Making medical decisions in dependence of genetic background: estimation of the utility of DNA testing in clinical, pharmaco-epidemiological or genetic studies.

PubMed

Nguyen, Thuy Trang; Schäfer, Helmut; Timmesfeld, Nina

2013-05-01

An index measuring the utility of testing a DNA marker before deciding between two alternative treatments is proposed which can be estimated from pharmaco-epidemiological case-control or cohort studies. In the case-control design, external estimates of the prevalence of the disease and of the frequency of the genetic risk variant are required for estimating the utility index. Formulas for point and interval estimates are derived. Empirical coverage probabilities of the confidence intervals were estimated under different scenarios of disease prevalence, prevalence of drug use, and population frequency of the genetic variant. To illustrate our method, we re-analyse pharmaco-epidemiological case-control data on oral contraceptive intake and venous thrombosis in carriers and non-carriers of the factor V Leiden mutation. We also re-analyse cross-sectional data from the Framingham study on a gene-diet interaction between an APOA2 polymorphism and high saturated fat intake on obesity. We conclude that the utility index may be helpful to evaluate and appraise the potential clinical and public health relevance of gene-environment interaction effects detected in genomic and candidate gene association studies and may be a valuable decision support for designing prospective studies on the clinical utility. © 2013 Wiley Periodicals, Inc.

Case-Mix Adjusting Performance Measures in a Veteran Population: Pharmacy- and Diagnosis-Based Approaches

PubMed Central

Liu, Chuan-Fen; Sales, Anne E; Sharp, Nancy D; Fishman, Paul; Sloan, Kevin L; Todd-Stenberg, Jeff; Nichol, W Paul; Rosen, Amy K; Loveland, Susan

2003-01-01

Objective To compare the rankings for health care utilization performance measures at the facility level in a Veterans Health Administration (VHA) health care delivery network using pharmacy- and diagnosis-based case-mix adjustment measures. Data Sources/Study Setting The study included veterans who used inpatient or outpatient services in Veterans Integrated Service Network (VISN) 20 during fiscal year 1998 (October 1997 to September 1998; N=126,076). Utilization and pharmacy data were extracted from VHA national databases and the VISN 20 data warehouse. Study Design We estimated concurrent regression models using pharmacy or diagnosis information in the base year (FY1998) to predict health service utilization in the same year. Utilization measures included bed days of care for inpatient care and provider visits for outpatient care. Principal Findings Rankings of predicted utilization measures across facilities vary by case-mix adjustment measure. There is greater consistency within the diagnosis-based models than between the diagnosis- and pharmacy-based models. The eight facilities were ranked differently by the diagnosis- and pharmacy-based models. Conclusions Choice of case-mix adjustment measure affects rankings of facilities on performance measures, raising concerns about the validity of profiling practices. Differences in rankings may reflect differences in comparability of data capture across facilities between pharmacy and diagnosis data sources, and unstable estimates due to small numbers of patients in a facility. PMID:14596393

Ground-source heat pump case studies and utility programs

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

Lienau, P.J.; Boyd, T.L.; Rogers, R.L.

1995-04-01

Ground-source heat pump systems are one of the promising new energy technologies that has shown rapid increase in usage over the past ten years in the United States. These systems offer substantial benefits to consumers and utilities in energy (kWh) and demand (kW) savings. The purpose of this study was to determine what existing monitored data was available mainly from electric utilities on heat pump performance, energy savings and demand reduction for residential, school and commercial building applications. In order to verify the performance, information was collected for 253 case studies from mainly utilities throughout the United States. The casemore » studies were compiled into a database. The database was organized into general information, system information, ground system information, system performance, and additional information. Information was developed on the status of demand-side management of ground-source heat pump programs for about 60 electric utility and rural electric cooperatives on marketing, incentive programs, barriers to market penetration, number units installed in service area, and benefits.« less

Integrating knowledge generation with knowledge diffusion and utilization: a case study analysis of the Consortium for Applied Research and Evaluation in Mental Health.

PubMed

Vingilis, Evelyn; Hartford, Kathleen; Schrecker, Ted; Mitchell, Beth; Lent, Barbara; Bishop, Joan

2003-01-01

Knowledge diffusion and utilization (KDU) have become a key focus in the health research community because of the limited success to date of research findings to inform health policies, programs and services. Yet, evidence indicates that successful KDU is often predicated on the early involvement of potential knowledge users in the conceptualization and conduct of the research and on the development of a "partnership culture". This study describes the integration of KDU theory with practice via a case study analysis of the Consortium for Applied Research and Evaluation in Mental Health (CAREMH). This qualitative study, using a single-case design, included a number of data sources: proposals, meeting minutes, presentations, publications, reports and curricula vitae of CAREMH members. CAREMH has adopted the following operational strategies to increase KDU capacity: 1) viewing research as a means and not as an end; 2) bringing the university and researcher to the community; 3) using participatory research methods; 4) embracing transdisciplinary research and interactions; and 5) using connectors. Examples of the iterative process between researchers and potential knowledge users in their contribution to knowledge generation, diffusion and utilization are provided. This case study supports the importance of early and ongoing involvement of relevant potential knowledge users in research to enhance its utilization potential. It also highlights the need for re-thinking research funding approaches.

Queer blindfolding: a case study on difference "blindness" toward persons who identify as lesbian, gay, bisexual, and transgender.

PubMed

Smith, Lance C; Shin, Richard Q

2014-01-01

The purpose of this article is to introduce and explore the narrative strategy of queer blindfolding. Utilizing psycho-discursive qualitative methodology, the authors will draw from a case study to demonstrate how some beneficent, well-intended persons who identify as heterosexual adopt the narrative strategy of queer blindfolding as they negotiate the discourse of heteronormativity. We will map this narrative strategy, compare and contrast it to racial colorblindness, and unpack the accompanying intra-psychic conflict and defense mechanisms that are utilized by the participant in the case study. We will also demonstrate how this discursive strategy positions participants within systemic heterosexism.

Using Online Case Studies to Enhance Teacher Preparation

ERIC Educational Resources Information Center

Richman, Laila

2015-01-01

The purpose of this study was to assess the impact interactive, online case studies have on learning for preservice teachers. More specifically, it evaluated whether the use of online case studies in instruction could enhance the level of knowledge the preservice teacher gained from the content material. This study utilized a nonequivalent group,…

Feasibility study for remote assessment of cognitive function in multiple sclerosis.

PubMed

George, Michaela F; Holingue, Calliope B; Briggs, Farren B S; Shao, Xiaorong; Bellesis, Kalliope H; Whitmer, Rachel A; Schaefer, Catherine; Benedict, Ralph Hb; Barcellos, Lisa F

2016-01-01

Cognitive impairment is common in multiple sclerosis (MS), and affects employment and quality of life. Large studies are needed to identify risk factors for cognitive decline. Currently, a MS-validated remote assessment for cognitive function does not exist. Studies to determine feasibility of large remote cognitive function investigations in MS have not been published. To determine whether MS patients would participate in remote cognitive studies. We utilized the Modified Telephone Interview for Cognitive Status (TICS-M), a previously validated phone assessment for cognitive function in healthy elderly populations to detect mild cognitive impairment. We identified factors that influenced participation rates. We investigated the relationship between MS risk factors and TICS-M score in cases, and score differences between cases and control individuals. The TICS-M was administered to MS cases and controls. Linear and logistic regression models were utilized. 11.5% of eligible study participants did not participate in cognitive testing. MS cases, females and individuals with lower educational status were more likely to refuse (p<0.001). Cases who did complete testing did not differ in terms of perceived cognitive deficit compared to cases that did participate. More severe disease, smoking, and being male were associated with a lower TICS-M score among cases (p<0.001). The TICS-M score was significantly lower in cases compared to controls (p=0.007). Our results demonstrate convincingly that a remotely administered cognitive assessment is quite feasible for conducting large epidemiologic studies in MS, and lay the much needed foundation for future work that will utilize MS-validated cognitive measures.

Feasibility study for remote assessment of cognitive function in multiple sclerosis

PubMed Central

George, Michaela F.; Holingue, Calliope B.; Briggs, Farren B.S.; Shao, Xiaorong; Bellesis, Kalliope H.; Whitmer, Rachel A.; Schaefer, Catherine; Benedict, Ralph HB; Barcellos, Lisa F.

2017-01-01

Background Cognitive impairment is common in multiple sclerosis (MS), and affects employment and quality of life. Large studies are needed to identify risk factors for cognitive decline. Currently, a MS-validated remote assessment for cognitive function does not exist. Studies to determine feasibility of large remote cognitive function investigations in MS have not been published. Objective To determine whether MS patients would participate in remote cognitive studies. We utilized the Modified Telephone Interview for Cognitive Status (TICS-M), a previously validated phone assessment for cognitive function in healthy elderly populations to detect mild cognitive impairment. We identified factors that influenced participation rates. We investigated the relationship between MS risk factors and TICS-M score in cases, and score differences between cases and control individuals. Methods The TICS-M was administered to MS cases and controls. Linear and logistic regression models were utilized. Results 11.5% of eligible study participants did not participate in cognitive testing. MS cases, females and individuals with lower educational status were more likely to refuse (p<0.001). Cases who did complete testing did not differ in terms of perceived cognitive deficit compared to cases that did participate. More severe disease, smoking, and being male were associated with a lower TICS-M score among cases (p<0.001). The TICS-M score was significantly lower in cases compared to controls (p=0.007). Conclusions Our results demonstrate convincingly that a remotely administered cognitive assessment is quite feasible for conducting large epidemiologic studies in MS, and lay the much needed foundation for future work that will utilize MS-validated cognitive measures. PMID:28255581

Conceptualizing race in economic models of medical utilization: a case study of community-based elders and the emergency room.

PubMed Central

White-Means, S I

1995-01-01

There is no consensus on the appropriate conceptualization of race in economic models of health care. This is because race is rarely the primary focus for analysis of the market. This article presents an alternative framework for conceptualizing race in health economic models. A case study is analyzed to illustrate the value of the alternative conceptualization. The case study findings clearly document the importance of model stratification according to race. Moreover, the findings indicate that empirical results are improved when medical utilization models are refined in a way that reflects the unique experiences of the population that is studied. PMID:7721593

Effect of diabetic case management intervention on health service utilization in Korea.

PubMed

Shin, Soon Ae; Kim, Hyeongsu; Lee, Kunsei; Lin, Vivian; Liu, George

2015-12-01

This study is to estimate the effectiveness of a diabetic case management programme on health-care service utilization. The study population included 6007 as the intervention group and 956,766 as the control group. As the indicators of health-care service utilization, numbers of medical ambulatory consultations, days of medication prescribed and medical expenses for one year were used, and we analysed the claim data of the health insurance from 2005 to 2007. The study population was classified into three subgroups based on the number of medical ambulatory consultations per year before this intervention. In the under-serviced subgroup, the intervention group showed a significant increase in the number of consultations (3.2), days of prescribed medication (66.4) and medical expenses (287,900 KRW) compared with the control group. Conversely, in the over-serviced subgroup, the intervention group showed a less decrease days of prescribed medication (1.6) compared with the control group. This showed that the case management programme led the intervention group to optimize their utilization of health-care services by subgroups. It is necessary to evaluate the appropriateness of health-care usage and clinical outcome to show the direct effectiveness of the case management programme by subgroups. © 2014 Wiley Publishing Asia Pty Ltd.

Analysis of Alternatives (AoA) Process Improvement Study

DTIC Science & Technology

2016-12-01

stakeholders, and mapped the process activities and durations. We tasked the SAG members with providing the information required on case studies and...are the expected time saves/cost/risk of any changes? (3) Utilization of case studies for both “good” and “challenged” AoAs to identify lessons...16 4 CASE STUDIES

A Mixed Methods Sampling Methodology for a Multisite Case Study

ERIC Educational Resources Information Center

Sharp, Julia L.; Mobley, Catherine; Hammond, Cathy; Withington, Cairen; Drew, Sam; Stringfield, Sam; Stipanovic, Natalie

2012-01-01

The flexibility of mixed methods research strategies makes such approaches especially suitable for multisite case studies. Yet the utilization of mixed methods to select sites for these studies is rarely reported. The authors describe their pragmatic mixed methods approach to select a sample for their multisite mixed methods case study of a…

[Home health resource utilization measures using a case-mix adjustor model].

PubMed

You, Sun-Ju; Chang, Hyun-Sook

2005-08-01

The purpose of this study was to measure home health resource utilization using a Case-Mix Adjustor Model developed in the U.S. The subjects of this study were 484 patients who had received home health care more than 4 visits during a 60-day episode at 31 home health care institutions. Data on the 484 patients had to be merged onto a 60-day payment segment. Based on the results, the researcher classified home health resource groups (HHRG). The subjects were classified into 34 HHRGs in Korea. Home health resource utilization according to clinical severity was in order of Minimum (C0) < 'Low (C1) < 'Moderate (C2) < 'High (C3), according to dependency in daily activities was in order of Minimum (F0) < 'High (F3) < 'Medium (F2) < 'Low (F1) < 'Maximum (F4). Resource utilization by HHRGs was the highest 564,735 won in group C0F0S2 (clinical severity minimum, dependency in daily activity minimum, service utilization moderate), and the lowest 97,000 won in group C2F3S1, so the former was 5.82 times higher than the latter. Resource utilization in home health care has become an issue of concern due to rising costs for home health care. The results suggest the need for more analytical attention on the utilization and expenditures for home care using a Case-Mix Adjustor Model.

The effect of an enhanced employee assistance program (EAP) intervention on EAP utilization.

PubMed

Zarkin, G A; Bray, J W; Karuntzos, G T; Demiralp, B

2001-05-01

An enhanced employee assistance program (EAP) intervention was developed that delivers comprehensive EAP outreach services to all employees who may have alcohol-related and other workplace problems; standard EAP materials traditionally targeted at white men were enhanced to include women and minorities. This study evaluates whether the enhanced EAP intervention increased EAP utilization. The enhanced EAP intervention was developed at a large community-based not-for-profit EAP located in Rockford, Illinois. Two primary worksites and 16 other newly contracted worksites received the enhanced EAP intervention and served as intervention sites; the 107 other worksites serviced by the EAP were used as comparison sites. We used time series data from 1991 to 1998 and included repeated measures on each firm's quarterly EAP utilization. The enhanced EAP intervention increased the mean number of women and minority cases per worksite by 58%, white male cases by 45% and total EAP cases by 53%. This study shows that, for a modest cost, the enhanced EAP intervention successfully increased utilization of EAP by all employees, especially utilization by women and minority employees. It also shows that traditional EAP services and outreach materials can be made more appealing to women and minorities without adversely affecting their utilization by white men.

The Utility of Case-Control Methods for Health Policy and Planning Analysis: An Illustration from Kinshasa, Zaire.

ERIC Educational Resources Information Center

Mock, Nancy B.; And Others

1993-01-01

The use of case-control methodology as an applied policy/planning research tool in assessing the potential effectiveness of behavioral interventions is studied in connection with diarrhea control in Zaire. Results with 107 matched pairs of children demonstrate the importance of hygiene-related knowledge and the utility of the research approach.…

Audit of the Functioning of the Elective Neurosurgical Operation Theater in India: A Prospective Study and Review of Literature.

PubMed

Saikia, Amrit Kumar; Sriganesh, Kamath; Ranjan, Manish; Claire, Marie; Mittal, Mohit; Pandey, Paritosh

2015-08-01

Knowledge about the utilization of the operation theater (OT) is essential to improve its efficiency. This study evaluated the neurosurgical operation theater utilization in a neurosciences teaching hospital. Data collected included OT start time, delay in start, anesthesia induction time, surgical preparation time, anesthesia recovery time, operating time, time between cases, and theater closing time. Five hundred thirty-seven surgeries were performed during the study period. The percentage of time used for anesthesia induction, actual surgical procedure, recovery from anesthesia, and theater preparation between the two cases were 8%, 70%, 6% and 5%, respectively. Fourteen percent of scheduled cases were cancelled. On 220 occasions (70.51%), theater was over-run. Late start contributed to loss of 8370 minutes (140 hours) of theater time. This study identified the proportion of time spent on each activity in the neurosurgical OT. This knowledge is likely to facilitate better planning of neurosurgical theater schedule and result in optimal utilization. Copyright © 2015 Elsevier Inc. All rights reserved.

White Sands Missile Range 2007 Urban Study: Data Processing - Volume DP-1 (Sonic Calibration)

DTIC Science & Technology

2008-09-01

calibrated in a wind tunnel against a NIST standard were positioned at the two ends of the lineup , closest to the buildings (positions 1 and 10 in...utilized westerly winds between 8 and 10 m/s (2007 February 24, 0600–0605 LT). The 5 min of data utilized by the “fast” case were sequential . The...2.4–11.2 m/s. The 5-min “variable” case utilized sequential minutes. Results from all three WS conditions were the following (Vaucher, 2007a

Digital enhancement of sub-quality bitemark photographs.

PubMed

Karazalus, C P; Palmbach, T T; Lee, H C

2001-07-01

Digital enhancement software was used to enhance bitemark photographs. This enhancement technique improved the resolution of the bitemark images. Lucis was the software program utilized in this study and case applications. First, this technique was applied on known bitemark images to evaluate the potential effectiveness of this digital enhancement method. Subsequently, Lucis was utilized on two separate unsolved cases involving enhancement of bitemark evidence. One case involved a severely beaten infant with a bitemark on the upper thigh. The second case involves a bitemark observed on the breast of a female sexual assault strangulation victim. In both cases, bitemark images were significantly improved after digital enhancement.

Earned Income Credit Utilization by Welfare Recipients: A Case Study of Minnesota's Earned Income Credit Program

ERIC Educational Resources Information Center

Hirasuna, Donald P.; Stinson, Thomas F.

2007-01-01

This paper examines utilization of a state earned income credit by AFDC and TANF recipients. Although utilization percentages are increasing, we find that among TANF recipients in 1999, 45.7 percent of all households and 34.8 percent of eligible households did not receive the state earned income credit. Moreover, we find that utilization may…

Effects of Diabetic Case Management on Knowledge, Self-Management Abilities, Health Behaviors, and Health Service Utilization for Diabetes in Korea

PubMed Central

Shin, Soon Ae; Lee, Kunsei; Lin, Vivian; Liu, George; Shin, Eunyoung

2015-01-01

Purpose This study aimed to evaluate the effects of a case management program for diabetics, using a pre-post comparison design. Materials and Methods The study population comprised 6007 diabetics who received case management intervention in 2006 and were sampled nationwide in Korea. Before and after the intervention, the study population answered questions regarding their knowledge of diabetes, self-management ability, and health behaviors. Body mass index (BMI) was also calculated. Healthcare service utilization for diabetes was extracted from health insurance claim data from 2005 to 2007. Results The case management program significantly improved the study population's knowledge of diabetes and ability to self-manage nutrition, blood glucose monitoring, foot and oral care, and medications. This program also significantly changed the study population's health behaviors regarding smoking, alcohol drinking, and exercise, and BMI was positively affected. In the over-serviced subgroup, there was a significant decrease in the number of consultations (mean=7.0; SD=19.5) after intervention. Conversely, in the under-serviced subgroup, there was a significant increase in the number of consultations (mean=3.2; SD=7.9) and the days of prescribed medication (mean=66.4; SD=120.3) after intervention. Conclusion This study showed that the case management program led the study population to improve their knowledge, self-management ability, health behaviors, and utilization of health care. It is necessary in future studies to evaluate the appropriateness of healthcare usage and clinical outcome by using a control group to determine the direct effectiveness of this case management program. PMID:25510771

Effects of diabetic case management on knowledge, self-management abilities, health behaviors, and health service utilization for diabetes in Korea.

PubMed

Shin, Soon Ae; Kim, Hyeongsu; Lee, Kunsei; Lin, Vivian; Liu, George; Shin, Eunyoung

2015-01-01

This study aimed to evaluate the effects of a case management program for diabetics, using a pre-post comparison design. The study population comprised 6007 diabetics who received case management intervention in 2006 and were sampled nationwide in Korea. Before and after the intervention, the study population answered questions regarding their knowledge of diabetes, self-management ability, and health behaviors. Body mass index (BMI) was also calculated. Healthcare service utilization for diabetes was extracted from health insurance claim data from 2005 to 2007. The case management program significantly improved the study population's knowledge of diabetes and ability to self-manage nutrition, blood glucose monitoring, foot and oral care, and medications. This program also significantly changed the study population's health behaviors regarding smoking, alcohol drinking, and exercise, and BMI was positively affected. In the over-serviced subgroup, there was a significant decrease in the number of consultations (mean=7.0; SD=19.5) after intervention. Conversely, in the under-serviced subgroup, there was a significant increase in the number of consultations (mean=3.2; SD=7.9) and the days of prescribed medication (mean=66.4; SD=120.3) after intervention. This study showed that the case management program led the study population to improve their knowledge, self-management ability, health behaviors, and utilization of health care. It is necessary in future studies to evaluate the appropriateness of healthcare usage and clinical outcome by using a control group to determine the direct effectiveness of this case management program.

Reexamining Ground SOF Command and Control: Does One Size Fit All

DTIC Science & Technology

2016-12-01

Case studies covering varying methods of employment of special operations forces in limited contingencies will be utilized. The case studies focus on ...operating environment, much like an open organization. This research examines three case studies including operation JUST CAUSE in Panama, RESTORE HOPE in... case studies , the HQ elements formed around existing homogenous commands and not a Theater Special Operations Command (TSOC) staff with limited

Interventions to improve utilization of cataract surgical services by girls: Case studies from Asia and Africa.

PubMed

Adhisesha Reddy, Priya; Kishiki, Elizabeth A; Thapa, Hari Bahadur; Demers, Lisa; Geneau, Robert; Bassett, Ken

2018-06-01

Gender and blindness initiatives continue to make eye care personnel aware of the service utilization inequity strongly favouring men, yet interventions to reduce that inequity, particularly for girls, are under developed. This descriptive study gathered quantitative data on the degree of gender equity at five Child Eye Health Tertiary Facilities (CEHTFs) in Asia and Africa and conducted in-depth interviews with eye care personnel to assess their strategies and capacity to reduce gender inequity. Cataract surgery was utilized to assess the degree of inequity and success of interventions to reduce inequity in case finding, service utilization, and follow-up. CEHTF administrative data showed significant gender inequity in cataract surgical services favouring boys in all settings. CEHTFs actively seek children through community and school-based outreach, yet do not have initiatives to reduce gender inequity. Little gender inequity was found among children receiving surgical and follow-up care, although two out of three children were boys. CEHTF staff, despite being aware, offered no effective means to reduce gender inequity involving cataract surgical services. Interventions that successfully increased service utilization by girls came from individual cases, involving extraordinary effort by a single eye care programme person. Community-based case finders such as Anganwadi workers in India, Female Community Health Volunteers (FCHVs) in Nepal, and Key Informants (KIs) in Africa are necessary to identify children in need of cataract services, but insufficient to increase service utilization by girls. Secondary, often extra-ordinary community-based interventions by eye care personnel are needed in all settings.

Utility as a rationale for choosing observer performance assessment paradigms for detection tasks in medical imaging.

PubMed

Wunderlich, Adam; Abbey, Craig K

2013-11-01

Studies of lesion detectability are often carried out to evaluate medical imaging technology. For such studies, several approaches have been proposed to measure observer performance, such as the receiver operating characteristic (ROC), the localization ROC (LROC), the free-response ROC (FROC), the alternative free-response ROC (AFROC), and the exponentially transformed FROC (EFROC) paradigms. Therefore, an experimenter seeking to carry out such a study is confronted with an array of choices. Traditionally, arguments for different approaches have been made on the basis of practical considerations (statistical power, etc.) or the gross level of analysis (case-level or lesion-level). This article contends that a careful consideration of utility should form the rationale for matching the assessment paradigm to the clinical task of interest. In utility theory, task performance is commonly evaluated with total expected utility, which integrates the various event utilities against the probability of each event. To formalize the relationship between expected utility and the summary curve associated with each assessment paradigm, the concept of a "natural" utility structure is proposed. A natural utility structure is defined for a summary curve when the variables associated with the summary curve axes are sufficient for computing total expected utility, assuming that the disease prevalence is known. Natural utility structures for ROC, LROC, FROC, AFROC, and EFROC curves are introduced, clarifying how the utilities of correct and incorrect decisions are aggregated by summary curves. Further, conditions are given under which general utility structures for localization-based methodologies reduce to case-based assessment. Overall, the findings reveal how summary curves correspond to natural utility structures of diagnostic tasks, suggesting utility as a motivating principle for choosing an assessment paradigm.

Direct medical costs of constipation in children over 15 years: a population-based birth cohort

PubMed Central

Choung, Rok Seon; Shah, Nilay D.; Chitkara, Denesh; Branda, Megan E.; Van Tilburg, Miranda A.; Whitehead, William E.; Katusic, Slavica K.; Locke, G. Richard; Talley, Nicholas J.

2011-01-01

Background Although direct medical costs for constipation-related medical visits are thought to be high, to date there have been no studies examining if longitudinal resource utilization is persistently elevated in children with constipation. Our aim was to estimate the incremental direct medical costs and types of health care utilization associated with constipation from childhood to early adulthood. Methods A nested case-control study was conducted to evaluate the incremental costs associated with constipation. The original sample consisted of 5,718 children in a population-based birth cohort who were born during 1976–1982 in Rochester, MN. The cases included individuals who presented to medical facilities with constipation. The controls were matched and randomly selected among all non-cases in the sample. Direct medical costs for cases and controls were collected from the time subjects were between 5–18 years of age or until the subject emigrated from the community. Results We identified 250 cases with a diagnosis of constipation in the birth cohort. While the mean inpatient costs for cases were $9994 (95% CI=2538, 37201) compared to $2391 (95% CI=923, 7452) for controls (p=0.22) over the time period, the mean outpatient costs for cases were $13927 (95% CI=11325, 16525) compared to $3448 (95% CI=3771, 4621) for controls (p<0.001) over the same time period. The mean annual number emergency department visits for cases were 0.66 (95% CI=0.62, 0.70) compared to 0.34 (95% CI=0.32, 0.35) for controls (p<0.0001). Conclusion Individuals with constipation have higher medical care utilization. Outpatient costs and ER utilization were significantly greater for individuals with constipation from childhood to early adulthood. PMID:20890220

The use of scenarios for long-range planning by investor-owned electric utilities in the Pacific Northwest

NASA Astrophysics Data System (ADS)

Lyons, John V.

Scenario planning is a method of organizing and understanding large amounts of quantitative and qualitative data for leaders to make better strategic decisions. There is a lack of academic research about scenario planning with a subsequent shortage of definitions and theories. This study utilized a case study methodology to analyze scenario planning by investor-owned electric utilities in the Pacific Northwest in their integrated resource planning (IRP) process. The cases include Avista Corporation, Idaho Power, PacifiCorp, Portland General Electric, and Puget Sound Energy. This study sought to determine how scenario planning was used, what scenario approach was used, the scenario outcomes, and the similarities and differences in the scenario planning processes. The literature review of this study covered the development of scenario planning, common definitions and theories, approaches to scenario development, and scenario outcomes. A research methodology was developed to classify the scenario development approach into intuitive, hybrid, or quantitative approaches; and scenario outcomes of changed thinking, stories of plausible futures, improved decision making, and enhanced organizational learning. The study found all three forms of scenario planning in the IRPs. All of the cases used a similar approach to IRP development. All of the cases had at least improved decision making as an outcome of scenario planning. Only one case demonstrated all four scenario outcomes. A critical finding was a correlation between the use of the intuitive approach and the use of all scenario outcomes. Another major finding was the unique use of predetermined elements, which are normally consistent across scenarios, but became critical uncertainties in some of the scenarios in the cases for this study. This finding will need to be confirmed by future research as unique to the industry or an aberration. An unusually high number of scenarios were found for cases using the hybrid approach, which was unexpected based on the literature. This work expanded the methods for studying scenario planning, enhanced the body of scholarly works on scenario planning, and provided a starting point for additional research concerning the use of scenario planning by electric utilities.

Homeland Security Collaboration: Catch Phrase or Preeminent Organizational Construct?

DTIC Science & Technology

2009-09-01

collaborative effort? C. RESEARCH METHODOLOGY This research project utilized a modified case study methodology. The traditional case study method ...discussing the research method , offering smart practices and culminate with findings and recommendations. Chapter II Homeland Security Collaboration...41 Centers for Regional Excellence, “Building Models.” 16 Chapter III Research Methodology:  Modified Case Study Method is

An Investigation of Strategic Decision Making in Service Marketing through Case Study Development and Analysis

ERIC Educational Resources Information Center

Rosetti, Joseph L.; Maceiko, Meghan

2009-01-01

Through the collaborative efforts of an undergraduate student and a professor of marketing, this paper focuses on a case study and corresponding teaching notes developed as a final component of an independent study in service marketing. The case utilizes the hospitality industry as the template for analysis of the appropriateness of marketing…

Exploring the Removal of Prayer from Public Schools: A Qualitative Case Study

ERIC Educational Resources Information Center

Patterson, Barbara K.

2018-01-01

This was a qualitative case study focused on a display of understanding how reinstating prayer within public schools can offer an effect on students nationwide. A case study was utilized in this investigation, to explore and provide a clear understanding from the teachers' perceptions on how reinstating prayer can be incorporated into students'…

A Case Study of Certified Support Staff Members' Perceptions of Professional Learning Communities

ERIC Educational Resources Information Center

Byrd, Tresseler S.

2012-01-01

The purpose of this qualitative case study was to examine the perceptions of certified support staff at a Georgia middle school, focusing on their opinions of Professional Learning Communities (PLC), the roles they played in PLCs and the effect PLCs had on their professional practices. This descriptive case study utilized open-ended interviews,…

School Is Your Job: A Case Study on School Leadership and Black Male Achievement

ERIC Educational Resources Information Center

Lee-Currie, Monica

2013-01-01

The purpose of this qualitative case study was to examine and report how four school leaders in a mid-sized, Mid-Atlantic high school created an environment that improved achievement levels, increased graduation rates, and reduced drop-out rates for Black male students. The researcher utilized a qualitative case study design which included…

A Qualitative Case Study of the Bilingual Teacher Shortage in One Texas School District

ERIC Educational Resources Information Center

Kennedy, Barbara H.

2013-01-01

The purpose of this study was to examine how stakeholders in one Texas school district perceive, experience, and respond to the Spanish bilingual teacher shortage. The research design was qualitative with an exploratory, single case study approach. The case study school district was a mid-sized suburban district in Texas that utilized a dual…

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

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

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

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

Economic impact of epilepsy and the cost of nonadherence to antiepileptic drugs in older Medicare beneficiaries.

PubMed

Ip, Queeny; Malone, Daniel C; Chong, Jenny; Harris, Robin B; Labiner, David M

2018-03-01

Epilepsy is most prevalent among older individuals, and its economic impact is substantial. The development of economic burden estimates that account for known confounders, and using percent incremental costs may provide meaningful comparison across time and different health systems. The first objective of the current study was to estimate the percent incremental healthcare costs and the odds ratio (OR) for inpatient utilization for older Medicare beneficiaries with epilepsy and without epilepsy. The second objective was to estimate the percent incremental healthcare costs and the OR for inpatient utilization associated with antiepileptic drug (AED) nonadherence among Medicare beneficiaries with epilepsy. The OR of inpatient utilization for cases compared with controls (i.e., non-cases) were 2.4 (95% CI 2.3 to 2.6, p-value<0.0001) for prevalent epilepsy and 3.6 (95% CI 3.2 to 4.0, p-value<0.0001) for incident epilepsy. With respect to total health care costs, prevalent cases incurred 61.8% (95% CI 56.6 to 67.1%, p-value<0.0001) higher costs than controls while incident cases incurred 71.2% (95% CI 63.2 to 79.5%, p-value <0.0001) higher costs than controls. The nonadherence rates were 33.6 and 32.9% for prevalent and incident cases, respectively. Compared to nonadherent cases, the OR of inpatient utilization for adherent prevalent cases was 0.66 (95% CI 0.55 to 0.81, p-value <0.0001). The cost saving for a prevalent case adherent to AEDs was 13.2% (95% CI 6.6 to 19.4%, p-value=0.0001) compared to a nonadherent case. An incident case adherent to AEDs spent 16.4% (95% CI 6.5 to 25.2%, p-value=0.002) less than a nonadherent incident case on health care. Epilepsy is associated with higher health care costs and utilization. Older Medicare beneficiaries with epilepsy incur higher total health care spending and have higher inpatient utilization than those without epilepsy. Total health care spending is less for older Medicare beneficiaries who have prevalent or incident epilepsy if they are adherent to AEDs. Copyright © 2018 Elsevier Inc. All rights reserved.

Optimized model tuning in medical systems.

PubMed

Kléma, Jirí; Kubalík, Jirí; Lhotská, Lenka

2005-12-01

In medical systems it is often advantageous to utilize specific problem situations (cases) in addition to or instead of a general model. Decisions are then based on relevant past cases retrieved from a case memory. The reliability of such decisions depends directly on the ability to identify cases of practical relevance to the current situation. This paper discusses issues of automated tuning in order to obtain a proper definition of mutual case similarity in a specific medical domain. The main focus is on a reasonably time-consuming optimization of the parameters that determine case retrieval and further utilization in decision making/ prediction. The two case studies - mortality prediction after cardiological intervention, and resource allocation at a spa - document that the optimization process is influenced by various characteristics of the problem domain.

Some case studies of ocean wave physical processes utilizing the GSFC airborne radar ocean wave spectrometer

NASA Technical Reports Server (NTRS)

Jackson, F. C.

1984-01-01

The NASA K sub u band Radar Ocean Wave Spectrometer (ROWS) is an experimental prototype of a possible future satellite instrument for low data rate global waves measurements. The ROWS technique, which utilizes short pulse radar altimeters in a conical scan mode near vertical incidence to map the directional slope spectrum in wave number and azimuth, is briefly described. The potential of the technique is illustrated by some specific case studies of wave physical processes utilizing the aircraft ROWS data. These include: (1) an evaluation of numerical hindcast model performance in storm sea conditions, (2) a study of fetch limited wave growth, and (3) a study of the fully developed sea state. Results of these studies, which are briefly summarized, show how directional wave spectral observations from a mobile platform can contribute enormously to our understanding of wave physical processes.

Biomarker Utility Analysis Using an Exposure-PBPK/PD Model: A Carbaryl Case Study

EPA Science Inventory

There are two common biomarkers: markers of exposure and markers of health effects. The strength of the correlation between exposure or effect and a biomarker measurement determines the utility of a biomarker for assessing exposures or risks. In the current study, a linked expo...

Case Assignment in Typically Developing English-Speaking Children: A Paired Priming Study

ERIC Educational Resources Information Center

Wisman Weil, Lisa Marie

2013-01-01

This study utilized a paired priming paradigm to examine the influence of input features on case assignment in typically developing English-speaking children. The Input Ambiguity Hypothesis (Pelham, 2011) was experimentally tested to help explain why children produce subject pronoun case errors. Analyses of third singular "-s" marking on…

Collaborative Assessment: Middle School Case Study

ERIC Educational Resources Information Center

Parkison, Paul T.

2014-01-01

Utilizing a participant observer research model, a case study of the efficacy of a collaborative assessment methodology within a middle school social studies class was conducted. A review of existing research revealed that students' perceptions of assessment, evaluation, and accountability influence their intrinsic motivation to learn. A…

Utility Bill Calibration Test Cases | Buildings | NREL

Science.gov Websites

illustrates the utility bill calibration test cases in BESTEST-EX. In these cases, participants are given software results have been generated. This diagram provides an overview of the BESTEST-EX utility bill calibration case process. On the left side of the diagram is a box labeled "BESTEST-EX Document"

A Successful Replication of the River Visitor Inventory and Monitoring Process for Capacity Management

Treesearch

Kenneth Chilman; James Vogel; Greg Brown; John H. Burde

2004-01-01

This paper has 3 purposes: to discuss 1. case study research and its utility for recreation management decisionmaking, 2. the recreation visitor inventory and monitoring process developed from case study research, and 3. a successful replication of the process in a large-scale, multi-year application. Although case study research is discussed in research textbooks as...

A Phenomenological Case Study of the Elementary to Secondary Transition for One Female Student Diagnosed with Selective Mutism

ERIC Educational Resources Information Center

Nashman-Smith, Mona

2017-01-01

Selective mutism (SM) is considered a communication and anxiety disorder that afflicts about 1% of students. The rarity of SM and the isolated cases of this condition has rendered the elementary to secondary school experience for a student with SM difficult to study. Utilizing a qualitative approach, this phenomenological case study examined the…

The dynamics of utilization review: a case study of 44 Massachusetts hospitals.

PubMed

Gertman, P M; Egdahl, R E

1978-10-01

Utilization review programs have existed on a national basis for over a decade, but relatively little is known about the patients who are scrutinized and what actions are taken to correct unnecessary use. In the fall of 1976, 44 of the 122 Massachusetts hospitals participated in a two-week in depth study of their utilization review activities. Over 22,000 admission and extended stay reviews were performed during this time period, and of these, 2,120 patients' continued stays in the hospital were questioned. In five admission review cases and 79 extended stay review cases, the UR committee formally terminated continued health insurance benefits, and in 12 admission reviews and 74 extended stay reviews, questioning by the UR committee led the attending physician to discharge the patient earlier than would have otherwise occurred. Ninety-four percent of the terminations occurred in Medicare patients and the median age of these patients exceeded 80 years. For medical patients, a disproportionate share of all those cases questioned and of those terminated occurred in chronic illness categories, such as cancer, heart failure, and organic brain syndromes. A higher than expected percentage of surgical cases questioned by the UR committee were in neurosurgical, cardiovascular and orthopedic procedure groups. The frequency with which UR committees identified and acted upon cases suggests that effective self-policing is occurring. A large portion of the utilization problem, however, may be related to the unavailability of appropriate sub-acute care for patients with chronic medical illness or surgical procedures which require long postoperative rehabilitation and recuperation.

Procurement Integrity in Contingency Operations: A Case Study of Army Contracting Officer Corruption in Operations Iraqi and Enduring Freedom Utilizing Occupational Fraud Theory

DTIC Science & Technology

2011-12-01

Study of Army Contracting Officer Corruption in Operations Iraqi and Enduring Freedom Utilizing Occupational Fraud Theory By: Amanda H...Operations Iraqi and Enduring Freedom Utilizing Occupational Fraud Theory 6. AUTHOR(S) Amanda H. Flint 5. FUNDING NUMBERS 7. PERFORMING ORGANIZATION...CCOs) during Operations Iraqi Freedom and Enduring Freedom (OIF/OEF) by applying occupational fraud theory, specifically the classic sociological

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…

The 1992-1993 advanced design program. Part 1: The Mars methane engine project. Part 2: The Mars oxygen processor new furnace

NASA Astrophysics Data System (ADS)

Lauer, Stephen; Hoover, Scott; Lawrence, Lori; Paparistodemou, Christos; Taylor, Doug

1993-04-01

Three constituents of the Martian atmosphere, methane, carbon dioxide, and oxygen, can be used for internal combustion in engines utilized for future space exploration on Mars. These three gases, considered as the test case in this research, will be examined to determine required flow rates needed for combustion and optimization of engine performance. Results of the test case are examined in relation to a base case of methane and air for comparative purposes. Testing of exhaust temperatures, cylinder pressure, and exhaust gas analysis were performed for the base case and test case. Also described is a study utilizing a zirconia cell to convert carbon dioxide into usable oxygen to help support future Mars missions.

The 1992-1993 advanced design program. Part 1: The Mars methane engine project. Part 2: The Mars oxygen processor new furnace

NASA Technical Reports Server (NTRS)

Lauer, Stephen; Hoover, Scott; Lawrence, Lori; Paparistodemou, Christos; Taylor, Doug

1993-01-01

Three constituents of the Martian atmosphere, methane, carbon dioxide, and oxygen, can be used for internal combustion in engines utilized for future space exploration on Mars. These three gases, considered as the test case in this research, will be examined to determine required flow rates needed for combustion and optimization of engine performance. Results of the test case are examined in relation to a base case of methane and air for comparative purposes. Testing of exhaust temperatures, cylinder pressure, and exhaust gas analysis were performed for the base case and test case. Also described is a study utilizing a zirconia cell to convert carbon dioxide into usable oxygen to help support future Mars missions.

A Case Study of an Expert Problem Poser for Mathematics Competitions

ERIC Educational Resources Information Center

Kontorovich, Igor'; Koichu, Boris

2016-01-01

This paper is concerned with organizational principles of a pool of familiar problems of expert problem posers and the ways by which they are utilized for creating new problems. The presented case of Leo is part of a multiple-case study with expert problem posers for mathematics competitions. We present and inductively analyze the data collected…

The effect of Channeling on in-home utilization and subsequent nursing home care: a simultaneous equation perspective.

PubMed Central

Rabiner, D J; Stearns, S C; Mutran, E

1994-01-01

OBJECTIVE. This study explored the relationship between participation in a home/community-based long-term care case management intervention (known as the Channeling demonstration), use of formal in-home care, and subsequent nursing home utilization. STUDY DESIGN. Structural analysis of the randomized Channeling intervention was conducted to decompose the total effects of Channeling on nursing home use into direct and indirect effects. DATA COLLECTION METHOD. Secondary data analysis of the National Long-Term Care Data Set. PRINCIPAL FINDINGS. The use of formal in-home care, which was increased by the Channeling intervention, was positively associated with nursing home utilization at 12 months. However, the negative direct effect of Channeling on nursing home use was of sufficient magnitude to offset this positive indirect effect, so that a small but significant negative total effect of Channeling on subsequent nursing home utilization was found. CONCLUSIONS. This study shows why Channeling did not have a large total impact on nursing home utilization. The analysis did not provide evidence of direct substitution of in-home care for nursing home care because the direct reductions in nursing home utilization due to other aspects of Channeling (including, but not limited to case management) were substantially offset by the indirect increases in nursing home utilization associated with additional home care use. PMID:8002352

Strategies and Sources of Support for Beginning Teachers of Science and Mathematics

ERIC Educational Resources Information Center

Friedrichsen, Patricia; Chval, Kathryn B.; Teuscher, Dawn

2007-01-01

This study examines the support structures and strategies utilized by beginning mathematics and science teachers. The qualitative case study of 18 teachers (0-3 years of experience) includes teachers from rural, suburban and urban schools. Data collection consisted of one-hour interviews. The findings indicate participants utilized formal and…

CYP1B1 copy number variation is not a major contributor to primary congenital glaucoma.

PubMed

Souzeau, Emmanuelle; Hayes, Melanie; Ruddle, Jonathan B; Elder, James E; Staffieri, Sandra E; Kearns, Lisa S; Mackey, David A; Zhou, Tiger; Ridge, Bronwyn; Burdon, Kathryn P; Dubowsky, Andrew; Craig, Jamie E

2015-01-01

To evaluate the prevalence and the diagnostic utility of testing for CYP1B1 copy number variation (CNV) in primary congenital glaucoma (PCG) cases unexplained by CYP1B1 point mutations in The Australian and New Zealand Registry of Advanced Glaucoma. In total, 50 PCG cases either heterozygous for disease-causing variants or with no CYP1B1 sequence variants were included in the study. CYP1B1 CNV was analyzed by Multiplex Ligation-dependent Probe Amplification (MLPA). No deletions or duplications were found in any of the cases. This is the first study to report on CYP1B1 CNV in PCG cases. Our findings show that this mechanism is not a major contributor to the phenotype and is of limited diagnostic utility.

Health and economic burden of post-partum Staphylococcus aureus breast abscess.

PubMed

Branch-Elliman, Westyn; Lee, Grace M; Golen, Toni H; Gold, Howard S; Baldini, Linda M; Wright, Sharon B

2013-01-01

To determine the health and economic burdens of post-partum Staphylococcus aureus breast abscess. We conducted a matched cohort study (N = 216) in a population of pregnant women (N = 32,770) who delivered at our center during the study period from 10/1/03-9/30/10. Data were extracted from hospital databases, or via chart review if unavailable electronically. We compared cases of S. aureus breast abscess to controls matched by delivery date to compare health services utilization and mean attributable medical costs in 2012 United States dollars using Medicare and hospital-based estimates. We also evaluated whether resource utilization and health care costs differed between cases with methicillin-resistant and -susceptible S. aureus isolates. Fifty-four cases of culture-confirmed post-partum S. aureus breast abscess were identified. Breastfeeding cessation (41%), milk fistula (11.1%) and hospital readmission (50%) occurred frequently among case patients. Breast abscess case patients had high rates of health services utilization compared to controls, including high rates of imaging and drainage procedures. The mean attributable cost of post-partum S. aureus breast abscess ranged from $2,340-$4,012, depending on the methods and data sources used. Mean attributable costs were not significantly higher among methicillin-resistant vs. -susceptible S. aureus cases. Post-partum S. aureus breast abscess is associated with worse health and economic outcomes for women and their infants, including high rates of breastfeeding cessation. Future study is needed to determine the optimal treatment and prevention of these infections.

A Study of Novice Systems Analysis Problem Solving Behaviors Using Protocol Analysis

DTIC Science & Technology

1992-09-01

conducted. Each subject was given the same task to perform. The task involved a case study (Appendix B) of a utility company’s customer order processing system...behavior (Ramesh, 1989). The task was to design a customer order processing system that utilized a centralized telephone answering service center...of the utility company’s customer order processing system that was developed based on information obtained by a large systems consulting firm during

Effective Utilization of ICT in English Language Learning--The Case of University of Botswana Undergraduates

ERIC Educational Resources Information Center

Umunnakwe, Ngozi; Sello, Queen

2016-01-01

The study investigates the effective utilization of Information and Communication Technology (ICT) by first year undergraduates of the University of Botswana (UB) in their reading and writing skills. The first year students are not first language (L1) learners of English. They have not utilized computers for learning reading and writing in their…

A Case Study of the Institutionalization of Service-Learning at a Baptist College

ERIC Educational Resources Information Center

Long, Jody Thomas

2013-01-01

This qualitative study, utilizing the case study method, sought to address the issues associated with the lack of institutionalization of service-learning practices on college campus by describing the institutionalization of service-learning practices at a Baptist-affiliated college. The study describes the development and institutionalization of…

"I Worry about My Community": African American Women Utilizing Communal Notions of Citizenship in the Social Studies Classroom

ERIC Educational Resources Information Center

Vickery, Amanda E.

2016-01-01

This qualitative multiple case study utilizes a Black feminist ethic of caring (Collins, 2009; Thompson, 1998) to explore how three African American women social studies teachers draw on their personal and community knowledge to conceptualize and teach the construct of citizenship to their students of color. Instead of conveying traditional…

Quantification of chaotic strength and mixing in a micro fluidic system

NASA Astrophysics Data System (ADS)

Kim, Ho Jun; Beskok, Ali

2007-11-01

Comparative studies of five different techniques commonly employed to identify the chaotic strength and mixing efficiency in micro fluidic systems are presented to demonstrate the competitive advantages and shortcomings of each method. The 'chaotic electroosmotic stirrer' of Qian and Bau (2002 Anal. Chem. 74 3616-25) is utilized as the benchmark case due to its well-defined flow kinematics. Lagrangian particle tracking methods are utilized to study particle dispersion in the conceptual device using spectral element and fourth-order Runge-Kutta discretizations in space and time, respectively. Stirring efficiency is predicted using the stirring index based on the box counting method, and Poincaré sections are utilized to identify the chaotic and regular regions under various actuation conditions. Finite time Lyapunov exponents are calculated to quantify the chaotic strength, while the probability density function of the stretching field is utilized as an alternative method to demonstrate the statistical analysis of chaotic and partially chaotic cases. Mixing index inverse, based on the standard deviation of scalar species distribution, is utilized as a metric to quantify the mixing efficiency. Series of numerical simulations are performed by varying the Peclet number (Pe) at fixed kinematic conditions. The mixing time (tm) is characterized as a function of the Pe number, and tm ~ ln(Pe) scaling is demonstrated for fully chaotic cases, while tm ~ Peα scaling with α ≈ 0.33 and α = 0.5 are observed for partially chaotic and regular cases, respectively. Employing the aforementioned techniques, optimum kinematic conditions and the actuation frequency of the stirrer that result in the highest mixing/stirring efficiency are identified.

Health and Economic Burden of Post-Partum Staphylococcus aureus Breast Abscess

PubMed Central

Branch-Elliman, Westyn; Lee, Grace M.; Golen, Toni H.; Gold, Howard S.; Baldini, Linda M.; Wright, Sharon B.

2013-01-01

Objectives To determine the health and economic burdens of post-partum Staphylococcus aureus breast abscess. Study design We conducted a matched cohort study (N = 216) in a population of pregnant women (N = 32,770) who delivered at our center during the study period from 10/1/03–9/30/10. Data were extracted from hospital databases, or via chart review if unavailable electronically. We compared cases of S. aureus breast abscess to controls matched by delivery date to compare health services utilization and mean attributable medical costs in 2012 United States dollars using Medicare and hospital-based estimates. We also evaluated whether resource utilization and health care costs differed between cases with methicillin-resistant and -susceptible S. aureus isolates. Results Fifty-four cases of culture-confirmed post-partum S. aureus breast abscess were identified. Breastfeeding cessation (41%), milk fistula (11.1%) and hospital readmission (50%) occurred frequently among case patients. Breast abscess case patients had high rates of health services utilization compared to controls, including high rates of imaging and drainage procedures. The mean attributable cost of post-partum S. aureus breast abscess ranged from $2,340–$4,012, depending on the methods and data sources used. Mean attributable costs were not significantly higher among methicillin-resistant vs. –susceptible S. aureus cases. Conclusions Post-partum S. aureus breast abscess is associated with worse health and economic outcomes for women and their infants, including high rates of breastfeeding cessation. Future study is needed to determine the optimal treatment and prevention of these infections. PMID:24039877

Utilization of Electronic Information Resources by Undergraduate Students of University of Ibadan: A Case Study of Social Sciences and Education

ERIC Educational Resources Information Center

Owolabi, Sola; Idowu, Oluwafemi A.; Okocha, Foluke; Ogundare, Atinuke Omotayo

2016-01-01

The study evaluated utilization of electronic information resources by undergraduates in the Faculties of Education and the Social Sciences in University of Ibadan. The study adopted a descriptive survey design with a study population of 1872 undergraduates in the Faculties of Education and the Social Sciences in University of Ibadan, from which a…

Commercial and Multifamily Building Tenant Energy Usage Aggregation and Privacy

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

Livingston, Olga V.; Pulsipher, Trenton C.; Wang, Na

2014-11-17

In a number of cities and states, building owners are required to disclose and/or benchmark their building energy use. This requires the building owner to possess monthly whole-building energy usage information, which can be challenging for buildings in which individual tenants have their own utility meters and accounts with the utility. Some utilities and utility regulators have turned to aggregation of customer data as a way to give building owners the whole-building energy usage data while protecting customer privacy. However, no utilities or regulators appear to have conducted a concerted statistical, cybersecurity, and privacy analysis to justify the level ofmore » aggregation selected. Therefore, the Tennant Data Aggregation Task was established to help utilities address these issues and provide recommendations as well as a theoretical justification of the aggregation threshold. This study is focused on the use case of submitting data for ENERGY STAR Portfolio Manager (ESPM), but it also looks at other potential use cases for monthly energy consumption data.« less

Cultural Identity and Regional Security in the Western Balkans

DTIC Science & Technology

2013-06-13

possible. Case Study as Qualitative Approach Creswell and other experts of the social research methodology suggest at least five forms of...descriptive research approach, and the main method is case study of the Western Balkans. This thesis utilizes the analytical frameworks of securitization

Inpatient imaging utilization: trends of the past decade.

PubMed

Shinagare, Atul B; Ip, Ivan K; Abbett, Sarah K; Hanson, Richard; Seltzer, Steven E; Khorasani, Ramin

2014-03-01

We have previously reported inpatient imaging utilization trends at our institution from fiscal year (FY) 1984 through FY 2002. In this study, we assessed the trends in imaging utilization for inpatients from FY 2003 through FY 2012. In this institutional review board-approved retrospective study performed at a 793-bed tertiary care academic institution, we reviewed imaging utilization in adult inpatients from October 1, 2002, through September 30, 2012 (FY 2003 through FY 2012), and recorded the gross number of imaging studies coded by modality (conventional [radiography and fluoroscopy], ultrasound, nuclear medicine, CT, and MRI) and associated relative value units (RVUs). We used linear regression to assess trends in number of imaging studies and RVUs per case-mix-adjusted admission (CMAA). The total number of imaging studies, as well as the number of CT, nuclear medicine, and conventional studies adjusted for case mix, decreased (p=0.02, p=0.0006, p=0.0008, and p=0.001, respectively); CT per CMAA increased until FY 2009 and then decreased through FY 2012. Utilization of ultrasound and MRI did not change significantly (p=0.15 and p=0.22, respectively). Unadjusted global RVUs increased until FY 2009 and then showed a slight decrease through FY 2012 (p=0.04), whereas RVUs per CMAA did not change significantly (p=0.18). After decades of continued rise, imaging utilization for inpatients significantly decreased by most measures between FY 2009 and FY 2012. Future studies to evaluate the contribution of various factors to this decline, including efforts to reduce inappropriate use of imaging and concerns about potential harms of radiation exposure, may be helpful in optimizing imaging utilization and resource planning.

Utilities Power Change: Engaging Commercial Customers in Workplace Charging

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

Lommele, Stephen; Dafoe, Wendy

As stewards of an electric grid that is available almost anywhere people park, utilities that support workplace charging are uniquely positioned to help their commercial customers be a part of the rapidly expanding network of charging infrastructure. Utilities understand the distinctive challenges of their customers, have access to technical information about electrical infrastructure, and have deep experience modeling and managing demand for electricity. This case study highlights the experiences of two utilities with workplace charging programs.

Review of utility values for economic modeling in type 2 diabetes.

PubMed

Beaudet, Amélie; Clegg, John; Thuresson, Per-Olof; Lloyd, Adam; McEwan, Phil

2014-06-01

Economic analysis in type 2 diabetes mellitus (T2DM) requires an assessment of the effect of a wide range of complications. The objective of this article was to identify a set of utility values consistent with the National Institute for Health and Care Excellence (NICE) reference case and to critically discuss and illustrate challenges in creating such a utility set. A systematic literature review was conducted to identify studies reporting utility values for relevant complications. The methodology of each study was assessed for consistency with the NICE reference case. A suggested set of utility values applicable to modeling was derived, giving preference to studies reporting multiple complications and correcting for comorbidity. The review considered 21 relevant diabetes complications. A total of 16,574 articles were identified; after screening, 61 articles were assessed for methodological quality. Nineteen articles met NICE criteria, reporting utility values for 20 of 21 relevant complications. For renal transplant, because no articles meeting NICE criteria were identified, two articles using other methodologies were included. Index value estimates for T2DM without complication ranged from 0.711 to 0.940. Utility decrement associated with complications ranged from 0.014 (minor hypoglycemia) to 0.28 (amputation). Limitations associated with the selection of a utility value for use in economic modeling included variability in patient recruitment, heterogeneity in statistical analysis, large variability around some point estimates, and lack of recent data. A reference set of utility values for T2DM and its complications in line with NICE requirements was identified. This research illustrates the challenges associated with systematically selecting utility data for economic evaluations. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Modeling the Dynamic Interrelations between Mobility, Utility, and Land Asking Price

NASA Astrophysics Data System (ADS)

Hidayat, E.; Rudiarto, I.; Siegert, F.; Vries, W. D.

2018-02-01

Limited and insufficient information about the dynamic interrelation among mobility, utility, and land price is the main reason to conduct this research. Several studies, with several approaches, and several variables have been conducted so far in order to model the land price. However, most of these models appear to generate primarily static land prices. Thus, a research is required to compare, design, and validate different models which calculate and/or compare the inter-relational changes of mobility, utility, and land price. The applied method is a combination of analysis of literature review, expert interview, and statistical analysis. The result is newly improved mathematical model which have been validated and is suitable for the case study location. This improved model consists of 12 appropriate variables. This model can be implemented in the Salatiga city as the case study location in order to arrange better land use planning to mitigate the uncontrolled urban growth.

Utilizing a Graphic Organizer for Promoting Pupils' Argumentation

ERIC Educational Resources Information Center

Hsieh, Fu-Pei; Lee, Sung-Tao

2011-01-01

The purpose of this study was utilizing a GO (graphic organizer) for promoting pupils' argumentation. The method of case study was employed. A total of eight fifth grade pupils from two classes were assigned (n = 4, two high achievers, two low achievers) with GOI (graphic organizer instruction), and the others (n = 4, 2 high achievers, 2 low…

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

Comprehensive Stuttering Treatment or Adolescents: A Case Study

ERIC Educational Resources Information Center

Coleman, Craig E.

2018-01-01

Purpose: This article will focus on a hypothetical case study to highlight comprehensive assessment and treatment for adolescent children who stutter. Method: Assessment and treatment are laid out with a literature review utilizing the components of the International Classification of Functioning, Disability and Health model. Specific assessment…

Profiling Neurolanguage Coaches Worldwide--A Case Study

ERIC Educational Resources Information Center

Zeppos, Dimitris

2014-01-01

Neurolanguage Coaching™ is a new approach of diversified personalized language instruction utilizing modern insights of neuroscientific and pedagogic theories. This paper addresses the issue of profiling educational experts, who utilize these theories to coach language learners through their language acquisition journey, by means of setting and…

Heading for Success: Three Case Studies of School Transformation through Capital Construction

ERIC Educational Resources Information Center

Chen, Wen-Yan; Pan, Hui-Ling Wendy

2016-01-01

Utilizing capital as a construct to analyze leadership that triggers school transformation is a newly emerged perspective. This study employed the capital theory as the framework to explore how schools undertook the transformative tasks by multi-case study. Three secondary schools in Taiwan were recruited to investigate how leaders constructed the…

The Characteristics of a Community of Practice in a National Writing Project Invitational Summer Institute

ERIC Educational Resources Information Center

Pearce, Terisa Ronette

2010-01-01

This qualitative naturalistic descriptive case study provides an understanding of the characteristics of a community of practice within a National Writing Project invitational summer institute. This study utilized naturalistic, descriptive case study methodology to answer the research question: What characteristics of a community of practice are…

Are You an Online Team Player? A Pilot Study

ERIC Educational Resources Information Center

Rawlings, Melody

2014-01-01

The purpose of this pilot case study was to answer the following research questions: How do previous experiences affect students' attitudes toward online teamwork? When do students' attitudes toward online teamwork first develop and why? Using a social constructivist framework, a qualitative case study design was utilized to conduct an online…

A Case Study on the Nature of Informal Conversation in an Organization Utilizing Microblogging Technology

ERIC Educational Resources Information Center

Dembeck, Thomas J.

2013-01-01

The purpose of this case study was to determine the nature of conversations that occur within an organizational microblog and compare them to traditional informal conversations. Since informal conversations are closely associated with reaction to change, this study explored how organizational microblog conversations may be understood to affect…

Teacher Efficacy Beliefs: A Case Study Investigation of Core Curriculum

ERIC Educational Resources Information Center

Brown, Natalie Marie

2017-01-01

The purpose of this qualitative case study was to understand how utilizing the Core Knowledge Sequence and aligned curricular resources influenced teachers' perceived self-efficacy for a sample of Arizona elementary charter school teachers. The sample for this study was a convenience sample of 15 elementary teachers, who were currently…

A Case Study on TRICARE Online Web-enabled Appointing: Improving Utilization Rates at Navy Medical Treatment Facilities

DTIC Science & Technology

2009-10-20

Low usage volume raised concerns about the effectiveness of TOL. In 2004, the eHealth Division of TMA Information Management conducted a study to...Case Study 31 (Version 15.8). Falls Church, VA: Department of Defense, TRICARE Management Activity, Information Management eHealth Division

Strategically Focused Training in Six Sigma Way: A Case Study

ERIC Educational Resources Information Center

Pandey, Ashish

2007-01-01

Purpose: The purpose of the current study is to examine the utility of Six Sigma interventions as a performance measure and explore its applicability for making the training design and delivery operationally efficient and strategically effective. Design/methodology/approach: This is a single revelatory case study. Data were collected from multiple…

Design of conveyor utilization monitoring system: a case study of powder coating line in sheet metal fabrication

NASA Astrophysics Data System (ADS)

Prasetyo, Hoedi; Sugiarto, Yohanes; Nur Rosyidi, Cucuk

2018-03-01

Conveyor is a very useful equipment to replace manpower in transporting the goods. It highly influences the productivity, production capacity utilization and eventually the production cost. This paper proposes a system to monitor the utilization of conveyor at a low cost through a case study at powder coating process line in a sheet metal fabrication. Preliminary observation was conducted to identify the problems. The monitoring system was then built and executed. The system consists of two sub systems. First is sub system for collecting and transmitting the required data and the second is sub system for displaying the data. The system utilizes sensors, wireless data transfer and windows-based application. The test results showed that the whole system works properly. By this system, the productivity and status of the conveyor can be monitored in real time. This research enriches the development of conveyor monitoring system especially for implementation in small and medium enterprises.

KC-135 Simulator Systems Engineering Case Study

DTIC Science & Technology

2010-01-01

performance. The utilization and misutilization of SE principles are highlighted, with special emphasis on the conditions that foster and impede...process, from the identification of the need to the development and utilization of the product, must continuously integrate and optimize system and... utilizing the Friedman-Sage framework to organize the assessment of the application of the SE process. The framework and the derived matrix can

Modelling utility-scale wind power plants. Part 1: Economics

NASA Astrophysics Data System (ADS)

Milligan, Michael R.

1999-10-01

As the worldwide use of wind turbine generators continues to increase in utility-scale applications, it will become increasingly important to assess the economic and reliability impact of these intermittent resources. Although the utility industry in the United States appears to be moving towards a restructured environment, basic economic and reliability issues will continue to be relevant to companies involved with electricity generation. This article is the first of two which address modelling approaches and results obtained in several case studies and research projects at the National Renewable Energy Laboratory (NREL). This first article addresses the basic economic issues associated with electricity production from several generators that include large-scale wind power plants. An important part of this discussion is the role of unit commitment and economic dispatch in production cost models. This paper includes overviews and comparisons of the prevalent production cost modelling methods, including several case studies applied to a variety of electric utilities. The second article discusses various methods of assessing capacity credit and results from several reliability-based studies performed at NREL.

Approaches for building community participation: A qualitative case study of Canadian food security programs.

PubMed

Hyett, Nerida; Kenny, Amanda; Dickson-Swift, Virginia

2017-10-01

There is increasing opportunity and support for occupational therapists to expand their scope of practice in community settings. However, evidence is needed to increase occupational therapists' knowledge, confidence, and capacity with building community participation and adopting community-centered practice roles. The purpose of this study is to improve occupational therapists' understanding of an approach to building community participation, through case study of a network of Canadian food security programs. Qualitative case study was utilized. Data were semistructured interviews, field observations, documents, and online social media. Thematic analysis was used to identify and describe four themes that relate to processes used to build community participation. The four themes were use of multiple methods, good leaders are fundamental, growing participation via social media, and leveraging outcomes. Occupational therapists can utilize an approach for building community participation that incorporates resource mobilization. Challenges of sustainability and social exclusion must be addressed.

Metropolitan Forensic Anthropology Team (MFAT) studies in identification: 1. Race and sex assessment by discriminant function analysis of the postcranial skeleton.

PubMed

Taylor, J V; DiBennardo, R; Linares, G H; Goldman, A D; DeForest, P R

1984-07-01

A case study is presented to demonstrate the utility of the team approach to the identification of human remains, and to illustrate a methodological innovation developed by MFAT. Case 1 represents the first of several planned case studies, each designed to present new methodological solutions to standard problems in identification. The present case describes a test, by application, of race and sex assessment of the postcranial skeleton by discriminant function analysis.

The Organizational Realities of Student Affairs: A Political Perspective

ERIC Educational Resources Information Center

Shinn, Jeremiah B.

2015-01-01

The purpose of this study was to understand the organizational functions of student-affairs at Indiana University and to understand the nature of the conflict between student-affairs and the larger organization. This study utilized the case-study research design. Much of the data collected and analyzed during this case study were of a historical…

Universities: Can They Be Considered as Learning Organizations?: A Preliminary Micro-Level Perspective

ERIC Educational Resources Information Center

Bak, Ozlem

2012-01-01

Purpose: The purpose of this study is to explore a department in a UK higher education (HE) institute based on Senge's five characteristics of learning organizations. Design/methodology/approach: In this study, a case study method was utilized. The case study entailed two lines of enquiry: a questionnaire, which was distributed to a UK…

Utility of proteomics in obstetric disorders: a review

PubMed Central

Hernández-Núñez, Jónathan; Valdés-Yong, Magel

2015-01-01

The study of proteomics could explain many aspects of obstetric disorders. We undertook this review with the aim of assessing the utility of proteomics in the specialty of obstetrics. We searched the electronic databases of MEDLINE, EBSCOhost, BVS Bireme, and SciELO, using various search terms with the assistance of a librarian. We considered cohort studies, case-control studies, case series, and systematic review articles published until October 2014 in the English or Spanish language, and evaluated their quality and the internal validity of the evidence provided. Two reviewers extracted the data independently, then both researchers simultaneously revised the data later, to arrive at a consensus. The search retrieved 1,158 papers, of which 965 were excluded for being duplicates, not relevant, or unrelated studies. A further 86 papers were excluded for being guidelines, protocols, or case reports, along with another 64 that did not contain relevant information, leaving 43 studies for inclusion. Many of these studies showed the utility of proteomic techniques for prediction, pathophysiology, diagnosis, management, monitoring, and prognosis of pre-eclampsia, perinatal infection, premature rupture of membranes, preterm birth, intrauterine growth restriction, and ectopic pregnancy. Proteomic techniques have enormous clinical significance and constitute an invaluable weapon in the management of obstetric disorders that increase maternal and perinatal morbidity and mortality. PMID:25926758

Drug utilization review of potassium chloride injection formulations available in a private hospital in kuching, sarawak, malaysia.

PubMed

Melissa, Mohammad Hirman; Azmi, Sarriff

2013-07-01

The concentrated potassium chloride injection is a high-alert medication and replacing it with a pre-mixed formulation can reduce the risks associated with its use. The aim of this study was to determine the clinical characteristics of patients receiving different potassium chloride formulations available at a private institution. The study also assessed the effectiveness and safety of pre-mixed formulations in the correction of hypokalaemia. This was a retrospective observational study consisting of 296 cases using concentrated and pre-mixed potassium chloride injections in 2011 in a private hospital in Kuching, Sarawak, Malaysia. There were 135 (45.6%) cases that received concentrated potassium chloride, and 161 (54.4%) cases that received pre-mixed formulations. The patients' clinical characteristics that were significantly related to the utilization of the different formulations were diagnosis (P < 0.001), potassium serum blood concentration (P < 0.05), and fluid overload risk (P < 0.05). The difference observed for the cases that achieved or maintained normokalaemia was statistically insignificant (P = 0.172). Infusion-related adverse effects were seen more in pre-mixes compared to concentrated formulations (6.8% versus 2.2%, P < 0.05). This study provides insight into the utilization of potassium chloride injections at this specific institution. The results support current recommendations to use pre-mixed formulations whenever possible.

Reduced health resource use after acupuncture for low-back pain.

PubMed

Moritz, Sabine; Liu, Ming F; Rickhi, Badri; Xu, Tracy J; Paccagnan, Patricia; Quan, Hude

2011-11-01

Acupuncture is commonly used to treat low-back pain (LBP) and clinical trials have demonstrated its efficacy. However, less is known about how the utilization of acupuncture impacts public health service utilization in the real world. This study investigates the association between acupuncture utilization for LBP and health care utilization by assessing whether patients who undergo acupuncture subsequently use fewer health care resources and whether those patients differ in their health care use from the general population with LBP. This study employed the design of a two-group pre/post secondary data analysis. There were two study populations. To identify patients who received acupuncture for LBP in 2000, patient charts at Alberta registered acupuncture clinics were reviewed. The comparison group was identified from the Alberta physician claims administrative database. Acupuncture group cases were matched with four comparison cases from the general population with LBP based on gender and age. Number of physician visits and physician service cost for LBP-related services for 1 year pre- and postacupuncture treatment period were calculated from the physician claims data for both study groups. For the 201 cases and 804 controls, the mean age was 48 years and 54% were female. The number of physician visits for the 1-year period postacupuncture decreased 49% for the acupuncture group (p<0.01) compared to the 1-year period preacupuncture. For the comparison there was a decrease of 2% in physician visits (p=0.59) for the same time periods. Corresponding to the decrease, physician services cost declined 37% for the case group (p=0.01) and 1% for the comparison (p=0.86). Results suggest that patients with LBP were less likely to visit physicians for LBP after acupuncture treatment. This led to reduced health services spending on LBP. © Mary Ann Liebert, Inc.

Economics of Utility Scale Photovoltaics at Purdue University

NASA Astrophysics Data System (ADS)

Arnett, William

The research for this case study shows that utility scale solar photovoltaics has become a competitive energy investment option, even when a campus operates a power plant at low electricity rates. To evaluate this an economic model called SEEMS (Solar Economic Evaluation Modelling Spreadsheets) was developed to evaluate a number of financial scenarios in Real Time Pricing for universities. The three main financing structures considered are 1) land leasing, 2) university direct purchase, and 3) third party purchase. Unlike other commercially available models SEEMS specifically accounts for real time pricing, where the local utility provides electricity at an hourly rate that changes with the expected demand. In addition, SEEMS also includes a random simulation that allows the model to predict the likelihood of success for a given solar installation strategy. The research showed that there are several options for utility scale solar that are financially attractive. The most practical financing structure is with a third party partnership because of the opportunity to take advantage of tax incentives. Other options could become more attractive if non-financial benefits are considered. The case study for this research, Purdue University, has a unique opportunity to integrate utility-scale solar electricity into its strategic planning. Currently Purdue is updating its master plan which will define how land is developed. Purdue is also developing a sustainability plan that will define long term environmental goals. In addition, the university is developing over 500 acres of land west of campus as part of its Aerospace Innovation District. This research helps make the case for including utility-scale solar electricity as part of the university's strategic planning.

Educational Knowledge Brokerage and Mobilization: The "Marshall Memo" Case

ERIC Educational Resources Information Center

Malin, Joel R.; Paralkar, Vijay Keshaorao

2017-01-01

The importance of intermediation between communities primarily engaged in research production and those primarily engaged in practice is increasingly acknowledged, yet our understanding of the nature and influence of this work in education remains limited. Accordingly, this study utilizes case study methodology and aspires to understand the…

Adaptations of International Standards on Educational Leadership Preparation in Egypt

ERIC Educational Resources Information Center

Purinton, Ted; Khalil, Dalia

2016-01-01

This paper is a case study of one leadership preparation program, utilizing US school leadership standards and practices, offered in Egypt. This case study illuminates how cultural and policy distinctions impact differing necessities of educational leadership, and how those necessities conflict or concur with the international standards and…

A CROSS-SPECIES MODE OF ACTION INFORMATION ASSESSMENT: A CASE STUDY OF BISPHENOL A

EPA Science Inventory

A case study assessing the utility of this approach was performed for bisphenol A (BPA). BPA, a component of polycarbonate plastics, epoxy resins, and polyester resins, was selected because it is a high production volume chemical; data have been identified for both vertebrate an...

Sustaining Latina Student Organizations: An Exploratory Instrumental Case Study

ERIC Educational Resources Information Center

Castellanos, Michelle

2016-01-01

Utilizing the exploratory case study methodology, the author examines the conditions that support and limit a Latina-based student organization at a predominately White institution of higher education. Seven organizational structures were found to influence the organization's ability to advance its aims, from interviews, documents, observations,…

Assessment and Treatment of Tic Behavior: A Review and Case Study.

ERIC Educational Resources Information Center

Pray, Bruce, Jr.; And Others

1986-01-01

A discussion of the classification, differential diagnosis, etiology, assessment, and treatment of tic disorders is presented. A case study is included in which a school psychologist utilized behavioral consultation to assist a 9-year-old girl's parent and teacher in implementing a habit reversal program. (Author/LMO)

Using and Providing Services: Case Studies in Early Intervention.

ERIC Educational Resources Information Center

McWilliam, Robin; Tocci, Lynn; Sideris, John; Harbin, Gloria

A case study approach was used to examine the complexities of service utilization in early intervention with infants, toddlers, and young children with disabilities. Seventy-two families of children (ages birth to 4) participating in nine early intervention programs in three states (Colorado, North Carolina, and Pennsylvania) and their service…

Managing Anxiety: A Case Study of an International Teaching Assistant's Interaction with American Students

ERIC Educational Resources Information Center

Zhou, Ji

2014-01-01

This case study utilizes structuration theory to explore the complexities in the academic interaction between a Chinese international teaching assistant (ITA) and her American students. Through four semi-structured participant interviews, eight classroom observations, and student feedback, major themes and variations were identified regarding the…

Transformative Learning through Education Abroad: A Case Study of a Community College Program

ERIC Educational Resources Information Center

Brenner, Ashley A.

2014-01-01

This case study examined how participating in a short-term education abroad program fostered transformative learning for a small group of community college students. As a participant-observer, I utilized ethnographic methods, including interviews, observations, and document analysis, to understand students' perceptions of their experiences…

Being an Insider Researcher while Conducting Case Study Research

ERIC Educational Resources Information Center

Unluer, Sema

2012-01-01

It is crucial for social researchers to clarify their researchers' roles, especially for those utilizing qualitative methodology to make their research credible. The purpose of this paper is to examine the advantages and disadvantages of the researcher's insider role, an instructor, occupied within case study research on the integration of…

A New Lean Paradigm in Higher Education: A Case Study

ERIC Educational Resources Information Center

Doman, Mark S.

2011-01-01

Purpose: This case study aims to demonstrate that lean principles and practices utilized in industry can be successfully applied to improve higher education administrative processes through an innovative and engaging learning experience involving undergraduate students. Design/methodology/approach: This is a first-hand account by the instructor of…

Examination of Student Outcomes in Play Therapy: A Qualitative Case Study Design

ERIC Educational Resources Information Center

Dillman Taylor, Dalena L.; Blount, Ashley J.; Bloom, Zachary

2017-01-01

Outcome research examining the effectiveness of teaching methods in counselor education is sparse. The researchers conducted a qualitative investigation utilizing an instrumental case study to examine the influence of a constructivist-developmental format on a play therapy counseling course in a large CACREP accredited university in the…

Why University Members Use and Resist Technology? A Structure Enactment Perspective

ERIC Educational Resources Information Center

Lin, Canchu; Singer, Ross; Ha, Louisa

2010-01-01

This case study investigated university members' use of and resistance to a communication information technology system in a higher education organization. This case study utilized the technology enactment framework to examine structure enactment in university members' technology use and resistance. We found that the following structures were…

NCI International EBV-Gastric Cancer Consortium

Cancer.gov

A collaboration among NCI and extramural investigators, established by DCEG in 2006, that utilizes data and biospecimens from completed and ongoing case series and observational studies of gastric cancer to replicate and extend findings from previous studies hindered by small numbers of EBV-positive cases, and to stimulate multidisciplinary research in this area.

Computers in the Gym: Friends and Assistants.

ERIC Educational Resources Information Center

Hurwitz, Dick

Designed to assist physical education teachers realize the benefits of microcomputer usage, this paper presents the case study of a hypothetical middle school teacher who utilizes Apple computers for record-keeping, planning, teaching, and coaching. The case study shows how the computers save time, assist in individualizing instruction, help…

Trends Analysis of rhBMP2 Utilization in Single-Level Anterior Lumbar Interbody Fusion in the United States

PubMed Central

Lao, Lifeng; Cohen, Jeremiah R.; Buser, Zorica; Brodke, Darrel S.; Yoon, S. Tim; Youssef, Jim A.; Park, Jong-Beom; Meisel, Hans-Joerg; Wang, Jeffrey C.

2017-01-01

Study Design: Retrospective case study. Objective: To evaluate the trends and demographics of recombinant human bone morphogenetic protein 2 (rhBMP2) utilization in single-level anterior lumbar interbody fusion (ALIF) in the United States. Methods: Patients who underwent single-level ALIF from 2005 to 2011 were identified by searching ICD-9 diagnosis and procedure codes in the PearlDiver Patient Records Database (PearlDiver Technologies, Fort Wayne, IN), a national database of orthopedic insurance records. The year of procedure, age, gender, and region of the United States were analyzed for each patient. Results: A total of 921 patients were identified who underwent a single-level ALIF in this study. The average rate of single-level ALIF with rhBMP2 utilization increased (35%-48%) from 2005 to 2009, but sharply decreased to 16.7% in 2010 and 15.0% in 2011. The overall incidence of single-level ALIF without rhBMP2 (0.20 cases per 100 000 patients) was more than twice of the incidence of single-level ALIF with rhBMP2 (0.09 cases per 100 000 patients). The average rate of single-level ALIF with rhBMP2 utilization is highest in West (41.4%), followed by Midwest (33.3%), South (26.5%) and Northeast (22.2%). The highest incidence of single-level ALIF with rhBMP2 was observed in the group aged less than 65 years (compared with any other age groups, P < .001), with an incidence of 0.21 per 100 000 patients. Conclusions: The incidence of rhBMP2 utilization in single-level ALIF increased from 2006 to 2009, but decreased in 2010 and 2011. The Northeast region had the lowest incidence of rhBMP2 utilization. The group aged less than 65 years trended to have the higher incidence of single-level ALIF with rhBMP2 utilization. PMID:29662743

Environmental Impact of Asbestos Cement Pipe Renewal Technologies (WaterRF Report 4465)

EPA Science Inventory

This report summarizes asbestos regulations within the United States and presents current utility practices for a select number of utilities in North America and Australia. In addition, two real-world renewal demonstrations are presented as case studies examining the impact of pi...

Traversing School-Community Partnerships Utilizing Cross-Boundary Leadership

ERIC Educational Resources Information Center

Krumm, Bernita L.; Curry, Katherine

2017-01-01

Utilizing the conceptual framework of cross-boundary leadership, researchers conducted this qualitative case study to gain a better understanding of district-level leaders' actions and attitudes that led to meaningful, sustainable partnerships between the school, families, and community. Administrators in two urban, two suburban, and two rural…

Prevalence of diabetes mellitus among insured of a health insurance company in Puerto Rico: 1997-1998.

PubMed

Pérez-Perdomo, R; Pérez-Cardona, C; Rodríguez-Lugo, L

2001-06-01

The purpose of this study was to determine the prevalence of diabetes mellitus in persons covered by a health insurance company. The medical claims of persons insured with Triple S Health Insurance Co. of Puerto Rico, whose main diagnosis was diabetes (ICD9-250.0-9), were selected for analysis. Prevalence and medical utilization rates were estimated. General characteristics and services utilization were compared by age and sex using the chi-square distribution. Overall prevalence was 4.73%. Prevalence in the male population (5.07%) was higher than that of females (4.43%) in all age groups, but the difference was not statistically significant (p > 0.05). The proportion of diabetic cases was larger in the > 60 age group. 64% of the cases had 1 or more visits to a physician office, 2% were hospitalized, and almost 3% had emergency room visits. 29% of the cases had insulin prescriptions while 59% had oral prescriptions. The younger age group (< or = 44 years) had a larger utilization rate of emergency room and hospital admissions. Health service utilization varied by age and sex, however, the only significant difference was observed in glucose test services utilization (p < 0.05). The prevalence of diabetes in this group was lower than the prevalence reported in the Behavioral Risk Factor Surveillance System. This may be partially explained by the fact that the study group did not represent the composition of the Puerto Rican population. Prevalence studies using other groups will be helpful to determine the prevalence of diabetes in Puerto Rico.

Resilience in Utility Technologies

NASA Astrophysics Data System (ADS)

Seaton, Roger

The following sections are included: * Scope of paper * Preamble * Background to the case-study projects * Source projects * Resilience * Case study 1: Electricity generation * Context * Model * Case study 2: Water recycling * Context * Model * Case study 3: Ecotechnology and water treatment * Context * The problem of classification: Finding a classificatory solution * Application of the new taxonomy to water treatment * Concluding comments and questions * Conclusions * Questions and issues * Purposive or Purposeful? * Resilience: Flexibility and adaptivity? * Resilience: With respect of what? * Risk, uncertainty, surprise, emergence - What sort of shock, and who says so? * Co-evolutionary friction * References

Noise Management in Twenty-First Century Libraries: Case Studies of Four U.S. Academic Institutions

ERIC Educational Resources Information Center

Franks, Janet E.; Asher, Darla C.

2014-01-01

University libraries have had to provide acceptable noise levels for many years and this pressure has not diminished in the twenty-first century. Library space has to be utilized to ensure noise levels are best managed. A study was undertaken across four university libraries in South Florida to determine how universities utilized their limited…

Utilizing GIS to Assess the Impact of Urbanization on Timberland Availibility in Southeastern Louisiana

Treesearch

Donald G. Hodges; James T. Gunter; Christopher M. Swalm; James L. Regens

1998-01-01

This study illustrates how remotely-sensed data and GIS can be utilized to allow planners to evaluate the relationship between land use, environmental protection policies, and resource availability. The case study examines St. Tammany Parish in Louisiana which has experienced tremendous population growth and land use change in the past two decades. To date, work has...

Applying DER-CAM for IIT Microgrid Explansion Planning

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

Shahidehpour, Mohammad; Li, Zuyi; Wang, Jianhui

The Distributed Energy Resources Customer Adoption Model (DER-CAM) is an economic and environmental model of customer DER adoption. This model has been in development at the Lawrence Berkeley National Laboratory since 2000. The objective of the model is to find optimal DER investments while minimizing total energy costs or carbon dioxide (CO2) emissions, or achieving a weighted objective that simultaneously considers both criteria. The Illinois Institute of Technology (IIT) Microgrid project started in August 2008, and the majority of the project was completed in May 2013. IIT Microgrid, funded mostly by a grant from the U.S. Department of Energy asmore » well as State and philanthropic contributions, empowers the campus consumers with the objective of establishing a smart microgrid that is highly reliable, economically viable, environmentally friendly, fuel-efficient, and resilient in extreme circumstances with a self-healing capability. In this project, we apply DER-CAM to study the expansion planning of the IIT Microgrid. First, the load data, environmental data, utility data, and technology data for the IIT Microgrid are gathered and organized to follow the DER-CAM input requirements. Then, DERCAM is applied to study the expansion planning of the IIT Microgrid for different cases, where different objectives in DER-CAM and different utility conditions are tested. Case 1 considers the objective of minimizing energy costs with fixed utility rates and 100% electric utility availability. Case 2 considers the objective of minimizing energy costs with real-time utility rates and 4 emergency weeks when the IIT Microgrid does not have access to the electric utility grid and has to operate in island mode. In Case 3, the utility rates are restored to fixed values and 100% electric utility availability is assumed, but a weighted multi-objective (Obj: a × costs + b × CO2 emissions, where a and b are weights for cost minimization and CO2 emissions minimization) is utilized to consider both energy costs and CO2 emissions. On the basis of the test results, the IIT Microgrid has the potential to benefit from investments in more DER technologies. The current annual energy costs and CO2 emissions for the IIT Microgrid are 6,495.1 k$ and 39,838.5 metric tons, respectively. This represents the baseline for this project.« less

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,…

Serum 25-Hydroxyvitamin D and Breast Cancer in the Military: A Case-control Study Utilizing Pre-diagnostic Serum

DTIC Science & Technology

2013-01-08

15. Shin MH, Holmes MD, Hankinson SE, Wu K, Colditz GA, Willett WC (2002) Intake of dairy products, calcium, and vitamin D and risk of breast cancer...Serum 25-hydroxyvitamin D concentrations and postmenopausal breast cancer risk: a nested case control study in the Cancer Prevention Study-II Nutrition

Code-Switching and Gender: A Longitudinal Study of Spanish/English Speaking Fraternal Boy-Girl Twins

ERIC Educational Resources Information Center

Robinson, Colin

2015-01-01

Researchers from Jean Piaget (1932) to Sehlauoi (2008) have utilized small case studies to intensively examine naturally occurring child language production in the home environment. This qualitative, 5-year longitudinal, five-year case study continues the focus of previous research on child bilingualism and code-switching; however, it aims to…

A Comparative Case Study of Developing Leaders through a Doctoral Program: A Study of One Academic Institution

ERIC Educational Resources Information Center

Scanlon, Sheryl Lynne

2012-01-01

The purpose of this comparative case study was to determine how one academic institution could address the leadership gap facing organizations today, through a traditional, classroom doctoral program in Organizational Leadership. Data was gathered utilizing mixed methods methodology that included a survey questionnaire, focus group information,…

Using Illustrations to Depict Preservice Science Teachers' Self-Efficacy: A Case Study

ERIC Educational Resources Information Center

Greco, Robert Del; Bernadowski, Carianne; Parker, Susan

2018-01-01

This qualitative case study conducted at a small private university in the U.S. found that preservice teacher self-efficacy increased over the course of four semesters when taught inquiry-based instruction from a Social Constructivist Theoretical framework. This study utilized "A Draw a Science Teacher Test Checklist (DASTT-C)" created…

Benefits of a Teacher and Coach Collaboration: A Case Study

ERIC Educational Resources Information Center

Neuberger, Jim

2012-01-01

This paper describes a case study of a math teacher working with a math coach and the effects of their interaction. A guiding question was whether the coaching intervention had affected the teacher's classroom practices and, if so, in what way. The study utilized data from teacher/coach planning sessions, classroom lessons, follow-up debriefing…

Innovation at U.S Medical Schools: A Multiple Case Study of Leaders' Perceptions of Educational Techology

ERIC Educational Resources Information Center

Parisky, Alex

2015-01-01

The purpose of this qualitative case study was to better understand the implementation of educational technology in selected medical schools. This study utilized Rogers' Diffusion of Innovation theory to investigate the perspectives of educational technology leaders at four different medical schools in the United States. In the coming years,…

The Effects of Mobile Natural-Science Learning Based on the 5E Learning Cycle: A Case Study

ERIC Educational Resources Information Center

Liu, Tzu-Chien; Peng, Hsinyi; Wu, Wen-Hsuan; Lin, Ming-Sheng

2009-01-01

This study has three major purposes, including designing mobile natural-science learning activities that rest on the 5E Learning Cycle, examining the effects of these learning activities on students' performances of learning aquatic plants, and exploring students' perceptions toward these learning activities. A case-study method is utilized and…

The impact of China's retail drug price control policy on hospital expenditures: a case study in two Shandong hospitals.

PubMed

Meng, Qingyue; Cheng, Gang; Silver, Lynn; Sun, Xiaojie; Rehnberg, Clas; Tomson, Göran

2005-05-01

In China, 44.4% of total health expenditures in 2001 were for pharmaceuticals. Containment of pharmaceutical expenditures is a top priority for policy intervention. Control of drug retail prices was adopted by the Chinese government for this purpose. This study aims to examine the impact of this policy on the containment of hospital drug expenditures, and to analyze contributing factors. This is a retrospective pre/post-reform case study in two public hospitals. Financial records were reviewed to analyze changes in drug expenditures for all patients. A tracer condition, cerebral infarction, was selected for in-depth examination of changes in prices, utilization, expenditures and rationality of drugs. In the two hospitals, a total of 104 and 109 cerebral infarction cases, hospitalized respectively before and after the reform, were selected. Prescribed daily dose (PDD) was used for measuring drug utilization, and the contribution of price and utilization to changes in drug expenditures were decomposed. Rationality of drug use post-reform was reviewed based on published literature. Drug expenditures for all patients still increased rapidly in the two hospitals after implementation of the pricing policy. In the provincial hospital, drug expenditures per patient for cerebral infarction cases declined, but not significantly. This was mainly attributable to reduced utilization. In the municipal hospital, drug expenditure per patient increased by 50.1% after the reform, mainly due to greater drug utilization. Three to five fold higher drug expenditure per inpatient day in the provincial hospital was due to use of more expensive drugs. Of the top 15 drugs for treating cerebral infarction cases after the reform, 19.5% and 46.5% of the expenditures, in the provincial and municipal hospitals, respectively, were spent on drugs with prices set by the government. A large proportion of expenditures for the top 15 drugs, at least 65% and 41% in the provincial and municipal hospitals, respectively, was spent on allopathic drugs without an adequate evidence base of safety and efficacy supporting use for cerebral infarction. Control of retail prices, implemented in isolation, was not effective in containing hospital drug expenditures in these two Chinese hospitals. Utilization, more than price, determined drug expenditures. Improvement of rational use of drugs and correcting the present incentive structure for hospitals and drug prescribers may be important additional strategies for achieving containment of drug expenditures.

Utilizing high-throughput bioassays associated with US EPA ToxCast Program to assess biological activity of environmental contaminants: A case study of chemical mixtures

EPA Science Inventory

Effects-based monitoring and surveillance is increasingly being utilized in conjunction with chemical monitoring to determine potential biological activity associated with environmental contaminants. Supervised approaches targeting specific chemical activity or molecular pathways...

Inverse transonic airfoil design methods including boundary layer and viscous interaction effects

NASA Technical Reports Server (NTRS)

Carlson, L. A.

1979-01-01

The development and incorporation into TRANDES of a fully conservative analysis method utilizing the artificial compressibility approach is described. The method allows for lifting cases and finite thickness airfoils and utilizes a stretched coordinate system. Wave drag and massive separation studies are also discussed.

Using Knowledge Management to Revise Software-Testing Processes

ERIC Educational Resources Information Center

Nogeste, Kersti; Walker, Derek H. T.

2006-01-01

Purpose: This paper aims to use a knowledge management (KM) approach to effectively revise a utility retailer's software testing process. This paper presents a case study of how the utility organisation's customer services IT production support group improved their test planning skills through applying the American Productivity and Quality Center…

Utilizing Municipal Trees: Ideas From Across the Country

Treesearch

Stephen M. Bratkovich

2001-01-01

To show how municipal tree removals can be utilized for traditional wood products, this publication highlights 16 successful projects from around the country. These case studies are organized by the different types of participants: State and regional partnerships, municipalities, tree service firms, entrepreneurs, and sawmills. Contact information is provided for each...

Previous Mental Health Service Utilization and Change in Clients' Depressive Symptoms

ERIC Educational Resources Information Center

Boswell, James F.; McAleavey, Andrew A.; Castonguay, Louis G.; Hayes, Jeffrey A.; Locke, Benjamin D.

2012-01-01

Although a potentially important factor in case conceptualization and treatment planning, the impact of previous treatment on subsequent counseling response has received little empirical attention. Using archival data, this study aimed to (a) report the prevalence of previous treatment utilization in a counseling population, (b) examine potential…

The Room Itself is Active: How Classroom Design Impacts Student Engagement

ERIC Educational Resources Information Center

Rands, Melissa L.; Gansemer-Topf, Ann M.

2017-01-01

A responsive case study evaluation approach utilizing interviews and focus groups collected student and faculty perspectives on examined how instructors and students utilized a newly redesigned active learning space at Iowa State University and the relationship of this design with environmental and behavioral factors of student engagement. The…

School-Based Cognitive-Behavioral Therapy for an Adolescent Presenting with ADHD and Explosive Anger: A Case Study

ERIC Educational Resources Information Center

Parker, Janise; Zaboski, Brian; Joyce-Beaulieu, Diana

2016-01-01

This case demonstrates the efficacy of utilizing an intensive, multi-faceted behavioral intervention paradigm. A comprehensive, integrative, school-based service model was applied to address attention deficit hyperactivity disorder symptomology, oppositional behaviors, and explosive anger at the secondary level. The case reviews a multi-modal…

A value-based medicine analysis of ranibizumab for the treatment of subfoveal neovascular macular degeneration.

PubMed

Brown, Melissa M; Brown, Gary C; Brown, Heidi C; Peet, Jonathan

2008-06-01

To assess the conferred value and average cost-utility (cost-effectiveness) for intravitreal ranibizumab used to treat occult/minimally classic subfoveal choroidal neovascularization associated with age-related macular degeneration (AMD). Value-based medicine cost-utility analysis. MARINA (Minimally Classic/Occult Trial of the Anti-Vascular Endothelial Growth Factor Antibody Ranibizumab in the Treatment of Neovascular AMD) Study patients utilizing published primary data. Reference case, third-party insurer perspective, cost-utility analysis using 2006 United States dollars. Conferred value in the forms of (1) quality-adjusted life-years (QALYs) and (2) percent improvement in health-related quality of life. Cost-utility is expressed in terms of dollars expended per QALY gained. All outcomes are discounted at a 3% annual rate, as recommended by the Panel on Cost-effectiveness in Health and Medicine. Data are presented for the second-eye model, first-eye model, and combined model. Twenty-two intravitreal injections of 0.5 mg of ranibizumab administered over a 2-year period confer 1.039 QALYs, or a 15.8% improvement in quality of life for the 12-year period of the second-eye model reference case of occult/minimally classic age-related subfoveal choroidal neovascularization. The reference case treatment cost is $52652, and the cost-utility for the second-eye model is $50691/QALY. The quality-of-life gain from the first-eye model is 6.4% and the cost-utility is $123887, whereas the most clinically simulating combined model yields a quality-of-life gain of 10.4% and cost-utility of $74169. By conventional standards and the most commonly used second-eye and combined models, intravitreal ranibizumab administered for occult/minimally classic subfoveal choroidal neovascularization is a cost-effective therapy. Ranibizumab treatment confers considerably greater value than other neovascular macular degeneration pharmaceutical therapies that have been studied in randomized clinical trials.

Case manager-reported utilization of support group, substance use and mental health services among HIV-positive women in New York City.

PubMed

Kupprat, Sandra A; Dayton, Alex; Guschlbauer, Andrea; Halkitis, Perry N

2009-07-01

A retrospective, longitudinal analysis of case management and medical charts was used to evaluate utilization of support group, mental health, and substance abuse treatment services among HIV-positive women in New York City. Analyses of 4134 case management and supportive service transactions revealed that 70% utilized support groups over the two-year study period. In contrast, only 35% utilized mental health services (therapy) and of those identified as using substances, only 48% utilized substance abuse treatment services. Considering the high prevalence of mental illness (63%, n=29) and substance use (54%, n=25) in the sample, the low utilization rates highlight unmet needs for service. Significant differences were found in utilization of mental health and substance abuse treatment services, with those who received services at a medical model agency (integrated care) being more likely to receive both types of treatment. In contrast, participants attending support groups in non-medical model agencies (77.8%, n=7) were significantly more likely to be retained in group (i.e., attend 11 or more sessions) than those at medical model agencies (39.1%, n=9). Based on the higher utilization rates of support groups among seropositive women, perhaps these groups could be a vehicle for establishing rapport between mental health professionals and group members to bridge the utilization gap and reduce the stigma associated with therapy and substance abuse treatment services. These findings both taut the success and highlight weaknesses regarding accessing mental health and substance abuse care, and support group retention. Sharing of information regarding recruitment and retention efforts between agencies of different modalities would be beneficial and also could identify service niches that capitalize on their subsequent strengths.

Problem-Based Learning in Online Environments

ERIC Educational Resources Information Center

An, Yun-Jo; Reigeluth, Charles M.

2008-01-01

This study examined 3 graduate-level online courses that utilized problem-based learning (PBL), considering each course as a case. Beyond describing how PBL was implemented in each case, this study identified what worked (strengths) and did not work (weaknesses) in the PBL and explored how the PBL could be improved (improvements) by collecting…

Incorporating AAC and General Instructional Strategies in Requesting Interventions: A Case Study in Down Syndrome

ERIC Educational Resources Information Center

Lanter, Elizabeth; Russell, Sharon D.; Kuriakose, Annu; Blevins, Kasey E.

2016-01-01

This article provides clinicians and educators a useful conceptualization of general instructional strategies often used to promote the performance of requests in children with developmental disabilities, and which can be applied in interventions that utilize augmentative and alternative communication. A case study illustrates the specialized…

Interpersonal Consulting Skills for Instructional Technology Consultants: A Multiple Case Study

ERIC Educational Resources Information Center

van Leusen, Peter; Ottenbreit-Lefwich, Anne T.; Brush, Thomas

2016-01-01

Building a trust-based relationship with faculty is one of the most important attributes of effective Instructional Technology Consultants (ITC) in order to integrate emerging technologies into higher education. Utilizing a multiple case study research design, four experienced ITCs at a large urban research university located in the Midwest showed…

Meaning Making with Picturebooks: Young Children's Use of Semiotic Resources

ERIC Educational Resources Information Center

Kachorsky, Dani; Moses, Lindsey; Serafini, Frank; Hoelting, Megan

2017-01-01

As part of a year-long, classroom-based research study examining literacy instruction and development, the research team observed emerging decoders draw from a range of semiotic resources while reading picturebooks. Utilizing a case study approach, the researchers selected eight first graders to act as a representative case, and examined their…

20171011 - Examining the Utility of In Vitro Bioactivity as a Conservative Point of Departure: A Case Study (Advancing the Pace of Chemical Risk Assessment meeting)

EPA Science Inventory

The defined objectives for the case study include: (1) Compare in vitro bioactivity-derived administered dose equivalents (ADEs) and publicly available PODs from traditional chemical assessments (PODtraditional) to determine whether ADEs provide a conservative estimate of PODtrad...

Analyzing Security Breaches in the U.S.: A Business Analytics Case-Study

ERIC Educational Resources Information Center

Parks, Rachida F.; Adams, Lascelles

2016-01-01

This is a real-world applicable case-study and includes background information, functional organization requirements, and real data. Business analytics has been defined as the technologies, skills, and practices needed to iteratively investigate historical performance to gain insight or spot trends. You are asked to utilize/apply critical thinking…

The Crisis Response to a School-Based Hostage Event: A Case Study

ERIC Educational Resources Information Center

Crepeau-Hobson, Franci; Summers, Laura L.

2011-01-01

During the past two decades there has been increased public, professional, and legislative interest in school crisis prevention and intervention. It is recommended that comprehensive crisis teams be established at the school, district, and community levels. A case study was conducted in which interviews were utilized to facilitate an increased…

A Case Study of Dual Language Program Administrators: The Teachers We Need

ERIC Educational Resources Information Center

Lachance, Joan R.

2017-01-01

In support of growing numbers of dual language programs nation-wide, dual language school administrators seek to find teachers who are specifically prepared to work with dual language learners for additive biliteracy. For this research the author utilized a case study design to explore practicing dual language administrators' perspectives…

CLOSED-LOOP TREATMENT OF ELECTROLYTIC AND ELECTROLESS NICKEL RINSE WATER BY POINT-OF-USE ION EXCHANGE: A CASE STUDY

EPA Science Inventory

Many recent pilot tests have demonstrated the benefits and cost effectiveness of point-of-use treatment technologies as opposed to centralized wastewater treatment for all sizes of plating facilities. A 9-month case study at a small plating facility in Cincinnati, OH utilizing po...

Improving Assistive Technology Service by Using 3D Printing: Three Case Studies.

PubMed

Watanabe, Takashi; Hatakeyama, Takuro; Tomiita, Mitsuru

2015-01-01

Assistive technology services are essential for adapting assistive devices to the individual needs of users with disabilities. In this study, we attempted to apply three-dimensional (3D) printing technology to three actual cases, and to study its use, effectiveness, and future applications. We assessed the usefulness of 3D printing technology by categorizing its utilization after reviewing the outcomes of these case studies. In future work, we aim to gather additional case studies and derive information on using 3D printing technology that will enable its effective application in the process of assistive technology services.

Managing for resilience: an information theory-based ...

EPA Pesticide Factsheets

Ecosystems are complex and multivariate; hence, methods to assess the dynamics of ecosystems should have the capacity to evaluate multiple indicators simultaneously. Most research on identifying leading indicators of regime shifts has focused on univariate methods and simple models which have limited utility when evaluating real ecosystems, particularly because drivers are often unknown. We discuss some common univariate and multivariate approaches for detecting critical transitions in ecosystems and demonstrate their capabilities via case studies. Synthesis and applications. We illustrate the utility of an information theory-based index for assessing ecosystem dynamics. Trends in this index also provide a sentinel of both abrupt and gradual transitions in ecosystems. In response to the need to identify leading indicators of regime shifts in ecosystems, our research compares traditional indicators and Fisher information, an information theory based method, by examining four case study systems. Results demonstrate the utility of methods and offers great promise for quantifying and managing for resilience.

The Normative Structure of Knowledge Production and Utilization in Education. Volume 2. Case Studies of the Infrastructure of Educational R and D.

ERIC Educational Resources Information Center

Markley, O. W.

This is the second volume of a report on a study that (1) investigated the "normative structure" (the governance system) of knowledge production and utilization (KPU) activities in education, (2) developed an analytical framework through which to understand how formal policy acts as a "regulator" of activities in KPU, (3) described the major…

Evidence-based nursing practice: both state of the art in general and specific to pressure sores.

PubMed

Buss, I C; Halfens, R J; Abu-Saad, H H; Kok, G

1999-01-01

The importance of research-based practice in nursing has been frequently stressed, and a number of nursing studies have been conducted whose results enable nursing to improve knowledge and practice. This study reports a literature review in which the current status of knowledge and research utilization with regard to pressure sores is described. This review first gives an overview of studies on knowledge utilization in general and shows that the spontaneous diffusion of knowledge is inappropriate. Furthermore, an overview of planned research utilization activities focusing on pressure sore prevention and treatment in nursing is presented. The results of these studies show that planned research utilization activities performed in individual organizations lead to positive outcomes in almost all cases. Therefore, it could be concluded that implementing planned research utilization activities in individual health care institutions seems to be an effective strategy to decrease pressure sore incidence and prevalence rates.

Estimating Leptospirosis Incidence Using Hospital-Based Surveillance and a Population-Based Health Care Utilization Survey in Tanzania

PubMed Central

Biggs, Holly M.; Hertz, Julian T.; Munishi, O. Michael; Galloway, Renee L.; Marks, Florian; Saganda, Wilbrod; Maro, Venance P.; Crump, John A.

2013-01-01

Background The incidence of leptospirosis, a neglected zoonotic disease, is uncertain in Tanzania and much of sub-Saharan Africa, resulting in scarce data on which to prioritize resources for public health interventions and disease control. In this study, we estimate the incidence of leptospirosis in two districts in the Kilimanjaro Region of Tanzania. Methodology/Principal Findings We conducted a population-based household health care utilization survey in two districts in the Kilimanjaro Region of Tanzania and identified leptospirosis cases at two hospital-based fever sentinel surveillance sites in the Kilimanjaro Region. We used multipliers derived from the health care utilization survey and case numbers from hospital-based surveillance to calculate the incidence of leptospirosis. A total of 810 households were enrolled in the health care utilization survey and multipliers were derived based on responses to questions about health care seeking in the event of febrile illness. Of patients enrolled in fever surveillance over a 1 year period and residing in the 2 districts, 42 (7.14%) of 588 met the case definition for confirmed or probable leptospirosis. After applying multipliers to account for hospital selection, test sensitivity, and study enrollment, we estimated the overall incidence of leptospirosis ranges from 75–102 cases per 100,000 persons annually. Conclusions/Significance We calculated a high incidence of leptospirosis in two districts in the Kilimanjaro Region of Tanzania, where leptospirosis incidence was previously unknown. Multiplier methods, such as used in this study, may be a feasible method of improving availability of incidence estimates for neglected diseases, such as leptospirosis, in resource constrained settings. PMID:24340122

Vein grafting your way out of trouble: Examining the utility and efficacy of vein grafts in microsurgery.

PubMed

Nelson, Jonas A; Fischer, John P; Grover, Ritwik; Kovach, Stephen J; Low, David W; Kanchwala, Suhail K; Levin, L Scott; Serletti, Joseph M; Wu, Liza C

2015-06-01

There is limited data on the indications, outcomes, and associated complications with use of interpositional vein grafts (IVG) in microsurgery. This study sought to critically examine and update the utility of this microsurgical technique. All microsurgical cases at a single institution from 2005 to 2011 were examined for use of IVGs in the primary procedure or during take back or salvage attempts. We examined the cohort overall and performed a subgroup analysis by timing of initial IVG. In the study period, 1718 patients underwent 2368 free flaps. 51 IVGs were utilized in 38 patients (2.2%) and 38 flaps (1.6%). Eight (42.1%) of the primary procedure IVGs (n = 19) were planned preoperatively. Nine total flap losses (24%) occurred when IVGs were utilized, 89% of which occurred in the take back cohort (p = 0.02). However, planned IVG had a 100% success rate, and IVG utilized in the primary procedure overall had a 95% success rate. Importantly, A significantly higher rate of thrombotic events was noted in all primary cases where IVGs were utilized (p = 0.005). This study demonstrates that IVGs can be utilized in primary free flap reconstructions with success rates exceeding 95%. However, in salvage procedures, the use of vein grafts does not approach the same rate of success likely due to multiple factors. Yet when utilized appropriately with thrombectomy and resection of the thrombosed vessel to healthy intima, IVGs can provide an important tool for flap salvage. prognostic/risk category, level II. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Operating room waste: disposable supply utilization in neurosurgical procedures.

PubMed

Zygourakis, Corinna C; Yoon, Seungwon; Valencia, Victoria; Boscardin, Christy; Moriates, Christopher; Gonzales, Ralph; Lawton, Michael T

2017-02-01

OBJECTIVE Disposable supplies constitute a large portion of operating room (OR) costs and are often left over at the end of a surgical case. Despite financial and environmental implications of such waste, there has been little evaluation of OR supply utilization. The goal of this study was to quantify the utilization of disposable supplies and the costs associated with opened but unused items (i.e., "waste") in neurosurgical procedures. METHODS Every disposable supply that was unused at the end of surgery was quantified through direct observation of 58 neurosurgical cases at the University of California, San Francisco, in August 2015. Item costs (in US dollars) were determined from the authors' supply catalog, and statistical analyses were performed. RESULTS Across 58 procedures (36 cranial, 22 spinal), the average cost of unused supplies was $653 (range $89-$3640, median $448, interquartile range $230-$810), or 13.1% of total surgical supply cost. Univariate analyses revealed that case type (cranial versus spinal), case category (vascular, tumor, functional, instrumented, and noninstrumented spine), and surgeon were important predictors of the percentage of unused surgical supply cost. Case length and years of surgical training did not affect the percentage of unused supply cost. Accounting for the different case distribution in the 58 selected cases, the authors estimate approximately $968 of OR waste per case, $242,968 per month, and $2.9 million per year, for their neurosurgical department. CONCLUSIONS This study shows a large variation and significant magnitude of OR waste in neurosurgical procedures. At the authors' institution, they recommend price transparency, education about OR waste to surgeons and nurses, preference card reviews, and clarification of supplies that should be opened versus available as needed to reduce waste.

Identification and medical utilization of incident cases of alcohol dependence: A population-based case-control study.

PubMed

Pan, Chun-Hung; Li, Min-Shan; Yang, Tien-Wey; Huang, Ming-Chyi; Su, Sheng-Shiang; Hung, Yen-Ni; Chen, Chiao-Chicy; Kuo, Chian-Jue

2018-05-05

Patients with alcohol dependence (AD) often seek help from medical professionals due to alcohol-related diseases, but the overall distribution of medical specialties identifying new AD cases is unclear. We investigated how such cases were identified and how medical resources were utilized before the identification of AD in a nationwide cohort. We enrolled a population-based cohort (N = 1,000,000) using the National Health Insurance Research Database of Taiwan; 8181 cases with incident AD were retrieved between January 1, 2000, and December 31, 2010. For this nested case-control study, four controls were matched for age and sex with each case based on risk-set sampling. We measured various dimensions of medical utilization before AD was diagnosed, including department visited, physical comorbidity, and medication used. Conditional logistic regression was used for estimating the variables associated with AD. Patients living in less urbanized areas who were unemployed were more likely to develop AD. The highest proportions (34.2%) of AD cases were identified in the internal medicine department, followed by the emergency (22.3%) and psychiatry (18.7%) departments. AD patients had a higher risk of comorbid chronic hepatic disease (adjusted RR = 2.72, p < 0.001) before identification of AD than controls. AD patients also had greater numbers of hospital admissions than controls, including non-psychiatric and psychiatric hospitalizations. Outpatient visit numbers were similar for AD patients and controls. The findings indicate that clinicians providing care in diverse medical settings should be prepared to screen for unhealthy alcohol use and to mitigate its detrimental effects. Copyright © 2018 Elsevier B.V. All rights reserved.

A Case Study of a Turnaround High School: An Examination of the Maryland State Department of Education Breakthrough Center Intervention

ERIC Educational Resources Information Center

Galindo, Claudia; Stein, Kathleen; Schaffer, Eugene

2016-01-01

This study examined the Maryland State Department of Education Breakthrough Center (BTC) engagement in a Baltimore City turnaround high school. Utilizing a case-study design and mixed-methods research, data were collected through interviews, informal observations, and review of administrative and achievement documents. Beginning in the 2011-2012…

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)

Transitioning First-Career Skills into a Second Career in Teaching: A Collective Case Study of Effective Elementary School Teachers

ERIC Educational Resources Information Center

Simmons, Timothy Joshua

2016-01-01

The purpose of this qualitative collective case study was to understand how first-career skills were utilized by highly effective second-career elementary school teachers in northeast Tennessee. The guiding research question for the study was: How do the skills acquired in a first career affect second-career elementary school teachers? The…

Exploring Enrollment Management for an Independent, Faith-Based, Secondary School: A Case Study

ERIC Educational Resources Information Center

McMaster, Jason Andrew

2017-01-01

This single site case study looked specifically at the foundation and the structure of an independent school in California with respect to how it managed its enrollment and retention rates. For context, the institution being studied utilized a high-tuition strategy combined with a strong financial aid program. In 2012, the school peaked in its…

The Influence of Alternative Pedagogical Methods in Postsecondary Biology Education: How Do Students Experience a Multimedia Case-Study Environment?

ERIC Educational Resources Information Center

Wolter, Bjorn Hugo Karl

2010-01-01

The purpose of this study was to better understand how an online, multimedia case study method influenced students' motivation, performance, and perceptions of science in collegiate level biology classes. It utilized a mix-methods design including data from pre- and post-test, student surveys, and focus group interviews to answer one primary…

An Examination of Resource Allocation Strategies That Promote Student Achievement: Case Studies of Rural Elementary Schools in Hawaii

ERIC Educational Resources Information Center

Acopan-Tuasivi, C. K.

2012-01-01

This study presents case studies of rural elementary schools in Hawaii that examine resource allocation strategies that promote student achievement. The combined frame work of the Evidence Based Model (Odden & Picus, 2008) and the 10 Strategies for Doubling Student Performance (Odden, 2009) were utilized to compare actual school resources and…

Design and Construction Process of Two LEED Certified University Buildings: A Collective Case Study

ERIC Educational Resources Information Center

Rich, Kim

2011-01-01

This study was conducted at the early stages of integrating LEED into the design process in which a clearer understanding of what sustainable and ecological design was about became evident through the duration of designing and building of two academic buildings on a university campus. In this case study, due to utilizing a grounded theory…

Students' Personal Mobile Devices in the Classroom: A Case Study of a BYOT District

ERIC Educational Resources Information Center

O'Sullivan-Donnell, Becca

2013-01-01

This case study explored the use of students' personal mobile devices in the classroom for learning. The context was a district with an initiative called Bring Your Own Technology (BYOT), whereby students regularly utilized their personal technology as part of the curriculum. The focus of this study was to better understand how students' personal…

Associations of daily pediatric asthma emergency department visits with air pollution in Newark, NJ: utilizing time-series and case-crossover study designs.

PubMed

Gleason, Jessie A; Fagliano, Jerald A

2015-10-01

Asthma is one of the most common chronic diseases affecting children. This study assesses the associations of ozone and fine particulate matter (PM2.5) with pediatric emergency department visits in the urban environment of Newark, NJ. Two study designs were utilized and evaluated for usability. We obtained daily emergency department visits among children aged 3-17 years with a primary diagnosis of asthma during April to September for 2004-2007. Both a time-stratified case-crossover study design with bi-directional control sampling and a time-series study design were utilized. Lagged effects (1-d through 5-d lag, 3-d average, and 5-d average) of ozone and PM2.5 were explored and a dose-response analysis comparing the bottom 5th percentile of 3-d average lag ozone with each 5 percentile increase was performed. Associations of interquartile range increase in same-day ozone were similar between the time-series and case-crossover study designs (RR = 1.08, 95% CI 1.04-1.12) and (OR = 1.10, 95% CI 1.06-1.14), respectively. Similar associations were seen for 1-day lag and 3-day average lag ozone levels. PM2.5 was not associated with the outcome in either study design. Dose-response assessment indicated a statistically significant and increasing association around 50-55 ppb consistent for both study designs. Ozone was statistically positively associated with pediatric asthma ED visits in Newark, NJ. Our results were generally comparable across the time-series and case-crossover study designs, indicating both are useful to assess local air pollution impacts.

A perspective on cost-effectiveness of greenhouse gas reduction solutions in water distribution systems

NASA Astrophysics Data System (ADS)

Hendrickson, Thomas P.; Horvath, Arpad

2014-01-01

Water distribution systems (WDSs) face great challenges as aging infrastructures require significant investments in rehabilitation, replacement, and expansion. Reducing environmental impacts as WDSs develop is essential for utility managers and policy makers. This study quantifies the existing greenhouse gas (GHG) footprint of common WDS elements using life-cycle assessment (LCA) while identifying the greatest opportunities for emission reduction. This study addresses oversights of the related literature, which fails to capture several WDS elements and to provide detailed life-cycle inventories. The life-cycle inventory results for a US case study utility reveal that 81% of GHGs are from pumping energy, where a large portion of these emissions are a result of distribution leaks, which account for 270 billion l of water losses daily in the United States. Pipe replacement scheduling is analyzed from an environmental perspective where, through incorporating leak impacts, a tool reveals that optimal replacement is no more than 20 years, which is in contrast to the US average of 200 years. Carbon abatement costs (CACs) are calculated for different leak reduction scenarios for the case utility that range from -130 to 35 t-1 CO2(eq). Including life-cycle modeling in evaluating pipe materials identified polyvinyl chloride (PVC) and cement-lined ductile iron (DICL) as the Pareto efficient options, however; utilizing PVC presents human health risks. The model developed for the case utility is applied to California and Texas to determine the CACs of reducing leaks to 5% of distributed water. For California, annual GHG savings from reducing leaks alone (3.4 million tons of CO2(eq)) are found to exceed California Air Resources Board’s estimate for energy efficiency improvements in the state’s water infrastructure.

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

Bird, Lori; Cochran, Jaquelin; Wang, Xi

This report examines U.S. curtailment practices, with a particular emphasis on utilities in the Western states. The information presented here is based on a series of interviews conducted with utilities, system operators, wind energy developers, and non-governmental organizations. The report provides case studies of curtailment experience and examines the reasons for curtailment, curtailment procedures, compensation, and practices that can minimize curtailment.

What Causes a Memory Strategy Utilization Deficiency?

ERIC Educational Resources Information Center

Miller, Patricia H.; And Others

1994-01-01

In memory strategy utilization deficiency, a child spontaneously produces an appropriate strategy but receives little or no benefit from it for recall. Three studies suggest two causes: children's failure to relate the task situation to their event knowledge, or to link the strategy to a second strategy, in this case linking a selective attention…

Health Care Utilization among Migrant Latino Farmworkers: The Case of Skin Disease

ERIC Educational Resources Information Center

Feldman, Steven R.; Vallejos, Quirina M.; Quandt, Sara A.; Fleischer, Alan B., Jr.; Schulz, Mark R.; Verma, Amit; Arcury, Thomas A.

2009-01-01

Context: Skin diseases are common occupational illnesses for migrant farmworkers. Farmworkers face many barriers in accessing health care resources. Purpose: Framed by the Health Behavior Model, the purpose of this study was to assess health care utilization for skin disease by migrant Latino farmworkers. Methods: Three hundred and four migrant…

Evaluation of an Interactive Case-Based Online Network (ICON) in a Problem Based Learning Environment

ERIC Educational Resources Information Center

Nathoo, Arif N.; Goldhoff, Patricia; Quattrochi, James J.

2005-01-01

Purpose: This study sought to assess the introduction of a web-based innovation in medical education that complements traditional problem-based learning curricula. Utilizing the case method as its fundamental educational approach, the Interactive Case-based Online Network (ICON) allows students to interact with each other, faculty and a virtual…

Relationship between endobronchial ultrasound‐guided (EBUS)‐transbronchial needle aspiration utility and computed tomography staging, node size at EBUS, and positron emission tomography scan node standard uptake values: A retrospective analysis

PubMed Central

Marchand, Clare

2017-01-01

Background Endobronchial ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA) diagnoses and stages mediastinal lymph node pathology. This retrospective study determined the relationship between EBUS‐TBNA utility and non‐small cell lung cancer (NSCLC) stage, lymph node size, and positron emission tomography (PET) standard uptake values (SUV), and the utility of neck ultrasound in bulky mediastinal disease. Methods Data of 284 consecutive patients who had undergone EBUS‐TBNA was collected. Two hundred patients had suspected NSCLC, with 148 confirmed NSCLC cases. The diagnostic utility of EBUS‐TBNA was determined according to NSCLC stage, EBUS lymph node size, PET SUV, use in distal metastases, and mutation testing. The utility of neck ultrasound for N3 disease was calculated in patients with bulky mediastinal disease. Results EBUS‐TBNA was well tolerated with 97% sensitivity in distant metastatic disease, avoiding the need for distal metastases biopsy in 81% of cases. It had equivalent diagnostic accuracy in all NSCLC stages and in lymph nodes <10 mm, <20 mm or >20 mm (sensitivity >92% in all cases), with no mutation testing failures. EBUS‐TBNA had 33% sensitivity in PET indolent (SUV < 4) nodes and 79% sensitivity in PET active nodes (SUV > 4). EBUS‐TBNA diagnosed 12 cases of lymphoma without flow cytometry. Conclusions The use of EBUS‐TBNA meant that distant metastatic biopsy was avoided in 81% of cases, performing well irrespective of cancer stage, node size, and facilitating mutation testing. Neck ultrasound failed to detect N3 disease in patients with bulky mediastinal disease. EBUS‐TBNA had a sensitivity of 33% for metastases in PET negative nodes, highlighting PET limitations. PMID:28436173

Clinical Utility of a Coronary Heart Disease Risk Prediction Gene Score in UK Healthy Middle Aged Men and in the Pakistani Population

PubMed Central

Beaney, Katherine E.; Cooper, Jackie A.; Ullah Shahid, Saleem; Ahmed, Waqas; Qamar, Raheel; Drenos, Fotios; Crockard, Martin A.; Humphries, Steve E.

2015-01-01

Background Numerous risk prediction algorithms based on conventional risk factors for Coronary Heart Disease (CHD) are available but provide only modest discrimination. The inclusion of genetic information may improve clinical utility. Methods We tested the use of two gene scores (GS) in the prospective second Northwick Park Heart Study (NPHSII) of 2775 healthy UK men (284 cases), and Pakistani case-control studies from Islamabad/Rawalpindi (321 cases/228 controls) and Lahore (414 cases/219 controls). The 19-SNP GS included SNPs in loci identified by GWAS and candidate gene studies, while the 13-SNP GS only included SNPs in loci identified by the CARDIoGRAMplusC4D consortium. Results In NPHSII, the mean of both gene scores was higher in those who went on to develop CHD over 13.5 years of follow-up (19-SNP p=0.01, 13-SNP p=7x10-3). In combination with the Framingham algorithm the GSs appeared to show improvement in discrimination (increase in area under the ROC curve, 19-SNP p=0.48, 13-SNP p=0.82) and risk classification (net reclassification improvement (NRI), 19-SNP p=0.28, 13-SNP p=0.42) compared to the Framingham algorithm alone, but these were not statistically significant. When considering only individuals who moved up a risk category with inclusion of the GS, the improvement in risk classification was statistically significant (19-SNP p=0.01, 13-SNP p=0.04). In the Pakistani samples, risk allele frequencies were significantly lower compared to NPHSII for 13/19 SNPs. In the Islamabad study, the mean gene score was higher in cases than controls only for the 13-SNP GS (2.24 v 2.34, p=0.04). There was no association with CHD and either score in the Lahore study. Conclusion The performance of both GSs showed potential clinical utility in European men but much less utility in subjects from Pakistan, suggesting that a different set of risk loci or SNPs may be required for risk prediction in the South Asian population. PMID:26133560

Tacit Knowledge Capture and the Brain-Drain at Electrical Utilities

NASA Astrophysics Data System (ADS)

Perjanik, Nicholas Steven

As a consequence of an aging workforce, electric utilities are at risk of losing their most experienced and knowledgeable electrical engineers. In this research, the problem was a lack of understanding of what electric utilities were doing to capture the tacit knowledge or know-how of these engineers. The purpose of this qualitative research study was to explore the tacit knowledge capture strategies currently used in the industry by conducting a case study of 7 U.S. electrical utilities that have demonstrated an industry commitment to improving operational standards. The research question addressed the implemented strategies to capture the tacit knowledge of retiring electrical engineers and technical personnel. The research methodology involved a qualitative embedded case study. The theories used in this study included knowledge creation theory, resource-based theory, and organizational learning theory. Data were collected through one time interviews of a senior electrical engineer or technician within each utility and a workforce planning or training professional within 2 of the 7 utilities. The analysis included the use of triangulation and content analysis strategies. Ten tacit knowledge capture strategies were identified: (a) formal and informal on-boarding mentorship and apprenticeship programs, (b) formal and informal off-boarding mentorship programs, (c) formal and informal training programs, (d) using lessons learned during training sessions, (e) communities of practice, (f) technology enabled tools, (g) storytelling, (h) exit interviews, (i) rehiring of retirees as consultants, and (j) knowledge risk assessments. This research contributes to social change by offering strategies to capture the know-how needed to ensure operational continuity in the delivery of safe, reliable, and sustainable power.

Considerations of study design.

PubMed

Koretz, Ronald L

2007-12-01

Research projects attempt to answer specific questions. The particular study design that is selected will depend in large measure on the nature of the question and the time and resources available. There are 5 common categories of clinical questions; they relate to etiology, prognosis, utility of diagnostic tests, efficacy of proposed interventions, and cost of treatment in specific disease states. A number of study designs can be used. Case reports serve to memorialize unusual or novel aspects of diseases. Retrospective case series are useful for defining natural history. Case-control studies are used by epidemiologists to elucidate potential etiologies of diseases. Prospective cohort studies can be used to assess natural history or to assess potential disease etiologies. Controlled trials are designed to assess the efficacy of therapeutic interventions. Studies that define the sensitivity and specificity of diagnostic tests can be used to assess the utility of those tests. Economic analyses estimate the costs that particular diseases or therapies will require. Each of these study designs has limitations; with the exception of high-quality randomized trials, none of these study designs can establish a causative relationship between putative etiologic (or therapeutic) factors and disease (outcomes).

Improvement of Coordination in the Multi-National Military Coordination Center of the Nepal Army in Respond to Disasters

DTIC Science & Technology

2017-06-09

primary question. This thesis has used the case study research methodology with Capability-Based Assessment (CBA) approach. My engagement in this...protected by more restrictions in their home countries, in which case further publication or sale of copyrighted images is not permissible...effective coordinating mechanism. The research follows the case study method utilizing the Capability Based Analysis (CBA) approach to scrutinize the

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

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…

The Education of Hindu Priests in the Diaspora: Assessing the Value of Community of Practice Theory

ERIC Educational Resources Information Center

Verma, Michele

2010-01-01

The utility and limitations of Lave and Wenger's social theory of learning can be evaluated through specific case studies which enhance our understanding of how education proceeds in diverse contexts. Here I provide an ethnographic case study of the training of Caribbean-born Hindu "pandits" ("priests") living and working in…

A Case Study of Understanding the Influence of Cultural Patterns on International Students' Perception and Experience with Online Learning

ERIC Educational Resources Information Center

Paralejas, Cynthia G.

2013-01-01

This dissertation aimed to understand the influence of cultural patterns on international students' perception and experience with online learning. This case study utilized Hofstede's cultural dimension model as an interpretative framework to understand what are the international students' perceptions and experiences with online courses. Two…

Breaking down Barriers: A Case Study of Juvenile Justice Personnel Perspectives on School Reentry

ERIC Educational Resources Information Center

Cole, Heather; Cohen, Rebecca

2013-01-01

This article utilizes a qualitative case study to explore juvenile justice personnel perspectives on school reentry. Juvenile justice personnel are a little tapped into source of information on the inner workings of the school-to-prison pipeline. They provide a unique perspective as firsthand observers of the pipeline, offering a different voice…

The Limits of Outcomes Analysis; A Comment on "Sex Discrimination in Higher Employment: An Empirical Analysis of the Case Law."

ERIC Educational Resources Information Center

Lee, Barbara A.

1990-01-01

Questions assumptions by Schoenfeld and Zirkel in a study reviewing gender discrimination cases against institutions of higher education. Critiques the methodology used in that study, cautions about the overall utility of "outcomes analysis," and reports more promising routes of empirical legal research. (15 references) (MLF)

Current Trends in Microform Use by Secondary Schools: Four Case Studies.

ERIC Educational Resources Information Center

Lee, Thomas Graham

The case study section of this booklet discusses a number of current microform programs in secondary schools. The remainder of the booklet presents an overview of microform activity, including comments on the history of secondary school microform utilization and an up-to-date listing of microform selection aids. The amount of information available…

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...

A Case Study in Market Transformation for Residential Energy Efficiency Programs

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

Building Technologies Office

This case study describes how the Midwest Energy Efficiency Alliance (MEEA) partnered with gas and electric utilities in Iowa to establish the Iowa residential heating, ventilation, and air conditioning System Adjustment and Verified Efficiency (HVAC SAVE) program, taking it to scale improving the performance and energy efficiency of HVAC systems, growing businesses, and gaining consumer trust.

A Case Study of Israeli Higher-Education Institutes Sharing Scholarly Information with the Community via Social Networks

ERIC Educational Resources Information Center

Forkosh-Baruch, Alona; Hershkovitz, Arnon

2012-01-01

The purpose of this study is to empirically examine cases in which Social Networking Sites (SNS) are being utilized for scholarly purposes by higher-education institutes in Israel. The research addresses questions regarding content patterns, activity patterns, and interactivity within Facebook and Twitter accounts of these institutes. Research…

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…

The Convergence of Content, Pedagogy, and Technology in Online Professional Development for Teachers of German: An Intrinsic Case Study

ERIC Educational Resources Information Center

Bustamante, Carolina; Moeller, Aleidine J.

2013-01-01

This qualitative case study describes a unique online professional development program utilizing Web 2.0 technologies for teachers of German using the Technological Pedagogical Content Knowledge (TPACK) model as a theoretical framework to promote technology literacy, expand German language proficiency and cultural knowledge, and integrate…

Perceptions of L1 Glossed Feedback in Automated Writing Evaluation: A Case Study

ERIC Educational Resources Information Center

Wilken, Jayme Lynn

2018-01-01

Learner perceptions toward and utilization of L1 glossed feedback in an automated writing evaluation (AWE) program were investigated in an Intensive English Program (IEP) class. This small case study focused on two Chinese students who responded to weekly surveys, semi-structured interviews, and screen capture videos of their revisions over a…

Students' Evaluations of Profit and Utility of Higher Education: A Comparative Case Study

ERIC Educational Resources Information Center

Davidovitch, Nitza; Lobovam Elena; Pryamikova, Elena; Semenova, Tatiana; Pechenkina, Tatiana; Yachmeneva, Maria

2013-01-01

This paper reviews the recent turn toward a capitalist approach to higher education with specific reference to the social, demographic, and legislative changes, including growing academic capitalism, which led to a transformation in Israel's higher education system. In an empirical comparative case study of students from Israel and Russia, this…

Using Debate to Maximize Learning Potential: A Case Study

ERIC Educational Resources Information Center

Firmin, Michael W.; Vaughn, Aaron; Dye, Amanda

2007-01-01

Following a review of the literature, an educational case study is provided for the benefit of faculty preparing college courses. In particular, we provide a transcribed debate utilized in a General Psychology course as a best practice example of how to craft a debate which maximizes student learning. The work is presented as a model for the…

Assessment and Treatment of Stereotypic Vocalizations in a Taiwanese Adolescent with Autism: A Case Study

ERIC Educational Resources Information Center

Wu, Ya-Ping; Mirenda, Pat; Wang, Hwa-Pey; Chen, Ming-Chung

2010-01-01

This case study describes the processes of functional analysis and modality assessment that were utilized to design a communication intervention for an adolescent with autism who engaged in loud and disruptive vocalizations for most of the school day. The functional analysis suggested that the vocalizations served both tangible and escape…

Epidemiology and long-term disease burden of herpes zoster and postherpetic neuralgia in Taiwan: a population-based, propensity score-matched cohort study.

PubMed

Lu, Wan-Hsuan; Lin, Chih-Wan; Wang, Chen-Yu; Chen, Liang-Kung; Hsiao, Fei-Yuan

2018-03-20

The objectives of this study were to characterize the burden of herpes zoster, as well as the longitudinal and incremental changes of healthcare service utilization among individuals with herpes zoster and postherpetic neuralgia (PHN) compared to those without. Using the National Health Insurance Research Database (NHIRD), we established a herpes zoster cohort of people diagnosed with herpes zoster between 2004 and 2008 as study cases. Another subset of the NHIRD, which was randomly selected from all elderly beneficiaries between 2004 and 2008 served as a non-herpes-zoster elderly control pool. Each case was then assigned one matched control according to age, gender, index date and propensity score. PHN cases were defined as those with persisting pain for more than 90 days after the onset of herpes zoster. Between 2004 and 2008, about 0.6 million patients were newly diagnosed with herpes zoster. The incidence increased with age, and most cases were identified during the summer period. Herpes zoster cases were found to have higher consumption of all types of healthcare services in the first year after the index date. Such increases were particularly obvious for patients with PHN, who showed incremental increases on average of 16.3 outpatient visits, 0.4 emergency room visits and 0.24 inpatient admissions per year. The incidence of herpes zoster increased with age and changed according to the seasons. Patients with herpes zoster were associated with higher healthcare utilization and this increase in healthcare utilization was most obvious for herpes zoster patients with PHN.

Quality Management Tools: Facilitating Clinical Research Data Integrity by Utilizing Specialized Reports with Electronic Case Report Forms

PubMed Central

Trocky, NM; Fontinha, M

2005-01-01

Data collected throughout the course of a clinical research trial must be reviewed for accuracy and completeness continually. The Oracle Clinical® (OC) data management application utilized to capture clinical data facilitates data integrity through pre-programmed validations, edit and range checks, and discrepancy management modules. These functions were not enough. Coupled with the use of specially created reports in Oracle Discoverer® and Integrated Review TM, both ad-hoc query and reporting tools, research staff have enhanced their ability to clean, analyze and report more accurate data captured within and among Case Report Forms (eCRFs) by individual study or across multiple studies. PMID:16779428

Utilization of Meteorological Satellite Imagery for World-Wide Environmental Monitoring the Lower Mississippi River Flood of 1979 - Case 1. [St. Louis, Missouri

NASA Technical Reports Server (NTRS)

Helfert, M. R.; Mccrary, D. G.; Gray, T. I. (Principal Investigator)

1981-01-01

The 1979 Lower Mississippi River flood was selected as a test case of environmental disaster monitoring utilizing NOAA-n imagery. A small scale study of the St. Louis Missouri area comparing ERTS-1 (LANDSAT) and NOAA-2 imagery and flood studies using only LANDSAT imagery for mapping the Rad River of the North, and Nimbus-5 imagery for East Australia show the nonmeteorological applications of NOAA satellites. While the level of NOAA-n imagery detail is not that of a LANDSAT image, for operational environmental monitoring users the NOAA-n imagery may provide acceptable linear resolution and spectral isolation.

Quantifying Morbidity Burdens and Medical Utilization of Children with Intellectual Disabilities in Taiwan: A Nationwide Study Using the ACG Case-Mix Adjustment System

ERIC Educational Resources Information Center

Lee, Wui-Chiang; Chen, Tzeng-Ji

2012-01-01

The purpose of this study was to quantify morbidity burdens of children with intellectual disability (ID) and to examine its association with total medical utilization and expenditure on a national basis in Taiwan. People under 18 years of age that had been continuously enrolled in the National Health Insurance (NHI) between year 2008 and 2010…

Trends Analysis of rhBMP2 Utilization in Single-Level Anterior Lumbar Interbody Fusion in the United States.

PubMed

Lao, Lifeng; Cohen, Jeremiah R; Buser, Zorica; Brodke, Darrel S; Yoon, S Tim; Youssef, Jim A; Park, Jong-Beom; Meisel, Hans-Joerg; Wang, Jeffrey C

2018-04-01

Retrospective case study. To evaluate the trends and demographics of recombinant human bone morphogenetic protein 2 (rhBMP2) utilization in single-level anterior lumbar interbody fusion (ALIF) in the United States. Patients who underwent single-level ALIF from 2005 to 2011 were identified by searching ICD-9 diagnosis and procedure codes in the PearlDiver Patient Records Database (PearlDiver Technologies, Fort Wayne, IN), a national database of orthopedic insurance records. The year of procedure, age, gender, and region of the United States were analyzed for each patient. A total of 921 patients were identified who underwent a single-level ALIF in this study. The average rate of single-level ALIF with rhBMP2 utilization increased (35%-48%) from 2005 to 2009, but sharply decreased to 16.7% in 2010 and 15.0% in 2011. The overall incidence of single-level ALIF without rhBMP2 (0.20 cases per 100 000 patients) was more than twice of the incidence of single-level ALIF with rhBMP2 (0.09 cases per 100 000 patients). The average rate of single-level ALIF with rhBMP2 utilization is highest in West (41.4%), followed by Midwest (33.3%), South (26.5%) and Northeast (22.2%). The highest incidence of single-level ALIF with rhBMP2 was observed in the group aged less than 65 years (compared with any other age groups, P < .001), with an incidence of 0.21 per 100 000 patients. The incidence of rhBMP2 utilization in single-level ALIF increased from 2006 to 2009, but decreased in 2010 and 2011. The Northeast region had the lowest incidence of rhBMP2 utilization. The group aged less than 65 years trended to have the higher incidence of single-level ALIF with rhBMP2 utilization.

Human Resource Development and New Technology in the Automobile Industry: A Case Study of Ford Motor Company's Dearborn Engine Plant. The Development and Utilization of Human Resources in the Context of Technological Change and Industrial Restructuring.

ERIC Educational Resources Information Center

Chen, Kan; And Others

This report centers around a plant-level study of the development and utilization of human resources in the context of technological change and industrial restructuring in the crankshaft production area of Ford Motor Company's Dearborn Engine Plant (DEP). The introductory chapter describes how the study was conducted, provides an introduction to…

Comparison of direct and indirect methods of estimating health state utilities for resource allocation: review and empirical analysis.

PubMed

Arnold, David; Girling, Alan; Stevens, Andrew; Lilford, Richard

2009-07-22

Utilities (values representing preferences) for healthcare priority setting are typically obtained indirectly by asking patients to fill in a quality of life questionnaire and then converting the results to a utility using population values. We compared such utilities with those obtained directly from patients or the public. Review of studies providing both a direct and indirect utility estimate. Papers reporting comparisons of utilities obtained directly (standard gamble or time tradeoff) or indirectly (European quality of life 5D [EQ-5D], short form 6D [SF-6D], or health utilities index [HUI]) from the same patient. PubMed and Tufts database of utilities. Sign test for paired comparisons between direct and indirect utilities; least squares regression to describe average relations between the different methods. Mean utility scores (or median if means unavailable) for each method, and differences in mean (median) scores between direct and indirect methods. We found 32 studies yielding 83 instances where direct and indirect methods could be compared for health states experienced by adults. The direct methods used were standard gamble in 57 cases and time trade off in 60(34 used both); the indirect methods were EQ-5D (67 cases), SF-6D (13), HUI-2 (5), and HUI-3 (37). Mean utility values were 0.81 (standard gamble) and 0.77 (time tradeoff) for the direct methods; for the indirect methods: 0.59(EQ-5D), 0.63 (SF-6D), 0.75 (HUI-2) and 0.68 (HUI-3). Direct methods of estimating utilities tend to result in higher health ratings than the more widely used indirect methods, and the difference can be substantial.Use of indirect methods could have important implications for decisions about resource allocation: for example, non-lifesaving treatments are relatively more favoured in comparison with lifesaving interventions than when using direct methods.

An Interprofessional Program Evaluation Case Study: Utilizing Multiple Measures To Assess What Matters. AIR 1997 Annual Forum Paper.

ERIC Educational Resources Information Center

Delaney, Anne Marie

This paper reviews the first two years of a model program-evaluation case study which is intended to show: (1) how program evaluation can contribute to academic and professional degree programs; (2) how qualitative and quantitative techniques can be used to produce reliable measures for evaluation studies; and (3) how the role of the institutional…

HIV and Sexually Transmitted Infection Testing Among High-Risk Youths: Supporting Positive Opportunities With Teens (SPOT) Youth Center

PubMed Central

Garbutt, Jane; Kaushik, Gaurav N.

2015-01-01

Objectives. We investigated the development of and service utilization at Supporting Positive Opportunities with Teens (SPOT)—a community-based health and social service facility in St. Louis, Missouri, for youths that focuses on increasing HIV and sexually transmitted infection (STI) testing. Methods. We identified the US-based, co-located youth health and social service models that guided the establishment of the SPOT. We analyzed the first 5 years (2008–2013) of service delivery and utilization data. Results. During the study period, the SPOT provided services for 8233 youths in 37 480 visits. The 5 most utilized services included HIV and STI screening, food, transportation, contraception, and case management. A total of 9812 gonorrhea and chlamydia screenings revealed 1379 (14.1%) cases of chlamydia and 437 (4.5%) cases of gonorrhea, and 5703 HIV tests revealed 59 HIV infections (1.0%); 93.0% of patients found to have an STI were treated within a 5-day window. Conclusions. Co-locating health and social services in informal community settings attracts high-risk youths to utilize services and can prove instrumental in reducing STI burden in this population. PMID:25973833

Understanding Service Utilization in Cases of Elder Abuse to Inform Best Practices.

PubMed

Burnes, David; Rizzo, Victoria M; Gorroochurn, Prakash; Pollack, Martha H; Lachs, Mark S

2016-10-01

Elder abuse (EA) case resolution is contingent upon victims accepting and pursuing protective service interventions. Refusal/underutilization of services is a major problem. This study explored factors associated with extent of EA victim service utilization (SU). Data were collected from a random sample of EA cases (n = 250) at a protective service program in New York City. In cases involving financial abuse, higher SU was associated with females, poor health, perceived danger, previous help-seeking, and self or family referral. In physical abuse cases, higher SU was associated with family referral and previous help-seeking; lower SU was related to Hispanic race/ethnicity, being married, and child/grandchild perpetrator. In emotional abuse cases, higher SU was associated with self or family referral, victim-perpetrator gender differential, perceived danger, and previous help-seeking; lower SU was related to child/grandchild perpetrator. Findings carry implications for best practices to retain and promote service use among elder victims of abuse. © The Author(s) 2014.

Measuring utilization and impact of home care services: a systems model approach for cost effectiveness.

PubMed

Day, S R

1984-01-01

The relevance of home care research to policy questions is discussed as framework for study on "effects" (precursors and sequelae) of home care. This study used a large, multi-service agency's longitudinal (8-year) case records (N = 2436) to examine a system model for relationships among entry characteristics, utilization of services, and need for services upon discharge from home care. Deducing case-mix from utilization patterns, pay plan at entry was identified as best of the available predictors of both duration and intensity (using multivariate analysis). Duration and intensity, dual contributors to "total visits," were found to vary inversely and were predicted by different entering pay plans. While 1/3 of all cases were discharged to informal or self care, that was the most prevalent exit status of the clients (49%) who entered directly from hospital care. The methods used in disaggregating and analyzing these retrospectively-coded case records suggest that home services research: 1. distinguish type, intensity, and duration as components of "total visits" which combine to account for costs of care; 2. find concomitants of functional level (such as pay plan) which are accessible for designating case mix for purpose of projecting service use; 3. measure effectiveness in terms relevant to stated objectives of the long term care system, which need to acknowledge mortality and to separate service needs at entry room those at exist from the series of formal and informal providers on a continuum of care.

Corporate Publics and Rhetorical Strategies: The Case of Union Carbide's Bhopal Crisis.

ERIC Educational Resources Information Center

Ice, Richard

1991-01-01

Examines the role of rhetorical strategies in repairing damaged corporate relationships. Demonstrates the utility of an integrated model (multiple-publics concept and strategies of apologia) to corporate public relations through a case study of Union Carbide's justification of the Bhopal gas leak. (KEH)

Case-Cohort Studies: Design and Applicability to Hand Surgery.

PubMed

Vojvodic, Miliana; Shafarenko, Mark; McCabe, Steven J

2018-04-24

Observational studies are common research strategies in hand surgery. The case-cohort design offers an efficient and resource-friendly method for risk assessment and outcomes analysis. Case-cohorts remain underrepresented in upper extremity research despite several practical and economic advantages over case-control studies. This report outlines the purpose, utility, and structure of the case-cohort design and offers a sample research question to demonstrate its value to risk estimation for adverse surgical outcomes. The application of well-designed case-cohort studies is advocated in an effort to improve the quality and quantity of observational research evidence in hand and upper extremity surgery. Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Assessing copper pinhole leaks in residential plumbing.

PubMed

Edwards, M; Rushing, J C; Kvech, S; Reiber, S

2004-01-01

Pinhole leaks in copper tubes are a major problem for homeowners, and an aggressive conscientious effort by utilities is recommended to diagnose the problem and identify potential solutions. In a case study at one utility, pinhole leak frequency data was compiled and a methodology was followed that might prove to be a useful guide for those facing similar problems.

First Impressions Matter: Navigating Graphic Novels Utilizing Linguistic, Visual, and Spatial Resources

ERIC Educational Resources Information Center

Jimenez, Laura M.; Meyer, Carla K.

2016-01-01

Graphic novels in the K-12 classroom are most often used to motivate marginalized readers because of the lower text load and assumption of easy reading. This assumption has thus far been unexplored by reading research. This qualitative multiple-case study utilized think-aloud protocols in a new attention-mapping activity to better understand how…

Utilization of antiepileptic drugs in Israel.

PubMed

Berman, Erez; Marom, Eli; Ekstein, Dana; Blatt, Ilan; Eyal, Sara

2016-08-01

The aim of the study was to identify trends in utilization of antiepileptic drugs (AEDs) over time in a nation-wide population in Israel. Data on AED utilization (for all indications) for the period 2010-2014 were obtained from pharmaceutical companies that distribute AEDs in Israel. Prevalence of AED utilization was reported as defined daily doses (DDD)/1000 inhabitants/day. The utilization of most AEDs included in our analysis remained stable over the study period. The greatest increases in utilization of drugs established in Israel were observed for lamotrigine (33%), oxcarbazepine (31%), and primidone (18%). Decreases in use were recorded for carbamazepine (18%) and phenobarbital (15%). Use of older AEDs appeared to be relatively high, compared with the use of newer AEDs. During the study period of 2010-2014, conventional AEDs remained a main treatment choice in Israel, in certain cases in contrast to current recommendations and guidelines, for reasons yet to be revealed in further research. Copyright © 2016 Elsevier Inc. All rights reserved.

Exploring the psychological and somatic impact of identity theft.

PubMed

Sharp, Tracy; Shreve-Neiger, Andrea; Fremouw, William; Kane, John; Hutton, Shawn

2004-01-01

Identity theft is a new and growing form of white-collar crime. This exploratory study examined the psychological and somatic impact of identity theft and coping methods utilized by victims. Thirty-seven victims of identity theft participated in regional victim focus groups. Participants completed a victim impact questionnaire designed by the authors and the Brief Symptom Inventory-18 (BSI-18). The majority of participants expressed an increase in maladaptive psychological and somatic symptoms post victimization. Results on the BSI indicated that identity theft victims with unresolved cases, in contrast to those with resolved cases, were more likely to have clinically elevated scores when compared with a normative sample. Relatively similar coping mechanisms were utilized across victims. The results from this study suggest that victims of identity theft do have increased psychological and physical distress, and for those whose cases remain unresolved, distress is maintained over time.

Teaching History with Comic Books: A Case Study of Violence, War, and the Graphic Novel

ERIC Educational Resources Information Center

Decker, Alicia C.; Castro, Mauricio

2012-01-01

In this essay, the authors present a case study that demonstrates how graphic novels can be utilized in the history classroom. More specifically, they discuss the benefits (and challenges) of using comic books to teach undergraduates about war and violence. While much of their discussion focuses on the historical particularities of Uganda, their…

The Integration of Mathematics in Physics Problem Solving: A Case Study of Greek Upper Secondary School Students

ERIC Educational Resources Information Center

Meli, Kalliopi; Zacharos, Konstantinos; Koliopoulos, Dimitrios

2016-01-01

This article presents a case study that examines the level of integration of mathematical knowledge in physics problem solving among first grade students of upper secondary school. We explore the ways in which two specific students utilize their knowledge and we attempt to identify the epistemological framings they refer to while solving a physics…

Increasing market share through consumer marketing: a case study in obstetrics.

PubMed

Kingsley, V H

1986-05-01

Consumers are becoming ever more selective in their choice of health care providers. Hospitals that are aware of local preferences and how to reach and influence consumers will gain a competitive advantage. Outlined in this article are consumer marketing techniques that can be utilized for all product lines. The concept is applied here as a case study in obstetrics.

The Internationalization of Experiential Learning for Deaf and Hard of Hearing College Students: A Case Study of Accessibility and Globalization

ERIC Educational Resources Information Center

Peisner, Elizabeth Suzanne

2011-01-01

Utilizing a qualitative case study, this dissertation analyzed how one university provided accessibility to international experiential learning opportunities for a primarily disabled student population. The Council for the Advancement of Standards (CAS, 2006) in Higher Education consists of a self-assessment guide adapted as a framework to analyze…

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…

A Case Study Exploring the Utilization of Fantasy Football and Its Effect on Teacher Morale

ERIC Educational Resources Information Center

Ryan, Scott

2014-01-01

The purpose of this case study was to investigate if teacher morale increased, as measured on the Staff Morale Questionnaire (Smith, 1976), after the implementation of a fantasy football league on a secondary campus in southeast Texas. Teaching is an occupation with a high turnover rate (Briggs & Richardson, 1992; Ingersol, 2003; Rafferty,…

Case Study of a Discontinued Start-Up Engineering Program: Critical Challenges and Lessons Learned

ERIC Educational Resources Information Center

Friess, Wilhelm A.

2017-01-01

The explanatory case study presented here analyzes the factors that have contributed to the failure of a start-up engineering program launched at an off-campus site, and aimed at imparting the first two years of the BSc Mechanical, Electrical, Computer and Civil Engineering utilizing an integrated curriculum. Findings indicate the root cause for…

Mobile Web 2.0 in the Workplace: A Case Study of Employees' Informal Learning

ERIC Educational Resources Information Center

Gu, Jia; Churchill, Daniel; Lu, Jie

2014-01-01

Employees' informal learning in the workplace warrants more attention, and such learning could benefit from the latest mobile technologies such as Web 2.0 applications, which have increasingly been utilized and have the potential to enhance learning outcomes. This multiple-case study examined the impact of mobile Web 2.0 applications on…

Acculturation Strategy, Integration Paradoxes and Educational Adaptation--A Case Study of Chinese Visiting Scholar's Family in the United States

ERIC Educational Resources Information Center

Weidong, Li; Chen, Sisi

2017-01-01

In this case study, we developed a theoretical framework for examining the relationship between acculturation strategy and educational adaptation. By interviews and observations of one Chinese visiting scholar's family in the United States, we found that the family utilized "integration" as the acculturation strategy to adapt to the US…

A Case Study of Career Emegency Medical Technicians: Factors That Influenced Their Decision to Stay

ERIC Educational Resources Information Center

Miller, Denine V.

2013-01-01

This case study (Stake, 1995) examined the perceptions of long-term Emergency Medical Technicians (EMTs) to identify factors influencing their decision to remain employed as EMTs for the duration of a career. EMT retention plans frequently utilize data from either employee exit interviews or workers with intent to leave, and since privacy law…

A National Study of the Validity and Utility of the Comprehensive Assessment of School Environment (CASE) Survey

ERIC Educational Resources Information Center

McGuffey, Amy R.

2016-01-01

A healthy school climate is necessary for improvement. The purpose of this study was to evaluate the construct validity and usability of the Comprehensive Assessment of School Environment (CASE) as it was purportedly realigned to the three dimensions of the Breaking Ranks Framework developed by the National Association of Secondary School…

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…

An Examination of Information Security Training and Education for IT Professionals in a Community College: A Case Study

ERIC Educational Resources Information Center

Stark, Adam

2017-01-01

This case study research explored the cybersecurity systems and training and education of IT professionals at a member college of the Florida College System. Thematic analysis was utilized to analyze interview transcripts of 6 respondents. A more descriptive analysis was completed using the survey responses from 15 respondents. From this analysis…

Children Coping with Surgery through Drawings: A Case Study from a Parenting Class

ERIC Educational Resources Information Center

Broecher, Joachim

2012-01-01

This case study illustrates how parents can help their children cope with the fear and pain of surgery by engaging them in expressive drawing. As part of a parenting class that utilized art therapy techniques, a father shared his 6-year-old son's spontaneous drawings that had been created directly before and after surgery. Through guidance by the…

Teaching Science for Empowerment in an Urban Classroom: A Case Study of a Hmong Teacher

ERIC Educational Resources Information Center

Upadhyay, Bhaskar

2009-01-01

This is a case study of Lee, a Hmong teacher, who reflects on her own schooling experiences in order to develop a culturally sensitive pedagogy based on empowerment and funds of knowledge. The findings indicate that Lee teaches science effectively using culturally sensitive pedagogy--utilizing Hmong students' and parents' funds of knowledge in…

Scheduling job shop - A case study

NASA Astrophysics Data System (ADS)

Abas, M.; Abbas, A.; Khan, W. A.

2016-08-01

The scheduling in job shop is important for efficient utilization of machines in the manufacturing industry. There are number of algorithms available for scheduling of jobs which depend on machines tools, indirect consumables and jobs which are to be processed. In this paper a case study is presented for scheduling of jobs when parts are treated on available machines. Through time and motion study setup time and operation time are measured as total processing time for variety of products having different manufacturing processes. Based on due dates different level of priority are assigned to the jobs and the jobs are scheduled on the basis of priority. In view of the measured processing time, the times for processing of some new jobs are estimated and for efficient utilization of the machines available an algorithm is proposed and validated.

Impact of Utility-Scale Distributed Wind on Transmission-Level System Operations

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

Brancucci Martinez-Anido, C.; Hodge, B. M.

2014-09-01

This report presents a new renewable integration study that aims to assess the potential for adding distributed wind to the current power system with minimal or no upgrades to the distribution or transmission electricity systems. It investigates the impacts of integrating large amounts of utility-scale distributed wind power on bulk system operations by performing a case study on the power system of the Independent System Operator-New England (ISO-NE).

A software framework for assessing the resilience of drinking water systems to disasters with an example earthquake case study

DOE PAGES

Klise, Katherine A.; Bynum, Michael; Moriarty, Dylan; ...

2017-07-07

Water utilities are vulnerable to a wide variety of human-caused and natural disasters. The Water Network Tool for Resilience (WNTR) is a new open source PythonTM package designed to help water utilities investigate resilience of water distribution systems to hazards and evaluate resilience-enhancing actions. In this paper, the WNTR modeling framework is presented and a case study is described that uses WNTR to simulate the effects of an earthquake on a water distribution system. The case study illustrates that the severity of damage is not only a function of system integrity and earthquake magnitude, but also of the available resourcesmore » and repair strategies used to return the system to normal operating conditions. While earthquakes are particularly concerning since buried water distribution pipelines are highly susceptible to damage, the software framework can be applied to other types of hazards, including power outages and contamination incidents.« less

A software framework for assessing the resilience of drinking water systems to disasters with an example earthquake case study

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

Klise, Katherine A.; Bynum, Michael; Moriarty, Dylan

Water utilities are vulnerable to a wide variety of human-caused and natural disasters. The Water Network Tool for Resilience (WNTR) is a new open source PythonTM package designed to help water utilities investigate resilience of water distribution systems to hazards and evaluate resilience-enhancing actions. In this paper, the WNTR modeling framework is presented and a case study is described that uses WNTR to simulate the effects of an earthquake on a water distribution system. The case study illustrates that the severity of damage is not only a function of system integrity and earthquake magnitude, but also of the available resourcesmore » and repair strategies used to return the system to normal operating conditions. While earthquakes are particularly concerning since buried water distribution pipelines are highly susceptible to damage, the software framework can be applied to other types of hazards, including power outages and contamination incidents.« less

Utilization and acceptance of virtual patients in veterinary basic sciences - the vetVIP-project.

PubMed

Kleinsorgen, Christin; Kankofer, Marta; Gradzki, Zbigniew; Mandoki, Mira; Bartha, Tibor; von Köckritz-Blickwede, Maren; Naim, Hassan Y; Beyerbach, Martin; Tipold, Andrea; Ehlers, Jan P

2017-01-01

Context: In medical and veterinary medical education the use of problem-based and cased-based learning has steadily increased over time. At veterinary faculties, this development has mainly been evident in the clinical phase of the veterinary education. Therefore, a consortium of teachers of biochemistry and physiology together with technical and didactical experts launched the EU-funded project "vetVIP", to create and implement veterinary virtual patients and problems for basic science instruction. In this study the implementation and utilization of virtual patients occurred at the veterinary faculties in Budapest, Hannover and Lublin. Methods: This report describes the investigation of the utilization and acceptance of students studying veterinary basic sciences using optional online learning material concurrently to regular biochemistry and physiology didactic instruction. The reaction of students towards this offer of clinical case-based learning in basic sciences was analysed using quantitative and qualitative data. Quantitative data were collected automatically within the chosen software-system CASUS as user-log-files. Responses regarding the quality of the virtual patients were obtained using an online questionnaire. Furthermore, subjective evaluation by authors was performed using a focus group discussion and an online questionnaire. Results: Implementation as well as usage and acceptance varied between the three participating locations. High approval was documented in Hannover and Lublin based upon the high proportion of voluntary students (>70%) using optional virtual patients. However, in Budapest the participation rate was below 1%. Due to utilization, students seem to prefer virtual patients and problems created in their native language and developed at their own university. In addition, the statement that assessment drives learning was supported by the observation that peak utilization was just prior to summative examinations. Conclusion: Veterinary virtual patients in basic sciences can be introduced and used for the presentation of integrative clinical case scenarios. Student post-course comments also supported the conclusion that overall the virtual cases increased their motivation for learning veterinary basic sciences.

Chronicles of Change: The Narrative Turn and E-Learning Research

ERIC Educational Resources Information Center

Friesen, Norm

2008-01-01

Narrative case research has been widely utilized in educational inquiry to investigate different and changing positions and perspectives on questions of identity, curriculum and classroom practice. Despite the fact that case-study research of this kind is well suited to the investigation of changing technologies and their interpretation in…

Behavioral treatment of the traumatically brain-injured: a case study.

PubMed

Horton, A M; Howe, N R

1981-10-01

The present case illustrates the application of behavioral modification methodology with a traumatically brain-injured adult. Such a treatment regime utilizing a report-card system and a response-cost procedure was implemented to decrease behaviors of using foul language and biting staff members. Dramatic improvement was demonstrated.

Tourism through Travel Club: A Database Project

ERIC Educational Resources Information Center

Pratt, Renée M. E.; Smatt, Cindi T.; Wynn, Donald E.

2017-01-01

This applied database exercise utilizes a scenario-based case study to teach the basics of Microsoft Access and database management in introduction to information systems and introduction to database course. The case includes background information on a start-up business (i.e., Carol's Travel Club), description of functional business requirements,…

Statistical properties of a utility measure of observer performance compared to area under the ROC curve

NASA Astrophysics Data System (ADS)

Abbey, Craig K.; Samuelson, Frank W.; Gallas, Brandon D.; Boone, John M.; Niklason, Loren T.

2013-03-01

The receiver operating characteristic (ROC) curve has become a common tool for evaluating diagnostic imaging technologies, and the primary endpoint of such evaluations is the area under the curve (AUC), which integrates sensitivity over the entire false positive range. An alternative figure of merit for ROC studies is expected utility (EU), which focuses on the relevant region of the ROC curve as defined by disease prevalence and the relative utility of the task. However if this measure is to be used, it must also have desirable statistical properties keep the burden of observer performance studies as low as possible. Here, we evaluate effect size and variability for EU and AUC. We use two observer performance studies recently submitted to the FDA to compare the EU and AUC endpoints. The studies were conducted using the multi-reader multi-case methodology in which all readers score all cases in all modalities. ROC curves from the study were used to generate both the AUC and EU values for each reader and modality. The EU measure was computed assuming an iso-utility slope of 1.03. We find mean effect sizes, the reader averaged difference between modalities, to be roughly 2.0 times as big for EU as AUC. The standard deviation across readers is roughly 1.4 times as large, suggesting better statistical properties for the EU endpoint. In a simple power analysis of paired comparison across readers, the utility measure required 36% fewer readers on average to achieve 80% statistical power compared to AUC.

An evaluation of the utilization of remote sensing in resource and environmental management of the Chesapeake Bay region

NASA Technical Reports Server (NTRS)

Fuller, D. B.; Harmon, D. M.; Fuller, K. B.

1976-01-01

A nine-month study was conducted to assess the effectiveness of the NASA Wallops Chesapeake Bay Ecological Program in remote sensing. The study consisted of a follow-up investigation and information analysis of actual cases in which remote sensing was utilized by management and research personnel in the Chesapeake Bay region. The study concludes that the NASA Wallops Chesapeake Bay Ecological Program is effective, both in terms of costs and performance.

The C-27J Spartan Procurement Program: A Case Study in USAF Sourcing Practices for National Security

DTIC Science & Technology

2012-06-15

9  Figure 2: Mobility System Utilization by MCRS Case...into the viability of other missions. Mobility Capabilities and Requirements Study 2016 The Mobility Capabilities and Requirements Study 2016 ( MCRS -16...the second since 9-11, and it was released in February 2010 using the programmed force in the 2009 President’s Budget (PB09). The MCRS -16 Executive

A Strategic Culture Assessment of the Transatlantic Divide

DTIC Science & Technology

2008-03-01

security divide through the strategic culture lens, taking a comparative case study approach . It analyzes the emergent EU strategic culture by looking...utilize the strategic culture approach in the ensuing case study comparisons. B. WHY THE USE OF STRATEGIC CULTURE? In a study published in 2004...analysis use a comparative cultural approach when a previous comparison of U.S. and EU behavior found these actors’ behavior most aligned with realism’s

The South: Birmingham Case Study, and The South as a Region. Grade Five (Unit IV). Resource Unit. Project Social Studies.

ERIC Educational Resources Information Center

Minnesota Univ., Minneapolis. Project Social Studies Curriculum Center.

A case study on Birmingham is presented in the first part of this resource unit on regional studies designed for fifth graders. The objective of the sequent occupance unit is to illustrate the impact which the discovery and utilization of a large natural resource, namely, iron ore, can have on the development of a city, in the hope that students…

Zipf's law in city size from a resource utilization model.

PubMed

Ghosh, Asim; Chatterjee, Arnab; Chakrabarti, Anindya S; Chakrabarti, Bikas K

2014-10-01

We study a resource utilization scenario characterized by intrinsic fitness. To describe the growth and organization of different cities, we consider a model for resource utilization where many restaurants compete, as in a game, to attract customers using an iterative learning process. Results for the case of restaurants with uniform fitness are reported. When fitness is uniformly distributed, it gives rise to a Zipf law for the number of customers. We perform an exact calculation for the utilization fraction for the case when choices are made independent of fitness. A variant of the model is also introduced where the fitness can be treated as an ability to stay in the business. When a restaurant loses customers, its fitness is replaced by a random fitness. The steady state fitness distribution is characterized by a power law, while the distribution of the number of customers still follows the Zipf law, implying the robustness of the model. Our model serves as a paradigm for the emergence of Zipf law in city size distribution.

Zipf's law in city size from a resource utilization model

NASA Astrophysics Data System (ADS)

Ghosh, Asim; Chatterjee, Arnab; Chakrabarti, Anindya S.; Chakrabarti, Bikas K.

2014-10-01

We study a resource utilization scenario characterized by intrinsic fitness. To describe the growth and organization of different cities, we consider a model for resource utilization where many restaurants compete, as in a game, to attract customers using an iterative learning process. Results for the case of restaurants with uniform fitness are reported. When fitness is uniformly distributed, it gives rise to a Zipf law for the number of customers. We perform an exact calculation for the utilization fraction for the case when choices are made independent of fitness. A variant of the model is also introduced where the fitness can be treated as an ability to stay in the business. When a restaurant loses customers, its fitness is replaced by a random fitness. The steady state fitness distribution is characterized by a power law, while the distribution of the number of customers still follows the Zipf law, implying the robustness of the model. Our model serves as a paradigm for the emergence of Zipf law in city size distribution.

M-OSCE as a method to measure dental hygiene students' critical thinking: a pilot study.

PubMed

McComas, Martha J; Wright, Rebecca A; Mann, Nancy K; Cooper, Mary D; Jacks, Mary E

2013-04-01

Educators in all academic disciplines have been encouraged to utilize assessment strategies to evaluate students' critical thinking. The purpose of this study was to assess the viability of the modified objective structured clinical examination (m-OSCE) to evaluate critical thinking in dental hygiene education. This evaluation utilized a convenience sample of senior dental hygiene students. Students participated in the m-OSCE in which portions of a patient case were revealed at four stations. The exam consisted of multiple-choice questions intended to measure students' ability to utilize critical thinking skills. Additionally, there was one fill-in-the-blank question and a treatment plan that was completed at the fifth station. The results of this study revealed that the m-OSCE did not reliably measure dental hygiene students' critical thinking. Statistical analysis found no satisfactory reliability within the multiple-choice questions and moderately reliable results within the treatment planning portion of the examination. In addition, the item analysis found gaps in students' abilities to transfer clinical evidence/data to basic biomedical knowledge as demonstrated through the multiple-choice questioning results. This outcome warrants further investigation of the utility of the m-OSCE, with a focus on modifications to the evaluation questions, grading rubric, and patient case.

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

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

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

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

Case study of fly ash brick manufacturing units at Kota in Rajasthan

NASA Astrophysics Data System (ADS)

Sharma, Y.; Saxena, B. K.; Rao, K. V. S.

2018-03-01

Kota Super Thermal Power Station of 1240 MW is located at Kota in Rajasthan, India. The quantity of fly ash generated by it is about 1.64 to 2.03 million tonnes per year. This fly ash is being utilized for making bricks, tiles, portland pozzolana cement, construction of highways, and other purposes. 1.79 million tonnes of fly ash was utilized for different applications in one year duration from April 01st, 2015 to March 31st, 2016. Out of this total utilization, 0.6439 million tonnes (36.06 %) of fly ash was used for making bricks, blocks, and tiles. In this paper, a case study of two fly ash brick manufacturing units using fly ash produced from Kota Super Thermal Power Station is described. These units produce about 15,000 and 20,000 bricks respectively by employing 10 and 16 workers each and are making a profit of about Rs. 6,000 and Rs. 8,000 per day in one shift.

The utilization of automated external defibrillators in Taiwan.

PubMed

Wang, Tsung-Hsi; Wu, Hsi-Wen; Hou, Peter C; Tseng, Hao-Jui

2018-03-24

Increasing attention to care of patient succumbed to out-of-hospital cardiac arrest (OHCA) and evidence for improved survival have resulted in many countries to encourage the use automated external defibrillators (AEDs) by legislation. In Taiwan, the amendment of the Emergency Medical Services Act mandated the installation of AEDs in designated areas in 2013. Since then, 6151 AEDs have been installed and registered in mandated and non-mandated locations. The purpose of this study was to investigate the utilization of AEDs at mandated and non-mandated locations. This paper analyzed 217 cases in whom AEDs was used between July 11, 2013 and July 31, 2015. Descriptive statistics were used to analyze the data. The highest frequency of AEDs used was in long-term care facilities, accounting for 34 (15.7%) cases. The second and third highest was in schools and commuting stations. The highest utilization rate of registered AED was in long-term care facilities (73.9%), the second was in residential areas, and the third was in hot spring areas. Employees at the designated locations or medical personnel operated the AED in 143 cases (84.6%), and bystanders, relatives, friends or others operated the AEDs in 26 cases (15.4%). On-site Return of Spontaneous Circulation (ROSC) after applying AEDs occurred in 76 cases (45.8%). Long-term care facilities had the highest utilization of AEDs and government should pay more attention to enforce the installing of AEDs in these places. The government also needs to promote the education public on how to search the AEDs locations. Copyright © 2018. Published by Elsevier B.V.

Improving Service Utilization for Parents with Substance Abuse Problems: Experimenting with Recovery Coaches in Child Welfare.

PubMed

Choi, Sam

2015-01-01

Substance abusers often face substantial systematic and personal barriers to receiving required substance abuse treatment services as well as other services; hence, various linkage mechanisms have been proposed for drug abuse treatment programs to overcome such barriers. Although there is a growing interest in the use of case management with a substance abuse background, its effectiveness in child welfare has yet to be explored. In this study the author attempts to investigate the effectiveness of case management in service utilization by systematically evaluating the five-year Alcohol and Other Drug Abuse (AODA) waiver demonstration project with Recovery Coaches in Illinois. A classic experimental design with a control group was used. Random assignment occurs at the agency level. Parents in the experimental group (N = 1562) received recovery coaches in addition to traditional child welfare services while parents in the control group (N = 598) only received traditional child welfare services. Bivariate and multivariate analyses (Ordinary Last Square regressions) were used. Compared to parents in the control group, parents in the experimental group were more likely to utilize substance abuse treatment. The results suggest that gender, education level, employment status, and the number of service needs were significantly associated with service utilization. Controlling other factors, recovery coaches improved overall service utilization. Because the outcome of child welfare often depends on the improvement of risks or resolution, it is important for parents to utilize the needed services. Future studies need to address what aspects of recovery coaches facilitate the services utilization.

Stemflow estimation in a redwood forest using model-based stratified random sampling

Treesearch

Jack Lewis

2003-01-01

Model-based stratified sampling is illustrated by a case study of stemflow volume in a redwood forest. The approach is actually a model-assisted sampling design in which auxiliary information (tree diameter) is utilized in the design of stratum boundaries to optimize the efficiency of a regression or ratio estimator. The auxiliary information is utilized in both the...

Utilities and manufacturers: Pioneering partnerships and their lessons for the 21st century

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

Bartsch, C.; DeVaul, D.

1994-12-31

Manufacturers who, in partnership with utilities, improved their production process through energy efficiency and waste minimization strategies are discussed. Frequently these investments changed the corporate culture and resulted in a commitment to continuous improvement that may ensure the industrialists adapt to a rapidly evolving marketplace. The Northeast-Midwest Institute`s work to record these case studies developed out of the observation that older manufacturing facilities too often are run until no longer competitive, then closed, and new plants are built somewhere else - increasingly overseas. Unemployment, poverty, and cycles of economic and social deterioration too often follow if a new economic basemore » cannot be created. At the same time, inefficient industrial plants tend to emit large quantities of waste materials; industry produces more than 600 million tons of hazardous wastes and approximately 13 billion tons of solid wastes each year. To help identify how to avoid such pitfalls, the Institute sought out manufacturers who modernized successfully. Case studies are presented that show that utilities often are instrumental in catalyzing change in their industrial partners. In fact, much can be gained from utilities and industries working together. Many manufacturers need technical and financial assistance to maintain peak productivity.« less

Mixed emotional and physical symptoms in general practice: what diagnoses do GPs use to describe them?

PubMed

Stone, Louise

2015-04-01

To determine what diagnostic terms are utilized by general practitioners (GPs) when seeing patients with mixed emotional and physical symptoms. Prototype cases of depression, anxiety, hypochondriasis, somatization and undifferentiated somatoform disorders were sourced from the psychiatric literature and the author's clinical practice. These were presented, in paper form, to a sample of GPs and GP registrars who were asked to provide a written diagnosis. Fifty-two questionnaires were returned (30% response rate). The depression and anxiety cases were identified correctly by most participants. There was moderate identification of the hypochondriasis and somatization disorder cases, and poor identification of the undifferentiated somatoform case. Somatization and undifferentiated somatoform disorders were infrequently recognized as diagnostic categories by the GPs in this study. Future research into the language and diagnostic reasoning utilized by GPs may help develop better diagnostic classification systems for use in primary care in this important area of practice.

Research Activity in Computational Physics utilizing High Performance Computing: Co-authorship Network Analysis

NASA Astrophysics Data System (ADS)

Ahn, Sul-Ah; Jung, Youngim

2016-10-01

The research activities of the computational physicists utilizing high performance computing are analyzed by bibliometirc approaches. This study aims at providing the computational physicists utilizing high-performance computing and policy planners with useful bibliometric results for an assessment of research activities. In order to achieve this purpose, we carried out a co-authorship network analysis of journal articles to assess the research activities of researchers for high-performance computational physics as a case study. For this study, we used journal articles of the Scopus database from Elsevier covering the time period of 2004-2013. We extracted the author rank in the physics field utilizing high-performance computing by the number of papers published during ten years from 2004. Finally, we drew the co-authorship network for 45 top-authors and their coauthors, and described some features of the co-authorship network in relation to the author rank. Suggestions for further studies are discussed.

Why Do Some Water Utilities Recycle More than Others? A Qualitative Comparative Analysis in New South Wales, Australia.

PubMed

Kunz, Nadja C; Fischer, Manuel; Ingold, Karin; Hering, Janet G

2015-07-21

Although the recycling of municipal wastewater can play an important role in water supply security and ecosystem protection, the percentage of wastewater recycled is generally low and strikingly variable. Previous research has employed detailed case studies to examine the factors that contribute to recycling success but usually lacks a comparative perspective across cases. In this study, 25 water utilities in New South Wales, Australia, were compared using fuzzy-set Qualitative Comparative Analysis (fsQCA). This research method applies binary logic and set theory to identify the minimal combinations of conditions that are necessary and/or sufficient for an outcome to occur within the set of cases analyzed. The influence of six factors (rainfall, population density, coastal or inland location, proximity to users; cost recovery and revenue for water supply services) was examined for two outcomes, agricultural use and "heavy" (i.e., commercial/municipal/industrial) use. Each outcome was explained by two different pathways, illustrating that different combinations of conditions are associated with the same outcome. Generally, while economic factors are crucial for heavy use, factors relating to water stress and geographical proximity matter most for agricultural reuse. These results suggest that policies to promote wastewater reuse may be most effective if they target uses that are most feasible for utilities and correspond to the local context. This work also makes a methodological contribution through illustrating the potential utility of fsQCA for understanding the complex drivers of performance in water recycling.

Financial and clinical characteristics of fibromyalgia: a case-control comparison.

PubMed

Palacio, Ana; Uribe, Claudia L; Li, Hua; Hanna, John; Deminski, Michael; Alvir, Jose; Chandran, Arthi; Sanchez, Robert

2010-05-01

To compare healthcare utilization and costs between subjects with and without fibromyalgia (FM) using claims data from a large health benefits company in the United States. Retrospective cohort. We analyzed 24 months of medical and pharmacy claims data comparing healthcare utilization and costs among Humana members diagnosed with FM to a propensity score matched control group without a diagnosis for FM. FM cases were identified as members aged 18 years and older, with at least 2 medical claims for International Classification of Diseases, Ninth Revision, Clinical Modification codes 729.0 and/or 729.1. The first medical claim for FM was utilized as the index date. A total of 9988 FM cases and 9988 controls were included in the analysis. Compared with controls, the use of pain-related medications by FM cases was approximately 2 times higher with opioids being used most commonly. FM cases utilized a mean (SD) of 22.5 (23.9) and 31.1 (26.6) outpatient services per year in the prediagnosis and postdiagnosis periods, respectively, compared with 14.8 (20.5) and 16.3 (24.5) among controls (P <.01). Office visits, tests, and procedures represented the majority of utilization. During the postdiagnosis period, the mean per-patient per-month costs for outpatient services among FM cases was $377 ($760) and $217 ($740.87) among controls (P <.01). FM cases had significantly higher utilization and costs compared with controls. Office visits, tests and procedures, and the use of pain-related medications accounted for the largest absolute differences between the 2 groups.

INITIAL EXPLORATION OF NEWLY IMPLEMENTED PUBLIC HEALTH POLICY USING GEOGRAPHIC INFORMATION SYSTEMS: THE CASE OF A U.S. SILVER ALERT PROGRAM.

PubMed

Yamashita, Takashi; Carr, Dawn C; Brown, J Scott

2014-01-01

Public health policies are designed for specific subsets of the population. Evidence that a policy is effectively designed should be based on whether it effectively addresses its mission. A critical factor is determining whether utilization patterns reflect the mission and the efficacy of public health policies, particularly during early stages of implementation. We assert that utilization patterns can be effectively assessed using geographic information systems (GIS). This paper uses the Silver Alert program, a recently implemented public health policy, as a case for how and why GIS can be used to examine utilization patterns. GIS are employed to visualize and spatially analyze a new health policy--North Carolina's Silver Alert policy. We use visualized data and spatial statistics to assess utilization patterns and mission adherence. Results show disproportionate utilization patterns of the Silver Alert policy. In particular, an outstanding number of Silver Alerts were used in Wake County and its surrounding counties, which are both the political and media center of North Carolina. Other counties, including populous counties, had few if any alerts. Findings suggest that the North Carolina's Silver Alert policy needs to be adjusted to more effectively address its mission. We identify several factors that need further examination prior to a statewide evaluation. From this case study, we propose ways future programs, particularly the introduction of the Affordable Care Act (ACA) in 2014, might use GIS to examine utilization patterns as a means to better understand whether and in what ways the health care needs of the public are being met with such a policy.

Impact of a complex chronic care patient case conference on quality and utilization.

PubMed

Weppner, William G; Davis, Kyle; Tivis, Rick; Willis, Janet; Fisher, Amber; King, India; Smith, C Scott

2018-05-23

There is need for effective venues to allow teams to coordinate care for high-risk or high-need patients. In addition, health systems need to assess the impact of such approaches on outcomes related to chronic health conditions and patient utilization. We evaluate the clinical impact of a novel case conference involving colocated trainees and supervisors in an interprofessional academic primary care clinic. The study utilized a prospective cohort with control group. Intervention patients (N = 104) were matched with controls (N = 104) from the same provider's panel using propensity scores based on age, gender, risk predictors, and prior utilization patterns. Clinical outcomes and subsequent utilization patterns were compared prior to and up to 6 months following the conference. In terms of utilization, intervention patients demonstrated increased visits with primary care team members (p = .0002) compared with controls, without a corresponding increase in the number of primary care providers' visits. There was a trend towards decreased urgent care and emergency visits (p = .07) and a significant decrease in the rate of hospitalizations (p = .04). Patients with poorly-controlled hypertension saw significant decreases in mean systolic blood pressure from 167 to 146 mm Hg. However, there were no differences between the intervention and control groups. Intervention patients with diabetes demonstrated a nonsignificant trend towards decreased hemoglobin A1c from 9.8 to 9.4, when compared with controls. Interprofessional case conferences have potential to improve care coordination and may be associated with improved disease management, decreased unplanned care, and overall reduced hospitalizations.

Spatial Case Information Management System (SCIMS)

Science.gov Websites

SCIMS facilitates the update of the Land Administration System (LAS) Case File location. Please select Cleanup Notes Utilities LAS Request Import Utility Privacy Copyright System Status Support User Guide

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…

Generating Academic Urgency through Improved Classroom Management: A Case Study of a University and Urban Charter High School Partnership

ERIC Educational Resources Information Center

Morales, Erik E.

2017-01-01

This case study documents a university and secondary school partnership designed to improve classroom management and student time on task at an urban charter high school. The initiative utilized the expertise and knowledge of college of education faculty to identify and ameliorate the high school's observed barriers to students' time on task, and…

Redefining "Community" through Collaboration and Co-Teaching: A Case Study of an ESOL Specialist, a Literacy Specialist, and a Fifth-Grade Teacher

ERIC Educational Resources Information Center

Ahmed Hersi, Afra; Horan, Deborah A.; Lewis, Mark A.

2016-01-01

This article explores the development of a professional learning community through a case study of three teachers--an ESOL specialist, a literacy specialist, and a fifth-grade teacher--who engaged in co-teaching and collaboration. The emerging community of practice offered these teachers a space to learn and problem-solve by utilizing their…

Creativity in the Era of Social Networking: A Case Study at Tertiary Education in the Greek Context

ERIC Educational Resources Information Center

Theodotou, Evgenia; Papastathopoulos, Avraam

2015-01-01

This paper investigates the utilization of a social network tool in order to promote creativity in higher education. Buddypress was selected as a social network tool and de Bono's "6 thinking hats" as a creativity strategy. The participants were 17 undergraduate students from a case study in a University in Greece in the field of social…

78 FR 24425 - Assay Migration Studies for In Vitro Diagnostic Devices; Guidance for Industry and Food and Drug...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-25

... approach to gain FDA approval of Class III or certain licensed in vitro diagnostic devices in cases when a... approach to gain FDA approval of Class III or certain licensed in vitro diagnostic devices in cases when a... fulfilled in order for a sponsor to utilize the migration study approach in support of the change. The FDA...

The Multi-Disciplinary Graduate Program in Educational Research. Final Report, Part IV; The Utilization of Sociological Ideas in Organizational Planning: A Case Study.

ERIC Educational Resources Information Center

Lazarsfeld, Paul F., Ed.

This document, the fourth in the final report on the Multi-Disciplinary Graduate Program in Educational Research, is a qualitative case study designed to show the form of sociological contributions to and the role of sociologists in policy formulation at an American Educational Research Association (AERA) colloquium. Discussions at the conference…

Trends in resource utilization associated with the inpatient treatment of neonatal congenital heart disease.

PubMed

Smith, Andrew H; Gay, James C; Patel, Neal R

2014-01-01

While neonates account for a significant proportion of health care expenditures related to inpatient care for congenital heart disease, key drivers of resource utilization among this population are poorly defined. Data from 2005 through 2011 were extracted from the Pediatric Health Information System for patients assigned a discharge All Patient Refined Diagnosis Related Group of 630 (neonates with birthweight >2499 g undergoing a major cardiovascular procedure). Mortality risk adjustment for patients undergoing operative interventions was performed with the Risk Adjusment in Congenital Heart Surgery (RACHS-1) score. A total of 13 156 cases were included in the analysis. Despite only a 3% increase in case mix index and no significant change in operative acuity over the study period (RACHS classifications of 3 or greater 67% in 2005 vs. 66% in 2011, P = .64), there were inflation-adjusted increases in both total estimated cost per case of (50% to $151 760 in 2011, P < .001), and mean charge per case (33% to $433 875 in 2011, P < .001). Pharmacy charges increased by 16% (P < .001), with agents including chlorothiazide and albumin accounting for the highest patient charges over the study period. Imaging charges increased by 42% (P < .001), with an average of 5.7 echocardiograms and $6517 in associated charges per case by 2011. While the proportion of patients receiving nitric oxide remained consistent, mean duration of administration increased by 25% to 6.6 days by 2011, accounting for average charges of $52 141 per patient exposed. Among neonates with serious congenital heart disease, increases in both institutional costs and charges to the patient are associated with relatively consistent utilization practices in recent years. Multiinstitutional collaboration may prove useful in aligning evidence-based reductions in practice variation with limitations in resource utilization without compromising the quality of care. © 2013 Wiley Periodicals, Inc.

Advance Care Planning in an Accountable Care Organization Is Associated with Increased Advanced Directive Documentation and Decreased Costs.

PubMed

Bond, William F; Kim, Minchul; Franciskovich, Chris M; Weinberg, Jason E; Svendsen, Jessica D; Fehr, Linda S; Funk, Amy; Sawicki, Robert; Asche, Carl V

2018-04-01

Advance care planning (ACP) documents patient wishes and increases awareness of palliative care options. To study the association of outpatient ACP with advanced directive documentation, utilization, and costs of care. This was a case-control study of cases with ACP who died matched 1:1 with controls. We used 12 months of data pre-ACP/prematch and predeath. We compared rates of documentation with logit model regression and conducted a difference-in-difference analysis using generalized linear models for utilization and costs. Medicare beneficiaries attributed to a large rural-suburban-small metro multisite accountable care organization from January 2013 to April 2016, with cross reference to ACP facilitator logs to find cases. The presence of advance directive forms was verified by chart review. Cost analysis included all utilization and costs billed to Medicare. We matched 325 cases and 325 controls (51.1% female and 48.9% male, mean age 81). 320/325 (98.5%) ACP versus 243/325 (74.8%) of controls had a Healthcare Power of Attorney (odds ratio [OR] 21.6, 95% CI 8.6-54.1) and 172/325(52.9%) ACP versus 145/325 (44.6%) controls had Practitioner Orders for Life Sustaining Treatment (OR 1.40, 95% CI 1.02-1.90) post-ACP/postmatch. Adjusted results showed ACP cases had fewer inpatient admissions (-0.37 admissions, 95% CI -0.66 to -0.08), and inpatient days (-3.66 days, 95% CI -6.23 to -1.09), with no differences in hospice, hospice days, skilled nursing facility use, home health use, 30-day readmissions, or emergency department visits. Adjusted costs were $9,500 lower in the ACP group (95% CI -$16,207 to -$2,793). ACP increases documentation and was associated with a reduction in overall costs driven primarily by a reduction in inpatient utilization. Our data set was limited by small numbers of minorities and cancer patients.

Microscope-Integrated OCT Feasibility and Utility With the EnFocus System in the DISCOVER Study.

PubMed

Runkle, Anne; Srivastava, Sunil K; Ehlers, Justis P

2017-03-01

To evaluate the feasibility and utility of a novel microscope-integrated intraoperative optical coherence tomography (OCT) system. The DISCOVER study is an investigational device study evaluating microscope-integrated intraoperative OCT systems for ophthalmic surgery. This report focuses on subjects imaged with the EnFocus prototype system (Leica Microsystems/Bioptigen, Morrisville, NC). OCT was performed at surgeon-directed milestones. Surgeons completed a questionnaire after each case to evaluate the impact of OCT on intraoperative management. Fifty eyes underwent imaging with the EnFocus system. Successful imaging was obtained in 46 of 50 eyes (92%). In eight cases (16%), surgical management was changed based on intraoperative OCT findings. In membrane peeling procedures, intraoperative OCT findings were discordant from the surgeon's initial impression in seven of 20 cases (35%). This study demonstrates the feasibility of microscope-integrated intraoperative OCT using the Bioptigen EnFocus system. Intraoperative OCT may provide surgeons with additional information that may influence surgical decision-making. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:216-222.]. Copyright 2017, SLACK Incorporated.

The Utility of Template Analysis in Qualitative Psychology Research.

PubMed

Brooks, Joanna; McCluskey, Serena; Turley, Emma; King, Nigel

2015-04-03

Thematic analysis is widely used in qualitative psychology research, and in this article, we present a particular style of thematic analysis known as Template Analysis. We outline the technique and consider its epistemological position, then describe three case studies of research projects which employed Template Analysis to illustrate the diverse ways it can be used. Our first case study illustrates how the technique was employed in data analysis undertaken by a team of researchers in a large-scale qualitative research project. Our second example demonstrates how a qualitative study that set out to build on mainstream theory made use of the a priori themes (themes determined in advance of coding) permitted in Template Analysis. Our final case study shows how Template Analysis can be used from an interpretative phenomenological stance. We highlight the distinctive features of this style of thematic analysis, discuss the kind of research where it may be particularly appropriate, and consider possible limitations of the technique. We conclude that Template Analysis is a flexible form of thematic analysis with real utility in qualitative psychology research.

Exploring Weight Management Recommendations across Australian Community Pharmacies Using Case Vignettes

ERIC Educational Resources Information Center

Fakih, Souhiela; Marriott, Jennifer L.; Hussainy, Safeera Y.

2014-01-01

With the increase in the overweight and obese population, it is critical that pharmacy staff are able to provide weight management advice to women at different stages of their life. This study utilized case vignettes to identify pharmacists' and pharmacy assistants' current weight management recommendations to women of different ages, life stages…

Magic from Social Networks that Talk to Management: Four Cases

ERIC Educational Resources Information Center

Sugarman, Barry

2010-01-01

Purpose: The purpose of this paper is to understand how social networks can help to produce the "magic" of extraordinary results for organizations. Design/methodology/approach: In this exploratory study four cases (from published reports) are compared in order to illustrate different management approaches to utilizing the power of networks.…

Juvenile Court Statistics - 1972.

ERIC Educational Resources Information Center

Office of Youth Development (DHEW), Washington, DC.

This report is a statistical study of juvenile court cases in 1972. The data demonstrates how the court is frequently utilized in dealing with juvenile delinquency by the police as well as by other community agencies and parents. Excluded from this report are the ordinary traffic cases handled by juvenile court. The data indicate that: (1) in…

Destructive Leadership: The Hatfield and McCoy Feud

ERIC Educational Resources Information Center

Sparks, George; Wolf, Patricia; Zurick, Andryce M.

2015-01-01

This paper explores the phenomenon of destructive leadership using the historical case study of the feud between the Hatfields and McCoys. The characteristics of destructive leadership as well as the consequences of this leadership style are reviewed, examined and analyzed. Utilizing a case from history to shine light on a contemporary problem,…

Utilizing the Peer Group Method with Case Studies to Teach Pharmacokinetics.

ERIC Educational Resources Information Center

Sims, Pamela J.

1994-01-01

A pharmacy school large-group (110 students) course in pharmacokinetics was designed to incorporate small-group team-based problem solving. The method allows students to learn material through traditional lecture, research the topic further, discuss the information gained, and apply the learning to specific cases in a manner that promotes…

Islamic Education in a Multicultural Society: The Case of a Muslim School in Canada

ERIC Educational Resources Information Center

Ali, Faisal Mohamed; Bagley, Carl

2015-01-01

The case study explores the ways in which a prominent, private Canadian Muslim school provides an Islamic education while negotiating its place in an integrated, socially cohesive, multicultural society. The data are derived from an in-depth qualitative investigation utilizing documentary analysis, participant observation, and interviews (N = 22).…

Instructional Leadership of High School Assistant Principals in Northern California

ERIC Educational Resources Information Center

Garrard, John Christian Timothy

2013-01-01

To identify how high school assistant principals in large suburban schools serve as instructional leaders and how they develop these skills, this research utilized a multiple-case study design, followed by a cross-case analysis of the data. This research explores the instructional leadership of three female comprehensive high school assistant…

Epidemiological review of scorpion stings in Qatar. The need for regional management guidelines in emergency departments.

PubMed

Alkahlout, Baha H; Abid, Muhammad M; Kasim, Mohammad M; Haneef, Shumaila M

2015-07-01

To review the epidemiology of scorpion sting in Qatar, to explore both the clinical significance, and the role of the emergency department (ED) in the management of such cases. In this retrospective study, we reviewed the records of all scorpion sting cases presented to the ED of Hamad General Hospital, Doha, Qatar between October 2010 and May 2013. A total of 111 cases of scorpion stings were reviewed, 81 (72.9%) were males and 30 (27.1%) were females, with a mean age of 38 years. Localized pain was the most frequent presenting complaint (89 [80.2%]), whereas localized redness (44 [39.6%]) and swelling (38 [34.2%]) were the most common clinical signs. Abroug's classification was used, and all cases  were found to be class I. All patients received symptomatic treatment and were sent home. Scorpion sting problem in Qatar has a low clinical significance. Data from such studies should be utilized to create more specific (local) management guidelines, which should be more efficient with more rational utilization of ED resources.

The Use of Interrupted Case Studies to Enhance Critical Thinking Skills in Biology

PubMed Central

White, Tracy K.; Whitaker, Paul; Gonya, Terri; Hein, Richard; Kroening, Dubear; Lee, Kevin; Lee, Laura; Lukowiak, Andrea; Hayes, Elizabeth

2009-01-01

There has been a dramatic increase in the availability of case studies for use in the biology classroom, and perceptions of the effectiveness of case-study-based learning are overwhelmingly positive. Here we report the results of a study in which we evaluated the ability of interrupted case studies to improve critical thinking in the context of experimental design and the conventions of data interpretation. Students were assessed using further case studies designed to evaluate their ability to recognize and articulate problematic approaches to these elements of experimentation. Our work reveals that case studies have broad utility in the classroom. In addition to demonstrating a small but statistically significant increase in the number of students capable of critically evaluating selected aspects of experimental design, we also observed increased student engagement and documented widespread misconceptions regarding the conventions of data acquisition and analysis. PMID:23653687

Evaluation of the Diagnostic Utility of the Traditional and Revised WHO Dengue Case Definitions

PubMed Central

Gutiérrez, Gamaliel; Gresh, Lionel; Pérez, María Ángeles; Elizondo, Douglas; Avilés, William; Kuan, Guillermina; Balmaseda, Ángel; Harris, Eva

2013-01-01

Dengue, a mosquito-borne viral illness, is a major public health problem worldwide, and its incidence continues to increase. In 2009, the World Health Organization published guidelines that included a revision of the dengue case definition. Compared to the traditional definition, the revised case definition relies more on signs than on symptoms, making it more applicable to young children. We evaluated the diagnostic utility of both case definitions in two studies of pediatric dengue in Managua, Nicaragua. In a community-based cohort study, we included data from 3,407 suspected dengue cases, of which 476 were laboratory-confirmed. In the second study, we collected information from 1,160 participants recruited at the national pediatric reference hospital (723 laboratory-confirmed). In the cohort study, the traditional definition had 89.3% sensitivity and 43.1% specificity, while the revised definition yielded similar sensitivity (86.6%) and higher specificity (55.2%, p<0.001). In the hospital study, the traditional case definition yielded 96.7% sensitivity and 22.0% specificity, whereas the revised case definition had higher sensitivity (99.3%, p<0.001) but lower specificity (8.5%, p<0.001). We then evaluated the performance of two diagnostic models based on the signs/symptoms included in each definition by analyzing the effect of increasing numbers of signs/symptoms on the sensitivity and specificity of case capture. Receiver operating characteristic analysis showed a slightly better performance for the revised model in both studies. Interestingly, despite containing less symptoms that cannot be readily expressed by children aged less than 4 years, the revised definition did not perform better in this age group. Overall, our results indicate that both case definitions have similar capacity to diagnose dengue. Owing to their high sensitivity and low specificity, they should be primarily used for screening purposes. However, in a primary care setting, neither of the case definitions performed well as a screening test in younger children. PMID:23991237

Applying Resource Utilization Groups (RUG-III) in Hong Kong Nursing Homes

ERIC Educational Resources Information Center

Chou, Kee-Lee; Chi, Iris; Leung, Joe C. B.

2008-01-01

Resource Utilization Groups III (RUG-III) is a case-mix system developed in the United States for categorization of nursing home residents and the financing of residential care services. In Hong Kong, RUG-III is based on several board groups of residents. The aim of this study was to examine the reliability and validity of the RUG-III in Hong Kong…

There is no place for the psychoanalytic case report in the British Journal of Psychiatry.

PubMed

Wolpert, Lewis; Fonagy, Peter

2009-12-01

As evidence-based mental health and the randomised controlled trial come to dominate the content of major psychiatric journals, the status and clinical utility of single case reports have been increasingly questioned. Arguably, owing to their subjective, anecdotal nature and unsuitability for rigorous scientific testing, this is particularly true of psychoanalytic case studies. Professor Peter Fonagy and Professor Lewis Wolpert debate here whether or not there is a place for such case reports in the British Journal of Psychiatry.

Industrial Processes to Reduce Generation of Hazardous Waste at DoD Facilities. Phase I Report. Evaluation of 40 Case Studies.

DTIC Science & Technology

1985-02-15

utilizes a cathode contained within a membrane module to selectively precipitate trivalent chromium and other cations from the plating solution...Cadmium Plating at Lockheed, Case No. 6 5-6 5.4.2 LICON Chromium Recovery at Pensacola NARF, Case No. 9 5-7 iii CONTENTS (continued) Page 5.4.3 LICON... Chromium Recovery at Charleston NYS, Case No. 12 5-9 5.4.4 Innovative Chromium Plating at Pensacola NARF, Case No. 10 5-10 5.4.5 Steam Condensate

Demand Response Compensation Methodologies: Case Studies for Mexico

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

Gagne, Douglas A; Settle, Donald E; Aznar, Alexandra Y

This report examines various compensation methodologies for demand response programs in Mexico. This report presents three case studies, including New England, California, and Hawaii. Demand response (DR) can refer to a variety of approaches to changing the amount and timing of customers' electricity use, allowing the electricity supplier to more easily balance electricity supply and demand. The level of compensation for a DR program will depend greatly upon both the regulatory context of the electricity supplier, as well as the economic circumstances of the DR providers. For a regulated utility, a proposed compensation level may need to pass regulatory approval.more » To determine the value of DR resources, a regulatory body typically seeks to determine the costs that the utility would avoid if demand-side resources 'produce' energy.« less

Human pluripotent stem cells in modeling human disorders: the case of fragile X syndrome.

PubMed

Vershkov, Dan; Benvenisty, Nissim

2017-01-01

Human pluripotent stem cells (PSCs) generated from affected blastocysts or from patient-derived somatic cells are an emerging platform for disease modeling and drug discovery. Fragile X syndrome (FXS), the leading cause of inherited intellectual disability, was one of the first disorders modeled in both embryonic stem cells and induced PCSs and can serve as an exemplary case for the utilization of human PSCs in the study of human diseases. Over the past decade, FXS-PSCs have been used to address the fundamental questions regarding the pathophysiology of FXS. In this review we summarize the methodologies for generation of FXS-PSCs, discuss their advantages and disadvantages compared with existing modeling systems and describe their utilization in the study of FXS pathogenesis and in the development of targeted treatment.

Examining the Transition to a Four-Day School Week and Investigating Post-Change Faculty/Staff Work-Life Balance: A Community College Case Study

ERIC Educational Resources Information Center

Cardinale, Nelly

2013-01-01

This single descriptive embedded case study examined the process of implementing a four-day work/school week at a community college and investigated post-change faculty/staff work-life balance. All of the students attending this college live at home. The change was implemented due to state funding shortfalls, increasing college utility expenses…

Case study to examine the effects of a growing-season burn and annosum root disease on mortality in a longleaf pine stand

Treesearch

Michelle M. Cram; Dan Shea; Ken Forbus

2010-01-01

A case study of a growing-season burn in a longleaf pine (Pinus palustris) stand affected by annosum root disease was conducted at Savannah River Site, SC. The project utilized a longleaf pine stand from a 1995 evaluation of a stump applicator system. The Tim-bor® (disodium octaborate tetrahydrate) and no stump treatment blocks (NST) were...

A Community of Practice Approach to Delivering Research Support Services in a Post-92 Higher Education Institution: A Reflective Case Study

ERIC Educational Resources Information Center

Coombs, Jenny; Thomas, Mandy; Rush, Nathan; Martin, Elizabeth

2017-01-01

The need for research support in U.K. universities is growing at a fast pace and a number of different professional and academic units within universities are involved in the process. This case study takes place in a post-92 higher education institution and discusses the benefit of utilizing a cross-university Community of Practice (CoP) approach…

Developing an Understanding of Quadratics through the Use of Concrete Manipulatives: A Case Study Analysis of the Metacognitive Development of a High School Student with Learning Disabilities

ERIC Educational Resources Information Center

Strickland, Tricia K.

2014-01-01

This case study analyzed the impact of a concrete manipulative program on the understanding of quadratic expressions for a high school student with a learning disability. The manipulatives were utilized as part of the Concrete-Representational-Abstract Integration (CRA-I) intervention in which participants engaged in tasks requiring them to…

Applying Value Stream Mapping Technique for Production Improvement in a Manufacturing Company: A Case Study

NASA Astrophysics Data System (ADS)

Jeyaraj, K. L.; Muralidharan, C.; Mahalingam, R.; Deshmukh, S. G.

2013-01-01

The purpose of this paper is to explain how value stream mapping (VSM) is helpful in lean implementation and to develop the road map to tackle improvement areas to bridge the gap between the existing state and the proposed state of a manufacturing firm. Through this case study, the existing stage of manufacturing is mapped with the help of VSM process symbols and the biggest improvement areas like excessive TAKT time, production, and lead time are identified. Some modifications in current state map are suggested and with these modifications future state map is prepared. Further TAKT time is calculated to set the pace of production processes. This paper compares the current state and future state of a manufacturing firm and witnessed 20 % reduction in TAKT time, 22.5 % reduction in processing time, 4.8 % reduction in lead time, 20 % improvement in production, 9 % improvement in machine utilization, 7 % improvement in man power utilization, objective improvement in workers skill level, and no change in the product and semi finished product inventory level. The findings are limited due to the focused nature of the case study. This case study shows that VSM is a powerful tool for lean implementation and allows the industry to understand and continuously improve towards lean manufacturing.

Single-incision laparoscopic surgery through an ostomy site: a natural approach by an unnatural orifice.

PubMed

Lopez, Nicole E; Peterson, Carrie Y; Ramamoorthy, Sonia L; McLemore, Elisabeth C; Sedrak, Michael F; Lowy, Andrew M; Horgan, Santiago; Talamini, Mark A; Sicklick, Jason K

2015-02-01

Single-incision laparoscopic surgery (SILS) is gaining popularity for a wide variety of surgical operations and capitalizes on the benefits of traditional laparoscopic surgery without incurring multiple incision sites. Traditionally, SILS is performed by a midline periumbilical approach. However, such a minimally invasive approach may be utilized in patients who already have an abdominal incision. Our series retrospectively reviews 7 cases in which we utilized the fascial defect at the time of after ostomy reversal as our SILS incision site. In turn, we performed a variety of concurrent intra-abdominal procedures with excellent technical success and outcomes. Our study is the largest single-institution case series of this novel approach and suggests that utilizing an existing ostomy-site abdominal incision is a safe and effective location for SILS port placement and should be considered in patients undergoing concurrent procedures.

The Validity of the Utilities Case.

ERIC Educational Resources Information Center

Jones, Linda F.; Fadely, L. Dean

During the past decade, debators have become more flexible in their affirmative analysis of the resolution. One case approach that an affirmative team may adopt is the utilities or no-needs need case in which they argue for the elimination of the status quo because it is unnecessary or restrictive or both. This paper examines: (1) the four…

A Production Lab the Faculty Can Call Their Own.

ERIC Educational Resources Information Center

Wilkening, Donald J.

1979-01-01

Presents a case study of the development of a faculty media production laboratory by Michigan State University's media center, describing funding, facilities, promotion, utilization, and future plans. (CMV)

Primary health care utilization prior to suicide: a retrospective case-control study among active-duty military personnel.

PubMed

Hochman, Eldar; Shelef, Leah; Mann, J John; Portugese, Shirly; Krivoy, Amir; Shoval, Gal; Weiser, Mark; Fruchter, Eyal

2014-08-01

About 45% of civilians who died by suicide had contact with a doctor within 1 month of death. Thus, educating primary care physicians (PCP) to detect and mitigate depression is an important suicide-prevention strategy. However, the PCP consulting rate before suicide has not been examined in a military population. We investigated the utilization of primary health care and mental health services by active-duty military personnel suicide cases prior to death in comparison to matched military controls. All suicides (N = 170) were extracted from a cohort of all active-duty Israeli military male personnel between 2002 and 2012. Applying a retrospective, nested case-control design, we compared primary care services utilization by suicide cases with demographic and occupationally matched military controls (N = 500). Whereas 38.3% of suicide cases contacted a PCP within the last month before death, only 27.6% of suicide cases contacted a mental health specialist during their entire service time. The PCP contact rate within 1 month before death or index day did not differ between suicide cases and military controls (38.3% vs. 33.8%, χ²₁ = 1.05, P = .3). More suicide cases contacted a mental health specialist within service time than did military controls (27.6% vs. 13.6%, χ²₁ = 10.85, P = .001). Even though PCP contact rate by military personnel who died by suicide is slightly lower than that reported for civilians who died by suicide prior to their death, it is higher than mental health specialist contact rate and higher than that by age-matched civilians who died by suicide. These results imply that PCPs education is a viable approach to suicide prevention in a military setting. © Copyright 2014 Physicians Postgraduate Press, Inc.

Lessons from a Dominican Republic Field Study

ERIC Educational Resources Information Center

Gunter, Michael M., Jr.

2010-01-01

Utilizing student-centered pedagogy, this case study explores an increasingly prominent and instructive addition to traditional academic coursework--the field study experience. This is particularly true in the arena of environmental education where students learn best by experiencing environmental problems first-hand and then interacting with…

An evaluation of energy conservation measures utilized by public transit systems : a case study in Texas

DOT National Transportation Integrated Search

1995-07-01

The primary focus of this study was to emphasize transit system energy characteristics by examining the vehicle characteristics, right-of-way charactertistics and the operational aspects of the services. The objectives : of this study were to become ...

Bridging communication between public and government: a case study on kim surabaya

NASA Astrophysics Data System (ADS)

Aji, G. G.; Tsuroyya; Dewi, P. A. R.

2018-01-01

In democratic era, the public communication paradigm has shifted from a one-way socialization to more interactive one. As a consequence of freedom of speech, the public can Actively communicate with the government and vice versa. The problem is government is almost impossible to reach all public groups. Therefore, they has created the concept of social institutions as a communication hub between the government and its public, named the Kelompok Informasi Masyarakat (KIM). This research examines the activity of KIM in Surabaya on bridging public between government and the public. Using a case study approach, this research utilized various techniques of data collection such as: interviews, observation, and documentation. The results Showed that KIM plays a role in the two-way flow of information; to diseminate program and submit complaints and suggestions from the public about the policy. This study confirm the urgency of utilization on various channels in communicating with the public.

A software framework for assessing the resilience of drinking ...

EPA Pesticide Factsheets

Journal article This paper introduces a new software tool called the Water Network Tool for Resilience (WNTR) that water utilities can use to assess their resilience to disasters. A case study of an earthquake is included that results in damage to pipes and tanks, fires, and power outages. The utility uses several response strategies including fixing damaged pipes and tanks, restoring power, fighting fires, and implementing conservation.

Proceedings: 1989 electric utility franchise conference

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

Romo, R.G.

The primary purpose of the Conference was to present and discuss strategic issues related to franchising electric service. The theme for the conference was to both improve the management of existing franchises and the negotiation of new franchises. To promote a better understanding of the planning issues related to this theme, the following sessions were designed: (1) public utility franchising, (2) investor owned utility and community perspectives on franchising, (3) franchise case study presentations, (4) alternatives to franchise renewal: the public acquisition option, and (5) special franchise issues. The Conference combined results from research coupled with actual franchise negotiating experiences,more » and concepts and ideas considered or implemented by utilities, government agencies, consultants and others.« less

Photovoltaics and electric utilities

NASA Astrophysics Data System (ADS)

Bright, R.; Leigh, R.; Sills, T.

1981-12-01

The long term value of grid connected, residential photovoltaic (PV) systems is determined. The value of the PV electricity is defined as the full avoided cost in accordance with the Public Utilities Regulatory Policies Act of 1978. The avoided cost is computed using a long range utility planning approach to measure revenue requirement changes in response to the time phased introduction of PV systems into the grid. A case study approach to three utility systems is used. The changing value of PV electricity over a twenty year period from 1985 is presented, and the fuel and capital savings due to FY are analyzed. These values are translated into measures of breakeven capital investment under several options of power interchange and pricing.

Water footprints as an indicator for the equitable utilization of shared water resources. (Case study: Egypt and Ethiopia shared water resources in Nile Basin)

NASA Astrophysics Data System (ADS)

Sallam, Osama M.

2014-12-01

The question of "equity." is a vague and relative term in any event, criteria for equity are particularly difficult to determine in water conflicts, where international water law is ambiguous and often contradictory, and no mechanism exists to enforce principles which are agreed-upon. The aim of this study is using the water footprints as a concept to be an indicator or a measuring tool for the Equitable Utilization of shared water resources. Herein Egypt and Ethiopia water resources conflicts in Nile River Basin were selected as a case study. To achieve this study; water footprints, international virtual water flows and water footprint of national consumption of Egypt and Ethiopia has been analyzed. In this study, some indictors of equitable utilization has been gained for example; Egypt water footprint per capita is 1385 CM/yr/cap while in Ethiopia is 1167 CM/yr/cap, Egypt water footprint related to the national consumption is 95.15 BCM/yr, while in Ethiopia is 77.63 BCM/yr, and the external water footprints of Egypt is 28.5%, while in Ethiopia is 2.3% of the national consumption water footprint. The most important conclusion of this study is; natural, social, environmental and economical aspects should be taken into account when considering the water footprints as an effective measurable tool to assess the equable utilization of shared water resources, moreover the water footprints should be calculated using a real data and there is a necessity to establishing a global water footprints benchmarks for commodities as a reference.

Use of Lean methodology to improve operating room efficiency in hospitals across the Kingdom of Saudi Arabia.

PubMed

Hassanain, Mazen; Zamakhshary, Mohammed; Farhat, Ghada; Al-Badr, Ahmed

2017-04-01

The objective of this study was to assess whether an intervention on process efficiency using the Lean methodology leads to improved utilization of the operating room (OR), as measured by key performance metrics of OR efficiency. A quasi-experimental design was used to test the impact of the intervention by comparing pre-intervention and post-intervention data on five key performance indicators. The ORs of 12 hospitals were selected across regions of the Kingdom of Saudi Arabia (KSA). The participants were patients treated at these hospitals during the study period. The intervention comprised the following: (i) creation of visual dashboards that enable starting the first case on time; (ii) use of computerized surgical list management; (iii) optimization of time allocation; (iv) development of an operating model with policies and procedures for the pre-anesthesia clinic; and (iv) creation of a governance structure with policies and procedures for day surgeries. The following were the main outcome measures: on-time start for the first case, room turnover times, percent of overrun cases, average weekly procedure volume and OR utilization. The hospital exhibited statistically significant improvements in the following performance metrics: on-time start for the first case, room turnover times and percent of overrun cases. A statistically significant difference in OR utilization or average weekly procedure volumes was not detected. The implementation of a Lean-based intervention targeting process efficiency applied in ORs across various KSA hospitals resulted in encouraging results on some metrics at some sites, suggesting that the approach has the potential to produce significant benefit in the future. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Heterogeneous dermatitis complaints after change in drinking water treatment: a case report

PubMed Central

Weintraub, June M; Berger, Magdalena; Bhatia, Rajiv

2006-01-01

Background The disinfectant monochloramine minimizes the formation of potentially hazardous and regulated byproducts, and many drinking water utilities are shifting to its use. Case presentation After a drinking water utility serving 2.4 million people switched to monochloramine for residual disinfection, a small number of residents complained of dermatitis reactions. We interviewed 17 people about their symptoms. Skin appearance, symptoms, and exposures were heterogeneous. Five respondents had history of hives or rash that preceded the switch to monochloramine. Conclusion The complaints described were heterogeneous, and many of the respondents had underlying or preexisting conditions that would offer plausible alternative explanations for their symptoms. We did not recommend further study of these complaints. PMID:16764728

Self-selection and moral hazard in Chilean health insurance.

PubMed

Sapelli, Claudio; Vial, Bernardita

2003-05-01

We study the existence of self-selection and moral hazard in the Chilean health insurance industry. Dependent workers must purchase health insurance either from one public or several private insurance providers. For them, we analyze the relationship between health care services utilization and the choice of either private or public insurance. In the case of independent workers, where there is no mandate, we analyze the relationship between utilization and the decision to voluntarily purchase health insurance. The results show self-selection against insurance companies for independent workers, and against public insurance for dependent workers. Moral hazard is negligible in the case of hospitalization, but for medical visits, it is quantitatively important.

A comparison of home care clients and nursing home residents: can community based care keep the elderly and disabled at home?

PubMed

Shugarman, L R; Fries, B E; James, M

1999-01-01

Admission cohorts from the Michigan Medicaid Home and Community-Based Waiver program and Ohio nursing homes were compared on measures of resource utilization including a modified Resource Utilization Groups (RUG-III) system, Activities of Daily Living (ADLs), and overall case mix. We found that, contrary to previous research, the two samples were remarkably similar across RUG-III categories. However, the nursing home sample was more functionally impaired on measures of ADL functioning and overall case mix. Results of this study may inform policymakers and providers of the potential for maintaining the appropriate population in the home with government-funded home care.

Utility of the clue - From assessing the investigative contribution of forensic science to supporting the decision to use traces.

PubMed

Bitzer, Sonja; Albertini, Nicola; Lock, Eric; Ribaux, Olivier; Delémont, Olivier

2015-12-01

In an attempt to grasp the effectiveness of forensic science in the criminal justice process, a number of studies introduced some form of performance indicator. However, most of these indicators suffer from different weaknesses, from the definition of forensic science itself to problems of reliability and validity. We suggest the introduction of the concept of utility of the clue as an internal evaluation indicator of forensic science in the investigation. Utility of the clue is defined as added value of information, gained by the use of traces. This concept could be used to assess the contribution of the trace in the context of the case. By extension, a second application of this concept is suggested. By formalising and considering, a priori, the perceived utility of using traces, we introduce the notion of expected utility that could be used as decision factor when choosing which traces to use, once they have been collected at the crime scene or from an object in the laboratory. In a case-based approach, utility can be assessed in the light of the available information to evaluate the investigative contribution of forensic science. In the decision-making process, the projection or estimation of the utility of the clue is proposed to be a factor to take into account when triaging the set of traces. Copyright © 2015 The Chartered Society of Forensic Sciences. Published by Elsevier Ireland Ltd. All rights reserved.

The Unani traditional medical system in India: a case study in health behaviour.

PubMed

Izhar, N

1989-01-01

The study examines the practice of Unani traditional medicine in India. The case study is based on the Unani Clinic situated in Aligarh Town; patients, practitioner of Unani medicine, and para-medical staff were interviewed about their patterns of patients' health behaviour, of particular interest was the utilization of Unani medical facilities by people of different age groups and belonging to different socio-economic strata. Observations are made regarding effectiveness of the Unani medical system.

Intraoperative utilization of advanced imaging modalities in a complex kidney stone case: a pilot case study.

PubMed

Christiansen, Andrew R; Shorti, Rami M; Smith, Cory D; Prows, William C; Bishoff, Jay T

2018-05-01

Despite the increasing use of advanced 3D imaging techniques and 3D printing, these techniques have not yet been comprehensively compared in a surgical setting. The purpose of this study is to explore the effectiveness of five different advanced imaging modalities during a complex renal surgical procedure. A patient with a horseshoe kidney and multiple large, symptomatic stones that had failed Extracorporeal Shock Wave Lithotripsy (ESWL) and ureteroscopy treatment was used for this evaluation. CT data were used to generate five different imaging modalities, including a 3D printed model, three different volume rendered models, and a geometric CAD model. A survey was used to evaluate the quality and breadth of the imaging modalities during four different phases of the laparoscopic procedure. In the case of a complex kidney procedure, the CAD model, 3D print, volume render on an autostereoscopic 3D display, interactive and basic volume render models demonstrated added insight and complemented the surgical procedure. CAD manual segmentation allowed tissue layers and/or kidney stones to be made colorful and semi-transparent, allowing easier navigation through abnormal vasculature. The 3D print allowed for simultaneous visualization of renal pelvis and surrounding vasculature. Our preliminary exploration indicates that various advanced imaging modalities, when properly utilized and supported during surgery, can be useful in complementing the CT data and laparoscopic display. This study suggests that various imaging modalities, such as ones utilized in this case, can be beneficial intraoperatively depending on the surgical step involved and may be more helpful than 3D printed models. We also present factors to consider when evaluating advanced imaging modalities during complex surgery.

24 CFR 245.416 - Initial submission of materials to HUD: Conversion from project-paid utilities to tenant-paid...

Code of Federal Regulations, 2010 CFR

2010-04-01

... HUD: Conversion from project-paid utilities to tenant-paid utilities or a reduction in tenant utility... Covered Action § 245.416 Initial submission of materials to HUD: Conversion from project-paid utilities to tenant-paid utilities or a reduction in tenant utility allowances. In the case of a conversion from...

Age and closeness of death as determinants of health and social care utilization: a case-control study.

PubMed

Forma, Leena; Rissanen, Pekka; Aaltonen, Mari; Raitanen, Jani; Jylhä, Marja

2009-06-01

We used case-control design to compare utilization of health and social services between older decedents and survivors, and to identify the respective impact of age and closeness of death on the utilization of services. Data were derived from multiple national registers. The sample consisted of 56,001 persons, who died during years 1998-2000 at the age of > or = 70, and their pairs matched on age, gender and municipality of residence, who were alive at least 2 years after their counterpart's death. Data include use of hospitals, long-term care and home care. Decedents' utilization within 2 years before death and survivors' utilization in the same period of time was assessed in three age groups (70-79, 80-89 and > or = 90 years) and by gender. Decedents used hospital and long-term care more than their surviving counterparts, but the time patterns were different. In hospital care the differences between decedents and survivors rose in the last months of the study period, whereas in long-term care there were clear differences during the whole 2-year period. The differences were smaller in the oldest age group than in younger age groups. Closeness of death is an important predictor of health and social service use in old age, but its influence varies between age groups. Not only the changing age structure, but also the higher average age at death affects the future need for services.

Primary school children's communication experiences with Twitter: a case study from Turkey.

PubMed

Gunuc, Selim; Misirli, Ozge; Odabasi, H Ferhan

2013-06-01

This case study examines the utilization of Twitter as a communication channel among primary school children. This study tries to answer the following questions: "What are the cases for primary school children's use of Twitter for communication?" and "What are primary school children's experiences of utilizing Twitter for communication?" Participants were 7th grade students (17 female, 34 male; age 13 years) studying in a private primary school in Turkey within the 2011-12 academic year. A questionnaire, semi-structured interview, document analysis, and open ended questions were used as data collection tools. The children were invited and encouraged to use Twitter for communication. Whilst participants had some minor difficulties getting accustomed to Twitter, they managed to use Twitter for communication, a conclusion drawn from the children's responses and tweets within the study. However, the majority of children did not consider Twitter as a communication tool, and were observed to quit using Twitter once the study had ended. They found Twitter unproductive and restrictive for communication. Furthermore, Twitter's low popularity among adolescents was also a problem. This study suggests that social networking tools favored by children should be integrated into educational settings in order to maximize instructional benefits for primary school children and adolescents.

Utilization of mechanical diagnosis and therapy (MDT) for the treatment of lumbar pain in the presence of known lumbar transverse process fractures: a case study

PubMed Central

Elenburg, J. L.; Foley, B. S.; Roberts, K.; Bayliss, A. J.

2016-01-01

Background Spinal fractures are typically considered a contraindication to mechanical diagnosis and therapy (MDT). Objective and importance The purpose of this case study is to illustrate how MDT was used safely and effectively to treat lumbar pain in a patient with multiple lumbar transverse process fractures. Clinical presentation The subject was a 24-year-old female with left L2-5 transverse process fractures, sustained 10 weeks prior in a pedestrian versus motor vehicle accident. Intervention (and technique) After collaboration with her physiatrist, an MDT examination revealed a presentation consistent with the lumbar derangement syndrome. Conclusion After three visits, utilizing patient generated forces with the extension principle of treatment, her pain, Oswestry disability index (ODI) score, and function all improved. PMID:27559276

Association between prenatal care utilization and risk of preterm birth among Chinese women.

PubMed

Zhang, Bin; Yang, Rong; Liang, Sheng-Wen; Wang, Jing; Chang, Jen Jen; Hu, Ke; Dong, Guang-Hui; Hu, Rong-Hua; Flick, Louise H; Zhang, Yi-Ming; Zhang, Dan; Li, Qing-Jie; Zheng, Tong-Zhang; Xu, Shun-Qing; Yang, Shao-Ping; Qian, Zheng-Min

2017-08-01

It is recognized that prenatal care plays an important role in reducing adverse birth. Chinese pregnant women with medical condition were required to seek additional health care based on the recommended at least 5 times health care visits. This study was to estimate the association between prenatal care utilization (PCU) and preterm birth (PTB), and to investigate if medical conditions during pregnancy modified the association. This population-based case control study sampled women with PTB as cases; one control for each case was randomly selected from women with term births. The Electronic Perinatal Health Care Information System (EPHCIS) and a questionnaire were used for data collection. The PCU was measured by a renewed Prenatal Care Utilization (APNCU) index. Logistic regression models were used to estimate odds ratios (OR) and the 95% confidence interval (95% CI). Totally, 2393 women with PTBs and 4263 women with term births were collected. In this study, 695 (10.5%) women experienced inadequate prenatal care, and 5131 (77.1%) received adequate plus prenatal care. Inadequate PCU was associated with PTB (adjusted OR: 1.41, 95% CI: 1.32-1.84); the similar positive association was found between adequate plus PCU and PTB. Among women with medical conditions, these associations still existed; but among women without medical conditions, the association between inadequate PCU and PTB disappeared. Our data suggests that women receiving inappropriate PCU are at an increased risk of having PTB, but it does depend on whether the woman has a medical condition during pregnancy.

Effects of catastrophic events on transportation system management and operations : cross cutting study

DOT National Transportation Integrated Search

2003-01-01

In order to provide a better understanding of how transportation is both affected and utilized in an emergency situation, the Federal Highway Administration (FHWA) commissioned a series of four case studies examining the effects of catastrophic event...

A comparative cost analysis of robot-assisted versus traditional laparoscopic partial nephrectomy.

PubMed

Hyams, Elias; Pierorazio, Philip; Mullins, Jeffrey K; Ward, Maryann; Allaf, Mohamad

2012-07-01

Robot-assisted laparoscopic partial nephrectomy (RALPN) is supplanting traditional laparoscopic partial nephrectomy (LPN) as the technique of choice for minimally invasive nephron-sparing surgery. This evolution has resulted from potential clinical benefits, as well as proliferation of robotic systems and patient demand for robot-assisted surgery. We sought to quantify the costs associated with the use of robotics for minimally invasive partial nephrectomy. A cost analysis was performed for 20 consecutive robot-assisted partial nephrectomy (RPN) and LPN patients at our institution from 2009 to 2010. Data included actual perioperative and hospitalization costs as well as professional fees. Capital costs were estimated using purchase costs and amortization of two robotic systems from 2001 to 2009, as well as maintenance contract costs. The estimated cost/case was obtained using total robotic surgical volume during this period. Total estimated costs were compared between groups. A separate analysis was performed assuming "ideal" robotic utilization during a comparable period. RALPN had a cost premium of +$1066/case compared with LPN, assuming actual robot utilization from 2001 to 2009. Assuming "ideal" utilization during a comparable period, this premium decreased to +$334; capital costs per case decreased from $1907 to $1175. Tumor size, operative time, and length of stay were comparable between groups. RALPN is associated with a small to moderate cost premium depending on assumptions regarding robotic surgical volume. Saturated utilization of robotic systems decreases attributable capital costs and makes comparison with laparoscopy more favorable. Purported clinical benefits of RPN (eg, decreased warm ischemia time, increased utilization of nephron-sparing surgery) need further study, because these may have cost implications.

The political economy of United States multiutilities: The United States electric power industry and communication services

NASA Astrophysics Data System (ADS)

Quail, Christine M.

This study consists of a political economic analysis of the multiutility industry, the industry located at the confluence of electric utilities, telephone, cable, and Internet markets. The study uses a theoretical framework based in political economy and urban theory. Methodologies used include industrial analysis and instrumental analysis. A discussion of technological convergence establishes the technical means by which multiutilities developed. Refusing technological determinism, however, the study presents a critical analysis of the history, philosophy, and regulation of utilities. Distinctions are made between public and private ownership structures in the electric utility industry. Next, the study embarks on an industrial analysis of the multiutility industry. The industrial analysis includes a discussion of the industry's history, markets, ownership types, and legal struggles. Following the broad industrial overview, two case studies are presented: Hawarden Integrated Technology, Energy and Communications (HITEC), and Con Edison Communications, LLC. HITEC is a public multiutility in the City of Hawarden, Iowa. Con Edison Communications is a private multiutility, based in New York City. The case studies provide a vehicle by which theoretical and philosophical underpinnings, as well as general trends, in the multiutility industry are localized and concretized. Finally, the study draws conclusions about the nature, history, and future of public versus private control of multiutilities' converged communications infrastructures. Questions of democratic control of media infrastructures are raised.

Reconciling the Knowledge of Scholars & Practitioners: An Extended Case Analysis of the Role of Theory in Student Affairs

ERIC Educational Resources Information Center

Kimball, Ezekiel

2016-01-01

This paper utilizes a critical post-pragmatist epistemological lens in tandem with an extended case analysis to explore how student affairs professionals process truth claims related to student experience. Findings from the study, which include the limited usage of formal theory and the iterative reconstruction of informal theory, are used to…

Finding novel relationships with integrated gene-gene association network analysis of Synechocystis sp. PCC 6803 using species-independent text-mining.

PubMed

Kreula, Sanna M; Kaewphan, Suwisa; Ginter, Filip; Jones, Patrik R

2018-01-01

The increasing move towards open access full-text scientific literature enhances our ability to utilize advanced text-mining methods to construct information-rich networks that no human will be able to grasp simply from 'reading the literature'. The utility of text-mining for well-studied species is obvious though the utility for less studied species, or those with no prior track-record at all, is not clear. Here we present a concept for how advanced text-mining can be used to create information-rich networks even for less well studied species and apply it to generate an open-access gene-gene association network resource for Synechocystis sp. PCC 6803, a representative model organism for cyanobacteria and first case-study for the methodology. By merging the text-mining network with networks generated from species-specific experimental data, network integration was used to enhance the accuracy of predicting novel interactions that are biologically relevant. A rule-based algorithm (filter) was constructed in order to automate the search for novel candidate genes with a high degree of likely association to known target genes by (1) ignoring established relationships from the existing literature, as they are already 'known', and (2) demanding multiple independent evidences for every novel and potentially relevant relationship. Using selected case studies, we demonstrate the utility of the network resource and filter to ( i ) discover novel candidate associations between different genes or proteins in the network, and ( ii ) rapidly evaluate the potential role of any one particular gene or protein. The full network is provided as an open-source resource.

Case-based reasoning for space applications: Utilization of prior experience in knowledge-based systems

NASA Technical Reports Server (NTRS)

King, James A.

1987-01-01

The goal is to explain Case-Based Reasoning as a vehicle to establish knowledge-based systems based on experimental reasoning for possible space applications. This goal will be accomplished through an examination of reasoning based on prior experience in a sample domain, and also through a presentation of proposed space applications which could utilize Case-Based Reasoning techniques.

"Teaching Case": Who Renews? Who Leaves? Identifying Customer Churn in a Telecom Company Using Big Data Techniques

ERIC Educational Resources Information Center

Asamoah, Daniel A.; Sharda, Ramesh; Kalgotra, Pankush; Ott, Mark

2016-01-01

Within the context of the telecom industry, this teaching case is an active learning analytics exercise to help students build hands-on expertise on how to utilize Big Data to solve a business problem. Particularly, the case utilizes an analytics method to help develop a customer retention strategy to mitigate against an increasing customer churn…

Population-based medical and disease management: an evaluation of cost and quality.

PubMed

Wise, Christopher G; Bahl, Vinita; Mitchell, Rita; West, Brady T; Carli, Thomas

2006-02-01

Reports by the Institute of Medicine and the Health Care Financing Administration have emphasized that the integration of medical care delivery, evidence-based medicine, and chronic care disease management may play a significant role in improving the quality of care and reducing medical care costs. The specific aim of this project is to assess the impact of an integrated set of care coordination tools and chronic disease management interventions on utilization, cost, and quality of care for a population of beneficiaries who have complementary health coverage through a plan designed to apply proactive medical and disease management processes. The utilization of health care services by the study population was compared to another population from the same geographic service area and covered by a traditional fee-for-service indemnity insurance plan that provided few medical or disease management services. Evaluation of the difference in utilization was based on the difference in the cost per-member-per-month (PMPM) in a 1-year measurement period, after adjusting for differences in fee schedules, case-mix and healthcare benefit design. After adjustments for both case-mix and benefit differences, the study group is $63 PMPM less costly than the comparison population for all members. Cost differences are largest in the 55-64 and 65 and above age groups. The study group is $115 PMPM lower than the comparison population for the age category of 65 years and older, after adjustments for case-mix and benefits. Health Plan Employer and Data Information Set (HEDIS)-based quality outcomes are near the 90th percentile for most indications. The cost outcomes of a population served by proactive, population-based disease management and complex care management, compared to an unmanaged population, demonstrates the potential of coordinated medical and disease management programs. Further studies utilizing appropriate methodologies would be beneficial.

Working memory, reasoning, and expertise in medicine-insights into their relationship using functional neuroimaging.

PubMed

Hruska, Pam; Krigolson, Olav; Coderre, Sylvain; McLaughlin, Kevin; Cortese, Filomeno; Doig, Christopher; Beran, Tanya; Wright, Bruce; Hecker, Kent G

2016-12-01

Clinical reasoning is dependent upon working memory (WM). More precisely, during the clinical reasoning process stored information within long-term memory is brought into WM to facilitate the internal deliberation that affords a clinician the ability to reason through a case. In the present study, we examined the relationship between clinical reasoning and WM while participants read clinical cases with functional magnetic resonance imaging (fMRI). More specifically, we examined the impact of clinical case difficulty (easy, hard) and clinician level of expertise (2nd year medical students, senior gastroenterologists) on neural activity within regions of cortex associated with WM (i.e., the prefrontal cortex) during the reasoning process. fMRI was used to scan ten second-year medical students and ten practicing gastroenterologists while they reasoned through sixteen clinical cases [eight straight forward (easy) and eight complex (hard)] during a single 1-h scanning session. Within-group analyses contrasted the easy and hard cases which were then subsequently utilized for a between-group analysis to examine effects of expertise (novice > expert, expert > novice). Reading clinical cases evoked multiple neural activations in occipital, prefrontal, parietal, and temporal cortical regions in both groups. Importantly, increased activation in the prefrontal cortex in novices for both easy and hard clinical cases suggests novices utilize WM more so than experts during clinical reasoning. We found that clinician level of expertise elicited differential activation of regions of the human prefrontal cortex associated with WM during clinical reasoning. This suggests there is an important relationship between clinical reasoning and human WM. As such, we suggest future models of clinical reasoning take into account that the use of WM is not consistent throughout all clinical reasoning tasks, and that memory structure may be utilized differently based on level of expertise.

Productivity growth in outpatient child and adolescent mental health services: the impact of case-mix adjustment.

PubMed

Halsteinli, Vidar; Kittelsen, Sverre A; Magnussen, Jon

2010-02-01

The performance of health service providers may be monitored by measuring productivity. However, the policy value of such measures may depend crucially on the accuracy of input and output measures. In particular, an important question is how to adjust adequately for case-mix in the production of health care. In this study, we assess productivity growth in Norwegian outpatient child and adolescent mental health service units (CAMHS) over a period characterized by governmental utilization of simple productivity indices, a substantial increase in capacity and a concurrent change in case-mix. We analyze the sensitivity of the productivity growth estimates using different specifications of output to adjust for case-mix differences. Case-mix adjustment is achieved by distributing patients into eight groups depending on reason for referral, age and gender, as well as correcting for the number of consultations. We utilize the nonparametric Data Envelopment Analysis (DEA) method to implicitly calculate weights that maximize each unit's efficiency. Malmquist indices of technical productivity growth are estimated and bootstrap procedures are performed to calculate confidence intervals and to test alternative specifications of outputs. The dataset consist of an unbalanced panel of 48-60 CAMHS in the period 1998-2006. The mean productivity growth estimate from a simple unadjusted patient model (one single output) is 35%; adjusting for case-mix (eight outputs) reduces the growth estimate to 15%. Adding consultations increases the estimate to 28%. The latter reflects an increase in number of consultations per patient. We find that the governmental productivity indices strongly tend to overestimate productivity growth. Case-mix adjustment is of major importance and governmental utilization of performance indicators necessitates careful considerations of output specifications. Copyright 2009 Elsevier Ltd. All rights reserved.

Study on advanced life support devices in the ambulances for emergency cases in Klang Valley, Malaysia.

PubMed

Ismail, M S; Hasinah, A B; Syaiful, M N; Murshidah, H B; Thong, T J; Zairi, Z; Idzwan, Z; Herbosa, T J; Johar, M J; Ho, S E; Das, S

2012-01-01

In an effort to improve pre-hospital care, the authors assessed the availability and utility of ambulance devices. The study aimed to identify commonly used devices for managing emergency cases in Klang Valley of Malaysia. This was a prospective study comprising of 1075 emergency ambulances running on 30 days. The study analyzed the availability and utilization of life support equipment in nine ambulance providers of Klang Valley in Malaysia. The devices were classified into: (a) airway and ventilation, (b) immobilization and haemorrhage control and (c) communication. The percentage of device utilization was analysed using computerised software. Results showed only one ambulance service had complete equipment in accordance to international standards. In term of utilisation of life support equipment, oxygen delivery devices were used in 493 (45.86%) runs. The most used devices in immobilisation and haemorrhage control were:- (a) scoop stretcher in 321 (29.86%) runs, (b) wound dressings in 250 (23.26%) runs and (c) rigid spinal board in 206 (19.16%) runs. Two-way radios were used in 745 (69.30%) runs while mobile phones were used in 429 (39.91%) runs. In conclusion, ambulances in Klang Valley had a large variation in the availability of life support devices. This emphasizes a need for standardization of equipment.

Expanding technology in the ICU: the case for the utilization of telemedicine.

PubMed

Deslich, Stacie; Coustasse, Alberto

2014-05-01

Telemedicine has been utilized in various healthcare areas to achieve better patient outcomes, lower costs of providing services, and increase patient access to care. Tele-intensive care unit (ICU) technology has been introduced as a way to provide effective ICU services to patients with reduced access, as well as to decrease costs and improve patient care. The methodology for this qualitative study was a literature search and review of case studies. The search was limited to sources published in the last 10 years (2003-2013) in the English language. In total, 55 references were used for this research exploration inquiry. Tele-ICU was found to be an effective way to use technology to decrease costs of providing intensive care, while improving patient outcomes such as mortality and length of stay. Several case studies supported the use of telemedicine in ICUs to provide intensive care to patients who lived in rural areas and lacked access to traditional ICUs. Furthermore, it was noted that, although the initial costs for tele-ICU startup were significant, as much as $100,000 per bed, the benefits of the utilization of this technology can offset those costs by reducing costs by 24% via decreased length of stay for patients. The findings of this study have suggested that the implementation of tele-ICU may have been more beneficial than costly, and it may have provided healthcare organizations the opportunity to increase quality of care and decrease mortality, while it might have decreased costs of delivering ICU services in both rural and urban areas.

Temperature dependence of the multistability of lactose utilization network of Escherichia coli

NASA Astrophysics Data System (ADS)

Nepal, Sudip; Kumar, Pradeep

Biological systems are capable of producing multiple states out of a single set of inputs. Multistability acts like a biological switch that allows organisms to respond differently to different environmental conditions and hence plays an important role in adaptation to changing environment. One of the widely studied gene regulatory networks underlying the metabolism of bacteria is the lactose utilization network, which exhibits a multistable behavior as a function of lactose concentration. We have studied the effect of temperature on multistability of the lactose utilization network at various concentrations of thio-methylgalactoside (TMG), a synthetic lactose. We find that while the lactose utilization network exhibits a bistable behavior for temperature T >20° C , a graded response arises for temperature T <=20° C. Furthermore, we construct a phase diagram of the graded and bistable response of lactose utilization network as a function of temperature and TMG concentration. Our results suggest that environmental conditions, in this case temperature, can alter the nature of cellular regulation of metabolism.

Hip arthroscopy utilization and associated complications: a population-based analysis

PubMed Central

Bernard, Johnathan A.; Pan, Ting J.; Ranawat, Anil S.; Nawabi, Danyal H.; Kelly, Bryan T.; Lyman, Stephen

2017-01-01

Abstract The purpose of this study is to review the trends in hip arthroscopy using data from a statewide database, focusing on utilization rates, patient demographics and complication rates. The Statewide Planning and Research Cooperative System (SPARCS) database for New York State was queried for cases of hip arthroscopy from 1998 to 2012. Patient demographics and procedural details were collected. Patients were subsequently reviewed for complications and readmissions within 30 and 90 days. In total, 12 194 hip arthroscopy procedures were performed by 295 surgeons in 137 centers between 1998 and 2012. There was a 95-fold increase in the annual frequency of hip arthroscopy procedures between 1998 (n = 24) and 2012 (n = 2296). Thirty-day complication rates were 0.2% (n = 19), whereas the 90-day complication rate was 0.3% (n = 30). The all-cause 30-day readmission rate was 0.5% (n = 66), whereas the 90-day rate was 1.6% (n = 200). The number of surgeons performing hip arthroscopy increased 7-fold over the observation period. However, only 14.9% (n = 44) of surgeons performed more than 30 procedures annually. Lower volume surgeons (<102 cases/year) demonstrated significantly higher 90-day readmission rates, compared with higher volume surgeons (>163 cases/year, P < 0.0060); however, complication rates and readmission rates did not differ based on surgeon volume. Our findings confirm our hypothesis, demonstrating a significant increase in utilization of hip arthroscopy in the State of New York. We did not identify an associated increase in annual complication rates as hypothesized with increasing utilization, although there was an association of higher readmission rates among lower volume surgeons. Further study is needed to define rates of failure requiring revision hip arthroscopy or conversion to arthroplasty, and to clarify the relationship between complication rates and surgeon volume and case complexity. Level of Evidence: III, retrospective cohort series. PMID:28948036

Computer-Assisted Instruction: A Case Study of Two Charter Schools

ERIC Educational Resources Information Center

Keengwe, Jared; Hussein, Farhan

2013-01-01

The purpose of this study was to examine the relationship in achievement gap between English language learners (ELLs) utilizing computer-assisted instruction (CAI) in the classroom, and ELLs relying solely on traditional classroom instruction. The study findings showed that students using CAI to supplement traditional lectures performed better…

A Vision of Improvement of Learning: South African Teachers' Conceptions of Classroom Assessment

ERIC Educational Resources Information Center

Sethusha, Mantsose Jane

2013-01-01

This article explored conceptions that teachers hold about classroom assessment and how these conceptions influence their classroom assessment practices. The qualitative study employed a case study approach. Semi-structured interviews, observations and document analyses were used. The study utilized Brown's (2004) conceptual framework on…

Mobile phones as a new memory aid: a preliminary investigation using case studies.

PubMed

Wade, T K; Troy, J C

2001-04-01

Memory impairment is one of the most common concerns following a brain injury of any severity. The use of effective external memory aids can help minimize the devastating effects such memory impairment can have on an individual's everyday life. Reviewed in this report are case studies of five individuals suffering significant everyday memory problems that were given a new memory aid that utilizes standard mobile phones. Measurements included diary-format observations and qualitative feedback. The results of the study show promising outcomes for all of the cases, and have led to recent adaptations to allow for wider and more effective use of this memory aid.

Using standardized nursing languages: a case study exemplar on management of diabetes mellitus.

PubMed

Fischetti, Natalie

2008-01-01

This case study illustrates the characteristics of the nursing diagnosis readiness for enhanced self health management. Published literature, experience, and expertise of the author were utilized as data sources. The standardized nursing languages of NANDA International, Nursing Outcomes Classification, Nursing Interventions Classification, and interventions related to the client's management of diabetes were derived for the case study. The use of standardized nursing languages with interventions related to the management of type 2 diabetes provided a framework for nurses to support clients with enhanced self-management to improve their outcomes. The use of standardized nursing language in the management of type 2 diabetes can improve client outcomes.

Pharmacy students' use and perceptions of Apple mobile devices incorporated into a basic health science laboratory.

PubMed

Bryant, Jennifer E; Richard, Craig A H

To describe pharmacy students' use of mobile devices in a basic health science laboratory and to report the students' perceptions on how solving cases with their mobile devices influenced their attitudes, abilities, and view on the use of mobile devices as tools for pharmacists. First-year pharmacy students utilized mobile devices to solve clinical case studies in a basic health sciences laboratory. A pre-survey and two post-surveys were administered to assess the students' comfort, awareness, use, and perceptions on the use of their mobile devices and apps. The pre-survey and first post-survey each had a response rate of 99%, and the second post-survey had a response rate of 100%. In comparing the pre-survey and first post-survey data, there was a statistically significant increase in the number of students that agreed or strongly agreed that they were more comfortable utilizing their mobile device (p = 0.025), they were more aware of apps for pharmacists (p < 0.005), and they have used more apps that can be useful for pharmacists (p < 0.005). The second post-survey demonstrated that over 78% of students agreed or strongly agreed that completing the case studies influenced them to be more comfortable with their mobile devices, to be more aware of apps that can be useful for pharmacists, and to be more agreeable with mobile device utilization by pharmacists in improving patient care. In addition, the second post-survey also demonstrated that 84% of students responded that using their mobile devices to solve the cases influenced them to either use their mobile device in a clinical setting for a clinical and/or pharmacy-related purpose for the first time or to use it more frequently for this purpose. The use of mobile devices to solve clinical cases in a first-year basic health science laboratory course was perceived as beneficial by students and influenced them to utilize their mobile device even more in a pharmacy practice setting. Copyright © 2016 Elsevier Inc. All rights reserved.

Endoscopic ultrasound guided brush/fine-needle aspiration cytology: A 15-month study.

PubMed

Tummidi, Santosh; Kothari, Kanchan; Sathe, Pragati; Agnihotri, Mona; Fernandes, Gwendolyn; Naik, Leena; Jain, Aleena; Chaturvedi, Rachana

2018-06-01

Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has become increasingly popular for the diagnosis and staging of gastrointestinal diseases and peri-gastrointestinal lesions. The application of FNA/Brush has dramatically expanded the clinical utility of EUS. To evaluate the diagnostic accuracy, study the spectrum of lesions encountered in EUS-FNAC/brush cytology of gastrointestinal and peri-gastrointestinal lesions. Total of 124 patients during the period from August 2015 to November 2016 was included in the study. Routine staining was done. A total of 124 cases were studied with 86% (107 cases) being satisfactory for evaluation. M:F ratio was 1:1.03, mean age of 50.5 years. The most common site was common bile duct (CBD) (37%) followed by lymph node (21%), pancreas (17.7%), esophagus (17%), stomach (3.5%), liver (1.8%), gallbladder (1%), and spleen (1%). In total, 53.4% lesions were benign, in 6.5% atypical cells were seen, 12.1% were suspicious for malignancy, and 28% cases were positive for malignancy. Follow-up was available in 102 cases with cyto-histopathological concordance rate of 90%. EUS-FNA/Brush is a reliable, sensitive, specific and minimally invasive way to establish a diagnosis. It can be utilized as a pre-operative procedure for the management of many intra-abdominal lesions and prevent unnecessary invasive procedures. © 2018 Wiley Periodicals, Inc.

Effect of emergency department CT on neuroimaging case volume and positive scan rates.

PubMed

Oguz, Kader Karli; Yousem, David M; Deluca, Tom; Herskovits, Edward H; Beauchamp, Norman J

2002-09-01

The authors performed this study to determine the effect a computed tomographic (CT) scanner in the emergency department (ED) has on neuroimaging case volume and positive scan rates. The total numbers of ED visits and neuroradiology CT scans requested from the ED were recorded for 1998 and 2000, the years before and after the installation of a CT unit in the ED. For each examination type (brain, face, cervical spine), studies were graded for major findings (those that affected patient care), minor findings, and normal findings. The CT utilization rates and positive study rates were compared for each type of study performed for both years. There was a statistically significant increase in the utilization rate after installation of the CT unit (P < .001). The fractions of studies with major findings, minor findings, and normal findings changed significantly after installation of the CT unit for facial examinations (P = .002) but not for brain (P = .12) or cervical spine (P = .24) examinations. In all types of studies, the percentage of normal examinations increased. In toto, there was a significant decrease in the positive scan rate after installation of the CT scanner (P = .004). After installation of a CT scanner in the ED, there was increased utilization and a decreased rate of positive neuroradiologic examinations, the latter primarily due to lower positive rates for facial CT scans.

Symptomatic complex partial status epilepticus manifesting as utilization behavior of a mobile phone.

PubMed

Carota, Antonio; Novy, Jan; Rossetti, Andrea O

2009-03-01

Utilization behavior (UB) consists of reaching out and using objects in the environment in an automatic manner and out of context. This behavior has been correlated to frontal lobe dysfunction, especially of the right hemisphere. We describe a 60-year-old woman, affected by a glioblastoma located in the right frontal region, who presented with intermittent UB of the mobile phone as the main clinical manifestation of partial complex status epilepticus. Video/EEG studies showed a striking correlation between mobile phone utilization and ictal epileptic activity. Clinical and EEG findings were markedly reduced after the introduction of antiepileptic drugs. This case study suggests that UB may be added to the symptoms described for partial seizures originating from frontal areas.

The effect of pressure on microwave-enhanced Diels-Alder reactions. A case study.

PubMed

Kaval, Nadya; Dehaen, Wim; Kappe, C Oliver; Van der Eycken, Erik

2004-01-21

It is demonstrated that microwave-assisted Diels-Alder reactions of substituted 2(1H)-pyrazinones with ethylene are significantly more effective utilizing pre-pressurized (up to 10 bar) reaction vessels.

Instructional Developer as Content Specialist: Three Case Studies Utilizing the Instructional Development-Operations Research Model.

ERIC Educational Resources Information Center

Faust, Stephen M.

1980-01-01

Presents a 3-phase model (content research, specification, delivery) for instructional development-operations research and describes its application in developing courses in zoology, geology, and paleontology. (MER)

Balance in Training for Latin American Water and Wastewater Utilities

ERIC Educational Resources Information Center

Carefoot, Neil F.

1977-01-01

Using a Peru case study, this article examines the problem of training imbalance for water and wastewater operators. Guidelines towards achieving adequate training for all water and wastewater personnel are suggested. (Author/MA)

Leadership Practices that Enhance Reading Achievement for African American Males: A Case Study

ERIC Educational Resources Information Center

Dawson, Dawnay Ardrean

2010-01-01

The purpose of this study was to examine leadership practices that lead to improving academic achievement for African American males. Specifically, this study examined cultural insensitivity and its impact on educating African American male students in reading. The study utilized several techniques to determine what practices educators used to…

Energy Optimization Modeling of Geothermal Power Plant (Case Study: Darajat Geothermal Field Unit III)

NASA Astrophysics Data System (ADS)

Sinaga, R. H. M.; Darmanto, P. S.

2016-09-01

Darajat unit III geothermal power plant is developed by PT. Chevron Geothermal Indonesia (CGI). The plant capacity is 121 MW and load 110%. The greatest utilization power is consumed by Hot Well Pump (HWP) and Cooling Tower Fan (CTF). Reducing the utility power can be attempted by utilizing the wet bulb temperature fluctuation. In this study, a modelling process is developed by using Engineering Equation Solver (EES) software version 9.430.The possibility of energy saving is indicated by Specific Steam Consumption (SSC) net in relation to wet bulb temperature fluctuation from 9°C up to 20.5°C. Result shows that the existing daily operation reaches its optimum condition. The installation of Variable Frequency Drive (VFD) could be applied to optimize both utility power of HWP and CTF. The highest gain is obtained by VFD HWP installation as much as 0.80% when wet bulb temperature 18.5 °C.

The Feasibility of Utilizing Wind Energy in Commercial Buildings With Special Reference to the Kingdom of Bahrain

NASA Astrophysics Data System (ADS)

Abdulrahim Saeed, Saeed

2017-11-01

This article shall investigate the feasibility of utilizing wind energy for commercial buildings with special reference to the Kingdom of Bahrain. Bahrain World Trade Center which was built in 2008, is located in the city of Manama. The fifty-story complex contains identical twin towers that rise over 240 meters in height. The towers are connected by three bridges which hold three turbines each 29 meters long. The three turbines were originally design to provide electric energy required for lighting. The Bahrain World Trade Center was selected as a case study to investigate the feasibility of utilizing wind energy technologies in skyscrapers with special reference to the Kingdom of Bahrain. It is hoped that the findings and conclusion of the study shall be of some value for future utilization of wind energy in the GCC countries and the world at large.

Nursing home case-mix reimbursement in Mississippi and South Dakota.

PubMed

Arling, Greg; Daneman, Barry

2002-04-01

To evaluate the effects of nursing home case-mix reimbursement on facility case mix and costs in Mississippi and South Dakota. Secondary data from resident assessments and Medicaid cost reports from 154 Mississippi and 107 South Dakota nursing facilities in 1992 and 1994, before and after implementation of new case-mix reimbursement systems. The study relied on a two-wave panel design to examine case mix (resident acuity) and direct care costs in 1-year periods before and after implementation of a nursing home case-mix reimbursement system. Cross-lagged regression models were used to assess change in case mix and costs between periods while taking into account facility characteristics. Facility-level measures were constructed from Medicaid cost reports and Minimum Data Set-Plus assessment records supplied by each state. Resident case mix was based on the RUG-III classification system. Facility case-mix scores and direct care costs increased significantly between periods in both states. Changes in facility costs and case mix were significantly related in a positive direction. Medicare utilization and the rate of hospitalizations from the nursing facility also increased significantly between periods, particularly in Mississippi. The case-mix reimbursement systems appeared to achieve their intended goals: improved access for heavy-care residents and increased direct care expenditures in facilities with higher acuity residents. However, increases in Medicare utilization may have influenced facility case mix or costs, and some facilities may have been unprepared to care for higher acuity residents, as indicated by increased rates of hospitalization.

Valuing Treatments for Parkinson Disease Incorporating Process Utility: Performance of Best-Worst Scaling, Time Trade-Off, and Visual Analogue Scales.

PubMed

Weernink, Marieke G M; Groothuis-Oudshoorn, Catharina G M; IJzerman, Maarten J; van Til, Janine A

2016-01-01

The objective of this study was to compare treatment profiles including both health outcomes and process characteristics in Parkinson disease using best-worst scaling (BWS), time trade-off (TTO), and visual analogue scales (VAS). From the model comprising of seven attributes with three levels, six unique profiles were selected representing process-related factors and health outcomes in Parkinson disease. A Web-based survey (N = 613) was conducted in a general population to estimate process-related utilities using profile-based BWS (case 2), multiprofile-based BWS (case 3), TTO, and VAS. The rank order of the six profiles was compared, convergent validity among methods was assessed, and individual analysis focused on the differentiation between pairs of profiles with methods used. The aggregated health-state utilities for the six treatment profiles were highly comparable for all methods and no rank reversals were identified. On the individual level, the convergent validity between all methods was strong; however, respondents differentiated less in the utility of closely related treatment profiles with a VAS or TTO than with BWS. For TTO and VAS, this resulted in nonsignificant differences in mean utilities for closely related treatment profiles. This study suggests that all methods are equally able to measure process-related utility when the aim is to estimate the overall value of treatments. On an individual level, such as in shared decision making, BWS allows for better prioritization of treatment alternatives, especially if they are closely related. The decision-making problem and the need for explicit trade-off between attributes should determine the choice for a method. Copyright © 2016. Published by Elsevier Inc.

Perceived Utility of the RE-AIM Framework for Health Promotion/Disease Prevention Initiatives for Older Adults: A Case Study from the U.S. Evidence-Based Disease Prevention Initiative.

PubMed

Ory, Marcia G; Altpeter, Mary; Belza, Basia; Helduser, Janet; Zhang, Chen; Smith, Matthew Lee

2014-01-01

Dissemination and implementation (D&I) frameworks are increasingly being promoted in public health research. However, less is known about their uptake in the field, especially for diverse sets of programs. Limited questionnaires exist to assess the ways that frameworks can be utilized in program planning and evaluation. We present a case study from the United States that describes the implementation of the RE-AIM framework by state aging services providers and public health partners and a questionnaire that can be used to assess the utility of such frameworks in practice. An online questionnaire was developed to capture community perspectives about the utility of the RE-AIM framework. Distributed to project leads in 27 funded states in an evidence-based disease prevention initiative for older adults, 40 key stakeholders responded representing a 100% state-participation rate among the 27 funded states. Findings suggest that there is perceived utility in using the RE-AIM framework when evaluating grand-scale initiatives for older adults. The RE-AIM framework was seen as useful for planning, implementation, and evaluation with relevance for evaluators, providers, community leaders, and policy makers. Yet, the uptake was not universal, and some respondents reported difficulties in use, especially adopting the framework as a whole. This questionnaire can serve as the basis to assess ways the RE-AIM framework can be utilized by practitioners in state-wide D&I efforts. Maximal benefit can be derived from examining the assessment of RE-AIM-related knowledge and confidence as part of a continual quality assurance process. We recommend such an assessment be performed before the implementation of new funding initiatives and throughout their course to assess RE-AIM uptake and to identify areas for technical assistance.

Charting the Emergence of Corporate Procurement of Utility-Scale PV

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

Heeter, Jenny S.; Cook, Jeffrey J.; Bird, Lori A.

Corporations and other institutions have contracted for more than 2300 MW of off-site solar, using power purchase agreements, green tariffs, or bilateral deals with utilities. This paper examines the benefits, challenges, and outlooks for large-scale off-site solar purchasing in the United States. Pathways differ based on where they are available, the hedge value they can provide, and their ease of implementation. The paper features case studies of an aggregate PPA (Massachusetts Institute of Technology, Boston Medical Center, and Post Office Square), a corporation exiting their incumbent utility (MGM Resorts), a utility offering large scale renewables to corporate customers (Alabama Powersmore » Renewable Procurement Program), and a company with approval to sell energy into wholesale markets (Google Energy Inc.).« less

Assessing the Utilization of Total Ankle Replacement in the United States.

PubMed

Reddy, Sudheer; Koenig, Lane; Demiralp, Berna; Nguyen, Jennifer T; Zhang, Qian

2017-06-01

Total ankle arthroplasty (TAR) has been shown to be a cost-effective procedure relative to conservative management and ankle arthrodesis. Although its use has grown considerably over the last 2 decades, it is less common than arthrodesis. The purpose of this investigation was to analyze the cost and utilization of TAR across hospitals. Our analytical sample consisted of Medicare claims data from 2011 and 2012 for Inpatient Prospective Payment System hospitals. Outcome variables of interest were the likelihood of a hospital performing TAR, the volume of TAR cases, TAR hospital costs, and hospital profit margins. Data from the 2010 Cost Report and Medicare inpatient claims were utilized to compute average margins for TAR cases and overall hospital margins. TAR cost was calculated based on the all payer cost-to-charge ratio for each hospital in the Cost Report. Nationwide Inpatient Sample data were used to generate descriptive statistics on all TAR patients across payers. Medicare participants accounted for 47.5% of the overall population of TAR patients. Average implant cost was $13 034, accounting for approximately 70% of the total all-payer cost. Approximately, one-third of hospitals were profitable with respect to primary TAR. Profitable hospitals had lower total costs and higher payments leading to a difference in profit of approximately $11 000 from TAR surgeries between profitable and nonprofitable hospitals. No difference was noted with respect to length of stay or number of cases performed between profitable and nonprofitable hospitals. TAR surgeries were more likely to take place in large and major teaching hospitals. Among hospitals performing at least 1 TAR, the margin on TAR cases was positively associated with the total number of TARs performed by a hospital. There is an overall significant financial burden associated with performing TAR with many health systems failing to demonstrate profitability despite its increased utilization. While additional factors such as improved patient outcomes may be driving utilization of TAR, financial barriers may exist that can affect utilization of TAR across health systems. Level III, comparative study.

An optimal consumption and investment problem with quadratic utility and negative wealth constraints.

PubMed

Roh, Kum-Hwan; Kim, Ji Yeoun; Shin, Yong Hyun

2017-01-01

In this paper, we investigate the optimal consumption and portfolio selection problem with negative wealth constraints for an economic agent who has a quadratic utility function of consumption and receives a constant labor income. Due to the property of the quadratic utility function, we separate our problem into two cases and derive the closed-form solutions for each case. We also illustrate some numerical implications of the optimal consumption and portfolio.

There is No Free Lunch: Tradeoffs in the Utility of Learned Knowledge

NASA Technical Reports Server (NTRS)

Kedar, Smadar T.; McKusick, Kathleen B.

1992-01-01

With the recent introduction of learning in integrated systems, there is a need to measure the utility of learned knowledge for these more complex systems. A difficulty arrises when there are multiple, possibly conflicting, utility metrics to be measured. In this paper, we present schemes which trade off conflicting utility metrics in order to achieve some global performance objectives. In particular, we present a case study of a multi-strategy machine learning system, mutual theory refinement, which refines world models for an integrated reactive system, the Entropy Reduction Engine. We provide experimental results on the utility of learned knowledge in two conflicting metrics - improved accuracy and degraded efficiency. We then demonstrate two ways to trade off these metrics. In each, some learned knowledge is either approximated or dynamically 'forgotten' so as to improve efficiency while degrading accuracy only slightly.

Fabrication of graphite/epoxy cases for orbit insertion motors

NASA Technical Reports Server (NTRS)

Schmidt, W. W.

1973-01-01

The fabrication procedures are described for filament-wound rocket motor cases, approximately 26.25 inches long by 25.50 inches diameter, utilizing graphite fibers. The process utilized prepreg tape which consists of Fortafil 4-R fibers in the E-759 epoxy resin matrix. This fabrication effect demonstrated an ability to fabricate high quality graphite/epoxy rocket motor cases in the 26.25 inch by 25.50 inch size range.

Combined effect of CVR and penetration of DG in the voltage profile and losses of lowvoltage secondary distribution networks

NASA Astrophysics Data System (ADS)

Bokhari, Abdullah

Demarcations between traditional distribution power systems and distributed generation (DG) architectures are increasingly evolving as higher DG penetration is introduced in the system. The concerns in existing electric power systems (EPSs) to accommodate less restrictive interconnection policies while maintaining reliability and performance of power delivery have been the major challenge for DG growth. In this dissertation, the work is aimed to study power quality, energy saving and losses in a low voltage distributed network under various DG penetration cases. Simulation platform suite that includes electric power system, distributed generation and ZIP load models is implemented to determine the impact of DGs on power system steady state performance and the voltage profile of the customers/loads in the network under the voltage reduction events. The investigation designed to test the DG impact on power system starting with one type of DG, then moves on multiple DG types distributed in a random case and realistic/balanced case. The functionality of the proposed DG interconnection is designed to meet the basic requirements imposed by the various interconnection standards, most notably IEEE 1547, public service commission, and local utility regulation. It is found that implementation of DGs on the low voltage secondary network would improve customer's voltage profile, system losses and significantly provide energy savings and economics for utilities. In a network populated with DGs, utility would have a uniform voltage profile at the customers end as the voltage profile becomes more concentrated around targeted voltage level. The study further reinforced the concept that the behavior of DG in distributed network would improve voltage regulation as certain percentage reduction on utility side would ensure uniform percentage reduction seen by all customers and reduce number of voltage violations.

In situ bioremediation of petroleum hydrocarbons and chlorinated hydrocarbons: Three case studies

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

Bost, R.C.; Perry, R.G.; Barber, T.

1997-06-01

In situ biodegradation of organic contaminants is one of the most cost-effective means of site remediation. This method has proven successful in soils, ground water, and slurries. Bacteria capable of degrading organic contaminants within an aquifer include many species from a wide spectrum of genera, e.g. Pseudomonas, Corynebacterium, Bacillus, etc. In most cases, a mixture of bacterial strains is required to completely oxidize a complex organic contaminant. Each strain of an organism may target a specific compound, working together with other organisms to ultimately degrade each intermediate until complete degradation, also known as mineralization, occurs. One or more of themore » following mechanisms are utilized by bacteria for organic chemical degradation: (1) aerobic, (2) anaerobic, and (3) co-metabolic. During aerobic oxidation of organic chemicals, bacteria utilize the pollutant as an electron and hydrogen source and oxygen acts as the electron and hydrogen acceptor, resulting in water. As the bacterial enzymes cleave the compound, oxidized products are produced along with energy for the reaction to proceed. This is the most rapid and widely utilized mechanism. Dehalogenation occurs under aerobic, or perhaps more often, under anoxic conditions. This process occurs in the presence of alternate electron acceptors and replaces chlorine with hydrogen. The mechanism of co-metabolism can be aerobic or anaerobic, but is more often aerobic. This process requires a separate energy source for the bacterial cell because the pollutant is not utilized as an energy source. The role of bioremediation in site remediation is demonstrated below by three case studies: (1) a refinery, (2) a municipal landfill and (3) a pesticide formulation plant.« less

A case study of an integrative genomic and experimental therapeutic approach for rare tumors: identification of vulnerabilities in a pediatric poorly differentiated carcinoma.

PubMed

Dela Cruz, Filemon S; Diolaiti, Daniel; Turk, Andrew T; Rainey, Allison R; Ambesi-Impiombato, Alberto; Andrews, Stuart J; Mansukhani, Mahesh M; Nagy, Peter L; Alvarez, Mariano J; Califano, Andrea; Forouhar, Farhad; Modzelewski, Beata; Mitchell, Chelsey M; Yamashiro, Darrell J; Marks, Lianna J; Glade Bender, Julia L; Kung, Andrew L

2016-10-31

Precision medicine approaches are ideally suited for rare tumors where comprehensive characterization may have diagnostic, prognostic, and therapeutic value. We describe the clinical case and molecular characterization of an adolescent with metastatic poorly differentiated carcinoma (PDC). Given the rarity and poor prognosis associated with PDC in children, we utilized genomic analysis and preclinical models to validate oncogenic drivers and identify molecular vulnerabilities. We utilized whole exome sequencing (WES) and transcriptome analysis to identify germline and somatic alterations in the patient's tumor. In silico and in vitro studies were used to determine the functional consequences of genomic alterations. Primary tumor was used to generate a patient-derived xenograft (PDX) model, which was used for in vivo assessment of predicted therapeutic options. WES revealed a novel germline frameshift variant (p.E1554fs) in APC, establishing a diagnosis of Gardner syndrome, along with a somatic nonsense (p.R790*) APC mutation in the tumor. Somatic mutations in TP53, MAX, BRAF, ROS1, and RPTOR were also identified and transcriptome and immunohistochemical analyses suggested hyperactivation of the Wnt/ß-catenin and AKT/mTOR pathways. In silico and biochemical assays demonstrated that the MAX p.R60Q and BRAF p.K483E mutations were activating mutations, whereas the ROS1 and RPTOR mutations were of lower utility for therapeutic targeting. Utilizing a patient-specific PDX model, we demonstrated in vivo activity of mTOR inhibition with temsirolimus and partial response to inhibition of MEK. This clinical case illustrates the depth of investigation necessary to fully characterize the functional significance of the breadth of alterations identified through genomic analysis.

Schematic representation of case study research designs.

PubMed

Rosenberg, John P; Yates, Patsy M

2007-11-01

The paper is a report of a study to demonstrate how the use of schematics can provide procedural clarity and promote rigour in the conduct of case study research. Case study research is a methodologically flexible approach to research design that focuses on a particular case - whether an individual, a collective or a phenomenon of interest. It is known as the 'study of the particular' for its thorough investigation of particular, real-life situations and is gaining increased attention in nursing and social research. However, the methodological flexibility it offers can leave the novice researcher uncertain of suitable procedural steps required to ensure methodological rigour. This article provides a real example of a case study research design that utilizes schematic representation drawn from a doctoral study of the integration of health promotion principles and practices into a palliative care organization. The issues discussed are: (1) the definition and application of case study research design; (2) the application of schematics in research; (3) the procedural steps and their contribution to the maintenance of rigour; and (4) the benefits and risks of schematics in case study research. The inclusion of visual representations of design with accompanying explanatory text is recommended in reporting case study research methods.

The impact of alternative diagnoses on the utility of influenza-like illness case definition to detect the 2009 H1N1 pandemic.

PubMed

Rumoro, Dino P; Bayram, Jamil D; Silva, Julio C; Shah, Shital C; Hallock, Marilyn M; Gibbs, Gillian S; Waddell, Michael J

2012-01-01

To investigate the impact of excluding cases with alternative diagnoses on the sensitivity and specificity of the Centers for Disease Control and Prevention's (CDC) influenza-like illness (ILI) case definition in detecting the 2009 H1N1 influenza, using Geographic Utilization of Artificial Intelligence in Real-Time for Disease Identification and Alert Notification, a disease surveillance system. Retrospective cross-sectional study design. Emergency department of an urban tertiary care academic medical center. 1,233 ED cases, which were tested for respiratory viruses from September 5, 2009 to May 5, 2010. The main outcome measures were positive predictive value, negative predictive value, sensitivity, specificity, and accuracy of the ILI case definition (both including and excluding alternative diagnoses) to detect H1N1. There was a significant decrease in sensitivity (chi2 = 9.09, p < 0.001) and significant improvement in specificity (chi2 = 179, p < 0.001), after excluding cases with alternative diagnoses. When early detection of an influenza epidemic is of prime importance, pursuing alternative diagnoses as part of CDC's ILI case definition may not be warranted for public health reporting due to the significant decrease in sensitivity, in addition to the resources required for detecting these alternative diagnoses.

Can pharmaco-electroencephalography help improve survival of central nervous system drugs in early clinical development?

PubMed

Wilson, Frederick J; Leiser, Steven C; Ivarsson, Magnus; Christensen, Søren R; Bastlund, Jesper F

2014-03-01

Pharmaco-electroencephalography has significant yet unrealised promise as a translatable intermediate biomarker of central pharmacodynamic activity that could help reduce Phase 2 attrition in the development of central nervous system drugs. In an effort to understand its true potential, a framework for decision-making was proposed and the utility of pharmaco-electroencephalography was assessed through several case studies. A key finding was that lack of standardisation reduces the value of data pooling and meta-analyses and renders assessment of translatability difficult, limiting utility in all but simple cases. Pre-competitive collaboration is essential both to improving understanding of translation and developing modern signal processing techniques. Copyright © 2013 Elsevier Ltd. All rights reserved.

How Visual Imagery Contributed to College: A Case of How Visual Imagery Contributes to a College Algebra Student's Understanding of the Concept of Function in the United States

ERIC Educational Resources Information Center

Lane, Rebekah M.

2011-01-01

This investigation utilized the qualitative case study method. Seventy-one College Algebra students were given a mathematical processing instrument. This testing device measured a student's preference for visual thinking. Two students were purposefully selected using the instrument. The visual mathematical learner (VL) was discussed in this…

An Expert Instructor's Use of Social Congruence, Cognitive Congruence, and Expertise in an Online Case-Based Instructional Design Course

ERIC Educational Resources Information Center

Watson, Sunnie Lee; Koehler, Adrie A.; Ertmer, Peggy; Kim, WooRi; Rico, Rudy

2018-01-01

Promoting and sustaining effective discussion--that which contributes to learning--is a skill that eludes many instructors (Darling-Hammond, 2008; Ge, Yamashiro, & Lee, 2000). This study explored the role and strategies of an expert instructor in an online advanced instructional design (ID) course that utilized a case-based learning (CBL)…

Does performance evaluation help public managers? A Balanced Scorecard approach in urban waste services.

PubMed

Guimarães, Bernardo; Simões, Pedro; Marques, Rui Cunha

2010-12-01

The urban waste market has evolved significantly in the past decades, which among other changes, has led to the creation of new utilities and new business models. However, very few things have changed for the users. Urban waste collection remains mainly under the responsibility of local authorities and the charges paid by the users in most countries are very low compared to the provision costs. This situation forces the injection of public money into the system, encouraging the 'quiet-life' within the utilities and, therefore, inefficiency. The present study intends to analyze the potential for the application of the Balanced Scorecard (BSc) methodology into the waste utilities. After a comprehensive revision of the urban waste sector in Portugal, the methodology of BSc and its application in local public services is described and discussed. Focusing on implementation rather than on strategy, a set of performance indicators is proposed to be utilized in the different management models of waste utilities in Portugal: the municipalities, semi-autonomous utilities, municipal companies and mixed companies. This implementation is then exemplified through four case studies, one for each type of utility. This paper provides a flexible framework proposal to be applied to waste utilities operating both in Portugal and abroad. Copyright © 2010 Elsevier Ltd. All rights reserved.

Improving operating room efficiency by applying bin-packing and portfolio techniques to surgical case scheduling.

PubMed

Van Houdenhoven, Mark; van Oostrum, Jeroen M; Hans, Erwin W; Wullink, Gerhard; Kazemier, Geert

2007-09-01

An operating room (OR) department has adopted an efficient business model and subsequently investigated how efficiency could be further improved. The aim of this study is to show the efficiency improvement of lowering organizational barriers and applying advanced mathematical techniques. We applied advanced mathematical algorithms in combination with scenarios that model relaxation of various organizational barriers using prospectively collected data. The setting is the main inpatient OR department of a university hospital, which sets its surgical case schedules 2 wk in advance using a block planning method. The main outcome measures are the number of freed OR blocks and OR utilization. Lowering organizational barriers and applying mathematical algorithms can yield a 4.5% point increase in OR utilization (95% confidence interval 4.0%-5.0%). This is obtained by reducing the total required OR time. Efficient OR departments can further improve their efficiency. The paper shows that a radical cultural change that comprises the use of mathematical algorithms and lowering organizational barriers improves OR utilization.

"Wishes" the Teacher Candidates Expressed in Communication with Themselves

ERIC Educational Resources Information Center

Çaliskan, Nihat

2014-01-01

The purpose of this study is to identify "the wish sentences" that teacher candidates create in the communication with themselves. The case study which is one of the type of qualitative research is utilized in this study. The study group is formed by 320 students studying in a university in central Anatolia. Data were collected by the…

Tensions in Distributed Leadership

ERIC Educational Resources Information Center

Ho, Jeanne; Ng, David

2017-01-01

Purpose: This article proposes the utility of using activity theory as an analytical lens to examine the theoretical construct of distributed leadership, specifically to illuminate tensions encountered by leaders and how they resolved these tensions. Research Method: The study adopted the naturalistic inquiry approach of a case study of an…

Impact of Instructional Design on Virtual Teamwork

ERIC Educational Resources Information Center

Rawlings, Melody

2012-01-01

The purpose of this participatory action research study was to answer the following research question: How does online instructional design impact students' virtual teamwork performance? Through the lens of social constructivism, a qualitative, in-depth multi-case study design was utilized to conduct document analyses, observations, and student…

Utility of pre-procurement bedside liver biopsy in the deceased extended-criteria liver donor.

PubMed

Mangus, Richard S; Borup, Tim C; Popa, Sam; Saxena, Romil; Cummings, Oscar; Tector, A Joseph

2014-12-01

The Indiana Organ Procurement Organization (IOPO) utilizes preoperative bedside liver biopsies in certain extended-criteria donors (ECDs), obtained by the on-site coordinator, to determine the utility of pursuing donation. This study reports the clinical and financial outcomes for this management strategy. All bedside liver biopsies obtained in ECDs over a five-yr period were reviewed. Study variables included the following: indication for biopsy, biopsy results, taking the case to the operating room, transplantation of the donor liver, and graft survival. All biopsies were processed at a single university center. There were 110 donors biopsied. Primary indications included the following: old age (29%), extensive/current alcohol abuse (26%), hepatitis C-positive serology (21%), obesity (25%), and severely elevated liver function enzymes (18%). Biopsy results demonstrated a potentially transplantable liver in 73 cases (66%), all of whom were taken to the OR (while 37 ruled out for donation based upon liver biopsy [34%]). Of all biopsied livers, 49 ultimately were transplanted (45%). Intra-operative decisions included the following: transplant 51/73 (70%), surgeon decision to exclude 20/73 (27%), nonuse due to finding of malignancy two (3%). Bedside liver biopsy may be a valuable tool to determine the utility in pursuing donation in ECDs, particularly with liver-only donors. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Physician organization care management capabilities associated with effective inpatient utilization management: a fuzzy set qualitative comparative analysis.

PubMed

Sheehy, Thomas J; Thygeson, N Marcus

2014-12-03

We studied the relationship between physician organization (PO) care management capabilities and inpatient utilization in order to identify PO characteristics or capabilities associated with low inpatient bed-days per thousand. We used fuzzy-set qualitative comparative analysis (fsQCA) to conduct an exploratory comparative case series study. Data about PO capabilities were collected using structured interviews with medical directors at fourteen California POs that are delegated to provide inpatient utilization management (UM) for HMO members of a California health plan. Health plan acute hospital claims from 2011 were extracted from a reporting data warehouse and used to calculate inpatient utilization statistics. Supplementary analyses were conducted using Fisher's Exact Test and Student's T-test. POs with low inpatient bed-days per thousand minimized length of stay and surgical admissions by actively engaging in concurrent review, discharge planning, and surgical prior authorization, and by contracting directly with hospitalists to provide UM-related services. Disease and case management were associated with lower medical admissions and readmissions, respectively, but not lower bed-days per thousand. Care management methods focused on managing length of stay and elective surgical admissions are associated with low bed-days per thousand in high-risk California POs delegated for inpatient UM. Reducing medical admissions alone is insufficient to achieve low bed-days per thousand. California POs with high bed-days per thousand are not applying care management best practices.

Colorado State University: A Midscale Market Solar Customer Case Study

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

Holm, Alison; Chernyakhovskiy, Ilya

Despite substantial increases in solar photovoltaic (PV) deployment between 2005 and 2015, a large untapped market for solar PV deployment still exists in midscale market investments by universities. Recent estimates show that if all universities in the United States installed enough solar PV to meet 25% of their annual electricity consumption, this would cumulatively result in just over 16 gigawatts (GW) of additional installed PV capacity. Within this context, midscale market projects - loosely defined as solar PV installations ranging from 100 kilowatts (kW) to 2 megawatts (MW), but more broadly representing installations not captured in the residential or utility-scalemore » sectors - could be an attractive option for universities. This case study focuses on one university solar customer, Colorado State University (CSU), to provide a detailed example of the challenges, solutions, and opportunities associated with university solar power procurement. Between 2009 and 2015, a combined 6,754 kW of both ground-mounted and rooftop solar PV was installed across multiple CSU campuses in Fort Collins, Colorado. This case study highlights CSU's decision-making process, campus engagement strategies, and relationships with state, local, and utility partners, which have culminated in significant on-campus PV deployment.« less

Questionnaire-based assessment of executive functioning: Case studies.

PubMed

Kronenberger, William G; Castellanos, Irina; Pisoni, David B

2018-01-01

Delays in the development of executive functioning skills are frequently observed in pediatric neuropsychology populations and can have a broad and significant impact on quality of life. As a result, assessment of executive functioning is often relevant for the development of formulations and recommendations in pediatric neuropsychology clinical work. Questionnaire-based measures of executive functioning behaviors in everyday life have unique advantages and complement traditional neuropsychological measures of executive functioning. Two case studies of children with spina bifida are presented to illustrate the clinical use of a new questionnaire measure of executive and learning-related functioning, the Learning, Executive, and Attention Functioning Scale (LEAF). The LEAF emphasizes clinical utility in assessment by incorporating four characteristics: brevity in administration, breadth of additional relevant content, efficiency of scoring and interpretation, and ease of availability for use. LEAF results were consistent with another executive functioning checklist in documenting everyday behavior problems related to working memory, planning, and organization while offering additional breadth of assessment of domains such as attention, processing speed, and novel problem-solving. These case study results demonstrate the clinical utility of questionnaire-based measurement of executive functioning in pediatric neuropsychology and provide a new measure for accomplishing this goal.

Hyperinsulin therapy for calcium channel antagonist poisoning: a seven-year retrospective study.

PubMed

Espinoza, Tamara R; Bryant, Sean M; Aks, Steve E

2013-01-01

The use of hyperinsulin therapy (HIT) in severe calcium channel antagonist (CCA) poisoning has become a more common therapy within the last decade. The objective of this study is to report 7 years of experience recommending HIT. This was a retrospective chart review utilizing our regional poison center (RPC) data from January 1, 2002, through December 31, 2008. All cases of CCA poisoning receiving HIT were searched. Endpoints included the number of CCA cases utilizing HIT, insulin dose, time of initiation of HIT, patient outcome, adverse events, age, glucose concentration, and lowest systolic blood pressure recorded. Forty-six cases of CCA poisoning were managed with HIT over 7 years. All the patients received standard antidotal therapy (= intravenous fluids, calcium salts, glucagon, and pressors). HIT administration followed our RPC recommendation 23 times (50%), and no hypoglycemic events occurred. Means (age, highest glucose measured, and lowest systolic blood pressure measured) were 51 years, 282 mg/dL, and 74 mm Hg, respectively. Our RPC recommendations for HIT were followed 50% of the time over the last 7 years. In light of the lack of hypoglycemia associated with HIT in our study population, we recommend HIT as an early and safe antidote in significant CCA poisoning.

The exploration of medical resources utilization among inguinal hernia repair in Taiwan diagnosis-related groups.

PubMed

Yan, Yu-Hua; Kung, Chih-Ming; Chen, Yi

2017-11-09

This study centered on differences in medical costs, using the Taiwan diagnosis-related groups (Tw-DRGs) on medical resource utilization in inguinal hernia repair (IHR) in hospitals with different ownership to provide suitable reference information for hospital administrators. The 2010-2011 data for three hospitals under different ownership were extracted from the Taiwan National Health Insurance claims database. A retrospective method was applied to analyze the age, sex, length of stay, diagnosis and surgical procedure code, and the change in financial risk of medical costs in IHR cases after introduction of Tw-DRGs. The study calculated the cost using Tw-DRG payment principles, and compared it with estimated inpatient medical costs calculated using the fee-for-service policy. There were 723 IHR cases satisfying the Tw-DRGs criteria. Cost control in the medical care corporation hospital (US$764.2/case) was more efficient than that in the public hospital (US$902.7/case) or nonprofit proprietary hospital (US$817.1/case) surveyed in this study. For IHR, anesthesiologists in the public hospital preferred to use general anesthesia (86%), while those in the two other hospitals tended to administer spinal anesthesia. We also discovered the difference in anesthesia cost was high, at US$80.2/case on average. Because the Tw-DRG-based reimbursement system produces varying hospital costs, hospital administrators should establish a financial risk assessment system as early as possible to improve healthcare quality and financial management efficiency. This would then benefit the hospital, patient, and Bureau of National Health Insurance.

The Contribution of Reverse Shoulder Arthroplasty to Utilization of Primary Shoulder Arthroplasty

PubMed Central

Jain, Nitin B.; Yamaguchi, Ken

2014-01-01

Background We assessed the contribution of reverse shoulder arthroplasty to overall utilization of primary shoulder arthroplasty, and present age and sex stratified national rates of shoulder arthroplasty. We also assessed contemporary complication rates, mortality, and indications for shoulder arthroplasty, as well as estimates and indications for revision arthroplasty. Methods We used the Nationwide Inpatient Samples for 2009–2011 to calculate estimates of shoulder arthroplasty and assessed trends using joinpoint regression. Results The cumulative estimated utilization of primary shoulder arthroplasty (total anatomical, hemi, and reverse) increased significantly from 52,397 procedures (95% CI=47,093–57,701) in 2009 to 67,184 cases (95% CI=60,638–73,731) in 2011. Reverse shoulder arthroplasty accounted for 42% of all primary shoulder arthroplasty procedures in 2011. The diagnosis of concomitant diagnosis of osteoarthritis and rotator cuff impairment was found in only 29.8% of reverse shoulder arthroplasty cases. The highest rate of reverse shoulder arthroplasty was in the 75–84 year female sub-group (77; 95% CI=67–87). Revision cases were 8.8% and 8.2% of all shoulder arthroplasties in 2009 and 2011, respectively, and 35% of revision cases were secondary to mechanical complications/loosening while 18% were due to dislocation. Conclusions The utilization of primary shoulder arthroplasty significantly increased in just a three year time span, with a major contribution from reverse shoulder arthroplasty in 2011. Indications appear to have expanded as a large percentage of patients did not have rotator cuff pathology. The burden from revision arthroplasties was also substantial and efforts to optimize outcomes and longevity of primary shoulder arthroplasty are needed. Level of evidence Epidemiology Study, Database Analysis PMID:25304043

Utility of an abbreviated version of the stanford-binet intelligence scales (5th ed.) in estimating 'full scale' IQ for young children with autism spectrum disorder.

PubMed

Twomey, Conal; O'Connell, Helen; Lillis, Mary; Tarpey, Sarah Louise; O'Reilly, Gary

2018-03-01

The fifth edition of the Stanford-Binet Intelligence scales allows 'full scale' IQ (FSIQ) to be estimated using an abridged version of the test-the abbreviated battery IQ (ABIQ). Set within a public early intervention team service, the current cross-sectional study investigated the utility of the ABIQ in estimating FSIQ for 40 children with autism spectrum disorder (ASD) aged 3-5 years. A strong ABIQ-FSIQ association was yielded (r = 0.89; r 2  = 0.808) and the ABIQ did not over-estimate mean FSIQ above a clinically-relevant threshold; however, clinically significant over-estimation occurred in 17.5% of individual cases. While the findings provide support for the utility of the ABIQ in estimating FSIQ for young children with ASD, caution relating to the over-estimation of FSIQ is warranted. Careful clinical judgment-ideally based on examination of previous cognitive assessment results (if available), thorough interactional observations, and close multi-disciplinary consultation-is necessary to determine the applicability of the ABIQ to individual cases. Autism Res 2018, 11: 503-508. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. We investigated the utility of a shortened version of the Stanford-Binet Intelligence Scales in estimating IQ for 40 young children with autism spectrum disorder (ASD). The findings provide qualified support for the instrument: acceptably accurate IQ estimation was achieved for most cases; but not so for a sizeable minority (17.5%). Careful clinical judgment is necessary to determine the applicability of the ABIQ to individual cases. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

Survey of resource opportunities and critical evaluation of economic requirements

NASA Technical Reports Server (NTRS)

Clark, Benton C.

1991-01-01

A series of mission analyses were performed to evaluate human mission to Mars and the moon with and without the aid of planetary resource utilization. The types of trade studies that are considered include the use of resources to manufacture propellant, food, habitat atmospheric gases, and lander habitat structure. Also, the potential for export of resources from the moon, Mars, Phobos, Deimos, and selected asteroids is also examined. In all cases, mass leveraging is evaluated. For certain cases, economic factors are evaluated as well. It is concluded that some uses are highly leveraging on the mission, whereas others have lesser impact and, therefore, should be afforded lesser priority in resource utilization studies. This survey is made with a consistent set of scaling laws for spacecraft propulsion and habitation systems and subsystems, and therefore, provides a rational basis for comparing different resource locations and use strategies.

Case study method and problem-based learning: utilizing the pedagogical model of progressive complexity in nursing education.

PubMed

McMahon, Michelle A; Christopher, Kimberly A

2011-08-19

As the complexity of health care delivery continues to increase, educators are challenged to determine educational best practices to prepare BSN students for the ambiguous clinical practice setting. Integrative, active, and student-centered curricular methods are encouraged to foster student ability to use clinical judgment for problem solving and informed clinical decision making. The proposed pedagogical model of progressive complexity in nursing education suggests gradually introducing students to complex and multi-contextual clinical scenarios through the utilization of case studies and problem-based learning activities, with the intention to transition nursing students into autonomous learners and well-prepared practitioners at the culmination of a nursing program. Exemplar curricular activities are suggested to potentiate student development of a transferable problem solving skill set and a flexible knowledge base to better prepare students for practice in future novel clinical experiences, which is a mutual goal for both educators and students.

Trading Water Conservation Credits: A Coordinative Approach for Enhanced Urban Water Reliability

NASA Astrophysics Data System (ADS)

Gonzales, P.; Ajami, N. K.

2016-12-01

Water utilities in arid and semi-arid regions are increasingly relying on water use efficiency and conservation to extend the availability of supplies. Despite spatial and institutional inter-dependency of many service providers, these demand-side management initiatives have traditionally been tackled by individual utilities operating in a silo. In this study, we introduce a new approach to water conservation that addresses regional synergies—a novel system of tradable water conservation credits. Under the proposed approach, utilities have the flexibility to invest in water conservation measures that are appropriate for their specific service area. When utilities have insufficient capacity for local cost-effective measures, they may opt to purchase credits, contributing to fund subsidies for utilities that do have that capacity and can provide the credits, while the region as whole benefits from more reliable water supplies. While similar programs have been used to address water quality concerns, to our knowledge this is one of the first studies proposing tradable credits for incentivizing water conservation. Through mathematical optimization, this study estimates the potential benefits of a trading program and demonstrates the institutional and economic characteristics needed for such a policy to be viable, including a proposed web platform to facilitate transparent regional planning, data-driven decision-making, and enhanced coordination of utilities. We explore the impacts of defining conservation targets tailored to local realities of utilities, setting credit prices, and different policy configurations. We apply these models to the case study of water utility members of the Bay Area Water Supply and Conservation Agency. Preliminary work shows that the diverse characteristics of these utilities present opportunities for the region to achieve conservation goals while maximizing the benefits to individual utilities through more flexible coordinative efforts.

OMC Compressor Case

NASA Technical Reports Server (NTRS)

Humphrey, W. Donald

1997-01-01

This report summarizes efforts expended in the development of an all-composite compressor case. Two pre-production units have been built, one utilizing V-CAP and one utilizing AFR-700B resin systems. Both units have been rig tested at elevated temperatures well above design limit loads. This report discusses the manufacturing processes, test results, and Finite Element Analysis performed. The V-CAP unit was funded by NASA-Lewis Research Center in 1994 under contract number NAS3- 27442 for Development of an All-Composite OMC Compressor Case. This contract was followed by an Air Force study in 1996 to build and identical unit using the AFR-700B resin system in place of the V-CAP system. The second compressor case was funded under U.S. Air Force contract F33615-93-D-5326, Advanced Materials for Aerospace Structures Special Studies (AMAS3), Delivery Order 0021 entitled "Advanced Polymeric Composite Materials and Structures Technology for Advanced High Temperature Gas Turbine Engines.' Initial studies using the V-CAP resin system were undertaken in 1993 under a NASA Lewis contract (NAS3-26829). A first prototype unit was developed in a joint program between Textron-Lycoming (now Allied Signal) and Brunswick (now Lincoln Composites). This unit included composite end closures using low density, high temperature molded end closures. The units was similar in size and shape to a titanium case currently used on the PT-21 0 engine and was funded as part of the integrated High Performance Turbine Engine Technology (EHPTET) initiative of DOD and NASA.

Profile of Kidney Histopathology in Cases of Burns - Particular Emphasis on Acridine Orange Fluorescence Study and to Explore its Forensic Utility

PubMed Central

Desai, Nandini J.; Gupta, B.D.; Patel, Pratik N.

2016-01-01

Introduction The major cause of death in the burn patients includes multiple organ failure and infection but, sometimes the exact cause of death in many fatally burned patients is difficult to detect. Many times in medico-legal post-mortem examinations in cases of burns, histopathological examination of organs is requested. Aim The aim was to study various histopathological changes in kidneys in the post-mortem cases of burns, by using routine Haematoxylin and Eosin stain (H&E stain), special Periodic and Schiff’s Stain (PAS) stain, to study the role of acridine orange fluorescence study, to explore the forensic utility of this microscopic study and to find out the relationship between duration of survival and histopathological changes observed. Materials and Methods An experimental longitudinal prospective study from October 2010 to September 2012. Total 32 cases of death due to burns were autopsied at mortuary, the Department of Forensic Medicine and Toxicology in our hospital. Bilateral kidneys were removed and preserved in 10% formalin solution. These were forwarded to Department of Pathology for histopathological examination. Routine microscopic examination by H&E stain as well as PAS stain and fluorescence study by acridine orange stain were done in all cases. Results It was observed that in 21 (65.63%) cases gross findings in kidneys were normal, in 06 (18.75%) were grossly pale and in 05 (15.62%) heavy & congested. Sections taken from kidneys and studied by H&E stain showed overlapping histopathological changes in all cases. In 26 (81.25%) cases, changes of Acute Tubular Necrosis (ATN) while in remaining 06 (18.75%), changes of cloudy swelling were observed. The sections stained by acridine orange and observed under fluorescent microscope were lightly positive in 15 (46.88%), brightly positive in 08 (25.00%) whereas, negative in 09 (28.12%). Conclusion Microscopy by various methods helps in getting specific lesions in kidney due to burns. However, it does not add any new tool to resolve any forensic issues of burns. Therefore, microscopy (including florescent), if done would be redundant. PMID:27190809

Benefit/cost comparison for utility SMES applications

NASA Astrophysics Data System (ADS)

Desteese, J. G.; Dagle, J. E.

1991-08-01

This paper summarizes eight case studies that account for the benefits and costs of superconducting magnetic energy storage (SMES) in system-specific utility applications. Four of these scenarios are hypothetical SMES applications in the Pacific Northwest, where relatively low energy costs impose a stringent test on the viability of the concept. The other four scenarios address SMES applications on high-voltage, direct-current (HVDC) transmission lines. While estimated SMES benefits are based on a previously reported methodology, this paper presents results of an improved cost-estimating approach that includes an assumed reduction in the cost of the power conditioning system (PCS) from approximately $160/kW to $80/kW. The revised approach results in all the SMES scenarios showing higher benefit/cost ratios than those reported earlier. However, in all but two cases, the value of any single benefit is still less than the unit's levelized cost. This suggests, as a general principle, that the total value of multiple benefits should always be considered if SMES is to appear cost effective in many utility applications. These results should offer utilities further encouragement to conduct more detailed analyses of SMES benefits in scenarios that apply to individual systems.

The Rivalry between Simulation and Problem-Based Learning: A Study of Learning Transfer in Physician Assistant Students

ERIC Educational Resources Information Center

Meyer, Kimberly E.

2010-01-01

The purpose of this dissertation was to evaluate learning transfer achieved by physician assistant students comparing two instructional methods, human patient simulation and electronic clinical case studies. This prospective, randomized, mixed-methods study utilized first and second-year physician assistant student volunteers taking a pretest and…

Like a Chameleon: A Beginning Teacher's Journey to Implement Active Learning

ERIC Educational Resources Information Center

Edwards, Susan

2017-01-01

The purpose of this study was to follow the learning trajectory of a beginning teacher attempting to implement active learning instructional methods in a middle grades classroom. The study utilized a qualitative case study methodological approach with the researcher in the role of participant observer. Three research questions were explored: the…

The Community College IR Shop and Accreditation: A Case Study

ERIC Educational Resources Information Center

Johnston, George

2011-01-01

This article presents results of a study the author recently conducted on the role of traditional institutional research (IR) offices in support of accreditation activities and institutional effectiveness. The purpose of the study was to confirm or disconfirm the utility of a theoretical model developed by Brittingham, O'Brien, and Alig (2008) of…

Internet Resources: Using Web Pages in Social Studies.

ERIC Educational Resources Information Center

Dale, Jack

1999-01-01

Contends that students in social studies classes can utilize Hypertext Markup Language (HTML) as a presentation and collaborative tool by developing websites. Presents two activities where students submitted webpages for country case studies and created a timeline for the French Revolution. Describes how to use HTML by discussing the various tags.…

Becoming Science Learners: A Study of Newcomers' Identity Work in Elementary School Science

ERIC Educational Resources Information Center

Gamez, Rebeca; Parker, Carolyn A.

2018-01-01

This study investigates how two newcomer students, Elena and Martin, identified with and in science within the context of a classroom utilizing a reform-based science curriculum where instruction occurred only in English. Using ethnographic case study methods, we drew from anthropological theories on identity development and sociocultural…

Small Claims Court.

ERIC Educational Resources Information Center

McKitric, Eloise; Davis, Janet

The study examined individuals and companies who used small claims courts and the results of decisions reached in small claims cases. A review of studies including an empirical study of two Ohio small claims courts monitored for 12 months made it clear that small claims courts need to be examined to determine if utilization and accessibility to…

Case Study of a Research Intervention: The University of Utah's Collaborative Approach.

ERIC Educational Resources Information Center

Driscoll, Amy

A report is presented on the progress of the Applying Research to Teacher Education (ARTE) Research Utilization in Elementary Teacher Education (RUETE) study. The purpose of the study is to develop preservice instruction incorporating current research findings on effective instruction and effective schools and to assess the impact of the…

Probability of detection of defects in coatings with electronic shearography

NASA Astrophysics Data System (ADS)

Maddux, Gary A.; Horton, Charles M.; Lansing, Matthew D.; Gnacek, William J.; Newton, Patrick L.

1994-07-01

The goal of this research was to utilize statistical methods to evaluate the probability of detection (POD) of defects in coatings using electronic shearography. The coating system utilized in the POD studies was to be the paint system currently utilized on the external casings of the NASA Space Transportation System (STS) Revised Solid Rocket Motor (RSRM) boosters. The population of samples was to be large enough to determine the minimum defect size for 90 percent probability of detection of 95 percent confidence POD on these coatings. Also, the best methods to excite coatings on aerospace components to induce deformations for measurement by electronic shearography were to be determined.

Probability of detection of defects in coatings with electronic shearography

NASA Technical Reports Server (NTRS)

Maddux, Gary A.; Horton, Charles M.; Lansing, Matthew D.; Gnacek, William J.; Newton, Patrick L.

1994-01-01

The goal of this research was to utilize statistical methods to evaluate the probability of detection (POD) of defects in coatings using electronic shearography. The coating system utilized in the POD studies was to be the paint system currently utilized on the external casings of the NASA Space Transportation System (STS) Revised Solid Rocket Motor (RSRM) boosters. The population of samples was to be large enough to determine the minimum defect size for 90 percent probability of detection of 95 percent confidence POD on these coatings. Also, the best methods to excite coatings on aerospace components to induce deformations for measurement by electronic shearography were to be determined.

Probability of detection of defects in coatings with electronic shearography

NASA Technical Reports Server (NTRS)

Russell, S. S.; Lansing, M. D.; Horton, C. M.; Gnacek, W. J.

1995-01-01

The goal of this research was to utilize statistical methods to evaluate the probability of detection (POD) of defects in coatings using electronic shearography. The coating system utilized in the POD studies was to be the paint system currently utilized on the external casings of the NASA space transportation system reusable solid rocket motor boosters. The population of samples was to be large enough to determine the minimum defect size for 90-percent POD of 95-percent confidence POD on these coatings. Also, the best methods to excite coatings on aerospace components to induce deformations for measurement by electronic shearography were to be determined.

Cape queer? A case study of Provincetown, Massachusetts.

PubMed

Krahulik, Karen Christel

2006-01-01

Cape Queer is a case study that details how sexuality intersects with race, gender, and class in the development of the gay and lesbian resort community, Provincetown, Massachusetts. It asks scholars to pay closer attention to the ways in which methodologies and practices utilizing LGBT studies and queer theory can combine rather than separate to interrogate LGBT and queer histories, politics and communities. In the process, it assesses how the global mechanics of capitalism led to the local queering and eventually un-queering of a gentrified, white, gay and lesbian enclave.

Biodegradability of pentachlorophenol in the environment: A literature review

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

Nakles, D.

1993-04-01

Pentachlorophenol has been widely used as a wood preserving agent for over 50 years to treat millions of electrical utility poles and crossarms. Treatment of poles with pentachlorophenol has in some cases resulted in contamination of soils, groundwater, and surface water. Environmental releases are a concern because of the potential toxicity of pentachlorophenol and its stringent regulation. Microbiological degradation of pentachlorophenol in environmental media has been demonstrated in numerous cases. The potential for pentachlorophenol to be biologically degraded is of interest to the electrical utility industry for two reasons. First, it is a factor in understanding the probable fate ofmore » pentachlorophenol where it has been released into the environment, and second, its biodegradability can potentially result in effective and economical treatment strategies for soils, water, and subsurface environments. The objective of this literature review is to collect a baseline of information on the biodegradability of pentachlorophenol in soils, surface water, and groundwater for the electric utility industry. The focus of the electric utility industry's interest in the environmental management and control of pentachlorophenol is primarily in the management of environmental media, particularly soils, that may have become incidentally contaminated with pentachlorophenol in association with the treatment, storage, or use of utility poles and crossarms. The review of the literature has found that [open quotes]unassisted[close quotes] biodegradation of pentachlorophenol in aquatic, soil, and subsurface environments may occur, presumably if there is an acclimated microbial population of sufficient density. Aerobic conditions appear to be most conducive to biodegradation in these cases. Several studies have shown that with an acclimated, mixed culture and conventional wastewater treatment approaches, pentachlorophenol can be effectively treated in water.« less

Biodegradability of pentachlorophenol in the environment: A literature review. Final report

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

Nakles, D.

1993-04-01

Pentachlorophenol has been widely used as a wood preserving agent for over 50 years to treat millions of electrical utility poles and crossarms. Treatment of poles with pentachlorophenol has in some cases resulted in contamination of soils, groundwater, and surface water. Environmental releases are a concern because of the potential toxicity of pentachlorophenol and its stringent regulation. Microbiological degradation of pentachlorophenol in environmental media has been demonstrated in numerous cases. The potential for pentachlorophenol to be biologically degraded is of interest to the electrical utility industry for two reasons. First, it is a factor in understanding the probable fate ofmore » pentachlorophenol where it has been released into the environment, and second, its biodegradability can potentially result in effective and economical treatment strategies for soils, water, and subsurface environments. The objective of this literature review is to collect a baseline of information on the biodegradability of pentachlorophenol in soils, surface water, and groundwater for the electric utility industry. The focus of the electric utility industry`s interest in the environmental management and control of pentachlorophenol is primarily in the management of environmental media, particularly soils, that may have become incidentally contaminated with pentachlorophenol in association with the treatment, storage, or use of utility poles and crossarms. The review of the literature has found that {open_quotes}unassisted{close_quotes} biodegradation of pentachlorophenol in aquatic, soil, and subsurface environments may occur, presumably if there is an acclimated microbial population of sufficient density. Aerobic conditions appear to be most conducive to biodegradation in these cases. Several studies have shown that with an acclimated, mixed culture and conventional wastewater treatment approaches, pentachlorophenol can be effectively treated in water.« less

Variability in imaging utilization in U.S. pediatric hospitals.

PubMed

Arnold, Ryan W; Graham, Dionne A; Melvin, Patrice R; Taylor, George A

2011-07-01

Use of medical imaging is under scrutiny because of rising costs and radiation exposure. We compare imaging utilization and costs across pediatric hospitals to determine their variability and potential determinants. Data were extracted from the Pediatric Health Information System (PHIS) database for all inpatient encounters from 40 U.S. children's hospitals. Imaging utilization and costs were compared by insurance type, geographical region, hospital size, severity of illness, length of stay and type of imaging, all among specific diagnoses. The hospital with the highest utilization performed more than twice as many imaging studies per patient as the hospital with the lowest utilization. Similarly, imaging costs ranged from $154 to $671/patient. Median imaging-utilization rate was 1.7 exams/patient on the ward and increased significantly in the PICU (11.8 exams/patient) and in the NICU (17.7 exams per patient, (P < 0.001). Considerable variability in imaging utilization persisted despite adjustment for case mix index (CMI, range in variation 16.6-25%). We found a significant correlation between imaging utilization and both CMI and length of stay, P < 0.0001). However, only 36% of the variation in imaging utilization could be explained by CMI. Diagnostic imaging utilization and costs vary widely in pediatric hospitals.

On the Impact of Execution Models: A Case Study in Computational Chemistry

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

Chavarría-Miranda, Daniel; Halappanavar, Mahantesh; Krishnamoorthy, Sriram

2015-05-25

Efficient utilization of high-performance computing (HPC) platforms is an important and complex problem. Execution models, abstract descriptions of the dynamic runtime behavior of the execution stack, have significant impact on the utilization of HPC systems. Using a computational chemistry kernel as a case study and a wide variety of execution models combined with load balancing techniques, we explore the impact of execution models on the utilization of an HPC system. We demonstrate a 50 percent improvement in performance by using work stealing relative to a more traditional static scheduling approach. We also use a novel semi-matching technique for load balancingmore » that has comparable performance to a traditional hypergraph-based partitioning implementation, which is computationally expensive. Using this study, we found that execution model design choices and assumptions can limit critical optimizations such as global, dynamic load balancing and finding the correct balance between available work units and different system and runtime overheads. With the emergence of multi- and many-core architectures and the consequent growth in the complexity of HPC platforms, we believe that these lessons will be beneficial to researchers tuning diverse applications on modern HPC platforms, especially on emerging dynamic platforms with energy-induced performance variability.« less

Utility assessment of a map-based online geo-collaboration tool.

PubMed

Sidlar, Christopher L; Rinner, Claus

2009-05-01

Spatial group decision-making processes often include both informal and analytical components. Discussions among stakeholders or planning experts are an example of an informal component. When participants discuss spatial planning projects they typically express concerns and comments by pointing to places on a map. The Argumentation Map model provides a conceptual basis for collaborative tools that enable explicit linkages of arguments to the places to which they refer. These tools allow for the input of explicitly geo-referenced arguments as well as the visual access to arguments through a map interface. In this paper, we will review previous utility studies in geo-collaboration and evaluate a case study of a Web-based Argumentation Map application. The case study was conducted in the summer of 2005 when student participants discussed planning issues on the University of Toronto St. George campus. During a one-week unmoderated discussion phase, 11 participants wrote 60 comments on issues such as safety, facilities, parking, and building aesthetics. By measuring the participants' use of geographic references, we draw conclusions on how well the software tool supported the potential of the underlying concept. This research aims to contribute to a scientific approach to geo-collaboration in which the engineering of novel spatial decision support methods is complemented by a critical assessment of their utility in controlled, realistic experiments.

Facilitating progress in health behaviour theory development and modification: the reasoned action approach as a case study.

PubMed

Head, Katharine J; Noar, Seth M

2014-01-01

This paper explores the question: what are barriers to health behaviour theory development and modification, and what potential solutions can be proposed? Using the reasoned action approach (RAA) as a case study, four areas of theory development were examined: (1) the theoretical domain of a theory; (2) tension between generalisability and utility, (3) criteria for adding/removing variables in a theory, and (4) organisational tracking of theoretical developments and formal changes to theory. Based on a discussion of these four issues, recommendations for theory development are presented, including: (1) the theoretical domain for theories such as RAA should be clarified; (2) when there is tension between generalisability and utility, utility should be given preference given the applied nature of the health behaviour field; (3) variables should be formally removed/amended/added to a theory based on their performance across multiple studies and (4) organisations and researchers with a stake in particular health areas may be best suited for tracking the literature on behaviour-specific theories and making refinements to theory, based on a consensus approach. Overall, enhancing research in this area can provide important insights for more accurately understanding health behaviours and thus producing work that leads to more effective health behaviour change interventions.

Breast Cancer Screening in Patients With Newly Diagnosed Lung and Colorectal Cancer: A Population-Based Study of Utilization

PubMed Central

Sadigh, Gelareh; Carlos, Ruth C.; Ward, Kevin C.; Switchenko, Jeffrey M.; Jiang, Renjian; Applegate, Kimberly E.; Duszak, Richard

2017-01-01

Purpose To assess breast cancer screening utilization in Medicare beneficiaries with colorectal and lung cancer versus cancer-free controls. Methods Female fee-for-service Medicare beneficiaries who were ≥67 years old and diagnosed with lung or colorectal cancer between 2000 and 2011 and who reported to a Surveillance, Epidemiology, and End Results (SEER) registry (case group) were followed for 2 years after their diagnoses, unless death, a diagnosis of breast cancer, or the end of 2013 came first. A similar number of cancer-free controls were individually matched to cases by age, race, registry region, and follow-up time. Screening utilization was defined as the percentage of women with ≥1 screening mammogram during follow-up. Results Overall, 104,164 cases (48% colorectal, 52% lung; 30% advanced cancer) and 104,164 controls were included. Among women with lung or colorectal cancer, 22% underwent ≥1 screening mammogram versus 26% of controls (odds ratio [OR] 0.80; 95% confidence interval [CI] 0.78–0.82). Stratified by cancer type, 28% of colorectal cancer cases versus 29% of controls (OR 0.98; 95% CI 0.95–1.01) and 17% of lung cancer cases versus 23% of controls (OR 0.63; 95% CI 0.60–0.65) received ≥1 mammogram. When stratified by stage, 8% with advanced cancer versus 18% of controls (OR 0.33; 95% CI 0.31–0.35) and 30% with early-stage cancer versus 30% of controls (OR 1; 95% CI 0.97–1.02) underwent ≥1 mammogram. Conclusion Screening mammography utilization rates are similar between Medicare beneficiaries with early-stage cancer versus controls. Although the majority of patients with advanced-stage cancer appropriately do not pursue screening mammography, a small number (8%) continue with screening. PMID:28325489

Breast Cancer Screening in Patients With Newly Diagnosed Lung and Colorectal Cancer: A Population-Based Study of Utilization.

PubMed

Sadigh, Gelareh; Carlos, Ruth C; Ward, Kevin C; Switchenko, Jeffrey M; Jiang, Renjian; Applegate, Kimberly E; Duszak, Richard

2017-07-01

To assess breast cancer screening utilization in Medicare beneficiaries with colorectal and lung cancer versus cancer-free controls. Female fee-for-service Medicare beneficiaries who were ≥67 years old and diagnosed with lung or colorectal cancer between 2000 and 2011 and who reported to a Surveillance, Epidemiology, and End Results (SEER) registry (case group) were followed for 2 years after their diagnoses, unless death, a diagnosis of breast cancer, or the end of 2013 came first. A similar number of cancer-free controls were individually matched to cases by age, race, registry region, and follow-up time. Screening utilization was defined as the percentage of women with ≥1 screening mammogram during follow-up. Overall, 104,164 cases (48% colorectal, 52% lung; 30% advanced cancer) and 104,164 controls were included. Among women with lung or colorectal cancer, 22% underwent ≥1 screening mammogram versus 26% of controls (odds ratio [OR] 0.80; 95% confidence interval [CI] 0.78-0.82). Stratified by cancer type, 28% of colorectal cancer cases versus 29% of controls (OR 0.98; 95% CI 0.95-1.01) and 17% of lung cancer cases versus 23% of controls (OR 0.63; 95% CI 0.60-0.65) received ≥1 mammogram. When stratified by stage, 8% with advanced cancer versus 18% of controls (OR 0.33; 95% CI 0.31-0.35) and 30% with early-stage cancer versus 30% of controls (OR 1; 95% CI 0.97-1.02) underwent ≥1 mammogram. Screening mammography utilization rates are similar between Medicare beneficiaries with early-stage cancer versus controls. Although the majority of patients with advanced-stage cancer appropriately do not pursue screening mammography, a small number (8%) continue with screening. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Patient ratings of case managers in a medical home: associations with patient satisfaction and health care utilization.

PubMed

Jubelt, Lindsay E; Graham, Jove; Maeng, Daniel D; Li, Huilin; Epstein, Andrew J; Metlay, Joshua P

2014-11-18

Case managers are employed in medical homes to coordinate care for clinically complex patients. To measure the association of patient perceptions of case manager performance with overall satisfaction and subsequent health care utilization. Retrospective cohort study. Integrated health system in Pennsylvania. Members of the health system-owned health plan who 1) received primary care in the health system's clinics, 2) were exposed to clinic-embedded case managers, and 3) completed a survey of satisfaction with care. Survey assessment of case manager performance and overall satisfaction with care and claims-based assessment of case manager performance and subsequent hospitalizations or emergency department visits. Survey measures were dichotomized into very good versus less than very good. A total of 1755 patients (44%) completed the survey and 1415 met study criteria. Survey respondents who reported very good ratings of case manager performance across all items had a higher probability of reporting very good overall satisfaction with care (92.2% vs. 62.5%; P < 0.001) and had a lower incidence of subsequent emergency department visits (incidence rate ratio, 0.79 [95% CI, 0.64 to 0.98]; P = 0.029) but not hospitalizations (incidence rate ratio, 0.92 [CI, 0.75 to 1.11]; P = 0.37) up to 2 years after the survey compared with survey respondents who reported less-than-very good case manager performance on 1 or more questions on the survey. Satisfaction data demonstrated substantial ceiling effects. Survey nonresponse may have introduced bias in the results. Patients' favorable perceptions of case managers are associated with higher overall satisfaction with care and may lower risk for future acute care use. Robert Wood Johnson Foundation and the U.S. Department of Veterans Affairs.

A Study on Low-Cost Case Hardening of Mild and Alloy Steels Utilizing Cassava Leaf Media

NASA Astrophysics Data System (ADS)

Gordon, Renee Erica

Conventional case hardening processes have major drawbacks in being expensive and hazardous to perform. A novel cyaniding technique has been developed to case harden steel which involves the use of cassava leaf. Cassava is ideal for use in this process as it contains varying degrees of cyanogenic glucoside (15-1000 mg of HCN per kg of cassava). The entire hardening process involves direct thermal decomposition of the HCN, which produced C and N gas that then diffused into the steel creating a hardened surface. Pulverized cassava leaf was involved in the pack-cyaniding of AISI 1018 and Nitralloy 135 within three varying process atmospheres. The use of barium carbonate (BaCO3) as an energizer was employed at the high temperature regime while barium chloride (BaCl2) was utilized at low temperatures. Vickers microhardness testing, microstructural characterization, and diffraction techniques were utilized for analysis. While no improvement was observed at low temperatures, processing within the high temperature regime showed significant hardening. The addition of BaCO3 to pulverized cassava leaf accelerated the hardening process by substantially increasing the resident surface microhardness while generating a shallow case layer distance. Diffusion theory was used to identify changes experienced with the variation in parameters. The presence of barium carbonate during processing decreased the diffusivity of hardening agents. This manifested in a very large, initial mass transfer of diffusing species localized in the case region followed by a minimum of any further increase in case depths, even as treatment time intervals were increased. The level of influence each parameter delivered was assessed using stepwise regression analysis and a unified model was constructed.

Comparisons of two moments‐based estimators that utilize historical and paleoflood data for the log Pearson type III distribution

USGS Publications Warehouse

England, John F.; Salas, José D.; Jarrett, Robert D.

2003-01-01

The expected moments algorithm (EMA) [Cohn et al., 1997] and the Bulletin 17B [Interagency Committee on Water Data, 1982] historical weighting procedure (B17H) for the log Pearson type III distribution are compared by Monte Carlo computer simulation for cases in which historical and/or paleoflood data are available. The relative performance of the estimators was explored for three cases: fixed‐threshold exceedances, a fixed number of large floods, and floods generated from a different parent distribution. EMA can effectively incorporate four types of historical and paleoflood data: floods where the discharge is explicitly known, unknown discharges below a single threshold, floods with unknown discharge that exceed some level, and floods with discharges described in a range. The B17H estimator can utilize only the first two types of historical information. Including historical/paleoflood data in the simulation experiments significantly improved the quantile estimates in terms of mean square error and bias relative to using gage data alone. EMA performed significantly better than B17H in nearly all cases considered. B17H performed as well as EMA for estimating X100 in some limited fixed‐threshold exceedance cases. EMA performed comparatively much better in other fixed‐threshold situations, for the single large flood case, and in cases when estimating extreme floods equal to or greater than X500. B17H did not fully utilize historical information when the historical period exceeded 200 years. Robustness studies using GEV‐simulated data confirmed that EMA performed better than B17H. Overall, EMA is preferred to B17H when historical and paleoflood data are available for flood frequency analysis.

Comparisons of two moments-based estimators that utilize historical and paleoflood data for the log Pearson type III distribution

NASA Astrophysics Data System (ADS)

England, John F.; Salas, José D.; Jarrett, Robert D.

2003-09-01

The expected moments algorithm (EMA) [, 1997] and the Bulletin 17B [, 1982] historical weighting procedure (B17H) for the log Pearson type III distribution are compared by Monte Carlo computer simulation for cases in which historical and/or paleoflood data are available. The relative performance of the estimators was explored for three cases: fixed-threshold exceedances, a fixed number of large floods, and floods generated from a different parent distribution. EMA can effectively incorporate four types of historical and paleoflood data: floods where the discharge is explicitly known, unknown discharges below a single threshold, floods with unknown discharge that exceed some level, and floods with discharges described in a range. The B17H estimator can utilize only the first two types of historical information. Including historical/paleoflood data in the simulation experiments significantly improved the quantile estimates in terms of mean square error and bias relative to using gage data alone. EMA performed significantly better than B17H in nearly all cases considered. B17H performed as well as EMA for estimating X100 in some limited fixed-threshold exceedance cases. EMA performed comparatively much better in other fixed-threshold situations, for the single large flood case, and in cases when estimating extreme floods equal to or greater than X500. B17H did not fully utilize historical information when the historical period exceeded 200 years. Robustness studies using GEV-simulated data confirmed that EMA performed better than B17H. Overall, EMA is preferred to B17H when historical and paleoflood data are available for flood frequency analysis.

Utilizing Thermal Mass in Refrigerated Display Cases to Reduce Peak Demand

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

Fricke, Brian A; Kuruganti, Teja; Nutaro, James J

The potential to store energy within refrigerated food products presents convenience store and supermarket operators with an opportunity to participate in utility sponsored demand response programs, whereby electricity usage can be shifted or reduced during peak periods. To determine the feasibility of reducing peak demand by shifting the refrigeration load to off-peak times, experimental and analytical analyses were performed. Simulated product, consisting of one-pint containers filled with a 50% ethylene glycol and 50% water solution, were stored in a medium-temperature vertical open refrigerated display case. Product temperature rise as a function of time was determined by turning off the refrigerationmore » to the display case, while product temperature pull-down time was subsequently determined by turning on the refrigeration to the display case. It was found that the thermal mass of the product in a medium-temperature display case was such that during a 2.5 hour period with no refrigeration, the average product temperature increased by 5.5 C. In addition, it took approximately 3.5 hours for the product to recover to its initial temperature after the refrigeration was turned on. Transient heat conduction analyses for one-dimensional objects is in good agreement with the experimental results obtained in this study. From the analysis, it appears that the thermal mass of the stored product in refrigerated display cases is sufficient to allow product temperatures to safely drift for a significant time under reduced refrigeration system operation. Thus, strategies for shifting refrigeration system electrical demand can be developed. The use of an advanced refrigeration system controller that can respond to utility signals can enable demand shifting with minimal impact.« less

Air pollution and case fatality of SARS in the People's Republic of China: an ecologic study

PubMed Central

Cui, Yan; Zhang, Zuo-Feng; Froines, John; Zhao, Jinkou; Wang, Hua; Yu, Shun-Zhang; Detels, Roger

2003-01-01

Background Severe acute respiratory syndrome (SARS) has claimed 349 lives with 5,327 probable cases reported in mainland China since November 2002. SARS case fatality has varied across geographical areas, which might be partially explained by air pollution level. Methods Publicly accessible data on SARS morbidity and mortality were utilized in the data analysis. Air pollution was evaluated by air pollution index (API) derived from the concentrations of particulate matter, sulfur dioxide, nitrogen dioxide, carbon monoxide and ground-level ozone. Ecologic analysis was conducted to explore the association and correlation between air pollution and SARS case fatality via model fitting. Partially ecologic studies were performed to assess the effects of long-term and short-term exposures on the risk of dying from SARS. Results Ecologic analysis conducted among 5 regions with 100 or more SARS cases showed that case fatality rate increased with the increment of API (case fatality = - 0.063 + 0.001 * API). Partially ecologic study based on short-term exposure demonstrated that SARS patients from regions with moderate APIs had an 84% increased risk of dying from SARS compared to those from regions with low APIs (RR = 1.84, 95% CI: 1.41–2.40). Similarly, SARS patients from regions with high APIs were twice as likely to die from SARS compared to those from regions with low APIs. (RR = 2.18, 95% CI: 1.31–3.65). Partially ecologic analysis based on long-term exposure to ambient air pollution showed the similar association. Conclusion Our studies demonstrated a positive association between air pollution and SARS case fatality in Chinese population by utilizing publicly accessible data on SARS statistics and air pollution indices. Although ecologic fallacy and uncontrolled confounding effect might have biased the results, the possibility of a detrimental effect of air pollution on the prognosis of SARS patients deserves further investigation. PMID:14629774

How Do Professional Learning Communities Foster Strong Career and Technical Education Programs of Study in Illinois Public High Schools?

ERIC Educational Resources Information Center

Custable, Wendy

2013-01-01

This research study examines how Illinois public high school Career and Technical Education educational leaders employ best practices in providing all students rigorous, relevant, and equitable learning experiences within a professional learning community structure. This study utilized a mixed method two-tier case study methodology. Tier one…

A Disability Studies Framework for Policy Activism in Postsecondary Education

ERIC Educational Resources Information Center

Gabel, Susan L.

2010-01-01

This article uses disability studies and the social model of disability as theoretical foundations for policy activism in postsecondary education. The social model is discussed and a model for policy activism is described. A case study of how disability studies and policy activism can be applied is provided utilizing the "3C Project to Provide…

Patient Satisfaction With Maternity Waiting Homes in Liberia: A Case Study During the Ebola Outbreak.

PubMed

Lori, Jody R; Munro-Kramer, Michelle L; Shifman, Jordan; Amarah, Patricia N M; Williams, Garfee

2017-03-01

Liberia in West Africa has one of the highest maternal mortality ratios in the world (990/100,000 live births). Many women in Liberia live in rural, remote villages with little access to safe maternity services. The World Health Organization has identified maternity waiting homes (MWHs) as one strategy to minimize the barrier of distance in accessing a skilled birth attendant. However, limited data exist on satisfaction with MWHs or maternal health care in Liberia. This mixed-methods case study examines women's satisfaction with their stay at a MWH and compares utilization rates before and during the Ebola outbreak. From 2012 to 2014, 650 women who stayed at one of 6 MWHs in rural Liberia during the perinatal or postnatal period were surveyed. Additionally, 60 semi-structured interviews were conducted with traditional providers, skilled birth attendants, and women utilizing the MWHs. Quantitative analyses assessed satisfaction rates before and during the Ebola outbreak. Content analysis of semi-structured interviews supplemented the quantitative data and provided a lens into the elements of satisfaction with the MWHs. The majority of women who utilized the MWHs stated they would suggest the MWH to a friend or relative who was pregnant (99.5%), and nearly all would utilize the home again (98.8%). Although satisfaction with the MWHs significantly decreased during the Ebola outbreak (P < .001), participants were satisfied overall with the MWHs. Content analysis identified areas of satisfaction that encompassed the themes of restful and supportive environment as well as areas for improvement such as lacking necessary resources and loneliness. This case study demonstrated that women using MWHs in Bong County, Liberia are generally satisfied with their experience and plan to use an MWH again during future pregnancies to access a skilled birth attendant for birth. Women are also willing to encourage family and friends to use MWHs. © 2017 by the American College of Nurse-Midwives.

Incidental Becomes Visible: A Comparison of School- and Community-Based Field Experience Narratives

ERIC Educational Resources Information Center

Holder, K. C.; Downey, Jayne A.

2008-01-01

The purpose of this study was to describe and compare student learning documented using written field experience summary narratives and occurring in community-based or school-based locations. Utilizing a hybrid portraiture--instrumental case study design, two researchers selected participants from undergraduate educational psychology courses using…

Learning to Cure, but Learning to Care?

ERIC Educational Resources Information Center

Michalec, Barret

2011-01-01

Utilizing interviews with students and a key administrator, analyses of academic schedules, and observations of courses, labs, and small groups, this study examines if and how elements of the explicit preclinical curriculum may have deleterious effects on medical students' humanitarian attributes, namely empathy. Findings from this case-study of a…

New Superintendents: Trust, Networking, and Social Capital

ERIC Educational Resources Information Center

Ripley, Joan; Mitchell, Roxanne M.; Richman, John A.

2013-01-01

This instrumental case study explored how five newly appointed superintendents identified key stakeholders and built trust and social capital with stakeholders in their districts. Stakeholder, trust, and social capital theory were the lenses that guided this study. We utilized a pragmatic research design and thematic data analysis to interpret our…

Culturally Responsive Pedagogy for Teachers of Color

ERIC Educational Resources Information Center

Gist, Conra D.

2017-01-01

This study utilizes the conceptual framework of culturally responsive pedagogy and theoretical suppositions about the culturally responsive teacher educator to examine the learning experiences of teacher candidates of color. Findings from the case study of a teacher educator's and teacher candidates' of color teaching and learning experiences in a…

An Organizational Diffusion Study on Distance Education

ERIC Educational Resources Information Center

Smith, Lillian Upton; Richter, Donna L.; Miner, Kathleen R.; Watkins, Ken; Usdan, Stuart

2005-01-01

This research explored the diffusion process of distance education in schools of public health to determine best practices in the planning and implementation of future programs. The researcher traced the diffusion process by utilizing a multiple-case study methodology using a semi-structured interview to collect the perceptions of Distance…

Increasing Student Engagement in Online Educational Leadership Courses

ERIC Educational Resources Information Center

Deschaine, Mark E.; Whale, David E.

2017-01-01

Utilization of online instruction continues to increase at universities, placing more emphasis on the exploration of issues related to adult graduate student engagement. This reflective case study reviews nontraditional student engagement in online courses. The goals of the study are to enhance student focus, attention, and interaction. Findings…

Persistence Factors of First-Generation Learners

ERIC Educational Resources Information Center

Braswell, Tawanda M.

2010-01-01

This dissertation utilized a qualitative narrative case study method to explore the unknown factors and elements of perseverance in spite of adversity and crisis. The study documented the lives of five African American women in order to describe, understand, and explain the central research question of how and why some first-generation learners…

Mind the Gap: Organizational Learning and Improvement in an Underperforming Urban System

ERIC Educational Resources Information Center

Finnigan, Kara S.; Daly, Alan J.

2012-01-01

Drawing on the theoretical lens of organizational learning, and utilizing the methodological approaches of social network and case-study analyses, our exploratory study examines whether schools under sanction exhibit the necessary processes, relationships, and social climates that support organizational learning and improvement. We also…

Gilles de la Tourette Syndrome: A Case Study.

ERIC Educational Resources Information Center

Hallenberg, Harvey

1997-01-01

Describes a Montessori teacher's experience with a sufferer of Tourette's syndrome, a dysfunction characterized by motor and vocal tics. Studies the progress over a school year, including work on academic skills utilizing the Montessori method and behavior. Shares research, successes, and failures in trying to reach the child. (SD)

Diploma Recovery: High School Graduates' Perceptions of Online Credit Recovery Programming

ERIC Educational Resources Information Center

Currier, Clay W.

2017-01-01

This phenomenological case study explored student experiences in a technology-based credit recovery program at several central Texas high schools. Students shared their perceptions about utilizing technology-based credit recovery environments. Participants in this study were ten high school graduates who had completed credit recovery courses at…

Academic Leadership in a Private University: An Iranian Case Study

ERIC Educational Resources Information Center

Hamidifar, Fatemeh; Ebrahimi, Mansoureh

2016-01-01

This study explores effective academic leadership as well as hindrances within Iran's private higher educational institutions. The author employed a qualitative approach that utilized purposive sampling to collect and analyze data. Findings were categorized into three classes comprising the (i) setting of direction, (ii) organizational and (iii)…

Pilot Decision-Making in Irreversible Emergencies

ERIC Educational Resources Information Center

Winter, Scott R.

2013-01-01

The purpose of this study was to determine if a reflexive learning treatment utilizing select case studies could enhance the decision-making of pilots who encounter an irreversible emergency. Participants, who consisted of members of the subject university's professional pilot program, were divided into either a control or experimental group and…

Vending Reimbursable Lunches to High School Students: A Study of Two Successes

ERIC Educational Resources Information Center

Carr, Deborah H.; Cross, Evelina W.

2008-01-01

Objectives: The objectives were to investigate the operational requirements for offering healthful vended reimbursable lunches to students and to identify barriers to implementation. Methods: A descriptive case study method was utilized to explore the operations of two school nutrition programs offering vended reimbursable lunches. Two school…

Student Metacognitive Responses to Feedback: A Multiple Case Study

ERIC Educational Resources Information Center

DeMello, Kate

2017-01-01

This study explored how undergraduate students perceive, self-regulate, and respond to feedback from instructors on written work. The general problem was that students in college are not prepared to practice metacognitive regulation to promote learning, particularly in the context of utilizing instructor feedback on written work to improve their…

Students with Autism Spectrum Disorders (ASD): The First-Year Postsecondary Educational Experience

ERIC Educational Resources Information Center

Shook Torres, Elizabeth

2014-01-01

This study utilized a qualitative case study interview methodology to explore the transition to postsecondary education and first-year postsecondary educational experiences of four students with Autism Spectrum Disorders (ASD). This research provided a comprehensive understanding of the first-year postsecondary educational experience of the…

Digital Education: Opportunities for Social Collaboration. Digital Education and Learning

ERIC Educational Resources Information Center

Thomas, Michael, Ed.

2011-01-01

This timely collection of theoretical and applied studies examines the pedagogical potential and realities of digital technologies in a wide range of disciplinary contexts across the educational spectrum. By mixing content-based chapters with a theoretical perspective with case studies detailing actual teaching approaches utilizing digital…

A Case Study of Leadership Pedagogy in an Organizational Behavior Class

ERIC Educational Resources Information Center

Ingerson, Kati; Bruce, Jackie

2015-01-01

The purpose of this study was to understand if selected leadership pedagogy (hands on activities) utilized in an organizational behavior classroom contributed to the development of workplace readiness skills. Since successful organizational behavior classes and hands on learning can lead to successful graduates, the importance of leadership…

A Comparison of Online and Traditional Instructional Delivery Methods on Learning in College Macroeconomics Courses

ERIC Educational Resources Information Center

Rivas, Rodolfo R.

2009-01-01

This exploratory study centered its investigation in the participants' responses provided in 2 different instructional teaching delivery methods (traditional and online) that utilized active-like teaching learning techniques (case studies, group projects, threaded discussions, class discussions, office hours, lectures, computerized assignments,…

The Role of Threshold Concepts in an Interdisciplinary Curriculum: A Case Study in Neuroscience

ERIC Educational Resources Information Center

Holley, Karri A.

2018-01-01

Threshold concepts have been widely utilized to understand learning in academic disciplines and student experiences in a disciplinary curriculum. This study considered how threshold concepts might operate within an interdisciplinary setting. Data were collected through interviews with 40 doctoral students enrolled in an interdisciplinary program…

Finding novel relationships with integrated gene-gene association network analysis of Synechocystis sp. PCC 6803 using species-independent text-mining

PubMed Central

Kreula, Sanna M.; Kaewphan, Suwisa; Ginter, Filip

2018-01-01

The increasing move towards open access full-text scientific literature enhances our ability to utilize advanced text-mining methods to construct information-rich networks that no human will be able to grasp simply from ‘reading the literature’. The utility of text-mining for well-studied species is obvious though the utility for less studied species, or those with no prior track-record at all, is not clear. Here we present a concept for how advanced text-mining can be used to create information-rich networks even for less well studied species and apply it to generate an open-access gene-gene association network resource for Synechocystis sp. PCC 6803, a representative model organism for cyanobacteria and first case-study for the methodology. By merging the text-mining network with networks generated from species-specific experimental data, network integration was used to enhance the accuracy of predicting novel interactions that are biologically relevant. A rule-based algorithm (filter) was constructed in order to automate the search for novel candidate genes with a high degree of likely association to known target genes by (1) ignoring established relationships from the existing literature, as they are already ‘known’, and (2) demanding multiple independent evidences for every novel and potentially relevant relationship. Using selected case studies, we demonstrate the utility of the network resource and filter to (i) discover novel candidate associations between different genes or proteins in the network, and (ii) rapidly evaluate the potential role of any one particular gene or protein. The full network is provided as an open-source resource. PMID:29844966

Organization of care for persons with HIV-infection: a systematic review.

PubMed

Handford, Curtis D; Tynan, Anne-Marie; Agha, Ayda; Rzeznikiewiz, Damian; Glazier, Richard H

2017-07-01

The objective of this systematic review was to examine the effectiveness of the organization of care: case management, multidisciplinary care, multi-faceted treatment, hours of service, outreach programs and health information systems on medical, immunological, virological, psychosocial and economic outcomes for persons living with HIV/AIDS. We searched PubMed (MEDLINE) and 10 other electronic databases from 1 January 1980 to April, 2012 for both experimental and controlled observational studies. Thirty-three studies met the inclusion criteria. Eleven studies were randomized controlled trials (RCTs), three of which were conducted in low-middle income settings. Patient characteristics, study design, organization measures and outcomes data were abstracted independently by two reviewers from all studies. A risk of bias tool was applied to RCTs and a separate tool was used to assess the quality of observational studies. This review concludes that case management interventions were most consistently associated with improvements in immunological outcomes but case management demonstrates no clear association with other outcome measures. The same mixed results were also identified for multidisciplinary and multi-faceted care interventions. Eight studies with an outreach intervention were identified and demonstrated improvements or non-inferiority with respect to mortality, receipt of antiretroviral medications, immunological outcomes, improvements in healthcare utilization and lower reported healthcare costs when compared to usual care. Of the interventions examined in this review, sustained in-person case management and outreach interventions were most consistently associated with improved medical and economic outcomes, in particular antiretroviral prescribing, immunological outcomes and healthcare utilization. No firm conclusions can be reached about the impact of any one intervention on patient mortality.

Compromise-based Robust Prioritization of Climate Change Adaptation Strategies for Watershed Management

NASA Astrophysics Data System (ADS)

Kim, Y.; Chung, E. S.

2014-12-01

This study suggests a robust prioritization framework for climate change adaptation strategies under multiple climate change scenarios with a case study of selecting sites for reusing treated wastewater (TWW) in a Korean urban watershed. The framework utilizes various multi-criteria decision making techniques, including the VIKOR method and the Shannon entropy-based weights. In this case study, the sustainability of TWW use is quantified with indicator-based approaches with the DPSIR framework, which considers both hydro-environmental and socio-economic aspects of the watershed management. Under the various climate change scenarios, the hydro-environmental responses to reusing TWW in potential alternative sub-watersheds are determined using the Hydrologic Simulation Program in Fortran (HSPF). The socio-economic indicators are obtained from the statistical databases. Sustainability scores for multiple scenarios are estimated individually and then integrated with the proposed approach. At last, the suggested framework allows us to prioritize adaptation strategies in a robust manner with varying levels of compromise between utility-based and regret-based strategies.

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

Ely, J.W.; Brown, T.D.; Reed, S.D.

A common trend in our industry is to minimize gel concentrations and utilize the lowest viscosity fluid available to place proppant. Barrett Resources Corporation has found, for lenticular microdarcy formations, that one of the keys for success is enhanced proppant transport. This is achieved incorporating stable gels which maintain greater than 1000 cps viscosity at bottomhole static temperature for the duration of the treatment. An extensive case study has been completed, involving over 500 fracture stimulation treatments in more than 175 wells, that illustrates the poor results achieved in the Williams Formation of the Mesaverde Group using low viscosity fluids.more » Low viscosity fluids invariably exhibit poor proppant transport. The statistical study shows that larger treatments utilizing {open_quotes}perfect proppant transport{close_quotes} fluids gain superior results. Based upon the case study, 100% economic success has been achieved upon incorporating stable fluids containing delayed breakers, reducing pad volumes to less than 5% of total job size, and minimizing echelon fractures while implementing a limited entry stimulation technique.« less

A unified framework for weighted parametric multiple test procedures.

PubMed

Xi, Dong; Glimm, Ekkehard; Maurer, Willi; Bretz, Frank

2017-09-01

We describe a general framework for weighted parametric multiple test procedures based on the closure principle. We utilize general weighting strategies that can reflect complex study objectives and include many procedures in the literature as special cases. The proposed weighted parametric tests bridge the gap between rejection rules using either adjusted significance levels or adjusted p-values. This connection is made by allowing intersection hypotheses of the underlying closed test procedure to be tested at level smaller than α. This may be also necessary to take certain study situations into account. For such cases we introduce a subclass of exact α-level parametric tests that satisfy the consonance property. When the correlation is known only for certain subsets of the test statistics, a new procedure is proposed to fully utilize this knowledge within each subset. We illustrate the proposed weighted parametric tests using a clinical trial example and conduct a simulation study to investigate its operating characteristics. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Quality of life instruments used in mental health research: properties and utilization.

PubMed

Prigent, Amélie; Simon, Sandrine; Durand-Zaleski, Isabelle; Leboyer, Marion; Chevreul, Karine

2014-01-30

Quality of life (QoL) assessment is increasingly used in mental health. Multiple instruments exist, but the conditions for choosing one instrument over another for purposes of a specific study are not clear. We performed a systematic review to identify the QoL instruments used in mental health. The instruments were systematically described regarding their intrinsic properties (e.g., generic v. disease-specific) and their characteristics of utilization in studies (e.g., study objectives). Using cluster analyses, we investigated the existence of similar instruments with respect to each of these sets of characteristics and studied potential links between instruments' intrinsic properties and their characteristics of utilization. We included 149 studies in which 56 distinct instruments were used. Similarities were found among instruments in terms of their intrinsic properties as well as their characteristics of utilization, leading to the construction of four clusters of instruments in each case. However, no relevant links were identified between instruments' intrinsic properties and their characteristics of utilization, suggesting that the choice of QoL instruments did not depend on their properties. A consensus about common QoL instruments must be reached to facilitate the choice of instruments, the comparison of results and thus to have an impact on clinical and policy decision-making. © 2013 Published by Elsevier Ireland Ltd.

Successful Downsizing Strategies.

ERIC Educational Resources Information Center

Khan, Marta

1987-01-01

Discusses techniques for reducing organizational staff while minimizing such harmful effects as layoffs, staff demoralization, and productivity losses. Case studies on the Petroleum Incentives Administration, the British Columbia Buildings Corporation, and the National Library of Canada present approaches to downsizing that utilized long range…

Paraneoplastic autoantibody panels: sensitivity and specificity, a retrospective cohort.

PubMed

Albadareen, Rawan; Gronseth, Gary; Goeden, Marcie; Sharrock, Matthew; Lechtenberg, Colleen; Wang, Yunxia

2017-06-01

Experts in the autoimmune paraneoplastic field recommend autoantibody testing as "panels" to improve the poor sensitivity of individual autoantibodies in detecting paraneoplastic neurological syndromes (PNS). The sensitivity of those panels was not reported to date in a fashion devoid of incorporation bias. We aimed to assess the collective sensitivity and specificity of one of the commonly used panels in detecting PNS. A single-centered retrospective cohort of all patients tested for paraneoplastic evaluation panel (PAVAL; test ID: 83380) over one year for the suspicion of PNS. Case adjudication was based on newly proposed diagnostic criteria in line with previously published literature, but modified to exclude serological status to avoid incorporation bias. Measures of diagnostic accuracy were subsequently calculated. Cases that failed to show association with malignancy within the follow-up time studied, reflecting a possibly pure autoimmune process was considered paraneoplastic-like syndromes. Out of 321 patients tested, 51 patients tested positive. Thirty-two patients met diagnostic criteria for paraneoplastic/paraneoplastic-like syndromes. The calculated collective sensitivity was 34% (95% CI: 17-53), specificity was 86% (95% CI: 81-90), Youden's index 0.2 and a positive clinical utility index 0.07 suggesting poor utility for case-detection. This is the first reported diagnostic accuracy measures of paraneoplastic panels without incorporation bias. Despite recommended panel testing to improve detection of PNS, sensitivity remains low with poor utility for case-detection. The high-calculated specificity suggests a possible role in confirming the condition in difficult cases suspicious for PNS, when enough supportive evidence is lacking on ancillary testing.

Utility of routine psychological screening in the childhood cancer survivor clinic.

PubMed

Recklitis, Christopher; O'Leary, Tara; Diller, Lisa

2003-03-01

This study examined the utility of routine psychologic screening in a childhood cancer survivor clinic by evaluating patient acceptance, comparing subjects' symptoms to normative data, examining the utility of specific tests, and identifying risk factors associated with psychological distress. During their annual clinic visit, 101 adult survivors of childhood cancer (median age, 25 years) completed the Symptom Checklist 90 Revised (SCL-90), as well as the Short Form 36 (SF-36), Beck Depression Inventory (BDI), and one additional suicide question. Psychological distress was operationally defined according to the published SCL-90 clinical case rule, classifying subjects with a consistent pattern of symptom elevations as clinical cases. The majority of subjects (80%) completed the screening in less than 30 minutes and reported little (15%) or no (84%) distress. Sixty-four percent believed it would help "very much" or "moderately" in getting to know them, and 35% thought it would help "slightly." On the SCL-90, 32 subjects (31.7%) had a positive screen, indicating significant psychological distress. All subjects with clinically significant symptoms on the BDI and SF-36 Mental Health Scale were cases on the SCL-90 (case-positive). Suicidal symptoms were reported in 13.9% of the sample, all of whom were SCL-90 cases. In a logistic regression model, subjects' dissatisfaction with physical appearance, poor physical health, and treatment with cranial radiation were associated with psychological distress. Results demonstrate that routine psychological screening can be successfully integrated into the cancer survivor clinic and may be effective in identifying those survivors with significant distress who require further evaluation.

Application of power transistors to residential and intermediate rating photovoltaic array power conditioners

NASA Astrophysics Data System (ADS)

Steigerwald, R. L.; Ferraro, A.; Turnbull, F. G.

1983-04-01

Power conditioning systems that interface with photovoltaic arrays are presently investigated for the cases of 5-30 kW residential systems interfacing with a 240-V single-phase utility connection, and 30-200 kW intermediate systems interfacing with a 480-V three-phase utility connection. Both systems require an isolation transformer between the array and the utility interface. A tradeoff study is conducted for numerous transistor and thyristor circuits and configurations, with weighting criteria that include full- and part-load efficiency, size, weight, reliability, ease of control, injected harmonics, reactive power requirements, and parts cost. On the basis of study results, a 10-kW high frequency transistor inverter feeding a high frequency isolation transformer with a sinusoidally shaped current wave was selected.

Population-based worksite obesity management interventions: a qualitative case study.

PubMed

Romney, Martha C; Thomson, Erin; Kash, Kathryn

2011-06-01

Due to the increased prevalence of obesity and associated direct and indirect costs to employers, weight management programs have become an integral component of employer and insurer benefits plans. The programs vary in foci, scope, breadth, and implementation. The aim of this study was to explore promising employer-sponsored population-based obesity management programs. A case study that utilized a telephonic semi-structured questionnaire was conducted with small and large organizations located in different regions of the United States that had been recruited to participate. Eight employers and 1 health care advocacy coalition who met the inclusion criteria were interviewed about features of their weight management programs. The case study revealed a number of themes consistent with reports in the literature and reflecting cited best practices. Key findings include confirmation that weight management is a significant component of the wellness strategy in all participating organizations because employers are invested in population health programs and cost savings. Based upon their experience and knowledge, occupational health specialists are responsible for designing, implementing, managing, and evaluating employee health programs. Almost all employers utilize electronic media as a prominent component of wellness and disease management initiatives. Experience has shown that incentives-both financial and nonmonetary-are effective motivators for employee engagement and outcomes. However, while employers report success, favorable outcomes have been difficult to quantify.

Work-related injuries in a state trauma registry: relationship between industry and drug screening.

PubMed

Bunn, Terry L; Slavova, Svetla; Bernard, Andrew C

2014-08-01

Work-related injuries exert a great financial and economic burden on the US population. The study objectives were to identify the industries and occupations associated with worker injuries and to determine the predictors for injured worker drug screening in trauma centers. Work-related injury cases were selected using three criteria (expected payer source of workers' compensation, industry-related e-codes, and work-related indicator) from the Kentucky Trauma Registry data set for years 2008 to 2012. Descriptive analyses and multiple logistic regression were performed on the work-related injury cases. The "other services" and construction industry sectors accounted for the highest number of work-related cases. Drugs were detected in 55% of all drug-screened work-related trauma cases. Higher percentages of injured workers tested positive for drugs in the natural resources and mining, transportation and public utilities, and construction industries. In comparison, higher percentages of injured workers in the other services as well as transportation and public utilities industries were drug screened. Treatment at Level I trauma centers and Glasgow Coma Scale (GCS) scores indicating a coma or severe brain injury were both significant independent predictors for being screened for drugs; industry was not a significant predictor for being drug screened. The injured worker was more likely to be drug screened if the worker had a greater than mild injury, regardless of whether the worker was an interfacility transfer. These findings indicate that there may be elevated drug use or abuse in natural resources and mining, transportation and public utilities, as well as construction industry workers; improved identification of the specific drug types in positive drug screen results of injured workers is needed to better target prevention efforts. Epidemiologic study, level III.

Contemporary trends in urinary tract stone surgery, a regional perspective: Auckland, New Zealand.

PubMed

Acland, George; Zargar-Shoshtari, Kamran; Rice, Michael

2016-04-01

The aim of the study is to assess the contemporary patterns of utilization of various therapeutic options for the management of nephrolithiasis in our tertiary referral institution in Auckland, New Zealand. A retrospective audit was conducted for all urinary stone procedures between January 2007 and December 2013. Procedure-related information was collected for each year. All elective and emergency procedures were included. Data were collected on the elective waiting lists for each procedure. A total of 5512 stone-related cases were performed during the study period. Six hundred and fifty-three cases were performed in 2007 compared with 945 in 2013. Total number of percutaneous nephrolithotomy (PCNLs) performed, as well as the proportion of PCNL cases, demonstrated a significant decline from 84 (12.9%) in 2007 to 67 (7.1%) in 2013. While the annual numbers of extracorporeal shock wave lithotripsy (ESWLs) have increased, the percentage of ESWLs performed relative to total stone procedures has declined from 33% to 23% over the last 4 years of this audit. There has been a significant rise in the numbers of rigid and flexible ureteroscopies, with these now being the most utilized procedure. The number of patients awaiting elective procedures declined over the duration of this audit, with an associated improvement in meeting annual demand for treatment of nephrolithiasis from 78% in 2007 to 91% in 2013. A proportional decline in PCNL and ESWL utilization with a significant increase in flexible and rigid ureteroscopic procedures has been observed over this time and this pattern has been associated with improved adherence to surgical targets despite an increasing number of cases. © 2015 Royal Australasian College of Surgeons.

Analysis of Low-Temperature Utilization of Geothermal Resources

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

Anderson, Brian

Full realization of the potential of what might be considered “low-grade” geothermal resources will require that we examine many more uses for the heat than traditional electricity generation. To demonstrate that geothermal energy truly has the potential to be a national energy source we will be designing, assessing, and evaluating innovative uses for geothermal-produced water such as hybrid biomass-geothermal cogeneration of electricity and district heating and efficiency improvements to the use of cellulosic biomass in addition to utilization of geothermal in district heating for community redevelopment projects. The objectives of this project were: 1) to perform a techno-economic analysis ofmore » the integration and utilization potential of low-temperature geothermal sources. Innovative uses of low-enthalpy geothermal water were designed and examined for their ability to offset fossil fuels and decrease CO2 emissions. 2) To perform process optimizations and economic analyses of processes that can utilize low-temperature geothermal fluids. These processes included electricity generation using biomass and district heating systems. 3) To scale up and generalize the results of three case study locations to develop a regionalized model of the utilization of low-temperature geothermal resources. A national-level, GIS-based, low-temperature geothermal resource supply model was developed and used to develop a series of national supply curves. We performed an in-depth analysis of the low-temperature geothermal resources that dominate the eastern half of the United States. The final products of this study include 17 publications, an updated version of the cost estimation software GEOPHIRES, and direct-use supply curves for low-temperature utilization of geothermal resources. The supply curves for direct use geothermal include utilization from known hydrothermal, undiscovered hydrothermal, and near-hydrothermal EGS resources and presented these results at the Stanford Geothermal Workshop. We also have incorporated our wellbore model into TOUGH2-EGS and began coding TOUGH2-EGS with the wellbore model into GEOPHIRES as a reservoir thermal drawdown option. Additionally, case studies for the WVU and Cornell campuses were performed to assess the potential for district heating and cooling at these two eastern U.S. sites.« less

Wind and turbine characteristics needed for integration of wind turbine arrays into a utility system

NASA Technical Reports Server (NTRS)

Park, G. L.

1982-01-01

Wind data and wind turbine generator (WTG) performance characteristics are often available in a form inconvenient for use by utility planners and engineers. The steps used by utility planners are summarized and the type of wind and WTG data needed for integration of WTG arrays suggested. These included long term yearly velocity averages for preliminary site feasibility, hourly velocities on a 'wind season' basis for more detailed economic analysis and for reliability studies, worst-case velocity profiles for gusts, and various minute-to-hourly velocity profiles for estimating the effect of longer-term wind fluctuations on utility operations. wind turbine data needed includes electrical properties of the generator, startup and shutdown characteristics, protection characteristics, pitch control response and control strategy, and electro-mechanical model for stability analysis.

Finding the Little 'c' in Physics: A Multiple Case Study Examining the Development of Creative Activities in the Physics Classroom

NASA Astrophysics Data System (ADS)

Wheeler, Christopher

This study focused on how physics teachers develop and implement activities that promote creative thinking strategies in the standards based physics classroom. A particular focus was placed on every day or little "c", creativity, which can be taught in the high school classroom. The study utilized a multiple case study design, which allows for in-depth study in a variety of settings. Four participants from various high schools were identified utilizing administrator recommendations. Data were then collected via interviews, observations, and documents. The data were coded and analyzed for emerging themes. The themes were then merged to determine findings to the stated research questions. The research demonstrated the importance of modifying activities for student interest and understanding through effective use of scientific inquiry. The past experiences and professional development of the participants served as a vital piece to the development of their educational pedagogy especially concerning inquiry and questioning strategies. It was also established that an unstructured, positive classroom environment is a vital aspect of teaching while supporting creative thinking skills.

Computer-Aided System Engineering and Analysis (CASE/A) Programmer's Manual, Version 5.0

NASA Technical Reports Server (NTRS)

Knox, J. C.

1996-01-01

The Computer Aided System Engineering and Analysis (CASE/A) Version 5.0 Programmer's Manual provides the programmer and user with information regarding the internal structure of the CASE/A 5.0 software system. CASE/A 5.0 is a trade study tool that provides modeling/simulation capabilities for analyzing environmental control and life support systems and active thermal control systems. CASE/A has been successfully used in studies such as the evaluation of carbon dioxide removal in the space station. CASE/A modeling provides a graphical and command-driven interface for the user. This interface allows the user to construct a model by placing equipment components in a graphical layout of the system hardware, then connect the components via flow streams and define their operating parameters. Once the equipment is placed, the simulation time and other control parameters can be set to run the simulation based on the model constructed. After completion of the simulation, graphical plots or text files can be obtained for evaluation of the simulation results over time. Additionally, users have the capability to control the simulation and extract information at various times in the simulation (e.g., control equipment operating parameters over the simulation time or extract plot data) by using "User Operations (OPS) Code." This OPS code is written in FORTRAN with a canned set of utility subroutines for performing common tasks. CASE/A version 5.0 software runs under the VAX VMS(Trademark) environment. It utilizes the Tektronics 4014(Trademark) graphics display system and the VTIOO(Trademark) text manipulation/display system.

Utilization of flow cytometry for diagnosis of hematologic malignancies in Thailand: increasing trends and diagnostic yields in 7,982 samples.

PubMed

Promsuwicha, Orathai; Kankhao, Supattra; Songmuang, Wayuree; Auewarakul, Chirayu U

2014-12-01

Diagnosis of hematologic malignancies requires a multidisciplinary approach. Flow cytometry (FCM) has become an essential tool for immunophenotypic studies of malignant hematopoietic cells. To evaluate the utilization trend of FCM and its diagnostic yields for hematologic malignancy at a major teaching hospital in Thailand. FCM results of bone marrow (BM) and peripheral blood (PB) specimens during 2000-2013 were analyzed and compared to clinical diagnosis. Overall, 7,982 specimens were submitted for diagnostic FCM including 6,561 BM and 1,421 PB. The number of specimens analyzedwas 121, 142, 164, 299, 491, 431, 690, 611, 719, 744, 725, 863, 955 and 1,027, respectively, from 2000 to 2013. The most common clinical diagnoses requested for FCM were acute leukemia (5,911 cases, 74%) followed by lymphoma (1,419 cases, 17.8%), and chronic lymphocytic leukemia (CLL) (634 cases, 7.94%). The highest diagnostic yield of FCM was found in acute leukemia cases (69.71%) followed by CLL (35.33%). Only 15.43% of clinically suspected lymphoma cases were positive by FCM. Overutilization of PB (35.6% of cases) instead of BM for lymphoma staging significantly contributed to low diagnostic yields of lymphoma by FCM as circulating tumor cells may not be present in such cases. FCM has an increasing role in the diagnosis of hematologic malignancies in Thai patients over the past 14 years with the highest diagnostic yield in acute leukemia. Appropriate specimen types and study indications are required in order to reduce futility of costly diagnostic tests and improve diagnostic yields.

Filament-wound graphite/epoxy rocket motor case

NASA Technical Reports Server (NTRS)

Humphrey, W. D.; Schmidt, W. W.

1972-01-01

The fabrication procedures are described for a filament-wound rocket motor case, approximately 56 cm long x 71 cm diameter, utilizing high tensile strength graphite fibers. The process utilized Fiberite Hy-E-1330B prepreg tape which consists of Courtaulds HTS fibers in a temperature-sensitive epoxy matrix. This fabrication effort, with resultant design, material and process recommendations, substantiates the manufacturing feasibility of graphite/epoxy rocket motor cases in the 56 cm x 71 cm size range.

Primary dermal pleomorphic liposarcoma: utility of adipophilin and MDM2/CDK4 immunostainings.

PubMed

Ramírez-Bellver, Jose L; López, Joaquín; Macías, Elena; Alegría-Landa, Victoria; Gimeno, Ignacio; Pérez-Plaza, Alejandra; Kutzner, Heinz; Requena, Luis

2017-03-01

Liposarcoma, usually arises in deep soft tissues and pleomorphic liposarcoma (PL), is the rarest histopathologic variant. However, 15 cases of entirely dermal PL have been reported. We describe a case of a 79-year-old man who developed a rapidly growing nodule on his thorax. Excisional biopsy was performed and immunohistochemical studies were carried. The lesion was a well-circumscribed dermal nodule composed of multivacuolated pleomorphic lipoblasts and atypical mitotic figures. Neoplastic cells expressed CD10 and resulted negative S100 protein, Melan-A, MITF-1, AE1/AE3, CD4, CD68 (PGM1), retinoblastoma gene family protein, pericentrine and lysozyme. Adipophilin stain showed the lipid contents in the cytoplasm of the neoplastic cells. MDM2 and CDK4 resulted both negative. A diagnosis of primary dermal PL was made. This case shows the utility of adipophilin immunostaining to prove the lipid contents in neoplastic cells, which has the advantage of using formalin-fixed paraffin-embedded tissue and making needless frozen sections and ultrastructural studies to show these findings. Negative MDM2/CDK4 staining in our case argues against the possibility of dedifferentiated liposarcoma and further supports the diagnosis of true PL. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

CD 99 immunocytochemistry in solid pseudopapillary tumor of pancreas: A study on fine-needle aspiration cytology smears.

PubMed

Ghosh, Ranajoy; Mallik, Saumya R; Mathur, Sandeep R; Iyer, Venkateswaran K

2013-07-01

Solid pseudopapillary tumor of pancreas (SPTP) is a rare pancreatic tumor of uncertain histogenesis usually affecting young women. Though these tumors have characteristic cytomorphology, it is sometimes difficult to differentiate them from neuroendocrine tumors of the pancreas. We reviewed cases of SPTP to delineate the diagnostic cytological features and also observed utility of CD 99 (MIC 2) immunostaining to aid in the diagnosis of this tumor. This study was designed to demonstrate the utility of CD 99 immunostaining along with cytological features for making a pre-operative diagnosis and delineating it from the neuroendocrine tumor of pancreas which is a close mimic. Cytomorphological features of 11 cases of solid pseudopapillary neoplasm diagnosed by pre-operative fine-needle aspiration cytology (FNAC) at our institute were reviewed. Immunocytochemistry for CD 99 was also performed on the smears. All the cases had cellular smears with monomorphic cells lying singly, as loosely cohesive clusters as well as forming delicate pseudopapillae. Presence of intra and extra-cellular basement membrane material, background foamy macrophages and nuclear grooves were the other salient features. Immunocytochemistry for CD 99 could be performed on eight cases and demonstrated typical paranuclear dot-like positivity. Pre-operative early diagnosis of SPTP can be made by FNAC which can further be aided by CD 99 immunocytochemistry.

Clinical utility of therapeutic drug monitoring in biological disease modifying anti-rheumatic drug treatment of rheumatic disorders: a systematic narrative review.

PubMed

Van Herwaarden, Noortje; Van Den Bemt, Bart J F; Wientjes, Maike H M; Kramers, Cornelis; Den Broeder, Alfons A

2017-08-01

Biological Disease Modifying Anti-Rheumatic Drugs (bDMARDs) have improved the treatment outcomes of inflammatory rheumatic diseases including Rheumatoid Arthritis and spondyloarthropathies. Inter-individual variation exists in (maintenance of) response to bDMARDs. Therapeutic Drug Monitoring (TDM) of bDMARDs could potentially help in optimizing treatment for the individual patient. Areas covered: Evidence of clinical utility of TDM in bDMARD treatment is reviewed. Different clinical scenarios will be discussed, including: prediction of response after start of treatment, prediction of response to a next bDMARD in case of treatment failure of the first, prediction of successful dose reduction or discontinuation in case of low disease activity, prediction of response to dose-escalation in case of active disease and prediction of response to bDMARD in case of flare in disease activity. Expert opinion: The limited available evidence does often not report important outcomes for diagnostic studies, such as sensitivity and specificity. In most clinical relevant scenarios, predictive value of serum (anti-) drug levels is absent, therefore the use of TDM of bDMARDs cannot be advocated. Well-designed prospective studies should be done to further investigate the promising scenarios to determine the place of TDM in clinical practice.

Software Tech News. The DoD Source for Software Technology Information. Software Testing Series: Part 2, Volume 3, Number 3, 1999

DTIC Science & Technology

1999-01-01

published in December of 1998. In addition, Mr. Drake is the author of a theme article entitled: "Measuring Software Quality: A Case Study...and services may run on different platforms in differing combinations , • Partial application failure (e.g., a client running, service down) is...result in a combined utility function that is some aggregation of the underlying utility functions. The benefit a client receives from a service

Accounting-Induced Distortion in Public Enterprise Pricing

NASA Astrophysics Data System (ADS)

Moncur, James E. T.; Pollock, Richard L.

1996-11-01

Municipal water utilities commonly aim to set prices at average cost. Because of various omissions and owing to inflation, unadjusted accounting data understate the economic costs of fixed assets and thus generate inefficiently low prices and high consumption rates for the output of these enterprises. We investigate the nature and extent of undercosting and underpricing for a group of large urban water utilities in the United States. Economic costs appear to be significantly greater than the corresponding accounting measures for the cases studied.

The incremental impact of cardiac MRI on clinical decision-making.

PubMed

Rajwani, Adil; Stewart, Michael J; Richardson, James D; Child, Nicholas M; Maredia, Neil

2016-01-01

Despite a significant expansion in the use of cardiac MRI (CMR), there is inadequate evaluation of its incremental impact on clinical decision-making over and above other well-established modalities. We sought to determine the incremental utility of CMR in routine practice. 629 consecutive CMR studies referred by 44 clinicians from 9 institutions were evaluated. Pre-defined algorithms were used to determine the incremental influence on diagnostic thinking, influence on clinical management and thus the overall clinical utility. Studies were also subdivided and evaluated according to the indication for CMR. CMR provided incremental information to the clinician in 85% of cases, with incremental influence on diagnostic thinking in 85% of cases and incremental impact on management in 42% of cases. The overall incremental utility of CMR exceeded 90% in 7 out of the 13 indications, whereas in settings such as the evaluation of unexplained ventricular arrhythmia or mild left ventricular systolic dysfunction, this was <50%. CMR was frequently able to inform and influence decision-making in routine clinical practice, even with analyses that accepted only incremental clinical information and excluded a redundant duplication of imaging. Significant variations in yield were noted according to the indication for CMR. These data support a wider integration of CMR services into cardiac imaging departments. These data are the first to objectively evaluate the incremental value of a UK CMR service in clinical decision-making. Such data are essential when seeking justification for a CMR service.

Utility of a non-invasive serum biomarker panel for diagnosis and monitoring of eosinophilic esophagitis: A prospective study

PubMed Central

Dellon, Evan S.; Rusin, Spencer; Gebhart, Jessica H.; Covey, Shannon; Higgins, Leana L.; Beitia, RoseMary; Speck, Olga; Woodward, Kimberly; Woosley, John T.; Shaheen, Nicholas J.

2015-01-01

Objectives Non-invasive biomarkers would be valuable for diagnosis and monitoring of eosinophilic esophagitis (EoE). The aim of this study was to determine the utility of a panel of serum biomarkers for the diagnosis and management of EoE. Methods We conducted a prospective cohort study of consecutive adults undergoing outpatient EGD. Incident cases of EoE were diagnosed per consensus guidelines; controls had GERD or dysphagia and did not meet EoE criteria. EoE cases were treated with topical steroids and had repeat endoscopy. Pre- and post-treatment serum samples were analyzed in a blinded fashion for: IL-4, IL-5, IL-6, IL-9, IL-13, TGF-α, TGF-β, TNF-α, eotaxin-1, -2, and -3, TSLP, major basic protein (MBP), and eosinophil-derived neurotoxin (EDN). Cases and controls were compared at baseline, and pre- and post-treatment assays were compared in cases. Results A total of 61 incident EoE cases and 87 controls were enrolled; 51 EoE cases had post-treatment serum analyzed. There were no significant differences in any of the biomarkers between EoE cases and controls at baseline. IL-13 and eotaxin-3 for cases and controls were 85 ±160 vs 43 ±161 pg/mL (p=0.12), and 41 ±159 vs 21 ±73 (p=0.30). There were no significant differences in assay values among cases before and after treatment. There were also no differences after stratification by atopic status or treatment response. Conclusions A panel of inflammatory factors known to be associated with EoE pathogenesis were not increased in the serum, nor were they responsive to therapy. None of these biomarkers are likely candidates for a serum test for EoE. Histologic analysis for diagnosis and management of EoE continues to be necessary, and novel, less invasive, biomarkers are needed. PMID:25781367

Barriers and Facilitators of Utilizing Research Among Nurses in Nepal.

PubMed

Kc, Srijana; Subramaniam, Prithwi Raj; Paudel, Sarita

2016-04-01

This study determined the perceived barriers to and facilitators of Nepalese nurses in utilizing research in the workplace. Evidence-based nursing practice provides the synergy for high-quality patient care, but it does not seem to be the case in underdeveloped countries, such as Nepal. A descriptive, cross-sectional study involving 97 nurses from Nepal was conducted. Data were collected using the BARRIERS Scale and a facilitator questionnaire. The top three barriers to research utilization in Nepalese nurses are (a) research reports and articles are not readily available (80.5%), (b) inadequate facilities for implementation (75.3%), and (c) research reports and articles are not published fast enough (71.6%). The top three facilitators perceived to encourage Nepalese nurses to utilize or participate in research are (a) initiation of nursing research projects (27.4%), (b) educational update on research methods (16.7%), and (c) provision of funding for research (15.5%). Findings from this study mirror the barriers to research utilization experienced by nurses in other countries. Macro- and micro-level support are needed to foster a culture of evidence-based practice among Nepalese nurses to empower them in making informed decisions based on research in providing quality patient care. Copyright 2016, SLACK Incorporated.

Balancing autonomy and utilization of solar power and battery storage for demand based microgrids

NASA Astrophysics Data System (ADS)

Lawder, Matthew T.; Viswanathan, Vilayanur; Subramanian, Venkat R.

2015-04-01

The growth of intermittent solar power has developed a need for energy storage systems in order to decouple generation and supply of energy. Microgrid (MG) systems comprising of solar arrays with battery energy storage studied in this paper desire high levels of autonomy, seeking to meet desired demand at all times. Large energy storage capacity is required for high levels of autonomy, but much of this expensive capacity goes unused for a majority of the year due to seasonal fluctuations of solar generation. In this paper, a model-based study of MGs comprised of solar generation and battery storage shows the relationship between system autonomy and battery utilization applied to multiple demand cases using a single particle battery model (SPM). The SPM allows for more accurate state-of-charge and utilization estimation of the battery than previous studies of renewably powered systems that have used empirical models. The increased accuracy of battery state estimation produces a better assessment of system performance. Battery utilization will depend on the amount of variation in solar insolation as well as the type of demand required by the MG. Consumers must balance autonomy and desired battery utilization of a system within the needs of their grid.

Effect of private health insurance on health care utilization in a universal public insurance system: a case of South Korea.

PubMed

Jeon, Boyoung; Kwon, Soonman

2013-11-01

This study examined the effect of private health insurance (PHI) on health care utilization in South Korea using a nationally representative sample of 9512 adults participating in Korea Health Panel Survey (KHPS). We compared the health care utilization and subsequent expenditure according to whether or not and how many PHIs are purchased, controlling for the endogeneity of insurance purchase by propensity score matching method and Heckman-type treatment effect model. The results of this study show that the probability of any health care utilization, both outpatient care and inpatient care, is higher for the people who have PHI. For those who utilize health care, PHI has a positive impact on outpatient expenditure, but not on the number of outpatient visits. The effect of PHI on the number of inpatient days and expenditure is not statistically significant among the users of inpatient care. These results imply a need for policy options to mitigate the moral hazard effect of PHI in the outpatient care sector. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Application of cooperative and non-cooperative games in large-scale water quantity and quality management: a case study.

PubMed

Mahjouri, Najmeh; Ardestani, Mojtaba

2011-01-01

In this paper, two cooperative and non-cooperative methodologies are developed for a large-scale water allocation problem in Southern Iran. The water shares of the water users and their net benefits are determined using optimization models having economic objectives with respect to the physical and environmental constraints of the system. The results of the two methodologies are compared based on the total obtained economic benefit, and the role of cooperation in utilizing a shared water resource is demonstrated. In both cases, the water quality in rivers satisfies the standards. Comparing the results of the two mentioned approaches shows the importance of acting cooperatively to achieve maximum revenue in utilizing a surface water resource while the river water quantity and quality issues are addressed.

Ventura County fare integration : a case study : promoting seamless regional fare coordination

DOT National Transportation Integrated Search

2001-09-01

This report details the approach taken in one specific region to plan, operate, and maintain a multi-agency, transit fare collection payment system demonstration utilizing smart card technology as well as other ITS (intelligent transportation systems...

Traumatic hallux varus repair utilizing a soft-tissue anchor: a case report.

PubMed

Labovitz, J M; Kaczander, B I

2000-01-01

Hallux varus is usually iatrogenic in nature; however, congenital and acquired etiologies have been described in the literature. The authors present a case of traumatic hallux varus secondary to rupture of the adductor tendon. Surgical correction was performed using a soft tissue anchor for maintenance of the soft tissues utilized for repair.

Evolution and Personal Religious Belief: Christian University Biology-Related Majors' Search for Reconciliation

ERIC Educational Resources Information Center

Winslow, Mark W.; Staver, John R.; Scharmann, Lawrence C.

2011-01-01

The goal of this study was to explore Christian biology-related majors' perceptions of conflicts between evolution and their religious beliefs. This naturalistic study utilized a case study design of 15 undergraduate biology-related majors at or recent biology-related graduates from a mid-western Christian university. The broad sources of data…

The Perception of Public Secondary Education through the Lens of African American Male Students

ERIC Educational Resources Information Center

Dandridge, Janae' K.

2012-01-01

This study examines the perspective of public secondary education through the lived experiences and voices of 10 African American male students. The study was qualitative in nature and utilized an action research case study design. The researcher conducted semi structured interviews with a randomly selected group of African American male students…

Enhancing Writing Achievement through a Digital Learning Environment: Case Studies of Three Struggling Adolescent Male Writers

ERIC Educational Resources Information Center

Pruden, Manning; Kerkhoff, Shea N.; Spires, Hiller A.; Lester, James

2017-01-01

The aim of this study was to explore how "Narrative Theatre," a narrative-centered digital learning environment, supported the writing processes of 3 struggling adolescent male writers. We utilized a multicase study approach to capture 3 sixth-grade participants' experiences with the digital learning environment before, during, and after…

An Examination of Amotivated Students within the Sport Education Model

ERIC Educational Resources Information Center

Perlman, Dana

2012-01-01

The purpose of this study was to examine the perceptions and experiences of 33 amotivated students (i.e. students with low levels of motivation) during four consecutive seasons of the Sport Education Model. A qualitative case-study approach was utilized within this study and data was collected using interviews, field notes and reflective journals.…

P-20 Education Policy: School to College Transition Policy in Washington State

ERIC Educational Resources Information Center

Pitre, Paul E.

2011-01-01

This study examines Washington State's attempt to move toward an integrated, P-20 system of education that enhances student transitions from high school to college. In analyzing Washington as a single case study, a profile of the state is developed on key access related characteristics. Data for this study were gathered utilizing fundamental case…

Impediments to the Successful Reconstruction of African Immigrant Teachers' Professional Identities in South African Schools

ERIC Educational Resources Information Center

Vandeyar, Saloshna; Vandeyar, Thirusellvan; Elufisan, Kolawole

2014-01-01

The purpose of this study was to explore difficulties and challenges that confront African immigrant teachers as they attempt to reconstruct their professional identities in South African schools. The study was qualitative in nature and utilized narrative inquiry and the case study approach. Data-gathering techniques included a mix of…

Dynamic Analysis of UTAUT: The Case of Microsoft Project Management Software

ERIC Educational Resources Information Center

Abualbasal, Wejdan; Abu-Shanab, Emad; Al-Quraan, Heba

2016-01-01

The technology adoption domain is rich with studies that utilized a cross-sectional snapshot of subjects' perceptions regarding the adoption of new technology. This research tried to implement a longitudinal study that took three measures within 4 months to estimate the influence of time and experience on students' perceptions. The study adopted a…

Parent Education for Dialogic Reading: Online and Face-to-Face Delivery Methods

ERIC Educational Resources Information Center

Beschorner, Beth; Hutchison, Amy

2016-01-01

This study explored the impact of a parent education program and the contextual factors that influenced the experiences of families in the program. Seventeen parents completed a 9-week, face-to-face program and 15 parents completed a similar online program. This study was designed as a multiple case study and utilized multimethods for data…

What Equivocal Data from Single Case Comparison Studies Reveal about Evidence-Based Practices in Early Childhood Special Education

ERIC Educational Resources Information Center

Ledford, Jennifer R.; Barton, Erin E.; Hardy, Jessica K.; Elam, Katie; Seabolt, Jordan; Shanks, Meredith; Hemmeter, M. L.; Kaiser, Ann

2016-01-01

Although comparison studies are important in early intervention/early childhood special education (EI/ECSE), results of well-designed comparison studies are likely to be unpublished because of undifferentiated or differently differentiated results across participants. The purpose of this article is to highlight the utility of comparison designs in…

A Study of the Barriers K-12 Teachers Encounter when Integrating Technology into the Curriculum

ERIC Educational Resources Information Center

Brown-Joseph, Theresa Denise

2010-01-01

This study utilized an outlined plan for a qualitative case study to explore the perceived barriers that teachers in K-12 grades encounter when integrating technology into the curriculum. A purposive sample of 20 teachers from both elementary and high schools provided information during structured interviews about their experiences with…

Sex offender polygraph examination: an evidence-based case management tool for social workers.

PubMed

Levenson, Jill S

2009-10-01

This article will review the use of polygraphy in the assessment and treatment of sexual perpetrators. Such information can be utilized by social workers who are involved in the treatment and case management of child sexual abuse cases. First, the controversial literature regarding the validity and reliability of polygraph examination in general will be reviewed. Next, an emerging body of evidence supporting the utility of polygraph testing with sex offenders will be discussed. Finally, ways that social workers can incorporate this knowledge into their case management and clinical roles will be offered.

The Social Justice Leadership Retreat: A Phenomenological Case Study of Students' Construction of Race and Its Influence on Beliefs, Behavior, and Actions

ERIC Educational Resources Information Center

Bettendorf, Anthony J.

2016-01-01

This study examines students' participation in an intensive intercultural experience, the Social Justice Leadership Retreat. The study utilizes the Intercultural Maturity Model, leadership and democracy outcomes as a framework for the research. Specifically, the study investigates how this experience impacts the ways students make meaning of…

Diagnostic Imaging Services in Magnet and Non-Magnet Hospitals: Trends in Utilization and Costs.

PubMed

Jayawardhana, Jayani; Welton, John M

2015-12-01

The purpose of this study was to better understand trends in utilization and costs of diagnostic imaging services at Magnet hospitals (MHs) and non-Magnet hospitals (NMHs). A data set was created by merging hospital-level data from the American Hospital Association's annual survey and Medicare cost reports, individual-level inpatient data from the Healthcare Cost and Utilization Project, and Magnet recognition status data from the American Nurses Credentialing Center. A descriptive analysis was conducted to evaluate the trends in utilization and costs of CT, MRI, and ultrasound procedures among MHs and NMHs in urban locations between 2000 and 2006 from the following ten states: Arizona, California, Colorado, Florida, Iowa, Maryland, North Carolina, New Jersey, New York, and Washington. When matched by bed size, severity of illness (case mix index), and clinical technological sophistication (Saidin index) quantiles, MHs in higher quantiles indicated higher rates of utilization of imaging services for MRI, CT, and ultrasound in comparison with NMHs in the same quantiles. However, average costs of MRI, CT, and ultrasounds were lower at MHs in comparison with NMHs in the same quantiles. Overall, MHs that are larger in size (number of beds), serve more severely ill patients (case mix index), and are more technologically sophisticated (Saidin index) show higher utilization of diagnostic imaging services, although costs per procedure at MHs are lower in comparison with similar NMHs, indicating possible cost efficiency at MHs. Further research is necessary to understand the relationship between the utilization of diagnostic imaging services among MHs and its impact on patient outcomes. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

The Publication Rate of Abstracts Presented at the 2003 Urological Brazilian Meeting

PubMed Central

Oliveira, Leonardo Resende Sousa; Figueiredo, André Avarese; Choi, Mauro; Ferrarez, Carlos Eduardo Prata Fernandes; Bastos, Andre Netto; Netto, Jose Murillo Bastos

2009-01-01

OBJECTIVE: To determine the publication rate of orally-presented abstracts from the 2003 Urological Brazilian Meeting, as well as the factors determining this publication rate. MATERIALS AND METHODS: The publication rate of the 313 orally-presented abstracts at the 2003 Urological Brazilian Meeting was evaluated by scanning the Lilacs, Scielo and Medline databases. The time between presentation and publication, the state and country of the abstract, the research methodology (cross-sectional, case-control, retrospective case series, prospective case series or clinical trial), whether drugs were utilized and the topic of the study were all characterized. RESULTS: Thirty-nine percent of the abstracts were published after a median time of 14 months (range: 1 to 51 months). There were high publication rates for cross-sectional abstracts (75%), drug utilization studies (51.3%), clinical trials (50%) and prospective case series’ (48.1%). However, there was only a moderate statistical trend towards a higher publication rate in the prospective case series (p=0.07), while the retrospective case series’ showed statistically lower publication rates than the other groups (33.7%, p=0.04). Abstracts on laparoscopic surgery had the highest publication rate (61.9%, p=0.03) compared to others topics. In 57% of the unpublished abstracts, there was no interest in or attempt to publish, and rejection was responsible for the lack of publication of only 4% of the abstracts. CONCLUSION: The publication rate of the orally-presented abstracts from the 2003 Urological Brazilian Meeting was comparable to that of international congresses. The subsequent publication of presented abstracts and the selection of prospective studies with stronger evidence should be encouraged and may improve the scientific quality of the meeting. PMID:19488593

From ICT Coordination to ICT Integration: A Longitudinal Case Study

ERIC Educational Resources Information Center

Tondeur, J.; Cooper, M.; Newhouse, C. P.

2010-01-01

This study utilizes a school-improvement perspective to examine the role of curriculum coordination in the integration of information and communication technologies (ICT) into primary schools. The nature and impact of this role is examined in seven primary schools in Australia. These seven schools were drawn from a longitudinal intervention that…

Selection of Sustainable Processes using Sustainability Footprint Method: A Case Study of Methanol Production from Carbon Dioxide

EPA Science Inventory

Chemical products can be obtained by process pathways involving varying amounts and types of resources, utilities, and byproduct formation. When such competing process options such as six processes for making methanol as are considered in this study, it is necessary to identify t...

Effective Leadership Practices Exercised by Elementary Principals in Turnaround Schools

ERIC Educational Resources Information Center

Tietjen, Jill Deanne

2014-01-01

The purpose of this study was to identify effective leadership practices, processes, and strategies utilized by elementary school principals in low-achieving schools as well as to discuss and identify leadership practices as they emerged in the literature. Qualitative methods in the form of case studies of three elementary school principals…

Empathetic and Pro-Social Awareness in Primary School Students: A Case Study

ERIC Educational Resources Information Center

Dar, Fatima Rehan

2016-01-01

The study addressed a cognitive-affective gap in a primary English curriculum and noticed whether the curriculum, texts and class activities utilized empathetic and pro-social themes in teaching English language. The findings from the document review, interviews and observations revealed that the said themes were underrepresented in the…

Parent-Infant Vocalisations at 12 Months Predict Psychopathology at 7 Years

ERIC Educational Resources Information Center

Allely, C. S.; Purves, D.; McConnachie, A.; Marwick, H.; Johnson, P.; Doolin, O.; Puckering, C.; Golding, J.; Gillberg, C.; Wilson, P.

2013-01-01

This study investigated the utility of adult and infant vocalisation in the prediction of child psychopathology. Families were sampled from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort. Vocalisation patterns were obtained from 180 videos (60 cases and 120 randomly selected sex-matched controls) of parent-infant…

An Examination of Educators' Perceptions of the School's Role in the Prevention of Childhood Obesity

ERIC Educational Resources Information Center

Johnson, Sharon Kay Harris

2011-01-01

Childhood obesity is a prevalent subject of research currently, and many researchers have studied the effectiveness of school programs in battling obesity among students. This case study, utilizing ethnographic tools of observation, interviews, and investigation of artifacts, examines educators' perceptions of the role of the school in the…

"Clustering" Documents Automatically to Support Scoping Reviews of Research: A Case Study

ERIC Educational Resources Information Center

Stansfield, Claire; Thomas, James; Kavanagh, Josephine

2013-01-01

Background: Scoping reviews of research help determine the feasibility and the resource requirements of conducting a systematic review, and the potential to generate a description of the literature quickly is attractive. Aims: To test the utility and applicability of an automated clustering tool to describe and group research studies to improve…

Elementary School Consolidation and Reconfiguration: An Autoethnographic Case Study

ERIC Educational Resources Information Center

Winer, Ellen J.

2010-01-01

This qualitative study was designed to examine the processes and practices that occurred before, during and after consolidation of the four elementary schools in the Great Local School district with the goal of developing a conceptual framework to be utilized by school districts that plan on implementing a school consolidation or reconfiguration.…

What Really Happens to Complimentary Textbook Software? A Case Study in Software Utilization.

ERIC Educational Resources Information Center

Vernon, Robert F.

1993-01-01

Discussion of complimentary computer software for college-level textbooks focuses on a study that investigated how a complimentary program was used and identified factors that influenced its use or nonuse. Barriers to use are described, including personal, technical, process, political, and economic factors. (Contains four references.) (LRW)

Framing Innovation: The Role of Distributed Leadership in Gaining Acceptance of Large-Scale Technology Initiatives

ERIC Educational Resources Information Center

Turner, Henry J.

2014-01-01

This dissertation of practice utilized a multiple case-study approach to examine distributed leadership within five school districts that were attempting to gain acceptance of a large-scale 1:1 technology initiative. Using frame theory and distributed leadership theory as theoretical frameworks, this study interviewed each district's…

The Effect of Suspension as a Deterrent to Student Misconduct

ERIC Educational Resources Information Center

Jackson, Angela Coleman

2014-01-01

The purpose of this study was to examine the effect of suspension as a deterrent to student misconduct. A mixed methods approach using both qualitative (interviews of administrators and teachers) and quantitative (discipline records of identified sixth graders) were utilized. In this case study approach, one-on-one semi-structured interviews were…

A Model for Integrating New Technologies into Pre-Service Teacher Training Programs Ajman University (A Case Study)

ERIC Educational Resources Information Center

Shaqour, Ali Zuhdi H.

2005-01-01

This study introduces a "Technology Integration Model" for a learning environment utilizing constructivist learning principles and integrating new technologies namely computers and the Internet into pre-service teacher training programs. The technology integrated programs and learning environments may assist learners to gain experiences…

Community Mental Health Systems Generate New Chronics: The Study of a Pure Case.

ERIC Educational Resources Information Center

Lieberman, Harvey J.; And Others

1988-01-01

Study indicated that, although well-integrated comprehensive community mental health system (CMHS) dramatically reduces utilization of long-stay inpatient beds compared to traditional health care systems, it does not banish appearance of "new chronic" patients from a catchment area. CMHS new chronic patients were younger, mostly male,…

Research Report: A Case Study of Some Performance Indicators in Higher Education in the United Kingdom

ERIC Educational Resources Information Center

Birch, D. W.; And Others

1977-01-01

The potential for performance indicators for the teaching function in higher education was examined. Study of data from Lanchester Polytechnic and Loughborough University indicates that there is support for the systematic collection of data on instruction and resource utilization patterns within and across institutions. (Author/LBH)

Collaboration, Intragroup Conflict, and Social Skills in Project-Based Learning

ERIC Educational Resources Information Center

Lee, Dabae; Huh, Yeol; Reigeluth, Charles M.

2015-01-01

This case study was conducted in two high school classrooms that utilized collaborative project-based learning (PBL). Collaboration is an important instructional strategy, especially used in conjunction with PBL, and is an essential learning outcome for the twenty-first century. This study examined how collaboration can be achieved as a learning…

The College-Choice Process of High Achieving Freshmen: A Comparative Case Study

ERIC Educational Resources Information Center

Dale, Amanda

2010-01-01

The purpose of this study was to examine the college-choice process of high achieving students. Employing current literature and previous research, it combined current models of college choice and the influential factors identified throughout the literature while utilizing the concept of bounded rationality to create a conceptual framework to…

Adult Day Health Center Participation and Health-Related Quality of Life

ERIC Educational Resources Information Center

Schmitt, Eva M.; Sands, Laura P.; Weiss, Sara; Dowling, Glenna; Covinsky, Kenneth

2010-01-01

Purpose: The purpose of this study was to assess the association between Adult Day Health Center (ADHC) participation and health-related quality of life. Design and Methods: Case-controlled prospective study utilizing the Medical Outcomes Survey Form 36 (SF-36) to compare newly enrolled participants from 16 ADHC programs with comparable…

Day Service Provision for People with Intellectual Disabilities: A Case Study Mapping 15-Year Trends in Ireland

ERIC Educational Resources Information Center

Fleming, Padraic; McGilloway, Sinead; Barry, Sarah

2017-01-01

Background: Day services for people with intellectual disabilities are experiencing a global paradigm shift towards innovative person-centred models of care. This study maps changing trends in day service utilization to highlight how policy, emergent patterns and demographic trends influence service delivery. Methods: National intellectual…

Case Study of Characteristics of Effective Leadership in Graduate Student Collaborative Work

ERIC Educational Resources Information Center

Duemer, Lee S.; Christopher, Mary; Hardin, Fred; Olibas, Lezlie; Rodgers, Terry; Spiller, Kevin

2004-01-01

The purpose of the study was to determine the effective leadership characteristics of graduate students working in a collaborative setting. A secondary goal was to develop recommendations that will help faculty better utilize group collaboration as a learning experience for graduate students. Data consisted of interviews of graduate students who…

Examining an Evolution: A Case Study of Organizational Change Accompanying the Community College Baccalaureate

ERIC Educational Resources Information Center

McKinney, Lyle; Morris, Phillip A.

2010-01-01

This study examined the nature and degree of organizational change that occurs when community colleges offer their own baccalaureate degree programs. Utilizing qualitative research methodology, we investigated how executive administrators at two Florida colleges managed this momentous change process and how this transformation has affected their…

A Comparative Assessment of Higher Education Financing in Six Arab Countries

ERIC Educational Resources Information Center

El-Araby, Ashraf

2011-01-01

This study analyses the policies for financing higher education in six Arab countries: Egypt, Jordan, Lebanon, Morocco, Syria, and Tunisia. It assesses the adequacy of spending on higher education, the efficiency with which resources are utilized, and the equity implications of resource allocations. Based on six detailed case studies, this…

Compilation of Case Studies: Exemplary Placement and Follow-Up Studies.

ERIC Educational Resources Information Center

Dale, Jack

Examples of placement and follow-up conceptual models developed for a program of vocational education (kindergarten through university) are presented. Section 1 contains a historical overview of placement and follow-up activities in Florida and describes a comprehensive model. Section 2, describing a model for utilizing community resources for the…

Study of the Half-Day/Full-Day Kindergarten Model

ERIC Educational Resources Information Center

McInroy, Thomas R.

2012-01-01

This case study and problem analysis was an in-depth investigation of the half-day/full-day kindergarten model by utilizing interviews and focus groups to provide insight from parents, teachers, and other district personnel as to how the model has impacted the social, emotional, and academic development of the participating students. This study…

Review of the Reported Measures of Clinical Validity and Clinical Utility as Arguments for the Implementation of Pharmacogenetic Testing: A Case Study of Statin-Induced Muscle Toxicity.

PubMed

Jansen, Marleen E; Rigter, T; Rodenburg, W; Fleur, T M C; Houwink, E J F; Weda, M; Cornel, Martina C

2017-01-01

Advances from pharmacogenetics (PGx) have not been implemented into health care to the expected extent. One gap that will be addressed in this study is a lack of reporting on clinical validity and clinical utility of PGx-tests. A systematic review of current reporting in scientific literature was conducted on publications addressing PGx in the context of statins and muscle toxicity. Eighty-nine publications were included and information was selected on reported measures of effect, arguments, and accompanying conclusions. Most authors report associations to quantify the relationship between a genetic variation an outcome, such as adverse drug responses. Conclusions on the implementation of a PGx-test are generally based on these associations, without explicit mention of other measures relevant to evaluate the test's clinical validity and clinical utility. To gain insight in the clinical impact and select useful tests, additional outcomes are needed to estimate the clinical validity and utility, such as cost-effectiveness.

Bulky mesonephric adenocarcinoma of the uterine cervix treated with neoadjuvant chemotherapy and radical surgery: report of the first case.

PubMed

Ditto, Antonino; Martinelli, Fabio; Bogani, Giorgio; Gasparri, Maria L; Donato, Violante Di; Paolini, Biagio; Carcangiu, Maria L; Lorusso, Domenica; Raspagliesi, Francesco

2016-11-11

Malignant mesonephric adenocarcinoma of the uterine cervix is a rare occurrence with few cases described in the literature. Although surgery seems to be effective in the treatment of early-stage tumor, no cases describing outcomes of locally advanced stage are available. We report the first case of a patient with International Federation of Obstetrics and Gynecologists stage IIB mesonephric adenocarcinoma undergoing neoadjuvant chemotherapy and radical surgery. Despite the inherent limitation of a single description of a case, our experience supports the utilization of neoadjuvant chemotherapy in patients with malignant mesonephric adenocarcinoma of the uterine cervix. Further prospective multi-institutional studies are needed.

Leadership skills for the California electric utility industry: A qualitative study

NASA Astrophysics Data System (ADS)

Hubbell, Michael

The purpose of this qualitative study was to determine the skills and knowledge necessary for leaders in the California electric utility industry in 2020. With rapid industry changes, skills to effectively lead and stay competitive are undetermined. Leaders must manage an increasingly hostile social and political environment, incorporate new technology, and deal with an aging workforce and infrastructure. Methodology. This study utilized a qualitative case study design to determine the factors that influence the skills leaders will require in 2020. It incorporated the perspectives of current electric utility leaders while looking with a future lens. Findings. Interviews were conducted with transmission and distribution (T&D) directors at 3 investor-owned public electric utilities headquartered in California. The questions followed an open-ended format to gather responses as perceived by electric utility leaders for each research question category: overall skills, aging workforce, regulation, technology, and leading younger generations. The research resulted in 18 major themes: 5 for overall skills, 3 for aging workforce, 4 for regulation, 3 for technology, and 3 for leading younger generations. Conclusions. The study identified leadership skills including the ability to embrace, leverage, and stay current with technology; understand and provide a clear vision for the future; increase creativity; manage the next set of workers; motivate during a time of great change; prepare for knowledge transfer and change in workforce culture; manage regulatory expectations; expand potential utility opportunities; leverage "big data"; allow worker collaboration; and understand what drives younger generations. Recommendations. California-based electric utility leaders can remain effective by implementing key strategies identified herein. Further research could examine perspectives of additional utility leaders who lead in organizational units outside of T&D, expand the research to include additional states, and/or demonstrate how to acquire the identified skills. It is also recommended that a replication of this study be undertaken to include a perspective and analysis of union or "field" workers.

Utilization of Google Earth for Distribution Mapping of Cholangiocarcinoma: a Case Study in Satuek District, Buriram, Thailand.

PubMed

Rattanasing, Wannaporn; Kaewpitoon, Soraya J; Loyd, Ryan A; Rujirakul, Ratana; Yodkaw, Eakachai; Kaewpitoon, Natthawut

2015-01-01

Cholangiocarcinoma (CCA) is a serious public health problem in the Northeast of Thailand. CCA is considered to be an incurable and rapidly lethal disease. Knowledge of the distribution of CCA patients is necessary for management strategies. This study aimed to utilize the Geographic Information System and Google EarthTM for distribution mapping of cholangiocarcinoma in Satuek District, Buriram, Thailand, during a 5-year period (2008-2012). In this retrospective study data were collected and reviewed from the OPD cards, definitive cases of CCA were patients who were treated in Satuek hospital and were diagnosed with CCA or ICD-10 code C22.1. CCA cases were used to analyze and calculate with ArcGIS 9.2, all of data were imported into Google Earth using the online web page www.earthpoint.us. Data were displayed at village points. A total of 53 cases were diagnosed and identified as CCA. The incidence was 53.57 per 100,000 population (65.5 for males and 30.8 for females) and the majority of CCA cases were in stages IV and IIA. The average age was 67 years old. The highest attack rate was observed in Thung Wang sub-district (161.4 per 100,000 population). The map display at village points for CCA patients based on Google Earth gave a clear visual deistribution. CCA is still a major problem in Satuek district, Buriram province of Thailand. The Google Earth production process is very simple and easy to learn. It is suitable for the use in further development of CCA management strategies.

An examination of Eyal & Hurst’s (2008) framework for promoting retention in resource-poor settings through locally-relevant training: A case study for the University of Guyana Surgical Training Program

PubMed Central

Prashad, Anupa J.; Cameron, Brian H.; McConnell, Meghan; Rambaran, Madan; Grierson, Lawrence E. M.

2017-01-01

Background Eyal and Hurst proposed that locally relevant medical education can offset the prevalence of physician “brain drain” in resource-poor regions of the world, and presented a framework of the ethical and pragmatic benefits and concerns posed by these initiatives. The present study explored the framework’s utility through a case study of the University of Guyana Diploma in Surgery (UGDS) program Methods The framework’s utility was evaluated using a case study design that included review and analysis of documents and semi-structured interviews with graduates, trainees, faculty members, and policy makers associated with the UGDS program. Data were analyzed from constructivist and interpretivist perspectives, and compared against the benefits and concerns described by Eyal and Hurst. Results The framework is a useful template for capturing the breadth of experience of locally relevant training in the Guyanese setting. However, the results suggest that delineating the framework factors as either beneficial or concerning may constrict its applicability. The case study design also provided specific insights about the UGDS program, which indicate that the Program has promoted the retention of graduates and a sustainable culture of postgraduate medical education in Guyana. Conclusion It is suggested that the framework be modified so as to represent the benefits and concerns of locally relevant training along a continuum of advantage. These approaches may help us understand retention within a resource-poor country, but also within particularly remote areas and public health care systems generally. PMID:29114344

Advance Care Planning in an Accountable Care Organization Is Associated with Increased Advanced Directive Documentation and Decreased Costs

PubMed Central

Kim, Minchul; Franciskovich, Chris M.; Weinberg, Jason E.; Svendsen, Jessica D.; Fehr, Linda S.; Funk, Amy; Sawicki, Robert; Asche, Carl V.

2018-01-01

Abstract Background: Advance care planning (ACP) documents patient wishes and increases awareness of palliative care options. Objective: To study the association of outpatient ACP with advanced directive documentation, utilization, and costs of care. Design: This was a case–control study of cases with ACP who died matched 1:1 with controls. We used 12 months of data pre-ACP/prematch and predeath. We compared rates of documentation with logit model regression and conducted a difference-in-difference analysis using generalized linear models for utilization and costs. Setting/subjects: Medicare beneficiaries attributed to a large rural-suburban-small metro multisite accountable care organization from January 2013 to April 2016, with cross reference to ACP facilitator logs to find cases. Measurements: The presence of advance directive forms was verified by chart review. Cost analysis included all utilization and costs billed to Medicare. Results: We matched 325 cases and 325 controls (51.1% female and 48.9% male, mean age 81). 320/325 (98.5%) ACP versus 243/325 (74.8%) of controls had a Healthcare Power of Attorney (odds ratio [OR] 21.6, 95% CI 8.6–54.1) and 172/325(52.9%) ACP versus 145/325 (44.6%) controls had Practitioner Orders for Life Sustaining Treatment (OR 1.40, 95% CI 1.02–1.90) post-ACP/postmatch. Adjusted results showed ACP cases had fewer inpatient admissions (−0.37 admissions, 95% CI −0.66 to −0.08), and inpatient days (−3.66 days, 95% CI −6.23 to −1.09), with no differences in hospice, hospice days, skilled nursing facility use, home health use, 30-day readmissions, or emergency department visits. Adjusted costs were $9,500 lower in the ACP group (95% CI −$16,207 to −$2,793). Conclusions: ACP increases documentation and was associated with a reduction in overall costs driven primarily by a reduction in inpatient utilization. Our data set was limited by small numbers of minorities and cancer patients. PMID:29206564

Cost-Benefit Analysis of Green Infrastructures on Community Stormwater Reduction and Utilization: A Case of Beijing, China.

PubMed

Liu, Wen; Chen, Weiping; Feng, Qi; Peng, Chi; Kang, Peng

2016-12-01

Cost-benefit analysis is demanded for guiding the plan, design and construction of green infrastructure practices in rapidly urbanized regions. We developed a framework to calculate the costs and benefits of different green infrastructures on stormwater reduction and utilization. A typical community of 54,783 m 2 in Beijing was selected for case study. For the four designed green infrastructure scenarios (green space depression, porous brick pavement, storage pond, and their combination), the average annual costs of green infrastructure facilities are ranged from 40.54 to 110.31 thousand yuan, and the average of the cost per m 3 stormwater reduction and utilization is 4.61 yuan. The total average annual benefits of stormwater reduction and utilization by green infrastructures of the community are ranged from 63.24 to 250.15 thousand yuan, and the benefit per m 3 stormwater reduction and utilization is ranged from 5.78 to 11.14 yuan. The average ratio of average annual benefit to cost of four green infrastructure facilities is 1.91. The integrated facilities had the highest economic feasibility with a benefit to cost ratio of 2.27, and followed by the storage pond construction with a benefit to cost ratio of 2.14. The results suggested that while the stormwater reduction and utilization by green infrastructures had higher construction and maintenance costs, their comprehensive benefits including source water replacements benefits, environmental benefits and avoided cost benefits are potentially interesting. The green infrastructure practices should be promoted for sustainable management of urban stormwater.

The impact on revenue of increasing patient volume at surgical suites with relatively high operating room utilization.

PubMed

Dexter, F; Macario, A; Lubarsky, D A

2001-05-01

We previously studied hospitals in the United States of America that are losing money despite limiting the hours that operating room (OR) staff are available to care for patients undergoing elective surgery. These hospitals routinely keep utilization relatively high to maximize revenue. We tested, using discrete-event computer simulation, whether increasing patient volume while being reimbursed less for each additional patient can reliably achieve an increase in revenue when initial adjusted OR utilization is 90%. We found that increasing the volume of referred patients by the amount expected to fill the surgical suite (100%/90%) would increase utilization by <1% for a hospital surgical suite (with longer duration cases) and 4% for an ambulatory surgery suite (with short cases). The increase in patient volume would result in longer patient waiting times for surgery and more patients leaving the surgical queue. With a 15% reduction in payment for the new patients, the increase in volume may not increase revenue and can even decrease the contribution margin for the hospital surgical suite. The implication is that for hospitals with a relatively high OR utilization, signing discounted contracts to increase patient volume by the amount expected to "fill" the OR can have the net effect of decreasing the contribution margin (i.e., profitability). Hospitals may try to attract new surgical volume by offering discounted rates. For hospitals with a relatively high operating room utilization (e.g., 90%), computer simulations predict that increasing patient volume by the amount expected to "fill" the operating room can have the net effect of decreasing contribution margin (i.e., profitability).