test for tuberculosis, is transforming the diagnostic landscape in high-burden settings. This study assessed the impact of up-front Xpert MTB/RIF testing on detection of pulmonary tuberculosis (PTB) and rifampicin-resistant PTB (DR-TB) cases in India. This demonstration study was implemented in 18 sub-district level TB programme units (TUs) in India in diverse geographic and demographic settings covering a population of 8.8 million. A baseline phase in 14 TUs captured programmatic baseline data, and an intervention phase in 18 TUs had Xpert MTB/RIF offered to all presumptive TB patients. We estimated changes in detection of TB and DR-TB, the former using binomial regression models to adjust for clustering and covariates. In the 14 study TUs, which participated in both phases, 10,675 and 70,556 presumptive TB patients were enrolled in the baseline and intervention phase, respectively, and 1,532 (14.4%) and 14,299 (20.3%) bacteriologically confirmed PTB cases were detected. The implementation of Xpert MTB/RIF was associated with increases in both notification rates of bacteriologically confirmed TB cases (adjusted incidence rate ratio [aIRR] 1.39; CI 1.18-1.64), and proportion of bacteriological confirmed TB cases among presumptive TB cases (adjusted risk ratio (aRR) 1.33; CI 1.6-1.52). Compared with the baseline strategy of selective drug-susceptibility testing only for PTB cases at high risk of drug-resistant TB, Xpert MTB/RIF implementation increased rifampicin resistant TB case detection by over fivefold. Among, 2765 rifampicin resistance cases detected, 1055 were retested with conventional drug susceptibility testing (DST). Positive predictive value (PPV) of rifampicin resistance detected by Xpert MTB/RIF was 94.7% (CI 91.3-98.1), in comparison to conventional DST. Introduction of Xpert MTB/RIF as initial diagnostic test for TB in public health facilities significantly increased case-notification rates of all bacteriologically confirmed TB by 39% and rifampicin-resistant TB case notification by fivefold.

Use of Xpert MTB/RIF in Decentralized Public Health Settings and Its Effect on Pulmonary TB and DR-TB Case Finding in India

PubMed Central

Sachdeva, Kuldeep Singh; Raizada, Neeraj; Sreenivas, Achuthan; van't Hoog, Anna H.; van den Hof, Susan; Dewan, Puneet K.; Thakur, Rahul; Gupta, R. S.; Kulsange, Shubhangi; Vadera, Bhavin; Babre, Ameet; Gray, Christen; Parmar, Malik; Ghedia, Mayank; Ramachandran, Ranjani; Alavadi, Umesh; Arinaminpathy, Nimalan; Denkinger, Claudia; Boehme, Catharina; Paramasivan, C. N.

2015-01-01

Background Xpert MTB/RIF, the first automated molecular test for tuberculosis, is transforming the diagnostic landscape in high-burden settings. This study assessed the impact of up-front Xpert MTB/RIF testing on detection of pulmonary tuberculosis (PTB) and rifampicin-resistant PTB (DR-TB) cases in India. Methods This demonstration study was implemented in 18 sub-district level TB programme units (TUs) in India in diverse geographic and demographic settings covering a population of 8.8 million. A baseline phase in 14 TUs captured programmatic baseline data, and an intervention phase in 18 TUs had Xpert MTB/RIF offered to all presumptive TB patients. We estimated changes in detection of TB and DR-TB, the former using binomial regression models to adjust for clustering and covariates. Results In the 14 study TUs, which participated in both phases, 10,675 and 70,556 presumptive TB patients were enrolled in the baseline and intervention phase, respectively, and 1,532 (14.4%) and 14,299 (20.3%) bacteriologically confirmed PTB cases were detected. The implementation of Xpert MTB/RIF was associated with increases in both notification rates of bacteriologically confirmed TB cases (adjusted incidence rate ratio [aIRR] 1.39; CI 1.18-1.64), and proportion of bacteriological confirmed TB cases among presumptive TB cases (adjusted risk ratio (aRR) 1.33; CI 1.6-1.52). Compared with the baseline strategy of selective drug-susceptibility testing only for PTB cases at high risk of drug-resistant TB, Xpert MTB/RIF implementation increased rifampicin resistant TB case detection by over fivefold. Among, 2765 rifampicin resistance cases detected, 1055 were retested with conventional drug susceptibility testing (DST). Positive predictive value (PPV) of rifampicin resistance detected by Xpert MTB/RIF was 94.7% (CI 91.3-98.1), in comparison to conventional DST. Conclusion Introduction of Xpert MTB/RIF as initial diagnostic test for TB in public health facilities significantly increased case-notification rates of all bacteriologically confirmed TB by 39% and rifampicin-resistant TB case notification by fivefold. PMID:25996389

Unresolved legal questions in cross-border health care in Europe: liability and data protection.

PubMed

van der Molen, I N; Commers, M J

2013-11-01

Directive 2011/24/EU was designed to clarify the rights of EU citizens in evaluating, accessing and obtaining reimbursement for cross-border care. Based on three regional case studies, the authors attempted to assess the added value of the Directive in helping clarify issues in to two key areas that have been identified as barriers to cross-border care: liability and data protection. Qualitative case study employing secondary data sources including research of jurisprudence, that set up a Legal framework as a base to investigate liability and data protection in the context of cross-border projects. By means of three case studies that have tackled liability and data protection hurdles in cross-border care implementation, this article attempts to provide insight into legal certainty and uncertainty regarding cross-border care in Europe. The case studies reveal that the Directive has not resolved core uncertainties related to liability and data protection issues within cross-border health care. Some issues related to the practice of cross-border health care in Europe have been further clarified by the Directive and some direction has been given to possible solutions for issues connected to liability and data protection. Directive 2011/24/EU is clearly a transposition of existing regulations on data protection and ECJ case law, plus a set of additional, mostly, voluntary rules that might enhance regional border cooperation. Therefore, as shown in the case studies, a practical and case by case approach is still necessary in designing and providing cross-border care. © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Sources of heterogeneity in case-control studies on associations between statins, ACE-inhibitors, and proton pump inhibitors and risk of pneumonia.

PubMed

de Groot, Mark C H; Klungel, Olaf H; Leufkens, Hubert G M; van Dijk, Liset; Grobbee, Diederick E; van de Garde, Ewoudt M W

2014-10-01

The heterogeneity in case-control studies on the associations between community-acquired pneumonia (CAP) and ACE-inhibitors (ACEi), statins, and proton pump inhibitors (PPI) hampers translation to clinical practice. Our objective is to explore sources of this heterogeneity by applying a common protocol in different data settings. We conducted ten case-control studies using data from five different health care databases. Databases varied on type of patients (hospitalised vs. GP), level of case validity, and mode of exposure ascertainment (prescription or dispensing based). Identified CAP patients and controls were matched on age, gender, and calendar year. Conditional logistic regression was used to calculate odds ratios (OR) for the associations between the drugs of interest and CAP. Associations were adjusted by a common set of potential confounders. Data of 38,742 cases and 118,019 controls were studied. Comparable patterns of variation between case-control studies were observed for ACEi, statins and PPI use and pneumonia risk with adjusted ORs varying from 1.04 to 1.49, 0.82 to 1.50 and 1.16 to 2.71, respectively. Overall, higher ORs were found for hospitalised CAP patients matched to population controls versus GP CAP patients matched to population controls. Prevalence of drug exposure was higher in dispensing data versus prescription data. We show that case-control selection and methods of exposure ascertainment induce bias that cannot be adjusted for and to a considerable extent explain the heterogeneity in results obtained in case-control studies on statins, ACEi and PPIs and CAP. The common protocol approach helps to better understand sources of variation in observational studies.

Systematic investigation of the relationship between high myopia and polymorphisms of the MMP2, TIMP2, and TIMP3 genes by a DNA pooling approach.

PubMed

Leung, Kim Hung; Yiu, Wai Chi; Yap, Maurice K H; Ng, Po Wah; Fung, Wai Yan; Sham, Pak Chung; Yip, Shea Ping

2011-06-01

This study examined the relationship between high myopia and three myopia candidate genes--matrix metalloproteinase 2 (MMP2) and tissue inhibitor of metalloproteinase-2 and -3 (TIMP2 and TIMP3)--involved in scleral remodeling. Recruited for the study were unrelated adult Han Chinese who were high myopes (spherical equivalent, ≤ -6.0 D in both eyes; cases) and emmetropes (within ±1.0 D in both eyes; controls). Sample set 1 had 300 cases and 300 controls, and sample set 2 had 356 cases and 354 controls. Forty-nine tag single-nucleotide polymorphisms (SNPs) were selected from these candidate genes. The first stage was an initial screen of six case pools and six control pools constructed from sample set 1, each pool consisting of 50 distinct subjects of the same affection status. In the second stage, positive SNPs from the first stage were confirmed by genotyping individual samples forming the DNA pools. In the third stage, positive SNPs from stage 2 were replicated, with sample set 2 genotyped individually. Of the 49 SNPs screened by DNA pooling, three passed the lenient threshold of P < 0.10 (nested ANOVA) and were followed up by individual genotyping. Of the three SNPs genotyped, two TIMP3 SNPs were found to be significantly associated with high myopia by single-marker or haplotype analysis. However, the initial positive results could not be replicated by sample set 2. MMP2, TIPM2, and TIMP3 genes were not associated with high myopia in this Chinese sample and hence are unlikely to play a major role in the genetic susceptibility to high myopia.

Using an Ishikawa diagram as a tool to assist memory and retrieval of relevant medical cases from the medical literature.

PubMed

Wong, Kam Cheong

2011-03-29

Studying medical cases is an effective way to enhance clinical reasoning skills and reinforce clinical knowledge. An Ishikawa diagram, also known as a cause-and-effect diagram or fishbone diagram, is often used in quality management in manufacturing industries.In this report, an Ishikawa diagram is used to demonstrate how to relate potential causes of a major presenting problem in a clinical setting. This tool can be used by teams in problem-based learning or in self-directed learning settings.An Ishikawa diagram annotated with references to relevant medical cases and literature can be continually updated and can assist memory and retrieval of relevant medical cases and literature. It could also be used to cultivate a lifelong learning habit in medical professionals.

What Makes for Successful Speaker-Listener Technique? Two Case Studies

ERIC Educational Resources Information Center

Wood, Mary R.

2010-01-01

This article reviews some of the controversy surrounding the use and effectiveness of active listening or the Speaker-Listener Technique (SL) in relational counseling. The purpose and function of SL is described and two case studies are presented to illustrate how SL operates in a therapeutic setting and how the outcomes can vary. These case…

Psychological Knowledge for Teaching Critical Thinking: The Agency of Epistemic Activity, Metacognitive Regulative Behaviour and (Student-Centred) Learning

ERIC Educational Resources Information Center

Maclellan, Effie; Soden, Rebecca

2012-01-01

This study considers the case of a tutor whose students repeatedly evidenced significantly superior critical thinking in summative assessment. For the purpose of surfacing appropriate pedagogical action to promote critical thinking (Bassey, "Case Study Research in Educational Settings," 1999), the singularity of one tutor's reported pedagogical…

Information Seeking in Organizational Communication: A Case Study of Applied Theory.

ERIC Educational Resources Information Center

Grunig, James E.

An experimental seminar in corporate communication at the University of Maryland was designed to (1) develop a set of theoretical concepts useful to the organizational communicator who functions as a mediator between management and labor, (2) utilize a practical methodology for these concepts, and (3) conduct a case study in cooperation with an…

Ways with Data: Understanding Coding as Writing

ERIC Educational Resources Information Center

Lindgren, Chris

2017-01-01

In this dissertation, I report findings from an exploratory case-study about Ray, a web developer, who works on a data-driven news team that finds and tells compelling stories with large sets of data. I implicate this case of Ray's coding on a data team in a writing studies epistemology, which is guided by the following question: "What might…

Towards Geographic Information Systems (GIS) Implementation: A Case Study

ERIC Educational Resources Information Center

Meaney, Miriam

2006-01-01

"Despite its central role in real-world geography, the Geographic Information System (GIS) has had little uptake to date in School Geography." (Wiegand, 2001) This statement can be accurately applied to the author's current school setting and was the focus of her and her colleagues' case study, commenced in 2004 and continued into 2005.…

Life in the Cloud: A WorldShare Management Services Case Study

ERIC Educational Resources Information Center

Hartman, Robin R.

2012-01-01

A small, private academic library took the risk of moving from a traditional integrated library system to adopting a system "in the cloud." This case study presents the setting, history, and local needs of the library, including staffing challenges, and explains the decision-making rationale and process. A description of the library's transition…

Reasons for Silence: A Case Study of Two Korean Students at a U.S. Graduate School

ERIC Educational Resources Information Center

Choi, Jung Yun

2015-01-01

This article explores the perception and reasons for Korean students' silence and low levels of oral participation in U.S. graduate programs. It analyzes a case study conducted with two Korean students currently attending graduate school in urban settings. The researcher conducted semi-structured interviews with the participants, using a constant…

Effective Practices in Continuing Professional Development: Lessons from Schools

ERIC Educational Resources Information Center

Earley, Peter; Porritt, Vivienne

2009-01-01

This book presents case studies of schools' journeys towards effective CPD practice as part of a TDA national project. It tells the story of the goals set and achieved, and the challenges and successes along the way. Each case study makes specific reference to the nine factors or approaches to CPD identified in the book as underpinning effective…

Capacity Building through Integration and Transformational Leadership--A Case Study

ERIC Educational Resources Information Center

Stöcklin, Sacha

2011-01-01

This article suggests that educational managers can have an influence through leadership by establishing certain moderators that integrate and shape the faculty into a solid team working towards a high performing organisation. The study looks at a case in China and draws suggestions that could be used in other similar settings. The conclusion is…

Multidisciplinary Case Study on Higher Education: An Innovative Experience in the Business Management Degree

ERIC Educational Resources Information Center

Martínez-Cañas, Ricardo; del Pozo-Rubio, Raúl; Mondéjar-Jiménez, José; Ruiz-Palomino, Pablo

2012-01-01

Higher education is constantly changing and looking for innovative educational solutions in order to increase the level of the student's knowledge and skills. As an important part of this set of educational policies, a new process is emerging for the ideation, planning and implementation of multidisciplinary case studies for students with the aim…

Case Study Application Of Determining End Of Asset Physical Life Using Survival Analysis:(WERF Report INFR2R11a)

EPA Science Inventory

Abstract:This case study application provides discussion on a selected application of advanced concepts, included in the End of Asset Life Reinvestment decision-making process tool, using a utility practitioner’s data set. The tool provides step-by-step process guidance to the as...

To Boldly Go...Or Not

ERIC Educational Resources Information Center

Zavrel, Erik

2008-01-01

This public-hearing case study is centered upon the recent decision by President George W. Bush to set NASA's primary goal as a return to the Moon, followed by a mission to Mars. The members on the expert panel are fictitious and the transcript contrived; however, the views expressed in the case study correspond to actual views held by leading…

Factors Affecting Women's Decisions to Pursue an IS Degree: A Case Study

ERIC Educational Resources Information Center

Serapiglia, Constance Patricia; Lenox, Terri L.

2010-01-01

The declining participation of women in the computer-related professions is a concern to academia and business. There appears to be a complex set of factors influencing the selection of a major and completing the degree. A case study of 25 undergraduate women explored, in detail, the events, conditions, and relationships that affected the decision…

Re-Engaging Marginalized Youth through Digital Music Production: Performance, Audience and Evaluation

ERIC Educational Resources Information Center

Brader, Andy; Luke, Allan

2013-01-01

This article presents two case studies of marginalized youth experimenting with digital music production in flexible education settings. The cases were drawn from a 3-year study of alternative assessment in flexible learning centres for youth who have left formal schooling in Queensland, Australia. The educational issues are framed by reference to…

Control systems on Lie groups.

NASA Technical Reports Server (NTRS)

Jurdjevic, V.; Sussmann, H. J.

1972-01-01

The controllability properties of systems which are described by an evolution equation in a Lie group are studied. The revelant Lie algebras induced by a right invariant system are singled out, and the basic properties of attainable sets are derived. The homogeneous case and the general case are studied, and results are interpreted in terms of controllability. Five examples are given.

Echolalia versus Inclusion: A Case Study of a Child Who Is Blind.

ERIC Educational Resources Information Center

Zoniou-Sideri, Athina; Karayianni, Panagiota

2000-01-01

A case study of a Greek child (age 5) with visual impairment and echolalia is presented to illustrate the symptoms of echolalia in inclusive settings, the forms that echolalia can take, and how echolalia is differentiated from the kinds of speech repetitions observed in conditions of normal language acquisition. (Contains references.) (CR)

Quality Standards Matter: A Comparative Case Study Examining Interactive Writing in the Preschool Setting

ERIC Educational Resources Information Center

Hall, Anna H.

2017-01-01

Interactive writing is a research-based early literacy strategy that has been found effective at increasing young children's oral language skills, alphabet knowledge, phonemic awareness, concepts of print, and early writing skills. This paper reports on a case study which explored the feasibility and fidelity of implementing interactive writing in…

Advanced supplier partnership practices: a case study.

PubMed

Williams, B R

2000-05-01

This article describes how a supplier partnership was set up to avoid the typical purchasing relationship--price being inversely proportional to quantity and having the purchaser take all the risk of product obsolescence. The case study also describes how rate-based replenishment replaced time-based delivery, and how all these advantages were achieved at reduced administrative costs.

Standards of Competence: A Multi-Site Case Study of School Reform. Project: Effects of Testing Reforms and Standards.

ERIC Educational Resources Information Center

Ellwein, Mary Catherine; Glass, Gene V.

A qualitative case study involving five educational institutions assessed the use of competency testing as a prerequisite for high school graduation, criterion for admission into college, criterion for teacher certification, and statewide assessment tool. Focus was on persons and processes involved in setting educational standards associated with…

Ka Lama o ke Kaiaulu: Research on Teacher Education for a Hawaiian Community.

ERIC Educational Resources Information Center

Au, Kathryn H.; Maaka, Margaret J.

1998-01-01

Introduces a three-year research project designed to answer the questions of how schools can better meet the educational needs of individuals from underrepresented groups. Provides overviews of a case study of a preservice teacher of Hawaiian ethnicity and a set of case studies of five Hawaiian women throughout their educations. (SLD)

A Qualitative Case Study of Cultural Competency among Advanced Placement Teachers in Florida

ERIC Educational Resources Information Center

Hayes, Monica G.

2010-01-01

The concept of cultural competency, its application, and impact on K-12 learning have not received much attention in the literature. Teachers need to understand the connection between culture and pedagogy when teaching minority and underrepresented students. The purpose of this qualitative case study was to examine whether the skill sets in…

Music Performance Anxiety in Instrumental Music Students: A Multiple Case Study of Teacher Perspectives

ERIC Educational Resources Information Center

Sieger, Crystal

2017-01-01

Music Performance Anxiety (MPA) is a sometimes debilitating condition affecting many young musicians as they perform in testing or concert settings. These students may consult their teachers to seek aid in overcoming their anxiety. The purpose of this multiple case study was to investigate the strategies and methods utilized by middle and high…

Student Presentations of Case Studies to Illustrate Core Concepts in Soil Biogeochemistry

ERIC Educational Resources Information Center

Duckworth, Owen W.; Harrington, James M.

2012-01-01

Soil biogeochemistry, a discipline that explores the chemical speciation and transformations of elements in soils and the relationships between soils and global biogeochemical cycles, is becoming a popular course offering because it unites themes from a number of other courses. In this article, we present a set of case studies that have been used…

The Impact of Instructor Grouping Strategies on Student Efficacy in Inquiry Science Labs: A Phenomenological Case Study of Grouping Perceptions and Strategies

ERIC Educational Resources Information Center

Miller, Nathaniel J.

2015-01-01

Abundant educational research has integrated Albert Bandura's concepts of self-efficacy and collective efficacy within educational settings. In this phenomenological case study, the investigation sought to capture the manifestation of self-efficacy and collective efficacy within inquiry-based science laboratory courses. Qualitative data was…

The Impact of Different Scoring Rubrics for Grading Virtual Patient-Based Exams

ERIC Educational Resources Information Center

Fors, Uno G. H.; Gunning, William T.

2014-01-01

Virtual patient cases (VPs) are used for healthcare education and assessment. Most VP systems track user interactions to be used for assessment. Few studies have investigated how virtual exam cases should be scored and graded. We have applied eight different scoring models on a data set from 154 students. Issues studied included the impact of…

Suggestions for Educational and Therapeutic Interventions with the Rett Syndrome Child.

ERIC Educational Resources Information Center

International Rett Syndrome Association, Inc., Fort Washington, MD.

This paper comprises a compilation of nine case studies of girls (aged 4-16 years) with Rett Syndrome. The educational settings involved are various and include private day school, public elementary school in both integrated and special needs classrooms, and a county-operated preschool program for handicapped children. Each case study outlines the…

Experience of Adjunct Novice Clinical Nursing Faculty: An Interpretive Case Study

ERIC Educational Resources Information Center

Mann, Carol

2013-01-01

The purpose of this qualitative interpretive case study was to describe the experience of adjunct novice clinical nursing faculty who has less than three years teaching experience or feels novice in this setting. The nursing shortage in the United States is well documented and is forecasted to have significant impacts on the health care delivery…

Why University Lecturers Enhance Their Teaching through the Use of Technology: A Systematic Review

ERIC Educational Resources Information Center

Jump, Lynne

2011-01-01

The purpose of this systematic review is to add to current understanding of technology-enhanced teaching through a process of synthesis and analysis of a collection of contemporary case studies set within university contexts. The justification to review case studies comes from Pinch and Bijker's concept of the "social construction of technology"…

Translanguaging Practices at a Bilingual University: A Case Study of a Science Classroom

ERIC Educational Resources Information Center

Mazak, Catherine M.; Herbas-Donoso, Claudia

2015-01-01

The objective of this ethnographic case study is to describe in detail one professor's translanguaging practices in an undergraduate science course at an officially bilingual university. The data-set is comprised of ethnographic field notes of 11 observed classes, audio recordings of those classes, an interview with the professor, and artifacts…

Mixed Methods Case Study of Generational Patterns in Responses to Shame and Guilt

ERIC Educational Resources Information Center

Ng, Tony

2013-01-01

Moral socialization and moral learning are antecedents of moral motivation. As many as 4 generations interact in workplace and education settings; hence, a deeper understanding of the moral motivation of members of those generations is needed. The purpose of this convergent mixed methods case study was to understand the moral motivation of 5…

Folie à deux in forensic setting.

PubMed

Kraya, N A; Patrick, C

1997-12-01

This paper is written with the aim of presenting a series of cases of folie à deux, an unusual disorder, occurring in a forensic setting where all the victims suffered a fatal or near-fatal outcome. Similarities in the psychopathology in these cases are drawn and comments are made about their outcome in court. The paper is also written to draw attention to the potential risks involved in this type of case and to accent patterns in psychopathology and in legal outcomes. Five folie à deux cases are described. All are well known to one of the authors (NK), who has treated them at some stage of their illness, provided medicolegal reports for the trial of cases 3, 4 and 5, and provided expert witness testimony in the trial of case 3. All case notes and other relevant documents were studied in detail and a brief summary is provided for each case. The cases appear to conform with the description of folie à deux given in the literature and consist of husband and wife (three cases), mother and daughter (one case) and twin brothers (one case). None of these cases had had any past psychiatric or criminal history, yet all the victims suffered a fatal or near fatal outcome. Additionally, all had shared religious delusions in one form or another. Folie à deux cases with shared religious delusions can be a very high risk and could be potentially fatal in a family setting. The authors also highlight the difficulties inherent in a forensic system restricted to McNaughton rules, particularly when a person is on trial having committed, or being alleged to have committed, a serious offence, and who is found to be suffering from a psychotic illness.

The Hands-Off Pilot Study of the Skills for Ethical Action Instructional Materials. Volume I: The Case Studies.

ERIC Educational Resources Information Center

Research for Better Schools, Inc., Philadelphia, PA.

Recognizing that similar approaches to moral education operate differently in different school settings, this paper assesses the methods and impact of a moral education course (Skills for Ethical Action, SEA) in six junior high school settings. SEA is an instructional program designed to teach seventh, eighth, and ninth grade students a…

Learning from the Experts: A Study of Free-Improvisation Pedagogues in University Settings

ERIC Educational Resources Information Center

Hickey, Maud

2015-01-01

There is a growing interest in alternative forms of pedagogy for students in K-12 settings. Free improvisation, a relatively new and unfamiliar genre, offers potential as an ensemble for teachers to provide in order to offer more egalitarian and creative music experiences for their students. The purpose of this multiple case study was to determine…

Thinking Maps: Research-Based Instructional Strategy in a PDS

ERIC Educational Resources Information Center

Kessler, Cristy; Zuercher, Deborah K.; Wong, Caroline S.

2013-01-01

An exploratory action research case study was conducted at Moanalua Middle School from 2006-2009 to examine the impact of Thinking Maps on student achievement. Thinking Maps are not just another set of graphic organizers but a set of eight of unique visual mind maps with each linked to a specific higher-order thinking pattern. This study tells the…

HYDROGEOLOGIC SETTING AND CHARACTERISTICS OF RIPARIAN MEADOW COMPLEXES IN THE MOUNTAINS OF CENTRAL NEVADA: A CASE STUDY

EPA Science Inventory

Riparian wet meadow complexes in the mountains of the central Great Basin are scarce, ecologically important systems threatened by stream incision. An interdisciplinary team from government and academia is investigating the origin, setting, and biological--physical interrelations...

Evaluation of the Xpert MTB/RIF assay for the diagnosis of smear-negative pulmonary and extrapulmonary tuberculosis in Madagascar.

PubMed

Rakotoarivelo, R; Ambrosioni, J; Rasolofo, V; Raberahona, M; Rakotosamimanana, N; Andrianasolo, R; Ramanampamonjy, R; Tiaray, M; Razafimahefa, J; Rakotoson, J; Randria, M; Bonnet, F; Calmy, A

2018-04-01

To evaluate the feasibility of the implementation of a commercial rapid molecular diagnostic test (Xpert MTB/RIF) for the routine diagnosis of smear-negative or extrapulmonary tuberculosis (TB) and its diagnostic accuracy, and to assess HIV prevalence in a real-life setting in Madagascar. This study was set in a tertiary care hospital in Madagascar. A prospective cohort study was conducted of all consecutive cases with suspected smear-negative and/or extrapulmonary TB over a 2-year period. Cases were classified as proven, probable, or possible TB cases, or as having an alternative diagnosis. Of the 363 patients included, 183 (50.4%) had suspected smear-negative pulmonary TB and 180 (49.6%) had suspected extrapulmonary TB. For proven cases, the sensitivity, specificity, positive and negative predictive values of Xpert MTB/RIF were 82.4%, 98.8%, 98.3%, and 86.6%, respectively; for proven and probable cases grouped together, these values were 65%, 98.8%, 98.5%, and 64%, respectively. The diagnostic accuracy was slightly lower for extrapulmonary TB compared to smear-negative pulmonary TB. The prevalence of HIV infection was 12.1%, but almost half of these cases did not have TB (alternative diagnosis group). The implementation of a rapid diagnosis programme for TB in a resource-poor setting is feasible. The performance of the Xpert-MTB/RIF was remarkable in this difficult-to-diagnose population. HIV prevalence in this study was much higher than the prevalence reported in the general population in Madagascar, in patients with TB and patients with conditions other than TB. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Self-reports of induced abortion: an empathetic setting can improve the quality of data.

PubMed Central

Rasch, V; Muhammad, H; Urassa, E; Bergström, S

2000-01-01

OBJECTIVES: This study estimated the proportion of incomplete abortions that are induced in hospital-based settings in Tanzania. METHODS: A cross-sectional questionnaire study was conducted in 2 phases at 3 hospitals in Tanzania. Phase 1 included 302 patients with a diagnosis of incomplete abortion, and phase 2 included 823 such patients. RESULTS: In phase 1, in which cases were classified by clinical criteria and information from the patient, 3.9% to 16.1% of the cases were classified as induced abortion. In phase 2, in which the structured interview was changed to an empathetic dialogue and previously used clinical criteria were omitted, 30.9% to 60.0% of the cases were classified as induced abortion. CONCLUSIONS: An empathetic dialogue improves the quality of data collected among women with induced abortion. PMID:10897196

Implementing Set Based Design into Department of Defense Acquisition

DTIC Science & Technology

2016-12-01

challenges for the DOD. This report identifies the original SBD principles and characteristics based on Toyota Motor Corporation’s Set Based Concurrent...Engineering Model. Additionally, the team reviewed DOD case studies that implemented SBD. The SBD principles , along with the common themes from the...perennial challenges for the DOD. This report identifies the original SBD principles and characteristics based on Toyota Motor Corporation’s Set

Chronic obstructive lung disease "expert system": validation of a predictive tool for assisting diagnosis.

PubMed

Braido, Fulvio; Santus, Pierachille; Corsico, Angelo Guido; Di Marco, Fabiano; Melioli, Giovanni; Scichilone, Nicola; Solidoro, Paolo

2018-01-01

The purposes of this study were development and validation of an expert system (ES) aimed at supporting the diagnosis of chronic obstructive lung disease (COLD). A questionnaire and a WebFlex code were developed and validated in silico. An expert panel pilot validation on 60 cases and a clinical validation on 241 cases were performed. The developed questionnaire and code validated in silico resulted in a suitable tool to support the medical diagnosis. The clinical validation of the ES was performed in an academic setting that included six different reference centers for respiratory diseases. The results of the ES expressed as a score associated with the risk of suffering from COLD were matched and compared with the final clinical diagnoses. A set of 60 patients were evaluated by a pilot expert panel validation with the aim of calculating the sample size for the clinical validation study. The concordance analysis between these preliminary ES scores and diagnoses performed by the experts indicated that the accuracy was 94.7% when both experts and the system confirmed the COLD diagnosis and 86.3% when COLD was excluded. Based on these results, the sample size of the validation set was established in 240 patients. The clinical validation, performed on 241 patients, resulted in ES accuracy of 97.5%, with confirmed COLD diagnosis in 53.6% of the cases and excluded COLD diagnosis in 32% of the cases. In 11.2% of cases, a diagnosis of COLD was made by the experts, although the imaging results showed a potential concomitant disorder. The ES presented here (COLD ES ) is a safe and robust supporting tool for COLD diagnosis in primary care settings.

Computer-aided diagnosis of lung cancer: the effect of training data sets on classification accuracy of lung nodules.

PubMed

Gong, Jing; Liu, Ji-Yu; Sun, Xi-Wen; Zheng, Bin; Nie, Sheng-Dong

2018-02-05

This study aims to develop a computer-aided diagnosis (CADx) scheme for classification between malignant and benign lung nodules, and also assess whether CADx performance changes in detecting nodules associated with early and advanced stage lung cancer. The study involves 243 biopsy-confirmed pulmonary nodules. Among them, 76 are benign, 81 are stage I and 86 are stage III malignant nodules. The cases are separated into three data sets involving: (1) all nodules, (2) benign and stage I malignant nodules, and (3) benign and stage III malignant nodules. A CADx scheme is applied to segment lung nodules depicted on computed tomography images and we initially computed 66 3D image features. Then, three machine learning models namely, a support vector machine, naïve Bayes classifier and linear discriminant analysis, are separately trained and tested by using three data sets and a leave-one-case-out cross-validation method embedded with a Relief-F feature selection algorithm. When separately using three data sets to train and test three classifiers, the average areas under receiver operating characteristic curves (AUC) are 0.94, 0.90 and 0.99, respectively. When using the classifiers trained using data sets with all nodules, average AUC values are 0.88 and 0.99 for detecting early and advanced stage nodules, respectively. AUC values computed from three classifiers trained using the same data set are consistent without statistically significant difference (p  >  0.05). This study demonstrates (1) the feasibility of applying a CADx scheme to accurately distinguish between benign and malignant lung nodules, and (2) a positive trend between CADx performance and cancer progression stage. Thus, in order to increase CADx performance in detecting subtle and early cancer, training data sets should include more diverse early stage cancer cases.

Computer-aided diagnosis of lung cancer: the effect of training data sets on classification accuracy of lung nodules

NASA Astrophysics Data System (ADS)

Gong, Jing; Liu, Ji-Yu; Sun, Xi-Wen; Zheng, Bin; Nie, Sheng-Dong

2018-02-01

This study aims to develop a computer-aided diagnosis (CADx) scheme for classification between malignant and benign lung nodules, and also assess whether CADx performance changes in detecting nodules associated with early and advanced stage lung cancer. The study involves 243 biopsy-confirmed pulmonary nodules. Among them, 76 are benign, 81 are stage I and 86 are stage III malignant nodules. The cases are separated into three data sets involving: (1) all nodules, (2) benign and stage I malignant nodules, and (3) benign and stage III malignant nodules. A CADx scheme is applied to segment lung nodules depicted on computed tomography images and we initially computed 66 3D image features. Then, three machine learning models namely, a support vector machine, naïve Bayes classifier and linear discriminant analysis, are separately trained and tested by using three data sets and a leave-one-case-out cross-validation method embedded with a Relief-F feature selection algorithm. When separately using three data sets to train and test three classifiers, the average areas under receiver operating characteristic curves (AUC) are 0.94, 0.90 and 0.99, respectively. When using the classifiers trained using data sets with all nodules, average AUC values are 0.88 and 0.99 for detecting early and advanced stage nodules, respectively. AUC values computed from three classifiers trained using the same data set are consistent without statistically significant difference (p  >  0.05). This study demonstrates (1) the feasibility of applying a CADx scheme to accurately distinguish between benign and malignant lung nodules, and (2) a positive trend between CADx performance and cancer progression stage. Thus, in order to increase CADx performance in detecting subtle and early cancer, training data sets should include more diverse early stage cancer cases.

Measles case fatality ratio in India a review of community based studies.

PubMed

Sudfeld, C R; Halsey, N A

2009-11-01

Measles remains a major cause of child mortality in India. Measles case fatality ratios (CFRs) vary substantially between countries and even within the same community over time. We present a review of Indian community-based measles CFR studies conducted from 1975 to 2008. PubMed, Cochrane Libraries, and all WHO databases were searched using a combination of terms. All community-based studies were abstracted into a database. We identified 25 studies with data on 27 communities. The median CFR was 1.63 per 100 cases (Q1= 0.00 and Q3= 5.06). Studies conducted after 1994 had significantly lower CFRs (P=0.031). Studies in rural settings had significantly higher CFRs compared to urban studies (P=0.015). No differences were found by study design or outbreak/endemic setting. This review suggests measles CFR may be declining in India. We hypothesize that increased measles vaccination coverage is the main factor contributing to the decline. Widespread vaccination increases both the average age of infection and the proportion of total measles cases previously vaccinated. Vitamin A treatment/supplementation is also likely to have contributed. In order to further reduce measles burden in India, vaccination and vitamin A treatment/supplementation coverage should be increased and a two dose vaccine strategy should be implemented in all areas.

Estimating the Economic Impact of Higher Education: A Case Study of the Five Colleges in Berks County, Pennsylvania. Professional File Number 117, Summer 2010

ERIC Educational Resources Information Center

D'Allegro, Mary-Lou; Paff, Lolita A.

2010-01-01

Most economic impact studies are prepared by external consultants at significant cost to an individual college, a higher education state system, or a set of institutions with similar Carnegie Classifications. This case study provides a detailed framework that academic institutions may use to derive economic impact estimates without hiring external…

Propylene Glycol Poisoning From Excess Whiskey Ingestion: A Case of High Osmolal Gap Metabolic Acidosis.

PubMed

Cunningham, Courtney A; Ku, Kevin; Sue, Gloria R

2015-01-01

In this report, we describe a case of high anion gap metabolic acidosis with a significant osmolal gap attributed to the ingestion of liquor containing propylene glycol. Recently, several reports have characterized severe lactic acidosis occurring in the setting of iatrogenic unintentional overdosing of medications that use propylene glycol as a diluent, including lorazepam and diazepam. To date, no studies have explored potential effects of excess propylene glycol in the setting of alcohol intoxication. Our patient endorsed drinking large volumes of cinnamon flavored whiskey, which was likely Fireball Cinnamon Whisky. To our knowledge, this is the first case of propylene glycol toxicity from an intentional ingestion of liquor containing propylene glycol.

The Use of CASES-97 Observations to Assess and Parameterize the Impact of Land-Surface Heterogeneity on Area-Average Surface Heat Fluxes for Large-Scale Coupled Atmosphere-Hydrology Models

NASA Technical Reports Server (NTRS)

Chen, Fei; Yates, David; LeMone, Margaret

2001-01-01

To understand the effects of land-surface heterogeneity and the interactions between the land-surface and the planetary boundary layer at different scales, we develop a multiscale data set. This data set, based on the Cooperative Atmosphere-Surface Exchange Study (CASES97) observations, includes atmospheric, surface, and sub-surface observations obtained from a dense observation network covering a large region on the order of 100 km. We use this data set to drive three land-surface models (LSMs) to generate multi-scale (with three resolutions of 1, 5, and 10 kilometers) gridded surface heat flux maps for the CASES area. Upon validating these flux maps with measurements from surface station and aircraft, we utilize them to investigate several approaches for estimating the area-integrated surface heat flux for the CASES97 domain of 71x74 square kilometers, which is crucial for land surface model development/validation and area water and energy budget studies. This research is aimed at understanding the relative contribution of random turbulence versus organized mesoscale circulations to the area-integrated surface flux at the scale of 100 kilometers, and identifying the most important effective parameters for characterizing the subgrid-scale variability for large-scale atmosphere-hydrology models.

Stability of Programmable Shunt Valve Settings with Simultaneous Use of the Optune Transducer Array: A Case Report.

PubMed

Chan, Andrew K; Birk, Harjus S; Winkler, Ethan A; Viner, Jennifer A; Taylor, Jennie W; McDermott, Michael W

2016-07-07

The Optune® transducer array (Novocure Ltd., Haifa, Israel) is an FDA-approved noninvasive regional therapy that aims to inhibit the growth of glioblastoma multiforme (GBM) cells via utilization of alternating electric fields. Some patients with GBM may develop hydrocephalus and benefit from subsequent shunt placement, but special attention must be paid to patients in whom programmable valves are utilized, given the potential effect of the magnetic fields on valve settings. We present the first case report illustrating the stability of programmable shunt valve settings in a neurosurgical patient undergoing therapy with the Optune device. In this study, shunt valve settings were stable over a period of five days despite Optune therapy. This is reassuring for patients with GBM who require simultaneous treatment with both the Optune device and a programmable shunt system.

Impact of interdisciplinary learning on critical thinking using case study method in allied health care graduate students.

PubMed

Zimmerman, Scott D; Lester Short, Glenda F; Hendrix, E Michael

2011-01-01

It remains unclear which classroom experiences, if any, foster critical think ability. We measured the effectiveness of interdisciplinary, case-based learning on the critical-thinking ability of graduate students enrolled in allied health care programs. We designed a voluntary classroom experience to examine the effectiveness of case studies used in an interdisciplinary setting to increase critical-thinking ability. Two groups of students were measured for their critical thinking ability using an online assessment both before and after their respective classroom experiences. One group of 14 graduate students from 4 different allied health care programs (interdisciplinary, ID) discussed complex interdisciplinary case studies and answered multiple-choice type questions formed around the cases. The second group was composed of graduate students (n = 28) from a single disciple enrolled in a clinical anatomy course (discipline specific, DS). They discussed complex case studies specific to their discipline and answered multiple-choice questions formed around the cases. There was no overall change in critical-thinking scores from the pre- to post-test in either group (delta scores: ID 1.5 ± 5.3, DS -1.7 ± 5.7). However, ID students scoring below the median on the pretest improved significantly (paired t-test, pre 50.7 ± 3.8, post 54.2 ± 1.7, p = 0.02). The interdisciplinary learning experience improved critical-thinking ability in students with the least proficiency. As case studies have long been used to advance deeper learning, these data provide evidence for a broader impact of cases when used in an interdisciplinary setting, especially for those students coming in with the least ability.

Estimating risk and rate levels, ratios and differences in case-control studies.

PubMed

King, Gary; Zeng, Langche

2002-05-30

Classic (or 'cumulative') case-control sampling designs do not admit inferences about quantities of interest other than risk ratios, and then only by making the rare events assumption. Probabilities, risk differences and other quantities cannot be computed without knowledge of the population incidence fraction. Similarly, density (or 'risk set') case-control sampling designs do not allow inferences about quantities other than the rate ratio. Rates, rate differences, cumulative rates, risks, and other quantities cannot be estimated unless auxiliary information about the underlying cohort such as the number of controls in each full risk set is available. Most scholars who have considered the issue recommend reporting more than just risk and rate ratios, but auxiliary population information needed to do this is not usually available. We address this problem by developing methods that allow valid inferences about all relevant quantities of interest from either type of case-control study when completely ignorant of or only partially knowledgeable about relevant auxiliary population information.

Approximate Cores of a General Class of Economies. Part II. Set-Up Costs and Firm Formation in Coalition Production Economies,

DTIC Science & Technology

1982-02-01

Figure 5 we depict two simple special cases to illus- trate "Increasing returns to coalition size" where Y[S] depends only on the number of agents in S...for the case where the nuber of types Is greater than one . 29 catch che fundamental nonsymmatry between a firm on existence and a firm- in-being, or...economy is given in terms of individuals, goods, preferences and production sets. Oligopoly theory, partial equilibrium theory and the study of game

The Digital Board in a University Setting: Two Real Cases in Europe and East Africa

NASA Astrophysics Data System (ADS)

Bertarelli, Fabio; Corradini, Matteo; Guaraldi, Giacomo; Genovese, Elisabetta; Kilwake, Juma; Mutua, Stephen

Usually the digital board is thought of as a tool that can only be used beneficially in the context of primary school, secondary school or in a situation of learning handicap. In this case study we want to highlight how the new tools can be used in more broad settings such as teaching in scientific and technical universities. The easy adoption of all useful software on the market to the use of these tools makes them an innovative element in the teaching techniques of the future.

"Cisneros v. CCISD" the Desegregation of the Corpus Christi Independent School District

ERIC Educational Resources Information Center

Trevino, John Albert

2010-01-01

The purpose of this historical case study was to add to the literature an analysis of the landmark legal case of Jose Cisneros v. CCISD. The outcome of this case established Mexican Americans as an ethnic minority and set the legal precedent that the 1954 Brown v. Board of Education Topeka ruling could be extended to other minorities beyond…

Early Childhood Numeracy in a Multiage Setting

ERIC Educational Resources Information Center

Wood, Karen; Frid, Sandra

2005-01-01

This research is a case study examining numeracy teaching and learning practices in an early childhood multiage setting with Pre-Primary to Year 2 children. Data were collected via running records, researcher reflection notes, and video and audio recordings. Video and audio transcripts were analysed using a mathematical discourse and social…

Organizational Constraints and Goal Setting

ERIC Educational Resources Information Center

Putney, Frederick B.; Wotman, Stephen

1978-01-01

Management modeling techniques are applied to setting operational and capital goals using cost analysis techniques in this case study at the Columbia University School of Dental and Oral Surgery. The model was created as a planning tool used in developing a financially feasible operating plan and a 100 percent physical renewal plan. (LBH)

A Snapshot of Science Education in Kindergarten Settings

ERIC Educational Resources Information Center

Campbell, Coral; Jobling, Wendy

2010-01-01

Across Victoria, early childhood practitioners are incorporating science activities into daily experiences for their children. A small research project, which asked teachers to describe what they did in science and how they did it, has highlighted some interesting differences. This paper will describe case studies of four kindergarten settings and…

Modernization: A Case Study of the Interaction of Setting, Custom, and Ideology.

ERIC Educational Resources Information Center

Frankel, Daniel G.; Roer-Bornstein, Dorit

An investigation was conducted to better understand the interaction between physical and social settings, culturally based customs for parenting, and the ideology of caretakers in two Israeli cultures undergoing modernization. Yemenite and Kurdish parenting systems were examined by observing mother/infant interactions in unstructured naturalistic…

Bilingual Advertising in Melbourne Chinatown

ERIC Educational Resources Information Center

Chen, Sherry Yong

2014-01-01

This paper explores the function of bilingual advertising by analyzing a case study of bilingual advertising in the Chinatown of Melbourne, Australia. The use of bilingual advertising in an immigrant setting differentiates itself from those in Asian settings where English is not used by dominant proportion of speakers in the society, and this…

Induction Program Design as It Relates to School Setting

ERIC Educational Resources Information Center

Gabel, Jamie Ann

2016-01-01

The purpose of this qualitative case study was to investigate the induction program differences offered to beginning teachers in rural versus suburban school settings and to identify which induction supports beginning teachers considered most important in achieving classroom success. The six participants included an administrator, mentor, and…

Breaking Bread: Spirituality, Food and Early Childhood Education

ERIC Educational Resources Information Center

Bone, Jane

2005-01-01

The spiritual aspect of early childhood education is supported by the early childhood curriculum in Aotearoa New Zealand, "Te Whariki". Research in three different early childhood settings presents new perspectives on the everyday experiences of children in terms of spirituality. Each setting formed a case study that included the voices…

Teacher and Paraeducator Perceptions of a Hierarchical to Hierarchical-Collaborative Relationship

ERIC Educational Resources Information Center

Dalley, Anna Maria

2017-01-01

This qualitative, descriptive single-case study explored the transition from a hierarchical to a hierarchical-collaborative relationship between special education teachers (SET) and special education paraeducators (SEP). Sixteen participants, including eight veteran SET and eight SEP working in one county located in the Mid-Atlantic region of the…

"Clubcasting": Educational Uses of Podcasting in Multicultural Settings

ERIC Educational Resources Information Center

Beilke, Jayne R.; Stuve, Matthew J.; Williams-Hawkins, Maria A.

2008-01-01

Purpose: This article aims to provide a case study example of the uses of podcasting in a multicultural educational setting. Design/methodology/approach: Pre-service undergraduate teaching majors collaborated with graduate students enrolled in an educational technology course and clients of a community agency service minority, low-income youth to…

Explicating the Concept of Contrapositive Equivalence

ERIC Educational Resources Information Center

Dawkins, Paul Christian; Hub, Alec

2017-01-01

This paper sets forth a concept (Simon, 2017) of contrapositive equivalence and explores some related phenomena of learning through a case study of Hugo's learning in a teaching experiment guiding the reinvention of mathematical logic. Our proposed concept of contrapositive equivalence rests upon set-based meanings for mathematical categories and…

A reference dataset for deformable image registration spatial accuracy evaluation using the COPDgene study archive

NASA Astrophysics Data System (ADS)

Castillo, Richard; Castillo, Edward; Fuentes, David; Ahmad, Moiz; Wood, Abbie M.; Ludwig, Michelle S.; Guerrero, Thomas

2013-05-01

Landmark point-pairs provide a strategy to assess deformable image registration (DIR) accuracy in terms of the spatial registration of the underlying anatomy depicted in medical images. In this study, we propose to augment a publicly available database (www.dir-lab.com) of medical images with large sets of manually identified anatomic feature pairs between breath-hold computed tomography (BH-CT) images for DIR spatial accuracy evaluation. Ten BH-CT image pairs were randomly selected from the COPDgene study cases. Each patient had received CT imaging of the entire thorax in the supine position at one-fourth dose normal expiration and maximum effort full dose inspiration. Using dedicated in-house software, an imaging expert manually identified large sets of anatomic feature pairs between images. Estimates of inter- and intra-observer spatial variation in feature localization were determined by repeat measurements of multiple observers over subsets of randomly selected features. 7298 anatomic landmark features were manually paired between the 10 sets of images. Quantity of feature pairs per case ranged from 447 to 1172. Average 3D Euclidean landmark displacements varied substantially among cases, ranging from 12.29 (SD: 6.39) to 30.90 (SD: 14.05) mm. Repeat registration of uniformly sampled subsets of 150 landmarks for each case yielded estimates of observer localization error, which ranged in average from 0.58 (SD: 0.87) to 1.06 (SD: 2.38) mm for each case. The additions to the online web database (www.dir-lab.com) described in this work will broaden the applicability of the reference data, providing a freely available common dataset for targeted critical evaluation of DIR spatial accuracy performance in multiple clinical settings. Estimates of observer variance in feature localization suggest consistent spatial accuracy for all observers across both four-dimensional CT and COPDgene patient cohorts.

Evidence of Recessive Alzheimer Disease Loci in a Caribbean Hispanic Data Set

PubMed Central

Ghani, Mahdi; Sato, Christine; Lee, Joseph H.; Reitz, Christiane; Moreno, Danielle; Mayeux, Richard; St George-Hyslop, Peter; Rogaeva, Ekaterina

2014-01-01

IMPORTANCE The search for novel Alzheimer disease (AD) genes or pathologic mutations within known AD loci is ongoing. The development of array technologies has helped to identify rare recessive mutations among long runs of homozygosity (ROHs), in which both parental alleles are identical. Caribbean Hispanics are known to have an elevated risk for AD and tend to have large families with evidence of inbreeding. OBJECTIVE To test the hypothesis that the late-onset AD in a Caribbean Hispanic population might be explained in part by the homozygosity of unknown loci that could harbor recessive AD risk haplotypes or pathologic mutations. DESIGN We used genome-wide array data to identify ROHs (>1 megabase) and conducted global burden and locus-specific ROH analyses. SETTING A whole-genome case-control ROH study. PARTICIPANTS A Caribbean Hispanic data set of 547 unrelated cases (48.8% with familial AD) and 542 controls collected from a population known to have a 3-fold higher risk of AD vs non-Hispanics in the same community. Based on a Structure program analysis, our data set consisted of African Hispanic (207 cases and 192 controls) and European Hispanic (329 cases and 326 controls) participants. EXPOSURE Alzheimer disease risk genes. MAIN OUTCOMES AND MEASURES We calculated the total and mean lengths of the ROHs per sample. Global burden measurements among autosomal chromosomes were investigated in cases vs controls. Pools of overlapping ROH segments (consensus regions) were identified, and the case to control ratio was calculated for each consensus region. We formulated the tested hypothesis before data collection. RESULTS In total, we identified 17 137 autosomal regions with ROHs. The mean length of the ROH per person was significantly greater in cases vs controls (P = .0039), and this association was stronger with familial AD (P = .0005). Among the European Hispanics, a consensus region at the EXOC4 locus was significantly associated with AD even after correction for multiple testing (empirical P value 1 [EMP1], .0001; EMP2, .002; 21 AD cases vs 2 controls). Among the African Hispanic subset, the most significant but nominal association was observed for CTNNA3, a well-known AD gene candidate (EMP1, .002; 10 AD cases vs 0 controls). CONCLUSIONS AND RELEVANCE Our results show that ROHs could significantly contribute to the etiology of AD. Future studies would require the analysis of larger, relatively inbred data sets that might reveal novel recessive AD genes. The next step is to conduct sequencing of top significant loci in a subset of samples with overlapping ROHs. PMID:23978990

The ISS SOLAR payload data preservation in the frame of the PERICLES FP-7 project: metadata aspects.

NASA Astrophysics Data System (ADS)

Muller, Christian; Pandey, Praveen

2016-04-01

PERICLES (Promoting and Enhancing the Reuse of Information throughout the Content Lifecycle exploiting Evolving Semantics) is an FP7 project started on February 2013. It aims at preserving by design large and complex data sets. PERICLES is coordinated by King's College London, UK and its partners are University of Borås (Sweden), CERTH- ITI (Greece), DotSoft (Greece), Georg-August-Universität Göttingen (Germany), University of Liverpool (UK), Space Application Services (Belgium), XEROX France and University of Edinburgh (UK). Two additional partners provide the two case studies: Tate Gallery (UK) brings the digital art and media case study and B.USOC (Belgian Users Support and Operations Centre) brings the space science case study . PERICLES addresses the life-cycle of large and complex data sets in order to cater for the evolution of context of data sets and user communities, including groups unanticipated when the data was created. Semantics of data sets are thus also expected to evolve and the project includes elements which could address the reuse of data sets at periods where the data providers and even their institutions are not available any more. PERICLES uses the Linked Resources Model (LRM) which will be compared with the OAIS standard. In this study we present the space science case associated with PERICLES. B.USOC supports experiments on the International Space Station and is the curator of the collected data and operations history. B.USOC has chosen to analyse the SOLAR payload flying since 2008 on the ESA COLUMBUS module of the ISS as the PERICLES prime space science case. Solar observation data are prime candidates for long term data preservation as variabilities of the solar spectral irradiance have an influence on earth climate. The nature of the data to be preserved for the reuse of the current SOLAR series is much more extended than a simple set of time tagged tables of spectral irradiances, it is an important inventory of more than 50 classes of documents and/or metadata directly relevant to SOLAR, it includes not only the calibration elements and their evolution during SOLAR lifetime but also all tools used as the software's and versions used in interpretation. In order to foster potential user's present and future needs, there is an ongoing survey involving a community of practice. Its initial outcome will be presented here. The aspects of data appraisal and metadata constitution in the frame of the PERICLES project will be developed.

Improving quality of care through routine, successful implementation of evidence-based practice at the bedside: an organizational case study protocol using the Pettigrew and Whipp model of strategic change

PubMed Central

2007-01-01

Background Evidence-based practice (EBP) is an expected approach to improving the quality of patient care and service delivery in health care systems internationally that is yet to be realized. Given the current evidence-practice gap, numerous authors describe barriers to achieving EBP. One recurrently identified barrier is the setting or context of practice, which is likewise cited as a potential part of the solution to the gap. The purpose of this study is to identify key contextual elements and related strategic processes in organizations that find and use evidence at multiple levels, in an ongoing, integrated fashion, in contrast to those that do not. Methods The core theoretical framework for this multi-method explanatory case study is Pettigrew and Whipp's Content, Context, and Process model of strategic change. This framework focuses data collection on three entities: the Why of strategic change, the What of strategic change, and the How of strategic change, in this case related to implementation and normalization of EBP. The data collection plan, designed to capture relevant organizational context and related outcomes, focuses on eight interrelated factors said to characterize a receptive context. Selective, purposive sampling will provide contrasting results between two cases (departments of nursing) and three embedded units in each. Data collection methods will include quantitative tools (e.g., regarding culture) and qualitative approaches including focus groups, interviews, and documents review (e.g., regarding integration and “success”) relevant to the EBP initiative. Discussion This study should provide information regarding contextual elements and related strategic processes key to successful implementation and sustainability of EBP, specifically in terms of a pervasive pattern in an acute care hospital-based health care setting. Additionally, this study will identify key contextual elements that differentiate successful implementation and sustainability of EBP efforts, both within varying levels of a hospital-based clinical setting and across similar hospital settings interested in EBP. PMID:17266756

30 CFR 250.1617 - Application for permit to drill.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) Formation fracture gradients; (iii) Potential lost circulation zones; (iv) Mud weights; (v) Casing setting... various casing strings, fracture gradients of the exposed formations, casing setting depths, and cementing...

30 CFR 250.1617 - Application for permit to drill.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) Formation fracture gradients; (iii) Potential lost circulation zones; (iv) Mud weights; (v) Casing setting... various casing strings, fracture gradients of the exposed formations, casing setting depths, and cementing...

30 CFR 250.1617 - Application for permit to drill.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) Formation fracture gradients; (iii) Potential lost circulation zones; (iv) Mud weights; (v) Casing setting... various casing strings, fracture gradients of the exposed formations, casing setting depths, and cementing...

The Context Dependency of the Self-Report Version of the Strength and Difficulties Questionnaire (SDQ): A Cross-Sectional Study between Two Administration Settings

PubMed Central

Hoofs, H.; Jansen, N. W. H.; Mohren, D. C. L.; Jansen, M. W. J.; Kant, I. J.

2015-01-01

Background The Strength and Difficulties Questionnaire (SDQ) is a screening instrument for psychosocial problems in children and adolescents, which is applied in “individual” and “collective” settings. Assessment in the individual setting is confidential for clinical applications, such as preventive child healthcare, while assessment in the collective setting is anonymous and applied in (epidemiological) research. Due to administration differences between the settings it remains unclear whether results and conclusions actually can be used interchangeably. This study therefore aims to investigate whether the SDQ is invariant across settings. Methods Two independent samples were retrieved (mean age = 14.07 years), one from an individual setting (N = 6,594) and one from a collective setting (N = 4,613). The SDQ was administered in the second year of secondary school in both settings. Samples come from the same socio-geographic population in the Netherlands. Results Confirmatory factor analysis showed that the SDQ was measurement invariant/equivalent across settings and gender. On average, children in the individual setting scored lower on total difficulties (mean difference = 2.05) and the psychosocial problems subscales compared to those in the collective setting. This was also reflected in the cut-off points for caseness, defined by the 90th percentiles, which were lower in the individual setting. Using cut-off points from the collective in the individual setting therefore resulted in a small number of cases, 2 to 3%, while ∼10% is expected. Conclusion The SDQ has the same connotation across the individual and collective setting. The observed structural differences regarding the mean scores, however, undermine the validity of the cross-use of absolute SDQ-scores between these settings. Applying cut-off scores from the collective setting in the individual setting could, therefore, result in invalid conclusions and potential misuse of the instrument. To correctly apply cut-off scores these should be retrieved from the applied setting. PMID:25886464

Anesthetic management of placenta accreta in a low-resource setting: a case series.

PubMed

Muñoz, L A; Mendoza, G J; Gomez, M; Reyes, L E; Arevalo, J J

2015-11-01

Current recommendations for the anesthetic management of placenta accreta support a conservative approach with neuraxial anesthesia and uterine artery embolization. These are based on case series from experienced centers in developed countries. The aim of this study was to describe the anesthetic management of placenta accreta in a low-resource setting. A retrospective case note review was performed. From 1 August 2006 to 31 July 2011 placentas from cases of suspected placenta accreta were reassessed histologically to confirm the diagnosis. Patient charts were reviewed and information on anesthetic technique, monitoring, blood transfusion, maternal and fetal outcomes was extracted. Thirty-nine cases were identified. Mean (± SD) maternal age was 33 ± 5.4 years. Hysterectomy was performed at the time of cesarean section in all cases. Thirty-four patients received neuraxial anesthesia, of whom 15 required conversion to general anesthesia. Invasive blood pressure monitoring was used in all patients and a central venous catheter was inserted in 33 cases. Complications associated with monitoring occurred in five patients. Median [IQR] blood loss was 2000 [1100-2700] mL and the median [IQR] number of units of red blood cell transfused was 2 [0-6]. Vasoactive medication was used in 14 patients and 15 patients were transferred to the intensive care unit postoperatively. No maternal or newborn deaths occurred. A multidisciplinary approach can prove valuable when placenta accreta is suspected before delivery. In low-resource settings, lack of interventional radiology services and prenatal diagnostic capability may have an impact on anesthetic management in patients with placenta accreta. However, other than greater blood loss, our study demonstrated that good maternal and neonatal outcomes are possible in spite of limited resources. Copyright © 2015 Elsevier Ltd. All rights reserved.

Stochastic Robust Mathematical Programming Model for Power System Optimization

DOE Office of Scientific and Technical Information (OSTI.GOV)

Liu, Cong; Changhyeok, Lee; Haoyong, Chen

2016-01-01

This paper presents a stochastic robust framework for two-stage power system optimization problems with uncertainty. The model optimizes the probabilistic expectation of different worst-case scenarios with ifferent uncertainty sets. A case study of unit commitment shows the effectiveness of the proposed model and algorithms.

An Automatic Approach for Analyzing Treatment Effectiveness Based on Medication Hierarchy - The Myocardial Infarction Case Study.

PubMed

Li, Yingxue; Hu, Yiying; Yang, Jingang; Li, Xiang; Liu, Haifeng; Xie, Guotong; Xu, Meilin; Hu, Jingyi; Yang, Yuejin

2017-01-01

Treatment effectiveness plays a fundamental role in patient therapies. In most observational studies, researchers often design an analysis pipeline for a specific treatment based on the study cohort. To evaluate other treatments in the data set, much repeated and multifarious work including cohort construction, statistical analysis need to be done. In addition, as treatments are often with an intrinsic hierarchical relationship, many rational comparable treatment pairs can be derived as new treatment variables besides the original single treatment one from the original cohort data set. In this paper, we propose an automatic treatment effectiveness analysis approach to solve this problem. With our approach, clinicians can assess the effect of treatments not only more conveniently but also more thoroughly and comprehensively. We applied this method to a real world case of estimating the drug effectiveness on Chinese Acute Myocardial Infarction (CAMI) data set and some meaningful results are obtained for potential improvement of patient treatments.

What's Eating Gilbert Grape?: A Case Study of Chronic Illness

ERIC Educational Resources Information Center

Alexander, Matthew; Waxman, Dael; White, Patricia

2006-01-01

Cinemeducation refers to the use of movies or movie clips to educate learners about the psychosocial aspects of health care. This paper describes the use of a clip from the movie, "What's Eating Gilbert Grape?" to teach medical students about chronic illness. The clip is used to set up a case study based on the lead character, Gilbert…

Transferring Learning to the Workplace. Seventeen Case Studies from the Real World of Training. In Action Series.

ERIC Educational Resources Information Center

Broad, Mary L., Ed.

Organized in three parts, this book contains an introductory chapter and 17 case studies selected to show transfer applications in a wide range of organizational settings. In part 1, two chapters review the rationale, context, and research relating to transfer: "Transfer Concepts and Research Overview" (Mary Broad); and "Success Factors in…

Employing a Case Study Approach to Capture Motivation and Self-Regulation of Young Students with Learning Disabilities in Authentic Educational Contexts

ERIC Educational Resources Information Center

Lichtinger, Einat; Kaplan, Avi

2015-01-01

Recent theory and research suggest that self-regulation is not a unitary set of strategies, and that students may employ different types of self-regulation strategies in ways that correspond with different motivational orientations. In this paper, we describe a situated case study approach to investigate the motivational orientation and…

Raised-Line Pictures, Blindness, and Tactile "Beliefs": An Observational Case Study

ERIC Educational Resources Information Center

D'Angiulli, Amedeo

2007-01-01

In this observational case study, a 13-year old boy, Carlo, who was born completely blind, was invited to explore and identify, a set of raised-line pictures without receiving feedback about the accuracy of his identification. He was then asked to explain, verbally or by drawing, why he believed that the names he suggested accurately identified…

Developing a Model and Applications for Probabilities of Student Success: A Case Study of Predictive Analytics

ERIC Educational Resources Information Center

Calvert, Carol Elaine

2014-01-01

This case study relates to distance learning students on open access courses. It demonstrates the use of predictive analytics to generate a model of the probabilities of success and retention at different points, or milestones, in a student journey. A core set of explanatory variables has been established and their varying relative importance at…

Teaching as Coaching: A Case Study of Awareness and Learning in Engineering Education

ERIC Educational Resources Information Center

Gynnild, Vidar; Holstad, Anders; Myrhaug, Dag

2007-01-01

This paper presents a number of case studies in Oceanography, an optional module in the third/fourth year of a Master of Science programme at Norwegian University of Science and Technology. The main objective was to gain more thorough insights into student learning by examining two sets of individual oral examinations. In addition, all students…

Increasing In-School Food Consumption of an Elementary Student with Emotional/Behavioral Disorders: A Case Study

ERIC Educational Resources Information Center

Wood, Brenna K.; Flanagan, Timothy F.

2013-01-01

Researchers conducted the present case study to address the immediate need of a student who consumed food at home and refused all food and liquids in her elementary school setting. In order to increase in-school food consumption, researchers developed a multicomponent treatment package that included antecedent adjustments (time and place food was…

Effectiveness of Written Materials in a Rehabilitative Program for Female Offenders: A Case Study at the Montana Women's Prison

ERIC Educational Resources Information Center

Dillon, Laura; Colling, Kyle

2010-01-01

This case study of the Therapeutic Community Program at Montana Women's Prison investigates the relationship between inmate reading levels and the self-help materials used for rehabilitative purposes within prison settings. The Therapeutic Community Handbook, published by the Montana Department of Corrections, is used as the primary method of…

What's Wrong with Bribery? An Example Utilizing Access to Safe Drinking Water

ERIC Educational Resources Information Center

Dhooge, Lucien J.

2013-01-01

This case study examines the role of bribery in the global marketplace through an example involving access to safe drinking water in the developing world. Parts II and III set out the objectives and methods of classroom delivery for the case study. Part IV is the background reading relating to bribery with particular emphasis on the Foreign…

Developing Student Voice and Participatory Pedagogy: A Case Study in a Spanish Primary School

ERIC Educational Resources Information Center

Susinos, Teresa; Haya, Ignacio

2014-01-01

This article describes a case study that is part of a broader research project in which schools set up processes of school improvement inspired by the proposals put forward by students. The project furthers the initiatives of the student voice movement and seeks to implement more participative pedagogical models. This as a whole represents a novel…

Social Network Analysis as an Analytic Tool for Task Group Research: A Case Study of an Interdisciplinary Community of Practice

ERIC Educational Resources Information Center

Lockhart, Naorah C.

2017-01-01

Group counselors commonly collaborate in interdisciplinary settings in health care, substance abuse, and juvenile justice. Social network analysis is a methodology rarely used in counseling research yet has potential to examine task group dynamics in new ways. This case study explores the scholarly relationships among 36 members of an…

From Swampy Lowlands to Giddy Heights: A Case Study of Leadership Development in a Mental Health Setting

ERIC Educational Resources Information Center

Storr, Lorna; Trenchard, Steve

2010-01-01

Purpose: The purpose of this case study is to describe the design and delivery of a leadership programme for a diverse group of clinicians and middle managers within a British mental health organisation. Design/methodology/approach: This paper shows how the course was co-designed between managers, clinicians and higher education, specifically to…

Case Studies in Systems Chemistry. Final Report. [Includes Complete Case Study, Carboxylic Acid Equilibria

ERIC Educational Resources Information Center

Fleck, George

This publication was produced as a teaching tool for college chemistry. The book is a text for a computer-based unit on the chemistry of acid-base titrations, and is designed for use with FORTRAN or BASIC computer systems, and with a programmable electronic calculator, in a variety of educational settings. The text attempts to present computer…

The Implementation of Pay for Performance in Idaho Schools: A Case Study of Teacher Perceptions

ERIC Educational Resources Information Center

Staniec, Shelly Ann

2013-01-01

This is a qualitative narrative case study set in an Idaho high school where twelve educators offered their viewpoints on the implementation of Idaho's pay-for-performance legislation. In the spring of 2011, Idaho legislators passed laws aimed at increasing student performance and college or career readiness. These laws, known as Idaho's Students…

Moving from the Classroom to the Workplace: A Service-Learning Case Study of a Media Production Capstone Course

ERIC Educational Resources Information Center

Giese, Mark

2013-01-01

This is a case study of how a capstone course, Producing and Directing, evolved into a service-learning course designed to provide graduating students with real-world workplace experience. It will examine issues including course structure, grading issues, course and client logistics, unaddressed skill sets, group work, and work-product quality…

Parent Training on Generalized Use of Behavior Analytic Strategies for Decreasing the Problem Behavior of Children with Autism Spectrum Disorder: A Data-Based Case Study

ERIC Educational Resources Information Center

Crone, Regina M.; Mehta, Smita Shukla

2016-01-01

Setting variables such as location of parent training, programming with common stimuli, generalization of discrete responses to non-trained settings, and subsequent reduction in child problem behavior may influence the effectiveness of interventions. The purpose of this study was to evaluate the effectiveness of home-versus clinic-based training…

"It's Just More in the Real World Really": How Can a Local Project Support Early Years Practitioners from Different Settings in Working and Learning Together?

ERIC Educational Resources Information Center

Cotton, Lizzie

2013-01-01

This article describes how early years practitioners working in different settings, with different experiences and qualifications, can work and learn together. It is a small-scale case study of an eight-month project, with a grass-roots approach, involving early years settings within the reach area of an inner-London Children's Centre. The data…

An integrated methods study of the experiences of youth with severe disabilities in leisure activity settings: the importance of belonging, fun, and control and choice.

PubMed

King, Gillian; Gibson, Barbara E; Mistry, Bhavnita; Pinto, Madhu; Goh, Freda; Teachman, Gail; Thompson, Laura

2014-01-01

The aim was to examine the leisure activity setting experiences of two groups of youth with severe disabilities - those with complex continuing care (CCC) needs and those who have little functional speech and communicate using augmentative and alternative communication (AAC). Twelve youth took part in a mixed methods study, in which their experiences were ascertained using qualitative methods (observations, photo elicitation and interviews) and the measure of Self-Reported Experiences of Activity Settings (SEAS). Data integration occurred using a "following a thread" technique and case-by-case analysis. The analysis revealed several highly valued aspects of leisure activity setting experiences for youth, including engagement with others, enjoying the moment, and control and choice in selection and participation in activity settings. The findings provide preliminary insights into the nature of optimal activity settings for youth with severe disabilities, and the mediators of these experiences. Compared to other youth, the data illustrate both the commonalities of experiences and differences in the ways in which these experiences are attained. Implications for research concern the utility of mixed methods approaches in understanding the complex nature of participation experiences. Implications for clinical practice concern the importance of not assuming the nature of youths' experiences.

Ecological quality boundary-setting procedures: the Gulf of Riga case study.

PubMed

Aigars, Juris; Müller-Karulis, Bärbel; Martin, Georg; Jermakovs, Vadims

2008-03-01

Two approaches for setting ecological class boundaries, response curves and a simplified mathematical boundary-setting protocol, were tested for coastal, transitional and open waters in the Gulf of Riga, Baltic Sea. The simplified mathematical boundary-setting protocol defines acceptable ecological status based on expert judgment by a uniform relative deviation from reference conditions. In contrast, response curves derive class boundary definitions from observed changes in biological quality elements along environmental pressure gradients for class boundary definitions. Identification of relevant environmental pressures for the construction of response curves was based on a conceptual model of eutrophication in the Gulf of Riga. Response curves were successfully established for summer chlorophyll a and transparency, as well as for macrozoobenthos abundance in the Central Gulf, macrozoobenthos biotic coefficient in the Southern Gulf, and maximum depth of phytobenthos in the Northern Gulf. In the Gulf of Riga response curves almost always permitted a larger deviation from reference conditions than the 50% deviation applied for the simplified mathematical boundary-setting protocol. The case study clearly demonstrated that class boundary definitions should take into account the sensitivity of the target water body. Also, the class boundaries for different ecological quality elements were internally more consistent than those derived by the simplified mathematical boundary-setting protocol.

Defining the methodological challenges and opportunities for an effective science of sociotechnical systems and safety.

PubMed

Waterson, Patrick; Robertson, Michelle M; Cooke, Nancy J; Militello, Laura; Roth, Emilie; Stanton, Neville A

2015-01-01

An important part of the application of sociotechnical systems theory (STS) is the development of methods, tools and techniques to assess human factors and ergonomics workplace requirements. We focus in this paper on describing and evaluating current STS methods for workplace safety, as well as outlining a set of six case studies covering the application of these methods to a range of safety contexts. We also describe an evaluation of the methods in terms of ratings of their ability to address a set of theoretical and practical questions (e.g. the degree to which methods capture static/dynamic aspects of tasks and interactions between system levels). The outcomes from the evaluation highlight a set of gaps relating to the coverage and applicability of current methods for STS and safety (e.g. coverage of external influences on system functioning; method usability). The final sections of the paper describe a set of future challenges, as well as some practical suggestions for tackling these. We provide an up-to-date review of STS methods, a set of case studies illustrating their use and an evaluation of their strengths and weaknesses. The paper concludes with a 'roadmap' for future work.

A 2cM genome-wide scan of European Holstein cattle affected by classical BSE

PubMed Central

2010-01-01

Background Classical bovine spongiform encephalopathy (BSE) is an acquired prion disease that is invariably fatal in cattle and has been implicated as a significant human health risk. Polymorphisms that alter the prion protein of sheep or humans have been associated with variations in transmissible spongiform encephalopathy susceptibility or resistance. In contrast, there is no strong evidence that non-synonymous mutations in the bovine prion gene (PRNP) are associated with classical BSE disease susceptibility. However, two bovine PRNP insertion/deletion polymorphisms, one within the promoter region and the other in intron 1, have been associated with susceptibility to classical BSE. These associations do not explain the full extent of BSE susceptibility, and loci outside of PRNP appear to be associated with disease incidence in some cattle populations. To test for associations with BSE susceptibility, we conducted a genome wide scan using a panel of 3,072 single nucleotide polymorphism (SNP) markers on 814 animals representing cases and control Holstein cattle from the United Kingdom BSE epidemic. Results Two sets of BSE affected Holstein cattle were analyzed in this study, one set with known family relationships and the second set of paired cases with controls. The family set comprises half-sibling progeny from six sires. The progeny from four of these sires had previously been scanned with microsatellite markers. The results obtained from the current analysis of the family set yielded both some supporting and new results compared with those obtained in the earlier study. The results revealed 27 SNPs representing 18 chromosomes associated with incidence of BSE disease. These results confirm a region previously reported on chromosome 20, and identify additional regions on chromosomes 2, 14, 16, 21 and 28. This study did not identify a significant association near the PRNP in the family sample set. The only association found in the PRNP region was in the case-control sample set and this was not significant after multiple test correction. The genome scan of the case-control animals did not identify any associations that passed a stringent genome-wide significance threshold. Conclusions Several regions of the genome are statistically associated with the incidence of classical BSE in European Holstein cattle. Further investigation of loci on chromosomes 2, 14, 16, 20, 21 and 28 will be required to uncover any biological significance underlying these marker associations. PMID:20350325

Supporting breast-feeding when a woman is homeless.

PubMed

Crespo-Fierro, Michele; Lunney, Margaret

2011-01-01

This case study demonstrates use of standardized nursing languages in the care of new mothers in community settings. The author collected data from clinical practice as an instructor in a baccalaureate nursing program and from the research literature. The appropriate nursing diagnoses, outcomes, and interventions were identified in partnership with the new mother. This case shows that NANDA International (NANDA-I), the Nursing Outcomes Classification (NOC), and the Nursing Interventions Classification (NIC) are useful to direct nursing care in community settings. When teaching nursing students in a baccalaureate program, nurse faculty can use NANDA-I, NOC, and NIC classifications to guide the growing practice of nursing students in community settings. © 2011, The Authors. International Journal of Nursing Terminologies and Classifications © 2011, NANDA International.

National Defense University's Influence on U.S. National Security Policy: Case Study about the Center for the Study of Weapons of Mass Destruction

ERIC Educational Resources Information Center

Rondeau, Ann E.

2010-01-01

This dissertation touches on a series of events leading to an aspect of United States public policy dealing with weapons of mass destruction (WMD). After exploring the literature that describes the understanding of public policy, this paper uses the case study method to understand why and how a single research center and a particular set of…

Micro-scale Spatial Clustering of Cholera Risk Factors in Urban Bangladesh.

PubMed

Bi, Qifang; Azman, Andrew S; Satter, Syed Moinuddin; Khan, Azharul Islam; Ahmed, Dilruba; Riaj, Altaf Ahmed; Gurley, Emily S; Lessler, Justin

2016-02-01

Close interpersonal contact likely drives spatial clustering of cases of cholera and diarrhea, but spatial clustering of risk factors may also drive this pattern. Few studies have focused specifically on how exposures for disease cluster at small spatial scales. Improving our understanding of the micro-scale clustering of risk factors for cholera may help to target interventions and power studies with cluster designs. We selected sets of spatially matched households (matched-sets) near cholera case households between April and October 2013 in a cholera endemic urban neighborhood of Tongi Township in Bangladesh. We collected data on exposures to suspected cholera risk factors at the household and individual level. We used intra-class correlation coefficients (ICCs) to characterize clustering of exposures within matched-sets and households, and assessed if clustering depended on the geographical extent of the matched-sets. Clustering over larger spatial scales was explored by assessing the relationship between matched-sets. We also explored whether different exposures tended to appear together in individuals, households, and matched-sets. Household level exposures, including: drinking municipal supplied water (ICC = 0.97, 95%CI = 0.96, 0.98), type of latrine (ICC = 0.88, 95%CI = 0.71, 1.00), and intermittent access to drinking water (ICC = 0.96, 95%CI = 0.87, 1.00) exhibited strong clustering within matched-sets. As the geographic extent of matched-sets increased, the concordance of exposures within matched-sets decreased. Concordance between matched-sets of exposures related to water supply was elevated at distances of up to approximately 400 meters. Household level hygiene practices were correlated with infrastructure shown to increase cholera risk. Co-occurrence of different individual level exposures appeared to mostly reflect the differing domestic roles of study participants. Strong spatial clustering of exposures at a small spatial scale in a cholera endemic population suggests a possible role for highly targeted interventions. Studies with cluster designs in areas with strong spatial clustering of exposures should increase sample size to account for the correlation of these exposures.

Case Study Observational Research: A Framework for Conducting Case Study Research Where Observation Data Are the Focus.

PubMed

Morgan, Sonya J; Pullon, Susan R H; Macdonald, Lindsay M; McKinlay, Eileen M; Gray, Ben V

2017-06-01

Case study research is a comprehensive method that incorporates multiple sources of data to provide detailed accounts of complex research phenomena in real-life contexts. However, current models of case study research do not particularly distinguish the unique contribution observation data can make. Observation methods have the potential to reach beyond other methods that rely largely or solely on self-report. This article describes the distinctive characteristics of case study observational research, a modified form of Yin's 2014 model of case study research the authors used in a study exploring interprofessional collaboration in primary care. In this approach, observation data are positioned as the central component of the research design. Case study observational research offers a promising approach for researchers in a wide range of health care settings seeking more complete understandings of complex topics, where contextual influences are of primary concern. Future research is needed to refine and evaluate the approach.

Case-based retrieval framework for gene expression data.

PubMed

Anaissi, Ali; Goyal, Madhu; Catchpoole, Daniel R; Braytee, Ali; Kennedy, Paul J

2015-01-01

The process of retrieving similar cases in a case-based reasoning system is considered a big challenge for gene expression data sets. The huge number of gene expression values generated by microarray technology leads to complex data sets and similarity measures for high-dimensional data are problematic. Hence, gene expression similarity measurements require numerous machine-learning and data-mining techniques, such as feature selection and dimensionality reduction, to be incorporated into the retrieval process. This article proposes a case-based retrieval framework that uses a k-nearest-neighbor classifier with a weighted-feature-based similarity to retrieve previously treated patients based on their gene expression profiles. The herein-proposed methodology is validated on several data sets: a childhood leukemia data set collected from The Children's Hospital at Westmead, as well as the Colon cancer, the National Cancer Institute (NCI), and the Prostate cancer data sets. Results obtained by the proposed framework in retrieving patients of the data sets who are similar to new patients are as follows: 96% accuracy on the childhood leukemia data set, 95% on the NCI data set, 93% on the Colon cancer data set, and 98% on the Prostate cancer data set. The designed case-based retrieval framework is an appropriate choice for retrieving previous patients who are similar to a new patient, on the basis of their gene expression data, for better diagnosis and treatment of childhood leukemia. Moreover, this framework can be applied to other gene expression data sets using some or all of its steps.

Autoantibodies to MUC1 glycopeptides cannot be used as a screening assay for early detection of breast, ovarian, lung or pancreatic cancer

PubMed Central

Burford, B; Gentry-Maharaj, A; Graham, R; Allen, D; Pedersen, J W; Nudelman, A S; Blixt, O; Fourkala, E O; Bueti, D; Dawnay, A; Ford, J; Desai, R; David, L; Trinder, P; Acres, B; Schwientek, T; Gammerman, A; Reis, C A; Silva, L; Osório, H; Hallett, R; Wandall, H H; Mandel, U; Hollingsworth, M A; Jacobs, I; Fentiman, I; Clausen, H; Taylor-Papadimitriou, J; Menon, U; Burchell, J M

2013-01-01

Background: Autoantibodies have been detected in sera before diagnosis of cancer leading to interest in their potential as screening/early detection biomarkers. As we have found autoantibodies to MUC1 glycopeptides to be elevated in early-stage breast cancer patients, in this study we analysed these autoantibodies in large population cohorts of sera taken before cancer diagnosis. Methods: Serum samples from women who subsequently developed breast cancer, and aged-matched controls, were identified from UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) and Guernsey serum banks to formed discovery and validation sets. These were screened on a microarray platform of 60mer MUC1 glycopeptides and recombinant MUC1 containing 16 tandem repeats. Additional case–control sets comprised of women who subsequently developed ovarian, pancreatic and lung cancer were also screened on the arrays. Results: In the discovery (273 cases, 273 controls) and the two validation sets (UKCTOCS 426 cases, 426 controls; Guernsey 303 cases and 606 controls), no differences were found in autoantibody reactivity to MUC1 tandem repeat peptide or glycoforms between cases and controls. Furthermore, no differences were observed between ovarian, pancreatic and lung cancer cases and controls. Conclusion: This robust, validated study shows autoantibodies to MUC1 peptide or glycopeptides cannot be used for breast, ovarian, lung or pancreatic cancer screening. This has significant implications for research on the use of MUC1 in cancer detection. PMID:23652307

[Assessment of SUSARs. Clinical evaluation of single cases in terms of regulatory requirements].

PubMed

Wroblewski, H; Schmickler, M

2005-04-01

In the course of implementing the European directives on pharmaceutical law, focus is set on suspected unexpected serious adverse reactions (SUSARs). SUSARs are essential for expedited reporting to authorities and ethics committees. During on-line monitoring of the study, the investigator documents all adverse events. Serious adverse events are forwarded to the sponsor in due time. The sponsor identifies SUSARs for expedited reporting. Clinical causality assessment between the investigational product and the adverse event is substantial in this process. This requires a balanced clinical assessment of all case relevant aspects and information available reflecting the complexity of the specific case, which cannot be covered by algorithms in general. In the setting of on-line monitoring, SUSARs ensure the safety of the patient and the study. In addition, SUSARs are relevant for generation of the safety profile of the substance.

Effect of Active Case Finding on Prevalence and Transmission of Pulmonary Tuberculosis in Dhaka Central Jail, Bangladesh

PubMed Central

Banu, Sayera; Rahman, Md. Toufiq; Uddin, Mohammad Khaja Mafij; Khatun, Razia; Khan, Md. Siddiqur Rahman; Rahman, Md. Mojibur; Uddin, Syed Iftekhar; Ahmed, Tahmeed; Heffelfinger, James D.

2015-01-01

Background Understanding tuberculosis (TB) transmission dynamics is essential for establishing effective TB control strategies in settings where the burden and risk of transmission are high. The objectives of this study were to evaluate the effect of active screening on controlling TB transmission and also to characterize Mycobacterium tuberculosis strains for investigating transmission dynamics in a correctional setting. Methods The study was carried out in Dhaka Central Jail (DCJ), from October 2005 to February 2010. An active case finding strategy for pulmonary TB was established both at the entry point to the prison and inside the prison. Three sputum specimens were collected from all pulmonary TB suspects and subjected to smear microscopy, culture, and drug susceptibility testing as well as genotyping which included deletion analysis, spoligotyping and analysis of mycobacterial interspersed repetitive units (MIRU). Results A total of 60,585 inmates were screened during the study period. We found 466 inmates with pulmonary TB of whom 357 (77%) had positive smear microscopy results and 109 (23%) had negative smear microscopy results but had positive results on culture. The number of pulmonary TB cases declined significantly, from 49 cases during the first quarter to 8 cases in the final quarter of the study period (p=0.001). Deletion analysis identified all isolates as M. tuberculosis and further identified 229 (70%) strains as ‘modern’ and 100 (30%) strains as ‘ancestral’. Analysis of MIRU showed that 347 strains (85%) exhibited unique patterns, whereas 61 strains (15%) clustered into 22 groups. The largest cluster comprised eight strains of the Beijing M. tuberculosis type. The rate of recent transmission was estimated to be 9.6%. Conclusions Implementation of active screening for TB was associated with a decline in TB cases in DCJ. Implementation of active screening in prison settings might substantially reduce the national burden of TB in Bangladesh. PMID:25933377

Effect of active case finding on prevalence and transmission of pulmonary tuberculosis in Dhaka Central Jail, Bangladesh.

PubMed

Banu, Sayera; Rahman, Md Toufiq; Uddin, Mohammad Khaja Mafij; Khatun, Razia; Khan, Md Siddiqur Rahman; Rahman, Md Mojibur; Uddin, Syed Iftekhar; Ahmed, Tahmeed; Heffelfinger, James D

2015-01-01

Understanding tuberculosis (TB) transmission dynamics is essential for establishing effective TB control strategies in settings where the burden and risk of transmission are high. The objectives of this study were to evaluate the effect of active screening on controlling TB transmission and also to characterize Mycobacterium tuberculosis strains for investigating transmission dynamics in a correctional setting. The study was carried out in Dhaka Central Jail (DCJ), from October 2005 to February 2010. An active case finding strategy for pulmonary TB was established both at the entry point to the prison and inside the prison. Three sputum specimens were collected from all pulmonary TB suspects and subjected to smear microscopy, culture, and drug susceptibility testing as well as genotyping which included deletion analysis, spoligotyping and analysis of mycobacterial interspersed repetitive units (MIRU). A total of 60,585 inmates were screened during the study period. We found 466 inmates with pulmonary TB of whom 357 (77%) had positive smear microscopy results and 109 (23%) had negative smear microscopy results but had positive results on culture. The number of pulmonary TB cases declined significantly, from 49 cases during the first quarter to 8 cases in the final quarter of the study period (p=0.001). Deletion analysis identified all isolates as M. tuberculosis and further identified 229 (70%) strains as 'modern' and 100 (30%) strains as 'ancestral'. Analysis of MIRU showed that 347 strains (85%) exhibited unique patterns, whereas 61 strains (15%) clustered into 22 groups. The largest cluster comprised eight strains of the Beijing M. tuberculosis type. The rate of recent transmission was estimated to be 9.6%. Implementation of active screening for TB was associated with a decline in TB cases in DCJ. Implementation of active screening in prison settings might substantially reduce the national burden of TB in Bangladesh.

Diagnostic criteria for CRPS I: differences between patient profiles using three different diagnostic sets.

PubMed

Perez, Roberto S G M; Collins, Susan; Marinus, Johan; Zuurmond, Wouter W A; de Lange, Jaap J

2007-11-01

Complex Regional Pain Syndrome type I (CRPS I) is an illness which usually occurs due to major or minor tissue injury to the extremities. Because a unique pathophysiological mechanism for CRPS I has not yet been established, the diagnosis is based on observation and measurement of clinical symptoms and signs. In this study, a comparison was made between three sets of diagnostic criteria (the IASP, Bruehl et al. and Veldman et al.) based on patient reports and physicians' assessments of signs and symptoms associated with CRPS I, in 372 outpatients suspected of having CRPS I. Agreement between CRPS I diagnosis among the three sets was poor (kappa-range: 0.29-0.42), leading to positive CRPS I diagnoses according to Veldman et al.'s criteria in 218 cases (59%), according to the IASP in 268 cases (72%), and according to Bruehl et al. in 129 cases (35%). Significant differences in patient profiles were found between the diagnostic sets for the number of patients reporting continuing disproportionate pain, larger area affected than the initial trauma (both p<0.001), increase of symptoms due to exercise (p=0.009), edema (p=0.015), temperature asymmetry (p=0.015), hyperesthesia, allodynia (both p<0.001) and hyperalgesia (p=0.036). Similarly, significant differences emerged for physicians' observations of hyperesthesia and allodynia (both p<0.001). Highest combined values of sensitivity (SE) and specificity (SP) for the strongest cases of presence (n=108) or absence (n=62) of CRPS I were found for reported hyperesthesia (SE+SP:165%), allodynia (160%), observed color asymmetry (162%), hyperesthesia (157%), temperature asymmetry (154%) and edema (152%). The lack of agreement between the different diagnostic sets for CRPS I and the different clinical profiles that result from it may lead to different therapeutic and study populations, hampering adequate treatment and scientific development for this illness. We propose explicit reference to diagnostic criteria used in studies, and registration in trials of a broad variety of CRPS I features, as used in this study, to make subgroup phenotyping and post hoc analyses based on different diagnostic criteria possible.

Integrating evidence-based practices for increasing cancer screenings in safety net health systems: a multiple case study using the Consolidated Framework for Implementation Research.

PubMed

Liang, Shuting; Kegler, Michelle C; Cotter, Megan; Emily, Phillips; Beasley, Derrick; Hermstad, April; Morton, Rentonia; Martinez, Jeremy; Riehman, Kara

2016-08-02

Implementing evidence-based practices (EBPs) to increase cancer screenings in safety net primary care systems has great potential for reducing cancer disparities. Yet there is a gap in understanding the factors and mechanisms that influence EBP implementation within these high-priority systems. Guided by the Consolidated Framework for Implementation Research (CFIR), our study aims to fill this gap with a multiple case study of health care safety net systems that were funded by an American Cancer Society (ACS) grants program to increase breast and colorectal cancer screening rates. The initiative funded 68 safety net systems to increase cancer screening through implementation of evidence-based provider and client-oriented strategies. Data are from a mixed-methods evaluation with nine purposively selected safety net systems. Fifty-two interviews were conducted with project leaders, implementers, and ACS staff. Funded safety net systems were categorized into high-, medium-, and low-performing cases based on the level of EBP implementation. Within- and cross-case analyses were performed to identify CFIR constructs that influenced level of EBP implementation. Of 39 CFIR constructs examined, six distinguished levels of implementation. Two constructs were from the intervention characteristics domain: adaptability and trialability. Three were from the inner setting domain: leadership engagement, tension for change, and access to information and knowledge. Engaging formally appointed internal implementation leaders, from the process domain, also distinguished level of implementation. No constructs from the outer setting or individual characteristics domain differentiated systems by level of implementation. Our study identified a number of influential CFIR constructs and illustrated how they impacted EBP implementation across a variety of safety net systems. Findings may inform future dissemination efforts of EBPs for increasing cancer screening in similar settings. Moreover, our analytic approach is similar to previous case studies using CFIR and hence could facilitate comparisons across studies.

A balanced perspective: using nonfinancial measures to assess financial performance.

PubMed

Watkins, Ann L

2003-11-01

Assessments of hospitals' financial performance have traditionally been based exclusively on analysis of a concise set of key financial ratios. One study, however, demonstrates that analysis of a hospital's financial condition can be significantly enhanced with the addition of several nonfinancial measures, including case-mix adjusted admissions, case-mix adjusted admissions per full-time equivalent, and case-mix adjusted admissions per beds in service.

School Counseling Principles: Ethics and Law

ERIC Educational Resources Information Center

Stone, Carolyn

2006-01-01

This practical guide will sensitize the professional school counselor to legal and ethical issues involved in working with minors in school settings. Using a case study approach and more than 100 cases representing school counselors daily dilemmas, chapters help the reader connect the reality of school counseling to critical federal and state…

Attention Training with Auditory Hallucinations: A Case Study

ERIC Educational Resources Information Center

Valmaggia, Lucia R.; Bouman, Theo K.; Schuurman, Laura

2007-01-01

The case presented in this paper illustrates how Attention Training (ATT; [Wells, A. (1990). "Panic disorder in association with relaxation induced anxiety: An attentional training approach to treatment." "Behavior Therapy," 21, 273-280.]) can be applied in an outpatient setting in the treatment of auditory hallucinations. The 25-year-old male…

Implementing and Analyzing Social Media in Higher Education

ERIC Educational Resources Information Center

Davis, Jenny L.; Compton, D'Lane; Farris, D. Nicole; Love, Tony P.

2015-01-01

This article examines how social media can incorporate into the higher education setting in meaningful ways using optional participation, active content production, and active moderation. The authors use two authoethnographic case studies. The first case pertains to pedagogical use through a student created and maintained Facebook group for a…

The Vroom and Yetton Normative Leadership Model Applied to Public School Case Examples.

ERIC Educational Resources Information Center

Sample, John

This paper seeks to familiarize school administrators with the Vroom and Yetton Normative Leadership model by presenting its essential components and providing original case studies for its application to school settings. The five decision-making methods of the Vroom and Yetton model, including two "autocratic," two…

Characteristics of Pesticide Poisoning in Rural and Urban Settings in Uganda.

PubMed

Pedersen, Bastian; Ssemugabo, Charles; Nabankema, Victoria; Jørs, Erik

2017-01-01

Pesticide poisoning is a significant burden on health care systems in many low-income countries. This study evaluates cases of registered pesticide poisonings treated in selected rural (N = 101) and urban (N = 212) health facilities in Uganda from January 2010 to August 2016. In the urban setting, pesticides were the most prevalent single poison responsible for intoxications (N = 212 [28.8%]). Self-harm constituted a significantly higher proportion of the total number of poisonings in urban (63.3%) compared with rural areas (25.6%) where unintentional poisonings prevailed. Men were older than women and represented a majority of around 60% of the cases in both the urban and rural settings. Unintentional cases were almost the only ones seen below the age of 10, whereas self-harm dominated among adolescents and young persons from 10 to 29 years of age. Organophosphorus insecticides accounted for 73.0% of the poisonings. Urban hospitals provided a more intensive treatment and had registered fever complications than rural health care settings. To minimize self-harm with pesticides, a restriction of pesticide availability as shown to be effective in other low-income countries is recommended. Training of health care workers in proper diagnosis and treatment of poisonings and improved equipment in the health care settings should be strengthened.

Characteristics of Pesticide Poisoning in Rural and Urban Settings in Uganda

PubMed Central

Pedersen, Bastian; Ssemugabo, Charles; Nabankema, Victoria; Jørs, Erik

2017-01-01

Pesticide poisoning is a significant burden on health care systems in many low-income countries. This study evaluates cases of registered pesticide poisonings treated in selected rural (N = 101) and urban (N = 212) health facilities in Uganda from January 2010 to August 2016. In the urban setting, pesticides were the most prevalent single poison responsible for intoxications (N = 212 [28.8%]). Self-harm constituted a significantly higher proportion of the total number of poisonings in urban (63.3%) compared with rural areas (25.6%) where unintentional poisonings prevailed. Men were older than women and represented a majority of around 60% of the cases in both the urban and rural settings. Unintentional cases were almost the only ones seen below the age of 10, whereas self-harm dominated among adolescents and young persons from 10 to 29 years of age. Organophosphorus insecticides accounted for 73.0% of the poisonings. Urban hospitals provided a more intensive treatment and had registered fever complications than rural health care settings. To minimize self-harm with pesticides, a restriction of pesticide availability as shown to be effective in other low-income countries is recommended. Training of health care workers in proper diagnosis and treatment of poisonings and improved equipment in the health care settings should be strengthened. PMID:28615953

Narrative pedagogy with evolving case study--A transformative approach to gerontic nursing practice for undergraduate nursing students.

PubMed

Laver, Shaorn; Croxon, Lyn

2015-09-01

Engaging nursing students in the complexities of care across community, acute, rehabilitation and residential aged care settings is challenging. Equally challenging is conceptualising and promoting diverse and comprehensive health assessments across care settings that reflect clinical reality, inform clinical decision making, traverse theory and practice, and transform clinical practice knowledge. This article describes the use of narrative and evolving case study as a teaching-learning tool utilised by the authors in a third year undergraduate gerontic nursing subject in a pre-service nursing degree at a rural university. Principles of transformative learning and strengths based nursing were drawn upon in the development of the case study. The aim of the approach was to draw on embedded knowledge and the experiences of students and academics from assorted practice settings to facilitate understanding of the lived experiences of an older community dwelling couple. Using social learning strategies students were encouraged to analyse and think critically and creatively about the situations they were presented with. They identified possible solutions that would be acceptable to the couple. Building on the older couple's strengths, achievements and personal social capital, the aim was to develop a positive paradigm for health and the way older people are viewed by nursing students. Copyright © 2015 Elsevier Ltd. All rights reserved.

Urban Background Study Webinar

EPA Pesticide Factsheets

This webinar presented the methodology developed for collecting a city-wide or urban area background data set, general results of southeastern cities data collected to date, and a case study that used this sampling method.

Pathway-based analysis of GWAs data identifies association of sex determination genes with susceptibility to testicular germ cell tumors.

PubMed

Koster, Roelof; Mitra, Nandita; D'Andrea, Kurt; Vardhanabhuti, Saran; Chung, Charles C; Wang, Zhaoming; Loren Erickson, R; Vaughn, David J; Litchfield, Kevin; Rahman, Nazneen; Greene, Mark H; McGlynn, Katherine A; Turnbull, Clare; Chanock, Stephen J; Nathanson, Katherine L; Kanetsky, Peter A

2014-11-15

Genome-wide association (GWA) studies of testicular germ cell tumor (TGCT) have identified 18 susceptibility loci, some containing genes encoding proteins important in male germ cell development. Deletions of one of these genes, DMRT1, lead to male-to-female sex reversal and are associated with development of gonadoblastoma. To further explore genetic association with TGCT, we undertook a pathway-based analysis of SNP marker associations in the Penn GWAs (349 TGCT cases and 919 controls). We analyzed a custom-built sex determination gene set consisting of 32 genes using three different methods of pathway-based analysis. The sex determination gene set ranked highly compared with canonical gene sets, and it was associated with TGCT (FDRG = 2.28 × 10(-5), FDRM = 0.014 and FDRI = 0.008 for Gene Set Analysis-SNP (GSA-SNP), Meta-Analysis Gene Set Enrichment of Variant Associations (MAGENTA) and Improved Gene Set Enrichment Analysis for Genome-wide Association Study (i-GSEA4GWAS) analysis, respectively). The association remained after removal of DMRT1 from the gene set (FDRG = 0.0002, FDRM = 0.055 and FDRI = 0.009). Using data from the NCI GWA scan (582 TGCT cases and 1056 controls) and UK scan (986 TGCT cases and 4946 controls), we replicated these findings (NCI: FDRG = 0.006, FDRM = 0.014, FDRI = 0.033, and UK: FDRG = 1.04 × 10(-6), FDRM = 0.016, FDRI = 0.025). After removal of DMRT1 from the gene set, the sex determination gene set remains associated with TGCT in the NCI (FDRG = 0.039, FDRM = 0.050 and FDRI = 0.055) and UK scans (FDRG = 3.00 × 10(-5), FDRM = 0.056 and FDRI = 0.044). With the exception of DMRT1, genes in the sex determination gene set have not previously been identified as TGCT susceptibility loci in these GWA scans, demonstrating the complementary nature of a pathway-based approach for genome-wide analysis of TGCT. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Coffee, decaffeinated coffee, tea and cancer of the colon and rectum: a review of epidemiological studies, 1990-2003.

PubMed

Tavani, Alessandra; La Vecchia, Carlo

2004-10-01

The literature from 1990 to 2003 on the relation between coffee, decaffeinated coffee, tea and colorectal cancer risk has been reviewed. For the relation with coffee, three cohort (517 total cases) and nine case-control studies (7555 cases) analysed colon cancer; three cohort (307 cases) and four case-control studies (2704 cases) rectal cancer; six case-control studies (854 cases) colorectal cancer. For colon cancer most case-control studies found risk estimates below unity; the results are less clear for cohort studies. No relation emerged for rectal cancer. A meta-analysis, including five cohort and twelve case-control studies, reported a pooled relative risk of 0.76 (significant). Any methodological artefact is unlikely to account for the consistent inverse association in different countries and settings. Plausible biological explanations include coffee-related reductions of cholesterol, bile acids and neutral sterol secretion in the colon; antimutagenic properties of selected coffee components; increased colonic motility. Decaffeinated coffee was not related to either colon or rectal cancer in three case-control studies. No overall association between tea and either colon or rectal cancer risk emerged in seven cohort (1756 total cases of colon, 759 of rectal and 60 of colorectal cancer) and 12 case-control studies (8058 cases of colon, 4865 of rectal, 604 of colorectal cancer).

Development and Validation of the Minnesota Borderline Personality Disorder Scale

ERIC Educational Resources Information Center

Bornovalova, Marina A.; Hicks, Brian M.; Patrick, Christopher J.; Iacono, William G.; McGue, Matt

2011-01-01

Although large epidemiological data sets can inform research on the etiology and development of borderline personality disorder (BPD), they rarely include BPD measures. In some cases, however, proxy measures can be constructed using instruments already in these data sets. In this study, the authors developed and validated a self-report measure of…

Personal Perspectives about Sustaining Inclusion in School Environments for Children with High Functioning Autism

ERIC Educational Resources Information Center

Wiatr, Jeanne Malecki

2016-01-01

Students, at a partial hospital setting in Western Tennessee with high functioning autism spectrum disorders (HFASD) were being removed from general education classrooms. Researchers have indicated that restrictive settings preclude interaction with neurotypical peers and access to general education experiences. The purpose of this case study was…

Making the Case for Space: The Effect of Learning Spaces on Teaching and Learning

ERIC Educational Resources Information Center

Byers, Terry; Imms, Wesley; Hartnell-Young, Elizabeth

2014-01-01

An explanatory, mixed method study examined the impact of learning spaces on teachers' pedagogy, student engagement and student learning outcomes in a technology-rich school setting. Its quasi-experimental design allowed examination of differences in these variables between two settings--'traditional' classrooms, and 'new generation learning…

Information Provision in Emergency Settings: The Experience of Refugee Communities in Zambia

ERIC Educational Resources Information Center

Kanyengo, Brendah Kakulwa; Kanyengo, Christine Wamunyima

2011-01-01

This article identifies information provision services in emergency settings using Zambia as a case study by identifying innovative ways of providing library and information services. The thrust of the article is to analyze information management practices of organizations that work within refugee camps and how they take specific cognizance of the…

Exploring the Effects of Cultural Variables in the Implementation of Behavior-Based Safety in Two Organizations

ERIC Educational Resources Information Center

Bumstead, Alaina; Boyce, Thomas E.

2005-01-01

The present case study examines how culture can influence behavior-based safety in different organizational settings and how behavior-based safety can impact different organizational cultures. Behavior-based safety processes implemented in two culturally diverse work settings are described. Specifically, despite identical implementation plans,…

Perceptions and Perspectives of Music Teachers in Urban Settings: Isolation, Conversation and Collaboration

ERIC Educational Resources Information Center

Sindberg, Laura K.

2014-01-01

Seven teachers from three schools in a major metropolitan community in the upper Midwest region of the USA participated in this case study designed to better understand the nature of music teacher isolation and interaction in the urban setting. Data analysis revealed several themes: "experiences of isolation," "urban factors,"…

Creating Relational Spaces: Everyday Spirituality in Early Childhood Settings

ERIC Educational Resources Information Center

Bone, Jane

2008-01-01

This research addressed the question of how the spiritual experience of young children might be supported in early childhood educational settings. Qualitative case study research took place in three different contexts: a Montessori casa, a Rudolf Steiner kindergarten and a private preschool. Children aged 2 1/2-6 years, their parents and teachers…

Gestalt Therapy in a Social Psychiatric Setting: The 'Oil & Water' Solution.

ERIC Educational Resources Information Center

Neill, R. B.

1979-01-01

In this case study of a residential treatment center for emotionally disturbed adolescents, evaluative data demonstrated that Gestalt Therapy was neither designed nor intended for use in an institutional setting with severely disturbed young adolescents, with people of lower socioeconomic status or of low verbal skill and intelligence. (Author/SJL)

Toward Integrated Family Services in Rural Settings: A Summary of Research and Practice. Program Report.

ERIC Educational Resources Information Center

Stoops, Jack W.; Hull, Janis L.

This report synthesizes research findings with observations of three Pacific Northwest sites attempting service integration in rural settings. At case-study sites in Washington and Oregon, rural schools, communities, and service providers collaborate to deliver services to students and community members suffering from high unemployment, alcohol…

Legionnaires' disease outbreak in an automobile engine manufacturing plant.

PubMed

Fry, Alicia M; Rutman, Miai; Allan, Terry; Scaife, Heidi; Salehi, Ellen; Benson, Robert; Fields, Barry; Nowicki, Scott; Parrish, Mary Kay; Carpenter, Joseph; Brown, Ellen; Lucas, Claressa; Horgan, Timothy; Koch, Elizabeth; Besser, Richard E

2003-03-15

We investigated 4 cases of legionnaires' disease (LD) reported among workers at an Ohio automotive plant in March 2001. A "confirmed" case of LD was defined as x-ray-confirmed pneumonia and a confirmatory laboratory test. A "possible" case of LD was defined as elevated titers of antibody and respiratory symptoms. Legionella pneumophila serogroup 1 (LP1) was isolated from 1 case patient. Legionella was isolated from 18 (9%) of 197 environmental samples; 3 isolates were LP1 but did not match the case isolate. We conducted a case-control study; 17 case patients with confirmed or possible LD and 86 control subjects (workers with low antibody titers and without symptoms) were enrolled. Visiting a specific cleaning line (odds ratio, [OR], 7.29; 95% confidence interval [CI], 2.31-23.00) and working in the cleaning region of the plant (OR, 3.22; 95% CI, 1.11-9.38) were associated with LD. LD can be transmitted in industrial settings in which aerosols are produced. Clinicians should consider LD when treating persons from these settings for pneumonia.

Risk assessment for patient perpetrated violence: Analysis of three assaults against healthcare workers.

PubMed

Bresler, Scott; Gaskell, Michael B

2015-01-01

Workplace violence in healthcare settings is a complex topic with many different environments in which aggression is sometimes expressed by patients toward those entrusted with providing their healthcare. The assessment of violence risk in a nursing home containing many patients with organic brain syndrome is quite distinct from assessment in forensic psychiatric units, inner city emergency rooms, or outpatient pain clinics. Three cases are presented that are composite summaries of actual assaults which took place across different hospital settings, all within an urban Midwestern city in the United States: (1) an emergency department; (2) a psychiatric emergency services (PES) center; (3) a short stay (typically 72 hours to 5 days) civil psychiatric inpatient unit. These case studies exemplify specific risk factors that violent patients have, depending upon the specific healthcare setting where the patient presents. Research is cited relevant to all three case studies and how one should assess their risk. Lastly, the complexity of this issue is highlighted by a brief discussion of the pitfalls entailed in profiling ``the dangerous patient.'' It is demonstrated that when violence is expressed by a patient toward a healthcare provider, it is usually a maladaptive response, one in which characteristics of that setting and behavior of those who work within it must be carefully considered when determining what factors precipitated the patient's violent act.

Child protection assessment in humanitarian emergencies: case studies from Georgia, Gaza, Haiti and Yemen.

PubMed

Ager, Alastair; Blake, Courtney; Stark, Lindsay; Daniel, Tsufit

2011-12-01

The paper reviews the experiences of conducting child protection assessments across four humanitarian emergencies where violence and insecurity, directly or indirectly, posed a major threat to children. We seek to identify common themes emerging from these experiences and propose ways to guide the planning and implementation of assessments that effectively identify, and suggest means of response to, threats to children's rights and well-being in emergency settings. In the context of a field evaluation of an inter-agency resource kit, crisis settings where an inter-agency assessment of child protection had been considered in the period August 2008 to July 2010 were identified. Email correspondence, telephone-based structured interviews and documentary review collated information from child protection coordinating agencies from a total of twenty sites, the minority of which had proceeded to complete an assessment. This paper presents case studies of the experience in Georgia (following the conflict between Russian and Georgian forces in August 2008), Gaza (following the Israeli military incursion beginning in December 2008), Haiti (following the earthquake of January 2010), and Yemen (following the ceasefire agreement between the government and rebel forces in early 2010). CASE STUDY FINDINGS: In each setting the context of the humanitarian emergency is outlined. The processes of the planning (and, where appropriate, implementation) of the child protection assessment is described. Where available, the findings of the child protection assessment and their use in shaping interventions are summarized. Case studies document experience across humanitarian settings widely divergent in terms of the nature of the emergency, social-political context, and institutional capacity. Despite such differences, analysis suggests securing inter-agency coordination, preparation and capacity building, and means of ensuring timeliness of findings to be recurrent themes in the effective mobilization of an effective assessment able to inform programming. Copyright © 2011 Elsevier Ltd. All rights reserved.

A meta-analysis of single-case research on the use of tablet-mediated interventions for persons with ASD.

PubMed

Hong, Ee Rea; Gong, Li-Yuan; Ninci, Jennifer; Morin, Kristi; Davis, John L; Kawaminami, Sawako; Shi, Yan-Qiu; Noro, Fumiyuki

2017-11-01

There is a growing amount of single-case research literature on the benefits of tablet-mediated interventions for individuals with autism spectrum disorder (ASD). With the development of tablet-based computers, tablet-mediated interventions have been widely utilized for education and treatment purposes; however, the overall quality and evidence of this literature-base are unknown. This article aims to present a quality review of the single-case experimental literature and aggregate results across studies involving the use of tablet-mediated interventions for individuals with ASD. Using the Tau nonoverlap effect size measure, the authors extracted data from single-case experimental studies and calculated effect sizes differentiated by moderator variables. The moderator variables included the ages of participants, participants' diagnoses, interventions, outcome measures, settings, and contexts. Results indicate that tablet-mediated interventions for individuals with ASD have moderate to large effect sizes across the variables evaluated. The majority of research in this review used tablets for video modeling and augmentative and alternative communication. To promote the usability of tablet-mediated interventions for individuals with ASD, this review indicates that more single-case experimental studies should be conducted with this population in naturalistic home, community, and employment settings. Copyright © 2017 Elsevier Ltd. All rights reserved.

Measuring Inviting School Climate: A Case Study of a Public Primary School in an Urban Low Socioeconomic Setting in Kenya

ERIC Educational Resources Information Center

Okaya, Tom Mboya; Horne, Marj; Lamig, Madeleine; Smith, Kenneth H.

2013-01-01

The present study utilized the Inviting School Survey-Revised (ISS-R) (Smith, 2005b, 2013) based on Invitational Theory and Practice (Purkey & Novak, 2008) to examine the school climate of a public primary school in a low urban socio-economic setting in Kenya. School climate was defined as the perceptions of primary school teachers and pupils…

Virtual Schooling through the Eyes of an At-Risk Student: A Case Study

ERIC Educational Resources Information Center

Barbour, Michael K.; Siko, Jason P.

2012-01-01

While much of the growth in the popularity of virtual schooling has involved at-risk students, little research exists on the experiences of these students in this largely independent setting. This paper describes a case study of an at-risk student in a rural school in the province of Newfoundland and Labrador who was enrolled in an online course…

Leading Change: A Case Study of Leadership Practices from the Development of the Niagara County Community College Culinary Institute

ERIC Educational Resources Information Center

Caton, Jazmin; Mistriner, Mark

2016-01-01

The purpose of this case study was to evaluate the lessons learned from the development of a project that set out to revitalize an economically depressed area with an innovative approach to workforce development through partnerships. The focus was to utilize the development of the Niagara County Community College Culinary Institute as an example…

SMART Moves? A Case Study of One Teacher's Pedagogical Change through Use of the Interactive Whiteboard

ERIC Educational Resources Information Center

Mohon, Elizabeth H.

2008-01-01

This case study investigates how the use of an interactive whiteboard (IWB) leads to pedagogical change within a UK secondary school classroom. A teacher's experiences as recorded in a reflective journal, and the responses of students as recorded in a questionnaire, are set within the context of rhetoric about the value of IWBs. It is argued that…

Samatha, Matthew, and Shane: A Case Study of the Motivational Factors That Drive These Triplets To Learn.

ERIC Educational Resources Information Center

Holmes, Julie A.

This paper describes a case study which sought to determine the motivational factors that prompted a set of triplets to excel in school. The working research questions dealt with different facets of school and home, and explored whether motivation was linked to certain subjects or certain topics within various subjects or was a function of the…

A Case Study Examining How Students Make Meaning out of Using Facebook as a Virtual Learning Community at a Midwestern University

ERIC Educational Resources Information Center

Hilscher, Jerome

2013-01-01

The purpose of this qualitative case study was to explore how peer mentors make meaning out of using Facebook as a virtual learning community. With the prevalence of Facebook usage by college students, and the introduction of Facebook into academic settings by educators, program facilitators, administrators, and recruiters, researchers have begun…

Global Citizenship Education within a Context of Accountability and 21st Century Skills: The Case of Olympus High School

ERIC Educational Resources Information Center

DiCicco, Marzia Cozzolino

2016-01-01

This article addresses the present gap in empirical research on the possibilities and challenges of global citizenship education in U.S. public schools by presenting findings from a five-year, ethnographic case study. The setting for this study is Olympus High School, a small, suburban public high school in Pennsylvania. Beginning in the 2009-2010…

A Case Study about the Use of E-Portfolio Assessment for Secondary Students with and without Disabilities in an Inclusive Classroom

ERIC Educational Resources Information Center

Ferrer-Montes, Janette

2013-01-01

This single case study examined how one inner city high school math teacher used e-portfolio assessment in an inclusive classroom setting. Specifically, it describes the teacher's perceptions and use of e-portfolio assessment, and its relationships to curricular content, as well as how the relationships among e-portfolio assessment,…

Ethnography's Capacity to Contribute to the Cumulation of Theory: A Case Study of Differentiation-Polarisation Theory

ERIC Educational Resources Information Center

Hillyard, Sam

2010-01-01

The paper sets out to examine the role that ethnographic work can and should play in the development of sociological theory, focusing on the case study of differentiation-polarisation theory. It provides a detailed discussion of the work of Hargreaves (1967), Lacey (1970) and Ball (1981) and assesses the degree to which their work was ethnographic…

Not Just a Walk in the Park: Case Study of a Greek Preschool Located on an Educational Farm

ERIC Educational Resources Information Center

Iskos, Eugenia; Karakosta, Stella

2015-01-01

This paper presents a case study of a private preschool in Thessaloniki, Greece. The school, located at the unique setting of an educational farm, has a curriculum focus on environmental education. An analysis of teacher interviews and lesson plans in the span of three years presents insights into the barriers teachers faced in implementing their…

Student Teachers of Technology and Design into Industry: A Northern Ireland Case Study

ERIC Educational Resources Information Center

Gibson, Ken

2013-01-01

This paper, based in Northern Ireland, is a case study of an innovative programme which places year 3 B.Ed. post-primary student teachers of Technology and Design into industry for a five-day period. The industrial placement programme is set in an international context of evolving pre-service field placements and in a local context defined by the…

Exploring Situational Factors Shaping Access in a Laptop Program for Socially Disadvantaged Children in India: A Case Study

ERIC Educational Resources Information Center

Padmanabhan, Poornima; Wise, Alyssa Friend

2012-01-01

Low-cost laptop programs attempt to address gaps in access to computers in developing countries. However, the translation of computing access from intention to actuality is mediated by many situational factors. This research presents a case study of how access to a set of laptops donated to a school for socially disadvantaged children in India was…

Making Sense of Social Justice Leadership: A Case Study of a Principal's Experiences to Create a More Inclusive School

ERIC Educational Resources Information Center

DeMatthews, David

2015-01-01

Social justice leadership in high-poverty urban schools is complex. Principals experience a range of feelings and emotions while practicing social justice leadership with implications on their leadership. This article presents a qualitative case study of an elementary school principal in an urban setting and how she led to create a more inclusive…

Public School Desegregation/Redesign: A Case Study in East Baton Rouge Parish, Louisiana. Urban Education Reports Number Fourteen.

ERIC Educational Resources Information Center

Stone, Frank Andrews

This publication presents a case study of the public school desegregation and redesign program of the East Baton Rouge Parish (Louisiana) School System, focusing on the 5 years from 1987 to 1992. Chapter 1 describes the setting and background, the sociocultural history of the area since pre-Revolutionary War days, the role and treatment of African…

Hyperendemic pulmonary tuberculosis in peri-urban areas of Karachi, Pakistan

PubMed Central

Akhtar, Saeed; White, Franklin; Hasan, Rumina; Rozi, Shafquat; Younus, Mohammad; Ahmed, Faiza; Husain, Sara; Khan, Bilquis Sana

2007-01-01

Background Currently there are very limited empirical data available on the prevalence of pulmonary tuberculosis among residents of marginalized settings in Pakistan. This study assessed the prevalence of pulmonary tuberculosis through active case detection and evaluated predictors of pulmonary tuberculosis among residents of two peri-urban neighbourhoods of Karachi, Pakistan. Methods A cross-sectional study was conducted in two peri-urban neighbourhoods from May 2002 to November 2002. Systematic sampling design was used to select households for inclusion in the study. Consenting subjects aged 15 years or more from selected households were interviewed and, whenever possible, sputum samples were obtained. Sputum samples were subjected to direct microscopy by Ziehl-Neelson method, bacterial culture and antibiotic sensitivity tests. Results The prevalence (per 100,000) of pulmonary tuberculosis among the subjects aged 15 years or more, who participated in the study was 329 (95% confidence interval (CI): 195 – 519). The prevalence (per 100,000) of pulmonary tuberculosis adjusted for non-sampling was 438 (95% CI: 282 – 651). Other than cough, none of the other clinical variables was significantly associated with pulmonary tuberculosis status. Analysis of drug sensitivity pattern of 15 strains of Mycobacterium tuberculosis revealed that one strain was resistant to isoniazid alone, one to streptomycin alone and one was resistant to isoniazid and streptomycin. The remaining 12 strains were susceptible to all five drugs including streptomycin, isoniazid, rifampicin, ethambutol, and pyrazinamide. Conclusion This study of previously undetected tuberculosis cases in an impoverished peri-urban setting reveals the poor operational performance of Pakistan's current approach to tuberculosis control; it also demonstrates a higher prevalence of pulmonary tuberculosis than current national estimates. Public health authorities may wish to augment health education efforts aimed at prompting health-seeking behaviour to facilitate more complete and earlier case detection. Such efforts to improve passive case-finding, if combined with more accessible DOTS infra-structure for treatment of detected cases, may help to diminish the high tuberculosis-related morbidity and mortality in marginalized populations. The economics of implementing a more active approach to case finding in resource-constrained setting also deserve further study. PMID:17477870

Studies in Course Design. Volume 1. Case Study I: One Year Postgraduate Course in Teaching for Biology Graduates. Case Study II: A Course for Teachers in General Medical Practice.

ERIC Educational Resources Information Center

Dallas, Dorothy; And Others

A collection of working papers from the course design process of two education courses is presented with attention focused on the category systems employed to set out course objectives and methods. The two studies illustrate the use of a grid to establish the relationships between various course objectives. The first collection of papers is based…

The time course of cancer detection performance

NASA Astrophysics Data System (ADS)

Taylor-Phillips, Sian; Clarke, Aileen; Wallis, Matthew; Wheaton, Margot; Duncan, Alison; Gale, Alastair G.

2011-03-01

The purpose of this study was to measure how mammography readers' performance varies with time of day and time spent reading. This was investigated in screening practice and when reading an enriched case set. In screening practice records of time and date that each case was read, along with outcome (whether the woman was recalled for further tests, and biopsy results where performed) was extracted from records from one breast screening centre in UK (4 readers). Patterns of performance with time spent reading was also measured using an enriched test set (160 cases, 41% malignant, read three times by eight radiologists). Recall rates varied with time of day, with different patterns for each reader. Recall rates decreased as the reading session progressed both when reading the enriched test set and in screening practice. Further work is needed to expand this work to a greater number of breast screening centres, and to determine whether these patterns of performance over time can be used to optimize overall performance.

Data Mining of Extremely Large Ad-Hoc Data Sets to Produce Reverse Web-Link Graphs

DTIC Science & Technology

2017-03-01

in most of the MR cases. From these studies , we also learned that computing -optimized instances should be chosen for serialized/compressed input data...maximum 200 words) Data mining can be a valuable tool, particularly in the acquisition of military intelligence. As the second study within a larger Naval...open web crawler data set Common Crawl. Similar to previous studies , this research employs MapReduce (MR) for sorting and categorizing output value

[Analysis of characteristics of acute poisoning caused by various poisons in Guangxi, China].

PubMed

Hu, De-hong; Zhang, Zhen-ming; Liu, Qing-hua; Jiang, Dong-fang

2013-11-01

To investigate the characteristics of acute poisonings caused by various poisons in Guangxi, China. A retrospective investigation was performed in 5859 cases of acute poisonings who were admitted to 63 hospitals in 11 cities, as well as 531 types of poisons involved. The poisons were categorized into 6 groups; each group of cases was stratified by the rural or urban settings, frequency of poisoning, and cause of poisoning to analyze the numbers of cases and constituent ratios. Most types of poisons (68.74%) belonged to drugs (217 types) and pesticides (148 types). Most cases of poisonings (61.63%) were caused by pesticides (n = 2547) and chemicals (n = 1064). Pesticides, poisons of plant origins, and poisons of animal origins were responsible for most of the cases in rural settings; 88.46%, 79.10%, and 66.74% of the cases of these poison categories happened in rural settings. Chemicals, drugs, and other poisons were responsible for most of the cases in urban settings; 70.20%, 61.74%, and 63.73% of the cases of these poison categories happened in urban settings. The numbers of cases in 5-year-poisoning groups were the highest in all categories of poisons, accounting for 85.24%, 88.57%, 55.16%, 70.79%, 68.36%, and 66.44%of cases of respective categories. Most cases of poisonings by chemicals, poisons of animal origin, and other poisons were accident-related (86.24%, 72.66%, and 46.71%of the poison categories). Most cases of poisonings by pesticides and drugs were suicide-related (59.39% and 33.52% of the poison categories). Most cases by poisons of plant origin were caused by accidental ingestion (70.36% of the poison category). Most of the acute poisonings in Guangxi area are caused by pesticides and chemicals; the most common causes of poisoning are accidents, accidental ingestion, and suicide. There are significant differences in the causes of acute poisonings between the urban and rural settings.

Traction force during vacuum extraction: a prospective observational study.

PubMed

Pettersson, K; Ajne, J; Yousaf, K; Sturm, D; Westgren, M; Ajne, G

2015-12-01

To investigate the traction force employed during vacuum extractions. Observational cross-sectional study. Obstetric Department, Karolinska University Hospital, Sweden, and the Swedish National Congress of Obstetrics and Gynaecology, 2013. Two hundred women with vacuum extraction at term and 130 obstetricians participating in a simulated setting. In a normal clinical setting, we used a specially adapted device to measure and record the force used to undertake vacuum extraction. In a subsequent part of the study, the force employed for vacuum extraction by a group of obstetricians in a fictive setting was estimated and objectively measured. Applied force during vacuum extraction in relation to the estimated level of difficulty in the delivery; perinatal diagnoses of asphyxia or head trauma; estimated force compared with objectively measured force employed in the fictive setting. The median (minimum-maximum) peak forces for minimum, average and excessive vacuum extraction in the clinical setting were 176 N (5-360 N), 225 N (115-436 N), and 241 N (164-452 N), respectively. In 34% of cases a force in excess of 216 N was employed. There was no correlation between the umbilical arterial pH at delivery and the traction force employed during extraction. Four cases of mild hypoxic ischaemic encephalopathy were observed, three of which were associated with a delivery whereby excessive traction force was employed during the vacuum extraction. In the fictive setting, the actual exerted force was twice the quantitative estimation. The measured forces in the clinical setting were four times higher than that estimated in the fictive setting. Higher than expected levels of traction force were used for vacuum extraction delivery. As obstetricians tend to underestimate the force applied during vacuum extraction, objective measurement with instantaneous feedback may be valuable in raising awareness. © 2015 Royal College of Obstetricians and Gynaecologists.

Association of High Myopia with Crystallin Beta A4 (CRYBA4) Gene Polymorphisms in the Linkage-Identified MYP6 Locus

PubMed Central

Ho, Daniel W. H.; Yap, Maurice K. H.; Ng, Po Wah; Fung, Wai Yan; Yip, Shea Ping

2012-01-01

Background Myopia is the most common ocular disorder worldwide and imposes tremendous burden on the society. It is a complex disease. The MYP6 locus at 22 q12 is of particular interest because many studies have detected linkage signals at this interval. The MYP6 locus is likely to contain susceptibility gene(s) for myopia, but none has yet been identified. Methodology/Principal Findings Two independent subject groups of southern Chinese in Hong Kong participated in the study an initial study using a discovery sample set of 342 cases and 342 controls, and a follow-up study using a replication sample set of 316 cases and 313 controls. Cases with high myopia were defined by spherical equivalent ≤ -8 dioptres and emmetropic controls by spherical equivalent within ±1.00 dioptre for both eyes. Manual candidate gene selection from the MYP6 locus was supported by objective in silico prioritization. DNA samples of discovery sample set were genotyped for 178 tagging single nucleotide polymorphisms (SNPs) from 26 genes. For replication, 25 SNPs (tagging or located at predicted transcription factor or microRNA binding sites) from 4 genes were subsequently examined using the replication sample set. Fisher P value was calculated for all SNPs and overall association results were summarized by meta-analysis. Based on initial and replication studies, rs2009066 located in the crystallin beta A4 (CRYBA4) gene was identified to be the most significantly associated with high myopia (initial study: P = 0.02; replication study: P = 1.88e-4; meta-analysis: P = 1.54e-5) among all the SNPs tested. The association result survived correction for multiple comparisons. Under the allelic genetic model for the combined sample set, the odds ratio of the minor allele G was 1.41 (95% confidence intervals, 1.21-1.64). Conclusions/Significance A novel susceptibility gene (CRYBA4) was discovered for high myopia. Our study also signified the potential importance of appropriate gene prioritization in candidate selection. PMID:22792142

Open wounds of the Achilles tendon in tropical settings: 36 cases at the Donka University Hospital in Guinea Conakry.

PubMed

Lamah, L; Diallo, M; Tékpa, J B D; Bah, M L; Keita, K; Sidime, S; Soumah, M T; Diallo, I

2017-06-01

The aim of this study was to analyze the epidemiologic, etiologic, and therapeutic aspects of open wounds of the Achilles tendon managed in the Donka University Hospital. This 3-year prospective included all patients admitted for an Achilles tendon injury. Closed injuries, suppurating wounds, and those that occurred more than 24 hours before admission were excluded. Surgical treatment consisted in debridement and tendon repair, with plaster cast protection for 6 weeks. The study included 36 patients with a mean age of 23.4 years, 29 of whom were male. The primary cause was traffic accidents (n = 21), mainly due to motorcycle taxis (n = 18). The mean follow-up was 9 months. Infection (7 cases) and skin necrosis (5 cases) were the main postoperative complications. The functional result, evaluated by the McComis score, was excellent in 20 cases, good or satisfactory in 10, and poor in 6 cases. Open injuries of the Achilles tendon are common in Guinea-Conakry and mostly due to motorcycle taxis. Outcome of surgical treatment depends on the severity of the injury. Infection and skin necrosis are frequent complications, and their management is challenging in this setting.

A power comparison of generalized additive models and the spatial scan statistic in a case-control setting.

PubMed

Young, Robin L; Weinberg, Janice; Vieira, Verónica; Ozonoff, Al; Webster, Thomas F

2010-07-19

A common, important problem in spatial epidemiology is measuring and identifying variation in disease risk across a study region. In application of statistical methods, the problem has two parts. First, spatial variation in risk must be detected across the study region and, second, areas of increased or decreased risk must be correctly identified. The location of such areas may give clues to environmental sources of exposure and disease etiology. One statistical method applicable in spatial epidemiologic settings is a generalized additive model (GAM) which can be applied with a bivariate LOESS smoother to account for geographic location as a possible predictor of disease status. A natural hypothesis when applying this method is whether residential location of subjects is associated with the outcome, i.e. is the smoothing term necessary? Permutation tests are a reasonable hypothesis testing method and provide adequate power under a simple alternative hypothesis. These tests have yet to be compared to other spatial statistics. This research uses simulated point data generated under three alternative hypotheses to evaluate the properties of the permutation methods and compare them to the popular spatial scan statistic in a case-control setting. Case 1 was a single circular cluster centered in a circular study region. The spatial scan statistic had the highest power though the GAM method estimates did not fall far behind. Case 2 was a single point source located at the center of a circular cluster and Case 3 was a line source at the center of the horizontal axis of a square study region. Each had linearly decreasing logodds with distance from the point. The GAM methods outperformed the scan statistic in Cases 2 and 3. Comparing sensitivity, measured as the proportion of the exposure source correctly identified as high or low risk, the GAM methods outperformed the scan statistic in all three Cases. The GAM permutation testing methods provide a regression-based alternative to the spatial scan statistic. Across all hypotheses examined in this research, the GAM methods had competing or greater power estimates and sensitivities exceeding that of the spatial scan statistic.

A power comparison of generalized additive models and the spatial scan statistic in a case-control setting

PubMed Central

2010-01-01

Background A common, important problem in spatial epidemiology is measuring and identifying variation in disease risk across a study region. In application of statistical methods, the problem has two parts. First, spatial variation in risk must be detected across the study region and, second, areas of increased or decreased risk must be correctly identified. The location of such areas may give clues to environmental sources of exposure and disease etiology. One statistical method applicable in spatial epidemiologic settings is a generalized additive model (GAM) which can be applied with a bivariate LOESS smoother to account for geographic location as a possible predictor of disease status. A natural hypothesis when applying this method is whether residential location of subjects is associated with the outcome, i.e. is the smoothing term necessary? Permutation tests are a reasonable hypothesis testing method and provide adequate power under a simple alternative hypothesis. These tests have yet to be compared to other spatial statistics. Results This research uses simulated point data generated under three alternative hypotheses to evaluate the properties of the permutation methods and compare them to the popular spatial scan statistic in a case-control setting. Case 1 was a single circular cluster centered in a circular study region. The spatial scan statistic had the highest power though the GAM method estimates did not fall far behind. Case 2 was a single point source located at the center of a circular cluster and Case 3 was a line source at the center of the horizontal axis of a square study region. Each had linearly decreasing logodds with distance from the point. The GAM methods outperformed the scan statistic in Cases 2 and 3. Comparing sensitivity, measured as the proportion of the exposure source correctly identified as high or low risk, the GAM methods outperformed the scan statistic in all three Cases. Conclusions The GAM permutation testing methods provide a regression-based alternative to the spatial scan statistic. Across all hypotheses examined in this research, the GAM methods had competing or greater power estimates and sensitivities exceeding that of the spatial scan statistic. PMID:20642827

Reducing selection bias in case-control studies from rare disease registries.

PubMed

Cole, J Alexander; Taylor, John S; Hangartner, Thomas N; Weinreb, Neal J; Mistry, Pramod K; Khan, Aneal

2011-09-12

In clinical research of rare diseases, where small patient numbers and disease heterogeneity limit study design options, registries are a valuable resource for demographic and outcome information. However, in contrast to prospective, randomized clinical trials, the observational design of registries is prone to introduce selection bias and negatively impact the validity of data analyses. The objective of the study was to demonstrate the utility of case-control matching and the risk-set method in order to control bias in data from a rare disease registry. Data from the International Collaborative Gaucher Group (ICGG) Gaucher Registry were used as an example. A case-control matching analysis using the risk-set method was conducted to identify two groups of patients with type 1 Gaucher disease in the ICGG Gaucher Registry: patients with avascular osteonecrosis (AVN) and those without AVN. The frequency distributions of gender, decade of birth, treatment status, and splenectomy status were presented for cases and controls before and after matching. Odds ratios (and 95% confidence intervals) were calculated for each variable before and after matching. The application of case-control matching methodology results in cohorts of cases (i.e., patients with AVN) and controls (i.e., patients without AVN) who have comparable distributions for four common parameters used in subject selection: gender, year of birth (age), treatment status, and splenectomy status. Matching resulted in odds ratios of approximately 1.00, indicating no bias. We demonstrated bias in case-control selection in subjects from a prototype rare disease registry and used case-control matching to minimize this bias. Therefore, this approach appears useful to study cohorts of heterogeneous patients in rare disease registries.

Political Impetus: Towards a Successful Agenda-Setting for Inclusive Health Policies in Low- and Middle-Income Countries Comment on "Shaping the Health Policy Agenda: The Case of Safe Motherhood Policy in Vietnam".

PubMed

Yang, Xiaoguang; Qian, Xu

2016-02-04

Agenda-setting is a crucial step for inclusive health policies in the low- and middle-income countries (LMICs). Enlightened by Ha et al manuscript, this commentary paper argues that 'political impetus' is the key to the successful agenda-setting of health policies in LMICs, though other determinants may also play the role during the process. This Vietnamese case study presents a good example for policy-makers of other LMICs; it offers insights for contexts where there are limited health resources and poor health performance. Further research which compares various stages of the health policy process across countries, is much needed. © 2016 by Kerman University of Medical Sciences.

The medline UK filter: development and validation of a geographic search filter to retrieve research about the UK from OVID medline.

PubMed

Ayiku, Lynda; Levay, Paul; Hudson, Tom; Craven, Jenny; Barrett, Elizabeth; Finnegan, Amy; Adams, Rachel

2017-07-13

A validated geographic search filter for the retrieval of research about the United Kingdom (UK) from bibliographic databases had not previously been published. To develop and validate a geographic search filter to retrieve research about the UK from OVID medline with high recall and precision. Three gold standard sets of references were generated using the relative recall method. The sets contained references to studies about the UK which had informed National Institute for Health and Care Excellence (NICE) guidance. The first and second sets were used to develop and refine the medline UK filter. The third set was used to validate the filter. Recall, precision and number-needed-to-read (NNR) were calculated using a case study. The validated medline UK filter demonstrated 87.6% relative recall against the third gold standard set. In the case study, the medline UK filter demonstrated 100% recall, 11.4% precision and a NNR of nine. A validated geographic search filter to retrieve research about the UK with high recall and precision has been developed. The medline UK filter can be applied to systematic literature searches in OVID medline for topics with a UK focus. © 2017 Crown copyright. Health Information and Libraries Journal © 2017 Health Libraries GroupThis article is published with the permission of the Controller of HMSO and the Queen's Printer for Scotland.

Epidemiology of Pediatric Convulsive Status Epilepticus With Fever in the Emergency Department: A Cohort Study of 381 Consecutive Cases.

PubMed

Hayakawa, Itaru; Miyama, Sahoko; Inoue, Nobuaki; Sakakibara, Hiroshi; Hataya, Hiroshi; Terakawa, Toshiro

2016-09-01

Pediatric convulsive status epilepticus with fever is common in the emergency setting but leads to severe neurological sequelae in some patients. To explore the epidemiology of convulsive status epilepticus with fever, a retrospective cohort covering all convulsive status epilepticus cases with fever seen in the emergency department of a tertiary care children's hospital were consecutively collected. Of the 381 consecutive cases gathered, 81.6% were due to prolonged febrile seizure, 6.6% to encephalopathy/encephalitis, 0.8% to meningitis, and 7.6% to epilepsy. In addition, seizures were significantly longer in encephalopathy/encephalitis cases than in prolonged febrile seizure cases (log rank test, P < .001). These results provide for the first time the pretest probability of final diagnoses in children with convulsive status epilepticus with fever in the emergency setting, and will help optimize the management of pediatric patients presenting to the emergency department with convulsive status epilepticus with fever. © The Author(s) 2016.

Subject-specific cardiovascular system model-based identification and diagnosis of septic shock with a minimally invasive data set: animal experiments and proof of concept.

PubMed

Chase, J Geoffrey; Lambermont, Bernard; Starfinger, Christina; Hann, Christopher E; Shaw, Geoffrey M; Ghuysen, Alexandre; Kolh, Philippe; Dauby, Pierre C; Desaive, Thomas

2011-01-01

A cardiovascular system (CVS) model and parameter identification method have previously been validated for identifying different cardiac and circulatory dysfunctions in simulation and using porcine models of pulmonary embolism, hypovolemia with PEEP titrations and induced endotoxic shock. However, these studies required both left and right heart catheters to collect the data required for subject-specific monitoring and diagnosis-a maximally invasive data set in a critical care setting although it does occur in practice. Hence, use of this model-based diagnostic would require significant additional invasive sensors for some subjects, which is unacceptable in some, if not all, cases. The main goal of this study is to prove the concept of using only measurements from one side of the heart (right) in a 'minimal' data set to identify an effective patient-specific model that can capture key clinical trends in endotoxic shock. This research extends existing methods to a reduced and minimal data set requiring only a single catheter and reducing the risk of infection and other complications-a very common, typical situation in critical care patients, particularly after cardiac surgery. The extended methods and assumptions that found it are developed and presented in a case study for the patient-specific parameter identification of pig-specific parameters in an animal model of induced endotoxic shock. This case study is used to define the impact of this minimal data set on the quality and accuracy of the model application for monitoring, detecting and diagnosing septic shock. Six anesthetized healthy pigs weighing 20-30 kg received a 0.5 mg kg(-1) endotoxin infusion over a period of 30 min from T0 to T30. For this research, only right heart measurements were obtained. Errors for the identified model are within 8% when the model is identified from data, re-simulated and then compared to the experimentally measured data, including measurements not used in the identification process for validation. Importantly, all identified parameter trends match physiologically and clinically and experimentally expected changes, indicating that no diagnostic power is lost. This work represents a further with human subjects validation for this model-based approach to cardiovascular diagnosis and therapy guidance in monitoring endotoxic disease states. The results and methods obtained can be readily extended from this case study to the other animal model results presented previously. Overall, these results provide further support for prospective, proof of concept clinical testing with humans.

Case Management in Community Corrections: Current Status and Future Directions

ERIC Educational Resources Information Center

Day, Andrew; Hardcastle, Lesley; Birgden, Astrid

2012-01-01

Case management is commonly regarded as the foundation of effective service provision across a wide range of human service settings. This article considers the case management that is offered to clients of community corrections, identifying the distinctive features of case management in this particular setting, and reviewing the empirical evidence…

Quantifying the economic benefits of prevention in a healthcare setting with severe financial constraints: the case of hypertension control.

PubMed

Athanasakis, Kostas; Kyriopoulos, Ilias-Ioannis; Boubouchairopoulou, Nadia; Stergiou, George S; Kyriopoulos, John

2015-01-01

Hypertension significantly contributes to the increased cardiovascular morbidity and mortality, thus leading to rising healthcare costs. The objective of this study was to quantify the clinical and economic benefits of optimal systolic blood pressure (SBP), in a setting under severe financial constraints, as in the case of Greece. Hence, a Markov model projecting 10-year outcomes and costs was adopted, in order to compare two scenarios. The first one depicted the "current setting", where all hypertensives in Greece presented an average SBP of 164 mmHg, while the second scenario namely "optimal SBP control" represented a hypothesis in which the whole population of hypertensives would achieve optimal SBP (i.e. <140 mmHg). Cardiovascular events' occurrence was estimated for four sub-models (according to gender and smoking status). Costs were calculated from the Greek healthcare system's perspective (discounted at a 3% annual rate). Findings showed that compared to the "current setting", universal "optimal SBP control" could, within a 10-year period, reduce the occurrence of non-fatal events and deaths, by 80 and 61 cases/1000 male smokers; 59 and 37 cases/1000 men non-smokers; whereas the respective figures for women were 69 and 57 cases/1000 women smokers; and accordingly, 52 and 28 cases/1000 women non-smokers. Considering health expenditures, they could be reduced by approximately €83 million per year. Therefore, prevention of cardiovascular events through BP control could result in reduced morbidity, thereby in substantial cost savings. Based on clinical and economic outcomes, interventions that promote BP control should be a health policy priority.

Clinical analysis of aqueductal stenosis in patients with hydrocephalus in a Kenyan setting.

PubMed

Kaur, Loyal Poonamjeet; Munyiri, Nderitu Joseph; Dismus, Wekesa Vincent

2017-01-01

Aqueductal stenosis is the commonest cause of congenital hydrocephalus. The scope of this paper is to highlight the disease burden of hydrocephalus attributed to aqueductal stenosis which still remains unknown in our setting. In a descriptive cross-sectional study, 258 records of patients diagnosed with hydrocephalus were analyzed after ethical approval from Kenyatta National Hospital- University of Nairobi (KNH-UON) ethics and research committee from January 2010 to May 2016. Patients with a diagnosis of hydrocephalus due to aqueductal stenosis were included in this study. Patients age, sex, mode of delivery, associated comorbidities, presenting complaints, neurosurgical intervention performed, Kafarnosky score were recorded. Data were divided into 2 sets based on the patient's age i.e. whether < 1 year or > 12 years. Data were recorded on google data collection form and analyzed using Google spreadsheets. Out of 258 cases of hydrocephalus, 52 had aqueductal stenosis. Male to female sex ratio for this condition was 3:2. There were 25 cases < 1year and 27 cases > 12 years old who were diagnosed with hydrocephalus due to aqueductal stenosis. Associated conditions were bilateral congenital talipes equinovarus, spina bifida, Arnold Chairi malformations, meningitis and HIV. The presenting complaints differed according to the age groups. Neurosurgical interventions included Endoscopic Third Ventriculostomy (ETV) in 21 cases, insertion of Ventriculoperitoneal (VP) shunt and ETV were done in 3 cases while the rest had only insertion of VP shunt. The Kafanosky score improve from < 50 pre-op to 19 cases achieving a score of 100, six months post-op. Aqueductal stenosis contributes a significant burden of morbidity in patients with hydrocephalus. Clinical presentation differs according to patients age. Accurate diagnosis and treatment remain a cardinal to improving patient outcome.

Treatment of Encopresis in a Classroom Setting: A Case Study

ERIC Educational Resources Information Center

Scott, E.

1977-01-01

This study describes the procedure and results of a behavior modification program carried out in the classroom and aimed at eliminating encopresis (involuntary defecation) in an 8-year-old boy. (Editor/RK)

The Pericles Space Case: Preserving Earth Observation Data for the Future

NASA Astrophysics Data System (ADS)

Muller, C.; Pandey, P.; Pericles Consortium

2016-08-01

PERICLES (Promoting and Enhancing the Reuse of Information throughout the Content Lifecycle exploiting Evolving Semantics) is an FP7 project started on February 2013. It aims at preserving by design large and complex data sets. PERICLES is coordinated by King's College London, UK and its partners are University of Borås (Sweden), CERT (Greece), DotSoft(Greece), GeorgAugustUniversität, Göttingen (Germany), University of Liverpool (UK), Space Application Services (Belgium), XEROX France and University of Edinburgh (UK). Two additional partners provide the case studies: Tate Gallery (UK) brings the digital art and media case study and B.USOC (Belgian Users Support and Operations Centre) brings the space science case study.

Ready, Set, Go ... Again: Renewing an Academy-Agency Child Welfare Partnership

ERIC Educational Resources Information Center

Pierce, Barbara; McGuire, Lisa E.; Howes, Patricia

2015-01-01

This article presents a case study of the renewed partnership between a midwestern public child welfare agency and a midwestern university school of social work. The partnership, which includes educating BSW and MSW students, preparing frontline child welfare case managers, and providing leadership training for supervisors and managers,…

Beyond Physics: A Case for Far Transfer

ERIC Educational Resources Information Center

Forsyth, Benjamin Robert

2012-01-01

This is a case study of a physics undergraduate who claimed that he "uses physics to understand other subjects." This statement suggested that this student could describe issues concerning the transfer of learning and especially instances of far transfer. Detailed instances of far transfer have been difficult to replicate in lab settings.…

Navigating Change with a Flexible Portfolio

ERIC Educational Resources Information Center

Tyksinski, Deborah J.

2009-01-01

This case study demonstrates how building a flexible portfolio of services allowed a continuing education (CE) unit to thrive during frequent leadership changes. The case is set in a small state college, State Technology Institute at Mohawk (STIM), which experienced nine leadership changes in as many years. The names of the institution and its…

Educational Change: A Case for a "Pedagogy of Compassion"

ERIC Educational Resources Information Center

Vandeyar, Saloshna; Swart, Ronel

2016-01-01

This paper sets out to advance the concept of an "epistemology of compassion" first proposed by Vandeyar (2013; 2016). Utilising a single embedded case study and the theoretical mooring of post-conflict pedagogy this paper attempts to find links between Jansen's perceptions of a post-conflict pedagogy and Freirean pedagogy and to argue a…

Applying Clinical Neuropsychology in the Public Schools.

ERIC Educational Resources Information Center

Federhar, David B.

Neuropsychology is an area in which the functioning or integrity of the brain is linked to measurable human behavior. This paper describes the use of the Reitan batteries (Reitan and Davison; 1974) in public school settings for documenting and prescribing appropriate academic programs. Three individual case studies are presented. Case 1 is a 16…

Primary care physicians’ perspectives on facilitating older patients’ access to community support services

PubMed Central

Ploeg, Jenny; Denton, Margaret; Hutchison, Brian; McAiney, Carrie; Moore, Ainsley; Brazil, Kevin; Tindale, Joseph; Lam, Annie

2017-01-01

Abstract Objective To understand how family physicians facilitate older patients’ access to community support services (CSSs) and to identify similarities and differences across primary health care (PHC) models. Design Qualitative, multiple-case study design using semistructured interviews. Setting Four models of PHC delivery, specifically 2 family health teams (FHTs), 4 non-FHTs family health organizations, 4 fee-for-service practices, and 2 community health centres in urban Ontario. Participants Purposeful sampling of 23 family physicians in solo and small and large group practices within the 4 models of PHC. Methods A multiple-case study approach was used. Semistructured interviews were conducted and data were analyzed using within- and cross-case analysis. Case study tactics to ensure study rigour included memos and an audit trail, investigator triangulation, and the use of multiple, rather than single, case studies. Main findings Three main themes were identified: consulting and communicating with the health care team to create linkages; linking patients and families to CSSs; and relying on out-of-date resources and ineffective search strategies for information on CSSs. All participants worked with their team members; however, those in FHTs and community health centres generally had a broader range of health care providers available to assist them. Physicians relied on home-care case managers to help make linkages to CSSs. Physicians recommended the development of an easily searchable, online database containing available CSSs. Conclusion This study shows the importance of interprofessional teamwork in primary care settings to facilitate linkages of older patients to CSSs. The study also provides insight into the strategies physicians use to link older persons to CSSs and their recommendations for change. This understanding can be used to develop resources and approaches to better support physicians in making appropriate linkages to CSSs. PMID:28115458

Prevention of sexual harassment in the medical setting applying Inoculation Theory.

PubMed

Matusitz, Jonathan; Breen, Gerald Mark

2005-01-01

This paper is an examination of how Inoculation Theory can be applied in the prevention of sexual harassment in the medical setting. The basic tenet of the theory is the study of the processes through which we withstand and oppose attitude transformation during social interactions that may influence or change our attitudes. More importantly, this paper analyzes sexual harassment as a pervasive phenomenon in the medical setting. As such, it defines what sexual harassment is, explains the prevalence of sexual harassment between the physician and the patient, describes some of the general studies conducted in medical settings, provides a case scenario of doctor-patient sexual harassment, and identifies some key consequences to doctors, patients, and society.

Co-Regulation and Knowledge Construction in an Online Synchronous Problem Based Learning Setting

ERIC Educational Resources Information Center

Lee, Lila; Lajoie, Susanne P.; Poitras, Eric G.; Nkangu, Miriam; Doleck, Tenzin

2017-01-01

Learning to monitor and regulate one's learning in an academic setting is a task that all students must engage in. Learning in "group" situations requires both self- and co-regulation. This research examines a case study of a small group of medical student interactions during an on-line problem based learning activity (PBL) where…

Employing Professional Identities: Case Study of a High School Principal in a Reform Setting

ERIC Educational Resources Information Center

Scribner, Samantha Paredes; Crow, Gary Monroe

2012-01-01

A problematic trend in the nature of work in educational settings has been the declining emphasis on a professional orientation to work and a growing emphasis on more technocratic approaches. This international trend has led to increased attention on skills and competencies and lessened attention to values, beliefs, motivations, energy, and…

Interplay of Entrepreneurial Learning Forms: A Case Study of Experiential Learning Settings

ERIC Educational Resources Information Center

Ramsgaard, Michael Breum; Christensen, Marie Ernst

2018-01-01

This paper explores the concept of learning in a setting of experiential knowledge acquisition. The main focus is how facilitators of learning processes can design learning spaces, where the boundaries of what is expected from the learner are challenged. The aim is to explore the action-based learning processes occurring in experiential learning…

Evaluation of a collaborative model: a case study analysis of watershed planning in the intermountain west

Treesearch

Gary Bentrup

2001-01-01

Collaborative planning processes have become increasingly popular for addressing environmental planning issues, resulting in a number of conceptual models for collaboration. A model proposed by Selin and Chavez suggests that collaboration emerges from a series of antecedents and then proceeds sequentially through problem-setting, direction-setting, implementation, and...

Combining Multilevel Analysis with National Value-Added Data Sets - A Case Study to Explore the Effects of School Diversity

ERIC Educational Resources Information Center

Schagen, Ian; Schagen, Sandie

2005-01-01

The advent of large-scale matched data sets, linking pupils' attainment across key stages, gives new opportunities to explore the effects of school organisational factors on pupil performance. Combined with currently available sophisticated and efficient software for multilevel analysis, it offers educational researchers the chance to develop…

Exploring the Integration of Technology into Jewish Education: Multi-User Virtual Environments and Supplementary School Settings

ERIC Educational Resources Information Center

Sohn, Johannah Eve

2014-01-01

This descriptive case study explores the implementation of a multi-user virtual environment (MUVE) in a Jewish supplemental school setting. The research was conducted to present the recollections and reflections of three constituent populations of a new technology exploring constructivist education in the context of supplemental and online…

The Nature of the Social Experiences of Students with Deaf-Blindness Who Are Educated in Inclusive Settings

ERIC Educational Resources Information Center

Correa-Torres, Silvia M.

2008-01-01

This qualitative case study investigated the nature of social experiences and opportunities for communication among students who are deaf-blind, their sighted peers with no hearing loss, and adults in inclusive settings. Strategies used by adults to promote interaction were also observed. Implications and suggestions for future research are…

How Do Social Networks Influence Learning Outcomes? A Case Study in an Industrial Setting

ERIC Educational Resources Information Center

Maglajlic, Seid; Helic, Denis

2012-01-01

and Purpose: The purpose of this research is to shed light on the impact of implicit social networks to the learning outcome of e-learning participants in an industrial setting. Design/methodology/approach: The paper presents a theoretical framework that allows the authors to measure correlation coefficients between the different affiliations that…

Teaching and Learning about Managing People: Human Resource Management for Education Settings--A Queensland Case.

ERIC Educational Resources Information Center

McCrea, Nadine L.; Ehrich, Lisa C.

1996-01-01

Describes the development of a human resource management (HRM) elective for educators aspiring to management positions in various educational settings. The unit is part of a graduate diploma offered within the Faculty of Education at one Australian university. The paper argues the necessity of HRM studies in postgraduate education courses. (SM)

Case Study on the Implementation of School-Wide Positive Behavioral Interventions and Supports in an Alternative Educational Setting

ERIC Educational Resources Information Center

Gelbar, Nicholas W.; Jaffery, Rose; Stein, Ravit; Cymbala, Heather

2015-01-01

School-wide positive behavior interventions and supports (SW-PBIS) can effectively reduce problem behaviors and simultaneously increase pro-social behaviors in general education settings. SW-PBIS is not a "packaged" intervention, but a framework through which schools create systemic changes for promoting expected behaviors, while also…

Prospects of poisoning - a multi facet study.

PubMed

Mishra, Pradeep K; Kulkarni, Rashmi; Sane, Mandar R; Deshpande, Ajit; Kushwah, Manish

2016-01-01

Aim of the study is to find out demographic profile, clinical characteristics and analysis of poison in clinical set up. The study carried out in Sri Aurobindo Medical College and PG Institute Indore, Madhya Pradesh. Total 75 cases of poisoning were studied for demographic profile, vitals (BP, pulse, heart rate, pupils, etc.), clinical features (such as vomiting, salivation, consciousness, etc.), type of poison and its analysis. Results: Poisoning was more common in cases between 15 and 25 years of age, in males than in females and in Hindu religion. Poisoning cases were predominantly from rural areas and in married people. Majority of cases were discharged after proper treatment and counseling. Altered vitals and clinical features were found in most of the cases. Organophosphate and aluminum phosphide compound were evaluated in most of the cases. Conclusions: Preventive measures should be applied through educating people, proper counseling, promoting poison information centers, and introducing separate toxicological units in hospitals.

Genomic Landscape of Atypical Adenomatous Hyperplasia Reveals Divergent Modes to Lung Adenocarcinoma.

PubMed

Sivakumar, Smruthy; Lucas, F Anthony San; McDowell, Tina L; Lang, Wenhua; Xu, Li; Fujimoto, Junya; Zhang, Jianjun; Futreal, P Andrew; Fukuoka, Junya; Yatabe, Yasushi; Dubinett, Steven M; Spira, Avrum E; Fowler, Jerry; Hawk, Ernest T; Wistuba, Ignacio I; Scheet, Paul; Kadara, Humam

2017-11-15

There is a dearth of knowledge about the pathogenesis of premalignant lung lesions, especially for atypical adenomatous hyperplasia (AAH), the only known precursor for the major lung cancer subtype adenocarcinoma (LUAD). In this study, we performed deep DNA and RNA sequencing analyses of a set of AAH, LUAD, and normal tissues. Somatic BRAF variants were found in AAHs from 5 of 22 (23%) patients, 4 of 5 of whom had matched LUAD with driver EGFR mutations. KRAS mutations were present in AAHs from 4 of 22 (18%) of patients. KRAS mutations in AAH were only found in ever-smokers and were exclusive to BRAF -mutant cases. Integrative analysis revealed profiles expressed in KRAS -mutant cases ( UBE2C, REL ) and BRAF -mutant cases ( MAX ) of AAH, or common to both sets of cases (suppressed AXL ). Gene sets associated with suppressed antitumor (Th1; IL12A, GZMB ) and elevated protumor ( CCR2, CTLA-4 ) immune signaling were enriched in AAH development and progression. Our results reveal potentially divergent BRAF or KRAS pathways in AAH as well as immune dysregulation in the pathogenesis of this premalignant lung lesion. Cancer Res; 77(22); 6119-30. ©2017 AACR . ©2017 American Association for Cancer Research.

Safety of laparoscopic colorectal surgery in a low-volume setting: review of early and late outcome.

PubMed

Gandy, Robert C; Berney, Christophe R

2014-01-01

Background. There is increasing evidence suggesting that the laparoscopic technique is the treatment of choice for large bowel resection, including for malignancy. The purpose of the study was to assess whether general surgeons, with particular skills in advanced laparoscopy, can adequately provide safe laparoscopic colorectal resections in a low-volume setting. Methods. A retrospective review of prospectively collected case series of all laparoscopic colorectal resections performed under the care of a single general surgeon is presented. The primary endpoint was postoperative clinical outcome in terms of morbidity and mortality. Secondary endpoints were adequacy of surgical margins and number of lymph nodes harvested for colorectal cancer cases. Results. Seventy-three patients underwent 75 laparoscopic resections between March, 2003, and May, 2011. There was no elective mortality and the overall 30-day postoperative morbidity was 9.3%. Conversion and anastomotic leakage rates were both 1.3%, respectively. None of the malignant cases had positive margins and the median number of lymph nodes retrieved was 17. Conclusions. Our results support the view that general surgeons with advanced skills in minimally invasive surgery may safely perform laparoscopic colorectal resection in a low-volume setting in carefully selected patient cases.

Safety of Laparoscopic Colorectal Surgery in a Low-Volume Setting: Review of Early and Late Outcome

PubMed Central

Gandy, Robert C.; Berney, Christophe R.

2014-01-01

Background. There is increasing evidence suggesting that the laparoscopic technique is the treatment of choice for large bowel resection, including for malignancy. The purpose of the study was to assess whether general surgeons, with particular skills in advanced laparoscopy, can adequately provide safe laparoscopic colorectal resections in a low-volume setting. Methods. A retrospective review of prospectively collected case series of all laparoscopic colorectal resections performed under the care of a single general surgeon is presented. The primary endpoint was postoperative clinical outcome in terms of morbidity and mortality. Secondary endpoints were adequacy of surgical margins and number of lymph nodes harvested for colorectal cancer cases. Results. Seventy-three patients underwent 75 laparoscopic resections between March, 2003, and May, 2011. There was no elective mortality and the overall 30-day postoperative morbidity was 9.3%. Conversion and anastomotic leakage rates were both 1.3%, respectively. None of the malignant cases had positive margins and the median number of lymph nodes retrieved was 17. Conclusions. Our results support the view that general surgeons with advanced skills in minimally invasive surgery may safely perform laparoscopic colorectal resection in a low-volume setting in carefully selected patient cases. PMID:24799890

Analyzing the Behavioral Differences between Students of Different Genders, Prior Knowledge and Learning Performance with an Educational MMORPG: A Longitudinal Case Study in an Elementary School

ERIC Educational Resources Information Center

Hou, Huei-Tse

2013-01-01

Many researchers have studied the effects of game-based learning (GBL) (eg, Annetta, Minogu, Holmes & Cheng, 2009; Kiili, 2007). However, empirical process analyses of long-term applications of GBL in a school setting are much less common. A process analysis of GBL in a school setting allows us to better understand the role of games in…

Field-based random sampling without a sampling frame: control selection for a case-control study in rural Africa.

PubMed

Crampin, A C; Mwinuka, V; Malema, S S; Glynn, J R; Fine, P E

2001-01-01

Selection bias, particularly of controls, is common in case-control studies and may materially affect the results. Methods of control selection should be tailored both for the risk factors and disease under investigation and for the population being studied. We present here a control selection method devised for a case-control study of tuberculosis in rural Africa (Karonga, northern Malawi) that selects an age/sex frequency-matched random sample of the population, with a geographical distribution in proportion to the population density. We also present an audit of the selection process, and discuss the potential of this method in other settings.

The Dilemma of Case-Based Teaching and Learning in Science in Hong Kong: Students Need It, Want It, but May Not Value It. Research Report

ERIC Educational Resources Information Center

McNaught, Carmel; Lau, W. M.; Lam, Paul; Hui, Mark Y. Y.; Au, Peter C. T.

2005-01-01

The paper reports a study for determining a suitable process for converting traditional surface science courses into case-based learning ones in two universities in Hong Kong. In this preparative study, a set of baseline data was collected on the current level of students' conceptual understanding and also students' perceptions about the…

A Case Study on the Impact of Homogenous Small Class Instruction as an Academic Intervention for At-Risk Students

ERIC Educational Resources Information Center

Mays, Jessica E.

2015-01-01

This case study examined the impact of a site-specific intervention for at-risk students in a small rural elementary school in the foothills of North Carolina. The research site uses a small homogenous class setting as a basis for accelerating academic growth for students who are considered at-risk in literacy based on the state-required literacy…

Toward Understanding the Role of Web 2.0 Technology in Self-Directed Learning and Job Performance in a Single Organizational Setting: A Qualitative Case Study

ERIC Educational Resources Information Center

Caruso, Shirley J.

2016-01-01

This single instrumental qualitative case study explores and thickly describes job performance outcomes based upon the manner in which self-directed learning activities of a purposefully selected sample of 3 construction managers are conducted, mediated by the use of Web 2.0 technology. The data collected revealed that construction managers are…

The Effect of Cartooning Instruction in a Full-Inclusive Setting on Rural Children's Performances on the Goodenough-Harris Drawing Test: Selected Case Studies.

ERIC Educational Resources Information Center

Elrod, G. Franklin; Obringer, S. John

Many researchers have attempted to link children's drawings to intelligence. The Goodenough-Harris Draw-a-Man (DAM) and Draw-a-Woman (DAW) test has been accepted as an indicator of intelligence. This study, via examination of specific cases, explored the effect that instruction in drawing cartoons had on the DAM and DAW performance of 16…

Opportunities and Challenges for Mixed Day Secondary School Headteachers in Promoting Girl-Child Education in Kenya: A Case Study of Kisumu Municipality

ERIC Educational Resources Information Center

Dawo, Jane-Irene A.; Simatwa, Enose M. W.

2010-01-01

Despite Kenya Government's commitment to enhancement of girl-child education, their participation rate at secondary school level is still notably low. Many studies on the girl-child education have concentrated in the rural populations with the assumption that the situation in the urban setting is nearly ideal. This was not the case as was…

Enabling a Prelinguistic Communicator with Autism to Use Picture Card as a Strategy for Repairing Listener Misunderstandings: A Case Study

ERIC Educational Resources Information Center

Ohtake, Yoshihisa; Wehmeyer, Michael; Uchida, Naomi; Nakaya, Akitaka; Yanagihara, Masafumi

2010-01-01

The purpose of this case study was to examine the effects of a time-delay prompting procedure on the acquisition of skills for repairing multiple listener misunderstandings. A prelinguistic student with autism was taught to use picture cards as a strategy to repair listener misunderstandings in a setting where the student had to ask the listener…

A Multiple Case Study of Challenges and Successes Experienced by Founders and Directors of Nature-Based Preschools in the United States

ERIC Educational Resources Information Center

Barnett, Alexandra Michaela

2016-01-01

Nature-based preschools are defined as educational settings in which children spend three or more hours per school day in natural environments such as woods, meadows, and beaches (Knight, 2013). The purpose of this qualitative, multiple case study was to obtain a deep understanding of the challenges and successes of nature-based preschool (NBP)…

The burden of acute respiratory infections in crisis-affected populations: a systematic review

PubMed Central

2010-01-01

Crises due to armed conflict, forced displacement and natural disasters result in excess morbidity and mortality due to infectious diseases. Historically, acute respiratory infections (ARIs) have received relatively little attention in the humanitarian sector. We performed a systematic review to generate evidence on the burden of ARI in crises, and inform prioritisation of relief interventions. We identified 36 studies published since 1980 reporting data on the burden (incidence, prevalence, proportional morbidity or mortality, case-fatality, attributable mortality rate) of ARI, as defined by the International Classification of Diseases, version 10 and as diagnosed by a clinician, in populations who at the time of the study were affected by natural disasters, armed conflict, forced displacement, and nutritional emergencies. We described studies and stratified data by age group, but did not do pooled analyses due to heterogeneity in case definitions. The published evidence, mainly from refugee camps and surveillance or patient record review studies, suggests very high excess morbidity and mortality (20-35% proportional mortality) and case-fatality (up to 30-35%) due to ARI. However, ARI disease burden comparisons with non-crisis settings are difficult because of non-comparability of data. Better epidemiological studies with clearer case definitions are needed to provide the evidence base for priority setting and programme impact assessments. Humanitarian agencies should include ARI prevention and control among infants, children and adults as priority activities in crises. Improved data collection, case management and vaccine strategies will help to reduce disease burden. PMID:20181220

Evaluation of Cirrus Cloud Simulations Using ARM Data - Development of a Case Study Data Set

NASA Technical Reports Server (NTRS)

O'C.Starr, David; Demoz, Belay; Lare, Andrew; Poellot, Michael; Sassen, Kenneth; Heymsfield, Andrew; Brown, Philip; Mace, Jay; Einaudi, Franco (Technical Monitor)

2001-01-01

Cloud-resolving models (CRMs) provide an effective linkage in terms of parameters and scales between observations and the parametric treatments of clouds in global climate models (GCMs). They also represent the best understanding of the physical processes acting to determine cloud system lifecycle. The goal of this project is to improve state-of-the-art CRMs used for studies of cirrus clouds and to establish a relative calibration with GCMs through comparisons among CRMs, single column model (SCM) versions of the GCMs, and observations. This project will compare and evaluate a variety of CRMs and SCMs, under the auspices of the GEWEX Cloud Systems Study (GCSS) Working Group on Cirrus Cloud Systems (WG2), using ARM data acquired at the Southern Great Plains (SGP) site. This poster will report on progress in developing a suitable WG2 case study data set based on the September 26, 1996 ARM IOP case - the Hurricane Nora outflow case. The environmental data (input) will be described as well as the wealth of validating cloud observations. We plan to also show results of preliminary simulations. The science questions to be addressed derive significantly from results of the GCSS WG2 cloud model comparison projects, which will be briefly summarized.

Prostate cancer risk regions at 8q24 and 17q24 are differentially associated with somatic TMPRSS2:ERG fusion status

PubMed Central

Luedeke, Manuel; Rinckleb, Antje E.; FitzGerald, Liesel M.; Geybels, Milan S.; Schleutker, Johanna; Eeles, Rosalind A.; Teixeira, Manuel R.; Cannon-Albright, Lisa; Ostrander, Elaine A.; Weikert, Steffen; Herkommer, Kathleen; Wahlfors, Tiina; Visakorpi, Tapio; Leinonen, Katri A.; Tammela, Teuvo L.J.; Cooper, Colin S.; Kote-Jarai, Zsofia; Edwards, Sandra; Goh, Chee L.; McCarthy, Frank; Parker, Chris; Flohr, Penny; Paulo, Paula; Jerónimo, Carmen; Henrique, Rui; Krause, Hans; Wach, Sven; Lieb, Verena; Rau, Tilman T.; Vogel, Walther; Kuefer, Rainer; Hofer, Matthias D.; Perner, Sven; Rubin, Mark A.; Agarwal, Archana M.; Easton, Doug F.; Al Olama, Ali Amin; Benlloch, Sara; Hoegel, Josef; Stanford, Janet L.

2016-01-01

Abstract Molecular and epidemiological differences have been described between TMPRSS2:ERG fusion-positive and fusion-negative prostate cancer (PrCa). Assuming two molecularly distinct subtypes, we have examined 27 common PrCa risk variants, previously identified in genome-wide association studies, for subtype specific associations in a total of 1221 TMPRSS2:ERG phenotyped PrCa cases. In meta-analyses of a discovery set of 552 cases with TMPRSS2:ERG data and 7650 unaffected men from five centers we have found support for the hypothesis that several common risk variants are associated with one particular subtype rather than with PrCa in general. Risk variants were analyzed in case-case comparisons (296 TMPRSS2:ERG fusion-positive versus 256 fusion-negative cases) and an independent set of 669 cases with TMPRSS2:ERG data was established to replicate the top five candidates. Significant differences (P < 0.00185) between the two subtypes were observed for rs16901979 (8q24) and rs1859962 (17q24), which were enriched in TMPRSS2:ERG fusion-negative (OR = 0.53, P = 0.0007) and TMPRSS2:ERG fusion-positive PrCa (OR = 1.30, P = 0.0016), respectively. Expression quantitative trait locus analysis was performed to investigate mechanistic links between risk variants, fusion status and target gene mRNA levels. For rs1859962 at 17q24, genotype dependent expression was observed for the candidate target gene SOX9 in TMPRSS2:ERG fusion-positive PrCa, which was not evident in TMPRSS2:ERG negative tumors. The present study established evidence for the first two common PrCa risk variants differentially associated with TMPRSS2:ERG fusion status. TMPRSS2:ERG phenotyping of larger studies is required to determine comprehensive sets of variants with subtype-specific roles in PrCa. PMID:27798103

A Study of False-Positive and False-Negative Error Rates in Cartridge Case Comparisons

DTIC Science & Technology

2014-04-07

materials for the study, in particular Vicki Sieve. 3 Abstract: This report provides the details for a study designed to...participate in ASCLD were provided with 15 sets of 3 known + 1 unknown cartridge cases fired from a collection of 25 new Ruger SR9 handguns . The...answer sheet allowing for the AFTE range of conclusions, and return shipping materials . They were also asked to assess how many of the 3 knowns were

Dissemination of an innovative mastery learning curriculum grounded in implementation science principles: a case study.

PubMed

McGaghie, William C; Barsuk, Jeffrey H; Cohen, Elaine R; Kristopaitis, Theresa; Wayne, Diane B

2015-11-01

Dissemination of a medical education innovation, such as mastery learning, from a setting where it has been used successfully to a new and different medical education environment is not easy. This article describes the uneven yet successful dissemination of a simulation-based mastery learning (SBML) curriculum on central venous catheter (CVC) insertion for internal medicine and emergency medicine residents across medical education settings. The dissemination program was grounded in implementation science principles. The article begins by describing implementation science which addresses the mechanisms of medical education and health care delivery. The authors then present a mastery learning case study in two phases: (1) the development, implementation, and evaluation of the SBML CVC curriculum at a tertiary care academic medical center; and (2) the dissemination of the SBML CVC curriculum to an academic community hospital setting. Contextual information about the drivers and barriers that affected the SBML CVC curriculum dissemination is presented. This work demonstrates that dissemination of mastery learning curricula, like all other medical education innovations, will fail without active educational leadership, personal contacts, dedication, hard work, rigorous measurement, and attention to implementation science principles. The article concludes by presenting a set of lessons learned about disseminating an SBML CVC curriculum across different medical education settings.

Defining the methodological challenges and opportunities for an effective science of sociotechnical systems and safety

PubMed Central

Waterson, Patrick; Robertson, Michelle M.; Cooke, Nancy J.; Militello, Laura; Roth, Emilie; Stanton, Neville A.

2015-01-01

An important part of the application of sociotechnical systems theory (STS) is the development of methods, tools and techniques to assess human factors and ergonomics workplace requirements. We focus in this paper on describing and evaluating current STS methods for workplace safety, as well as outlining a set of six case studies covering the application of these methods to a range of safety contexts. We also describe an evaluation of the methods in terms of ratings of their ability to address a set of theoretical and practical questions (e.g. the degree to which methods capture static/dynamic aspects of tasks and interactions between system levels). The outcomes from the evaluation highlight a set of gaps relating to the coverage and applicability of current methods for STS and safety (e.g. coverage of external influences on system functioning; method usability). The final sections of the paper describe a set of future challenges, as well as some practical suggestions for tackling these. Practitioner Summary: We provide an up-to-date review of STS methods, a set of case studies illustrating their use and an evaluation of their strengths and weaknesses. The paper concludes with a ‘roadmap’ for future work. PMID:25832121

Implementing accountability for reasonableness--the case of pharmaceutical reimbursement in Sweden.

PubMed

Jansson, Sandra

2007-04-01

This paper aims to describe the priority-setting procedure for new original pharmaceuticals practiced by the Swedish Pharmaceutical Benefits Board (LFN), to analyse the outcome of the procedure in terms of decisions and the relative importance of ethical principles, and to examine the reactions of stakeholders. All the 'principally important' decisions made by the LFN during its first 33 months of operation were analysed. The study is theoretically anchored in the theory of fair and legitimate priority-setting procedures by Daniels and Sabin, and is based on public documents, media articles, and semi-structured interviews. Only nine cases resulted in a rejection of a subsidy by the LFN and 15 in a limited or conditional subsidy. Total rejections rather than limitations gave rise to actions by stakeholders. Primarily, the principle of cost-effectiveness was used when limiting/conditioning or totally rejecting a subsidy. This study suggests that implementing a priority-setting process that fulfils the conditions of accountability for reasonableness can result in a priority-setting process which is generally perceived as fair and legitimate by the major stakeholders and may increase social learning in terms of accepting the necessity of priority setting in health care. The principle of cost-effectiveness increased in importance when the demand for openness and transparency increased.

Clinical utility of multiplex ligation-dependent probe amplification technique in identification of aetiology of unexplained mental retardation: a study in 203 Indian patients.

PubMed

Boggula, Vijay R; Shukla, Anju; Danda, Sumita; Hariharan, Sankar V; Nampoothiri, Sheela; Kumar, Rashmi; Phadke, Shubha R

2014-01-01

Developmental delay (DD)/mental retardation also described as intellectual disability (ID), is seen in 1-3 per cent of general population. Diagnosis continues to be a challenge at clinical level. With the advancement of new molecular cytogenetic techniques such as cytogenetic microarray (CMA), multiplex ligation-dependent probe amplification (MLPA) techniques, many microdeletion/microduplication syndromes with DD/ID are now delineated. MLPA technique can probe 40-50 genomic regions in a single reaction and is being used for evaluation of cases with DD/ID. In this study we evaluated the clinical utility of MLPA techniques with different probe sets to identify the aetiology of unexplained mental retardation in patients with ID/DD. A total of 203 randomly selected DD/ID cases with/without malformations were studied. MLPA probe sets for subtelomeric regions (P070/P036) and common microdeletions/microduplications (P245-A2) and X-chromosome (P106) were used. Positive cases with MLPA technique were confirmed using either fluorescence in situ hybridization (FISH) or follow up confirmatory MLPA probe sets. The overall detection rate was found to be 9.3 per cent (19 out of 203). The detection rates were 6.9 and 7.4 per cent for common microdeletion/microduplication and subtelomeric probe sets, respectively. No abnormality was detected with probe set for X-linked ID. The subtelomeric abnormalities detected included deletions of 1p36.33, 4p, 5p, 9p, 9q, 13q telomeric regions and duplication of 9pter. The deletions/duplications detected in non telomeric regions include regions for Prader Willi/Angelman regions, Williams syndrome, Smith Magenis syndrome and Velocardiofacial syndrome. Our results show that the use of P245-A2 and P070/P036-E1 probes gives good diagnostic yield. Though MLPA cannot probe the whole genome like cytogenetic microarray, due to its ease and relative low cost it is an important technique for evaluation of cases with DD/ID.

The Case for Decision-Forcing Cases: Preparing Teachers for EFL Settings.

ERIC Educational Resources Information Center

Jackson, Jane

2000-01-01

Focuses on the role that cases can play in preparing English-as-a-foreign-language teachers for the linguistic, cultural, and pedagogical realities of teaching English in an unfamiliar sociocultural setting. Describes some of the benefits of a case-based approach in TEFL teacher development programs. Offers a definition of decision-forcing cases…

Surgical implications and variability in the use of the flat epithelial atypia diagnosis on breast biopsy specimens.

PubMed

Samples, Laura S; Rendi, Mara H; Frederick, Paul D; Allison, Kimberly H; Nelson, Heidi D; Morgan, Thomas R; Weaver, Donald L; Elmore, Joann G

2017-08-01

Flat epithelial atypia (FEA) is a relatively new diagnostic term with uncertain clinical significance for surgical management. Any implied risk of invasive breast cancer associated with FEA is contingent upon diagnostic reproducibility, yet little is known regarding its use. Pathologists in the Breast Pathology Study interpreted one of four 60-case test sets, one slide per case, constructed from 240 breast biopsy specimens. An electronic data form with standardized diagnostic categories was used; participants were instructed to indicate all diagnoses present. We assessed participants' use of FEA as a diagnostic term within: 1) each test set; 2) 72 cases classified by reference as benign without FEA; and 3) six cases classified by reference as FEA. 115 pathologists participated, providing 6900 total independent assessments. Notation of FEA ranged from 0% to 35% of the cases interpreted, with most pathologists noting FEA on 4 or more test cases. At least one participant noted FEA in 34 of the 72 benign non-FEA cases. For the 6 reference FEA cases, participant agreement with the case reference FEA diagnosis ranged from 17% to 52%; diagnoses noted by participating pathologists for these FEA cases included columnar cell hyperplasia, usual ductal hyperplasia, atypical lobular hyperplasia, and atypical ductal hyperplasia. We observed wide variation in the diagnosis of FEA among U.S. pathologists. This suggests that perceptions of diagnostic criteria and any implied risk associated with FEA may also vary. Surgical excision following a core biopsy diagnosis of FEA should be reconsidered and studied further. Copyright © 2017 Elsevier Ltd. All rights reserved.

Crystallization tendency of active pharmaceutical ingredients following rapid solvent evaporation--classification and comparison with crystallization tendency from undercooled melts.

PubMed

Van Eerdenbrugh, Bernard; Baird, Jared A; Taylor, Lynne S

2010-09-01

In this study, the crystallization behavior of a variety of compounds was studied following rapid solvent evaporation using spin coating. Initial screening to determine model compound suitability was performed using a structurally diverse set of 51 compounds in three different solvent systems [dichloromethane (DCM), a 1:1 (w/w) dichloromethane/ethanol mixture (MIX), and ethanol (EtOH)]. Of this starting set of 153 drug-solvent combinations, 93 (40 compounds) were selected for further evaluation based on solubility, chemical solution stability, and processability criteria. These systems were spin coated and their crystallization was monitored using polarized light microscopy (7 days, dry conditions). The crystallization behavior of the samples could be classified as rapid (Class I: 39 cases), intermediate (Class II: 23 cases), or slow (Class III: 31 cases). The solvent system employed influenced the classification outcome for only four of the compounds. The various compounds showed very diverse crystallization behavior. Upon comparison of classification results with those of a previous study, where cooling from the melt was used as a preparation technique, a good similarity was found whereby 68% of the cases were identically classified. Multivariate analysis was performed using a set of relevant physicochemical compound characteristics. It was found that a number of these parameters tended to differ between the different classes. These could be further interpreted in terms of the nature of the crystallization process. Additional multivariate analysis on the separate classes of compounds indicated some potential in predicting the crystallization tendency of a given compound.

Infantile anorexia, co-excitation and co-mastery in the parent/baby cathexis: The contribution of Sigmund and Anna Freud.

PubMed

Cascales, Thomas

2017-04-01

Recent epidemiological studies show that 2% of babies in ordinary paediatric clinics suffer from infantile anorexia. In the first part of this paper we present a case study from our hospital clinical activity. Our framework combines clinical psychoanalytic sessions and perinatal videos. In the second part, we will focus on the concepts of instinct and excitation proposed by Sigmund Freud and the concept of mastery proposed by Anna Freud. In the third part, we will examine these concepts in the light of the case study. The fourth part is devoted to clinical recommendations from our hospital psychoanalytic practice. In conclusion, unlike other clinical settings, the psychoanalytic setting allows for the elaboration of the parental hatred included in the libidinal cathexis. Our psychoanalytic setting (sessions/videos) makes it possible to decontaminate parental intrapsychic elements overloaded with excitement, saturated with hate elements, and rendered sterile by the instinct for mastery. An initial part of the treatment process involves working through the intersubjective elements observed in the video. Copyright © 2016 Institute of Psychoanalysis.

Multi-modality 3D breast imaging with X-Ray tomosynthesis and automated ultrasound.

PubMed

Sinha, Sumedha P; Roubidoux, Marilyn A; Helvie, Mark A; Nees, Alexis V; Goodsitt, Mitchell M; LeCarpentier, Gerald L; Fowlkes, J Brian; Chalek, Carl L; Carson, Paul L

2007-01-01

This study evaluated the utility of 3D automated ultrasound in conjunction with 3D digital X-Ray tomosynthesis for breast cancer detection and assessment, to better localize and characterize lesions in the breast. Tomosynthesis image volumes and automated ultrasound image volumes were acquired in the same geometry and in the same view for 27 patients. 3 MQSA certified radiologists independently reviewed the image volumes, visually correlating the images from the two modalities with in-house software. More sophisticated software was used on a smaller set of 10 cases, which enabled the radiologist to draw a 3D box around the suspicious lesion in one image set and isolate an anatomically correlated, similarly boxed region in the other modality image set. In the primary study, correlation was found to be moderately useful to the readers. In the additional study, using improved software, the median usefulness rating increased and confidence in localizing and identifying the suspicious mass increased in more than half the cases. As automated scanning and reading software techniques advance, superior results are expected.

Quantum chemical modeling of enzymatic reactions: the case of histone lysine methyltransferase.

PubMed

Georgieva, Polina; Himo, Fahmi

2010-06-01

Quantum chemical cluster models of enzyme active sites are today an important and powerful tool in the study of various aspects of enzymatic reactivity. This methodology has been applied to a wide spectrum of reactions and many important mechanistic problems have been solved. Herein, we report a systematic study of the reaction mechanism of the histone lysine methyltransferase (HKMT) SET7/9 enzyme, which catalyzes the methylation of the N-terminal histone tail of the chromatin structure. In this study, HKMT SET7/9 serves as a representative case to examine the modeling approach for the important class of methyl transfer enzymes. Active site models of different sizes are used to evaluate the methodology. In particular, the dependence of the calculated energies on the model size, the influence of the dielectric medium, and the particular choice of the dielectric constant are discussed. In addition, we examine the validity of some technical aspects, such as geometry optimization in solvent or with a large basis set, and the use of different density functional methods. Copyright 2010 Wiley Periodicals, Inc.

COLLABORATE©, Part IV: Ramping Up Competency-Based Performance Management.

PubMed

Treiger, Teresa M; Fink-Samnick, Ellen

The purpose of this fourth part of the COLLABORATE© article series provides an expansion and application of previously presented concepts pertaining to the COLLABORATE paradigm of professional case management practice. The model is built upon a value-driven foundation that: PRIMARY PRACTICE SETTING(S):: Applicable to all health care sectors where case management is practiced. As an industry, health care continues to evolve. Terrain shifts and new influences continually surface to challenge professional case management practice. The need for top-performing and nimble professionals who are knowledgeable and proficient in the workplace continues to challenge human resource departments. In addition to care setting knowledge, professional case managers must continually invest in their practice competence toolbox to grow skills and abilities that transcend policies and processes. These individuals demonstrate agility in framing (and reframing) their professional practice to facilitate the best possible outcomes for their clients. Therefore, the continued emphasis on practice competence conveyed through the performance management cycle is an essential ingredient to performance management focused on customer service excellence and organizational improvement. Professional case management transcends professional disciplines, educational levels, and practice settings. Business objectives continue to drive work process and priorities in many practice settings. However, competencies that align with regulatory and accreditation requirements should be the critical driver for consistent, high-quality case management practice. Although there is inherent value in what various disciplines bring to the table, this advanced model unifies behind case management's unique, strengths-based identity instead of continuing to align within traditional divisions (e.g., discipline, work setting, population served). This model fosters case management's expanding career advancement opportunities.

GROUND WATER PROTECTION EFFORTS IN FOUR NEW ENGLAND STATES

EPA Science Inventory

This study is part of the National Network for Environmental Management Studies conducted under the auspices of the Office of Cooperative Environmental Management--U.S. Environmental Protection Agency. The motivation for this study (a set of four case studies) emanates from the W...

Population versus hospital controls for case-control studies on cancers in Chinese hospitals

PubMed Central

2011-01-01

Background Correct control selection is crucial to the internal validity of case-control studies. Little information exists on differences between population and hospital controls in case-control studies on cancers in Chinese hospital setting. Methods We conducted three parallel case-control studies on leukemia, breast and colorectal cancers in China between 2009 and 2010, using population and hospital controls to separately match 540 incident cases by age, gender and residency at a 1:1 ratio. Demographic and lifestyle factors were measured using a validated questionnaire in face-to-face interview. Odds ratios (ORs) and 95% confidence intervals (CIs) were obtained using conditional logistic regression analyses. Results The two control groups had closely similar exposure distributions of 15 out of 16 factors, with the only exception being that hospital controls were less likely to have a BMI ≥ 25 (OR = 0.71, 95% CI: 0.54, 0.93). For exposure of green tea drinking, the adjusted ORs (95% CIs) comparing green tealeaves intake ≥ 1000 grams annually with non-drinkers were 0.51 (0.31, 0.83) and 0.21 (0.27, 0.74) for three cancers combined, 0.06 (0.01, 0.61) and 0.07 (0.01, 0.47) for breast cancer, 0.52 (0.29, 0.94) and 0.45 (0.25, 0.82) for colorectal cancer, 0.65 (0.08, 5.63) and 0.57 (0.07, 4.79) for leukemia using hospital and population controls respectively. Conclusions The study found that hospital controls were comparable with population controls for most demographic characteristics and lifestyle factors measured, but there was a slight difference between the two control groups. Hospital outpatients provide a satisfactory control group in hospital-based case-control study in the Chinese hospital setting. PMID:22171783

Population versus hospital controls for case-control studies on cancers in Chinese hospitals.

PubMed

Li, Lin; Zhang, Min; Holman, D'Arcy

2011-12-15

Correct control selection is crucial to the internal validity of case-control studies. Little information exists on differences between population and hospital controls in case-control studies on cancers in Chinese hospital setting. We conducted three parallel case-control studies on leukemia, breast and colorectal cancers in China between 2009 and 2010, using population and hospital controls to separately match 540 incident cases by age, gender and residency at a 1:1 ratio. Demographic and lifestyle factors were measured using a validated questionnaire in face-to-face interview. Odds ratios (ORs) and 95% confidence intervals (CIs) were obtained using conditional logistic regression analyses. The two control groups had closely similar exposure distributions of 15 out of 16 factors, with the only exception being that hospital controls were less likely to have a BMI ≥ 25 (OR = 0.71, 95% CI: 0.54, 0.93). For exposure of green tea drinking, the adjusted ORs (95% CIs) comparing green tealeaves intake ≥ 1000 grams annually with non-drinkers were 0.51 (0.31, 0.83) and 0.21 (0.27, 0.74) for three cancers combined, 0.06 (0.01, 0.61) and 0.07 (0.01, 0.47) for breast cancer, 0.52 (0.29, 0.94) and 0.45 (0.25, 0.82) for colorectal cancer, 0.65 (0.08, 5.63) and 0.57 (0.07, 4.79) for leukemia using hospital and population controls respectively. The study found that hospital controls were comparable with population controls for most demographic characteristics and lifestyle factors measured, but there was a slight difference between the two control groups. Hospital outpatients provide a satisfactory control group in hospital-based case-control study in the Chinese hospital setting.

Association Study of Prostate Cancer Susceptibility Variants with Risks of Invasive Ovarian, Breast, and Colorectal Cancer

PubMed Central

Song, Honglin; Koessler, Thibaud; Ahmed, Shahana; Ramus, Susan J.; Kjaer, Susanne Krüger; DiCioccio, Richard A.; Wozniak, Eva; Hogdall, Estrid; Whittemore, Alice S.; McGuire, Valerie; Ponder, Bruce A.J.; Turnbull, Clare; Hines, Sarah; Rahman, Nazneen; Eeles, Rosalind A.; Easton, Douglas F.; Gayther, Simon A.; Dunning, Alison M.; Pharoah, Paul D.P.

2009-01-01

Several prostate cancer susceptibility loci have recently been identified by genome-wide association studies. These loci are candidates for susceptibility to other epithelial cancers. The aim of this study was to test these tag single nucleotide polymorphisms (SNP) for association with invasive ovarian, colorectal, and breast cancer. Twelve prostate cancer-associated tag SNPs were genotyped in ovarian (2,087 cases/3,491 controls), colorectal (2,148 cases/2,265 controls) and breast (first set, 4,339 cases/4,552controls; second set, 3,800 cases/3,995 controls) case-control studies. The primary test of association was a comparison of genotype frequencies between cases and controls, and a test for trend stratified by study where appropriate. Genotype-specific odds ratios (OR) were estimated by logistic regression. SNP rs2660753 (chromosome 3p12) showed evidence of association with ovarian cancer [per minor allele OR, 1.19; 95% confidence interval (95% CI), 1.04-1.37; Ptrend = 0.012]. This association was stronger for the serous histologic subtype (OR, 1.29; 95% CI, 1.09-1.53; P = 0.003). SNP rs7931342 (chromosome 11q13) showed some evidence of association with breast cancer (per minor allele OR, 0.95; 95% CI, 0.91-0.99; Ptrend = 0.028). This association was somewhat stronger for estrogen receptor-positive tumors (OR, 0.92; 95% CI, 0.87-0.98; P = 0.011). None of these tag SNPs were associated with risk of colorectal cancer. In conclusion, loci associated with risk of prostate cancer may also be associated with ovarian and breast cancer susceptibility. However, the effects are modest and warrant replication in larger studies. PMID:18974127

Optimal culture incubation time in orthopedic device-associated infections: a retrospective analysis of prolonged 14-day incubation.

PubMed

Schwotzer, Nora; Wahl, Peter; Fracheboud, Dominique; Gautier, Emanuel; Chuard, Christian

2014-01-01

Accurate diagnosis of orthopedic device-associated infections can be challenging. Culture of tissue biopsy specimens is often considered the gold standard; however, there is currently no consensus on the ideal incubation time for specimens. The aim of our study was to assess the yield of a 14-day incubation protocol for tissue biopsy specimens from revision surgery (joint replacements and internal fixation devices) in a general orthopedic and trauma surgery setting. Medical records were reviewed retrospectively in order to identify cases of infection according to predefined diagnostic criteria. From August 2009 to March 2012, 499 tissue biopsy specimens were sampled from 117 cases. In 70 cases (59.8%), at least one sample showed microbiological growth. Among them, 58 cases (82.9%) were considered infections and 12 cases (17.1%) were classified as contaminations. The median time to positivity in the cases of infection was 1 day (range, 1 to 10 days), compared to 6 days (range, 1 to 11 days) in the cases of contamination (P < 0.001). Fifty-six (96.6%) of the infection cases were diagnosed within 7 days of incubation. In conclusion, the results of our study show that the incubation of tissue biopsy specimens beyond 7 days is not productive in a general orthopedic and trauma surgery setting. Prolonged 14-day incubation might be of interest in particular situations, however, in which the prevalence of slow-growing microorganisms and anaerobes is higher.

Use of genomic data in risk assessment case study: II. Evaluation of the dibutyl phthalate toxicogenomic data set

DOE Office of Scientific and Technical Information (OSTI.GOV)

Euling, Susan Y., E-mail: euling.susan@epa.gov; White, Lori D.; Kim, Andrea S.

An evaluation of the toxicogenomic data set for dibutyl phthalate (DBP) and male reproductive developmental effects was performed as part of a larger case study to test an approach for incorporating genomic data in risk assessment. The DBP toxicogenomic data set is composed of nine in vivo studies from the published literature that exposed rats to DBP during gestation and evaluated gene expression changes in testes or Wolffian ducts of male fetuses. The exercise focused on qualitative evaluation, based on a lack of available dose–response data, of the DBP toxicogenomic data set to postulate modes and mechanisms of action formore » the male reproductive developmental outcomes, which occur in the lower dose range. A weight-of-evidence evaluation was performed on the eight DBP toxicogenomic studies of the rat testis at the gene and pathway levels. The results showed relatively strong evidence of DBP-induced downregulation of genes in the steroidogenesis pathway and lipid/sterol/cholesterol transport pathway as well as effects on immediate early gene/growth/differentiation, transcription, peroxisome proliferator-activated receptor signaling and apoptosis pathways in the testis. Since two established modes of action (MOAs), reduced fetal testicular testosterone production and Insl3 gene expression, explain some but not all of the testis effects observed in rats after in utero DBP exposure, other MOAs are likely to be operative. A reanalysis of one DBP microarray study identified additional pathways within cell signaling, metabolism, hormone, disease, and cell adhesion biological processes. These putative new pathways may be associated with DBP effects on the testes that are currently unexplained. This case study on DBP identified data gaps and research needs for the use of toxicogenomic data in risk assessment. Furthermore, this study demonstrated an approach for evaluating toxicogenomic data in human health risk assessment that could be applied to future chemicals. - Highlights: ► We evaluate the dibutyl phthalate toxicogenomic data for use in risk assessment. ► We focus on information about the mechanism of action for the developing testis. ► Multiple studies report effects on testosterone and insl3-related pathways. ► We identify additional affected pathways that may explain some testis effects. ► The case study is a template for evaluating toxicogenomic data in risk assessment.« less

Case Studies in Modelling, Control in Food Processes.

PubMed

Glassey, J; Barone, A; Montague, G A; Sabou, V

This chapter discusses the importance of modelling and control in increasing food process efficiency and ensuring product quality. Various approaches to both modelling and control in food processing are set in the context of the specific challenges in this industrial sector and latest developments in each area are discussed. Three industrial case studies are used to demonstrate the benefits of advanced measurement, modelling and control in food processes. The first case study illustrates the use of knowledge elicitation from expert operators in the process for the manufacture of potato chips (French fries) and the consequent improvements in process control to increase the consistency of the resulting product. The second case study highlights the economic benefits of tighter control of an important process parameter, moisture content, in potato crisp (chips) manufacture. The final case study describes the use of NIR spectroscopy in ensuring effective mixing of dry multicomponent mixtures and pastes. Practical implementation tips and infrastructure requirements are also discussed.

Navigating political minefields: partnerships in organizational case study research.

PubMed

Moll, Sandra

2012-01-01

The purpose of this paper is to examine key challenges associated with conducting politically sensitive research within a workplace setting, and to highlight strategic partnerships that can be developed to address these challenges. The author's research on employee mental health issues within a large healthcare facility serves as the foundation for identification and description of "political minefields" that investigators may encounter when conducting organizational case study research. Key methodological principles from the literature on qualitative case study research will frame discussion of how to understand and address political sensitivities in the research process. The benefits of conducting organizational case study research will be outlined, followed by discussion of methodological challenges that can emerge in negotiating entry, collecting data (gatekeepers, researcher reflexivity, participant authenticity and non-maleficence), and communicating research findings. Courage, collaboration and clear communication with stakeholders at all levels of the organization are critical to the success of workplace based case study research.

Managing the Social Determinants of Health: Part I: Fundamental Knowledge for Professional Case Management.

PubMed

Fink-Samnick, Ellen

PRIMARY PRACTICE SETTING(S):: Applicable to health and behavioral health settings, wherever case management is practiced. The SDH pose major challenges to the health care workforce in terms of effective resource provision, health and behavioral health treatment planning plus adherence, and overall coordination of care. Obstacles and variances to needed interventions easily lead to less than optimal outcomes for case managers and their health care organizations. Possessing sound knowledge and clear understanding of each SDH, the historical perspectives, main theories, and integral dynamics, as well as creative resource solutions, all support a higher level of intentional and effective professional case management practice. Those persons and communities impacted most by the SDH comprise every case management practice setting. These clients can be among the most vulnerable and disenfranchised members of society, which can easily engender biases on the part of the interprofessional workforce. They are also among the costliest to care for with 50% of costs for only 5% of the population. Critical attention to knowledge about managing the SDH leverages and informs case management practice, evolves more effective programming, and enhances operational outcomes across practice settings.

[Criteria for the classification as a "domestic-setting corpse"--a literature search and review to define the term].

PubMed

Merz, Marius; Birngruber, Christoph G; Heidorn, Frank; Ramsthaler, Frank; Risse, Manfred; Kreutz, Kerstin; Krähahn, Jonathan; Verhoff, Marcel A

2011-01-01

In German medical and media circles (daily routine, specialist literature, press, novels), the term "domestic-setting corpse" is frequently used, but the term is only vaguely defined. The authors thus decided to perform an in-depth study of the literature, including historic textbooks and all German- and English-language medicolegal journals, going as far back as their first issues, in an attempt to more clearly define the term. Inclusion criteria used in the search were a post-mortem interval of at least 24 hours prior to discovery and discovery of the corpse in a domestic setting. In the literature, 37 cases that complied with the above-mentioned inclusion criteria were found. These cases frequently described "advanced decomposition", often "unclear cause of death" and "problems in identification". These characteristics can thus be considered as being additional pointers in the definition. However, we suggest that the two general defining characteristics of a "domestic-setting corpse" are a post-mortem interval of more than 24 hours before discovery and the discovery of the corpse in a domestic setting.

Emergency residential care settings: A model for service assessment and design.

PubMed

Graça, João; Calheiros, Maria Manuela; Patrício, Joana Nunes; Magalhães, Eunice Vieira

2018-02-01

There have been calls for uncovering the "black box" of residential care services, with a particular need for research focusing on emergency care settings for children and youth in danger. In fact, the strikingly scant empirical attention that these settings have received so far contrasts with the role that they often play as gateway into the child welfare system. To answer these calls, this work presents and tests a framework for assessing a service model in residential emergency care. It comprises seven studies which address a set of different focal areas (e.g., service logic model; care experiences), informants (e.g., case records; staff; children/youth), and service components (e.g., case assessment/evaluation; intervention; placement/referral). Drawing on this process-consultation approach, the work proposes a set of key challenges for emergency residential care in terms of service improvement and development, and calls for further research targeting more care units and different types of residential care services. These findings offer a contribution to inform evidence-based practice and policy in service models of residential care. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Real-World Problem of Care Coordination: A Longitudinal Qualitative Study with Patients Living with Advanced Progressive Illness and Their Unpaid Caregivers

PubMed Central

Daveson, Barbara A.; Harding, Richard; Shipman, Cathy; Mason, Bruce L.; Epiphaniou, Eleni; Higginson, Irene J.; Ellis-Smith, Clare; Henson, Lesley; Munday, Dan; Nanton, Veronica; Dale, Jeremy R.; Boyd, Kirsty; Worth, Allison; Barclay, Stephen; Donaldson, Anne; Murray, Scott

2014-01-01

Objectives To develop a model of care coordination for patients living with advanced progressive illness and their unpaid caregivers, and to understand their perspective regarding care coordination. Design A prospective longitudinal, multi-perspective qualitative study involving a case-study approach. Methods Serial in-depth interviews were conducted, transcribed verbatim and then analyzed through open and axial coding in order to construct categories for three cases (sites). This was followed by continued thematic analysis to identify underlying conceptual coherence across all cases in order to produce one coherent care coordination model. Participants Fifty-six purposively sampled patients and 27 case-linked unpaid caregivers. Settings Three cases from contrasting primary, secondary and tertiary settings within Britain. Results Coordination is a deliberate cross-cutting action that involves high-quality, caring and well-informed staff, patients and unpaid caregivers who must work in partnership together across health and social care settings. For coordination to occur, it must be adequately resourced with efficient systems and services that communicate. Patients and unpaid caregivers contribute substantially to the coordination of their care, which is sometimes volunteered at a personal cost to them. Coordination is facilitated through flexible and patient-centered care, characterized by accurate and timely information communicated in a way that considers patients’ and caregivers’ needs, preferences, circumstances and abilities. Conclusions Within the midst of advanced progressive illness, coordination is a shared and complex intervention involving relational, structural and information components. Our study is one of the first to extensively examine patients’ and caregivers’ views about coordination, thus aiding conceptual fidelity. These findings can be used to help avoid oversimplifying a real-world problem, such as care coordination. Avoiding oversimplification can help with the development, evaluation and implementation of real-world coordination interventions for patients and their unpaid caregivers in the future. PMID:24788451

How would case managers' practice change in a consumer-directed care environment in Australia?

PubMed

You, Emily Chuanmei; Dunt, David; Doyle, Colleen

2017-01-01

The aim of this study was to explore case managers' perceived changes in their practice in the future when consumer-directed care (CDC) is widely implemented in Australia's community aged care system. Purposeful sampling was used and semi-structured individual and group interviews were conducted between September 2012 and March 2013. Participants were drawn from a list of all case managers who administered publicly funded community aged care packages in Victoria, Australia. Empowerment theory was used to guide the analysis and interpretation of the data. The thematic analysis revealed that case managers had mixed views about CDC. They also perceived changes in case managers' practice in the future when CDC is widely implemented. These might specifically include: first, case managers would not directly manage clients' budgets. While some case managers were concerned about losing power for this change, others believed that they would still have important financial roles to perform, such as setting rules, providing financial support and monitoring clients' use of budgets. Second, case managers would focus on performing roles in providing information, and empowering, facilitating and educating clients. These would help to strengthen clients' capacities and assist them to self-manage their care. Third, case managers would work in partnership with clients through frequent or skilful communication, mutual goal setting and goal facilitation. Fourth, case managers would manage more clients. In addition, they would provide less support to each individual client and perform less care co-ordination role. The findings suggest case managers paying attention to power balance regarding budget management in a CDC environment. Furthermore, they might frequently or skilfully communicate with, empower, facilitate and educate clients; work together with them to set up goals; and facilitate them to achieve goals. New research using empowerment theory to examine the actual practice of case managers in a well-established CDC system is warranted. © 2015 John Wiley & Sons Ltd.

Inhaled methoxyflurane for pain and anxiety relief during burn wound care procedures: an Australian case series.

PubMed

Wasiak, Jason; Mahar, Patrick D; Paul, Eldho; Menezes, Hana; Spinks, Anneliese B; Cleland, Heather

2014-02-01

Pain is a common and significant feature of burn injury. The use of intravenous opioids forms the mainstay of procedural burn pain management, but in an outpatient setting, the demand for novel agents that do not require parenteral access, are easy to administer and have a rapid onset are urgently needed. One such agent is the inhaled anaesthetic agent, methoxyflurane (MF). The aim of this study was to conduct a pilot investigation into the clinical effectiveness of MF inhaler on pain and anxiety scores in patients undergoing burn wound care procedures in an outpatient setting. A prospective case series involved recruiting patients undergoing a burn wound care procedure in an ambulatory burn care setting. Pain and anxiety were assessed using numerical rating scales. Overall, median numerical pain rating score was significantly higher post-dressing [pre-dressing: 2; interquartile range (IQR): 1-3 versus post-dressing: 3; IQR 1·5-4; P = 0·01], whereas median numerical anxiety score significantly reduced following the dressing (pre-dressing: 5; IQR 4-7 versus post-dressing: 2; IQR 1-2; P < 0·001). Our study suggests that there is a role for MF in the pain management armamentarium in those undergoing burn care procedures in the ambulatory care setting. However, there is an urgent need for larger case series and randomised controlled trials to determine its overall clinical effectiveness. © 2012 The Authors. International Wound Journal © 2012 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Complicating Counterspaces: Intersectionality and the Michigan Womyn's Music Festival.

PubMed

McConnell, Elizabeth A; Todd, Nathan R; Odahl-Ruan, Charlynn; Shattell, Mona

2016-06-01

The counterspaces framework articulated by Case and Hunter (2012), follows from community psychology's long-standing interest in the potential for settings to promote well-being and liberatory responses to oppression. This framework proposes that certain settings (i.e., "counterspaces") facilitate a specific set of processes that promote the well-being of marginalized groups. We argue that an intersectional analysis is crucial to understand whether and how counterspaces achieve these goals. We draw from literature on safe spaces and present a case study of the Michigan Womyn's Music Festival (Michfest) to illustrate the value of an intersectional analysis and explore how these processes operate. Based on 20 in-person interviews, 23 responses to an online survey, and ethnographic field notes, we show how Michfest was characterized by a particular intersection of identities at the setting level, and intersectional diversity complicated experiences at the individual level. Moreover, intersectional identities provided opportunities for dialogue and change at the setting level, including the creation of counterspaces within counterspaces. Overall, we demonstrate the need to attend to intersectionality in counterspaces, and more broadly in how we conceptualize settings in community psychology. © Society for Community Research and Action 2016.

Priority setting and implementation in a centralized health system: a case study of Kerman province in Iran.

PubMed

Khayatzadeh-Mahani, Akram; Fotaki, Marianna; Harvey, Gillian

2013-08-01

The question of how priority setting processes work remains topical, contentious and political in every health system across the globe. It is particularly acute in the context of developing countries because of the mismatch between needs and resources, which is often compounded by an underdeveloped capacity for decision making and weak institutional infrastructures. Yet there is limited research into how the process of setting and implementing health priorities works in developing countries. This study aims to address this gap by examining how a national priority setting programme works in the centralized health system of Iran and what factors influence its implementation at the meso and micro levels. We used a qualitative case study approach, incorporating mixed methods: in-depth interviews at three levels and a textual analysis of policy documents. The data analysis showed that the process of priority setting is non-systematic, there is little transparency as to how specific priorities are decided, and the decisions made are separated from their implementation. This is due to the highly centralized system, whereby health priorities are set at the macro level without involving meso or micro local levels or any representative of the public. Furthermore, the two main benefit packages are decided by different bodies (Ministry of Health and Medical Education and Ministry of Welfare and Social Security) and there is no co-ordination between them. The process is also heavily influenced by political pressure exerted by various groups, mostly medical professionals who attempt to control priority setting in accordance with their interests. Finally, there are many weaknesses in the implementation of priorities, resulting in a growing gap between rural and urban areas in terms of access to health services.

Non-invasive fetal sex determination by maternal plasma sequencing and application in X-linked disorder counseling.

PubMed

Pan, Xiaoyu; Zhang, Chunlei; Li, Xuchao; Chen, Shengpei; Ge, Huijuan; Zhang, Yanyan; Chen, Fang; Jiang, Hui; Jiang, Fuman; Zhang, Hongyun; Wang, Wei; Zhang, Xiuqing

2014-12-01

To develop a fetal sex determination method based on maternal plasma sequencing (MPS), assess its performance and potential use in X-linked disorder counseling. 900 cases of MPS data from a previous study were reviewed, in which 100 and 800 cases were used as training and validation set, respectively. The percentage of uniquely mapped sequencing reads on Y chromosome was calculated and used to classify male and female cases. Eight pregnant women who are carriers of Duchenne muscular dystrophy (DMD) mutations were recruited, whose plasma were subjected to multiplex sequencing and fetal sex determination analysis. In the training set, a sensitivity of 96% and false positive rate of 0% for male cases detection were reached in our method. The blinded validation results showed 421 in 423 male cases and 374 in 377 female cases were successfully identified, revealing sensitivity and specificity of 99.53% and 99.20% for fetal sex determination, at as early as 12 gestational weeks. Fetal sex for all eight DMD genetic counseling cases were correctly identified, which were confirmed by amniocentesis. Based on MPS, high accuracy of non-invasive fetal sex determination can be achieved. This method can potentially be used for prenatal genetic counseling.

The Advocacy of an Appraisal System for Teachers: A Case Study

ERIC Educational Resources Information Center

Bisschoff, Tom; Mathye, Annah

2009-01-01

Education systems all over the world, like all other organisations, have certain organisational goals that they set and wish to achieve. It is argued that for increased pupil performance, in the case of education systems, teachers must work harder and smarter. A performance system is regarded as part of the process to achieve this organisational…

Self-Management for Primary School Students Demonstrating Problem Behavior in Regular Classrooms: Evidence Review of Single-Case Design Research

ERIC Educational Resources Information Center

Busacca, Margherita L.; Anderson, Angelika; Moore, Dennis W.

2015-01-01

This review evaluates self-management literature targeting problem behaviors of primary school students in general education settings. Thirty-one single-case design studies met inclusion criteria, of which 16 demonstrated adequate methodological rigor, according to What Works Clearinghouse (WWC) design standards. Visual analysis and WWC…

Experiential Learning and Its Role in Training and Improved Practice in High Level Sports Officiating

ERIC Educational Resources Information Center

Grover, Kenda S.

2014-01-01

This qualitative study investigated how high level sports officials engage in experiential learning to improve their practice. Adult learning occurs in formal, nonformal and informal environments, and in some cases it is difficult to differentiate between these settings. In the case of cycling officials, learning begins in a nonformal environment…

Valuing the Adult Learner in E-Learning: Part Two--Insights from Four Companies

ERIC Educational Resources Information Center

Waight, Consuelo L.; Stewart, Barbara L.

2005-01-01

Purpose--To investigate how the adult learner is valued in e-learning corporate settings. Design/methodology/approach--Case study methodology was used for this research. Four Fortune 500 companies that had active e-learning initiatives for a minimum of four years were selected. Data for the development of the four cases were collected via…

Multispecies reaction-diffusion systems

NASA Astrophysics Data System (ADS)

Aghamohammadi, A.; Fatollahi, A. H.; Khorrami, M.; Shariati, A.

2000-10-01

Multispecies reaction-diffusion systems, for which the time evolution equations of correlation functions become a closed set, are considered. A formal solution for the average densities is found. Some special interactions and the exact time dependence of the average densities in these cases are also studied. For the general case, the large-time behavior of the average densities has also been obtained.

Responses to Islam in the Classroom: A Case of Muslim Girls from Minority Communities of Interpretation

ERIC Educational Resources Information Center

Merchant, Natasha Hakimali

2016-01-01

Coinciding with the rise of "Islamophobia" in the United States is a small but growing set of educational scholarship around the curricular impact of and response to Islamophobia. The qualitative case study discussed in this manuscript aims to contribute to this conversation by investigating how Muslim girls from minority communities of…

Elementary School Teachers' Perceptions toward ICT: The Case of Using Magic Board for Teaching Mathematics

ERIC Educational Resources Information Center

Yuan, Yuan; Lee, Chun-Yi

2012-01-01

This study aims at investigating elementary school teachers' perceptions toward to the use of ICT. Magic Board, an interactive web-based environment which provides a set of virtual manipulatives for elementary mathematics, is used as the case of ICT. After participating in Magic Board workshops, 250 elementary school teachers in Taiwan responded…

Clinical Practice as Natural Laboratory for Psychotherapy Research: A Guide to Case-Based Time-Series Analysis

ERIC Educational Resources Information Center

Borckardt, Jeffrey J.; Nash, Michael R.; Murphy, Martin D.; Moore, Mark; Shaw, Darlene; O'Neil, Patrick

2008-01-01

Both researchers and practitioners need to know more about how laboratory treatment protocols translate to real-world practice settings and how clinical innovations can be systematically tested and communicated to a skeptical scientific community. The single-case time-series study is well suited to opening a productive discourse between practice…

Poverty, Privilege, and Political Dynamics within Rural School Reform: Unraveling Educational Leadership in the Invisible America

ERIC Educational Resources Information Center

Mette, Ian M.; Biddle, Catharine; Mackenzie, Sarah V.; Harris-Smedberg, Kathy

2016-01-01

This case was written to help prepare teacher-leaders, principals, and central office administrators, particularly those in rural and economically marginalized settings, who are expected to lead teachers and stakeholders in their community through increasingly stressed economic conditions. The intent of the case study is for educators to examine…

Data Gap Analysis and Damage Case Studies: Risk Analyses from Construction and Demolition Debris Landfills and Recycling Facilities

EPA Science Inventory

The report presents an evaluation of construction and demolition (C&D) debris management in the US to update and expand upon the previous set of data to include information on more recent cases of damage and potential impacts and expand the breadth of damages beyond groundwater a...

Variability in Accreditation Council for Graduate Medical Education Resident Case Log System practices among orthopaedic surgery residents.

PubMed

Salazar, Dane; Schiff, Adam; Mitchell, Erika; Hopkinson, William

2014-02-05

The Accreditation Council for Graduate Medical Education (ACGME) Resident Case Log System is designed to be a reflection of residents' operative volume and an objective measure of their surgical experience. All operative procedures and manipulations in the operating room, Emergency Department, and outpatient clinic are to be logged into the Resident Case Log System. Discrepancies in the log volumes between residents and residency programs often prompt scrutiny. However, it remains unclear if such disparities truly represent differences in operative experiences or if they are reflections of inconsistent logging practices. The purpose of this study was to investigate individual recording practices among orthopaedic surgery residents prior to August 1, 2011. Orthopaedic surgery residents received a questionnaire on case log practices that was distributed through the Council of Orthopaedic Residency Directors list server. Respondents were asked to respond anonymously about recording practices in different clinical settings as well as types of cases routinely logged. Hypothetical scenarios of common orthopaedic procedures were presented to investigate the differences in the Current Procedural Terminology codes utilized. Two hundred and ninety-eight orthopaedic surgery residents completed the questionnaire; 37% were fifth-year residents, 22% were fourth-year residents, 18% were third-year residents, 15% were second-year residents, and 8% were first-year residents. Fifty-six percent of respondents reported routinely logging procedures performed in the Emergency Department or urgent care setting. Twenty-two percent of participants routinely logged procedures in the clinic or outpatient setting, 20% logged joint injections, and only 13% logged casts or splints applied in the office setting. There was substantial variability in the Current Procedural Terminology codes selected for the seven clinical scenarios. There has been a lack of standardization in case-logging practices among orthopaedic surgery residents prior to August 1, 2011. ACGME case log data prior to this date may not be a reliable measure of residents' procedural experience.

Exploring Situational Awareness in Diagnostic Errors in Primary Care

PubMed Central

Singh, Hardeep; Giardina, Traber Davis; Petersen, Laura A.; Smith, Michael; Wilson, Lindsey; Dismukes, Key; Bhagwath, Gayathri; Thomas, Eric J.

2013-01-01

Objective Diagnostic errors in primary care are harmful but poorly studied. To facilitate understanding of diagnostic errors in real-world primary care settings using electronic health records (EHRs), this study explored the use of the Situational Awareness (SA) framework from aviation human factors research. Methods A mixed-methods study was conducted involving reviews of EHR data followed by semi-structured interviews of selected providers from two institutions in the US. The study population included 380 consecutive patients with colorectal and lung cancers diagnosed between February 2008 and January 2009. Using a pre-tested data collection instrument, trained physicians identified diagnostic errors, defined as lack of timely action on one or more established indications for diagnostic work-up for lung and colorectal cancers. Twenty-six providers involved in cases with and without errors were interviewed. Interviews probed for providers' lack of SA and how this may have influenced the diagnostic process. Results Of 254 cases meeting inclusion criteria, errors were found in 30 (32.6%) of 92 lung cancer cases and 56 (33.5%) of 167 colorectal cancer cases. Analysis of interviews related to error cases revealed evidence of lack of one of four levels of SA applicable to primary care practice: information perception, information comprehension, forecasting future events, and choosing appropriate action based on the first three levels. In cases without error, the application of the SA framework provided insight into processes involved in attention management. Conclusions A framework of SA can help analyze and understand diagnostic errors in primary care settings that use EHRs. PMID:21890757

International benchmarking of specialty hospitals. A series of case studies on comprehensive cancer centres.

PubMed

van Lent, Wineke A M; de Beer, Relinde D; van Harten, Wim H

2010-08-31

Benchmarking is one of the methods used in business that is applied to hospitals to improve the management of their operations. International comparison between hospitals can explain performance differences. As there is a trend towards specialization of hospitals, this study examines the benchmarking process and the success factors of benchmarking in international specialized cancer centres. Three independent international benchmarking studies on operations management in cancer centres were conducted. The first study included three comprehensive cancer centres (CCC), three chemotherapy day units (CDU) were involved in the second study and four radiotherapy departments were included in the final study. Per multiple case study a research protocol was used to structure the benchmarking process. After reviewing the multiple case studies, the resulting description was used to study the research objectives. We adapted and evaluated existing benchmarking processes through formalizing stakeholder involvement and verifying the comparability of the partners. We also devised a framework to structure the indicators to produce a coherent indicator set and better improvement suggestions. Evaluating the feasibility of benchmarking as a tool to improve hospital processes led to mixed results. Case study 1 resulted in general recommendations for the organizations involved. In case study 2, the combination of benchmarking and lean management led in one CDU to a 24% increase in bed utilization and a 12% increase in productivity. Three radiotherapy departments of case study 3, were considering implementing the recommendations.Additionally, success factors, such as a well-defined and small project scope, partner selection based on clear criteria, stakeholder involvement, simple and well-structured indicators, analysis of both the process and its results and, adapt the identified better working methods to the own setting, were found. The improved benchmarking process and the success factors can produce relevant input to improve the operations management of specialty hospitals.

International benchmarking of specialty hospitals. A series of case studies on comprehensive cancer centres

PubMed Central

2010-01-01

Background Benchmarking is one of the methods used in business that is applied to hospitals to improve the management of their operations. International comparison between hospitals can explain performance differences. As there is a trend towards specialization of hospitals, this study examines the benchmarking process and the success factors of benchmarking in international specialized cancer centres. Methods Three independent international benchmarking studies on operations management in cancer centres were conducted. The first study included three comprehensive cancer centres (CCC), three chemotherapy day units (CDU) were involved in the second study and four radiotherapy departments were included in the final study. Per multiple case study a research protocol was used to structure the benchmarking process. After reviewing the multiple case studies, the resulting description was used to study the research objectives. Results We adapted and evaluated existing benchmarking processes through formalizing stakeholder involvement and verifying the comparability of the partners. We also devised a framework to structure the indicators to produce a coherent indicator set and better improvement suggestions. Evaluating the feasibility of benchmarking as a tool to improve hospital processes led to mixed results. Case study 1 resulted in general recommendations for the organizations involved. In case study 2, the combination of benchmarking and lean management led in one CDU to a 24% increase in bed utilization and a 12% increase in productivity. Three radiotherapy departments of case study 3, were considering implementing the recommendations. Additionally, success factors, such as a well-defined and small project scope, partner selection based on clear criteria, stakeholder involvement, simple and well-structured indicators, analysis of both the process and its results and, adapt the identified better working methods to the own setting, were found. Conclusions The improved benchmarking process and the success factors can produce relevant input to improve the operations management of specialty hospitals. PMID:20807408

Fit for purpose? Introducing a rational priority setting approach into a community care setting.

PubMed

Cornelissen, Evelyn; Mitton, Craig; Davidson, Alan; Reid, Colin; Hole, Rachelle; Visockas, Anne-Marie; Smith, Neale

2016-06-20

Purpose - Program budgeting and marginal analysis (PBMA) is a priority setting approach that assists decision makers with allocating resources. Previous PBMA work establishes its efficacy and indicates that contextual factors complicate priority setting, which can hamper PBMA effectiveness. The purpose of this paper is to gain qualitative insight into PBMA effectiveness. Design/methodology/approach - A Canadian case study of PBMA implementation. Data consist of decision-maker interviews pre (n=20), post year-1 (n=12) and post year-2 (n=9) of PBMA to examine perceptions of baseline priority setting practice vis-à-vis desired practice, and perceptions of PBMA usability and acceptability. Findings - Fit emerged as a key theme in determining PBMA effectiveness. Fit herein refers to being of suitable quality and form to meet the intended purposes and needs of the end-users, and includes desirability, acceptability, and usability dimensions. Results confirm decision-maker desire for rational approaches like PBMA. However, most participants indicated that the timing of the exercise and the form in which PBMA was applied were not well-suited for this case study. Participant acceptance of and buy-in to PBMA changed during the study: a leadership change, limited organizational commitment, and concerns with organizational capacity were key barriers to PBMA adoption and thereby effectiveness. Practical implications - These findings suggest that a potential way-forward includes adding a contextual readiness/capacity assessment stage to PBMA, recognizing organizational complexity, and considering incremental adoption of PBMA's approach. Originality/value - These insights help us to better understand and work with priority setting conditions to advance evidence-informed decision making.

Spectroscopic techniques (Mössbauer spectrometry, NMR, ESR,…) as tools to resolve doubtful NMR images: Study of the craniopharyngioma tumor

NASA Astrophysics Data System (ADS)

Rimbert, J. N.; Dumas, F.; Lafargue, C.; Kellershohn, C.; Brunelle, F.; Lallemand, D.

1990-07-01

Craniopharyngioma, an intracranial tumor, exhibits hyperintensity in the Spin-Echo-T2-NMR image and a hyposignal in the SE-T1-image. However, in some cases (15-20% cases), hypersignals are seen in both SE-T1 and T2-MRI. Using spectroscopic techniques, Mössbauer spectrometry in particular, we have demonstrated that the T1 hypersignal is due to ferritin, dissolved in the cystic liquid, after tumor cell lysis, in the course of time. Other possible reasons inducing a shortening of the T1 relaxation time (presence of lipids, intratumoral hemorrhage) have been rejected.

Two-rowed Hecke algebra representations at roots of unity

NASA Astrophysics Data System (ADS)

Welsh, Trevor Alan

1996-02-01

In this paper, we initiate a study into the explicit construction of irreducible representations of the Hecke algebraH n (q) of typeA n-1 in the non-generic case whereq is a root of unity. The approach is via the Specht modules ofH n (q) which are irreducible in the generic case, and possess a natural basis indexed by Young tableaux. The general framework in which the irreducible non-genericH n (q)-modules are to be constructed is set up and, in particular, the full set of modules corresponding to two-part partitions is described. Plentiful examples are given.

Nonlinear multivariable design by total synthesis. [of gas turbine engine control systems

NASA Technical Reports Server (NTRS)

Sain, M. K.; Peczkowski, J. L.

1982-01-01

The Nominal Design Problem (NDP) is extended to nonlinear cases, and a new case study of robust feedback synthesis for gas turbine control design is presented. The discussion of NDP extends and builds on earlier Total Synthesis Problem theory and ideas. Some mathematical preliminaries are given in which a bijection from a set S onto a set T is considered, with T admitting the structure of an F-vector space. NDP is then discussed for a nonlinear plant, and nonlinear nominal design is defined and characterized. The design of local controllers for a turbojet and the scheduling of these controls into a global control are addressed.

Comparing Architectural Styles for Service-Oriented Architectures - a REST vs. SOAP Case Study

NASA Astrophysics Data System (ADS)

Becker, Jörg; Matzner, Martin; Müller, Oliver

Two architectural styles are currently heavily discussed regarding the design of service-oriented architectures (SOA). Within this chapter we have compared those two alternative styles - the SOAP-style with procedural designs similar to remote procedure calls and the REST-style with loosely coupled services similar to resources of the World Wide Web. We introduce the case of a business network consisting of manufacturers and service providers of the electronics industry for deriving a set of requirements towards a specific SOA implementation. For each architectural style we present a concrete SOA design and evaluate it against the defined set of requirements.

Micro-scale Spatial Clustering of Cholera Risk Factors in Urban Bangladesh

PubMed Central

Bi, Qifang; Azman, Andrew S.; Satter, Syed Moinuddin; Khan, Azharul Islam; Ahmed, Dilruba; Riaj, Altaf Ahmed; Gurley, Emily S.; Lessler, Justin

2016-01-01

Close interpersonal contact likely drives spatial clustering of cases of cholera and diarrhea, but spatial clustering of risk factors may also drive this pattern. Few studies have focused specifically on how exposures for disease cluster at small spatial scales. Improving our understanding of the micro-scale clustering of risk factors for cholera may help to target interventions and power studies with cluster designs. We selected sets of spatially matched households (matched-sets) near cholera case households between April and October 2013 in a cholera endemic urban neighborhood of Tongi Township in Bangladesh. We collected data on exposures to suspected cholera risk factors at the household and individual level. We used intra-class correlation coefficients (ICCs) to characterize clustering of exposures within matched-sets and households, and assessed if clustering depended on the geographical extent of the matched-sets. Clustering over larger spatial scales was explored by assessing the relationship between matched-sets. We also explored whether different exposures tended to appear together in individuals, households, and matched-sets. Household level exposures, including: drinking municipal supplied water (ICC = 0.97, 95%CI = 0.96, 0.98), type of latrine (ICC = 0.88, 95%CI = 0.71, 1.00), and intermittent access to drinking water (ICC = 0.96, 95%CI = 0.87, 1.00) exhibited strong clustering within matched-sets. As the geographic extent of matched-sets increased, the concordance of exposures within matched-sets decreased. Concordance between matched-sets of exposures related to water supply was elevated at distances of up to approximately 400 meters. Household level hygiene practices were correlated with infrastructure shown to increase cholera risk. Co-occurrence of different individual level exposures appeared to mostly reflect the differing domestic roles of study participants. Strong spatial clustering of exposures at a small spatial scale in a cholera endemic population suggests a possible role for highly targeted interventions. Studies with cluster designs in areas with strong spatial clustering of exposures should increase sample size to account for the correlation of these exposures. PMID:26866926

Trajectories of Identification Across Social Spaces: Intersections Between Home, School and Everyday Spaces

NASA Astrophysics Data System (ADS)

Fields, Deborah Anne

This is a theory-building study taking a wide-angled perspective on youths' development of trajectories of identification across social settings of their everyday lives. I investigated the relationships within and between trajectories of identification across the everyday lives of four youth, studying the conflicts, cohesion, and gaps in their trajectories of identification as they moved across and participated in multiple social settings. I asked how trajectories of identification were built across social settings (i.e. relationships within a trajectory of identification); what kinds of relationships existed between youths' trajectories of identification; and what facilitated the building of trajectories of identification across social settings. To study these questions, I argued for three interrelated lenses on identity: local acting and positioning in practice, the ways one thinks of oneself (self-narratives), and the ways that others think of one (others'-narratives). Using these lenses I shaped a connective ethnography studying four 11-12 year old youth across everyday settings including school, home, hobbies like sports and music, community organizations, and peer groups, following two youth for six months and two youth for one year. I analyzed findings across the four youth. The cases presented in this thesis demonstrate the ways that youth form identities through their travel and not just in a single setting. First, I found that youth build trajectories of identification across social settings and not just in a single setting. As learning is not just within a single mind, so is identity developed beyond a single space. Second, I demonstrated how multiple interacting trajectories of identification within a youth's life may shape each other in inclusive and exclusive ways. Third, throughout the cases I highlighted how traveling artifacts can support building trajectories of identification across social settings, including boundary objects, artifacts created by the youth, and succinct narratives. Their ability to travel depends on how well they encompass values of people from different social settings. In turn, the travel and influence of artifacts are strengthened by certification and brokering.

Pinning down inelastic dark matter in the Sun and in direct detection

DOE Office of Scientific and Technical Information (OSTI.GOV)

Blennow, Mattias; Clementz, Stefan; Herrero-Garcia, Juan, E-mail: emb@kth.se, E-mail: scl@kth.se, E-mail: juhg@kth.se

2016-04-01

We study the solar capture rate of inelastic dark matter with endothermic and/or exothermic interactions. By assuming that an inelastic dark matter signal will be observed in next generation direct detection experiments we can set a lower bound on the capture rate that is independent of the local dark matter density, the velocity distribution, the galactic escape velocity as well as the scattering cross section. In combination with upper limits from neutrino observatories we can place upper bounds on the annihilation channels leading to neutrinos. We find that, while endothermic scattering limits are weak in the isospin-conserving case, strong boundsmore » may be set for exothermic interactions, in particular in the spin-dependent case. Furthermore, we study the implications of observing two direct detection signals, in which case one can halo-independently obtain the dark matter mass and the mass splitting, and disentangle the endothermic/exothermic nature of the scattering. Finally we discuss isospin violation.« less

[Etiological diagnosis of central diabetes insipidus: about 41 cases].

PubMed

Chaker, Fatma; Chihaoui, Melika; Yazidi, Meriem; Slimane, Hedia

2016-01-01

The occurrence of polyuria-polydipsia syndrome with hypotonic urine requires careful diagnostic strategy. This study aims to evaluate diagnostic modalities for central diabetes insipidus. We conducted a retrospective study of 41 cases with central diabetes insipidus (CDI). Data were collected at the Department of Endocrinology, University Hospital La Rabta, Tunis, from 1990 to 2013. We identified the circumstances for detecting CDI, the abnormalities in anterior pituitary assessment and pituitary imaging. CDI occurred in the postoperative period in 20 patients. The average urine 24-hour volume was significantly higher in patients with CDI outside a surgical setting. Water deprivation test was successful in all patients who benefited from it. Outside of neurosurgery, infiltration causes were found in 6 patients and tumor causes were found in 6 patients. CDI was associated with empty sella turcica in 1 case and idiopathic sella turcica in 3 patients. Hypothalamic-pituitary magnetic resonance imaging and anterior pituitary balance sheet are systematic outside pituitary surgery setting and obvious primary polydipsia.

Incidence of scalp metastases in breast cancer: a retrospective cohort study in women who were offered scalp cooling.

PubMed

Lemieux, Julie; Amireault, Carl; Provencher, Louise; Maunsell, Elizabeth

2009-12-01

Scalp cooling is an intervention used to decrease the degree of chemotherapy-induced alopecia. The objective is to determine the incidence of scalp metastases among women with early breast cancer who received neoadjuvant or adjuvant chemotherapy. We conducted a retrospective cohort study of women with breast carcinoma diagnosed between June 1, 1998 and June 30, 2002. The median follow-up was 5.8 years (+/-1.7) for the scalp cooling group (n = 553) and 5.4 years (+/-1.7) for the non-scalp cooling group (n = 87). The incidence of scalp metastases was 1.1% (6 cases out of 553 patients) among women who used scalp cooling in the neoadjuvant or adjuvant setting and 1.2% also (1 case out of 87 patients) among women who did not use scalp cooling in the neoadjuvant or adjuvant setting. The incidence of scalp metastases was low and no case presented as an isolated site of relapse.

Digital Storytelling with Pre-Service Teachers. Raising Awareness for Refugees through ICTS in ESL Primary Classes

ERIC Educational Resources Information Center

Alcantud Diaz, Maria

2016-01-01

This article describes the design and implementation of a Digital Storytelling (DS) experience that was carried out in a foreign language setting with pre-service teachers. This case study sets out to assess the effect of DS aimed at becoming a social awareness and pedagogical tool for both, high education and consequently, primary students. The…

Visual Communication in Transition: Designing for New Media Literacies and Visual Culture Art Education across Activities and Settings

ERIC Educational Resources Information Center

Zuiker, Steven J.

2014-01-01

As an example of design-based research, this case study describes and analyses the enactment of a collaborative drawing and animation studio in a Singapore secondary school art classroom. The design embodies principles of visual culture art education and new media literacies in order to organize transitions in the settings of participation and…

The Use of an Antecedent-Based Intervention to Decrease Stereotypic Behavior in a General Education Classroom: A Case Study

ERIC Educational Resources Information Center

Conroy, Maureen A.; Asmus, Jennifer M.; Sellers, Jennifer A.; Ladwig, Crystal N.

2005-01-01

The incidence of children identified as having autism spectrum disorders (ASD) is increasing (U.S. Department of Education, Office of Special Education Programs, 2003). Many of these children are enrolled in general education settings, posing an ever-growing challenge for the teachers in those settings. There is a critical need to develop…

A Case Study of Gendered Play in Preschools: How Early Childhood Educators' Perceptions of Gender Influence Children's Play

ERIC Educational Resources Information Center

Chapman, Rachel

2016-01-01

This research aimed to explore children's play in relation to gender stereotypes and beliefs and practices of educators in preschool settings. A feminist poststructuralist approach framed the design of the research and data were collected in two settings through predetermined categories of play during periods of spontaneous free play. The question…

Alex in the Middle: Inclusion of a Child with Severe Disabilities and Complex Health Needs.

ERIC Educational Resources Information Center

Bruns, Deborah A.

This case study describes the 2-year process of moving a young child with severe disabilities and complex medical needs from a special school setting to a special class in a regular education setting. The child had Marshall-Smith Syndrome, characterized by respiratory, pulmonary, and skeletal abnormalities, and developmental delays due to the…

"Why Do Parrots Talk?" Co-Investigation as a Model for Promoting Family Learning through Conversation in a Natural History Gallery

ERIC Educational Resources Information Center

Harris, Emily; Winterbottom, Mark

2018-01-01

Research into how and what families learn in science museums and other informal science learning settings suggests that parent-child interactions play an important role in shaping children's learning experiences. Our exploratory case study set out to discover and analyse learning happening within family groups during a visit to a traditional…

Programa de Fortalecimiento de Capacidades: Reflections on a Case Study of Community-Based Teacher Education Set in Rural Northern Peru

ERIC Educational Resources Information Center

Alsop, Steve; Ames, Patricia; Arroyo, Graciela Cordero; Dippo, Don

2010-01-01

This article explores distinctive features of a 5-year international education development project set in rural northern Peru (PROMEB, the "Proyecto de Mejoramiento de la Educacion Basica"). Grounded within a partnership between teacher educators from Peru, Mexico and Canada, and rural Peruvian teachers, students and their communities,…

Analysis of binary responses with outcome-specific misclassification probability in genome-wide association studies.

PubMed

Rekaya, Romdhane; Smith, Shannon; Hay, El Hamidi; Farhat, Nourhene; Aggrey, Samuel E

2016-01-01

Errors in the binary status of some response traits are frequent in human, animal, and plant applications. These error rates tend to differ between cases and controls because diagnostic and screening tests have different sensitivity and specificity. This increases the inaccuracies of classifying individuals into correct groups, giving rise to both false-positive and false-negative cases. The analysis of these noisy binary responses due to misclassification will undoubtedly reduce the statistical power of genome-wide association studies (GWAS). A threshold model that accommodates varying diagnostic errors between cases and controls was investigated. A simulation study was carried out where several binary data sets (case-control) were generated with varying effects for the most influential single nucleotide polymorphisms (SNPs) and different diagnostic error rate for cases and controls. Each simulated data set consisted of 2000 individuals. Ignoring misclassification resulted in biased estimates of true influential SNP effects and inflated estimates for true noninfluential markers. A substantial reduction in bias and increase in accuracy ranging from 12% to 32% was observed when the misclassification procedure was invoked. In fact, the majority of influential SNPs that were not identified using the noisy data were captured using the proposed method. Additionally, truly misclassified binary records were identified with high probability using the proposed method. The superiority of the proposed method was maintained across different simulation parameters (misclassification rates and odds ratios) attesting to its robustness.

Risk factors for geriatric patient falls in rehabilitation hospital settings: a systematic review.

PubMed

Vieira, Edgar Ramos; Freund-Heritage, Rosalie; da Costa, Bruno R

2011-09-01

To review the literature to identify and synthesize the evidence on risk factors for patient falls in geriatric rehabilitation hospital settings. Eligible studies were systematically searched on 16 databases from inception to December 2010. The search strategies used a combination of terms for rehabilitation hospital patients, falls, risk factors and older adults. Cross-sectional, cohort, case-control studies and randomized clinical trials (RCTs) published in English that investigated risks for falls among patients ≥65 years of age in rehabilitation hospital settings were included. Studies that investigated fall risk assessment tools, but did not investigate risk factors themselves or did not report a measure of risk (e.g. odds ratio, relative risk) were excluded. A total of 2,824 references were identified; only eight articles concerning six studies met the inclusion criteria. In these, 1,924 geriatric rehabilitation patients were followed. The average age of the patients ranged from 77 to 83 years, the percentage of women ranged from 56% to 81%, and the percentage of fallers ranged from 15% to 54%. Two were case-control studies, two were RCTs and four were prospective cohort studies. Several intrinsic and extrinsic risk factors for falls were identified. Carpet flooring, vertigo, being an amputee, confusion, cognitive impairment, stroke, sleep disturbance, anticonvulsants, tranquilizers and antihypertensive medications, age between 71 and 80, previous falls, and need for transfer assistance are risk factors for geriatric patient falls in rehabilitation hospital settings.

Diagnostic accuracy of mammography readers and their memory performance have no correlation with each other.

PubMed

Kok, P; Pitman, A G; Cawson, J N; Gledhill, S; Kremer, S; Lawson, J; Mehta, K; Mercuri, V; Shnier, D; Taft, R; Zentner, L

2010-08-01

The study aims to determine if any association exists between visual memory performance and diagnostic accuracy performance in a group of radiologist mammogram readers. One hundred proven mammograms (23 with cancers) were grouped into 5 sets of 20 cases, with sets being of equal difficulty. Pairs of sets were presented in 5 reads (40 cases per read, order random) to a panel of 8 radiologist readers (either present or past screening readers, with experience range from <1 year to >20 years). The readers were asked to either 'clear' or 'call back' cases depending on need for further workup, and at post-baseline reads to indicate whether each case was 'new' or 'old' (i.e. remembered from prior read). Two sets were presented only at baseline (40 cases per reader), and were used to calculate the reader's false recollection rate. Three sets were repeated post-baseline once or twice (100 cases per reader). Reading conditions were standardised. Memory performance differed markedly between readers. The number of correctly remembered cases (of 100 'old' cases) had a median of 10.5 and range of 0-58. The observed number of false recollections (of 40 'totally new' cases) had a median of 2 and range of 0-17. Diagnostic performance measures were mean (range): sensitivity 0.68 (0.54-0.81); specificity 0.82 (0.74-0.91); positive predictive value (PPV) 0.55 (0.50-0.65); negative predictive value (NPV) 0.89 (0.86-0.93) and accuracy 0.78 (0.76-0.83). Confidence intervals (CIs; 95%) for each reader overlapped for all the diagnostic parameters, indicating a lack of statistically significant difference between the readers at the 5% level. The most sensitive and the most specific reader showed a trend away from each other on sensitivity, specificity, NPV and PPV; their accuracies were 0.76 and 0.82, respectively, and their accuracy 95% CIs overlapped considerably. Correlation analysis by reader showed no association between observed memory performance and any of the diagnostic accuracy measures in our group of readers. In particular, there was no correlation between diagnostic accuracy and memory performance. There was no association between visual memory performance and diagnostic accuracy as a screening mammographer in our group of eight representative readers. Whether a radiologist has a good or a bad visual memory for cases, and in particular mammograms, should not impact on his or her performance as a radiologist and mammogram reader.

Using case study within a sequential explanatory design to evaluate the impact of specialist and advanced practice roles on clinical outcomes: the SCAPE study.

PubMed

Lalor, Joan G; Casey, Dympna; Elliott, Naomi; Coyne, Imelda; Comiskey, Catherine; Higgins, Agnes; Murphy, Kathy; Devane, Declan; Begley, Cecily

2013-04-08

The role of the clinical nurse/midwife specialist and advanced nurse/midwife practitioner is complex not least because of the diversity in how the roles are operationalised across health settings and within multidisciplinary teams. This aim of this paper is to use The SCAPE Study: Specialist Clinical and Advanced Practitioner Evaluation in Ireland to illustrate how case study was used to strengthen a Sequential Explanatory Design. In Phase 1, clinicians identified indicators of specialist and advanced practice which were then used to guide the instrumental case study design which formed the second phase of the larger study. Phase 2 used matched case studies to evaluate the effectiveness of specialist and advanced practitioners on clinical outcomes for service users. Data were collected through observation, documentary analysis, and interviews. Observations were made of 23 Clinical Specialists or Advanced Practitioners, and 23 matched clinicians in similar matched non-postholding sites, while they delivered care. Forty-one service users, 41 clinicians, and 23 Directors of Nursing or Midwifery were interviewed, and 279 service users completed a survey based on the components of CS and AP practice identified in Phase 1. A coding framework, and the generation of cross tabulation matrices in NVivo, was used to make explicit how the outcome measures were confirmed and validated from multiple sources. This strengthened the potential to examine single cases that seemed 'different', and allowed for cases to be redefined. Phase 3 involved interviews with policy-makers to set the findings in context. Case study is a powerful research strategy to use within sequential explanatory mixed method designs, and adds completeness to the exploration of complex issues in clinical practice. The design is flexible, allowing the use of multiple data collection methods from both qualitative and quantitative paradigms. Multiple approaches to data collection are needed to evaluate the impact of complex roles and interventions in health care outcomes and service delivery. Case study design is an appropriate methodology to use when study outcomes relate to clinical practice.

Childhood risk factors in Korean women with anorexia nervosa: two sets of case-control studies with retrospective comparisons.

PubMed

Kim, Youl-Ri; Heo, Si Young; Kang, Heechan; Song, Ki Jun; Treasure, Janet

2010-11-01

The aim of this study was to investigate the characteristics of the risk factors for anorexia nervosa (AN) in Korean women. Two sets of case-control comparisons were conducted, in which 52 women with lifetime AN from Seoul, S. Korea, were compared with 108 Korean healthy controls and also with 42 women with lifetime AN from the UK in terms of their childhood risk factors. A questionnaire designed to conduct a retrospective assessment of the childhood risk factors was administered to all participants. The Korean AN women were more likely to report premorbid anxiety, perfectionism, and emotional undereating and were less likely to report having supportive figures in their childhood than the Korean healthy controls. There were no overall differences in the childhood risk factors between the Korean and British women with AN. Premorbid anxiety, perfectionism, less social support, and emotional undereating merit attention as risk factors in Korean AN. The current results are informative, but an epidemiologically robust prospective case-control study would be needed to validate these findings. © 2009 by Wiley Periodicals, Inc.

Coastal groundwater/surface-water interactions: a Great Lakes case study

USGS Publications Warehouse

Neff, Brian P.; Haack, Sheridan K.; Rosenberry, Donald O.; Savino, Jacqueline F.; Lundstrom, Scott C.

2006-01-01

Key similarities exist between marine and Great Lakes coastal environments. Water and nutrient fluxes across lakebeds in the Great Lakes are influenced by seiche and wind set-up and set-down, analogous to tidal influence in marine settings. Groundwater/surface-water interactions also commonly involve a saline-fresh water interface, although in the Great-Lakes cases, it is groundwater that is commonly saline and surface water that is fresh. Evapotranspiration also affects nearshore hydrology in both settings. Interactions between groundwater and surface water have recently been identified as an important component of ecological processes in the Great Lakes. Water withdrawals and the reversal of the groundwater/surface water seepage gradient are also common to many coastal areas around the Great Lakes. As compared to surface water, regional groundwater that discharges to western Lake Erie from Michigan is highly mineralized. Studies conducted by the U.S. Geological Survey at Erie State Game Area in southeastern Michigan, describe groundwater flow dynamics and chemistry, shallow lake-water chemistry, and fish and invertebrate communities. Results presented here provide an overview of recent progress of ongoing interdisciplinary studies of Great Lakes nearshore systems and describe a conceptual model that identifies relations among geologic, hydrologic, chemical, and biological processes in the coastal habitats of Lake Erie. This conceptual model is based on analysis of hydraulic head in piezometers at the study site and chemical analysis of deep and shallow coastal groundwater.

An artificial neural network prediction model of congenital heart disease based on risk factors: A hospital-based case-control study.

PubMed

Li, Huixia; Luo, Miyang; Zheng, Jianfei; Luo, Jiayou; Zeng, Rong; Feng, Na; Du, Qiyun; Fang, Junqun

2017-02-01

An artificial neural network (ANN) model was developed to predict the risks of congenital heart disease (CHD) in pregnant women.This hospital-based case-control study involved 119 CHD cases and 239 controls all recruited from birth defect surveillance hospitals in Hunan Province between July 2013 and June 2014. All subjects were interviewed face-to-face to fill in a questionnaire that covered 36 CHD-related variables. The 358 subjects were randomly divided into a training set and a testing set at the ratio of 85:15. The training set was used to identify the significant predictors of CHD by univariate logistic regression analyses and develop a standard feed-forward back-propagation neural network (BPNN) model for the prediction of CHD. The testing set was used to test and evaluate the performance of the ANN model. Univariate logistic regression analyses were performed on SPSS 18.0. The ANN models were developed on Matlab 7.1.The univariate logistic regression identified 15 predictors that were significantly associated with CHD, including education level (odds ratio  = 0.55), gravidity (1.95), parity (2.01), history of abnormal reproduction (2.49), family history of CHD (5.23), maternal chronic disease (4.19), maternal upper respiratory tract infection (2.08), environmental pollution around maternal dwelling place (3.63), maternal exposure to occupational hazards (3.53), maternal mental stress (2.48), paternal chronic disease (4.87), paternal exposure to occupational hazards (2.51), intake of vegetable/fruit (0.45), intake of fish/shrimp/meat/egg (0.59), and intake of milk/soymilk (0.55). After many trials, we selected a 3-layer BPNN model with 15, 12, and 1 neuron in the input, hidden, and output layers, respectively, as the best prediction model. The prediction model has accuracies of 0.91 and 0.86 on the training and testing sets, respectively. The sensitivity, specificity, and Yuden Index on the testing set (training set) are 0.78 (0.83), 0.90 (0.95), and 0.68 (0.78), respectively. The areas under the receiver operating curve on the testing and training sets are 0.87 and 0.97, respectively.This study suggests that the BPNN model could be used to predict the risk of CHD in individuals. This model should be further improved by large-sample-size research.

Treatment of perforated giant gastric ulcer in an emergency setting.

PubMed

Kumar, Pradeep; Khan, Hosni Mubarak; Hasanrabba, Safarulla

2014-01-27

To study and assess clinical outcomes of various modes of treatment for perforated giant gastric ulcer in an emergency setting. From May 2010 to February 2013, 20 cases of perforated giant gastric ulcer (> 2 cm) were operated on in an emergency setting. All the patients presented with features of peritonitis and were resuscitated aggressively before taking for surgery. In the first 4 cases, primary closure was done after taking a biopsy and among these, the 3(rd) case also underwent partial distal gastrectomy and gastrojejunostomy and the 4(th) case underwent a radical subtotal gastrectomy with D2 lymphadenectomy and gastrojejunostomy for malignancy. All the remaining 16 cases underwent partial distal gastrectomy and gastrojejunostomy. Among the first 4 cases, 2 had an uneventful recovery and were discharged on the 6(th) postoperative day. The 3(rd) and 4(th) patients developed gastric fistula, leading to prolonged hospitalization. For the 3(rd) patient, conservative management was tried for 1 wk, followed by partial distal gastrectomy and gastrojejunostomy, and he was discharged on the 20(th) day after admission, while the 4(th) patient underwent a radical subtotal gastrectomy with D2 lymphadenectomy and gastrojejunostomy. Postoperatively, he developed adult respiratory distress syndrome, multiorgan dysfunction syndrome and expired on the 3(rd) postoperative day of the second surgery. All the remaining 16 patients underwent partial distal gastrectomy and gastrojejunostomy and recovered well. Among these, 4 of them were malignant and the remaining were benign ulcers. All had an uneventful recovery. The percentage of malignancy in our series was 30% (6 out of 20 cases). In our study, 86% had an uneventful recovery, complications were seen in about 10%, and mortality was about 5%. In giant gastric ulcer, the chances of malignancy and leak after primary closure are high. So, we feel that partial distal gastrectomy and gastrojejunostomy is better.

Geometric Hitting Set for Segments of Few Orientations

DOE PAGES

Fekete, Sandor P.; Huang, Kan; Mitchell, Joseph S. B.; ...

2016-01-13

Here we study several natural instances of the geometric hitting set problem for input consisting of sets of line segments (and rays, lines) having a small number of distinct slopes. These problems model path monitoring (e.g., on road networks) using the fewest sensors (the \\hitting points"). We give approximation algorithms for cases including (i) lines of 3 slopes in the plane, (ii) vertical lines and horizontal segments, (iii) pairs of horizontal/vertical segments. Lastly, we give hardness and hardness of approximation results for these problems. We prove that the hitting set problem for vertical lines and horizontal rays is polynomially solvable.

Implementing augmentative and alternative communication in inclusive educational settings: a case study.

PubMed

Stoner, Julia B; Angell, Maureen E; Bailey, Rita L

2010-06-01

The purpose of this study was to describe a single case of augmentative and alternative communication (AAC) implementation. Case study methodology was used to describe the perspectives of educational team members regarding AAC implementation for Joey, a high school junior with athetoid cerebral palsy. Benefits included greater intelligibility for Joey and subsequent comfort of the staff. Facilitators of Joey's AAC system use included the team's student-focused disposition and willingness to implement use of the device, Joey's increased intelligibility, peers' acceptance of the technology, and the resulting increase in Joey's socialization. Limited team cohesiveness, problem solving, and communication were the true barriers in this case. Implications of these facilitators and barriers are discussed and recommendations for school-based AAC implementation are made.

MPT64 antigen detection test improves routine diagnosis of extrapulmonary tuberculosis in a low-resource setting: A study from the tertiary care hospital in Zanzibar.

PubMed

Jørstad, Melissa Davidsen; Marijani, Msafiri; Dyrhol-Riise, Anne Ma; Sviland, Lisbet; Mustafa, Tehmina

2018-01-01

Extrapulmonary tuberculosis (EPTB) is a diagnostic challenge. An immunochemistry-based MPT64 antigen detection test (MPT64 test) has reported higher sensitivity in the diagnosis of EPTB compared with conventional methods. The objective of this study was to implement and evaluate the MPT64 test in routine diagnostics in a low-resource setting. Patients with presumptive EPTB were prospectively enrolled at Mnazi Mmoja Hospital, Zanzibar, and followed to the end of treatment. Specimens collected were subjected to routine diagnostics, GeneXpert® MTB/RIF assay and the MPT64 test. The performance of the MPT64 test was assessed using a composite reference standard, defining the patients as tuberculosis (TB) cases or non-TB cases. Patients (n = 132) were classified as confirmed TB (n = 12), probable TB (n = 34), possible TB (n = 18), non-TB (n = 62) and uncategorized (n = 6) cases. Overall, in comparison to the composite reference standard for diagnosis, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the MPT64 test was 69%, 95%, 94%, 75% and 82%, respectively. The MPT64 test performance was best in TB lymphadenitis cases (n = 67, sensitivity 79%, specificity 97%) and in paediatric TB (n = 41, sensitivity 100%, specificity 96%). We show that the MPT64 test can be implemented in routine diagnostics in a low-resource setting and improves the diagnosis of EPTB, especially in TB lymphadenitis and in children.

Association of CASP9, CASP10 gene polymorphisms and tea drinking with colorectal cancer risk in the Han Chinese population.

PubMed

Liu, He; Jiang, Xia; Zhang, Ming-wu; Pan, Yi-feng; Yu, Yun-xian; Zhang, Shan-chun; Ma, Xin-yuan; Li, Qi-long; Chen, Kun

2013-01-01

The initiators caspase-9 (CASP9) and caspase-10 (CASP10) are two key controllers of apoptosis and play important roles in carcinogenesis. This study aims to explore the association between CASPs gene polymorphisms and colorectal cancer (CRC) susceptibility in a population-based study. A two-stage designed population-based case-control study was carried out, including a testing set with 300 cases and 296 controls and a validation set with 206 cases and 845 controls. A total of eight tag selected single nucleotide polymorphisms (SNPs) in CASP9 and CASP10 were chosen based on HapMap and the National Center of Biotechnology Information (NCBI) datasets and genotyped by restriction fragment length polymorphism (RFLP) assay. Multivariate logistic regression models were applied to evaluate the association of SNPs with CRC risk. In the first stage, from eight tag SNPs, three polymorphisms rs4646077 (odds ratio (OR)(AA+AG): 0.654, 95% confidence interval (CI): 0.406-1.055; P=0.082), rs4233532 (OR(CC): 1.667, 95% CI: 0.967-2.876; OR(CT): 1.435, 95% CI: 0.998-2.063; P=0.077), and rs2881930 (OR(CC): 0.263, 95% CI: 0.095-0.728, P=0.036) showed possible association with CRC risk. However, none of the three SNPs, rs4646077 (OR(AA+AG): 1.233, 95% CI: 0.903-1.683), rs4233532 (OR(CC): 0.892, 95% CI: 0.640-1.243; OR(CT): 1.134, 95% CI: 0.897-1.433), and rs2881930 (OR(CC): 1.096, 95% CI: 0.620-1.938; OR(CT): 1.009, 95% CI: 0.801-1.271), remained significant with CRC risk in the validation set, even after stratification for different tumor locations (colon or rectum). In addition, never tea drinking was associated with a significantly increased risk of CRC in testing set together with validation set (OR: 1.755, 95% CI: 1.319-2.334). Our results found that polymorphisms of CASP9 and CASP10 genes may not contribute to CRC risk in Chinese population and thereby the large-scale case-control studies might be in consideration. In addition, tea drinking was a protective factor for CRC.