Perception versus reality: elucidating motivation and expectations of current fellowship council minimally invasive surgery fellows.

PubMed

Watkins, Jeffrey R; Pryor, Aurora D; Truitt, Michael S; Jeyarajah, D Rohan

2018-04-17

The aim of our study is to determine minimally invasive trainee motivation and expectations for their respective fellowship. Minimally Invasive Surgery (MIS) is one of the largest non-ACGME post-residency training pathways though little is known concerning the process of residents choosing MIS as a fellowship focus. As general surgery evolves, it is important to understand resident motivation in order to better prepare them for a surgical career. A survey invitation was sent to current trainees in the Minimally Invasive and related pathways through the Fellowship Council. The participants were asked to complete a web-based questionnaire detailing demographics, experiences preparing for fellowship, motivation in choosing an MIS fellowship, and expectations for surgical practice after fellowship. Sixty-seven MIS trainees responded to the survey out of 151 invitations (44%). The Fellowship Council website, mentors, and other fellows were cited as the most helpful source of information when applying for fellowship. Trainees were active in surgical societies as residents, with 78% having membership in the ACS and 60% in SAGES. When deciding to pursue MIS as a fellowship, the desire to increase laparoscopic training was the most important factor. The least important reasons cited were lack of laparoendoscopic training in residency and desire to learn robotic surgery. The majority of trainees believed their laparoscopic skill set was above that of their residency cohort (81%). The most desired post-fellowship employment model is hospital employee (46%) followed by private practice (27%). Most fellows plan on marketing themselves as MIS surgeons (90%) or General Surgeons (78%) when in practice. Residents who choose MIS as a fellowship have a strong exposure to laparoscopy and want to become specialists in their field. Mentors and surgical societies including ACS and SAGES play a vital role in preparing residents for fellowship and practice.

Attitudes of newly qualified doctors towards a career in general practice: a qualitative focus group study.

PubMed

Merrett, Alexandra; Jones, Daniel; Sein, Kim; Green, Trish; Macleod, Una

2017-04-01

A key element of the NHS is universal access to a GP. Recently, UK general practice has been described as being in crisis, with training places unfilled and multiple practices reporting vacancies or facing closure. The recruitment of GPs continues to be a key focus for both the Royal College of General Practitioners (RCGP) and the government. To understand the attitudes of newly qualified doctors towards a career in general practice, to appreciate potential reasons for the crisis in GP recruitment, and to recommend ways to improve recruitment. A qualitative study comprising five focus groups with 74 Foundation Year 1 (FY1) doctors from one Yorkshire deanery. Audio recordings were transcribed verbatim and thematic analysis undertaken. Foundation Year 1 doctors' thoughts towards a career in general practice were summarised in four themes: quality of life, job satisfaction, uncertainty surrounding the future of general practice, and the lack of respect for GPs among both doctors and the public. Participants felt that general practice could provide a good work-life balance, fair pay, and job stability. Job satisfaction, with the ability to provide care from the cradle to the grave, and to work within a community, was viewed positively. Uncertainties around future training, skill levels, pay, and workload, together with a perceived stigma experienced in medical schools and hospitals, were viewed as a deterrent to a career in general practice. This study has gathered the opinions of doctors at a critical point in their careers, before they choose a future specialty. Findings highlight areas of concern and potential deterrents to a career in general practice, together with recommendations to address these issues. © British Journal of General Practice 2017.

Hypothetical contractarianism and the disclosure requirement problem in informed consent.

PubMed

Cust, Kenneth F T

1991-01-01

Two of the more deeply problematic issues surrounding the doctrine of informed consent are providing a justification for the practice of informed consent and providing an account of the nature and amount of information that must be disclosed in order for informed consent to take place. This paper is concerned with the latter problem, the problem of disclosure requirements, but it deals with this problem in a novel way; it approaches the problem by asking what fully informed and fully rational agents would agree to under certain hypothetical conditions. In general terms I juxtapose the hypothetical contractarianism found in Rawls' A Theory of Justice with that found in Gauthier's Morals By Agreement and ask what their respective hypothetical contractors would agree to with respect to choosing a particular standard of disclosure to govern the practice of informed consent. In more specific terms a contrast is made between what a Rawlsian agent behind a veil of ignorance would choose as compared to what, in Gauthier's terms, an ideal actor making an Archimedean choice would choose. The idea of an Archimedean point, and the subsequent choice made from that point, although technically identified by Rawls, originated with Archimedes of Syracuse.

Influences on students’ career decisions concerning general practice: a focus group study

PubMed Central

Nicholson, Sandra; Hastings, Adrian Michael; McKinley, Robert Kee

2016-01-01

Background Despite concerns about recruitment to UK general practice, there has been no concerted educational intervention to address them. Aim To better understand how medical students’ perceptions of their experiences of their undergraduate curriculum may affect choosing general practice as a career. Design and setting Qualitative study comprising focus groups of a total of 58 students from a range of medical schools across the UK. Method A range of UK medical schools students were invited by email to participate in focus groups and return a questionnaire detailing their current career choice to facilitate sampling students with varied career preferences. Students late in their studies were sampled as they were likely to be considering future careers. Focus group discussions were audiotaped, transcribed, and anonymised for both school and participant, then thematically analysed. Perceived differences in medical school culture, curriculum philosophy, design, and intent were explored. Results Six focus groups (58 students) were convened. Some student participants’ career aspirations were strongly shaped by family and home, but clinical placements remained important in confirming or refuting these choices. High-quality general practice attachments are a powerful attractor to general practice and, when they reflect authentic clinical practice, promote general practice careers. GP tutors can be powerful, positive role models. Students’ comments revealed conflicting understandings about general practice. Conclusion Attracting rather than coercing students to general practice is likely to be more effective at changing their career choices. Early, high-quality, ongoing and, authentic clinical exposure promotes general practice and combats negative stereotyping. It is recommended that increasing opportunities to help students understand what it means to be a ‘good GP’ and how this can be achieved are created. PMID:27578812

General Practice as a career choice among undergraduate medical students in Greece

PubMed Central

Mariolis, Anargiros; Mihas, Constantinos; Alevizos, Alevizos; Gizlis, Vasilis; Mariolis, Theodoros; Marayiannis, Konstantinos; Tountas, Yiannis; Stefanadis, Christodoulos; Philalithis, Anastas; Creatsas, George

2007-01-01

Background Although General Practice (GP) was recognized as a medical specialty in Greece in 1986, the number of GPs is insufficient to cover needs and only few medical graduates choose GP as a career option. In the present study we investigated the profile of medical students in terms of their decisions regarding specialization and the possible association of career choices different from GP with the status of undergraduate training regarding GP. Methods The sample consisted of final year students in the Medical School of the University of Athens, Greece. Students filled in a self-reported questionnaire focusing on medical specialization, and GP in particular. Results Response rate was 82.5% with 1021 questionnaires collected, out of 1237 eligible medical students. Only 44 out of the 1021 (4.3%) respondents stated that GP is -or could be- among their choices for specialty. The most popular medical specialty was General Surgery (10.9%), followed by Cardiology (9.6%), Endocrinology (8.7%) and Obstetrics-Gynaecology (8.3%). The most common criterion for choosing GP was the guaranteed employment on completion of the residency (54.6%) while a 56.6% of total respondents were positive to the introduction of GP/FM as a curriculum course during University studies. Conclusion Despite the great needs, GP specialty is currently not a career option among undergraduate students of the greater Medical University in Greece and is still held in low esteem. A university department responsible for undergraduate teaching, promotion and research in GP (where not available) is essential; the status of undergraduate training in general practice/family medicine seems to be one of the most important factors that influence physician career choices regarding primary care specialties. PMID:17543106

The use of the truth and deception in dementia care amongst general hospital staff.

PubMed

Turner, Alex; Eccles, Fiona; Keady, John; Simpson, Jane; Elvish, Ruth

2017-08-01

Deceptive practice has been shown to be endemic in long-term care settings. However, little is known about the use of deception in dementia care within general hospitals and staff attitudes towards this practice. This study aimed to develop understanding of the experiences of general hospital staff and explore their decision-making processes when choosing whether to tell the truth or deceive a patient with dementia. This qualitative study drew upon a constructivist grounded theory approach to analyse data gathered from semi-structured interviews with a range of hospital staff. A model, grounded in participant experiences, was developed to describe their decision-making processes. Participants identified particular triggers that set in motion the need for a response. Various mediating factors influenced how staff chose to respond to these triggers. Overall, hospital staff were reluctant to either tell the truth or to lie to patients. Instead, 'distracting' or 'passing the buck' to another member of staff were preferred strategies. The issue of how truth and deception are defined was identified. The study adds to the growing research regarding the use of lies in dementia care by considering the decision-making processes for staff in general hospitals. Various factors influence how staff choose to respond to patients with dementia and whether deception is used. Similarities and differences with long-term dementia care settings are discussed. Clinical and research implications include: opening up the topic for further debate, implementing staff training about communication and evaluating the impact of these processes.

Why doctors choose small towns: a developmental model of rural physician recruitment and retention.

PubMed

Hancock, Christine; Steinbach, Alan; Nesbitt, Thomas S; Adler, Shelley R; Auerswald, Colette L

2009-11-01

Shortages of health care professionals have plagued rural areas of the USA for more than a century. Programs to alleviate them have met with limited success. These programs generally focus on factors that affect recruitment and retention, with the supposition that poor recruitment drives most shortages. The strongest known influence on rural physician recruitment is a "rural upbringing," but little is known about how this childhood experience promotes a return to rural areas, or how non-rural physicians choose rural practice without such an upbringing. Less is known about how rural upbringing affects retention. Through twenty-two in-depth, semi-structured interviews with both rural- and urban-raised physicians in northeastern California and northwestern Nevada, this study investigates practice location choice over the life course, describing a progression of events and experiences important to rural practice choice and retention in both groups. Study results suggest that rural exposure via education, recreation, or upbringing facilitates future rural practice through four major pathways. Desires for familiarity, sense of place, community involvement, and self-actualization were the major motivations for initial and continuing small-town residence choice. A history of strong community or geographic ties, either urban or rural, also encouraged initial rural practice. Finally, prior resilience under adverse circumstances was predictive of continued retention in the face of adversity. Physicians' decisions to stay or leave exhibited a cost-benefit pattern once their basic needs were met. These results support a focus on recruitment of both rural-raised and community-oriented applicants to medical school, residency, and rural practice. Local mentorship and "place-specific education" can support the integration of new rural physicians by promoting self-actualization, community integration, sense of place, and resilience. Health policy efforts to improve the physician workforce must address these complexities in order to support the variety of physicians who choose and remain in rural practice.

Language Matters in Rural Schools in South Africa: Are Educators Making the Implementation of the Language in Education Policy (1997) Work?

ERIC Educational Resources Information Center

Sookrajh, Reshma; Joshua, Jenny

2009-01-01

In July 1997, the Language-in-Education Policy (LiEP) was introduced in South Africa. While the intention of this policy was to promote all 11 official languages and give individuals the right to choose the language of learning and teaching, the practical implementation has generally been fraught with challenges. However, language policy…

Choosing a New Telephone System for Your Medical Practice.

PubMed

Metherell, Brian

2016-01-01

E-mail may rule the world in other types of businesses, but for medical practices, the telephone remains the primary mode of communication with patients, specialists, and pharmacies. From making appointments to calling in prescriptions, telephones are essential to patient care. With technology changing very quickly and new capabilities coming into the medical practice, such as telemedicine and Skype, you need to know your options when choosing a new telephone system. The possibilities include on-site, cloud, and hybrid networked solutions. A wide variety of features and capabilities are available, from dozens of vendors. Of course, no matter what telephone solution you choose, you must meet regulatory compliance, particularly HIPAA, and Payment Card Industry Data Security Standard if you take credit cards. And it has to be affordable, reliable, and long lasting. This article explores what medical practices need to know when choosing a new business telephone system in order to find the right solutions for their businesses.

GPs’ job satisfaction: doctors who chose general practice early or late

PubMed Central

Lambert, Trevor; Smith, Fay; Goldacre, Michael

2013-01-01

Background In the UK many practising GPs did not choose general practice as their first choice of career when they originally graduated as doctors. Aim To compare job satisfaction of GPs who chose general practice early or later in their career. Design and setting Questionnaires were sent to all UK-trained doctors who graduated in selected years between 1993 and 2000. Method Questionnaires were sent to the doctors 1, 3, 7 and 10 years after graduation. Results Of all 3082 responders working in general practice in years 7 and 10, 38% had first specified general practice as their preferred career when responding 1 year after graduation, 19% by year 3, 21% by year 5, and 22% after year 5. Job satisfaction was high and, generally, there was little difference between the first three groups (although, when different, the most positive responses were from the earliest choosers); but there were slightly lower levels of job satisfaction in the ‘more than 5 years’ group. For example, in response to the statement ‘I find enjoyment in my current post’, the percentages agreeing in the four groups, respectively, were 91.5%, 91.1%, 91.0% and 88.2%. In response to ‘I am doing interesting and challenging work’ the respective percentages were 90.2%, 88.0%, 86.6% and 82.6%. Conclusions Job satisfaction levels were generally high among the late choosers as well as the early choosers. On this evidence, most doctors who turn to general practice, after preferring another specialty in their early career, are likely to have a satisfying career. PMID:24267855

Who attracts whom to rural general practice? Variation in temperament and character profiles of GP registrars across different vocational training pathways.

PubMed

Eley, Diann S; Laurence, Caroline; Cloninger, C R; Walters, Lucie

2015-01-01

The ongoing rural doctor workforce shortage continues to stimulate interest in new strategies to alleviate the situation. Alongside increasingly promising approaches is the notion that attracting and nurturing the 'right' individuals may be paramount to achieving long-term success in recruitment and retention. This study compares the patterns of demographic and temperament and character trait profiles of general practice registrars in training across three Australian vocational training pathways: the Australian College of Rural and Remote Medicine independent rural pathway, and the rural and general pathways of Australian general practice training. The aim is to describe the predominant personalities of existing trainees. At its foundation, this study strives to obtain more information about those individuals choosing rural practice, which may inform ways to enhance future recruitment and training into rural medicine. This rationale has been explored with medical students using intention as the dependent variable, but registrars are that much closer to their final career choice, and therefore may provide more practical and reliable indicators of the notion of who attracts whom into rural practice. A cross-sectional design sampled four registrar training groups: one from the Australian College of Rural and Remote Medicine, one Australian general practice training rural only, and two Australian general practice training rural and general pathway regional training providers. Registrars (451) completed a questionnaire that gathered basic demographics and a personality trait profile using the Temperament and Character Inventory plus a measure of resilience. Statistical analysis explored the relationships between variables (multivariate analyses of variance) and compared levels of traits between registrar groups (analyses of variance). Registrars training via the Australian College of Rural and Remote Medicine pathway were more likely to be male, older, have a definite interest in or already practising in a rural area and were significantly (with moderate effect sizes) lower in levels of harm avoidance and higher in persistence, self-directedness and resilience compared to the other training pathways. The implications of the data to the recruitment and training of general practice registrars goes further than identifying groups of individuals with similar temperament and character trait patterns. This sample is portrayed as relatively homogenous in light of their overall trait levels as compared to population norms. However, it is the combination of the levels of individual traits that suggests a profile that differs between registrars on a rural or general training path. Importantly the combination of trait levels that tend to differentiate registrars (low harm avoidance, high self-directedness and persistence) correlates strongly with high levels of resilience. Doctors and medical students benefit from a high level of resilience to cope with and manage the challenges of the profession and arguably more so in rural practice. Along with certain demographic characteristics, the combination and levels of temperament (stable) and character (developmental) traits support the notion of a mixture of personal traits that may be indicative of individuals best suited to rural and remote medicine. Further investigation is needed to determine whether individuals with a certain pattern of personal traits are attracted to rural practice training or whether the training itself, in part by exposure to rural life and rural medical practice, selects for those who are most suited to and will eventually choose to practice in a rural location.

Theory and interpretation in qualitative studies from general practice: Why and how?

PubMed

Malterud, Kirsti

2016-03-01

In this article, I want to promote theoretical awareness and commitment among qualitative researchers in general practice and suggest adequate and feasible theoretical approaches. I discuss different theoretical aspects of qualitative research and present the basic foundations of the interpretative paradigm. Associations between paradigms, philosophies, methodologies and methods are examined and different strategies for theoretical commitment presented. Finally, I discuss the impact of theory for interpretation and the development of general practice knowledge. A scientific theory is a consistent and soundly based set of assumptions about a specific aspect of the world, predicting or explaining a phenomenon. Qualitative research is situated in an interpretative paradigm where notions about particular human experiences in context are recognized from different subject positions. Basic theoretical features from the philosophy of science explain why and how this is different from positivism. Reflexivity, including theoretical awareness and consistency, demonstrates interpretative assumptions, accounting for situated knowledge. Different types of theoretical commitment in qualitative analysis are presented, emphasizing substantive theories to sharpen the interpretative focus. Such approaches are clearly within reach for a general practice researcher contributing to clinical practice by doing more than summarizing what the participants talked about, without trying to become a philosopher. Qualitative studies from general practice deserve stronger theoretical awareness and commitment than what is currently established. Persistent attention to and respect for the distinctive domain of knowledge and practice where the research deliveries are targeted is necessary to choose adequate theoretical endeavours. © 2015 the Nordic Societies of Public Health.

A new model to understand the career choice and practice location decisions of medical graduates.

PubMed

Stagg, P; Greenhill, J; Worley, P S

2009-01-01

Australian medical education is increasingly influenced by rural workforce policy. Therefore, understanding the influences on medical graduates' practice location and specialty choice is crucial for medical educators and medical workforce planners. The South Australian Flinders University Parallel Rural Community Curriculum (PRCC) was funded by the Australian Government to help address the rural doctor workforce shortage. The PRCC was the first community based medical education program in Australia to teach a full academic year of medicine in South Australian rural general practices. The aim of this research was to identify what factors influence the career choices of PRCC graduates. A retrospective survey of all contactable graduates of the PRCC was undertaken. Quantitative data were analysed using SPSS 14.0 for Windows. Qualitative data were entered into NVIVO 7 software for coding, and analysed using content analysis. Usable data were collected from 46 of the 86 contactable graduates (53%). More than half of the respondents (54%) reported being on a rural career path. A significant relationship exists between being on a rural career pathway and making the decision prior to or during medical school (p = 0.027), and between graduates in vocational training who are on an urban career path and making a decision on career specialty after graduation from medical school (p = .004). Graduates in a general practice vocational training program are more likely to be on a rural career pathway than graduates in a specialty other than general practice (p = .003). A key influence on graduates' practice location is geographic location prior to entering medical school. Key influences on graduates choosing a rural career pathway are: having a spouse/partner with a rural background; clinical teachers and mentors; the extended rural based undergraduate learning experience; and a specialty preference for general practice. A lack of rural based internships and specialist training places is influencing both urban- and rural-origin graduates to practise in urban locations. Further analysis of graduates' career pathway choices (rural or urban) and geographic background (rural or urban) was conducted. This resulted in the development of a new model, 'The Four Qs Model'. This model consists of four quadrants derived from the variables career pathway choice (rural or urban) and geographic background (rural or urban). Clustering of consistent demographic and qualitative trends unique to each quadrant was demonstrated. The distinctive clustering that emerged from the data resulted in the quadrants being renamed 'The True Believers', 'The Convertibles' 'The Frustrated' and 'The Metro Docs'. The PRCC is influencing graduates to choose a rural career path. The PRCC program affirms the career preferences of rural origin students while graduates with little rural exposure prior to the PRCC report being positively influenced to pursue a rural career path. The Four Qs Model is a useful model in that it demonstrates consistent themes in the characteristics of PRCC graduates and assists understanding of why they choose a rural medical career. This could be relevant to the selection of medical students into rural medical education programs and in the construction of rural curricula. The model also offers a useful framework for further research in this field.

Video-assisted feedback in general practice internships using German general practitioner's guidelines

PubMed Central

Bölter, Regine; Freund, Tobias; Ledig, Thomas; Boll, Bernhard; Szecsenyi, Joachim; Roos, Marco

2012-01-01

Introduction: The planned modification of the Medical Licenses Act in Germany will strengthen the specialty of general practice. Therefore, medical students should get to know the daily routine of general practitioners during their academic studies. At least 10% of students should get the possibility to spend one quarter of the internship, in the last year of their academic studies, in a practice of family medicine. The demonstrated teaching method aims at giving feedback to the student based on video recordings of patient consultations (student-patient) with the help of a checklist. Video-feedback is already successful used in medical teaching in Germany and abroad. This feasibility study aims at assessing the practicability of video-assisted feedback as a teaching method during internship in general practice. Teaching method: First of all, the general practice chooses a guideline as the learning objective. Secondly, a subsequent patient – student – consultation is recorded on video. Afterwards, a video-assisted formative feedback is given by the physician. A checklist with learning objectives (communication, medical examination, a structured case report according to the guideline) is used to structure the feedback content. Feasibility: The feasibility was assessed by a semi structured interview in order to gain insight into barriers and challenges for future implementation. The teaching method was performed in one general practice. Afterwards the teaching physician and the trainee intern were interviewed. The following four main categories were identified: feasibility, performance, implementation in daily routine, challenges of the teaching concept. The results of the feasibility study show general practicability of this approach. Installing a video camera in one examination room may solve technical problems. The trainee intern mentioned theoretical and practical benefits using the guideline. The teaching physician noted the challenge to reflect on his daily routines in the light of evidence-based guidelines. Conclusion: This teaching method supports quality control and standardizing of learning objectives during the internship in general practice by using general practice guidelines. The use of a checklist enhances this method in general practice. We consider the presented teaching method in the context of the planned modification of the Medical Licenses Act is part of quality control and standardisation of medical teaching during general practice internships. In order to validate these presumptions, further, evaluation of this method concerning the learning objectives using the guidelines of general practice need to be carried out. PMID:23255963

Video-assisted feedback in general practice internships using German general practitioner's guidelines.

PubMed

Bölter, Regine; Freund, Tobias; Ledig, Thomas; Boll, Bernhard; Szecsenyi, Joachim; Roos, Marco

2012-01-01

The planned modification of the Medical Licenses Act in Germany will strengthen the specialty of general practice. Therefore, medical students should get to know the daily routine of general practitioners during their academic studies. At least 10% of students should get the possibility to spend one quarter of the internship, in the last year of their academic studies, in a practice of family medicine. The demonstrated teaching method aims at giving feedback to the student based on video recordings of patient consultations (student-patient) with the help of a checklist. Video-feedback is already successful used in medical teaching in Germany and abroad. This feasibility study aims at assessing the practicability of video-assisted feedback as a teaching method during internship in general practice. First of all, the general practice chooses a guideline as the learning objective. Secondly, a subsequent patient - student - consultation is recorded on video. Afterwards, a video-assisted formative feedback is given by the physician. A checklist with learning objectives (communication, medical examination, a structured case report according to the guideline) is used to structure the feedback content. The feasibility was assessed by a semi structured interview in order to gain insight into barriers and challenges for future implementation. The teaching method was performed in one general practice. Afterwards the teaching physician and the trainee intern were interviewed. The Following four main categories were identified: feasibility, performance, implementation in daily routine, challenges of the teaching concept.The results of the feasibility study show general practicability of this approach. Installing a video camera in one examination room may solve technical problems. The trainee intern mentioned theoretical and practical benefits using the guideline. The teaching physician noted the challenge to reflect on his daily routines in the light of evidence-based guidelines. This teaching method supports quality control and standardizing of learning objectives during the internship in general practice by using general practice guidelines. The use of a checklist enhances this method in general practice. We consider the presented teaching method in the context of the planned modification of the Medical Licenses Act is part of quality control and standardisation of medical teaching during general practice internships. In order to validate these presumptions, further, evaluation of this method concerning the learning objectives using the guidelines of general practice need to be carried out.

Choosing High-Yield Tasks for the Mathematical Development of Practicing Secondary Teachers

ERIC Educational Resources Information Center

Epperson, James A. Mendoza; Rhoads, Kathryn

2015-01-01

Many mathematics teacher educators encounter the challenge of creating or choosing mathematical tasks that evoke important mathematical insights and connections yet remain firmly grounded in school mathematics. This challenge increases substantially when trying to meet the needs of practicing secondary mathematics teachers pursuing graduate work…

The evidence-based practice ideologies.

PubMed

Mantzoukas, Stefanos

2007-10-01

This paper puts forward the argument that there are various, competing, and antithetical evidence-based practice (EBP) definitions and acknowledges that the different EBP definitions are based on different epistemological perspectives. However, this is not enough to understand the way in which nurse professionals choose between the various EBP formations and consequently facilitate them in choosing the most appropriate for their needs. Therefore, the current article goes beyond and behind the various EBP epistemologies to identify how individuals choose an epistemology, which consequently will assist our understanding as to how an individual chooses a specific EBP formation. Individuals choose an epistemology on the mere belief that the specific epistemology offers the ideals or ideas of best explaining or interpreting daily reality. These ideals or ideas are termed by science, history, and politics as ideology. Similarly, individual practitioners choose or should choose between the different EBP formations based on their own personal ideology. Consequently, this article proceeds to analyse the various ideologies behind different EBP definitions as to conclude that there are two broad ideologies that inform the various EBP formations, namely the ideology of truth and the ideology of individual emancipation. These two ideologies are analysed and their connections to the various EBP formations are depicted. Eventually, the article concludes that the in-depth, critical, and intentional analysis by individual nurses of their own ideology will allow them to choose the EBP formation that is most appropriate and fitting for them, and their specific situation. Hence, the conscious analysis of individual ideology becomes the criterion for choosing between competing EBP formations and allows for best evidence to be implemented in practice. Therefore, the best way to teach EBP courses is by facilitating students to analyse their own ideology.

Choosing Wisely in Emergency Medicine: A National Survey of Emergency Medicine Academic Chairs and Division Chiefs.

PubMed

Maughan, Brandon C; Baren, Jill M; Shea, Judy A; Merchant, Raina M

2015-12-01

The Choosing Wisely campaign was launched in 2011 to promote stewardship of medical resources by encouraging patients and physicians to speak with each other regarding the appropriateness of common tests and procedures. Medical societies including the American College of Emergency Physicians (ACEP) have developed lists of potentially low-value practices for their members to address with patients. No research has described the awareness or attitudes of emergency physicians (EPs) regarding the Choosing Wisely campaign. The study objective was to assess these beliefs among leaders of academic departments of emergency medicine (EM). This was a Web-based survey of emergency department (ED) chairs and division chiefs at institutions with allopathic EM residency programs. The survey examined awareness of Choosing Wisely, anticipated effects of the program, and discussions of Choosing Wisely with patients and professional colleagues. Participants also identified factors they associated with the use of potentially low-value services in the ED. Questions and answer scales were refined using iterative pilot testing with EPs and health services researchers. Seventy-eight percent (105/134) of invited participants responded to the survey. Eighty percent of respondents were aware of Choosing Wisely. A majority of participants anticipate the program will decrease costs of care (72% of respondents) and use of ED diagnostic imaging (69%) but will have no effect on EP salaries (94%) or medical-legal risks (65%). Only 45% of chairs have ever addressed Choosing Wisely with patients, in contrast to 88 and 82% who have discussed it with faculty and residents, respectively. Consultant-requested tests were identified by 97% of residents as a potential contributor to low-value services in the ED. A substantial majority of academic EM leaders in our study were aware of Choosing Wisely, but only slightly more than half could recall any ACEP recommendations for the program. Respondents familiar with Choosing Wisely anticipated generally positive effects, but chairs reported only infrequently discussing Choosing Wisely with patients. Future research should identify potentially low-value tests requested by consultants and objectively measure the utility and cost of these tests among ED patient populations. © 2015 by the Society for Academic Emergency Medicine.

General Secondary or Vocational Education

ERIC Educational Resources Information Center

Popova, S.A.

2016-01-01

After the completion of the basic general education program (after the ninth grade), Russian students must choose one of two educational trajectories: to continue their general secondary education (enroll in 10th grade) or to enter a vocational education program. What do Russian schoolchildren choose? This article examines data from the last 15…

Choosing and Using Images in Environmental Science Education

ERIC Educational Resources Information Center

Muthersbaugh, Debbie Smick

2012-01-01

Although using images for teaching has been a common practice in science classrooms (Gordon & Pea, 1995) understanding the purpose or how to choose images has not typically been intentional. For this dissertation three separate studies relating to choosing and using images are prepared with environmental science in mind. Each of the studies…

Images of otoscopy: rate and extent of non-compliance with good practice standards.

PubMed

Crundwell, G; Harmer, J; Maltby, M; Mills, T; Neumann, C; Walsh, L; Baguley, D

2015-01-01

The British Society of Audiology has produced clear guidelines as to how otoscopy should be undertaken; however, no nationally recognised guidelines exist for the wider clinical community. Images of otoscopy appear in many books, journals, magazines and websites. This study aimed to determine the rate of non-compliance with good practice in images of otoscopy, the seriousness of the breach, and whether this is more common in sites for professionals or the general public. Google Images was searched using the terms 'otoscopy' and 'ear examination'. A total of 200 images were identified and collated. The images were reviewed for compliance with good practice standards. Only 12.75 per cent of the images were graded as having no breach of good practice standards. Professional websites have a responsibility to show best practice. When choosing an image, the source of the image needs to be carefully considered.

A review of post-nuclear-catastrophe management

NASA Astrophysics Data System (ADS)

Nifenecker, Hervé

2015-07-01

The purpose of this paper is to make radioactive risk more generally understandable. To that end, we compare it to smoking tobacco. Further, we show that the concept of loss of life expectancy permits a quantitative comparison between various aggressions. The demystification of radioactive risk should lead to basic changes in post-catastrophe management, allowing victims to choose whether or not to leave contaminated areas. A less emotional appreciation of radioactive risks should lead to the adaptation of legal practices when dealing with probabilistic situations.

Analysis of quantum information processors using quantum metrology

NASA Astrophysics Data System (ADS)

Kandula, Mark J.; Kok, Pieter

2018-06-01

Physical implementations of quantum information processing devices are generally not unique, and we are faced with the problem of choosing the best implementation. Here, we consider the sensitivity of quantum devices to variations in their different components. To measure this, we adopt a quantum metrological approach and find that the sensitivity of a device to variations in a component has a particularly simple general form. We use the concept of cost functions to establish a general practical criterion to decide between two different physical implementations of the same quantum device consisting of a variety of components. We give two practical examples of sensitivities of quantum devices to variations in beam splitter transmittivities: the Knill-Laflamme-Milburn (KLM) and reverse nonlinear sign gates for linear optical quantum computing with photonic qubits, and the enhanced optical Bell detectors by Grice and Ewert and van Loock. We briefly compare the sensitivity to the diamond distance and find that the latter is less suited for studying the behavior of components embedded within the larger quantum device.

Determinants of an urban origin student choosing rural practice: a scoping review.

PubMed

Myhre, Douglas L; Bajaj, Sameer; Jackson, Wesley

2015-01-01

The shortage of physicians in rural and remote communities is an ongoing problem. Many studies have shown that the rural background of a student (ie rural origin) is a primary factor in recruiting physicians for practice in rural communities. Scoping reviews are primarily done to gauge the extent of literature on the research question at hand, typically with an intent that future research in that area is a constructive addition to pre-existing knowledge. This scoping review focuses on factors that predispose urban-origin students to choose a carrier in rural medicine. The study used Arksey and O'Malley's guidelines for a scoping review of the literature, which, in contrast to a traditional systematic review, is brief yet comprehensive. Medline (Ovid) and PubMed databases were used to review literature published between 1 January 1970 and 30 November 2014. After removing duplicates, articles were screened based on inclusion and exclusion criteria set up by the research team. The literature search resulted in 435 articles, 418 of which were excluded, leaving 17 articles for comprehensive review. Out of these 17 studies, the following four factors that suggest why urban-origin medical students may choose rural practice were generated: geographic diffusion of physicians in response to economic forces such as debt repayment and financial incentives (five studies), scope of practice and personal satisfaction (five studies), undergraduate and postgraduate rural training (nine studies) and premedical school mindset to practice rurally (five studies). Urban-origin students may choose rural practice because of market forces as well as financial incentives. The participation in undergraduate and postgraduate rural training is reported to positively alter the attitude of urban-origin students. A small subset of these students has a predetermined mindset to practice rurally at the time of matriculation. Obstacles for choosing a rural carrier include, but are not limited to lack of job and education opportunities for spouses/partners, lack of recreational and educational opportunities for children, and obscure opportunities for continuing medical education.

Choosing Your Medical Specialty

MedlinePlus

... the Payment Process Physician Payment Resource Center Reinventing Medical Practice Managing Your Practice CPT® (Current Procedural Terminology) Medicare & Medicaid Private Payer Reform Claims Processing & Practice ...

Attitudes, norms and controls influencing lifestyle risk factor management in general practice.

PubMed

Ampt, Amanda J; Amoroso, Cheryl; Harris, Mark F; McKenzie, Suzanne H; Rose, Vanessa K; Taggart, Jane R

2009-08-26

With increasing rates of chronic disease associated with lifestyle behavioural risk factors, there is urgent need for intervention strategies in primary health care. Currently there is a gap in the knowledge of factors that influence the delivery of preventive strategies by General Practitioners (GPs) around interventions for smoking, nutrition, alcohol consumption and physical activity (SNAP). This qualitative study explores the delivery of lifestyle behavioural risk factor screening and management by GPs within a 45-49 year old health check consultation. The aims of this research are to identify the influences affecting GPs' choosing to screen and choosing to manage SNAP lifestyle risk factors, as well as identify influences on screening and management when multiple SNAP factors exist. A total of 29 audio-taped interviews were conducted with 15 GPs and one practice nurse over two stages. Transcripts from the interviews were thematically analysed, and a model of influencing factors on preventive care behaviour was developed using the Theory of Planned Behaviour as a structural framework. GPs felt that assessing smoking status was straightforward, however some found assessing alcohol intake only possible during a formal health check. Diet and physical activity were often inferred from appearance, only being assessed if the patient was overweight. The frequency and thoroughness of assessment were influenced by the GPs' personal interests and perceived congruence with their role, the level of risk to the patient, the capacity of the practice and availability of time. All GPs considered advising and educating patients part of their professional responsibility. However their attempts to motivate patients were influenced by perceptions of their own effectiveness, with smoking causing the most frustration. Active follow-up and referral of patients appeared to depend on the GPs' orientation to preventive care, the patient's motivation, and cost and accessibility of services to patients. General practitioner attitudes, normative influences from both patients and the profession, and perceived external control factors (time, cost, availability and practice capacity) all influence management of behavioural risk factors. Provider education, community awareness raising, support and capacity building may improve the uptake of lifestyle modification interventions.

Using Data Augmentation to Facilitate Conduct of Phase I–II Clinical Trials with Delayed Outcomes

PubMed Central

Jin, Ick Hoon; Liu, Suyu; Thall, Peter F.; Yuan, Ying

2014-01-01

A practical impediment in adaptive clinical trials is that outcomes must be observed soon enough to apply decision rules to choose treatments for new patients. For example, if outcomes take up to six weeks to evaluate and the accrual rate is one patient per week, on average three new patients will be accrued while waiting to evaluate the outcomes of the previous three patients. The question is how to treat the new patients. This logistical problem persists throughout the trial. Various ad hoc practical solutions are used, none entirely satisfactory. We focus on this problem in phase I–II clinical trials that use binary toxicity and efficacy, defined in terms of event times, to choose doses adaptively for successive cohorts. We propose a general approach to this problem that treats late-onset outcomes as missing data, uses data augmentation to impute missing outcomes from posterior predictive distributions computed from partial follow-up times and complete outcome data, and applies the design’s decision rules using the completed data. We illustrate the method with two cancer trials conducted using a phase I–II design based on efficacy-toxicity trade-offs, including a computer stimulation study. PMID:25382884

Personal, interpersonal, and situational influences on behavioral self-handicapping.

PubMed

Brown, Christina M; Kimble, Charles E

2009-12-01

This study explored the combined effects of personal factors (participant sex), interpersonal factors (experimenter sex), and situational factors (performance feedback) on two forms of behavioral self-handicapping. Participants received non-contingent success or failure feedback concerning their performance on a novel ability and were given the opportunity to self-handicap before performing again. Behavioral self-handicapping took the form of (a) exerting less practice effort (practice) or (b) choosing a performance-debilitating tape (choice). Men practiced least after failure feedback and chose a debilitating tape if they were interacting with a female experimenter. Generally, across all participants in both choice and practice conditions, high performance concern and the presence of a male experimenter led to the most self-handicapping. Results are interpreted in terms of self-presentational concerns that emphasize a desire to impress or an awareness of the female or male experimenter's acceptance of self-handicappers.

Choosing to become a general practitioner - What attracts and what deters? An analysis of German medical graduates' motives.

PubMed

Deutsch, Tobias; Lippmann, Stefan; Heitzer, Maximilian; Frese, Thomas; Sandholzer, Hagen

2016-01-01

To be able to counter the increasing shortage of general practitioners (GPs) in many countries, it is crucial to remain up-to-date with the decisive reasons why young physicians choose or reject a career in this field. Qualitative content analysis was performed using data from a cross-sectional survey among German medical graduates (n = 659, response rate = 64.2%). Subsequently, descriptive statistics was calculated. The most frequent motives to have opted for a GP career were (n = 74/81): Desire for variety and change (62.2%), interest in a long-term bio-psycho-social treatment of patients (52.7%), desire for independence and self-determination (44.6%), positively perceived work-life balance (27.0%), interest in contents of the field (12.2%), and reluctance to work in a hospital (12.2%). The most frequent motives to have dismissed the seriously considered idea of becoming a GP were (n = 207/578): Reluctance to establish a practice or perceived associated risks and impairments (33.8%), stronger preference for another field (19.3%), perception of workload being too heavy or an unfavorable work-life balance (15.0%), perception of too low or inadequate earning opportunities (14.0%), perception of the GP as a distributor station with limited diagnostic and therapeutic facilities (11.6%), perception of too limited specialization or limited options for further sub-specialization (10.6%), rejection of (psycho-) social aspects and demands in general practice (9.7%), and perceived monotony (9.7%). While some motives appear to be hard to influence, others reveal starting points to counter the GP shortage, in particular, with regard to working conditions, the further academic establishment, and the external presentation of the specialty.

Choosing to become a general practitioner – What attracts and what deters? An analysis of German medical graduates’ motives

PubMed Central

Deutsch, Tobias; Lippmann, Stefan; Heitzer, Maximilian; Frese, Thomas; Sandholzer, Hagen

2016-01-01

Background: To be able to counter the increasing shortage of general practitioners (GPs) in many countries, it is crucial to remain up-to-date with the decisive reasons why young physicians choose or reject a career in this field. Materials and Methods: Qualitative content analysis was performed using data from a cross-sectional survey among German medical graduates (n = 659, response rate = 64.2%). Subsequently, descriptive statistics was calculated. Results: The most frequent motives to have opted for a GP career were (n = 74/81): Desire for variety and change (62.2%), interest in a long-term bio-psycho-social treatment of patients (52.7%), desire for independence and self-determination (44.6%), positively perceived work-life balance (27.0%), interest in contents of the field (12.2%), and reluctance to work in a hospital (12.2%). The most frequent motives to have dismissed the seriously considered idea of becoming a GP were (n = 207/578): Reluctance to establish a practice or perceived associated risks and impairments (33.8%), stronger preference for another field (19.3%), perception of workload being too heavy or an unfavorable work-life balance (15.0%), perception of too low or inadequate earning opportunities (14.0%), perception of the GP as a distributor station with limited diagnostic and therapeutic facilities (11.6%), perception of too limited specialization or limited options for further sub-specialization (10.6%), rejection of (psycho-) social aspects and demands in general practice (9.7%), and perceived monotony (9.7%). Conclusion: While some motives appear to be hard to influence, others reveal starting points to counter the GP shortage, in particular, with regard to working conditions, the further academic establishment, and the external presentation of the specialty. PMID:27453840

Factors driving James Cook University Bachelor of Medicine, Bachelor of Surgery graduates' choice of internship location and beyond.

PubMed

Schauer, Anna; Woolley, Torres; Sen Gupta, Tarun

2014-04-01

To identify the main reason James Cook University (JCU) Bachelor of Medicine, Bachelor of Surgery graduates chose their internship location and first four practice relocations. This cross-sectional study invited 261 JCU medical graduates to participate in an email or telephone survey. Graduates' main reason for choosing internship location and up to four subsequent relocations, post-graduate specialty training undertaken and practice location (either metropolitan or non-metropolitan) for graduates' internship year and current practice year (2012). Respondents (n=175; response rate=67%) reported personal factors as the primary driver for choosing their internship location, with 33% returning to 'near their family/home town', and 21% staying in the town they were based in Years 5 and 6. Professional reasons dominated for subsequent relocations, particularly 'long-term career ambitions'. Fifty-nine of the 175 (34%) JCU graduates had undertaken their internship in a metropolitan location (Australian Standard Geographical Classification Remoteness Area 1), while 80 (46%) currently (in 2012) practised in a metropolitan location. Internship location was not associated with later specialty training, but current metropolitan practice was associated with Surgical or Paediatrics training (P=0.007 and P=0.063, respectively), while current non-metropolitan practice was associated with General Practice and Rural Generalist training (P=0.010 and P=0.001, respectively). Personal decisions take precedence over professional career decisions for why JCU medical graduates chose their internship location, but subsequent relocations are driven by career ambitions, usually around specialty training requirements. These findings support establishing more post-graduate training opportunities in non-metropolitan settings for Surgical and Paediatric specialties as a retention strategy for a rural medical career. © 2014 National Rural Health Alliance Inc.

Exploring resilience in rural GP registrars--implications for training.

PubMed

Walters, Lucie; Laurence, Caroline O; Dollard, Joanne; Elliott, Taryn; Eley, Diann S

2015-07-02

Resilience can be defined as the ability to rebound from adversity and overcome difficult circumstances. General Practice (GP) registrars face many challenges in transitioning into general practice, and additional stressors and pressures apply for those choosing a career in rural practice. At this time of international rural generalist medical workforce shortages, it is important to focus on the needs of rural GP registrars and how to support them to become resilient health care providers. This study sought to explore GP registrars' perceptions of their resilience and strategies they used to maintain resilience in rural general practice. In this qualitative interpretive research, semi-structured interviews were recorded, transcribed and analysed using an inductive approach. Initial coding resulted in a coding framework which was refined using constant comparison and negative case analysis. Authors developed consensus around the final conceptual model. Eighteen GP registrars from: Australian College of Rural and Remote Medicine Independent Pathway, and three GP regional training programs with rural training posts. Six main themes emerged from the data. Firstly, rural GP registrars described four dichotomous tensions they faced: clinical caution versus clinical courage; flexibility versus persistence; reflective practice versus task-focused practice; and personal connections versus professional commitment. Further themes included: personal skills for balance which facilitated resilience including optimistic attitude, self-reflection and metacognition; and finally GP registrars recognised the role of their supervisors in supporting and stretching them to enhance their clinical resilience. Resilience is maintained as on a wobble board by balancing professional tensions within acceptable limits. These limits are unique to each individual, and may be expanded through personal growth and professional development as part of rural general practice training.

Preoperative Site Marking: Are We Adhering to Good Surgical Practice?

PubMed

Bathla, Sonia; Chadwick, Michael; Nevins, Edward J; Seward, Joanna

2017-06-29

Wrong-site surgery is a never event and a serious, preventable patient safety incident. Within the United Kingdom, national guidance has been issued to minimize the risk of such events. The mandate includes preoperative marking of all surgical patients. This study aimed to quantify regional variation in practice within general surgery and opinions of the surgeons, to help guide the formulation and implementation of a regional general surgery preoperative marking protocol. A SurveyMonkey questionnaire was designed and distributed to 120 surgeons within the Mersey region, United Kingdom. This included all surgical trainees in Mersey (47 registrars, 56 core trainees), 15 consultants, and 2 surgical care practitioners. This sought to ascertain their routine practice and how they would choose to mark for 12 index procedures in general surgery, if mandated to do so. A total of 72 responses (60%) were obtained to the SurveyMonkey questionnaire. Only 26 (36.1%) said that they routinely marked all of their patients preoperatively. The operating surgeon marked the patient in 69% of responses, with the remainder delegating this task. Markings were visible after draping in only 55.6% of marked cases. Based on our findings, surgeons may not be adhering to "Good Surgical Practice"; practice is widely variable and surgeons are largely opposed and resistant to marking patients unless laterality is involved. We suggest that all surgeons need to be actively engaged in the design of local marking protocols to gain support, change practice, and reduce errors.

Healthy Foodservice Benchmarking and Leading Practices

DTIC Science & Technology

2012-07-01

identified a vending machine company selling foods and beverages free of partially hydrogenated oils (i.e. trans fats), high fructose corn syrup , and...Benchmarking and Leading Practices | 4  Commissary officials are working to reduce the number of products sold in commissaries that are high in fat...were 48% more likely to choose a low-calorie meal and patrons given the menu with the default high -calorie options were 47% less likely to choose a

Primary care specialty career choice among Canadian medical students

PubMed Central

Osborn, Heather Ann; Glicksman, Jordan T.; Brandt, Michael G.; Doyle, Philip C.; Fung, Kevin

2017-01-01

Abstract Objective To identify which factors influence medical students’ decision to choose a career in family medicine and pediatrics, and which factors influence their decision to choose careers in non–front-line specialties. Design Survey that was created based on a comprehensive literature review to determine which factors are considered important when choosing practice specialty. Setting Ontario medical school. Participants An open cohort of medical students in the graduating classes of 2008 to 2011 (inclusive). Main outcome measures The main factors that influenced participants’ decision to choose a career in primary care or pediatrics, and the main factors that influenced participants’ decision to choose a career in a non–front-line specialty. Results A total of 323 participants were included in this study. Factors that significantly influenced participants’ career choice in family medicine or pediatrics involved work-life balance (acceptable hours of practice [P = .005], acceptable on-call demands [P = .012], and lifestyle flexibility [P = .006]); a robust physician-patient relationship (ability to promote individual health promotion [P = .014] and the opportunity to form long-term relationships [P < .001], provide comprehensive care [P = .001], and treat patients and their families [P = .006]); and duration of residency program (P = .001). The career-related factors that significantly influenced participants’ decision to choose a non–front-line specialty were as follows: becoming an expert (P < .001), maintaining a focused scope of practice (P < .001), having a procedure-focused practice (P = .001), seeing immediate results from one’s actions (P < .001), potentially earning a high income (P < .001), and having a perceived status among colleagues (P < .001). Conclusion In this study, 8 factors were found to positively influence medical students’ career choice in family medicine and pediatrics, and 6 factors influenced the decision to choose a career in a non–front-line specialty. Medical students can be encouraged to explore a career in family medicine or pediatrics by addressing misinformation, by encouraging realistic expectations of career outcomes in the various specialties, and by demonstrating the capacity of primary care fields to incorporate specific motivating factors. PMID:28209702

Primary care specialty career choice among Canadian medical students: Understanding the factors that influence their decisions.

PubMed

Osborn, Heather Ann; Glicksman, Jordan T; Brandt, Michael G; Doyle, Philip C; Fung, Kevin

2017-02-01

To identify which factors influence medical students' decision to choose a career in family medicine and pediatrics, and which factors influence their decision to choose careers in non-front-line specialties. Survey that was created based on a comprehensive literature review to determine which factors are considered important when choosing practice specialty. Ontario medical school. An open cohort of medical students in the graduating classes of 2008 to 2011 (inclusive). The main factors that influenced participants' decision to choose a career in primary care or pediatrics, and the main factors that influenced participants' decision to choose a career in a non-front-line specialty. A total of 323 participants were included in this study. Factors that significantly influenced participants' career choice in family medicine or pediatrics involved work-life balance (acceptable hours of practice [ P = .005], acceptable on-call demands [ P = .012], and lifestyle flexibility [ P = .006]); a robust physician-patient relationship (ability to promote individual health promotion [ P = .014] and the opportunity to form long-term relationships [ P  < .001], provide comprehensive care [ P = .001], and treat patients and their families [ P = .006]); and duration of residency program ( P = .001). The career-related factors that significantly influenced participants' decision to choose a non-front-line specialty were as follows: becoming an expert ( P  < .001), maintaining a focused scope of practice ( P  < .001), having a procedure-focused practice ( P = .001), seeing immediate results from one's actions ( P  < .001), potentially earning a high income ( P  < .001), and having a perceived status among colleagues ( P  < .001). In this study, 8 factors were found to positively influence medical students' career choice in family medicine and pediatrics, and 6 factors influenced the decision to choose a career in a non-front-line specialty. Medical students can be encouraged to explore a career in family medicine or pediatrics by addressing misinformation, by encouraging realistic expectations of career outcomes in the various specialties, and by demonstrating the capacity of primary care fields to incorporate specific motivating factors. Copyright© the College of Family Physicians of Canada.

The future of optometric practice? The results of a survey of optometrists and optometry students.

PubMed

Silverman, Morton W; Woodruff, Chris; Hardigan, Patrick C

2004-10-01

There is an apparent increase in the number of private optometry practices that are closing due to a lack of interested buyers. We examined some of the factors that influence the market for optometry practices in a survey of practicing optometrists and third- and fourth-year optometry students. Optometrists in six states, and students at four schools and colleges of optometry, completed a mailed or faxed survey regarding attitudes toward optometric practice, including fair/reasonable compensation for a new optometrist, the value of optometric practices, and preferred mode of practice on graduation. Doctors and students differed significantly in the amount of money they reported as fair/reasonable compensation for a recently graduated optometrist joining a practice. Comparing students to doctors in specific categories of compensation, students chose a higher fair/reasonable compensation compared to doctors. Students were more likely than doctors to choose >$70,000 as fair/reasonable compensation, while doctors were more likely than students to choose $40,000 to $69,000. Doctors tended to overvalue their practices for the purpose of selling the practice when using percentage of gross income as a valuation method. Students' choices for mode of practice changed dramatically from their ideal when taking their current financial situation into consideration. Students were more likely to choose corporate practice as their preferred practice mode when considering their current financial situation than when not restricted. There are many factors that affect the value and marketability of an optometric practice. In order to sell a practice, the owner must consider the effects of the needs and desires of recently graduated optometrists.

Influences on physicians' choices of intravenous colloids.

PubMed

Miletin, Michael S; Stewart, Thomas E; Norton, Peter G

2002-07-01

Controversy over the optimal intravenous fluid for volume resuscitation continues unabated. Our objectives were to characterize the demographics of physicians who prescribe intravenous colloids and determine factors that enter into their decision to choose a colloid. Questionnaire with 61 items. Ten percent ( n = 364) of frequent intravenous fluid prescribers in the province of Ontario, Canada. The response rate was 74%. Colloid use in the past year was reported by 79% of the responding physicians. Important reasons for choosing a colloid included blood loss and manipulation of oncotic pressure. Physicians tended to prefer either albumin or pentastarch, but no important reasons were found for choosing between the two. Albumin with or without crystalloid was preferred in 5/13 scenarios by more than 50% of the respondents, whereas pentastarch was not favored by more than 50% of respondents in any scenario. Physicians practising in critical care areas and teaching hospitals generally preferred pentastarch to albumin. Physicians reporting pentastarch as representing greater than 90% of total colloid use were more likely to have been visited by a drug detailer for pentastarch than those who used less synthetic colloid (54 vs 22%, p < 0.001). The majority of physicians surveyed prescribe colloid products and the reported use of albumin and pentastarch has a bimodal distribution. Although albumin appeared to be preferred in more clinical niches, most physicians did not state reasons for choosing between products. Marketing, specialty, location of practice and clinical scenario appear to play significant roles in the utilization of colloid products.

Factors associated with the choice of general medicine as a career among Japanese medical students.

PubMed

Kawamoto, Ryuichi; Ninomiya, Daisuke; Kasai, Yoshihisa; Kusunoki, Tomo; Ohtsuka, Nobuyuki; Kumagi, Teru; Abe, Masanori

2016-01-01

Background In Japan, there is a shortage of young physicians in various specialties; the present situation of general medicine or family medicine (GM/FM) in particular is risky. The factors influencing the career choice of Japanese medical students are poorly understood. This study aims to identify factors related to choosing GM/FM as a career. Methods The study was designed as a cross-sectional survey. Students at one medical school in Japan filled out a questionnaire. Students were asked to state their intended medical specialty, and they rated the importance of specific individual and occupational aspects using a 4-point likert scale. Factor analysis was performed on the variables. Reliability of the factor scores was estimated using Cronbach's alpha coefficients; biserial correlations between the factors and career choices were calculated. Furthermore, multiple linear regression analysis was performed using career choice (GM/FM vs. others) as the criterion variable and the factors plus demographic characteristics as confounding variables. Results Factor analysis produced six factors that explained future career plans. Medical students in this study had a positive and realistic idea about GM/FM, but only 18.8% of them chose GM/FM first as a career. The significant variables associated with choosing GM/FM first as a career were: 'Admission from hometown' (β=0.189, P=0.001), 'Student preparing for the entrance exam' (β=0.172; P=0.001), 'Intent for rural practice' (β=0.123, P=0.016), and 'Work-life balance' (β=0.126, P=0.013). While significant variables that were negatively associated with choosing GM/FM were 'Presence of medical relatives' (β=-0.107, P=0.037) and 'Scientific orientation' (β=-0.125, P=0.013). Conclusions Strategies have been suggested, such as recruiting medical students with significant variables that were associated with choosing GM/FM first as a career. By engaging students early in their choice of career, we may be able to increase enthusiasm for this specialty.

Factors associated with the choice of general medicine as a career among Japanese medical students.

PubMed

Kawamoto, Ryuichi; Ninomiya, Daisuke; Kasai, Yoshihisa; Kusunoki, Tomo; Ohtsuka, Nobuyuki; Kumagi, Teru; Abe, Masanori

2016-01-01

In Japan, there is a shortage of young physicians in various specialties; the present situation of general medicine or family medicine (GM/FM) in particular is risky. The factors influencing the career choice of Japanese medical students are poorly understood. This study aims to identify factors related to choosing GM/FM as a career. The study was designed as a cross-sectional survey. Students at one medical school in Japan filled out a questionnaire. Students were asked to state their intended medical specialty, and they rated the importance of specific individual and occupational aspects using a 4-point likert scale. Factor analysis was performed on the variables. Reliability of the factor scores was estimated using Cronbach's alpha coefficients; biserial correlations between the factors and career choices were calculated. Furthermore, multiple linear regression analysis was performed using career choice (GM/FM vs. others) as the criterion variable and the factors plus demographic characteristics as confounding variables. Factor analysis produced six factors that explained future career plans. Medical students in this study had a positive and realistic idea about GM/FM, but only 18.8% of them chose GM/FM first as a career. The significant variables associated with choosing GM/FM first as a career were: 'Admission from hometown' (β=0.189, P=0.001), 'Student preparing for the entrance exam' (β=0.172; P=0.001), 'Intent for rural practice' (β=0.123, P=0.016), and 'Work-life balance' (β=0.126, P=0.013). While significant variables that were negatively associated with choosing GM/FM were 'Presence of medical relatives' (β=-0.107, P=0.037) and 'Scientific orientation' (β=-0.125, P=0.013). Strategies have been suggested, such as recruiting medical students with significant variables that were associated with choosing GM/FM first as a career. By engaging students early in their choice of career, we may be able to increase enthusiasm for this specialty.

The moral foundation of the clinical duties of care: needs, duties and human rights.

PubMed

Doyal, L

2001-10-01

It has become fashionable to question attempts to derive internationally agreed duties of clinical care from more general theories of human rights. For example, some argue that such attempts risk moral abstraction through their neglect for the importance of culture and community in shaping moral consciousness and thus often unhelpful in the resolution of concrete moral dilemmas within medicine. Others denounce the importance of general moral principles altogether in bioethics and attempt to articulate what are claimed to be more practical approaches to resolving moral conflict. This paper challenges such arguments. It does so through arguing that: i) all humans everywhere have the same basic human needs; ii) the satisfaction of these needs varies with culture; iii) the imputation of moral duties on others entails respect for their right to basic need satisfaction, including the right to choose between presumptions about the duties and rights of patients which follow from these more general principles and v) problems of moral indeterminancy that arise from putting these principles into practice can be resolved through associated procedural policies of rational negotiation and compromise. The moral importance and practicality of respect for individual human rights within the practice of medicine is thus defended. Indeed, the paper concludes by arguing that without belief in human rights linked to a theory of basic human needs, communitarian theories of morality are incoherent.

Educational debt and intended employment choice among dental school seniors.

PubMed

Wanchek, Tanya; Nicholson, Sean; Vujicic, Marko; Menezes, Adriana; Ziebert, Anthony

2014-05-01

The authors examined the association between educational debt and dental school seniors' intended activity after graduation. The authors used multinomial logit regression analysis to estimate the relationship between dental educational debt and intended activity after graduation, controlling for potentially confounding variables. They used data from the 2004 through 2011 ADEA (American Dental Education Association) Survey of Dental School Seniors. Fourth-year dental school students with high levels of educational debt were more likely to express an interest in choosing to go into private practice, although the magnitude of this effect was relatively small. For each $10,000 increase in debt, the likelihood of choosing advanced education relative to private practice was 1.5 percent lower (relative risk ratio [RRR], 0.985 [95 percent confidence interval {CI}, 0.978-0.991]). For the same $10,000 increase in debt, the probability of choosing teaching, research and administration was 3.1 percent lower than that for choosing private practice (RRR, 0.969 [95 percent CI, 0.954-0.986]) and was 8.4 percent lower than that for choosing a government service position (RRR, 0.916 [95 percent CI, 0.908-0.924]). Although educational debt was statistically significant for predicting intended activity after graduation, the magnitude of influence of other variables such as sex, race and whether a parent is a dentist was substantially larger. Practical Implications Concerns regarding rising educational debt and its effect on the dental labor market may be misplaced. The characteristics of the dental school student body may be a more accurate predictor of employment choices that dental school seniors are making than are total educational debt levels.

Comparison of software packages for detecting differential expression in RNA-seq studies

PubMed Central

Seyednasrollah, Fatemeh; Laiho, Asta

2015-01-01

RNA-sequencing (RNA-seq) has rapidly become a popular tool to characterize transcriptomes. A fundamental research problem in many RNA-seq studies is the identification of reliable molecular markers that show differential expression between distinct sample groups. Together with the growing popularity of RNA-seq, a number of data analysis methods and pipelines have already been developed for this task. Currently, however, there is no clear consensus about the best practices yet, which makes the choice of an appropriate method a daunting task especially for a basic user without a strong statistical or computational background. To assist the choice, we perform here a systematic comparison of eight widely used software packages and pipelines for detecting differential expression between sample groups in a practical research setting and provide general guidelines for choosing a robust pipeline. In general, our results demonstrate how the data analysis tool utilized can markedly affect the outcome of the data analysis, highlighting the importance of this choice. PMID:24300110

Comparison of software packages for detecting differential expression in RNA-seq studies.

PubMed

Seyednasrollah, Fatemeh; Laiho, Asta; Elo, Laura L

2015-01-01

RNA-sequencing (RNA-seq) has rapidly become a popular tool to characterize transcriptomes. A fundamental research problem in many RNA-seq studies is the identification of reliable molecular markers that show differential expression between distinct sample groups. Together with the growing popularity of RNA-seq, a number of data analysis methods and pipelines have already been developed for this task. Currently, however, there is no clear consensus about the best practices yet, which makes the choice of an appropriate method a daunting task especially for a basic user without a strong statistical or computational background. To assist the choice, we perform here a systematic comparison of eight widely used software packages and pipelines for detecting differential expression between sample groups in a practical research setting and provide general guidelines for choosing a robust pipeline. In general, our results demonstrate how the data analysis tool utilized can markedly affect the outcome of the data analysis, highlighting the importance of this choice. © The Author 2013. Published by Oxford University Press.

Bookshelf. Seize the Moment.

ERIC Educational Resources Information Center

Wilde, Susie

1997-01-01

Optimal classroom read-aloud sessions result from teachers' planning and practice. Important considerations include choosing the right book, prereading, reading dramatically, and choosing authors who have written several books. Books that are sure to go over well include those that let the students get involved, stories that start discussions, and…

[Lack of interest in general practice during the National Ranking Examination in 2005].

PubMed

Lanson, Yves

2006-03-01

The second national ranking test took place in 2005 in the same conditions as the year before. Analysis of the results permits us to assess whether the objectives of this reform have been met so far. Data crossing of the results provided by the national testing center allowed us to rank: 1) the appeal of specializations for each geographic subdivision, 2) the candidates by medical school, and 3) the appeal of each subdivision by candidate rank. 66% of the students were classified high enough to be able to choose any specialization. Trends observed from the first examination, in 2004, were confirmed, with the clear desirability of medical specializations and a certain lack of interest in occupational medicine and public health. All the surgery posts were filled, even though the number of posts had increased enormously since the first examination. After adjustment for the number of posts available, the specializations in decreasing order of popularity were: medical, surgical, pediatrics, anesthesiology, gynecology-obstetrics, general medicine, psychiatry, and biology. Approximately 1000 posts in general medicine were not filled. The medical schools whose students ranked highest were Paris Pitié, Paris V, Paris West, Lyon North, Grenoble, and Aix-Marseille. Some medical schools did less well than previously: Marseille very slightly and Angers substantially. Strasbourg, Nancy Amiens and Bobigny were at the bottom of the list. The cities most desired for internships were Paris, Toulouse, Lyon, and Aix-Marseille, while Brest, Nancy, Limoges and the West Indies were ranked lowest, although each was chosen by highly ranked candidate. Two thirds of the students were ranked high enough to allow them a free choice of specializations. All the specializations except public health and occupational medicine had very highly ranked students. Medical specializations are the most desired, but surgery remains highly demanded, despite a substantial increase in the number of posts. All posts were filled in all specializations, but only 41% of those in general medicine. Medical schools whose students ranked highest had the fewest students choosing general practice.

Sarah was a butch: sexual identity, gender practices, and Sarah's place as mother in the Jewish National Pantheon.

PubMed

Kalev, Henriette Dahan

2012-01-01

Three fields of discourse regarding a masculine-like woman connect at a point that the queer field calls intersex, medical practice calls a sexual disorder, and rabbinic literature terms aylonit. The queer discursive field focuses on the freedom to choose an identity, but not the freedom from choosing one. The medical field focuses on sexual practice as the source of determining "normal" sexuality. In the discursive field of Jewish law there are no demands, because the Halakhic authority determines gender identity on behalf of the individual, maintaining ambiguity. Copyright © Taylor & Francis Group, LLC

Factors that affect general practice as a choice of medical speciality: implications for policy development.

PubMed

Vohra, Amit; Ladyshewsky, Richard; Trumble, Stephen

2017-11-28

Objective This article critically appraises the range of personal, professional and social factors that affect the choice of speciality across medical students, prevocational doctors, general practice registrars and general practitioners. Methods This qualitative study applied constructs from the fields of decision theory and career theory to better understand the complex nature of choosing a speciality. In all, 47 in-depth interviews were conducted with participants at different stages of their career cycle. The data was codified and analysed using NVivo to identify key factors that influenced speciality choice. Results The research identified 77 individual findings influencing general practice as a choice of medical speciality. These were distilled into a matrix to show that factors such as money, prestige and peer interaction did not have a compelling effect, whereas clinical and academic role models, flexibility, work-life balance, scope of practice, connection with patients, training environment and practical opportunities did. Conclusion The findings indicate that the decision in relation to the choice of medical speciality is a complex cognitive process that is undertaken within a personal, social and professional context particular to each individual. What is known about the topic? Current literature aims to quantify changes in attitudes towards choice of speciality or the effect of particular variables in isolation while ignoring the complexity of this decision process and how the numerous variables compare with each other. What does this paper add? The present study is the first intergenerational research on this topic in the Australian context and the paper dismisses the role of prestige and remuneration as key drivers of choice in picking general practice as a speciality, noting that money is merely a 'hygiene factor'. What are the implications for policy makers? A policy framework outlining 10 key principles is presented to assist policy makers seeking to affect workforce outcomes by applying policy levers to influence doctors' choice of speciality.

Comparison of urban and rural general surgeons: motivations for practice location, practice patterns, and education requirements.

PubMed

Heneghan, Steven J; Bordley, James; Dietz, Patrick A; Gold, Michael S; Jenkins, Paul L; Zuckerman, Randall J

2005-11-01

The purpose of this study is to determine the differences between rural and urban surgeons with regard to practice patterns, factors in choosing a practice location, and educational needs. A list of surgeons obtained from the American Medical Association was examined using the Office of Management and Budget definition of rural. Seventeen hundred rural surgeons were mailed surveys; 421 responded. One hundred fourteen urban surgeons were contacted by telephone. Questions were designed to measure job and community satisfaction, factors influencing their decision to practice in their current location, spectrum and volume of cases, and their perceived educational needs. Age distribution did not differ markedly between urban and rural surgeons. Motivation to practice in their current location varied considerably between urban and rural surgeons. Both groups equally rated quality of life as the leading factor influencing their current practice location. Urban surgeons rated other factors, such as income, practice growth, hospital facilities, and proximity to family, higher than rural surgeons. Practice patterns and educational needs also varied between the two groups. Rural surgeons performed more procedures per year with more variety in procedure type. Both groups felt that additional training in advanced laparoscopic techniques would be helpful, and rural surgeons felt that additional training in the surgical subspecialty areas was important. Although rural and urban surgeons do not differ in age or the importance of lifestyle in deciding career location, different factors do impact their choice of location. Practice pattern and educational needs varied markedly between rural and urban general surgeons.

Chinese hotel general managers' perspectives on energy-saving practices

NASA Astrophysics Data System (ADS)

Zhu, Yidan

As hotels' concern about sustainability and budget-control is growing steadily, energy-saving issues have become one of the important management concerns hospitality industry face. By executing proper energy-saving practices, previous scholars believed that hotel operation costs can decrease dramatically. Moreover, they believed that conducting energy-saving practices may eventually help the hotel to gain other benefits such as an improved reputation and stronger competitive advantage. The energy-saving issue also has become a critical management problem for the hotel industry in China. Previous research has not investigated energy-saving in China's hotel segment. To achieve a better understanding of the importance of energy-saving, this document attempts to present some insights into China's energy-saving practices in the tourist accommodations sector. Results of the study show the Chinese general managers' attitudes toward energy-saving issues and the differences among the diverse hotel managers who responded to the study. Study results indicate that in China, most of the hotels' energy bills decrease due to the implementation of energy-saving equipments. General managers of hotels in operation for a shorter period of time are typically responsible for making decisions about energy-saving issues; older hotels are used to choosing corporate level concerning to this issue. Larger Chinese hotels generally have official energy-saving usage training sessions for employees, but smaller Chinese hotels sometimes overlook the importance of employee training. The study also found that for the Chinese hospitality industry, energy-saving practices related to electricity are the most efficient and common way to save energy, but older hotels also should pay attention to other ways of saving energy such as water conservation or heating/cooling system.

Practical guidelines for implementing adaptive optics in fluorescence microscopy

NASA Astrophysics Data System (ADS)

Wilding, Dean; Pozzi, Paolo; Soloviev, Oleg; Vdovin, Gleb; Verhaegen, Michel

2018-02-01

In life sciences, interest in the microscopic imaging of increasingly complex three dimensional samples, such as cell spheroids, zebrafish embryos, and in vivo applications in small animals, is growing quickly. Due to the increasing complexity of samples, more and more life scientists are considering the implementation of adaptive optics in their experimental setups. While several approaches to adaptive optics in microscopy have been reported, it is often difficult and confusing for the microscopist to choose from the array of techniques and equipment. In this poster presentation we offer a small guide to adaptive optics providing general guidelines for successful adaptive optics implementation.

Marital Equality When Fathers Stay at Home.

ERIC Educational Resources Information Center

Zimmerman, Toni Schindler; Northen, Leslie Parker; Seng, Stephanie Crandall; Grogan, John W.

1999-01-01

Examines the experience of the family arrangement in which fathers choose to stay at home as the primary caregiver while their wives provide the family's income. Results indicate that couples choose this arrangement for both practical and philosophical reasons and that these couples are sharing more responsibilities than couples have…

7 CFR 43.106 - Choosing AQL's and sampling plans.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 2 2010-01-01 2010-01-01 false Choosing AQL's and sampling plans. 43.106 Section 43.106 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE COMMODITY STANDARDS AND STANDARD CONTAINER REGULATIONS STANDARDS FOR SAMPLING PLANS...

Dental students' perceptions of dental specialties and factors influencing specialty and career choices.

PubMed

Dhima, Matilda; Petropoulos, Vicki C; Han, Rita K; Kinnunen, Taru; Wright, Robert F

2012-05-01

The goals of this study were to 1) evaluate dental students' perceptions of dental specialties, 2) identify factors that play an important role in students' decision to pursue specialty training or career choices, and 3) establish a baseline of students' perceptions of the dental fields with the best future in terms of salary, personal and patient quality of life, and overall impact on the dental profession. Surveys were distributed to 494 students at the University of Pennsylvania School of Dental Medicine. Data were collected from 380 traditional four-year students and thirty advanced standing students. Chi-square tests, multivariate analysis, and logistic regressions were used to determine associations and independent contributions of student demographics to their perceptions of dental specialties and factors influencing specialty training or career choices. Debt was a statistically significant factor (p<0.001) in choosing specialty training or career independent of gender, age, or class year. Enjoyment of providing care in a specialty or field was identified as the single most important factor in choosing a specialty career. Half of the respondents had decided not to specialize. Pursuing postdoctoral general dentistry training and private practice in general dentistry were the most commonly reported plans after completion of dental school. Suggestions are made for ways to inform students about specialty training.

General surgery in crisis--factors that impact on a career in general surgery.

PubMed

Kahn, D; Pillay, S; Veller, M G; Panieri, E; Westcott, M J R

2006-08-01

The Association of Surgeons of South Africa (ASSA), because of a concern about the decline in the number of applicants for registrar posts, undertook this study into the various factors that may influence the choice of surgery as career option. The study involved a combination of desk research and structured interviews with heads of departments, specialists, and registrars in general surgery. The reasons for choosing general surgery as a career included the immediately visible results of a surgeon's efforts and the practical and intellectual challenge of the specialty. General surgery continued to enjoy a high status in society. The greater focus on primary health care has affected facilities at tertiary and secondary institutions. General surgeons worked excessively long hours, which was associated with increased levels of stress and placed severe strains on family life. All respondents felt that their levels of remuneration were 'poor' in relation to other disciplines and professions. In this study we identified various factors that impacted either positively or negatively on the choice of general surgery as a career option.

Application of Dirac's Generalized Hamiltonian Dynamics to Atomic and Molecular Systems

NASA Astrophysics Data System (ADS)

Uzer, Turgay

2002-10-01

Incorporating electronic degrees of freedom into classical treatments of atoms and molecules is a challenging problem from both the practical and fundamental points of view. Because it goes to the heart of classical-quantal correspondence, there are now a number of prescriptions which differ by the extent of quantal information that they include. We reach back to Dirac for inspiration, who, half a century ago, designed a so-called Generalized Hamiltonian Dynamics (GHD) with applications to field theory in mind. Physically, the GHD is a purely classical formalism for systems with constraints; it incorporates the constraints into the Hamiltonian. We apply the GHD to atomic and molecular physics by choosing integrals of motion as the constraints. We show that this purely classical formalism allows the derivation of energies of non-radiating states.

Factors relating to usage patterns of amalgam and resin composite for posterior restorations--a prospective analysis.

PubMed

Khalaf, Mai E; Alomari, Qasem D; Omar, Ridwaan

2014-07-01

This study prospectively analyzed the use of amalgam and resin composite posterior restorations placed by general dentists in relation to dentist, patient and cavity factors. One thousand posterior restorations placed by a representative sample of general dentists working in the Ministry of Health (MOH), Kuwait, during routine clinical practice were included. Information about the restorations was recorded using a survey questionnaire. Descriptive statistics and multivariate logistic regression analysis were used to determine the factors associated with the use of amalgam versus tooth coloured restoratives. Dentists chose amalgam for 30.8% of the 1000 restorations. Dentists with longer work experience (>15 years) were more likely to choose amalgam (OR=2.61, 95% CI=1.06, 6.40). Younger dentists (≤30 years) were less likely to choose amalgam (OR=0. 45, 95% CI=0.26, 0.77). Amalgam was more likely to be chosen for patients with poor oral hygiene (OR=1.58, 95% CI=1.08, 2.32) and a higher number (≥4) of restorations (OR=1.44, 95% CI=1.07, 1.94) with large cavity sizes (OR=6.33, 95% CI=3.88, 10.32). Tooth-coloured restorations were more likely to be chosen for cavities of smaller sizes. The use of resin composite materials as the dominant choice among dentists in Kuwait reflects the trend worldwide. Nevertheless, clinicians still find a use for amalgam in posterior load-bearing teeth and in the high-caries risk population. The findings give insight into factors influencing material usage under different clinical conditions and provides information about the perceived deficiencies or shortcomings of resin composite materials in a general dental practice setting. This information can be useful for identifying perceived barriers to the usage of newer restorative materials and finding ways to overcome them. Copyright © 2014 Elsevier Ltd. All rights reserved.

Why Men Choose to Become Primary Teachers

ERIC Educational Resources Information Center

Cruickshank, Vaughan

2012-01-01

This paper presents a critical analysis of literature relating to why males choose to become primary school teachers. Discussion within the paper concentrates on identifying and exploring connections between what is currently known about being a male primary school teacher and what motivates these men as they both pursue and practice within the…

Are patients' preferences regarding the place of treatment heard and addressed at the point of referral: an exploratory study based on observations of GP-patient consultations.

PubMed

Victoor, Aafke; Noordman, Janneke; Sonderkamp, Johan A; Delnoij, Diana M J; Friele, Roland D; van Dulmen, Sandra; Rademakers, Jany J D J M

2013-12-10

Today, in several north-western European countries, patients are encouraged to choose, actively, a healthcare provider. However, patients often visit the provider that is recommended by their general practitioner (GP). The introduction of patient choice requires GPs to support patients to be involved, actively, in the choice of a healthcare provider. We aim to investigate whether policy on patient choice is reflected in practice, i.e. what the role of the patient is in their choices of healthcare providers at the point of referral and to what extent GPs' and patients' healthcare paths influence the role that patients play in the referral decision. In 2007-2008, we videotaped Dutch GP-patient consultations. For this study, we selected, at random, 72 videotaped consultations between 72 patients and 39 GPs in which the patient was referred to a healthcare provider. These were analysed using an observation protocol developed by the researchers. The majority of the patients had little or no input into the choice of a healthcare provider at the point of referral by their GP. Their GPs did not support them in actively choosing a provider and the patients often agreed with the provider that the GP proposed. Patients who were referred for diagnostic purposes seem to have had even less input into their choice of a provider than patients who were referred for treatment. We found that the GP chooses a healthcare provider on behalf of the patient in most consultations, even though policy on patient choice expects from patients that they choose, actively, a provider. On the one hand, this could indicate that the policy needs adjustments. On the other hand, adjustments may be needed to practice. For instance, GPs could help patients to make an active choice of provider. However, certain patients prefer to let their GP decide as their agent. Even then, GPs need to know patients' preferences, because in a principal-agent relationship, it is necessary that the agent is fully informed about the principal's preferences.

Are patients’ preferences regarding the place of treatment heard and addressed at the point of referral: an exploratory study based on observations of GP-patient consultations

PubMed Central

2013-01-01

Background Today, in several north-western European countries, patients are encouraged to choose, actively, a healthcare provider. However, patients often visit the provider that is recommended by their general practitioner (GP). The introduction of patient choice requires GPs to support patients to be involved, actively, in the choice of a healthcare provider. We aim to investigate whether policy on patient choice is reflected in practice, i.e. what the role of the patient is in their choices of healthcare providers at the point of referral and to what extent GPs’ and patients’ healthcare paths influence the role that patients play in the referral decision. Methods In 2007–2008, we videotaped Dutch GP-patient consultations. For this study, we selected, at random, 72 videotaped consultations between 72 patients and 39 GPs in which the patient was referred to a healthcare provider. These were analysed using an observation protocol developed by the researchers. Results The majority of the patients had little or no input into the choice of a healthcare provider at the point of referral by their GP. Their GPs did not support them in actively choosing a provider and the patients often agreed with the provider that the GP proposed. Patients who were referred for diagnostic purposes seem to have had even less input into their choice of a provider than patients who were referred for treatment. Conclusions We found that the GP chooses a healthcare provider on behalf of the patient in most consultations, even though policy on patient choice expects from patients that they choose, actively, a provider. On the one hand, this could indicate that the policy needs adjustments. On the other hand, adjustments may be needed to practice. For instance, GPs could help patients to make an active choice of provider. However, certain patients prefer to let their GP decide as their agent. Even then, GPs need to know patients’ preferences, because in a principal-agent relationship, it is necessary that the agent is fully informed about the principal’s preferences. PMID:24325155

Over-reporting significant figures--a significant problem?

PubMed

Hawkins, Robert C; Badrick, Tony; Hickman, Peter E

2007-01-01

Excessive use of significant figures in numerical data gives a spurious impression of laboratory imprecision to clinicians. We describe reporting practices in 24 Asia-Pacific laboratories, assess whether these reporting formats and those used in the literature can be justified based on actual laboratory performance and outline how to choose the appropriate number of significant places. Thirty-two laboratories in Asia-Pacific were surveyed as to their reporting practices for serum creatinine, ferritin, sodium and TSH. Imprecision data from the General Serum Chemistry program from the RCPA-AACB Quality Assurance Program (QAP) were used to assess whether the reporting unit magnitude implicitly suggested in Tietz, the RCPA Manual and the General Serum Chemistry program itself was justified. There was a 75% response rate to the survey, with laboratories generally reporting data using unjustifiable deciles. Unit sizes from the RCPA manual, Tietz and the RCPA-AACB QAP were not justified by the majority of laboratories in the RCPA-AACB QAP. The reporting unit size used by many laboratories is not justified by present laboratory performance using a 95% probability level. A consensus on appropriate reporting unit size is needed to encourage laboratories to change their present reporting formats.

Factors influencing the decision of surgery residency graduates to pursue general surgery practice versus fellowship.

PubMed

Klingensmith, Mary E; Cogbill, Thomas H; Luchette, Frederick; Biester, Thomas; Samonte, Kelli; Jones, Andrew; Lewis, Frank R; Malangoni, Mark A

2015-09-01

Surgery residency serves 2 purposes-prepare graduates for general surgery (GS) practice or postresidency surgical fellowship, leading to specialty surgical practice (SS). This study was undertaken to elucidate factors influencing career choice for these 2 groups. All US allopathic surgery residency graduates from 2009 to 2013 (n = 5512) were surveyed by the American Board of Surgery regarding confidence, autonomy, and reasons for career selection between GS and SS. Surveys were distributed by mail in November 2013, with follow-up mailings to initial nonrespondents. Sixty-one percent (3354) of graduates completed the survey; 26% pursued GS, and 74% SS. GS expressed greater levels of confidence than SS across the common surgical procedures queried. Confidence increased with each year after completion of residency for GS but not SS. The decision to pursue GS or SS was made during residency by 77% and 74%, respectively. Fifty-seven percent of those who chose GS indicated that a GS mentor significantly influenced their decision. GS rated procedural variety, opportunity for practice autonomy, choice of practice location, and influence of a mentor as reasons to pursue GS practice. SS listed control over scope of practice, prestige, salary, and specialty interest as reasons to pursue SF. Both groups expressed a high degree of satisfaction with their career choice (GS, 94%; SS, 90%). Most graduates who pursue GS practice are confident and content. The decision to pursue GS is strongly influenced by a GS mentor. Lack of confidence may be a more significant factor for choosing SS. These findings suggest opportunities for improvements in confidence and mentorship during residency.

Choosing a Primary Health Care Provider (PCP): A Guide for Young Men

MedlinePlus

... Conditions Nutrition & Fitness Emotional Health Choosing a Primary Health Care Provider (PCP): General Information Posted under Health Guides . ... needs. How do I find the names of health care providers? Here are some ways to find a ...

[Postgraduate training program in neurology at the regional hospitals in Hokkaido area].

PubMed

Matsumoto, Akihisa

2007-11-01

In the new post graduate training system, the 55% of interns in the Hokkaido area choosed the post graduate training at the general hospitals and 45% of them choosed the medical universities (Hokkaido university, Asahikawa medical university, Sapporo medical university). Furthermore, 23% of interns in Hokkaido area choosed the general hospitals and medical universities in Sapporo city. As to the post graduate training system in neurology, 5 hospitals included the neurology for at least 1 month to 3 months. On the other hand, in one general hospital in Sapporo city, the clinical training of neurology was not included in the post graduate training system. During 2 years of the new post graduate training system, only 25% of the interns could rotate the neurological department. Since the neurology training course is necessary for the post graduate training system, it is suggested to need to support the opportunity to rotate the neurology for the interns.

Choosing the Right Assessment for the Right Purpose

ERIC Educational Resources Information Center

Eliasson, Ann-Christin

2012-01-01

Assessments used for both clinical practice and research should show evidence of validity and reliability for the target group of people. It is easy to agree with this statement, but it is not always easy to choose the right assessment for the right purpose. Recently there have been increasing numbers of studies which investigate further the…

Comparision of Alternatively Certified and Traditionally Certified Missouri High School Science Teachers' Perceptions of Self-Efficacy during the Induction Period

ERIC Educational Resources Information Center

Gaither, Linda

2013-01-01

Sixty percent of America's teachers choose traditional baccalaureate programs while the remaining choose one of several alternative pathways. While certification/training is certainly important to preparing effective teachers, other research indicates that teacher efficacy serves as the foundation of teacher behaviors and classroom practice. The…

Influencing Factors on Choosing Psychiatry as a Career: An Exploration in Chinese University Students.

PubMed

Zhong, Jiawei; Zheng, Luna; Chen, Xiaoling; Gao, Qianqian; Zhang, Bingren; Wang, Wei

2016-12-01

There is a consistent need of psychiatric professionals in the world including China, and a consistent challenge to recruit more medical students into the psychiatric careers. We aimed to look for factors which have an impact on career-choosing of psychiatry in Chinese university students. We invited 508 non-medical students (NM), 304 medical students without (MO) and 123 medical students with clinical internship experience (MW), to answer a matrix of 43 questions regarding factors influencing career-choosing of psychiatry. Answers to these questions were analyzed through exploratory and confirmatory factor analyses, once the latent factors were identified and structurally-validated, their mean scores in three groups of students were calculated. Five factors with five items each were identified, namely social status inferiority, career importance, practice reward, career preference, and practice stress. NM scored lower than MO and MW did on Social Status Inferiority; NM group scored higher than MO and MW groups did on Career Importance; MW scored lower than NM and MO did on Practice Reward and on Career Preference; Regarding Practice Stress, NM scored higher than MO did, who then in turn, scored higher than MW did. In addition, Practice Stress was positively correlated with advice of the medical educators; and Social Status Inferiority and Career Preference were positively correlated with the psychiatry teaching of the medical educators. Raising career rewards, improving social status, and reinforcing psychiatric education might help to recruit more medical students to specialize in psychiatry practicing.

Outsourcing your medical practice call center: how to choose a vendor to ensure regulatory compliance.

PubMed

Johnson, Bill

2014-01-01

Medical practices receive hundreds if not thousands of calls every week from patients, payers, pharmacies, and others. Outsourcing call centers can be a smart move to improve efficiency, lower costs, improve customer care, ensure proper payer management, and ensure regulatory compliance. This article discusses how to know when it's time to move to an outsourced call center, the benefits of making the move, how to choose the right call center, and how to make the transition. It also provides tips on how to manage the call center to ensure the objectives are being met.

Elimination of micropollutants and hazardous substances at the source in the chemical and pharmaceutical industry.

PubMed

Blöcher, C

2007-01-01

Industrial wastewater, especially from chemical and pharmaceutical production, often contains substances that need to be eliminated before being discharged into a biological treatment plant and following water bodies. This can be done within the production itself, in selected waste water streams or in a central treatment plant. Each of these approaches has certain advantages and disadvantages. Furthermore, a variety of wastewater treatment processes exist that can be applied at each stage, making it a challenging task to choose the best one in economic and ecological terms. In this work a general approach for that and examples from practice are discussed.

De-implementation of inappropriately tight control (of hypoglycemia) for health: protocol with an example of a research grant application.

PubMed

Aron, David C; Lowery, Julie; Tseng, Chin-lin; Conlin, Paul; Kahwati, Leila

2014-05-19

Implementation of practice change is difficult and large scale implementation is particularly difficult. Among the challenges facing the healthcare system in general and healthcare organizations is the overuse of low value care. Improving medication safety also constitutes an attempt to reduce low value or potentially harmful care. Critical issues of overuse of low value practices and medication safety intersect in overtreatment of diabetes. Specifically, (over)intensive glycemic control increases hypoglycemia risk and morbidity without providing meaningful benefit. Our work indicates that among patients with diabetes who are at high risk for hypoglycemia, potential overtreatment is common. The Choosing Wisely Initiative to reduce low value care led by the American Board of Internal Medicine Foundation recommends not to treat most persons over 65 years of age with medications to reduce the A1c<7.5%. For most physicians this involves a change in practice. We will study the implementation of the Veterans Health Administration's Choosing Wisely Initiative (which includes hypoglycemic safety as a targeted condition) with three specific aims: (1) to assess the overall impact, both intended and unintended, of the Choosing Wisely Initiative to reduce overtreatment of diabetes in especially vulnerable populations; (2) to assess the impact of commitment to quality, teaching intensity, and safety culture on likelihood of overtreatment; and (3) to identify configurations of the implementation strategy, provider characteristics and organizational level factors that are associated with successful reduction of overtreatment rates by comparing high and low performers. Because focus on this initiative could have the unintended consequence of paying less attention to poor glycemic control (A1c>9%), we will also assess undertreatment. We will take advantage of a natural experiment and use a Type III Hybrid Design that focuses on study of implementation while at the same time observing and gathering information on clinical interventions and outcomes. This mixed methods study will use longitudinal data and qualitative methods including Qualitative Comparative Analyses. Our multi-paradigm approach to examining potential mechanisms to explain the variation in reduction of rates of overtreatment will contribute to a better understanding of implementation of national dissemination projects and multi-component interventions in complex systems.

Men and Women Choose Different Careers in Medicine: Causes and Consequences

PubMed Central

Ferrier, Barbara M.; Cohen, May; Woodward, Christel A.

1989-01-01

Women medical graduates of McMaster University were divided into two groups: those in the fields traditionally chosen by women (primary care, general internal medicine, pediatrics, psychiatry, and anesthesia), and those in nontraditional fields (surgery, subspecialties of medicine, and academic medicine). The careers of the two groups of women were then compared with matched groups of men physicians. More women choosing traditional careers worked in another field, frequently health-related, before deciding to enter medicine than women entering nontraditional careers. Fewer of the former had a university education in the natural sciences, and more of them were married at the start of post-graduate training. Both groups of women worked shorter hours than the comparison groups of men. More women in traditional careers had selected group practice than had the corresponding men. Influences on career choices showed more sex similarities than career-type similarities, with women influenced more by factors related to family responsibilities. Few in any group reported that their choices are not their preferences. The results suggest that complete convergence of the medical careers of men and women in the near future is unlikely. PMID:21248965

Resident Preparation for Careers in General Surgery: A Survey of Program Directors.

PubMed

Cogbill, Thomas H; Klingensmith, Mary E; Jones, Andrew T; Biester, Thomas W; Malangoni, Mark A

2015-01-01

The number of general surgery (GS) residency graduates who choose GS practice has diminished as the popularity of postresidency fellowships has dramatically increased over the past several decades. This study was designed to document current methods of GS preparation during surgery residency and to determine characteristics of programs that produce more graduates who pursue GS practice. An email survey was sent by the American Board of Surgery General Surgery Advisory Committee to program directors of all GS residencies. Program demographic information was procured from the American Board of Surgery database and linked to survey results. Multiple regression was used to predict postresidency choices of graduates. Totally, 252 US allopathic surgical residencies. Totally, 171 residency program directors (68% response rate). The proportion of programs using an emergency/acute care surgery rotation at the main teaching hospital to teach GS increased from 63% in 2003 to 83% in 2014. An autonomous GS outpatient experience was offered in 38% of programs. Practice management curricula were offered in 28% of programs. Institutions with fewer postresidency fellowships (p < 0.003) and fewer surgical specialty residencies (p < 0.036) had a greater percentage of graduates who pursued GS practice. The addition of each fellowship at an institution was associated with a 2% decrease in the number of graduates pursuing GS practice. Residency size was not associated with predilection for fellowship selection and there was no difference between university and independent residencies vis-a-vis the proportion selecting fellowship vs GS practice. Practice management principles and autonomous GS outpatient clinic experiences are offered in a minority of programs. Graduates of programs in institutions with fewer surgery fellowships and residencies are more likely to pursue GS practice. Increased number of postresidency fellowships and specialty residencies may be associated with fewer GS rotations and fewer GS mentors. Further study of these relationships seems warranted. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Optimal control theory (OWEM) applied to a helicopter in the hover and approach phase

NASA Technical Reports Server (NTRS)

Born, G. J.; Kai, T.

1975-01-01

A major difficulty in the practical application of linear-quadratic regulator theory is how to choose the weighting matrices in quadratic cost functions. The control system design with optimal weighting matrices was applied to a helicopter in the hover and approach phase. The weighting matrices were calculated to extremize the closed loop total system damping subject to constraints on the determinants. The extremization is really a minimization of the effects of disturbances, and interpreted as a compromise between the generalized system accuracy and the generalized system response speed. The trade-off between the accuracy and the response speed is adjusted by a single parameter, the ratio of determinants. By this approach an objective measure can be obtained for the design of a control system. The measure is to be determined by the system requirements.

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

PubMed

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

2007-11-19

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

Preventing Trunk Diseases in the Vineyard: Choosing the Best Practices

USDA-ARS?s Scientific Manuscript database

Over years of research on control of grapevine trunk diseases, field trials identified cultural and chemical practices that prevent and limit infections of pruning wounds by the spores. These practices include delayed pruning, double pruning, and applications of pruning-wound protectants (e.g., thio...

Accounting for medical variation: the case of prescribing activity in a New Zealand general practice sample.

PubMed

Davis, P B; Yee, R L; Millar, J

1994-08-01

Medical practice variation is extensive and well documented, particularly for surgical interventions, and raises important questions for health policy. To date, however, little work has been carried out on interpractitioner variation in prescribing activity in the primary care setting. An analytical model of medical variation is derived from the literature and relevant indicators are identified from a study of New Zealand general practice. The data are based on nearly 9,500 completed patient encounter records drawn from over a hundred practitioners in the Waikato region of the North Island, New Zealand. The data set represents a 1% sample of all weekday general practice office encounters in the Hamilton Health District recorded over a 12-month period. Overall levels of prescribing, and the distribution of drug mentions across diagnostic groupings, are broadly comparable to results drawn from international benchmark data. A multivariate analysis is carried out on seven measures of activity in the areas of prescribing volume, script detail, and therapeutic choice. The analysis indicates that patient, practitioner and practice attributes exert little systematic influence on the prescribing task. The principal influences are diagnosis, followed by practitioner identity. The pattern of findings suggests also that the prescribing task cannot be viewed as an undifferentiated activity. It is more usefully considered as a process of decision-making in which 'core' judgements--such as the decision to prescribe and the choice of drug--are highly predictable and strongly influenced by diagnosis, while 'peripheral' features of the task--such as choosing a combination drug or prescribing generically--are less determinate and more subject to the exercise of clinical discretion.(ABSTRACT TRUNCATED AT 250 WORDS)

A Parent's Guide to Choosing the Right Online Program. Promising Practices in Online Learning

ERIC Educational Resources Information Center

Watson, John; Gemin, Butch; Coffey, Marla

2010-01-01

Online learning continues to grow rapidly across the United States and the world, opening new learning opportunities for students and families. Informed estimates put the number of K-12 students in online courses at over 1 million, as parents and students are choosing online courses and schools for a variety of reasons that grow out of their…

DaRT: A CALL System to Help Students Practice and Develop Reasoning Skills in Choosing English Articles.

ERIC Educational Resources Information Center

Yoshii, Rika; Milne, Alastair

1998-01-01

Describes DaRT, a computer assisted language-learning system for helping English-as-a-Second-Language students master English articles. DaRT uses a diagrammatic reasoning tool to present communicative contexts for exercises in choosing appropriate articles. This paper describes the development of DaRT and DaRT's system components and concludes…

Defining the culture of your practice.

PubMed

Weinstock, Donna

2014-01-01

Your practice should want patients to understand and appreciate its uniqueness and beliefs. Simply stated, the culture of your practice is the excellent care you provide and how your practice is able to achieve that excellence. Defining and sharing your culture will encourage patients to choose your practice for their healthcare. Monitoring and continually updating your definition of "culture" will help your practice thrive and maintain high standards.

Using Signs to Facilitate Vocabulary in Children with Language Delays

ERIC Educational Resources Information Center

Lederer, Susan Hendler; Battaglia, Dana

2015-01-01

The purpose of this article is to explore recommended practices in choosing and using key word signs (i.e., simple single-word gestures for communication) to facilitate first spoken words in hearing children with language delays. Developmental, theoretical, and empirical supports for this practice are discussed. Practical recommendations for…

Physicians' Assessments of a Rural Preceptorship and Its Influence on Career Choice and Practice Site.

ERIC Educational Resources Information Center

Chaulk, C. Patrick; And Others

1987-01-01

Graduates of the University of Nebraska's medical school preceptorship program, in which students choose their preceptors from rural sites and are exposed to the social and economic aspects of rural practice, were surveyed after entering private practice about the program's effects on them. (MSE)

Best Practices, 1999-2000.

ERIC Educational Resources Information Center

North Carolina Community Coll. System, Raleigh.

This report contains descriptions of 34 best practices of North Carolina high school/community college Tech Prep (TP) consortia from a 2000 review. All consortia were allowed to choose their best effort or accomplishment completed or in operation at the end of 1999-2000. Among the practices described were: a comprehensive career development…

Resistance and Disidentification in Reflective Practice with Preservice Teaching Interns

ERIC Educational Resources Information Center

Middleton, Michael; Abrams, Eleanor; Seaman, Jayson

2011-01-01

Teachers who engage in reflective practices are better able to recognize the complexity of teaching, use judgment to choose appropriate strategies for teaching and learning in their specific contexts, and experience improved self-confidence. For these reasons, many teacher education programs emphasize self-reflective practice. Self-reflective…

Gender, infertility, motherhood, and assisted reproductive technology (ART) in Turkey.

PubMed

Sahinoglu, Serap; Buken, Nuket Ornek

2010-01-01

In Turkey, as in many other countries, infertility is generally regarded as a negative phenomenon in a woman's life and is associated with a lot of stigma by society. In other words, female infertility and having a baby using Assisted Reproductive Technologies (ART) have to be taken into consideration with respect to gender motherhood, social factors, religion and law. Yet if a woman chooses to use ART she has to deal with the consequences of her decision, such as being ostracized by society. Other types of procedures in this area, such as sperm and ova donation or surrogate motherhood, are not permitted in law. However; both before and after the development of this techonology, society has been finding its own solutions which are rarely questioned and are still performed This article will discuss what these practices are and try to reach some pragmatic conclusions concerning female infertility, the concept of motherhood and some traditional practices in Turkey.

Instruments to measure behavioural and psychological symptoms of dementia.

PubMed

van der Linde, Rianne M; Stephan, Blossom C M; Dening, Tom; Brayne, Carol

2014-03-01

Reliable and valid measurement of behavioural and psychological symptoms of dementia (BPSD) is important for research and clinical practice. Here we provide an overview of the different instruments and discuss issues involved in the choice of the most appropriate instrument to measure BPSD in research. A list of BPSD instruments was generated. For each instrument Pubmed and SCOPUS were searched for articles that reported on their use or quality. Eighty-three instruments that are used to measure BPSD were identified. Instruments differ in length and detail, whether the interview is with participants, informants or by observation, the target sample and the time frames for use. Reliability and validity is generally good, but reported in few independent samples. When choosing a BPSD instrument for research the research question should be carefully scrutinised and the symptoms of interest, population, quality, detail, time frame and practical issues should be considered. Copyright © 2014 John Wiley & Sons, Ltd.

What Employees Look for in First and Subsequent Employers.

ERIC Educational Resources Information Center

Bewayo, Edward D.

1986-01-01

A questionnaire was distributed to 1,060 employees of 33 companies. It asked about motivations for choosing first-time and subsequent employers. Results showed that employees generally choose their first full-time job for advancement opportunities, benefits, and skills usage, while salary is a chief consideration for job changers. (CH)

[Practice marketing. Data analysis of a urological group practice].

PubMed

Schneider, T; Schneider, B; Eisenhardt, A; Sperling, H

2009-07-01

The urological practice setting in Germany has changed tremendously over the last years. Group practices with two or more urologists working together are becoming more and more popular. At the same time, marketing has become essential even for urologists. To evaluate the patient flow to our group practice, we asked all new patients to fill out a questionnaire (n=2112). We also evaluated the efficacy of our recall system. The analysis showed that patients were 18-93 years old (mean 57 years), 68% being male and 32% female. The largest age group consisted of 41-50-year-olds. The most important reasons for choosing our practice were recommendations by general practitioners in 38%, recommendations by specialists in 11%, and recommendations by friends and relatives in 27%. Five percent of the patients chose the practice because of the Internet home page and 10% because of entries in various phone books. Three percent of the patients came because of newspaper articles about the practice owners, and <1% had attended patient presentations. The Internet was used mainly by 31-40-year-old patients. Our recall system showed an efficacy of 59%. In summary, a good reputation in the medical society as well as in the neighbourhood is still the best advertising for a urological practice. Phone books are increasingly becoming less important, and the Internet is increasingly attractive to the younger population. Recall systems can also be useful for urological practices.

From Couch Potatoes to Critical Learners: A Theoretical Framework for Television Use in EFL/ESL Classrooms

ERIC Educational Resources Information Center

Mora, Raul Alberto

2004-01-01

Television shows have been a traditional outlet for language practices in second language classrooms around the world. However, the only criteria that teachers seem to have to choose said shows are that they are in English and native speakers are involved. This may lead to choosing materials for the sake of watching or selecting materials that do…

Euthanasia or physician-assisted suicide? A survey from the Netherlands.

PubMed

Kouwenhoven, Pauline S C; van Thiel, Ghislaine J M W; Raijmakers, Natasja J H; Rietjens, Judith A C; van der Heide, Agnes; van Delden, Johannes J M

2014-03-01

Legalizing euthanasia or physician-assisted suicide (PAS) is a current topic of debate in many countries. The Netherlands is the only country where legislation covers both. To study physicians' experiences and attitudes concerning the choice between euthanasia and PAS. A questionnaire including vignettes was sent to a random sample of 1955 Dutch general practitioners, elderly care physicians and medical specialists. In total, 793 physicians (41%) participated. There was no clear preference for euthanasia (36%) or PAS (34%). Two thirds of physicians thought that PAS underlines the autonomy and responsibility of the patient and considered this a reason to choose PAS. Reasons for not choosing PAS were expected practical problems. A minority (22%) discussed the possibility of PAS with their patient in case of a request for assistance in dying. Patients receiving PAS more often experienced psychosocial suffering in comparison with patients receiving euthanasia. In vignettes of patients with a request for assistance in dying due to psychosocial suffering, physicians agreed more often with the performance of PAS than with euthanasia. Dutch physicians perceive a difference between euthanasia and PAS. Although they believe PAS underlines patient autonomy and responsibility, the option of PAS is rarely discussed with the patient. The more psychosocial in nature the patient's suffering, the more physicians choose PAS. In these cases, PAS seems to fulfil physicians' preferences to emphasize patient autonomy and responsibility. Expected technical problems and unfamiliarity with PAS also play a role. Paradoxically, the choice for PAS is predominantly a physician's one.

Different reasons for one significant choice: Factors influencing homeschooling choice in Israel

NASA Astrophysics Data System (ADS)

Guterman, Oz; Neuman, Ari

2017-06-01

Homeschooling is an alternative to conventional education in many countries all over the world, though legal regulations vary. This article examines why parents opt for homeschooling. The large body of research on the topic (especially from the United States) points to a variety of reasons for making the choice to homeschool. The most common reasons are of a pedagogical nature, but in many cases they are also family-related. What has not yet been investigated in depth is the relationship between the different reasons for choosing homeschooling and the way in which homeschooling is practised. There is also a lack of research on the relationship between the reasons for choosing homeschooling and the parents' personalities, educational background and attitudes towards both homeschooling in particular and the education system in general. Using a mixed methods design in order to examine these relationships, the authors of this article questioned 62 homeschooling families in Israel. The findings indicate that some parents chose to homeschool for pedagogical reasons only and others for both pedagogical and family-related reasons. Furthermore, the latter group held more positive views of the effect of homeschooling on children - and the mothers in that group, on average, were more educated compared with those who cited pedagogical reasons alone. The reasons for choosing homeschooling were also found to be associated with the character of the homeschooling practice, with families whose reasons were pedagogical only devoting more hours, on average, specifically to studying.

Career changers: dentists who choose to leave private practice.

PubMed

Rice, C D; Hayden, W J; Glaros, A G; Thein, D J

1997-01-01

Some dentists have voluntarily chosen to leave the dental profession despite the considerable time, effort, and financial expenditures involved in their educations. The purpose of this study was to survey the entire population of dentists who had identified themselves as being principally employed in a career outside of clinical practice in the American Dental Association's 1991 Census. A four-page survey was mailed to 654 former dentists, with a total of 237 usable responses (36%). Analysis of major demographic variables showed no significant difference between the survey respondents and the 1992 ADA Survey of Dentists. Major reasons cited by respondents for entering dentistry included professional, financial, and independence factors. Respondents as a group rated their dental school experience as average in degree of difficulty. Clinical dental experience was varied, with a substantially smaller percentage (37%) choosing solo clinical positions than the 1992 ADA Survey of Dentists reported (69%). Reasons for leaving practice included financial, stress, and external regulation concerns. Current careers varied widely, with business, teaching, medicine, and investing being the most common. Respondents ranked their current careers as considerably more favorable on measures of perceived creativity, freedom, belonging, and whether they would choose the same career again. These findings indicate that there was a difference between the perception of a dental career and the reality of clinical practice for the study sample.

Obstetrics and gynaecology as a career choice: a cohort study of canadian medical students.

PubMed

Scott, Ian M; Nasmith, Trudy; Gowans, Margot C; Wright, Bruce J; Brenneis, Fraser R

2010-11-01

to describe the characteristics of medical students interested in obstetrics and gynaecology and to build a model that predicts which of these students will choose obstetrics and gynaecology as their career. students were surveyed in 2002, 2003, and 2004 at the commencement of their medical studies. Data were collected on career choice, attitudes to practice, and demographics at medical school entry and on career choice at medical school exit. three items present at entry to medical school were predictive of students ultimately choosing a career in obstetrics and gynaecology: having this career as one of their first three career choices at entry (having it as their first choice was the strongest predictor), being female, and desiring a narrow scope of practice. students choosing a career in obstetrics and gynaecology have attributes at medical school entry that differentiate them from students interested in other specialties. Identifying these attributes may guide education in and recruitment to obstetrics and gynaecology.

Informal Theory: The Ignored Link in Theory-to-Practice

ERIC Educational Resources Information Center

Love, Patrick

2012-01-01

Applying theory to practice in student affairs is dominated by the assumption that formal theory is directly applied to practice. Among the problems with this assumption is that many practitioners believe they must choose between their lived experiences and formal theory, and that graduate students are taught that their experience "does not…

Developing the Practice of Teacher Questioning through a K-2 Elementary Mathematics Field Experience

ERIC Educational Resources Information Center

Schwartz, Catherine

2015-01-01

This article presents findings from research on a field experience designed to help elementary preservice teachers learn the practice of teacher questioning during formal and informal interviews to analyze student mathematical thinking in K-2 classrooms. The practice of teacher questioning is framed as choosing a mathematical goal, analyzing…

Creating and Maintaining Online Communities of Practice in Malaysian Smart Schools: Challenging Realities

ERIC Educational Resources Information Center

Thang, Siew Ming; Hall, Carol; Murugaiah, Puvaneswary; Azman, Hazita

2011-01-01

Wenger describes an educational community of practice (CoP) as a group of professionals who share a passionate concern for practice-based issues and who voluntarily choose to deepen their knowledge, understanding and skills through collaborative and critical dialogue. Peer collaboration of this kind, which involves social interaction, reflection…

Standing at the Crossroads: The Pedagogical Intersection between Standards and Relationships

ERIC Educational Resources Information Center

King, Jeffry

2015-01-01

The purpose of this case is to examine the connection between the pedagogical practices of standards and relationships. Although research supports the importance of both practices, current efforts often construct a situation where educators must choose between the two. This perception pits one practice against the other, demanding educators choose…

Breaking up is never easy: GPs' accounts of removing patients from their lists.

PubMed

Stokes, Tim; Dixon-Woods, Mary; McKinley, Robert K

2003-12-01

The aim of this study was to understand why GPs choose to end their relationship with patients by removing them from their lists. Semi-structured interviews were carried out with 25 GPs from 22 general practices in Leicestershire. Qualitative analysis was performed using the constant comparative method. The main outcome measures were participants' accounts of removing patients from their lists. GPs use removal as a means of ending their professional relationships with problematic patients. All of the doctors indicated that they wished to retain the right to remove patients and stressed that removal is a rare event which they only use as a "last resort". There are two distinct but overlapping types of patients who are most likely to become eligible for removal: "bad" patients, who break the rules of the doctor-patient or practice-patient relationship, and "difficult" patients, with whom the doctor-patient relationship is so strained that doctors feel they can no longer care for them. The doctors may choose to remove a patient without warning or else to write a short letter giving "relationship breakdown" as the reason. They find it hard to confront the patient openly about the difficulties in the relationship. The ability to remove patients is a right that GPs value. They report that it is rare for them to seek to end their relationships with patients and, when they do, it is for reasons that are important in the maintenance of professional boundaries or fulfilling professional responsibilities.

Choosing a silvicultural system

Treesearch

H. Clay Smith; Gary G. Naughton

1989-01-01

Landowners frequently have definite objectives and preferences that should influence the selection of a silvicultural system. Timber production is not the primary reason many landowners practice forestry, and silvicultural practices must be flexible enough to provide other "products" such as wildlife, esthetics, and recreation.

Results of nine Connecticut Cancer Partnership implementation projects.

PubMed

Morra, Marion E; Mowad, Linda Z; Hogarty, Lucinda Hill; Kettering, Shiu-Yu

2012-01-01

The Connecticut Cancer Partnership (Partnership), through funds from the Connecticut legislature, the AttorneyGeneral Fund and some limited federal funding, has spearheaded the implementation of a series of projects by Connecticut institutions and State of Connecticut departments. Among them are projects in prevention, detection, treatment, survivorship and end-of-life care, along with programs that target ethnic and uninsured populations. This article highlights funding sources, procedures for choosing projects and summaries for nine completed projects of interest to practicing physicians. It also includes a listing of additional projects currently underway. The use of shared funding among the State's partners highlights the energy of the Partnership in carrying out the common vision embodied in the Connecticut Cancer Plan.

Photonics education development for electrical engineering students

NASA Astrophysics Data System (ADS)

Cao, Yang; Luo, Yuan; Liu, Yu; Hu, ZhangFang; Cai, Xuemei

2017-08-01

We describe the contents of an advanced undergraduate course on photonics at School of Electrical Engineering, Chongqing University of Posts and Telecommunications. The main goal of the course is to equip the student with the necessary theoretical and practical knowledge to participate in photonics-related industry and further graduate level study and research if they choose. The prerequisites include college-level physics and higher mathematics which a general engineering student has already had in his/her first and second year college study. Although applications of photonics are ubiquitous such as telecommunications, photonic computing, spectroscopy, military technology, and biophotonics etc. Telecommunication information system application is more emphasized in our course considering about the potential job chances for our students.

Toward a Psychology of Surrogate Decision Making.

PubMed

Tunney, Richard J; Ziegler, Fenja V

2015-11-01

In everyday life, many of the decisions that we make are made on behalf of other people. A growing body of research suggests that we often, but not always, make different decisions on behalf of other people than the other person would choose. This is problematic in the practical case of legally designated surrogate decision makers, who may not meet the substituted judgment standard. Here, we review evidence from studies of surrogate decision making and examine the extent to which surrogate decision making accurately predicts the recipient's wishes, or if it is an incomplete or distorted application of the surrogate's own decision-making processes. We find no existing domain-general model of surrogate decision making. We propose a framework by which surrogate decision making can be assessed and a novel domain-general theory as a unifying explanatory concept for surrogate decisions. © The Author(s) 2015.

A Nationwide Survey to Determine Who Chooses Instructional Films.

ERIC Educational Resources Information Center

Breen, Myles P.; Ary, Donald E.

1972-01-01

The selection and purchase of instructional films for use in elementary and secondary schools is a complex process. Generally choosing a film is the task of the classroom teacher or the principal. However the decision can involve a wide variety of other personnel including audiovisual coordinators, business managers, and librarians. This survey of…

An expert system for choosing the best combination of options in a general purpose program for automated design synthesis

NASA Technical Reports Server (NTRS)

Rogers, J. L.; Barthelemy, J.-F. M.

1986-01-01

An expert system called EXADS has been developed to aid users of the Automated Design Synthesis (ADS) general purpose optimization program. ADS has approximately 100 combinations of strategy, optimizer, and one-dimensional search options from which to choose. It is difficult for a nonexpert to make this choice. This expert system aids the user in choosing the best combination of options based on the users knowledge of the problem and the expert knowledge stored in the knowledge base. The knowledge base is divided into three categories; constrained problems, unconstrained problems, and constrained problems being treated as unconstrained problems. The inference engine and rules are written in LISP, contains about 200 rules, and executes on DEC-VAX (with Franz-LISP) and IBM PC (with IQ-LISP) computers.

Motives of former interns in general practice for speciality-choice − Results of a cross-sectional study among graduates 2007 to 2012

PubMed Central

Abendroth, Jens; Schnell, Ute; Lichte, Thomas; Oemler, Matthias; Klement, Andreas

2014-01-01

Background: The influence of a final-year elective internship in general practice (IGP) on motives affecting graduates’ choice of specialty is the object of great public interest, yet still insufficiently evaluated. Longitudinal studies show the influence of numerous motives (e.g. work-life balance), but not following the IGP experience itself. Thus, we performed a cross-sectional questionnaire study of all graduates who completed the IGP in Saxony-Anhalt during 2007-2012 regarding their motives for choosing a speciality. Method: A standardized questionnaire was sent to 109 former interns in general practice. The questionnaire contained 29 items addressing three topics (personal attitudes, concept of personal and professional life, motives for speciality choice) and used single-choice and multiple-choice answers, as well as Likert scales. Correlation analysis was carried out by means of Kendall's tau. Results: The questionnaire reached 97 former interns, of which 45 (46%) responded. In the overall ranking of motives for speciality choice, family (71%), leisure time (66%) and job opportunities (48%) rated as more important than income (36%), mentoring (20%), status or scientific work (20%). Only 29% of the respondents stated that their speciality choice was changed by the IGP. If the speciality choice was already established before the IGP, the influence of the IGP on speciality choice was significantly low (r=-.5; p<.01). However, if the IGP had an influence on speciality choice, it was correlated with a new perception of general practice (r=.36; p<.01). This new perception was associated with a positive influence of the medical teacher during the IGP. Conclusion: The final-year IGP is an opportunity to change the perception of general practice in students who are still undecided. This can lead to different speciality choices in a subgroup. Personal attitudes and concepts of personal life and career were also important factors affecting speciality choice. The aspects of the positive influence exerted by medical teachers on those students who are still undecided during the IGP should be carefully evaluated. PMID:24575153

Motives of former interns in general practice for speciality-choice--results of a cross-sectional study among graduates 2007 to 2012.

PubMed

Abendroth, Jens; Schnell, Ute; Lichte, Thomas; Oemler, Matthias; Klement, Andreas

2014-01-01

The influence of a final-year elective internship in general practice (IGP) on motives affecting graduates' choice of specialty is the object of great public interest, yet still insufficiently evaluated. Longitudinal studies show the influence of numerous motives (e.g., work-life balance), but not following the IGP experience itself. Thus, we performed a cross-sectional questionnaire study of all graduates who completed the IGP in Saxony-Anhalt during 2007-2012 regarding their motives for choosing a speciality. A standardized questionnaire was sent to 109 former interns in general practice. The questionnaire contained 29 items addressing three topics (personal attitudes, concept of personal and professional life, motives for speciality choice) and used single-choice and multiple-choice answers, as well as Likert scales. Correlation analysis was carried out by means of Kendall's tau. The questionnaire reached 97 former interns, of which 45 (46%) responded. In the overall ranking of motives for speciality choice, family (71%), leisure time (66%) and job opportunities (48%) rated as more important than income (36%), mentoring (20%), status or scientific work (20%). Only 29% of the respondents stated that their speciality choice was changed by the IGP. If the speciality choice was already established before the IGP, the influence of the IGP on speciality choice was significantly low (r = -.5; p < .01). However, if the IGP had an influence on speciality choice, it was correlated with a new perception of general practice (r = .36; p<.01). This new perception was associated with a positive influence of the medical teacher during the IGP. The final-year IGP is an opportunity to change the perception of general practice in students who are still undecided. This can lead to different speciality choices in a subgroup. Personal attitudes and concepts of personal life and career were also important factors affecting speciality choice. The aspects of the positive influence exerted by medical teachers on those students who are still undecided during the IGP should be carefully evaluated.

A qualitative study of factors influencing family physicians' prescription of the Written Asthma Action Plan in primary care in Singapore.

PubMed

Tan, N C; Tay, I H; Ngoh, A; Tan, M

2009-02-01

The Written Asthma Action Plan (WAAP) educates patients on the early recognition and treatment of deteriorating asthma. It has been adopted in Singapore polyclinics and restructured hospitals in the past few years as recommended by the Singapore National Asthma Programme. Local asthma patients can choose to be treated by family physicians at public polyclinics or by private general practitioners (GPs). In a previous study, half of the physicians in primary care self-reported that they formulated an asthma action plan for their patients, but little is known about their actual practices. This qualitative study explored family physicians' views of WAAP and its implementation in primary care in Singapore. Qualitative data was obtained for 29 participants from polyclinics, GP clinics or locum doctors at five separate focus group discussions. The data was coded using NVivo-7 software, audited and analysed to identify emergent themes. The participants generally perceived the usefulness of WAAP. While WAAP was widely used in polyclinics, GPs rarely used it. Even in polyclinics, usage varied and was associated with participants' training and practice of WAAP and task substitution to nurses. They perceived that WAAP would benefit only selected motivated patients who could understand and use it. They were hampered by language barriers in educating their multiracial patients and the perceived lack of time related to patient loads in polyclinics. The GPs lacked training and practice, role models and relied on verbal instructions as a personalised form of care delivery. Family physicians generally perceived WAAP as useful, but implementation was hampered by lack of training and practice, language barriers and perceived benefits for patients.

HMO penetration and the geographic mobility of practicing physicians.

PubMed

Polsky, D; Kletke, P R; Wozniak, G D; Escarce, J J

2000-09-01

In this study, we assessed the influence of changes in health maintenance organization (HMO) penetration on the probability that established patient care physicians relocated their practices or left patient care altogether. For physicians who relocated their practices, we also assessed the impact of HMO penetration on their destination choices. We found that larger increases in HMO penetration decreased the probability that medical/surgical specialists in early career stayed in patient care in the same market, but had no impact on generalists, hospital-based specialists, or mid career medical/surgical specialists. We also found that physicians who relocated their practices were much more likely to choose destination markets with the same level of HMO penetration or lower HMO penetration compared with their origin markets than they were to choose destination markets with higher HMO penetration. The largely negligible impact of changes in HMO penetration on established physicians' decisions to relocate their practices or leave patient care is consistent with high relocation and switching costs. Relocating physicians' attraction to destination markets with the same level of HMO penetration as their origin markets suggests that, while physicians' styles of medical practice may adapt to changes in market conditions, learning new practice styles is costly.

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

PubMed Central

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

2007-01-01

Background Most clinical trial publications include figures, but there is little guidance on what results should be displayed as figures and how. Purpose To evaluate the current use of figures in Trial reports, and to make constructive suggestions for future practice. Methods We surveyed all 77 reports of randomised controlled trials in five general medical journals during November 2006 to January 2007. The numbers and types of figures were determined, and then each Figure was assessed for its style, content, clarity and suitability. As a consequence, guidelines are developed for presenting figures, both in general and for each specific common type of Figure. Results Most trial reports contained one to three figures, mean 2.3 per article. The four main types were flow diagram, Kaplan Meier plot, Forest plot (for subgroup analyses) and repeated measures over time: these accounted for 92% of all figures published. For each type of figure there is a considerable diversity of practice in both style and content which we illustrate with selected examples of both good and bad practice. Some pointers on what to do, and what to avoid, are derived from our critical evaluation of these articles' use of figures. Conclusion There is considerable scope for authors to improve their use of figures in clinical trial reports, as regards which figures to choose, their style of presentation and labelling, and their specific content. Particular improvements are needed for the four main types of figures commonly used. PMID:18021449

Exploring Online Community among Rural Medical Education Students: A Case Study

ERIC Educational Resources Information Center

Palmer, Ryan Tyler

2013-01-01

There is a severe shortage of rural physicians in America. One reason physicians choose not to practice, or persist in practice, in rural areas is due to a lack of professional community, i.e., community of practice (CoP). Online, "virtual" CoPs, enabled by now common Internet communication technology can help give rural physicians the…

Physicians' exodus: why medical graduates leave Austria or do not work in clinical practice.

PubMed

Scharer, Sebastian; Freitag, Andreas

2015-05-01

Austria has the highest number of medical graduates of all Organisation for Economic Co-operation and Development (OECD) countries in relation to its population size, but over 30% choose not to pursue a career as physicians in the country. This article describes under- and postgraduate medical education in Austria and analyses reasons for the exodus of physicians. In Austria, medicine is a 5- or 6-year degree offered at four public and two private medical schools. Medical graduates have to complete training in general medicine or a speciality to attain a licence to practice. While not compulsory for speciality training, board certification in general medicine has often been regarded as a prerequisite for access to speciality training posts. Unstructured postgraduate training curricula, large amounts of administrative tasks, low basic salaries and long working hours present for incentives for medical graduates to move abroad or to work in a non-clinical setting. The scope of current reforms, such as the establishment of a new medical faculty and the implementation of a common trunk, is possibly insufficient in addressing the issue. Extensive reforms regarding occupational conditions and the structure of postgraduate medical education are necessary to avoid a further exodus of junior doctors.

Attitudes, perceptions and awareness concerning quaternary prevention among family doctors working in the Social Security System, Peru: a cross-sectional descriptive study.

PubMed

Cuba Fuentes, María Sofía; Zegarra Zamalloa, Carlos Orlando; Reichert, Sonja; Gill, Dawn

2016-04-27

Quaternary Prevention is defined as the action taken to identify patients at risk of overtreatment, to protect them from additional medical treatments, and to suggest interventions that are ethically acceptable. Many countries and organizations have joined in the efforts to practice quaternary prevention. These countries started a campaign called Choosing Wisely that implements recommendations in order to avoid harming patients. To determine the attitudes, perceptions and awareness towards Quaternary Prevention and the practice of “Choosing Wisely Canada Recommendations” among family doctors working in the Social Security System in Peru. A questionnaire was developed after reviewing the literature and contacting experts in the field and was sent by email to all 64 family physicians in the Social Security System (Essalud) in Lima Peru. Responses were received from 40 participants. The response rate was 64%. Approximately 95% reported that they understand the concept of quaternary prevention. Agreement with all the recommendations was 90% or higher. In most of the recommendations the applicability was more than 80%. The most important barriers perceived for the practice of Quaternary Prevention were patients’ expectations (33%). There are positive perceptions towards Quaternary Preventions and Choosing Wisely recommendations in the family doctors of social security in Lima Peru.

Career satisfaction of US women physicians: results from the Women Physicians' Health Study. Society of General Internal Medicine Career Satisfaction Study Group.

PubMed

Frank, E; McMurray, J E; Linzer, M; Elon, L

1999-07-12

Despite major changes in health care, the prevalence and predictors of career satisfaction have not recently been comprehensively studied in either women or men physicians. The Women Physicians' Health Study surveyed a nationally representative random sample (n = 4501 respondents; response rate, 59%) of US women physicians. Using univariate and logistic regression analyses, we examined personal and professional characteristics that were correlated with 3 major outcomes: career satisfaction, desire to become a physician again, and desire to change one's specialty. Women physicians were generally satisfied with their careers (84% usually, almost always, or always satisfied). However, 31% would maybe, probably, or definitely not choose to be a physician again, and 38% would maybe, probably, or definitely prefer to change their specialty. Physician's age, control of the work environment, work stress, and a history of harassment were independent predictors of all 3 outcomes, with younger physicians and those having least work control, most work stress, or having experienced severe harassment reporting the most dissatisfaction. The strongest association (odds ratio, 11.3; 95% confidence interval, 7.3-17.5; P<.001) was between work control and career satisfaction. Other significant predictors (P<.01) of outcomes included birthplace, ethnicity, sexual orientation, having children, stress at home, religious fervor, mental health, specialty, practice type, and workload. Women physicians generally report career satisfaction, but many, if given the choice, would not become a physician again or would choose a different specialty. Correctable factors such as work stress, harassment, and poor control over work environment should be addressed to improve the recruitment and retention of women physicians.

A retrospective review of general surgery training outcomes at the University of Toronto

PubMed Central

Compeau, Christopher; Tyrwhitt, Jessica; Shargall, Yaron; Rotstein, Lorne

2009-01-01

Background Surgical educators have struggled with achieving an optimal balance between the service workload and education of surgical residents. In Ontario, a variety of factors during the past 12 years have had the net impact of reducing the clinical training experience of general surgery residents. We questioned what impact the reductions in trainee workload have had on general surgery graduates at the University of Toronto. Methods We evaluated graduates from the University of Toronto general surgery training program from 1995 to 2006. We compared final-year In-Training Evaluation Reports (ITERs) of trainees during this interval. For purposes of comparison, we subdivided residents into 4 groups according to year of graduation (1995–1997, 1998–2000, 2001–2003 and 2004–2006). We evaluated postgraduate “performance” by categorizing residents into 1 of 4 groups: first, residents who entered directly into general surgery practice after graduation; second, residents who entered into a certification subspecialty program of the Royal College of Physicians and Surgeons of Canada (RCPSC); third, residents who entered into a noncertification program of the RCPSC; and fourth, residents who entered into a variety of nonregulated “clinical fellowships.” Results We assessed and evaluated 118 of 134 surgical trainees (88%) in this study. We included in the study graduates for whom completed ITER records were available and postgraduate training records were known and validated. The mean scores for each of the 5 evaluated residency training parameters included in the ITER (technical skills, professional attitudes, application of knowledge, teaching performance and overall performance) were not statistically different for each of the 4 graduating groups from 1995 to 2006. However, we determined that there were statistically fewer general surgery graduates (p < 0.05) who entered directly into general surgery practice in the 2004–2006 group compared with the 1998–2000 and 2001–2003 groups. The graduates from 2004 to 2006 who did not enter into general surgery practice appeared to choose a clinical fellowship. Conclusion These observations may indicate that recent surgical graduates possess an acceptable skill set but may lack the clinical confidence and experience to enter directly into general surgery practice. Evidence seems to indicate that the clinical fellowship has become an unregulated surrogate extension of the training program whereby surgeons can gain additional clinical experience and surgical expertise. PMID:19865542

Practical Work-up and Management of Recurrent Pregnancy Loss for the Front-Line Clinician.

PubMed

Branch, D Ware; Silver, Robert M

2016-09-01

Only a few so-called etiologies of recurrent pregnancy loss recurrent pregnancy loss in otherwise healthy women are adequately supported by well-designed investigations of association. The majority of proposed "treatments" have not been subjected to rigorous trials. The American Board of Internal Medicine Choosing Wisely initiative urges providers and patients to have constructive dialog aimed at choosing health care that is supported by evidence, not duplicative of other tests or procedures already received, free from harm, and truly necessary. We support the refreshing, objective frankness promoted by this campaign. A version of the Choosing Wisely "Do" and "Don't" format for recurrent pregnancy loss is presented.

Report of the Canadian Neurological Society Manpower Survey 2012.

PubMed

Kirby, Sarah; Weston, Lyle E; Barton, Jason J S; Buske, Lynda; Chauhan, Tara S

2016-03-01

The Canadian Neurological Society commissioned a manpower survey in 2012 to assess Canadian neurological manpower and resources. Surveys were sent electronically to all Canadian neurologists with available email addresses. Responses were analysed for effects of physician gender, age, geographic location (eastern or western Canada) or type of practice (academic, community). Questions focused on work patterns, neurologic conditions treated, access to or performance of procedures, and service and manpower issues. A total of 694 of 854 neurologists in Canada were surveyed and 219 (32%) responded. Respondents were 70% male with mean age of 50 years. Neurologists worked an average of 57 hours/week and saw a mean of 40 patients per week. There were significant differences in number of patients seen, types of practice, and areas of neurological specialization between community and academic neurologists. Fifty percent of neurologists report shortages of neurologists in their community, particularly of general adult neurologists. Wait times for neurological services exceeded international standards for consultations and also were longer than Canadian averages for other specialists. More community (18%) than academic (5%) neurologists planned to retire within the next 5 years. The demand for neurological services continues to outstrip resources despite the increased number of neurologists. Impending retirement of community neurologists will exacerbate manpower issues unless adequate numbers of trainees choose general neurologic practice in the community as a career.

Language as Cultural Practice: Mexicanos en el Norte.

ERIC Educational Resources Information Center

Schecter, Sandra R.; Bayley, Robert

This book offers an ethnographic account of language socialization practices within Mexican-background families residing in California and Texas. It illustrates cases where language is used by speakers to choose between alternative self-definitions and where language interacts differentially with other defining categories (ethnicity, gender, and…

Activity-Based Intervention Practices in Special Education

ERIC Educational Resources Information Center

Ozen, Arzu; Ergenekon, Yasemin

2011-01-01

Teaching practices in natural settings such as activity-based intervention (ABI) are suggested as alternatives to be used in effective early childhood education. As a multidisciplinary model, ABI consists of four components, which are choosing activities according to the child's interests; teaching generalizable goals embedded in routines and…

The Course in Professionalism at the University of Pennsylvania.

ERIC Educational Resources Information Center

Riser, Wayne H.

1979-01-01

A course to help students adjust to a practicing career as a veterinarian included sessions on: opportunities in the field, choosing a specialty and location; applying for jobs; women in practice; finances; improving professional skills; the veterinarian as hospital administrator; and malpractice and health insurance. (BH)

Studying Changes in the Practice of Two Teachers Developing Assessment for Learning

ERIC Educational Resources Information Center

Lee, Clare; Wiliam, Dylan

2005-01-01

This article describes changes in the practice of two teachers, observed over an 18-month period, who were participating in a study intended to support teachers in developing their use of assessment in support of learning. The design of the intervention allowed each teacher to choose for themselves which aspects of their practice to develop.…

Generalized approach to cooling charge-coupled devices using thermoelectric coolers

NASA Technical Reports Server (NTRS)

Petrick, S. Walter

1987-01-01

This paper is concerned with the use of thermoelectric coolers (TECs) to cool charge-coupled devices (CCDs). Heat inputs to the CCD from the warmer environment are identified, and generalized graphs are used to approximate the major heat inputs. A method of choosing and estimating the power consumption of the TEC is discussed. This method includes the use of TEC performance information supplied by the manufacturer and equations derived from this information. Parameters of the equations are tabulated to enable the reader to use the TEC performance equations for choosing and estimating the power needed for specific TEC applications.

Choice of unconventional treatment by patients with cancer.

PubMed

Kimby, Charlotte Kira; Launsø, Laila; Henningsen, Inge; Langgaard, Henrik

2003-08-01

Previous studies conducted on the use of unconventional treatment by patients with cancer have focused on unconventional treatment as a joint group of therapies. The objective of this study is to gather preliminary information about the use of different modes of unconventional cancer treatment by patients with cancer and to describe user profiles of standardized and individualized treatments. Data originate from an ongoing explorative 5-year study of 441 consecutively registered cancer patients who have consulted medical doctors and alternative therapists practicing unconventional treatment in Denmark. This paper is based on data from the first and second of six questionnaires. The unconventional treatments included in this study are categorized into two forms of treatment: standardized and individualized treatment. Four hundred and forty-one (441) Danish patients with cancer who use unconventional cancer treatment. The analysis shows significant correlations between type of treatment and the following variables: gender, education, occupational status, type of cancer, purpose of seeking unconventional treatment, metastatic spread, opinion regarding appropriate unconventional treatment, and simultaneous use of unconventional treatment. The study shows that there are significant differences between patients with cancer choosing standardized and those choosing individualized unconventional treatment. The probability of choosing standardized unconventional treatment is greatest among male participants, patients having shorter school education, and for patients who have recovery as the goal of seeking unconventional treatment. The probability of choosing individualized unconventional treatment is greatest among women, for patients with longer school education, and for patients wanting relief from symptoms, information, and improvement of general condition as the purpose of seeking unconventional cancer treatment. Patients with breast and gynecologic cancer are more inclined to seek individualized treatment than patients with all other cancer diseases. The study points to the fact that it might be essential to differentiate between different forms of unconventional treatment to understand the use by patients with cancer and the outcomes of these treatments.

Preventative Disease Management and Grower Decision Making: A Case Study of California Wine-Grape Growers.

PubMed

Hillis, Vicken; Lubell, Mark; Kaplan, Jonathan; Baumgartner, Kendra

2017-06-01

Preventative disease management is challenging to farmers because it requires paying immediate costs in the hopes of returning uncertain future benefits. Understanding farmer decision making about prevention has the potential to reduce disease incidence and minimize the need for more costly postinfection practices. For example, the grapevine trunk-disease complex (esca, Botryosphaeria dieback, Eutypa dieback, and Phomopsis dieback) significantly affects vineyard productivity and longevity. Given the chronic nature of the infections and inability to eradicate the fungal pathogens, the preventative practices of delayed pruning, applications of pruning-wound protectants, and double pruning (also known as prepruning) are the most effective means of management. We surveyed wine-grape growers in six regions of California on their use of these three practices. In spite of acknowledging the yield impacts of trunk diseases, a substantial number of respondents either choose not to use preventative practices or incorrectly adopted them in mature vineyards, too late in the disease cycle to be effective. Growers with more negative perceptions of cost efficacy were less likely to adopt preventative practices or were more likely to time adoption incorrectly in mature vineyards. In general, preventative management may require strong intervention in the form of policy or extension to motivate behavioral change.

The public's opinions of physicians: do perceived choice and exercised choice matter?

PubMed

Tai-Seale, Ming; Pescosolido, Bernice

2003-09-01

To assess whether the public's opinions of physicians are affected by one's perceived ability to choose providers and by past experience with switching providers or health plans. Cross-sectional survey of the American general public in 1998. Multivariate quantitative analyses of opinions according to respondents' perceived ability to choose providers, history of exercising choice of providers or plans, and health status. Exploratory factor analyses resulted in 4 scales of opinions: trusting personal physician, positive opinions of physicians as a group, negative opinions of physicians as a group, and concerns about the influence of managed care on personal physicians' practice patterns. Although 75% (879/1172) of the sample perceived that they could use any physician they wanted, only 20% had ever switched health providers or plans owing to dissatisfaction. Perceived lack of choice is associated with lower levels of trust in personal physicians and with higher levels of concern about the influence of managed care on personal physicians. Individuals who have not switched in the past are more positive about physicians as a group and are less concerned about the influence of managed care. Health status affected opinions significantly. Educational attainment is negatively associated with opinions. The public's opinions of physicians are significantly associated with one's perceived ability to choose any provider, past experience with switching health providers or plans, health status, and education. Ensuring consumer choice of providers and targeting those who have switched in the past and the sick could potentially improve the public's opinions. Meaningful provider quality information is necessary to ensure choices that can enhance consumer welfare.

Why Don't More Students Major in IS?

ERIC Educational Resources Information Center

Kuechler, William L.; McLeod, Alexander; Simkin, Mark G.

2009-01-01

The large increases in the number of information systems (IS) majors about 10 years ago have been matched by equally large decreases in IS enrollments over the last few years. This article addresses the question of why students choose any major in general, and why students no longer choose to become an IS major in particular. We used a validated…

Student Perceptions of General Education Requirements at a Large Public University: No Surprises?

ERIC Educational Resources Information Center

Thompson, Clarissa A.; Eodice, Michele; Tran, Phuoc

2015-01-01

The current study surveyed students' knowledge of and perceptions about general education requirements at a large research-intensive university. Findings revealed that students harbored misconceptions about general education requirements and illuminated the reasons why students were choosing to take required general education courses at other…

A Discounting Framework for Choice With Delayed and Probabilistic Rewards

PubMed Central

Green, Leonard; Myerson, Joel

2005-01-01

When choosing between delayed or uncertain outcomes, individuals discount the value of such outcomes on the basis of the expected time to or the likelihood of their occurrence. In an integrative review of the expanding experimental literature on discounting, the authors show that although the same form of hyperbola-like function describes discounting of both delayed and probabilistic outcomes, a variety of recent findings are inconsistent with a single-process account. The authors also review studies that compare discounting in different populations and discuss the theoretical and practical implications of the findings. The present effort illustrates the value of studying choice involving both delayed and probabilistic outcomes within a general discounting framework that uses similar experimental procedures and a common analytical approach. PMID:15367080

Standing at the Intersection: Reconsidering the Balance in Administration.

ERIC Educational Resources Information Center

Lancaster, James M.; Cooper, Diane L.

1998-01-01

States that student affairs administrators must choose wisely between increasing reliance on legal minimalism and a more reflective judgment model that can evolve toward a model of unified practice balancing policy and law with developmentally appropriate practices. Offers recommendations concerning the future of student affairs. (Author/MKA)

Choosing Assessment Instruments for Anxiety Practice and Outcome Research with School-Aged Youth

ERIC Educational Resources Information Center

Erford, Bradley T.; Lutz, Julie A.

2015-01-01

Using effect size results from our meta-analysis for the treatment of anxiety in school-aged youth, the practical and technical aspects of five commonly used anxiety instruments were analyzed, and effect size estimates compared to indicate the best choices for use in anxiety outcome research.

[Female veterinary surgeons: a follow up study].

PubMed

Nicol, J

1983-03-01

Questionnaires were sent out to 68 registered female veterinary surgeons in South Africa to obtain career information essential to vocational guidance. The 46 respondents represent 51,7% of the 89 female BVSc graduates up to 1981; their average age was 33,3 years, 63% were married, 30,4% were from the Pretoria area, 60,9% were living in the Transvaal, 52,2% had had 6 and more years of veterinary experience. All the comparisons done indicated that the response group was representative of the women who had obtained the BVSc degree from the University of Pretoria. Some of the more important findings were the following: No less than 97,8% of the response group are at present actively engaged in veterinary work--73,9% on a full-time basis. Asked what they would choose now, 84,8% of the respondents declared that they would choose veterinary science once again; 67,4% would like to see their daughters enter the profession. The most important reason for this positive attraction towards veterinary practice was given as "job satisfaction experienced". Respondents indicated the things that they liked about veterinary practice: factors intrinsic to the job like surgery, pathology and research topped the list followed by the opportunity to work with and help animals and also the variety experienced in their work. The most important grievances were firstly the general attitude and actions of the public--callousness of animal-owners and inconsiderate behaviour towards practitioners. Long and irregular hours, administrative red tape and insufficient technical help were also complaints.(ABSTRACT TRUNCATED AT 250 WORDS)

Combining accounting approaches to practice valuation.

PubMed

Schwartzben, D; Finkler, S A

1998-06-01

Healthcare organizations that wish to acquire physician or ambulatory care practices can choose from a variety of practice valuation approaches. Basic accounting methods assess the value of a physician practice on the basis of a historical, balance-sheet description of tangible assets. Yet these methods alone are inadequate to determine the true financial value of a practice. By using a combination of accounting approaches to practice valuation that consider factors such as fair market value, opportunity cost, and discounted cash flow over a defined time period, organizations can more accurately assess a practice's actual value.

Research challenges in municipal solid waste logistics management.

PubMed

Bing, Xiaoyun; Bloemhof, Jacqueline M; Ramos, Tania Rodrigues Pereira; Barbosa-Povoa, Ana Paula; Wong, Chee Yew; van der Vorst, Jack G A J

2016-02-01

During the last two decades, EU legislation has put increasing pressure on member countries to achieve specified recycling targets for municipal household waste. These targets can be obtained in various ways choosing collection methods, separation methods, decentral or central logistic systems, etc. This paper compares municipal solid waste (MSW) management practices in various EU countries to identify the characteristics and key issues from a waste management and reverse logistics point of view. Further, we investigate literature on modelling municipal solid waste logistics in general. Comparing issues addressed in literature with the identified issues in practice result in a research agenda for modelling municipal solid waste logistics in Europe. We conclude that waste recycling is a multi-disciplinary problem that needs to be considered at different decision levels simultaneously. A holistic view and taking into account the characteristics of different waste types are necessary when modelling a reverse supply chain for MSW recycling. Copyright © 2015 Elsevier Ltd. All rights reserved.

What Motivates Science Teachers to Teach in Urban Settings? A Mixed Method Approach

ERIC Educational Resources Information Center

Alhashem, Fatimah

2012-01-01

The high rate of teacher turnover in the United States has prompted a number of studies into why teachers leave as well as why they stay. The present study aims to add to that knowledge specifically regarding why teachers choose to stay at urban schools. Several reasons teachers in general choose to stay have been identified in previous studies…

[Guideline implementation study on asthma: Results of a pragmatic implementation approach].

PubMed

Redaèlli, Marcus; Vollmar, Horst Christian; Simic, Dusan; Maly-Schürer, Cornelia; Löscher, Susanne; Koneczny, Nikolaus

2015-01-01

Knowledge transfer from theory to practice in healthcare systems poses a challenge worldwide. Typical examples include national disease management guidelines. The present study contributes towards improving implementation strategies for an asthma guideline. A guideline implementation strategy was examined in a four-armed, non-randomised, controlled intervention study with an additional control group. The study participants were general practitioners and paediatricians recruited from primary care quality circles. All study participants attended an interactive seminar on the evidence-based recommendations for patients with asthma. In addition, the participants were asked to choose among the following options: no further intervention, additional e-learning, training of their practice nurses, or e-learning and training of their practice nurses. The success of the intervention was measured by questionnaire (and the success rate expressed as a percentage). About one third of all participants (n=313) opted for the combination of an interactive seminar and a training of practice nurses; two third preferred the classic way of continuing medical education with an interactive seminar without a further intervention. Just 10 % of the physicians participated in e-learning. Independently of their choice for continuing medical education, all participants demonstrated an increase in knowledge about asthma and an improvement in the management of asthma. The physicians exhibited an average increase in both categories of about 10 % of the percentage values, compared to an increase of about 28 % among the practice nurses without continuing medical education. The physicians' free choice of the educative modules might be an integral part of successful implementation strategies. However, this will require a change of focus from general continuing medical education packages to a more individualised culture of continuing professional development in Germany. Copyright © 2015. Published by Elsevier GmbH.

Choosing a Family Doctor

MedlinePlus

... of Family Physicians (AAFP). The AAFP provides high-quality learning opportunities for family physicians, as well as patient education materials and practice management support. When to see a doctor Congratulations on ...

Students' Perceptions of Teaching and Learning Practices: A Principal Component Approach

ERIC Educational Resources Information Center

Mukorera, Sophia; Nyatanga, Phocenah

2017-01-01

Students' attendance and engagement with teaching and learning practices is perceived as a critical element for academic performance. Even with stipulated attendance policies, students still choose not to engage. The study employed a principal component analysis to analyze first- and second-year students' perceptions of the importance of the 12…

"Fostering Library as Place for Distance Students: Best Practices from Two Universities"--Conference Report

ERIC Educational Resources Information Center

Cannady, Rachel E.

2011-01-01

In this article, the author reports on the Association of College and Research Libraries (ACRL) Conference which occurred in Philadelphia, Pennsylvania, March 29-April 2, 2011. There were numerous panel sessions to choose from, and the author attended "Fostering Library as Place for Distance Students: Best Practices from Two…

Predictors of Success on the Prosthetics Certification Examination

ERIC Educational Resources Information Center

Miro, Rebecca Maria

2014-01-01

Students who graduate from a practitioner program in prosthetics & orthotics must achieve certification in order to obtain licensure and practice independently in 16 states. In states where licensure is not mandatory, graduates may choose to pursue certification in order assure patients that they are practicing at the highest level as well as…

Designing and Conducting Strong Quasi-Experiments in Education. Version 2

ERIC Educational Resources Information Center

Scher, Lauren; Kisker, Ellen; Dynarski, Mark

2015-01-01

The purpose of this paper is to describe best practices in designing and implementing strong quasi-experimental designs (QED) when assessing the effectiveness of policies, programs or practices. The paper first discusses the issues researchers face when choosing to conduct a QED, as opposed to a more rigorous randomized controlled trial design.…

Recruitment and retention of rural physicians: outcomes from the rural physician associate program of Minnesota.

PubMed

Halaas, Gwen Wagstrom; Zink, Therese; Finstad, Deborah; Bolin, Keli; Center, Bruce

2008-01-01

Founded in 1971 with state funding to increase the number of primary care physicians in rural Minnesota, the Rural Physician Associate Program (RPAP) has graduated 1,175 students. Third-year medical students are assigned to primary care physicians in rural communities for 9 months where they experience the realities of rural practice with hands-on participation, mentoring, and one-to-one teaching. Students complete an online curriculum, participate in online discussion with fellow students, and meet face-to-face with RPAP faculty 6 times during the 9-month rotation. Projects designed to bring value to the community, including an evidence-based practice and community health assessment, are completed. To examine RPAP outcomes in recruiting and retaining rural primary care physicians. The RPAP database, including moves and current practice settings, was examined using descriptive statistics. On average, 82% of RPAP graduates have chosen primary care, and 68% family medicine. Of those currently in practice, 44% have practiced in a rural setting all of the time, 42% in a metropolitan setting and 14% have chosen both, with more than 50% of their time in rural practice. Rural origin has only a small association with choosing rural practice. RPAP data suggest that the 9-month longitudinal experience in a rural community increases the number of students choosing primary care practice, especially family medicine, in a rural setting.

Comply with regulations or risk paying hefty fines: ten tips for choosing call recording to help ensure compliance.

PubMed

Johnson, Bill

2014-01-01

Medical practices are paying hundreds of thousands of dollars in fines for not complying with various governmental regulations, including a variety of HIPAA rules and credit card compliance. One solution to help reduce this risk and avoid fines is to use call recording to help ensure compliance. This article provides readers with key considerations for choosing and implementing a call recording solution for their medical practices to ensure that it will be compliant with key regulations. These tips include being able to customize call recording policies and procedures for their unique needs; providing secure, private storage; allowing easy access for authorized users; secure sharing of call recordings; regulatory compliance training; disaster recovery; and maintaining an audit-ready and compliant-evident state at all times.

The Space That Difference Makes: On Marginality, Social Justice and the Future of the Health Humanities.

PubMed

Gutierrez, Kevin J; DasGupta, Sayantani

2016-12-01

Feminist theorist and educator, bell hooks, asserts that to seek true liberation one must choose marginality. One must choose to occupy the space outside the binary between colonizer-colonized, hegemonic center-periphery, and us-them in order to create a location of possibility. This essay will reveal the practice of social justice as the navigation of the space that difference makes and argue that choosing marginality provides a framework for health humanities work towards social justice in health care. The space of the launderette that is depicted in Hanif Kureishi's 1986 film, My Beautiful Laundrette, provides an example of choosing marginality and illustrates how difference structures both real and imagined spaces, which influences how individuals ultimately perceive one another. We will draw from the work of bell hooks; political geographer, Edward Soja; and Marxist philosopher, Henri Lefebvre, to demonstrate the importance of the health humanities' position at the margin to traditional health care education.

Relationship Between Citation-Based Scholarly Activity of United States Radiation Oncology Residents and Subsequent Choice of Academic Versus Private-Practice Career.

PubMed

McClelland, Shearwood; Mitin, Timur; Wilson, Lynn D; Thomas, Charles R; Jaboin, Jerry J

2018-05-01

To assess h-index data and their association with radiation oncology resident choice of academic versus private-practice career, using a recent resident graduating class. A list of 2016 radiation oncology resident graduates (163 residents from 76 Accreditation Council for Graduate Medical Education-certified programs) and their postresidency career choice (academic vs private practice) was compiled. The Scopus bibliometric citation database was then searched to collect h-index data for each resident. Demographics included in analyses were gender and PhD degree status. Mean h-index score for all resident graduates was 4.15. Residents with a PhD had significantly higher h-index scores (6.75 vs 3.42; P < .01), whereas there was no statistically significant difference in h-index scores between male and female residents (4.38 vs 3.36; P = .06). With regard to career choice, residents choosing academic careers had higher h-index scores than those choosing private practice (5.41 vs 2.96; P < .01). There was no significant difference in mean h-index scores between male and female residents regardless of private-practice (3.15 vs 2.19; P = .25) or academic (5.80 vs 4.30; P = .13) career choice. The average radiation oncology resident graduate published a minimum of 4 manuscripts cited at least 4 times. Graduates with a PhD are significantly more likely to have higher h-index scores, as are residents who choose academic over private-practice careers. There is no significant difference in h-index score between male and female residents, regardless of career choice. These results offer up-to-date benchmarks for evaluating radiation oncology resident productivity and have potential utility in predicting postresidency career choices. Copyright © 2018 Elsevier Inc. All rights reserved.

Near DC eddy current measurement of aluminum multilayers using MR sensors and commodity low-cost computer technology

NASA Astrophysics Data System (ADS)

Perry, Alexander R.

2002-06-01

Low Frequency Eddy Current (EC) probes are capable of measurement from 5 MHz down to DC through the use of Magnetoresistive (MR) sensors. Choosing components with appropriate electrical specifications allows them to be matched to the power and impedance characteristics of standard computer connectors. This permits direct attachment of the probe to inexpensive computers, thereby eliminating external power supplies, amplifiers and modulators that have heretofore precluded very low system purchase prices. Such price reduction is key to increased market penetration in General Aviation maintenance and consequent reduction in recurring costs. This paper examines our computer software CANDETECT, which implements this approach and permits effective probe operation. Results are presented to show the intrinsic sensitivity of the software and demonstrate its practical performance when seeking cracks in the underside of a thick aluminum multilayer structure. The majority of the General Aviation light aircraft fleet uses rivets and screws to attach sheet aluminum skin to the airframe, resulting in similar multilayer lap joints.

Reducing Annotation Effort Using Generalized Expectation Criteria

DTIC Science & Technology

2007-11-30

constraints additionally consider input variables. Active learning is a related problem in which the learner can choose the particular instances to be...labeled. In pool-based active learning [Cohn et al., 1994], the learner has access to a set of unlabeled instances, and can choose the instance that...has the highest expected utility according to some metric. A standard pool- based active learning method is uncertainty sampling [Lewis and Catlett

Simple, Defensible Sample Sizes Based on Cost Efficiency

PubMed Central

Bacchetti, Peter; McCulloch, Charles E.; Segal, Mark R.

2009-01-01

Summary The conventional approach of choosing sample size to provide 80% or greater power ignores the cost implications of different sample size choices. Costs, however, are often impossible for investigators and funders to ignore in actual practice. Here, we propose and justify a new approach for choosing sample size based on cost efficiency, the ratio of a study’s projected scientific and/or practical value to its total cost. By showing that a study’s projected value exhibits diminishing marginal returns as a function of increasing sample size for a wide variety of definitions of study value, we are able to develop two simple choices that can be defended as more cost efficient than any larger sample size. The first is to choose the sample size that minimizes the average cost per subject. The second is to choose sample size to minimize total cost divided by the square root of sample size. This latter method is theoretically more justifiable for innovative studies, but also performs reasonably well and has some justification in other cases. For example, if projected study value is assumed to be proportional to power at a specific alternative and total cost is a linear function of sample size, then this approach is guaranteed either to produce more than 90% power or to be more cost efficient than any sample size that does. These methods are easy to implement, based on reliable inputs, and well justified, so they should be regarded as acceptable alternatives to current conventional approaches. PMID:18482055

Career influences among final year dental students who plan to enter private practice.

PubMed

Nashleanas, Benjamin M; McKernan, Susan C; Kuthy, Raymond A; Qian, Fang

2014-03-08

Existing research about the influence of educational debt on students' decision to enter general practice immediately after graduation is conflicting. Other potential factors that could affect this decision include the influence of a spouse or other family member, the importance of a mentoring dentist, and how students perceive the burden of their debt. The goal of this study was to examine the importance of debt on career decision-making while also considering the role of other influences. Responses to a self-completed questionnaire of all final (fourth) year students at the University of Iowa College of Dentistry from 2007 through 2010 were analyzed to identify the importance of educational debt and the influence of spouses, other family members, and mentoring dentists in the decision to enter private general practice immediately after graduation. Statistical analysis included bivariate tests (t-tests and Chi-square tests) and multivariable logistic regression. 58.9% of respondents (N = 156) planned to immediately enter private practice after dental school. Bivariate analyses revealed women to be more likely to enter private practice than their male counterparts (69.0% vs. 51.8%, p = .006). Students planning to enter practice immediately did not differ significantly from those with other career plans on the basis of marital status or having a family member in dentistry. Anticipated educational debt of at least $100,000 was positively associated with plans to enter private practice immediately after graduation. Self-reported importance of educational debt was not associated with career plans. However, the influence of a spouse, other family members, and family dentists were also positively associated with the decision to enter private practice. These factors all maintained significance in the final multivariable model (p < 0.05); however, educational debt of at least $100,000 was the strongest predictor of plans to enter private practice (OR = 2.34; p = 0.023). Since the 1970s, increasing numbers of dentists in the U.S. have pursued specialty training after dental school. However, rising educational debts may counter this trend as increasing numbers of dentists choose to immediately pursue general dentistry at graduation. This project has demonstrated the significant influence of educational debt, beyond other external influences.

Career influences among final year dental students who plan to enter private practice

PubMed Central

2014-01-01

Background Existing research about the influence of educational debt on students’ decision to enter general practice immediately after graduation is conflicting. Other potential factors that could affect this decision include the influence of a spouse or other family member, the importance of a mentoring dentist, and how students perceive the burden of their debt. The goal of this study was to examine the importance of debt on career decision-making while also considering the role of other influences. Methods Responses to a self-completed questionnaire of all final (fourth) year students at the University of Iowa College of Dentistry from 2007 through 2010 were analyzed to identify the importance of educational debt and the influence of spouses, other family members, and mentoring dentists in the decision to enter private general practice immediately after graduation. Statistical analysis included bivariate tests (t-tests and Chi-square tests) and multivariable logistic regression. Results 58.9% of respondents (N = 156) planned to immediately enter private practice after dental school. Bivariate analyses revealed women to be more likely to enter private practice than their male counterparts (69.0% vs. 51.8%, p = .006). Students planning to enter practice immediately did not differ significantly from those with other career plans on the basis of marital status or having a family member in dentistry. Anticipated educational debt of at least $100,000 was positively associated with plans to enter private practice immediately after graduation. Self-reported importance of educational debt was not associated with career plans. However, the influence of a spouse, other family members, and family dentists were also positively associated with the decision to enter private practice. These factors all maintained significance in the final multivariable model (p < 0.05); however, educational debt of at least $100,000 was the strongest predictor of plans to enter private practice (OR = 2.34; p = 0.023). Conclusions Since the 1970s, increasing numbers of dentists in the U.S. have pursued specialty training after dental school. However, rising educational debts may counter this trend as increasing numbers of dentists choose to immediately pursue general dentistry at graduation. This project has demonstrated the significant influence of educational debt, beyond other external influences. PMID:24606674

Relationship between decile score of secondary school, the size of town of origin and career intentions of New Zealand medical students.

PubMed

Mitchell, Clinton J; Shulruf, Boaz; Poole, Phillippa J

2010-09-01

New Zealand is facing a general practice workforce crisis, especially in rural communities. Medical school entrants from low decile schools or rural locations may be more likely to choose rural general practice as their career path. To determine whether a relationship exists between secondary school decile rating, the size of the town of origin of medical students and their subsequent medical career intentions. University of Auckland medical students from 2006 to 2008 completed an entry questionnaire on a range of variables thought important in workforce determination. Analyses were performed on data from the 346 students who had attended a high school in New Zealand. There was a close relationship between size of town of origin and decile of secondary school. Most students expressed interests in a wide range of careers, with students from outside major cities making slightly fewer choices on average. There is no strong signal from these data that career specialty choices will be determined by decile of secondary school or size of town of origin. An increase in the proportion of rural students in medical programmes may increase the number of students from lower decile schools, without adding another affirmative action pathway.

The design of sampling transects for characterizing water quality in estuaries

USGS Publications Warehouse

Jassby, A.D.; Cole, B.E.; Cloern, J.E.

1997-01-01

The high spatial variability of estuaries poses a challenge for characterizing estuarine water quality. This problem was examined by conducting monthly high-resolution transects for several water quality variables (chlorophyll a, suspended particulate matter and salinity) in San Francisco Bay (California, U.S.A.). Using these data, six different ways of choosing station locations along a transect, in order to estimate mean conditions, were compared. In addition, 11 approaches to estimating the variance of the transect mean when stations are equally spaced were compared, and the relationship between variance of the estimated transect mean and number of stations was determined. The results provide guidelines for sampling along the axis of an estuary: (1) Choose as many equally-spaced stations as practical; (2) estimate the variance of the mean y?? by var (y??)=(1/10n2)??(j=2)/(n) (y(j)-y(j-1)2, where y1,...,y(n) are the measurements at the n stations; and (3) attain the desired precision by adjusting the number of stations according to var(y??)???1/n2. The inverse power of 2 in the last step is a consequence of the underlying spatial correlation structure in San Francisco Bay; more studies of spatial structure at other estuaries are needed to determine the generality of this relationship.

Gender Differences in Pediatric Orthopaedics: What Are the Implications for the Future Workforce?

PubMed

Amoli, Marielle A; Flynn, John M; Edmonds, Eric W; Glotzbecker, Michael P; Kelly, Derek M; Sawyer, Jeffrey R

2016-09-01

Although the number of women in surgical specialties has increased dramatically over the past two decades, little research exists regarding how a surgeon's gender impacts job selection and practice models. Because the number of women specializing in pediatric orthopaedics continues to increase, it is important to understand how one's gender affects practice choices and how this may affect the future workforce. (1) Among pediatric orthopaedic surgeons, is gender associated with choice of practice type (academic, private practice, hospital-based, solo)? (2) For men and women, what are the most common reasons for choosing a job? (3) For new graduates, do men and women have equal starting salaries? (4) Do men have a higher chance of getting job offers? (5) Is there a difference in workload (call frequency and surgical case volume) for men and women? (6) Finally, is there a difference in imminent retirement plans for men and women? The 2015 Pediatric Orthopaedic Society of North American (POSNA) Needs Assessment Survey was sent to POSNA members and a special 36-question survey was sent to recent pediatric orthopaedic fellowship graduates. Both surveys included questions about self-reported gender, practice type, reasons for job selection, and call frequency. In addition, the new graduates' survey also included questions about starting salary, job offers, and number of additional fellowships completed. Responses were analyzed by gender. Chi-square and Fisher's exact tests assessed for statistical significance. Among the new graduates, women are more likely to choose academic practice (women: 13 of 18 [72%], men: 21 of 44 [48%], odds ratio [OR], 3.10 [confidence interval {CI}, 0.86-11.10], p < 0.001), whereas men are more likely to choose private practice (men: 14 of 44 [32‰], women: one of 18 [6%], OR, 0.12 [CI, 0.015-1.001], p < 0.001). The primary reasons for choosing a job were not different between men and women. Among the new graduates, geography/family considerations were reported as being highly important when selecting a job (men: 33 of 44 [75%], women: 16 of 18 [89%]) followed by academic opportunities (men: 24 of 44 [55%], women: 14 of 18 [78%]). Interestingly, a higher percentage of males reported finances as being important when selecting a job (men: 23 of 44 [52%], women: five of 18 [28%]). For the current POSNA members, the most important reasons when choosing a job for both men and women were quality of partners (men: 168 of 408 [41%], women: 66 of 122 [54%]) and an interesting practice (men: 155 of 408 [38%], women 54 of 122 [44%]. As a result of our small sample size, there was no difference in starting salaries between men and women (< USD 350,000: men 22 of 44 [50%], women 12 of 18 [67%]; USD 350,000-450,000: men 11 of 44 [25%], women six of 18 [33%]; > USD 450,000: men eight of 44 [18%], women zero of 18 [0%], p = 0.131). When stratified by practice type, for private practice starting salaries, over half of men (seven of 13 [54%]) placed in the highest category of > USD 400,000, whereas the single woman respondent placed in the lowest category of < USD 300,000. Men were more likely to report having job offers before starting their fellowship (men: 24 of 44 [54%], women: eight of 18 [44%], OR, 0.67 [CI, 0.22-2.0], p = 0.042). Finally, among POSNA members, women reported a lower weekly surgical case volume compared with men. Of the men, 108 of 408 (26%) reported performing more than seven surgeries per week compared with 12 of 122 women (10%; OR, 3.4 [CI, 1.8-6.44], p < 0.001). Although the numbers are small given the specialized nature of pediatric orthopaedic surgery, this study has uncovered some initial gender differences regarding practice characteristics and job opportunities among pediatric orthopaedic surgeons. As more men plan to reduce their workload or retire in the next 5 years, there may be further increases in the percentage of women surgeons in the workforce, so it is important that we begin to understand what effect, if any, gender has on practice patterns, job selection, and opportunities. Also, the finding that among the new graduates more women than men are choosing careers in academic practice over private practice suggests an extraordinary opportunity to develop more female leaders and role models at major pediatric orthopaedic centers.

Quantitative microscopy of the lung: a problem-based approach. Part 1: basic principles of lung stereology.

PubMed

Ochs, Matthias; Mühlfeld, Christian

2013-07-01

The growing awareness of the importance of accurate morphometry in lung research has recently motivated the publication of guidelines set forth by a combined task force of the American Thoracic Society and the European Respiratory Society (20). This official ATS/ERS Research Policy Statement provides general recommendations on which stereological methods are to be used in quantitative microscopy of the lung. However, to integrate stereology into a particular experimental study design, investigators are left with the problem of how to implement this in practice. Specifically, different animal models of human lung disease require the use of different stereological techniques and may determine the mode of lung fixation, tissue processing, preparation of sections, and other things. Therefore, the present companion articles were designed to allow a short practically oriented introduction into the concepts of design-based stereology (Part 1) and to provide recommendations for choosing the most appropriate methods to investigate a number of important disease models (Part 2). Worked examples with illustrative images will facilitate the practical performance of equivalent analyses. Study algorithms provide comprehensive surveys to ensure that no essential step gets lost during the multistage workflow. Thus, with this review, we hope to close the gap between theory and practice and enhance the use of stereological techniques in pulmonary research.

Series: Pragmatic trials and real world evidence: Paper 1. Introduction.

PubMed

Zuidgeest, Mira G P; Goetz, Iris; Groenwold, Rolf H H; Irving, Elaine; van Thiel, Ghislaine J M W; Grobbee, Diederick E

2017-08-01

This is the introductory paper in a series of eight papers. In this series, we integrate the theoretical design options with the practice of conducting pragmatic trials. For most new market-approved treatments, the clinical evidence is insufficient to fully guide physicians and policy makers in choosing the optimal treatment for their patients. Pragmatic trials can fill this gap, by providing evidence on the relative effectiveness of a treatment strategy in routine clinical practice, already in an early phase of development, while maintaining the strength of randomized controlled trials. Selecting the setting, study population, mode of intervention, comparator, and outcome are crucial in designing pragmatic trials. In combination with monitoring and data collection that does not change routine care, this will enable appropriate generalization to the target patient group in clinical practice. To benefit from the full potential of pragmatic trials, there is a need for guidance and tools in designing these studies while ensuring operational feasibility. This paper introduces the concept of pragmatic trial design. The complex interplay between pragmatic design options, feasibility, stakeholder acceptability, validity, precision, and generalizability will be clarified. In this way, balanced design choices can be made in pragmatic trials with an optimal chance of success in practice. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

A Patient Record-Filing System for Family Practice

PubMed Central

Levitt, Cheryl

1988-01-01

The efficient storage and easy retrieval of quality records are a central concern of good family practice. Many physicians starting out in practice have difficulty choosing a practical and lasting system for storing their records. Some who have established practices are installing computers in their offices and finding that their filing systems are worn, outdated, and incompatible with computerized systems. This article describes a new filing system installed simultaneously with a new computer system in a family-practice teaching centre. The approach adopted solved all identifiable problems and is applicable in family practices of all sizes.

Profile of the medical student and his outlook on medical education--the Basrah experience.

PubMed

Al-Na'ama, M R; Alkafajei, A M; Joseph, G

1980-11-01

The aim of the study was to obtain the students' views on the current system of medical education with focus on training and evaluation in the College of Medicine, University of Basrah, Iraq. The data were gathered by circulation of a questionnaire to students belonging to all the classes (1 to 6 years). An attempt was made to look for trends in student responses and attitudes over the years. National service, i.e., joining the national health care system, appears to be the dominant motive among the first- and second-year students in choosing the profession. Though the practice of general clinical disciplines at the basic doctor's level are preferred, general practice per se does not seem to be popular. An apparent dislike for certain curricular subjects was observed which was more evident among students who had to pass an examination in that subject during the particular year. Lectures and dictation of notes are rated low. A good majority of students consider their active participation in the learning-teaching process as something highly useful. Though examinations are not generally liked, the students showed their preference for periodical tests as compared to a single annual examination. Students generally do not prefer assessment based on problem solving exercises. Little use is made of the library and there is hardly any student-teacher contact outside the classroom. The study has brought out the need for greater emphasis on self-directed learning. The relevance of the students' views in educational planning are highlighted in the discussion.

Neural networks: What non-linearity to choose

NASA Technical Reports Server (NTRS)

Kreinovich, Vladik YA.; Quintana, Chris

1991-01-01

Neural networks are now one of the most successful learning formalisms. Neurons transform inputs (x(sub 1),...,x(sub n)) into an output f(w(sub 1)x(sub 1) + ... + w(sub n)x(sub n)), where f is a non-linear function and w, are adjustable weights. What f to choose? Usually the logistic function is chosen, but sometimes the use of different functions improves the practical efficiency of the network. The problem of choosing f as a mathematical optimization problem is formulated and solved under different optimality criteria. As a result, a list of functions f that are optimal under these criteria are determined. This list includes both the functions that were empirically proved to be the best for some problems, and some new functions that may be worth trying.

Grounded for an ethical dilemma: disequilibrium in a commercial airline pilot.

PubMed

Kirschen, Matthew P; Friedlander, Joel A

2012-10-01

This article presents the case of a 41-year-old airline pilot with benign paroxysmal positional vertigo who requests that his diagnosis not be disclosed to his commercial airline employer or his aviation medical examiner because it may result in the suspension of medical certification. The legal and ethical requirements for physicians reporting impaired pilots are discussed as well as practical recommendations for handling such situations. The argument is made that a physician's obligation to honor patient confidentiality should not take precedence over his or her duty to protect the safety and well-being of the airplane passengers and the general public. If the patient chooses not to self-report, a physician has an ethical obligation to report the patient's medical condition to the Federal Aviation Administration.

Writing a case report: polishing a gem?

PubMed

Papanas, N; Lazarides, M K

2008-08-01

Case reports describe patient cases which are of particular interest due to their novelty and their potential message for clinical practice. While there are several types of case reports, originality and clinical implications constitute the main virtues by which case reports are judged. Defining the educational message and choosing the right audience are vital steps in the process of writing. Generally, a case report is structured, its main components being the abstract, the introduction, the case description and the discussion. Guidelines and tips for writing case reports are not enough for making a successful author, but they help, especially less experienced doctors, to exercise and improve their writing. If properly prepared, case reports can still communicate new observations in an interesting and pleasant way, thereby enriching our knowledge, even in the era of evidence-based medicine.

Evaluating Heuristics for Planning Effective and Efficient Inspections

NASA Technical Reports Server (NTRS)

Shull, Forrest J.; Seaman, Carolyn B.; Diep, Madeline M.; Feldmann, Raimund L.; Godfrey, Sara H.; Regardie, Myrna

2010-01-01

A significant body of knowledge concerning software inspection practice indicates that the value of inspections varies widely both within and across organizations. Inspection effectiveness and efficiency can be measured in numerous ways, and may be affected by a variety of factors such as Inspection planning, the type of software, the developing organization, and many others. In the early 1990's, NASA formulated heuristics for inspection planning based on best practices and early NASA inspection data. Over the intervening years, the body of data from NASA inspections has grown. This paper describes a multi-faceted exploratory analysis performed on this · data to elicit lessons learned in general about conducting inspections and to recommend improvements to the existing heuristics. The contributions of our results include support for modifying some of the original inspection heuristics (e.g. Increasing the recommended page rate), evidence that Inspection planners must choose between efficiency and effectiveness, as a good tradeoff between them may not exist, and Identification of small subsets of inspections for which new inspection heuristics are needed. Most Importantly, this work illustrates the value of collecting rich data on software Inspections, and using it to gain insight into, and Improve, inspection practice.

Practical concept of pharmacokinetics/pharmacodynamics in the management of skin and soft tissue infections.

PubMed

Pea, Federico

2016-04-01

This article gives an overview of the practical concept of pharmacokinetic/pharmacodynamic principles useful for clinicians in the management of skin and soft tissue infections (SSTIs). Recent studies suggest that distinguishing between bacteriostatic or bactericidal activity when choosing an antimicrobial for the treatment of severe infections could probably be clinically irrelevant. Conversely, what could help clinicians in maximizing the therapeutic efficacy of the various drugs in routine practice is taking care of some pharmacokinetic/pharmacodynamic principles. Concentration-dependent agents may exhibit more rapid bacterial killing than observed with time-dependent agents. Serum concentrations may not always adequately predict tissue exposure in patients with SSTIs, and measuring concentrations at the infection site is preferable. Hydrophilic antimicrobials showed generally lower penetration rates than the lipophilic ones and might require alternative dosing approaches in the presence of severe sepsis or septic shock. Conversely, tissue penetration of lipophilic antimicrobials is often unaffected by the pathophysiological status. Real-time therapeutic drug monitoring may be a very helpful tool for optimizing therapy of severe infections. Taking care of pharmacokinetic/pharmacodynamic principles deriving from the most recent findings may help clinicians in maximizing treatment of SSTIs with antimicrobials in every situation.

Gender differences in practice patterns for diagnosis and treatment of dental caries: Findings from The Dental PBRN

PubMed Central

Riley, Joseph L.; Gordan, Valeria V.; Rouisse, Kathleen M.; McClelland, Jocelyn; Gilbert, Gregg H.

2011-01-01

Objectives A number of articles have addressed gender differences in the productivity of dentists, but little is known about differences in practice patterns for caries management. This study compared the use of a comprehensive range of specific diagnostic methods, preventive agents, and restorative decision making for caries management between male and female dentists who were members of The Dental Practice-Based Research Network(DPBRN). Methods This study surveyed general dentists who were members of DPBRN and who practiced within the United States. The survey asked about dentist, practice, and patient characteristics, as well as prevention, assessment, and treatment of dental caries. Differences in years since dental school graduation, practice model, full/part-time status, and practice owner/employee were adjusted in the statistical models, before making conclusions about gender differences. Results Three hundred ninety-three male (84%) and seventy-three female (16%) dentists participated. Female dentists recommended at-home fluoride to a significantly larger proportion of their patients, whereas males had a preference for using in-office fluoride treatments with pediatric patients. Female dentists also choose to restore interproximal lesions at a significantly later stage of development, preferring to use preventive therapy more often at earlier stages of dental caries. There were few differences in diagnostic methods, time spent on or charges for restorative dentistry, and busyness of their practices. Conclusion DPBRN female dentists differ from their male counterparts in some aspects of the prevention, assessment, and treatment of dental caries, even with significant covariates taken into account. Practice patterns of female dentists suggest a greater caries preventive treatment philosophy. PMID:21454850

[The research protocol VI: How to choose the appropriate statistical test. Inferential statistics].

PubMed

Flores-Ruiz, Eric; Miranda-Novales, María Guadalupe; Villasís-Keever, Miguel Ángel

2017-01-01

The statistical analysis can be divided in two main components: descriptive analysis and inferential analysis. An inference is to elaborate conclusions from the tests performed with the data obtained from a sample of a population. Statistical tests are used in order to establish the probability that a conclusion obtained from a sample is applicable to the population from which it was obtained. However, choosing the appropriate statistical test in general poses a challenge for novice researchers. To choose the statistical test it is necessary to take into account three aspects: the research design, the number of measurements and the scale of measurement of the variables. Statistical tests are divided into two sets, parametric and nonparametric. Parametric tests can only be used if the data show a normal distribution. Choosing the right statistical test will make it easier for readers to understand and apply the results.

Allowing Learners to Choose: Self-Controlled Practice Schedules for Learning Multiple Movement Patterns

ERIC Educational Resources Information Center

Wu, Will F. W.; Magill, Richard A.

2011-01-01

For this study, we investigated the effects of self-controlled practice on learning multiple motor skills. Thirty participants were randomly assigned to self-control or yoked conditions. Participants learned a three-keystroke pattern with three different relative time structures. Those in the self-control group chose one of three relative time…

Fertility, Menstrual Characteristics, and Contraceptive Practices among White, Black, and Southeast Asian Refugee Adolescents.

ERIC Educational Resources Information Center

Swenson, Ingrid; And Others

1989-01-01

Compared fertility and menstrual characteristics and contraceptive practices of adolescents in maternal and infant care program. Hmong subjects were more likely to have live birth; Asians were usually married while Whites and Blacks were not. Asians were less likely to have used contraceptives and Hmongs were less likely to choose contraception…

Do Students Think That Difficult or Valuable Materials Should Be Restudied Sooner Rather than Later?

ERIC Educational Resources Information Center

Cohen, Michael S.; Yan, Veronica X.; Halamish, Vered; Bjork, Robert A.

2013-01-01

Despite the clear long-term benefits of spaced practice, students and teachers often choose massed practice. Whether learners actually fail to appreciate the benefits of spacing is, however, open to question. Early studies (e.g., Zechmeister & Shaughnessy, 1980) found that participants' judgments of learning were higher after massed than after…

Innovative Writing Instruction: Practice Makes Perfect! Realizing Classrooms as "Landscapes of Learning," Not Places of Perfection

ERIC Educational Resources Information Center

Ozier, Lance

2011-01-01

Pressure for students to produce writing perfection in the classroom often eclipses the emphasis placed on the need for students to practice writing. Occasions for students to choose, challenge, and reflect--to actually risk risking--are too often absent from conversations among students and teachers in countless English classrooms. Tom Romano…

Anaphylaxis

MedlinePlus

... past allergic reactions. Videos: Choosing Wisely » Anaphylaxis Treatment & Management The best ways to manage your condition are: • ... Referral Guidelines Citing the Evidence » The Diagnosis and Management of Anaphylaxis: Practice Paramer » The Diagnosis and Management ...

Rhinitis Overview

MedlinePlus

... triggers. Videos: Choosing Wisely » Rhinitis (Hay Fever) Treatment & Management Once specific allergens are diagnosed, your allergist / immunologist ... Pitfalls of Diagnostic Allergy Testing » The Diagnosis and Management of Rhinitis: An Updated Practice Parameter » Allergen Immunotherapy: ...

Pick and Choose: A Videotape Series on Nutrition for Migrant Families (Coja y Escoja: Peliculas para Television Sobre la Nutricion para las Familias Migratorias).

ERIC Educational Resources Information Center

1979

One of the major problems faced by migrant workers throughout the United States is a lack of awareness of the relationship between proper diet and an individual's general health and well being. To help solve this problem was the major objective of the series "Pick and Choose." The three 15-minute programs in the series present…

A Theoretical Assessment of Regional Development Effects on the Demand for General Education

ERIC Educational Resources Information Center

Iwahashi, Roki

2007-01-01

This study addresses a prospective aspect of general education: through general education, people obtain information about returns to their future specific education, thereby enabling them to choose fields in which they excel. According to that property of education, this paper presents a theoretical framework as a basis for understanding effects…

Home Birth: Know the Pros and Cons

MedlinePlus

... these complications, including having: Assistance from a certified nurse-midwife Access to a practicing obstetric doctor A ... health care providers to assist. Choose a certified nurse-midwife, a certified midwife, a midwife whose education ...

Accounting for Parcel-Allocation Variability in Practice: Combining Sources of Uncertainty and Choosing the Number of Allocations.

PubMed

Sterba, Sonya K; Rights, Jason D

2016-01-01

Item parceling remains widely used under conditions that can lead to parcel-allocation variability in results. Hence, researchers may be interested in quantifying and accounting for parcel-allocation variability within sample. To do so in practice, three key issues need to be addressed. First, how can we combine sources of uncertainty arising from sampling variability and parcel-allocation variability when drawing inferences about parameters in structural equation models? Second, on what basis can we choose the number of repeated item-to-parcel allocations within sample? Third, how can we diagnose and report proportions of total variability per estimate arising due to parcel-allocation variability versus sampling variability? This article addresses these three methodological issues. Developments are illustrated using simulated and empirical examples, and software for implementing them is provided.

A fast and objective multidimensional kernel density estimation method: fastKDE

DOE PAGES

O'Brien, Travis A.; Kashinath, Karthik; Cavanaugh, Nicholas R.; ...

2016-03-07

Numerous facets of scientific research implicitly or explicitly call for the estimation of probability densities. Histograms and kernel density estimates (KDEs) are two commonly used techniques for estimating such information, with the KDE generally providing a higher fidelity representation of the probability density function (PDF). Both methods require specification of either a bin width or a kernel bandwidth. While techniques exist for choosing the kernel bandwidth optimally and objectively, they are computationally intensive, since they require repeated calculation of the KDE. A solution for objectively and optimally choosing both the kernel shape and width has recently been developed by Bernacchiamore » and Pigolotti (2011). While this solution theoretically applies to multidimensional KDEs, it has not been clear how to practically do so. A method for practically extending the Bernacchia-Pigolotti KDE to multidimensions is introduced. This multidimensional extension is combined with a recently-developed computational improvement to their method that makes it computationally efficient: a 2D KDE on 10 5 samples only takes 1 s on a modern workstation. This fast and objective KDE method, called the fastKDE method, retains the excellent statistical convergence properties that have been demonstrated for univariate samples. The fastKDE method exhibits statistical accuracy that is comparable to state-of-the-science KDE methods publicly available in R, and it produces kernel density estimates several orders of magnitude faster. The fastKDE method does an excellent job of encoding covariance information for bivariate samples. This property allows for direct calculation of conditional PDFs with fastKDE. It is demonstrated how this capability might be leveraged for detecting non-trivial relationships between quantities in physical systems, such as transitional behavior.« less

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

O'Brien, Travis A.; Kashinath, Karthik; Cavanaugh, Nicholas R.

Numerous facets of scientific research implicitly or explicitly call for the estimation of probability densities. Histograms and kernel density estimates (KDEs) are two commonly used techniques for estimating such information, with the KDE generally providing a higher fidelity representation of the probability density function (PDF). Both methods require specification of either a bin width or a kernel bandwidth. While techniques exist for choosing the kernel bandwidth optimally and objectively, they are computationally intensive, since they require repeated calculation of the KDE. A solution for objectively and optimally choosing both the kernel shape and width has recently been developed by Bernacchiamore » and Pigolotti (2011). While this solution theoretically applies to multidimensional KDEs, it has not been clear how to practically do so. A method for practically extending the Bernacchia-Pigolotti KDE to multidimensions is introduced. This multidimensional extension is combined with a recently-developed computational improvement to their method that makes it computationally efficient: a 2D KDE on 10 5 samples only takes 1 s on a modern workstation. This fast and objective KDE method, called the fastKDE method, retains the excellent statistical convergence properties that have been demonstrated for univariate samples. The fastKDE method exhibits statistical accuracy that is comparable to state-of-the-science KDE methods publicly available in R, and it produces kernel density estimates several orders of magnitude faster. The fastKDE method does an excellent job of encoding covariance information for bivariate samples. This property allows for direct calculation of conditional PDFs with fastKDE. It is demonstrated how this capability might be leveraged for detecting non-trivial relationships between quantities in physical systems, such as transitional behavior.« less

Value of freedom to choose encoded by the human brain

PubMed Central

Fujiwara, Juri; Usui, Nobuo; Park, Soyoung Q.; Williams, Tony; Iijima, Toshio; Taira, Masato; Tsutsui, Ken-Ichiro

2013-01-01

Humans and animals value the opportunity to choose by preferring alternatives that offer more rather than fewer choices. This preference for choice may arise not only from an increased probability of obtaining preferred outcomes but also from the freedom it provides. We used human neuroimaging to investigate the neural basis of the preference for choice as well as for the items that could be chosen. In each trial, participants chose between two options, a monetary amount option and a “choice option.” The latter consisted of a number that corresponded to the number of everyday items participants would subsequently be able to choose from. We found that the opportunity to choose from a larger number of items was equivalent to greater amounts of money, indicating that participants valued having more choice; moreover, participants varied in the degree to which they valued having the opportunity to choose, with some valuing it more than the increased probability of obtaining preferred items. Neural activations in the mid striatum increased with the value of the opportunity to choose. The same region also coded the value of the items. Conversely, activation in the dorsolateral striatum was not related to the value of the items but was elevated when participants were offered more choices, particularly in those participants who overvalued the opportunity to choose. These data suggest a functional dissociation of value representations within the striatum, with general representations in mid striatum and specific representations of the value of freedom provided by the opportunity to choose in dorsolateral striatum. PMID:23864380

Why Do Women Choose to Enter Academic Oral and Maxillofacial Surgery?

PubMed

Kolokythas, Antonia; Miloro, Michael

2016-05-01

To determine why women choose to enter an academic career in oral and maxillofacial surgery (OMS). An online questionnaire was developed and e-mailed to female OMS surgeons to assess the reasons women choose to pursue an academic career, the perceived positive and negative features of academia for women, and proposed measures to increase the percentage of women choosing to specialize in OMS and pursue an academic career. Thirty-one female OMS surgeons completed the questionnaire; 1 additional participant accessed the survey but did not respond to any of the questions. There were 25 full-time academics and 6 part-time academics (≥50% time commitment). Of the responders, 72% were married, and of these, 72% were married before entering academics. Forty-seven percent of the women had children, all during their academic tenure. Among the full-time academicians with children, only 2 (7.7%) reported moderate difficulty finding the time for childbirth and maternity leave, whereas 3 of the 5 part-time academics with children reported moderate or significant difficulty with childbirth and maternity leave. Factors associated with choosing and enjoying an academic career are involvement in resident-student teaching (78%), followed by colleague camaraderie and collaboration (65.6%), research potential (50%), time flexibility, and not having to deal with excessive "business" practice issues (33%). The main reason for considering leaving an academic OMS career and/or among the least enjoyable aspects of being in academics was the potential for a higher income in private practice (56%). Less significant reasons for considering leaving an academic OMS career were a more flexible work schedule in the private sector and less institutional red tape (37.5%), as well as independence/being in control and more family time (22%). Engaging residents and students by female OMS surgeons, better mentorship from academic OMS surgeons, and increasing the number of women serving in leadership positions in organized OMS were identified as the most important measures to increase female involvement in academic OMS. This study shows that among the major motivating factors for choosing an academic career are involvement in resident-student teaching and colleague camaraderie and collaboration. Additional important factors for making this career choice are the research potential in academia, time flexibility, and not having to deal with excessive business practice issues. The reasons that deter women from entering OMS as a specialty and choosing a full-time academic OMS career are not significantly related to childbirth and family life. The main reason for potentially considering leaving an academic OMS career and/or among the least enjoyable aspects of being in academics is the potential for a higher income in private practice. Other reasons for potentially considering leaving an academic OMS career indicated by this study are independence/being in control and more family time, as well as the lack of institutional red tape. It appears that engaging female residents and students by female OMS surgeons, better mentorship by (both male and female) academic OMS surgeons, and increasing the number of female surgeons who can serve as role models may be beneficial in increasing the number of female OMS surgeons interested in an academic career. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Professional perceptions of plastic and reconstructive surgery: what primary care physicians think.

PubMed

Tanna, Neil; Patel, Nitin J; Azhar, Hamdan; Granzow, Jay W

2010-08-01

The great breadth of the specialty of plastic surgery is often misunderstood by practitioners in other specialties and by the public at large. The authors investigate the perceptions of primary care physicians in training toward the practice of different areas of plastic and reconstructive surgery. A short, anonymous, Web-based survey was administered to residents of internal medicine, family medicine, and pediatrics training programs in the United States. Respondents were asked to choose the specialist they perceived to be an expert for six specific clinical areas, including eyelid surgery, cleft lip and palate surgery, facial fractures, hand surgery, rhinoplasty, and skin cancer of the face. Specialists for selection included the following choices: dermatologist, general surgeon, ophthalmologist, oral and maxillofacial surgeon, orthopedic surgeon, otolaryngologist, and plastic surgeon. A total of 1020 usable survey responses were collected. Respondents believed the following specialists were experts for eyelid surgery (plastic surgeon, 70 percent; ophthalmologist, 59 percent; oral and maxillofacial surgeon, 15 percent; dermatologist, 5 percent; and otolaryngologist, 5 percent); cleft lip and palate surgery (oral and maxillofacial surgeon, 78 percent; plastic surgeon, 57 percent; and otolaryngologist, 36 percent); facial fractures (oral and maxillofacial surgeon, 88 percent; plastic surgeon, 36 percent; otolaryngologist, 30 percent; orthopedic surgeon, 11 percent; general surgeon, 3 percent; and ophthalmologist, 2 percent); hand surgery (orthopedic surgeon, 76 percent; plastic surgeon, 52 percent; and general surgeon, 7 percent); rhinoplasty (plastic surgeon, 76 percent; otolaryngologist, 45 percent; and oral and maxillofacial surgeon, 18 percent); and skin cancer of the face (dermatologist, 89 percent; plastic surgeon, 35 percent; oral and maxillofacial surgeon, 9 percent; otolaryngologist, 8 percent; and general surgeon, 7 percent). As the field of plastic surgery and other areas of medicine continue to evolve, additional education of internal medicine, pediatrics, and family practice physicians and trainees in the scope of plastic surgery practice will be critical.

‘Just a GP’: a mixed method study of undermining of general practice as a career choice in the UK

PubMed Central

Alberti, Hugh; Collingwood, Helen; Merritt, Kymberlee

2017-01-01

Objectives Failure to recruit sufficient applicants to general practice (GP) training has been a problem both nationally and internationally for many years and undermining of GP is one possible contributing factor. The aim of our study was to ascertain what comments, both negative and positive, are being made in UK clinical settings to GP trainees about GP and to further explore these comments and their influence on career choice. Methodology We conducted a mixed methods study. We surveyed all foundation doctors and GP trainees within one region of Health Education England regarding any comments they experienced relating to a career in GP. We also conducted six focus groups with early GP trainees to discuss any comments that they experienced and whether these comments had any influence on their or others career choice. Results Positive comments reported by trainees centred around the concept that choosing GP is a positive, family-focused choice which facilities a good work–life balance. Workload was the most common negative comment, alongside the notion of being ‘just a GP’; the belief that GP is boring, a waste of training and a second-class career choice. The reasons for and origin of the comments are multifactorial in nature. Thematic analysis of the focus groups identified key factors such as previous exposure to and experience of GP, family members who were GPs, GP role models, demographics of the clinician and referral behaviour. Trainees perceived that negative comments may be discouraging others from choosing GP as a career. Conclusion Our study demonstrates that negative comments towards GP as a career do exist within clinical settings and are having a potential impact on poor recruitment rates to GP training. We have identified areas in which further negative comments could be prevented by changing perceptions of GP as a career. Additional time spent in GP as undergraduates and postgraduates, and positive GP role models, could particularly benefit recruitment. We recommend that undermining of GP as a career choice be approached with a zero-tolerance policy. PMID:29102997

40 CFR 63.2241 - What are the work practice requirements and how must I meet them?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Products Compliance Options, Operating Requirements, and Work Practice Requirements § 63.2241 What are the...) If you have a dry rotary dryer, you may choose to designate your dry rotary dryer as a green rotary dryer and meet the more stringent compliance options and operating requirements in § 63.2240 for green...

Encouraging Wildland Fire Preparedness: Lessons Learned from Three Wildfire Education Programs

Treesearch

Victoria Sturtevant; Sarah McCaffrey

2006-01-01

Managers may often wonder why some people do not choose to adopt defensible space practices despite understanding the benefits of doing so. Research has sought to understand why a new practice or innovation is or is not adopted. This paper will briefly discuss factors found to influence adoption rates and describe how three different fire education programs - Firewise...

Growing Your Musician: A Practical Guide for Band and Orchestra Parents

ERIC Educational Resources Information Center

Bancroft, Tony

2004-01-01

This user-friendly guide covers a variety of issues such as choosing the right instrument, how to set practice guidelines, how parents can talk about music with their children, and ways to inspire children and enhance their creativity and confidence. Includes a list of frequently asked questions, a handy guide to musical terms, and lots of tables…

Rural origin and exposure drives Ghanaian midwives reported future practice.

PubMed

Lori, Jody R; Livingston, Laura; Eagle, Megan; Rominski, Sarah; Nakua, Emmanuel Kweku; Agyei-Baffour, Peter

2014-09-01

A primary cause of Ghana's higher than global average maternal mortality rate is limited access to maternal care in rural areas. To date, few studies have examined how rural background/training of midwives impacts their future willingness to work in remote areas. The purpose of this paper is to describe the relationship between Ghanaian student midwife place of origin and rural training on their willingness to choose a future rural practice location. A cross-sectional computer-based survey was completed by 238 final year Ghanaian midwifery students from two public midwifery training schools located in urban Ghana between October and December 2009. The relationship between rural exposure and willingness to work in rural Ghana was analyzed using independent t-test, chi-square, and bivariate logistic regression. Participants who experienced a rural rotation (OR: 1.51, 95% CI: 0.71, 3.22) and those born in a rural area (OR: 2.24, 95% CI: 0.74, 6.75) resulted in greater odds ratio to choose rural practice following graduation. This study indicates an association between midwifery students' place of origin and training and their willingness to practice in a rural area after graduation.

DiGeorge Syndrome (DGS)

MedlinePlus

... confirm the diagnosis. Videos: Choosing Wisely » DGS Treatment & Management As the organs and tissues involved and the ... the Evidence » Practice Parameter for the Diagnosis and Management of Primary Immunodefiency » 2017 Non-CME Recordings » Vaccination ...

Switched Systems and Motion Coordination: Combinatorial Challenges

NASA Technical Reports Server (NTRS)

Sadovsky, Alexander V.

2016-01-01

Problems of routing commercial air traffic in a terminal airspace encounter different constraints: separation assurance, aircraft performance limitations, regulations. The general setting of these problems is that of a switched control system. Such a system combines the differentiable motion of the aircraft with the combinatorial choices of choosing precedence when traffic routes merge and choosing branches when the routes diverge. This presentation gives an overview of the problem, the ATM context, related literature, and directions for future research.

Rare variant testing across methods and thresholds using the multi-kernel sequence kernel association test (MK-SKAT).

PubMed

Urrutia, Eugene; Lee, Seunggeun; Maity, Arnab; Zhao, Ni; Shen, Judong; Li, Yun; Wu, Michael C

Analysis of rare genetic variants has focused on region-based analysis wherein a subset of the variants within a genomic region is tested for association with a complex trait. Two important practical challenges have emerged. First, it is difficult to choose which test to use. Second, it is unclear which group of variants within a region should be tested. Both depend on the unknown true state of nature. Therefore, we develop the Multi-Kernel SKAT (MK-SKAT) which tests across a range of rare variant tests and groupings. Specifically, we demonstrate that several popular rare variant tests are special cases of the sequence kernel association test which compares pair-wise similarity in trait value to similarity in the rare variant genotypes between subjects as measured through a kernel function. Choosing a particular test is equivalent to choosing a kernel. Similarly, choosing which group of variants to test also reduces to choosing a kernel. Thus, MK-SKAT uses perturbation to test across a range of kernels. Simulations and real data analyses show that our framework controls type I error while maintaining high power across settings: MK-SKAT loses power when compared to the kernel for a particular scenario but has much greater power than poor choices.

The Uncertainty Reducing Capabilities of Primary Care Physicians' Video Biographies for Choosing a New Doctor: Is a Video Worth More Than Two Hundred Words?

PubMed

Perrault, Evan K; Silk, Kami J

2016-12-01

Choosing a primary care physician for the first time is an important decision, one that health care systems do not make particularly easy for prospective patients to make solely through the limited information provided on their websites. Without knowledge from others, a new patient is likely to have uncertainty about the physician he or she chooses. Three hundred and twenty participants completed an online experiment and were exposed to two biographies of different doctors with different media and either professional or personal information. Predictions generated by media richness theory revealed greater reductions in uncertainty for video biographies than traditional text biographies. Video biographies, and those containing personal information about the physician, were also related to higher levels of anticipated patient satisfaction and care quality. When asked to choose the physicians they would want to visit, participants overwhelmingly chose the physician with whom they perceived the greatest similarity to themselves, as well as the doctor who provided a video biography. Both theoretical and practical implications of this research are discussed.

Like Hercules and the Hydra: Trade-offs and strategies in ecological model-building and experimental design.

PubMed

Inkpen, S Andrew

2016-06-01

Experimental ecologists often invoke trade-offs to describe the constraints they encounter when choosing between alternative experimental designs, such as between laboratory, field, and natural experiments. In making these claims, they tend to rely on Richard Levins' analysis of trade-offs in theoretical model-building. But does Levins' framework apply to experiments? In this paper, I focus this question on one desideratum widely invoked in the modelling literature: generality. Using the case of generality, I assess whether Levins-style treatments of modelling provide workable resources for assessing trade-offs in experimental design. I argue that, of four strategies modellers employ to increase generality, only one may be unproblematically applied to experimental design. Furthermore, modelling desiderata do not have obvious correlates in experimental design, and when we define these desiderata in a way that seem consistent with ecologists' usage, the trade-off framework falls apart. I conclude that a Levins-inspired framework for modelling does not provide the content for a similar approach to experimental practice; this does not, however, mean that it cannot provide the form. Copyright © 2016 Elsevier Ltd. All rights reserved.

Atlantic salmon brood stock management and breeding handbook

USGS Publications Warehouse

Kincaid, Harold L.; Stanley, Jon G.

1989-01-01

Anadromus runs of Atlantic salmon have been restored to the Connecticut, Merrimack, Pawcatuck, Penobscot, and St. Croix rivers in New England by the stocking of more than 8 million smolts since 1948. Fish-breeding methods have been developed that minimize inbreeding and domestication and enhance natural selection. Methods are available to advance the maturation of brood stock, control the sex of production lots and store gametes. Current hatchery practices emphasize the use of sea-run brood stock trapped upon return to the rivers and a limited number of captive brood stock and rejuvenated kelts. Fish are allowed to mature naturally, after which they are spawned and incubated artificially. Generally, 1-year smolts are produced, and excess fish are stocked as fry in headwater streams. Smolts are stocked during periods of rising water in spring. Self-release pools are planned that enable smolts to choose the emigration time. Culturists keep good records that permit evaluation of the performance of strains and the effects of breeding practices. As Atlantic salmon populations expand, culturists must use sound breeding methods that enhance biotic potential while maintaining genetic diversity and protecting unique gene pools.

Hypnosis, hypnotizability and treatment.

PubMed

Sutcher, Howard

2008-07-01

There is broad agreement that a phenomenon we call "hypnosis" exists. However, there is no generally accepted definition of hypnosis. A brief historical overview of the use of hypnosis in healing practices demonstrates how it evolved willy-nilly, and like Topsy, "just growed" into its current status in medicine, psychiatry, psychology and dentistry. The mechanisms underlying hypnosis and how hypnosis differs from other cognitive states are almost totally unknown. With the exceptions of suggestions for pain control, current concepts of high, medium, low or non-hypnotizability do not reliably predict clinical outcomes for most medical, psychiatric or dental disorders. We do know that it is relatively easy to reliably evaluate hypnotizability, but other than choosing volunteers or subjects who will or will not exhibit traditional hypnotic phenomena, we rarely know what to do with that evaluation with actual clinical patients. Four case studies, representative of many others, chosen retrospectively from a practice that spans 45 years, illustrate how traditional or modern hypnotizability assessment is irrelevant in the clinical setting. Although the four patients differed obviously and vastly in hypnotizability, they all benefited from the use of hypnosis.

Selective IgA Deficiency

MedlinePlus

... immunoglobulins. Videos: Choosing Wisely » Selective IgA Deficiency Treatment & Management The underlying cause for Selective IgA Deficiency is ... the Evidence » Practice Parameter for the Diagnosis and Management of Primary Immunodefiency » 2017 Non-CME Recordings » Vaccination ...

The Decline of Arranged Marriage? Marital Change and Continuity in India

PubMed Central

Allendorf, Keera; Pandian, Roshan K.

2017-01-01

This article evaluates whether arranged marriage declined in India from 1970 to 2012. Specifically, the authors examine trends in spouse choice, the length of time spouses knew each other prior to marriage, intercaste marriage, and consanguineous marriage at the national level, as well as by region, urban residence, and religion/caste. During this period, women were increasingly active in choosing their own husbands, spouses meeting on their wedding day decreased, intercaste marriage rose, and consanguineous marriage fell. However, many of these changes were modest in size and substantial majorities of recent marriages still show the hallmarks of arranged marriage. Further, instead of displacing parents, young women increasingly worked with parents to choose husbands collectively. Rather than unilateral movement towards Western marriage practices, as suggested by theories of family change and found in other Asian contexts, these trends point to a hybridization of customary Western and Indian practices. PMID:28344368

40 CFR 86.016-1 - General applicability.

Code of Federal Regulations, 2012 CFR

2012-07-01

... solar-powered vehicles. Use good engineering judgment to apply these requirements to these vehicles... (CONTINUED) CONTROL OF EMISSIONS FROM NEW AND IN-USE HIGHWAY VEHICLES AND ENGINES General Provisions for... the manufacturer satisfies the requirements of § 86.007-23(f). (3) When a manufacturer chooses to use...

40 CFR 86.016-1 - General applicability.

Code of Federal Regulations, 2013 CFR

2013-07-01

... solar-powered vehicles. Use good engineering judgment to apply these requirements to these vehicles... (CONTINUED) CONTROL OF EMISSIONS FROM NEW AND IN-USE HIGHWAY VEHICLES AND ENGINES General Provisions for... the manufacturer satisfies the requirements of § 86.007-23(f). (3) When a manufacturer chooses to use...

Guidelines for Interpretive Building Design.

ERIC Educational Resources Information Center

Manly, Richard J., Ed.

This booklet is intended to assist those planning nature centers to choose building designs appropriate for intended purposes. The publication presents a set of general interpretive building-site and design considerations compiled over years of experience in nature center design. These generalizations are complemented by examples of floor plans,…

What procedure to choose while designing a fuzzy control? Towards mathematical foundations of fuzzy control

NASA Technical Reports Server (NTRS)

Kreinovich, Vladik YA.; Quintana, Chris; Lea, Robert

1991-01-01

Fuzzy control has been successfully applied in industrial systems. However, there is some caution in using it. The reason is that it is based on quite reasonable ideas, but each of these ideas can be implemented in several different ways, and depending on which of the implementations chosen different results are achieved. Some implementations lead to a high quality control, some of them not. And since there are no theoretical methods for choosing the implementation, the basic way to choose it now is experimental. But if one chooses a method that is good for several examples, there is no guarantee that it will work fine in all of them. Hence the caution. A theoretical basis for choosing the fuzzy control procedures is provided. In order to choose a procedure that transforms a fuzzy knowledge into a control, one needs, first, to choose a membership function for each of the fuzzy terms that the experts use, second, to choose operations of uncertainty values that corresponds to 'and' and 'or', and third, when a membership function for control is obtained, one must defuzzy it, that is, somehow generate a value of the control u that will be actually used. A general approach that will help to make all these choices is described: namely, it is proved that under reasonable assumptions membership functions should be linear or fractionally linear, defuzzification must be described by a centroid rule and describe all possible 'and' and 'or' operations. Thus, a theoretical explanation of the existing semi-heuristic choices is given and the basis for the further research on optimal fuzzy control is formulated.

Where to find information about drugs

PubMed Central

Day, Richard O; Snowden, Leone

2016-01-01

SUMMARY Good medicines information is critical to medical practice. Choose high-quality, pre-appraised sources first and make sure they are current. Select the information that is most relevant to the needs of your particular patient. Take the time to become familiar with the features of the resources you use. Australian Medicines Handbook, Therapeutic Guidelines, Australian Prescriber and NPS MedicineWise cover most routine clinical practice needs. PMID:27346917

To Jointly Negotiate a Personal Decision: A Qualitative Study on Information Literacy Practices in Midwifery Counselling about Contraceptives at Youth Centres in Southern Sweden

ERIC Educational Resources Information Center

Eckerdal, Johanna Rivano

2011-01-01

Introduction: The study is part of a project in which young women's evaluation of information sources before choosing a contraceptive is studied. It focuses on young women meeting midwives for counselling about contraceptives. Conversations are information literacy practices with both parties negotiating about needed and appropriate information on…

The Impact of Governmental and Institutional Language Policy and Practices on the Individual's Choice of the Instructional Medium in Schools in Hong Kong.

ERIC Educational Resources Information Center

Tam, Peter tim-kui

To help resolve the language of instruction dilemma in Hong Kong schools, this paper examines the hypothetical effect of government, business, and university language policy and practice on individuals' choice of intructional medium. While government policy has always allowed schools and students to choose either Chinese or English, most have…

How do general practitioners experience providing care to refugees with mental health problems? A qualitative study from Denmark

PubMed Central

2013-01-01

Background Refugees are a particularly vulnerable group in relation to the development of mental illness and many may have been subjected to torture or other traumatic experiences. General practitioners are gatekeepers for access to several parts of the psychiatric system and knowledge of their patients’ refugee background is crucial to secure adequate care. The aim of this study is to investigate how general practitioners experience providing care to refugees with mental health problems. Methods The study was conducted as part of an EU project on European Best Practices in Access, Quality and Appropriateness of Health Services for Immigrants in Europe (EUGATE). Semi-structured interviews were carried out with nine general practitioners in the vicinity of Copenhagen purposively selected from areas with a high proportion of immigrants. The analysis of the interviews is inspired by qualitative content analysis. Results One of the main themes identified in the analysis is communication. This includes the use of professional interpreters and that communication entails more than sharing a common language. Quality of care is another theme that emerges and includes awareness of possible trauma history, limited possibilities for refugees to participate in certain treatments due to language barriers and feelings of hopelessness in the general practitioners. The general practitioners may also choose different referral pathways for refugees and they report that their patients lack understanding regarding the differences between psychological problems and physical symptoms. Conclusion General practitioners experience that providing care to refugees differs from providing care for patients from the majority population. The different strategies employed by the general practitioners in the health care treatment of refugees may be the result of the great diversity in the organisation of general practice in Denmark and the lack of a national strategy in the health care management of refugees. The findings from this study suggest that the development of conversational models for general practitioners including points to be aware of in the treatment of refugee patients may serve as a support in the management of refugee patients in primary care. PMID:23356401

Are women engineers in Lebanon prepared for the challenges of an engineering profession?

NASA Astrophysics Data System (ADS)

Baytiyeh, Hoda

2013-08-01

This study investigates the status of women engineers in the Middle East, considering women engineers in Lebanon as a case study. The author investigated the following questions: What are the influences behind females' decisions to choose engineering as their major course of study? What are the motives behind this decision? What are the perceptions of females regarding the essential skills for a successful engineering career? An online survey consisting of Likert-scale items was completed by 327 female engineers who graduated from universities in Lebanon and now work in various locations around the world. A genuine interest in the field appeared to be the main influence in the participants' decisions to choose engineering profession. The potential for professional growth was the leading motivator for choosing engineering. Although participants reported that they possessed adequate theoretical knowledge and technical skills before graduation, in the actual practice of engineering, they noted weaknesses in creativity and innovation.

Algorithms for selecting informative marker panels for population assignment.

PubMed

Rosenberg, Noah A

2005-11-01

Given a set of potential source populations, genotypes of an individual of unknown origin at a collection of markers can be used to predict the correct source population of the individual. For improved efficiency, informative markers can be chosen from a larger set of markers to maximize the accuracy of this prediction. However, selecting the loci that are individually most informative does not necessarily produce the optimal panel. Here, using genotypes from eight species--carp, cat, chicken, dog, fly, grayling, human, and maize--this univariate accumulation procedure is compared to new multivariate "greedy" and "maximin" algorithms for choosing marker panels. The procedures generally suggest similar panels, although the greedy method often recommends inclusion of loci that are not chosen by the other algorithms. In seven of the eight species, when applied to five or more markers, all methods achieve at least 94% assignment accuracy on simulated individuals, with one species--dog--producing this level of accuracy with only three markers, and the eighth species--human--requiring approximately 13-16 markers. The new algorithms produce substantial improvements over use of randomly selected markers; where differences among the methods are noticeable, the greedy algorithm leads to slightly higher probabilities of correct assignment. Although none of the approaches necessarily chooses the panel with optimal performance, the algorithms all likely select panels with performance near enough to the maximum that they all are suitable for practical use.

A multiobjective optimization framework for multicontaminant industrial water network design.

PubMed

Boix, Marianne; Montastruc, Ludovic; Pibouleau, Luc; Azzaro-Pantel, Catherine; Domenech, Serge

2011-07-01

The optimal design of multicontaminant industrial water networks according to several objectives is carried out in this paper. The general formulation of the water allocation problem (WAP) is given as a set of nonlinear equations with binary variables representing the presence of interconnections in the network. For optimization purposes, three antagonist objectives are considered: F(1), the freshwater flow-rate at the network entrance, F(2), the water flow-rate at inlet of regeneration units, and F(3), the number of interconnections in the network. The multiobjective problem is solved via a lexicographic strategy, where a mixed-integer nonlinear programming (MINLP) procedure is used at each step. The approach is illustrated by a numerical example taken from the literature involving five processes, one regeneration unit and three contaminants. The set of potential network solutions is provided in the form of a Pareto front. Finally, the strategy for choosing the best network solution among those given by Pareto fronts is presented. This Multiple Criteria Decision Making (MCDM) problem is tackled by means of two approaches: a classical TOPSIS analysis is first implemented and then an innovative strategy based on the global equivalent cost (GEC) in freshwater that turns out to be more efficient for choosing a good network according to a practical point of view. Copyright © 2011 Elsevier Ltd. All rights reserved.

Strategies for addressing barriers to publishing pediatric quality improvement research.

PubMed

Van Cleave, Jeanne; Dougherty, Denise; Perrin, James M

2011-09-01

Advancing the science of quality improvement (QI) requires dissemination of the results of QI. However, the results of few QI interventions reach publication. To identify barriers to publishing results of pediatric QI research and provide practical strategies that QI researchers can use to enhance publishability of their work. We reviewed and summarized a workshop conducted at the Pediatric Academic Societies 2007 meeting in Toronto, Ontario, Canada, on conducting and publishing QI research. We also interviewed 7 experts (QI researchers, administrators, journal editors, and health services researchers who have reviewed QI manuscripts) about common reasons that QI research fails to reach publication. We also reviewed recently published pediatric QI articles to find specific examples of tactics to enhance publishability, as identified in interviews and the workshop. We found barriers at all stages of the QI process, from identifying an appropriate quality issue to address to drafting the manuscript. Strategies for overcoming these barriers included collaborating with research methodologists, creating incentives to publish, choosing a study design to include a control group, increasing sample size through research networks, and choosing appropriate process and clinical quality measures. Several well-conducted, successfully published QI studies in pediatrics offer guidance to other researchers in implementing these strategies in their own work. Specific, feasible approaches can be used to improve opportunities for publication in pediatric, QI, and general medical journals.

Flow assignment model for quantitative analysis of diverting bulk freight from road to railway

PubMed Central

Liu, Chang; Wang, Jiaxi; Xiao, Jie; Liu, Siqi; Wu, Jianping; Li, Jian

2017-01-01

Since railway transport possesses the advantage of high volume and low carbon emissions, diverting some freight from road to railway will help reduce the negative environmental impacts associated with transport. This paper develops a flow assignment model for quantitative analysis of diverting truck freight to railway. First, a general network which considers road transportation, railway transportation, handling and transferring is established according to all the steps in the whole transportation process. Then general functions which embody the factors which the shippers will pay attention to when choosing mode and path are formulated. The general functions contain the congestion cost on road, the capacity constraints of railways and freight stations. Based on the general network and general cost function, a user equilibrium flow assignment model is developed to simulate the flow distribution on the general network under the condition that all shippers choose transportation mode and path independently. Since the model is nonlinear and challenging, we adopt a method that uses tangent lines to constitute envelope curve to linearize it. Finally, a numerical example is presented to test the model and show the method of making quantitative analysis of bulk freight modal shift between road and railway. PMID:28771536

Manager's handbook for jack pine in the north central states.

Treesearch

John W. Benzie

1977-01-01

Provides a key for the resource manager to use in choosing silvicultural practices for the management of jack pine. Control of stand composition, growth, and stand establishment for timber production, water, wildlife, and recreation are discussed.

Manager's handbook for northern hardwoods in the north-central states.

Treesearch

Carl H. Tubbs

1977-01-01

Provides a key for the resource manager to use in choosing silvicultural practices for the management of northern hardwoods. Control of stand composition, growth, and stand establishment for timber production, water, wildlife, and recreation are discussed.

Choosing rural road investments to help reduce poverty

DOT National Transportation Integrated Search

2000-10-01

The paper examines how rural road investment projects should be selected when the specific objective is taken to be poverty reduction. After critically reviewing past and current practices, an attempt is made to develop an operational approach that i...

The Hollow Core: Failure of the General Education Curriculum. A Fifty College Study

ERIC Educational Resources Information Center

Latzer, Barry

2004-01-01

This report provides empirical proof of a disturbing trend in higher education. Over the last several decades colleges and universities have substituted so-called "distribution requirements" for a solid core curriculum. Distribution requirements enable students freely to choose their general education courses, the courses outside their…

General Learning at a Women's College.

ERIC Educational Resources Information Center

Ratcliff, James L.; Jones, Elizabeth A.

A study was conducted at a women's college to compare contrasting ideas of general education curriculum requirements: the prescribed core curriculum in which all students take the same courses versus the distributive model in which students are required to choose a minimum number of courses within specified academic areas. Graduating seniors were…

XY vs X Mixer in Quantum Alternating Operator Ansatz for Optimization Problems with Constraints

NASA Technical Reports Server (NTRS)

Wang, Zhihui; Rubin, Nicholas; Rieffel, Eleanor G.

2018-01-01

Quantum Approximate Optimization Algorithm, further generalized as Quantum Alternating Operator Ansatz (QAOA), is a family of algorithms for combinatorial optimization problems. It is a leading candidate to run on emerging universal quantum computers to gain insight into quantum heuristics. In constrained optimization, penalties are often introduced so that the ground state of the cost Hamiltonian encodes the solution (a standard practice in quantum annealing). An alternative is to choose a mixing Hamiltonian such that the constraint corresponds to a constant of motion and the quantum evolution stays in the feasible subspace. Better performance of the algorithm is speculated due to a much smaller search space. We consider problems with a constant Hamming weight as the constraint. We also compare different methods of generating the generalized W-state, which serves as a natural initial state for the Hamming-weight constraint. Using graph-coloring as an example, we compare the performance of using XY model as a mixer that preserves the Hamming weight with the performance of adding a penalty term in the cost Hamiltonian.

Euthanasia and end-of-life practices in France and Germany. A comparative study.

PubMed

Horn, Ruth

2013-05-01

The objective of this paper is to understand from a sociological perspective how the moral question of euthanasia, framed as the "right to die", emerges and is dealt with in society. It takes France and Germany as case studies, two countries in which euthanasia is prohibited and which have similar legislation on the issue. I presuppose that, and explore how, each society has its own specificities in terms of practical, social and political norms that affect the ways in which they deal with these issues. The paper thus seeks to understand how requests for the "right to die" emerge in each society, through both the debate (analysis of daily newspapers, medical and philosophical literature, legal texts) and the practices (ethnographic work in three French and two German hospitals) that elucidate the phenomenon. It does so, however, without attempting to solve the moral question of euthanasia. In spite of the differences observed between these two countries, the central issue at stake in their respective debates is the question of the individual's autonomy to choose the conditions in which he or she wishes to die; these conditions depend, amongst others, on the doctor-patient relationship, the organisation of end-of-life care in hospital settings, and more generally, on the way autonomy is defined and handled in the public debate.

Comparison of seven fall risk assessment tools in community-dwelling Korean older women.

PubMed

Kim, Taekyoung; Xiong, Shuping

2017-03-01

This study aimed to compare seven widely used fall risk assessment tools in terms of validity and practicality, and to provide a guideline for choosing appropriate fall risk assessment tools for elderly Koreans. Sixty community-dwelling Korean older women (30 fallers and 30 matched non-fallers) were evaluated. Performance measures of all tools were compared between the faller and non-faller groups through two sample t-tests. Receiver Operating Characteristic curves were generated with odds ratios for discriminant analysis. Results showed that four tools had significant discriminative power, and the shortened version of Falls Efficacy Scale (SFES) showed excellent discriminant validity, followed by Berg Balance Scale (BBS) with acceptable discriminant validity. The Mini Balance Evaluation System Test and Timed Up and Go, however, had limited discriminant validities. In terms of practicality, SFES was also excellent. These findings suggest that SFES is the most suitable tool for assessing the fall risks of community-dwelling Korean older women, followed by BBS. Practitioner Summary: There is no general guideline on which fall risk assessment tools are suitable for community-dwelling Korean older women. This study compared seven widely used assessment tools in terms of validity and practicality. Results suggested that the short Falls Efficacy Scale is the most suitable tool, followed by Berg Balance Scale.

Knowledge, attitudes and practices of health professionals and women towards medication use in breastfeeding: A review

PubMed Central

2011-01-01

Many breastfeeding women require and regularly take medicines, especially those available over-the-counter, and the safe use of these is dependent on the advice provided by health professionals such as general practitioners and pharmacists. The primary aim of this review therefore, was to investigate the literature relating to health professionals' and women's knowledge, attitudes and practices towards medication use and safety in breastfeeding. The limited literature that was uncovered identified that general practitioners and pharmacists have poor knowledge, but positive attitudes, and variable practices that are mostly guided by personal experience. They tend to make decisions about the use of a medicine whilst breastfeeding based on the potential 'risk' that it poses to the infant in terms of possible adverse reactions, rather than its 'compatibility' with breast milk. The decision-making process between health professionals and women is usually not a negotiated process, and women are often asked to stop breastfeeding whilst taking a medicine. Women, in turn, are left dissatisfied with the advice received, many choosing not to initiate therapy or not to continue breastfeeding. Some directions for future research have been suggested to address the issues identified in this critical area. This review is important from a societal perspective because many breastfeeding women require and regularly take medications, especially those available without prescription, and the safe use of these is dependent on the advice provided by health professionals, which is ultimately influenced by their knowledge, attitudes and practices. However, there is an absence of high quality evidence from randomised controlled trials on the safety of medications taken during breastfeeding, which naturally would hinder health professionals from appropriately advising women. It is equally important to know about women's experiences of advice received from health professionals, and whether there is consistency between recommendations made across resources on medication safety in breastfeeding, in order to gain a full understanding of the issues prevalent in this area of practice. PMID:21867562

Find a Physician from the Society for Vascular Medicine

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Pumps vs. airlifts: Theoretical and practical energy implications

USDA-ARS?s Scientific Manuscript database

In the design of a recirculating aquaculture system five life-supporting issues should be considered which include aeration, degasification, circulation, biofiltration, and clarification. The implications associated with choosing a pumped system versus an airlift system to address these issues was e...

Transit value capture coordination : case studies, best practices, and recommendations.

DOT National Transportation Integrated Search

2015-02-17

This study is based on the hypothesis that coordination between transit capital planners, municipal taxation authorities, and private developers and stakeholders can be a benefit to transit capital projects that choose to use value capture as a fundi...

Promoting healthy diets and tackling obesity and diet-related chronic diseases: what are the agricultural policy levers?

PubMed

Hawkes, Corinna

2007-06-01

Diet-related chronic diseases are now a serious global public health problem. Public health groups are calling for the agricultural sector to play a greater role in tackling the threat. To identify potential points of policy intervention in the agricultural sector that could be leveraged to promote healthy diets and tackle obesity and diet-related chronic diseases. A review of the literature on the dietary implications of agriculture, a conceptual analysis of the issues, and the identification of relevant examples. There are two main potential points of intervention in the agricultural sector that could be leveraged to promote healthy diets: agricultural policies and agricultural production practices. Agricultural policies and practices affect diet through their influence on food availability, price, and nutrient quality, which in turn affects food choices available to consumers. Agricultural policies amenable to intervention include input, production, and trade policies; agricultural production practices amenable to intervention include crop breeding, crop fertilization practices, livestock-feeding practices, and crop systems diversity. It is well-known that agricultural policies and production practices influence what farmers choose to grow. Agricultural policies and production practices could also play a role in influencing what consumers choose to eat. To identify how agricultural policies and practices can usefully contribute toward promoting healthy diets and tackling obesity and diet-related chronic diseases, health policymakers need to examine whether current agricultural policies and production practices are contributing to-or detracting from-efforts to attain dietary goals; where and how could agricultural intervention help achieve dietary goals; and whether there are trade-offs between these interventions and other important concerns, such as undernutrition and the livelihoods of agricultural producers. Given the potential of agriculture to contribute to large-scale, population-level dietary improvements, these questions warrant closer attention from health policymakers.

A letter to fellows: transitioning from training into practice in uncertain times.

PubMed

Nayak, Rahul S

2012-01-01

The end of training marks the beginning of learning. Moving into practice is exciting, and there are good opportunities. Although there is still a great deal of uncertainty with the economy, you have a skill set that is in demand. By understanding your real priorities, being deliberate and organized in your search, and being willing to extend outside your comfort zone, you will find a practice that fits you. Each person has an ideal practice. Choose your new practice setting with your eyes wide open, especially regarding new changes that are expected with health care reform. Copyright © 2012 Elsevier Inc. All rights reserved.

Care Practice #5: Spontaneous Pushing in Upright or Gravity-Neutral Positions

PubMed Central

DiFranco, Joyce T.; Romano, Amy M.; Keen, Ruth

2007-01-01

This updated edition of Care Practice Paper #5 presents the evidence for the benefits of spontaneous pushing in upright or gravity-neutral positions during labor. Various pushing positions and techniques are described, and the advantages and disadvantages are reviewed. Women are encouraged to push when and how their bodies tell them to and to choose the positions for birth that are the most comfortable. PMID:18566649

Why do clinicians choose the therapies and techniques they do? Exploring clinical decision-making via treatment selections in dysphagia practice.

PubMed

McCurtin, Arlene; Healy, Chiara

2017-02-01

Speech-language pathologists (SLPs) are assumed to use evidence-based practice to inform treatment decisions. However, the reasoning underpinning treatment selections is not well known. Understanding why SLPs choose the treatments they do may be clarified by exploring the reasoning tied to specific treatments such as dysphagia interventions. An electronic survey methodology was utilised. Participants were accessed via the gatekeepers of two national dysphagia special interest groups representing adult and paediatric populations. Information was elicited on the dysphagia therapies and techniques used and on the reasoning for using/not using therapies. Data was analysed using descriptive and non-parametric statistics. The survey had a 74.8% response rate (n = 116). Consensus in both treatment selections and reasoning supporting treatment decisions was evident. Three favoured interventions (texture modification, thickening liquids, positioning changes) were identified. The reasoning supporting treatment choices centred primarily on client suitability and clinician knowledge. Knowledge reflected both absent knowledge (e.g. training) and accumulated knowledge (clinical experience). Dysphagia practice appears highly-defined, being characterised by group consensus regarding both preferred treatments and the reasoning underpinning treatment selections. Treatment selections are based on two core criteria: client suitability and the SLPs experience/knowledge. Explicit scientific reasoning is less influential than practice-centric influences.

The impact of price reductions on individuals' choice of healthy meals away from home.

PubMed

Nordström, Jonas; Thunström, Linda

2015-06-01

Food high in energy but low in nutritional value is an important contributor to several serious illnesses, and one type of food that is particularly high in energy but low in nutrition is food consumed away from home. In this paper, we examine the demand and willingness to pay for healthy, Keyhole-labelled meals. A Keyhole-labelled meal is particularly low in energy, fat, sugar and salt, but particularly high in fibre. The results suggest that to get the majority of individuals to choose the healthy option regularly it would be necessary to alter the relative price between healthy and less healthy meals. Generally groups of individuals with a poor nutritional intake require a larger compensation (subsidy) before they choose the healthy alternative. About one third of respondents would choose the healthy option regularly if the prices for a healthy and less healthy meal were the same. In particular groups of individuals who already have a relatively good nutritional intake would select the healthy option. Groups with a generally poor nutritional intake (men and individuals with lower education and lower income) would gain health benefits from a subsidy of Keyhole-labelled meals. Copyright © 2015 Elsevier Ltd. All rights reserved.

Planning an Effective Child Care Center.

ERIC Educational Resources Information Center

Wright, Rodney; Wright, Sydney

This conference presentation offers general guidelines for planning a new child care facility. Particular attention is given to site selection, space requirements, functional requirements, materials, climate, and choosing an architect. (RH)

Flexible working: understanding the locum pharmacist in Great Britain.

PubMed

Shann, Phillip; Hassell, Karen

2006-09-01

There is a growing trend in Great Britain (GB) for pharmacists to work as self-employed "locums" rather than as permanent employees. Despite this trend, little is known about their work patterns or why they choose to pursue nonstandard forms of work. The overall aim of the study was to explore why locums choose self-employment over a permanent contract and to explore a number of issues commonly associated with nonstandard working, such as marginalization and job satisfaction. A qualitative interview study was undertaken. In-depth telephone interviews were conducted with 34 locum pharmacists randomly selected from the GB register of pharmacists. Locums from a range of age groups, different sectors of practice, and with different work patterns were selected to ensure that a wide range of experiences and views were covered. The need or desire for flexibility was the overriding factor for choosing to work as a locum. A wide range and variety of individual personal circumstances were important drivers, but a desire for work-life balance was fundamental to many. A variety of work patterns were found, ranging from those with more ad hoc working arrangements to those who worked in the same store on a regular basis. Avoiding stress, paperwork, and nonprofessional duties were among reasons for choosing to locum. Disadvantages associated with being a locum included being viewed and treated negatively by peers, and having fewer opportunities for training. No conclusive evidence could be found for locums being marginalized, except for the training issues for some pharmacists. The findings do suggest some cause for concern, with some locums selecting places to work on the basis of attitudes not congruent with socially inclusive approaches to public health care. The locum workforce is far from homogenous or uniform. Freelance working of this kind has advantages for the individual: freedom and independence. But there may be risks for the profession if nonstandard work practices become more widespread: isolation, lack of social cohesiveness, and amoral attitudes. Improving working conditions and practices may prevent pharmacists from leaving permanent positions.

Back from the Brink: Harvard Gets it Right. Carnegie Perspectives

ERIC Educational Resources Information Center

Ehrlich, Tom

2007-01-01

Eighteen months after soundly criticizing a new Harvard general education that proposed to abandon the concept of a structured general education, substituting a minimum distribution requirement under which students could choose a few courses from hundreds offered by the faculty, the writer applauds the shift, encouraged by interim president Derek…

Self-Assembled Student Interactions in Undergraduate General Chemistry Clicker Classrooms

ERIC Educational Resources Information Center

MacArthur, James R.; Jones, Loretta

2013-01-01

Student interviews, focus groups, and classroom observations were used in an exploratory study of the nature of student interactions in a large (300+ students) general chemistry course taught with clickers. These data suggest that students are self-assembling their learning environment: choosing ways in which to interact with one another during…

Use of a Market Survey in Identifying Potential Publics.

ERIC Educational Resources Information Center

Ruddock, Maryann S.

Perceptions of St. Edward's University, Austin, Texas, by current students, alumni, Austin area high school seniors, and the general public were studied. Respondents' knowledge of the university and what they look for when choosing a school were assessed. About 500 general public respondents and about 300 respondents for each of the other groups…

General Education at UNC-Chapel Hill

ERIC Educational Resources Information Center

Schalin, Jay; Robinson, Jenna Ashley

2013-01-01

The general education program at UNC-Chapel Hill has abandoned the concept of a core curriculum. Instead, students choose their "required" classes from lists of thousands of courses that may be as narrow and idiosyncratic as Love, Sex and Marriage in Soviet Culture (RUSS 277) or The Gardens, Shrines and Temples of Japan (ASIA 586).…

A Qualitative Study of Undergraduate Instrumentalists Teaching Elementary General Music Education

ERIC Educational Resources Information Center

Corfield-Adams, Maggie Beth

2012-01-01

The central purpose of this multiple-case study was to describe the professional identities of six general music teachers who identified as instrumentalists as undergraduates. The study builds upon research addressing why students choose music education (Bergee, et al., 2001; Bright, 2006; Gillespie & Hamann, 1999; Lee, 2003; Madsen &…

Asking good clinical research questions and choosing the right study design.

PubMed

Bragge, P

2010-07-01

Clinicians and researchers seek answers to clinical research questions, primarily by accessing the results of clinical research studies. This paper moves the focus of research enquiry from getting answers to developing good clinical research questions. Using worked examples, the steps involved in refining questions drawn from various sources to create 'answerable' clinical research questions using the 'PICO' principle are described. Issues to consider in prioritising clinical research questions are also identified. Theoretical and practical considerations involved in choosing the right study design for a clinical research question are then discussed using the worked examples. These include: Copyright (c) 2010 Elsevier Ltd. All rights reserved.

Physician consideration of patients' out-of-pocket costs in making common clinical decisions.

PubMed

Pham, Hoangmai H; Alexander, G Caleb; O'Malley, Ann S

2007-04-09

Patients face growing cost-sharing through higher deductibles and other out-of-pocket (OP) expenses, with uncertain effects on clinical decision making. We analyzed data on 6628 respondents to the nationally representative 2004-2005 Community Tracking Study Physician Survey to examine how frequently physicians report considering their insured patients' OP expenses when prescribing drugs, selecting diagnostic tests, and choosing inpatient vs outpatient care settings. Responses were dichotomized as always/usually vs sometimes/rarely/never. In separate multivariate logistic regressions, we examined associations between physicians' reported frequency of considering OP costs for each type of decision and characteristics of individual physicians and their practices. Seventy-eight percent of physicians reported routinely considering OP costs when prescribing drugs, while 51.2% reported doing so when selecting care settings, and 40.2% when selecting diagnostic tests. In adjusted analyses, primary care physicians were more likely than medical specialists to consider patients' OP costs in choosing prescription drugs (85.3% vs 74.5%) (P<.001), care settings (53.9% vs 43.1%) (P<.001), and diagnostic tests (46.3% vs 29.9%) (P<.001). Physicians working in large groups or health maintenance organizations were more likely to consider OP costs in prescribing generic drugs (P<.001 for comparisons with solo and 2-person practices), but those in solo or 2-person practices were more likely to do so in choosing tests and care settings (P<.05 for all comparisons with other practice types). Physicians providing at least 10 hours of charity care a month were more likely than those not providing any to consider OP costs in both diagnostic testing (40.7% vs 35.8%) (P<.001) and care setting decisions (51.4% vs 47.6%) (P<.005). Cost-sharing arrangements targeting patients are likely to have limited effects in safely reducing health care spending because physicians do not routinely consider patients' OP costs when making decisions regarding more expensive medical services.

Let the Buyer Beware.

ERIC Educational Resources Information Center

Hamilton, Jack A.; Wheeler, Jeanette D.

1979-01-01

A literature search indicates that many adult consumers of postsecondary education need protection from abusive practices by some schools, such as misleading advertising, incomplete information, inferior facilities, false promises, etc. The article provides a checklist for potential adult students to use in making decisions about choosing a…

Choosing a Carreer Path

EPA Science Inventory

Having graduated with a PhD in wetland ecology and recently completed a post-doctorate fellowship with Mary E. Kentula at the US Environmental Protection Agency, I have a lot of practical advice for undergraduates who are interested in pursuing a career in aquatic sciences. The g...

ANALYSIS OF THE POTENTIAL EFFECTS OF TOXICS ON MUNICIPAL SOLID WASTE MANGEMENT OPTIONS

EPA Science Inventory

Many alternative waste management practices and strategies are available to manage the large quantities of MSW generated every year. These management alternatives include recycling, composting, waste-to-fuel/energy recovery, and landfilling. In choosing the best possible manageme...

ANALYSIS OF THE POTENTIAL EFFECTS OF TOXICS ON MUNICIPAL SOLID WASTE MANAGEMENT OPTIONS

EPA Science Inventory

Many alternative waste management practices and strategies are available to manage the large quantities of MSW generated every year. hese management alternatives include recycling, composting, waste-to-fuel/energy recovery, and landfilling. n choosing the best possible management...

An Ethical and Legal Framework for Physicians as Surrogate Decision-Makers for Their Patients.

PubMed

Rosoff, Philip M; Leong, Kelly M

2015-01-01

In Western industrialized countries, it is well established that legally competent individuals may choose a surrogate healthcare decision-maker to represent their interests should they lose the capacity to do so themselves. There are few limitations on who they may select to fulfill this function. However, many jurisdictions place restrictions on or prohibit the patient's attending physician or other provider involved with an individual's care to serve in this role. Several authors have previously suggested that respect for the autonomy of patients requires that there be few (if any) constraints on whomever they may appoint as a proxy. In this essay we revisit this topic by first providing a survey of current state laws governing this activity. We then analyze the clinical and ethical circumstances in which potential difficulties could arise. We take a more nuanced and circumspect view of prior suggestions that patients should have virtually unfettered liberty to choose their healthcare proxies. We suggest a strategy to balance the freedom of patients' right to choose their surrogates with fiduciary duty of the state as regulator of medical practice. We identify six domains of possible concern with such relationships and suggest straightforward methods of mitigating their potential negative effects that could be plausibly be incorporated into physician practice. © 2015 American Society of Law, Medicine & Ethics, Inc.

A general practice approach to Bell's palsy.

PubMed

Phan, Nga T; Panizza, Benedict; Wallwork, Benjamin

2016-11-01

Bell's palsy is characterised by an acute onset of unilateral, lower motor neuron weakness of the facial nerve in the absence of an identifiable cause. Establishing the correct diagnosis is imperative and choosing the correct treatment options can optimise the likelihood of recovery. This article summarises our understanding of Bell's palsy and the evidence-based management options available for adult patients. The basic assessment should include a thorough history and physical examination as the diagnosis of Bell's palsy is based on exclusion. For confirmed cases of Bell's palsy, corticosteroids are the mainstay of treatment and should be initiated within 72 hours of symptom onset. Antiviral therapy in combination with corticosteroid therapy may confer a small benefit and may be offered on the basis of shared decision making. Currently, no recommendations can be made for acupuncture, physical therapy, electrotherapy or surgical decompression because well-designed studies are lacking and available data are of low quality.

Safety considerations for outpatient electroconvulsive therapy.

PubMed

Reti, Irving M; Walker, Melinda; Pulia, Kathy; Gallegos, Jesus; Jayaram, Geetha; Vaidya, Punit

2012-03-01

As electroconvulsive therapy (ECT) requires general anesthesia and is associated with both cognitive and non-cognitive side effects, careful consideration must be given to the safety aspects of providing ECT on an outpatient basis. Drawing upon published literature and their clinical experience administering outpatient ECT, the authors propose best practices for safely providing ECT to outpatients. They review criteria for selecting patients for outpatient ECT as well as treatment and programmatic issues. The authors highlight the importance of educating referring clinicians as well as patients and their families about factors involved in the safe delivery of ECT for outpatients. Fiscal considerations and the drive toward reduced length of stay are prompting insurers and caregivers to choose outpatient over inpatient ECT. For each patient, such a choice merits a careful analysis of the risks of outpatient ECT, as well as the implementation of measures to ensure patient safety.

Human-Robot Teaming for Hydrologic Data Gathering at Multiple Scales

NASA Astrophysics Data System (ADS)

Peschel, J.; Young, S. N.

2017-12-01

The use of personal robot-assistive technology by researchers and practitioners for hydrologic data gathering has grown in recent years as barriers to platform capability, cost, and human-robot interaction have been overcome. One consequence to this growth is a broad availability of unmanned platforms that might or might not be suitable for a specific hydrologic investigation. Through multiple field studies, a set of recommendations has been developed to help guide novice through experienced users in choosing the appropriate unmanned platforms for a given application. This talk will present a series of hydrologic data sets gathered using a human-robot teaming approach that has leveraged unmanned aerial, ground, and surface vehicles over multiple scales. The field case studies discussed will be connected to the best practices, also provided in the presentation. This talk will be of interest to geoscience researchers and practitioners, in general, as well as those working in fields related to emerging technologies.

Intravital microscopy

PubMed Central

Masedunskas, Andrius; Milberg, Oleg; Porat-Shliom, Natalie; Sramkova, Monika; Wigand, Tim; Amornphimoltham, Panomwat; Weigert, Roberto

2012-01-01

Intravital microscopy is an extremely powerful tool that enables imaging several biological processes in live animals. Recently, the ability to image subcellular structures in several organs combined with the development of sophisticated genetic tools has made possible extending this approach to investigate several aspects of cell biology. Here we provide a general overview of intravital microscopy with the goal of highlighting its potential and challenges. Specifically, this review is geared toward researchers that are new to intravital microscopy and focuses on practical aspects of carrying out imaging in live animals. Here we share the know-how that comes from first-hand experience, including topics such as choosing the right imaging platform and modality, surgery and stabilization techniques, anesthesia and temperature control. Moreover, we highlight some of the approaches that facilitate subcellular imaging in live animals by providing numerous examples of imaging selected organelles and the actin cytoskeleton in multiple organs. PMID:22992750

Cognitive Behavioural Suicide Prevention for Male Prisoners: Case examples

PubMed Central

Pratt, Daniel; Gooding, Patricia; Awenat, Yvonne; Eccles, Steve; Tarrier, Nicholas

2015-01-01

Suicide is a serious public health problem but a problem that is preventable. This complex and challenging problem is particularly prevalent amongst prisoners; associated with a five-fold increase in risk compared to the general community. Being in prison can lead people to experience fear, distrust, lack of control, isolation, and shame, which is often experienced as overwhelming and intolerable with some choosing suicide as a way to escape. Few effective psychological interventions exist to prevent suicide although cognitive behaviour therapies appear to offer some promise. Offering cognitive behaviour suicide prevention (CBSP) therapy to high risk prisoners may help to reduce the likelihood of preventable self-inflicted deaths. In this paper we present three cases drawn from a randomised controlled trial designed to investigate the feasibility of CBSP for male prisoners. Implications of the current findings for future research and clinical practice are considered. PMID:27713616

A generalized concept of power helped to choose optimal endpoints in clinical trials.

PubMed

Borm, George F; van der Wilt, Gert J; Kremer, Jan A M; Zielhuis, Gerhard A

2007-04-01

A clinical trial may have multiple objectives. Sometimes the results for several parameters may need to be significant or meet certain other criteria. In such cases, it is important to evaluate the probability that all these objectives will be met, rather than the probability that each will be met. The purpose of this article is to introduce a definition of power that is tailored to handle this situation and that is helpful for the design of such trials. We introduce a generalized concept of power. It can handle complex situations, for example, in which there is a logical combination of partial objectives. These may be formulated not only in terms of statistical tests and of confidence intervals, but also in nonstatistical terms, such as "selecting the optimal by dose." The power of a trial was calculated for various objectives and combinations of objectives. The generalized concept of power may lead to power calculations that closely match the objectives of the trial and contribute to choosing more efficient endpoints and designs.

Large-scale survey to describe acne management in Brazilian clinical practice

PubMed Central

Seité, Sophie; Caixeta, Clarice; Towersey, Loan

2015-01-01

Background Acne is a chronic disease of the pilosebaceous unit that mainly affects adolescents. It is the most common dermatological problem, affecting approximately 80% of teenagers between 12 and 18 years of age. Diagnosis is clinical and is based on the patient’s age at the time the lesions first appear, and on its polymorphism, type of lesions, and their anatomical location. The right treatment for the right patient is key to treating acne safely. The aim of this investigational survey was to evaluate how Brazilian dermatologists in private practice currently manage acne. Materials and methods Dermatologists practicing in 12 states of Brazil were asked how they manage patients with grades I, II, III, and IV acne. Each dermatologist completed a written questionnaire about patient characteristics, acne severity, and the therapy they usually prescribe for each situation. Results In total, 596 dermatologists were interviewed. Adolescents presented as the most common acneic population received by dermatologists, and the most common acne grade was grade II. The doctors could choose more than one type of treatment for each patient, and treatment choices varied according to acne severity. A great majority of dermatologists considered treatment with drugs as the first alternative for all acne grades, choosing either topical or oral presentation depending on the pathology severity. Dermocosmetics were chosen mostly as adjunctive therapy, and their inclusion in the treatment regimen decreased as acne grades increased. Conclusion This survey illustrates that Brazilian dermatologists employ complex treatment regimens to manage acne, choosing systemic drugs, particularly isotretinoin, even in some cases of grade I acne, and heavily prescribe antibiotics. Because complex regimens are harder for patients to comply with, this result notably raises the question of adherence, which is a key factor in successful treatment. PMID:26609243

How do Medical Societies Select Science for Conference Presentation? How Should They?

PubMed Central

Kuczmarski, Thomas M.; Raja, Ali S.; Pallin, Daniel J.

2015-01-01

Introduction Nothing has been published to describe the practices of medical societies in choosing abstracts for presentations at their annual meetings. We surveyed medical societies to determine their practices, and also present a theoretical analysis of the topic. Methods We contacted a convenience sample of large U.S. medical conferences, and determined their approach to choosing abstracts. We obtained information from web sites, telephone, and email. Our theoretical analysis compares values-based and empirical approaches for scoring system development. Results We contacted 32 societies and obtained data on 28 (response rate 88%). We excluded one upon learning that research was not presented at its annual meeting, leaving 27 for analysis. Only 2 (7%) made their abstract scoring process available to submitters. Reviews were blinded in most societies (21;78%), and all but one asked reviewers to recuse themselves for conflict of interest (96%). All required ≥3 reviewers. Of the 24 providing information on how scores were generated, 21 (88%) reported using a single gestalt score, and three used a combined score created from pooled domain-specific sub-scores. We present a framework for societies to use in choosing abstracts, and demonstrate its application in the development of a new scoring system. Conclusions Most medical societies use subjective, gestalt methods to select research for presentation at their annual meetings and do not disclose to submitters the details of how abstracts are chosen. We present a new scoring system that is transparent to submitters and reviewers alike with an accompanying statement of values and ground rules. We discuss the challenges faced in selecting abstracts for a large scientific meeting and share the values and practical considerations that undergird the new system. PMID:26265966

How do Medical Societies Select Science for Conference Presentation? How Should They?

PubMed

Kuczmarski, Thomas M; Raja, Ali S; Pallin, Daniel J

2015-07-01

Nothing has been published to describe the practices of medical societies in choosing abstracts for presentations at their annual meetings. We surveyed medical societies to determine their practices, and also present a theoretical analysis of the topic. We contacted a convenience sample of large U.S. medical conferences, and determined their approach to choosing abstracts. We obtained information from web sites, telephone, and email. Our theoretical analysis compares values-based and empirical approaches for scoring system development. We contacted 32 societies and obtained data on 28 (response rate 88%). We excluded one upon learning that research was not presented at its annual meeting, leaving 27 for analysis. Only 2 (7%) made their abstract scoring process available to submitters. Reviews were blinded in most societies (21;78%), and all but one asked reviewers to recuse themselves for conflict of interest (96%). All required ≥3 reviewers. Of the 24 providing information on how scores were generated, 21 (88%) reported using a single gestalt score, and three used a combined score created from pooled domain-specific sub-scores. We present a framework for societies to use in choosing abstracts, and demonstrate its application in the development of a new scoring system. Most medical societies use subjective, gestalt methods to select research for presentation at their annual meetings and do not disclose to submitters the details of how abstracts are chosen. We present a new scoring system that is transparent to submitters and reviewers alike with an accompanying statement of values and ground rules. We discuss the challenges faced in selecting abstracts for a large scientific meeting and share the values and practical considerations that undergird the new system.

Choosing a Microcomputer: A Success Story.

ERIC Educational Resources Information Center

Mason, Robert M.

1983-01-01

Documentation of author's personal experience in the purchasing of a microcomputer discusses background learning, the purchase decision, needs assessment, computer literacy, general information on microcomputers, the situation assessment, and the final check. (EJS)

What to Look for in Your First Job

PubMed Central

Ree, Eun Jin; Weber, Robert J.

2014-01-01

The first job is very important in setting a trajectory for career development and progress. Although new pharmacy graduates will generally enjoy excellent job opportunities, they need to consider specific factors in choosing their first job. In addition, the increased number of pharmacy schools has produced more pharmacy graduates, leading to more competition for jobs. This tight job market may cause students or residents to make a hasty decision about their first job. The goal of this Director’s Forum is to provide guidance to young pharmacists as they choose their first job after schooling or training. This article specifically addresses the importance of the first job on career and personal development, lists the specific considerations in finding and deciding on the first job, and presents some experiences from others that may highlight possible pitfalls in choosing the first job. We hope the information in this article will provide some guidance to young pharmacists in choosing a job that meets the goals of their life plan while helping them to develop a career focused on providing patient-centered pharmacy services. PMID:25477603

Computerized Vocational Guidance (CVG) Systems: Evaluation for Use in Military Recruiting.

DTIC Science & Technology

1984-02-01

how to relate the two, and how to explore, project, and choose. Whether Rogerian or more directive in nature, the essential counseling ingredient is to...Conference, Princeton, NJ: Educational Testing Service, 1974, 43-69. Katz, M. R., & Shatkin, L. Computer-assisted guidance: Concepts and practices (Res. Rep...Canadian Forces Personnel Applied Research Unit, 1980. Katz, M. R., & Shatkin, L. Computer-assisted guidance: Concepts and practices (Res. Rep. RR-80-1

Manager's handbook for red pine in the north-central states.

Treesearch

John W. Benzie

1977-01-01

Provides a key for the resource manager to use in choosing silvicultural practices for the management of red pine. Control of stand composition and growth, regulating the forest, and control of stand establishment for timber production, water, wildlife, and recreation are discussed.

School-Based Methylphenidate Placebo Protocols: Methodological and Practical Issues.

ERIC Educational Resources Information Center

Hyman, Irwin A.; Wojtowicz, Alexandra; Lee, Kee Duk; Haffner, Mary Elizabeth; Fiorello, Catherine A.; And Others

1998-01-01

Focuses on methodological issues involved in choosing instruments to monitor behavior, once a comprehensive evaluation has suggested trials on Ritalin. Case examples illustrate problems of teacher compliance in filling out measures, supplying adequate placebos, and obtaining physical cooperation. Emerging school-based methodologies are discussed…

Methods and Strategies: Extending the Classroom

ERIC Educational Resources Information Center

Smith-Walters, Cindi; Hargrove, Karen; Ervin, Bonnie

2014-01-01

This article provides ideas and techniques to improve science teaching, while providing tips for planning and executing field trips. Discussed here are practical planning suggestions for choosing an appropriate destination months before the trip, the cost per student, availability of restroom and lunch facilities, transportation arrangements,…

Case studies suggest practical ways to increase the visibility of high-visibility enforcement programs : traffic tech.

DOT National Transportation Integrated Search

2013-08-01

High-visibility enforcement (HVE) models are an effective : strategy to reduce impaired driving. They work by increasing : drivers perceived risk of being stopped and arrested by : law enforcement if they choose to drive while impaired by : alcoho...

Lesson Planning the Kodaly Way.

ERIC Educational Resources Information Center

Boshkoff, Ruth

1991-01-01

Discusses the contribution of Zoltan Kodaly to music lesson planning. Emphasizes preparation, presentation, and practice as the three important strategies in teaching concepts and skills to be included in a lesson plan. Includes a sample lesson plan covering a semester and advice on choosing song material. (DK)

Educational Choice: Practical Policy Questions. Occasional Paper Series No. 7.

ERIC Educational Resources Information Center

First, Patricia F.

The consideration of school choice plans raises policy questions for school administrators. This paper addresses pragmatic concerns about definitions and policy questions related to educational finance. Interdistrict choice, emphasizing families' right to choose among existing public schools, raises questions regarding transportation and…

Communication Analysis of Environment.

ERIC Educational Resources Information Center

Malik, M. F.; Thwaites, H. M.

This textbook was developed for use in a Concordia University (Quebec) course entitled "Communication Analysis of Environment." Designed as a practical application of information theory and cybernetics in the field of communication studies, the course is intended to be a self-instructional process, whereby each student chooses one…

Fairness in Knowing: Science Communication and Epistemic Justice.

PubMed

Medvecky, Fabien

2017-09-22

Science communication, as a field and as a practice, is fundamentally about knowledge distribution; it is about the access to, and the sharing of knowledge. All distribution (science communication included) brings with it issues of ethics and justice. Indeed, whether science communicators acknowledge it or not, they get to decide both which knowledge is shared (by choosing which topic is communicated), and who gets access to this knowledge (by choosing which audience it is presented to). As a result, the decisions of science communicators have important implications for epistemic justice: how knowledge is distributed fairly and equitably. This paper presents an overview of issues related to epistemic justice for science communication, and argues that there are two quite distinct ways in which science communicators can be just (or unjust) in the way they distribute knowledge. Both of these paths will be considered before concluding that, at least on one of these accounts, science communication as a field and as a practice is fundamentally epistemically unjust. Possible ways to redress this injustice are suggested.

Evaluation of personal digital assistant drug information databases for the managed care pharmacist.

PubMed

Lowry, Colleen M; Kostka-Rokosz, Maria D; McCloskey, William W

2003-01-01

Personal digital assistants (PDAs) are becoming a necessity for practicing pharmacists. They offer a time-saving and convenient way to obtain current drug information. Several software companies now offer general drug information databases for use on hand held computers. PDAs priced less than 200 US dollars often have limited memory capacity; therefore, the user must choose from a growing list of general drug information database options in order to maximize utility without exceeding memory capacity. This paper reviews the attributes of available general drug information software databases for the PDA. It provides information on the content, advantages, limitations, pricing, memory requirements, and accessibility of drug information software databases. Ten drug information databases were subjectively analyzed and evaluated based on information from the product.s Web site, vendor Web sites, and from our experience. Some of these databases have attractive auxiliary features such as kinetics calculators, disease references, drug-drug and drug-herb interaction tools, and clinical guidelines, which may make them more useful to the PDA user. Not all drug information databases are equal with regard to content, author credentials, frequency of updates, and memory requirements. The user must therefore evaluate databases for completeness, currency, and cost effectiveness before purchase. In addition, consideration should be given to the ease of use and flexibility of individual programs.

A Randomized Controlled Trial of a CPR Decision Support Video for Patients Admitted to the General Medicine Service.

PubMed

Merino, Aimee M; Greiner, Ryan; Hartwig, Kristopher

2017-09-01

Patient preferences regarding cardiopulmonary resuscitation (CPR) are important, especially during hospitalization when a patient's health is changing. Yet many patients are not adequately informed or involved in the decision-making process. We examined the effect of an informational video about CPR on hospitalized patients' code status choices. This was a prospective, randomized trial conducted at the Minneapolis Veterans Affairs Health Care System in Minnesota. We enrolled 119 patients, hospitalized on the general medicine service, and at least 65 years old. The majority were men (97%) with a mean age of 75. A video described code status choices: full code (CPR and intubation if required), do not resuscitate (DNR), and do not resuscitate/do not intubate (DNR/DNI). Participants were randomized to watch the video (n = 59) or usual care (n = 60). The primary outcome was participants' code status preferences. Secondary outcomes included a questionnaire designed to evaluate participants' trust in their healthcare team and knowledge and perceptions about CPR. Participants who viewed the video were less likely to choose full code (37%) compared to participants in the usual care group (71%) and more likely to choose DNR/DNI (56% in the video group vs. 17% in the control group) ( < 0.00001). We did not see a difference in trust in their healthcare team or knowledge and perceptions about CPR as assessed by our questionnaire. Hospitalized patients who watched a video about CPR and code status choices were less likely to choose full code and more likely to choose DNR/DNI. © 2017 Society of Hospital Medicine

Strategies for Controlling Item Exposure in Computerized Adaptive Testing with the Generalized Partial Credit Model

ERIC Educational Resources Information Center

Davis, Laurie Laughlin

2004-01-01

Choosing a strategy for controlling item exposure has become an integral part of test development for computerized adaptive testing (CAT). This study investigated the performance of six procedures for controlling item exposure in a series of simulated CATs under the generalized partial credit model. In addition to a no-exposure control baseline…

Toward a Web-Enhanced Model of Interaction in Freshman General Education History Courses

ERIC Educational Resources Information Center

Olt, Phillip

2018-01-01

While American students increasingly choose to study online, most professors remain skeptical of its quality. This paper explores the perspectives of history professors at a liberal arts institution regarding their general education classes taught face-to-face (F2F) and online, focusing on interactive communication with students between the two…

Popular Music Genres, Music Producers, and Song Creation in the General Music Classroom

ERIC Educational Resources Information Center

Colquhoun, Shane

2018-01-01

In secondary general music classes, music educators have the opportunity to bridge the gap between the music students' experiences in school and the music they engage with outside of school. According to Williams, nontraditional music students have musical lives outside of school but choose not to participate in traditional ensembles. In this…

Women Physicians: Choosing a Career in Academic Medicine

PubMed Central

Borges, Nicole J.; Navarro, Anita M.; Grover, Amelia C.

2011-01-01

Purpose Despite recent efforts to understand the complex process of physician career development, the medical education community has a poor understanding of why, how, and when women physicians embark on a career in academic medicine. Method In 2010, the authors phone-interviewed women physicians in academic medicine regarding why, how, and when they chose an academic medicine career. Project investigators first individually and then collectively analyzed transcripts to identify themes in the data. Results Through analyzing the transcripts of the 53 interviews, the investigators identified five themes related to why women choose careers in academic medicine: fit, aspects of the academic health center environment, people, exposure, and clincial medicine. They identified five themes related to how women make the decision to enter academic medicine: change in specialty, dissatisfaction with former career, emotionality, parental influence, and decision-making styles. The authors also identified four themes regarding when women decide to enter academic medicine: as a practicing phyisican, fellow, resident, or medical student. Conclusions Choosing a career in academic medicine is greatly influenced by the environment in which one trains and by people—be they faculty, mentors, role models, or family. An interest in teaching is a primary reason women choose a career in academic medicine. Many women physicians entering acadmic medicine chose this after or during fellowship, which is when they became more aware of academic medicine as a possible career. For many women, choosing academic medicine was not necessarily an active, planned decision; rather it was serendipitous or circumstantial. PMID:22104052

Women physicians: choosing a career in academic medicine.

PubMed

Borges, Nicole J; Navarro, Anita M; Grover, Amelia C

2012-01-01

Despite recent efforts to understand the complex process of physician career development, the medical education community has a poor understanding of why, how, and when women physicians embark on careers in academic medicine. In 2010, the authors phone-interviewed women physicians in academic medicine regarding why, how, and when they chose academic medicine careers. Project investigators first individually and then collectively analyzed transcripts to identify themes in the data. Through analyzing the transcripts of the 53 interviews, the investigators identified five themes related to why women choose careers in academic medicine: fit, aspects of the academic health center environment, people, exposure, and clinical medicine. They identified five themes related to how women make the decision to enter academic medicine: change in specialty, dissatisfaction with former career, emotionality, parental influence, and decision-making styles. The authors also identified four themes regarding when women decide to enter academic medicine: as a practicing physician, fellow, resident, or medical student. Choosing a career in academic medicine is greatly influenced by the environment in which one trains and by people-be they faculty, mentors, role models, or family. An interest in teaching is a primary reason women choose a career in academic medicine. Many women physicians entering academic medicine chose to do so after or during fellowship, which is when they became more aware of academic medicine as a possible career. For many women, choosing academic medicine was not necessarily an active, planned decision; rather, it was serendipitous or circumstantial.

General and disease-specific use of outcomes scores for the shoulder: a survey of AOSSM, AANA, and ISAKOS members.

PubMed

Provencher, Matthew T; Frank, Rachel M; Scuderi, Matthew G; Solomon, Daniel J; Ghodadra, Neil S; Bach, Bernard R; McCarty, Eric; Romeo, Anthony A

2014-09-01

To report on the knowledge and use of both general and disease-specific shoulder outcomes scores among orthopedic surgeons. A 22-question Internet survey was administered to members of the American Orthopaedic Society for Sports Medicine, the Arthroscopy Association of North American, and the International Society of Arthroscopy, Knee Surgery, and Orthopedic Sports Medicine via voluntary e-mail participation. Questions targeted demographic information, preferred surgical management of shoulder conditions, and the preferred use of shoulder outcomes instruments in clinical practice. Excluding defunct and duplicate e-mails among membership societies, a total of 3892 unique e-mails were sent, from which 1129 surveys were returned and were fully completed (29%). The largest number of respondents were in private practice (52%); 21% were in academia; and 26% were in a mix of settings. As for location, 74% practiced in the United States, 10% in Europe, 8% in Mexico/South America, and 6% in Asia. A total of 31% total respondents used scores all or most of the time, and 30% used scores at least some of the time. Respondents felt that the 3 most commonly utilized shoulder scores were the American Shoulder and Elbow Surgeons (ASES) score, the University of California at Los Angeles (UCLA) score, and the Constant score. The majority of respondents (76%) performed all-arthroscopic instability repairs. The ASES and Western Ontario Shoulder Instability Index (WOSI) scores were the most preferred measures to monitor instability patients, whether or not the scores were actually implemented in their practice. Most perform between 10 and 25 superior labrum anterior-posterior repairs per year and preferred the ASES, UCLA, and Constant scores for these repairs; rotator cuff repair preferred outcomes instruments were similar. When asked to choose 1 score for all shoulder conditions, the ASES was the clear favorite. This study reports the knowledge and utilization of shoulder scores for both general and disease-specific conditions. Most respondents preferred the ASES score for most shoulder conditions; however, other scores, such as the WOSI, the Constant, and the Short-Form (SF)-36/12, were popular. This information offers insight into the current and future use of shoulder outcomes both for general and disease-specific use.

'Just a GP': a mixed method study of undermining of general practice as a career choice in the UK.

PubMed

Alberti, Hugh; Banner, Kimberley; Collingwood, Helen; Merritt, Kymberlee

2017-11-03

Failure to recruit sufficient applicants to general practice (GP) training has been a problem both nationally and internationally for many years and undermining of GP is one possible contributing factor. The aim of our study was to ascertain what comments, both negative and positive, are being made in UK clinical settings to GP trainees about GP and to further explore these comments and their influence on career choice. We conducted a mixed methods study. We surveyed all foundation doctors and GP trainees within one region of Health Education England regarding any comments they experienced relating to a career in GP. We also conducted six focus groups with early GP trainees to discuss any comments that they experienced and whether these comments had any influence on their or others career choice. Positive comments reported by trainees centred around the concept that choosing GP is a positive, family-focused choice which facilities a good work-life balance. Workload was the most common negative comment, alongside the notion of being 'just a GP'; the belief that GP is boring, a waste of training and a second-class career choice. The reasons for and origin of the comments are multifactorial in nature. Thematic analysis of the focus groups identified key factors such as previous exposure to and experience of GP, family members who were GPs, GP role models, demographics of the clinician and referral behaviour. Trainees perceived that negative comments may be discouraging others from choosing GP as a career. Our study demonstrates that negative comments towards GP as a career do exist within clinical settings and are having a potential impact on poor recruitment rates to GP training. We have identified areas in which further negative comments could be prevented by changing perceptions of GP as a career. Additional time spent in GP as undergraduates and postgraduates, and positive GP role models, could particularly benefit recruitment. We recommend that undermining of GP as a career choice be approached with a zero-tolerance policy. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Guidelines for the Diagnosis and Treatment of Chronic Functional Constipation in Korea, 2015 Revised Edition

PubMed Central

Shin, Jeong Eun; Jung, Hye-Kyung; Lee, Tae Hee; Jo, Yunju; Lee, Hyuk; Song, Kyung Ho; Hong, Sung Noh; Lim, Hyun Chul; Lee, Soon Jin; Chung, Soon Sup; Lee, Joon Seong; Rhee, Poong-Lyul; Lee, Kwang Jae; Choi, Suck Chei; Shin, Ein Soon

2016-01-01

The Korean Society of Neurogastroenterology and Motility first published guidelines for chronic constipation in 2005 and was updated in 2011. Although the guidelines were updated using evidence-based process, they lacked multidisciplinary participation and did not include a diagnostic approach for chronic constipation. This article includes guidelines for diagnosis and treatment of chronic constipation to realistically fit the situation in Korea and to be applicable to clinical practice. The guideline development was based upon the adaptation method because research evidence was limited in Korea, and an organized multidisciplinary group carried out systematical literature review and series of evidence-based evaluations. Six guidelines were selected using the Appraisal of Guidelines for Research & Evaluation (AGREE) II process. A total 37 recommendations were adopted, including 4 concerning the definition and risk factors of chronic constipation, 8 regarding diagnoses, and 25 regarding treatments. The guidelines are intended to help primary physicians and general health professionals in clinical practice in Korea, to provide the principles of medical treatment to medical students, residents, and other healthcare professionals, and to help patients for choosing medical services based on the information. These guidelines will be updated and revised periodically to reflect new diagnostic and therapeutic methods. PMID:27226437

Reproducibility-optimized test statistic for ranking genes in microarray studies.

PubMed

Elo, Laura L; Filén, Sanna; Lahesmaa, Riitta; Aittokallio, Tero

2008-01-01

A principal goal of microarray studies is to identify the genes showing differential expression under distinct conditions. In such studies, the selection of an optimal test statistic is a crucial challenge, which depends on the type and amount of data under analysis. While previous studies on simulated or spike-in datasets do not provide practical guidance on how to choose the best method for a given real dataset, we introduce an enhanced reproducibility-optimization procedure, which enables the selection of a suitable gene- anking statistic directly from the data. In comparison with existing ranking methods, the reproducibilityoptimized statistic shows good performance consistently under various simulated conditions and on Affymetrix spike-in dataset. Further, the feasibility of the novel statistic is confirmed in a practical research setting using data from an in-house cDNA microarray study of asthma-related gene expression changes. These results suggest that the procedure facilitates the selection of an appropriate test statistic for a given dataset without relying on a priori assumptions, which may bias the findings and their interpretation. Moreover, the general reproducibilityoptimization procedure is not limited to detecting differential expression only but could be extended to a wide range of other applications as well.

The Road to Covergence

ERIC Educational Resources Information Center

Villano, Matt

2008-01-01

In this article, the author offers six best practices for physical and data security convergence. These are: (1) assess the cable plant; (2) choose wisely; (3) be patient; (4) engineer for high availability; (5) test the converged network to make sure it works; and (6) don't forget the humans.

40 CFR 63.8256 - What records must I keep?

Code of Federal Regulations, 2014 CFR

2014-07-01

...) National Emission Standards for Hazardous Air Pollutants: Mercury Emissions From Mercury Cell Chlor-Alkali... malfunction. (b) Records associated with the by-product hydrogen stream and end box ventilation system vent... the work practice standards. (1) If you choose not to institute a cell room monitoring program...

40 CFR 63.8256 - What records must I keep?

Code of Federal Regulations, 2010 CFR

2010-07-01

...) National Emission Standards for Hazardous Air Pollutants: Mercury Emissions From Mercury Cell Chlor-Alkali... malfunction. (b) Records associated with the by-product hydrogen stream and end box ventilation system vent... the work practice standards. (1) If you choose not to institute a cell room monitoring program...

40 CFR 63.8256 - What records must I keep?

Code of Federal Regulations, 2011 CFR

2011-07-01

...) National Emission Standards for Hazardous Air Pollutants: Mercury Emissions From Mercury Cell Chlor-Alkali... malfunction. (b) Records associated with the by-product hydrogen stream and end box ventilation system vent... the work practice standards. (1) If you choose not to institute a cell room monitoring program...

40 CFR 63.8256 - What records must I keep?

Code of Federal Regulations, 2013 CFR

2013-07-01

...) National Emission Standards for Hazardous Air Pollutants: Mercury Emissions From Mercury Cell Chlor-Alkali... malfunction. (b) Records associated with the by-product hydrogen stream and end box ventilation system vent... the work practice standards. (1) If you choose not to institute a cell room monitoring program...

40 CFR 63.8256 - What records must I keep?

Code of Federal Regulations, 2012 CFR

2012-07-01

...) National Emission Standards for Hazardous Air Pollutants: Mercury Emissions From Mercury Cell Chlor-Alkali... malfunction. (b) Records associated with the by-product hydrogen stream and end box ventilation system vent... the work practice standards. (1) If you choose not to institute a cell room monitoring program...

Research Mathematicians' Practices in Selecting Mathematical Problems

ERIC Educational Resources Information Center

Misfeldt, Morten; Johansen, Mikkel Willum

2015-01-01

Developing abilities to create, inquire into, qualify, and choose among mathematical problems is an important educational goal. In this paper, we elucidate how mathematicians work with mathematical problems in order to understand this mathematical process. More specifically, we investigate how mathematicians select and pose problems and discuss to…

Of Swallowtails and Swallows

ERIC Educational Resources Information Center

Bennett, Samantha

2016-01-01

Education consultant Samantha Bennett describes an inquiry unit in which 2nd graders practice the habits of lepidopterists to learn about butterflies and to create a literary nonfiction story that incorporated their butterfly research. She takes the reader through the teacher's process of planning this unit, including choosing the "4…

An Exploratory Study in School Counselor Consultation Engagement

ERIC Educational Resources Information Center

Perera-Diltz, Dilani M.; Moe, Jeffry L.; Mason, Kimberly L.

2011-01-01

Consultation, an indirect school counselor service, is provided by 79% (n = 998) school counselor currently. Most frequently consultation occurs with teachers, parents, and principals. MANOVA and post hoc analysis indicate differences in consultation practices across academic levels. Choosing a consultation model based on the type of service…

Practical Guide to HVAC for Schools.

ERIC Educational Resources Information Center

ASHRAE Journal, 1998

1998-01-01

Features six articles on heating, ventilation, and air-conditioning systems for schools. Examines how to avoid air temperature complaints when choosing a system; special system features; engineers, indoor air quality, and schools; mechanical systems noise in classrooms; operation and management issues related to design; and details on bids and…

Effective Group Dynamics: Theories and Practices.

ERIC Educational Resources Information Center

Murk, Peter J.

Using a brief experiential group activity called "Choosing a Color Exercise" as an introductory measure, this paper explains the basics of group dynamics and reviews the major theoretical relationships between the group's structure, the dynamics of maintenance and task behaviors, and effective individual performances. The types of functional and…

78 FR 35808 - Proposed priority-Rehabilitation Training: Rehabilitation Long-Term Training Program-Vocational...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-14

..., Labor, and the Social Security Administration. The goal of this conference was to explore several..., research report, 1-15. Proposed Priority The Assistant Secretary for Special Education and Rehabilitative... practicable--the costs of cumulative regulations; (3) In choosing among alternative regulatory approaches...

Designing a diverse high-quality library for crystallography-based FBDD screening.

PubMed

Tounge, Brett A; Parker, Michael H

2011-01-01

A well-chosen set of fragments is able to cover a large chemical space using a small number of compounds. The actual size and makeup of the fragment set is dependent on the screening method since each technique has its own practical limits in terms of the number of compounds that can be screened and requirements for compound solubility. In this chapter, an overview of the general requirements for a fragment library is presented for different screening platforms. In the case of the FBDD work at Johnson & Johnson Pharmaceutical Research and Development, L.L.C., our main screening technology is X-ray crystallography. Since every soaked protein crystal needs to be diffracted and a protein structure determined to delineate if a fragment binds, the size of our initial screening library cannot be a rate-limiting factor. For this reason, we have chosen 900 as the appropriate primary fragment library size. To choose the best set, we have developed our own mix of simple property ("Rule of 3") and "bad" substructure filtering. While this gets one a long way in terms of limiting the fragment pool, there are still tens of thousands of compounds to choose from after this initial step. Many of the choices left at this stage are not drug-like, so we have developed an FBDD Score to help select a 900-compound set. The details of this score and the filtering are presented. Copyright © 2011 Elsevier Inc. All rights reserved.

Screening with Papanicolaou tests in Alberta

PubMed Central

Symonds, Christopher J.; Chen, Wenxin; Rose, Marianne Sarah; Cooke, Lara J.

2018-01-01

Abstract Objective To describe the prevalence and geographic distribution of cervical cancer screening, as well as the age groups of those undergoing screening, in Alberta, and to determine if screening practices conform to current guidelines and follow Choosing Wisely Canada recommendations. Design Descriptive study using data from the Alberta Ministry of Health Analytics and Performance Reporting Branch. Setting Alberta. Participants Women who had 1 or more Papanicolaou tests between 2011 and 2013. Main outcome measures Number of women aged 15 to 20 and those aged 70 and older who had 1 or more Pap tests in a 3-year period; year-to-year trends in screening rates for women in these 2 age groups; trends in screening rates in various geographic regions (ie, cities and zones) in Alberta; and the discipline of clinicians who ordered the Pap tests. Results Between 2011 and 2013, 805 632 women in the province of Alberta had 1 or more Pap tests for cervical cancer screening. Overall, 25 511 (17.5%) women aged 15 to 20 and 16 818 (10.3%) aged 70 and older were screened contrary to most existing guidelines. Screening rates varied markedly in different geographic regions of the province. Most Pap tests were ordered by family physicians or general practitioners. Conclusion Within the geographic regions of Alberta, provincial, national, and international guidelines for screening with Pap tests are inconsistently followed. This strongly echoes the need for clinicians and patients to consider the Choosing Wisely Canada recommendations and current guidelines for cervical cancer screening. PMID:29358254

Choosing estimands in clinical trials with missing data.

PubMed

Mallinckrodt, Craig; Molenberghs, Geert; Rathmann, Suchitrita

2017-01-01

Recent research has fostered new guidance on preventing and treating missing data. Consensus exists that clear objectives should be defined along with the causal estimands; trial design and conduct should maximize adherence to the protocol specified interventions; and a sensible primary analysis should be used along with plausible sensitivity analyses. Two general categories of estimands are effects of the drug as actually taken (de facto, effectiveness) and effects of the drug if taken as directed (de jure, efficacy). Motivated by examples, we argue that no single estimand is likely to meet the needs of all stakeholders and that each estimand has strengths and limitations. Therefore, stakeholder input should be part of an iterative study development process that includes choosing estimands that are consistent with trial objectives. To this end, an example is used to illustrate the benefit from assessing multiple estimands in the same study. A second example illustrates that maximizing adherence reduces sensitivity to missing data assumptions for de jure estimands but may reduce generalizability of results for de facto estimands if efforts to maximize adherence in the trial are not feasible in clinical practice. A third example illustrates that whether or not data after initiation of rescue medication should be included in the primary analysis depends on the estimand to be tested and the clinical setting. We further discuss the sample size and total exposure to placebo implications of including post-rescue data in the primary analysis. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Physicians' engagement in dual practices and the effects on labor supply in public hospitals: results from a register-based study.

PubMed

Johannessen, Karl-Arne; Hagen, Terje P

2014-07-10

Physician dual practice, a combination of public and private practice, has attracted attention due to fear of reduced work supply and a lack of key personnel in the public system, increase in low priority treatments, and conflicts of interest for physicians who may be competing for their own patients when working for private suppliers. In this article, we analyze both choice of dual practice among hospital physicians and the dual practices' effect on work supply in public hospitals. The sample consisted of 12,399 Norwegian hospital physicians working in public hospitals between 2001 and 2009. We linked hospital registry data on salaries and hospital working hours with data from national income and other registries covering non-hospital income, including income from dual work, cohabiting status, childbirths and socioeconomic characteristics. Our dataset also included hospital variables describing i.e. workload. We estimated odds ratio for choosing dual practice and the effects of dual practice on public working hours using different versions of mixed models. The percentage of physicians engaged in dual practice fell from 35.1% for men and 17.6% for women in 2001 to 25.0% and 14.2%, respectively, in 2009. For both genders, financial debt and interest payments were positively correlated and having a newborn baby was negatively correlated with engaging in dual practice. Larger family size and being cohabitating increased the odds ratio of dual practice among men but reduced it for women. The most significant internal hospital factor for choosing dual practice was high wages for extended working hours, which significantly reduced the odds ratio for dual practice. The total working hours in public hospitals were similar for both those who did and did not engage in dual practice; however, dual practice reduced public working hours in some specialties. Economic factors followed by family variables are significant elements influencing dual practice. Although our findings indicate that engagement in dual practice by public hospital physicians in a well-regulated market may increase the total labor supply, this may vary significantly between medical specialties.

How do workplaces, working practices and colleagues affect UK doctors’ career decisions? A qualitative study of junior doctors’ career decision making in the UK

PubMed Central

Pearson, Emma; Gibson, Jonathan; Checkland, Kath

2017-01-01

Objectives This study draws on an in-depth investigation of factors that influenced the career decisions of junior doctors. Setting Junior doctors in the UK can choose to enter specialty training (ST) programmes within 2 years of becoming doctors. Their specialty choices contribute to shaping the balance of the future medical workforce, with views on general practice (GP) careers of particular interest because of current recruitment difficulties. This paper examines how experiences of medical work and perceptions about specialty training shape junior doctors’ career decisions. Participants Twenty doctors in the second year of a Foundation Training Programme in England were recruited. Purposive sampling was used to achieve a diverse sample from respondents to an online survey. Results Narrative interviewing techniques encouraged doctors to reflect on how experiences during medical school and in medical workplaces had influenced their preferences and perceptions of different specialties. They also spoke about personal aspirations, work priorities and their wider future. Junior doctors’ decisions were informed by knowledge about the requirements of ST programmes and direct observation of the pressures under which ST doctors worked. When they encountered negative attitudes towards a specialty they had intended to choose, some became defensive while others kept silent. Achievement of an acceptable work-life balance was a central objective that could override other preferences. Events linked with specific specialties influenced doctors’ attitudes towards them. For example, findings confirmed that while early, positive experiences of GP work could increase its attractiveness, negative experiences in GP settings had the opposite effect. Conclusions Junior doctors’ preferences and perceptions about medical work are influenced by multiple intrinsic and extrinsic factors and experiences. This paper highlights the importance of understanding how perceptions are formed and preferences are developed, as a basis for generating learning and working environments that nurture students and motivate their professional careers. PMID:29074517

High Satisfaction and Low Distress in Breast Cancer Patients One Year after BRCA-Mutation Testing without Prior Face-to-Face Genetic Counseling.

PubMed

Sie, Aisha S; Spruijt, Liesbeth; van Zelst-Stams, Wendy A G; Mensenkamp, Arjen R; Ligtenberg, Marjolijn J L; Brunner, Han G; Prins, Judith B; Hoogerbrugge, Nicoline

2016-06-01

According to standard practice following referral to clinical genetics, most high risk breast cancer (BC) patients in many countries receive face-to-face genetic counseling prior to BRCA-mutation testing (DNA-intake). We evaluated a novel format by prospective study: replacing the intake consultation with telephone, written and digital information sent home. Face-to-face counseling then followed BRCA-mutation testing (DNA-direct). One year after BRCA-result disclosure, 108 participants returned long-term follow-up questionnaires, of whom 59 (55 %) had previously chosen DNA-direct (intervention) versus DNA-intake (standard practice i.e., control: 45 %). Questionnaires assessed satisfaction and psychological distress. All participants were satisfied and 85 % of DNA-direct participants would choose this procedure again; 10 % would prefer DNA-intake and 5 % were undecided. In repeated measurements ANOVA, general distress (GHQ-12, p = 0.01) and BC-specific distress (IES-bc, p = 0.03) were lower in DNA-direct than DNA-intake at all time measurements. Heredity-specific distress (IES-her) did not differ significantly between groups. Multivariate regression analyses showed that choice of procedure did not significantly contribute to either general or heredity-specific distress. BC-specific distress (after BC diagnosis) did contribute to both general and heredity-specific distress. This suggests that higher distress scores reflected BC experience, rather than the type of genetic diagnostic procedure. In conclusion, the large majority of BC patients that used DNA-direct reported high satisfaction without increased distress both in the short term, and 1 year after conclusion of genetic testing.

The "global surgeon": is it time for modifications in the American surgical training paradigm?

PubMed

Ginwalla, Rashna F; Rustin, Rudolph B

2015-01-01

"Global surgery" is becoming an increasingly popular concept not only for new trainees, but also for established surgeons. The need to provide surgical care in low-resource settings is laudable, but the American surgical training system currently does not impart the breadth of skills required to provide quality care. We propose one possible model for a surgical fellowship program that provides those trainees who desire to practice in these settings a comprehensive experience that encompasses not only broad technical skills but also the opportunity to engage in policy and programmatic development and implementation. This is a descriptive commentary based on personal experience and a review of the literature. The proposed model is 2 years long, and can either be done after general surgery training as an additional "global surgery" fellowship or as part of a 3 + 2 general surgery + global surgery system. It would incorporate training in general surgery as well as orthopedics, urology, obstetrics & gynecology, neurosurgery, plastics & reconstructive surgery, as well as dedicated time for health systems training. Incorporating such training in a low-resource setting would be a requirement of such a program, in order to obtain field experience. Global surgery is a key word these days in attracting young trainees to academic surgical residency programs, yet they are subsequently inadequately trained to provide the required surgical services in these low-resource settings. Dedicated programmatic changes are required to allow those who choose to practice in these settings to obtain the full breadth of training needed to become safe, competent surgeons in such environments. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

How to choose the right financial planner.

PubMed

Maurer, Timothy J

2010-01-01

An "economic Pearl Harbor." That is how the world's most famous investor, Warren Buffett, described what we have gone through and what we're still going through.' Even the most optimistic appraisals of our economic conditions suggest that we are likely to feel the effects of the Great Recession through the decade we recently entered. Healthcare reform, in whatever form, may also create change in your medical practice ranging from immaterial to revolutionary. To whom should you turn to ensure that your personal economy survives and thrives, especially in these times? A financial planner, possibly, but what is a financial planner, how do you choose one, and what sort of service should you expect?

Adolescent care. Part 2: communication and referral practices of family physicians caring for adolescents with mental health problems.

PubMed

Maheux, Brigitte; Gilbert, Andrée; Haley, Nancy; Frappier, Jean-Yves

2006-11-01

To document with whom family physicians communicate when evaluating adolescents with mental health problems, to whom they refer these adolescents, and their knowledge and perceptions of the accessibility of mental health services in their communities. Mailed survey completed anonymously. Province of Quebec. All general practitioners who reported seeing at least 10 adolescents weekly (n = 255) among 707 physicians who participated in a larger survey on adolescent mental health care in general practice. Whether family physicians communicated with people (such as parents, teachers, or school nurses) when evaluating adolescents with mental health problems. Number of adolescents referred to mental health services during the last year. Knowledge of mental health services in the community and perception of their accessibility. When asked about the last 5 adolescents seen with symptoms of depression or suicidal thoughts, depending on type of practice, 9% to 19% of physicians reported routinely communicating with parents, and 22% to 32% reported not contacting parents. Between 16% and 43% of physicians referred 5 adolescents or fewer to mental health services during a 12-month period. Most practitioners reported being adequately informed about the mental health services available in their local community clinics. Few physicians knew about services offered by private-practice psychologists, child psychiatrists, or community groups. Respondents perceived mental health services in community clinics (CLSCs) as the most accessible and child psychiatrists as the least accessible services. Few physicians routinely contact parents when evaluating adolescents with serious mental health problems. Collaboration between family physicians and mental health professionals could be improved. The few referrals made to mental health professionals might indicate barriers to mental health services that could mean many adolescents do not receive the care they need. The lack of access to mental health services, notably to child psychiatrists, reported by most respondents could explain why some physicians choose not to refer adolescents.

Physicians’ engagement in dual practices and the effects on labor supply in public hospitals: results from a register-based study

PubMed Central

2014-01-01

Background Physician dual practice, a combination of public and private practice, has attracted attention due to fear of reduced work supply and a lack of key personnel in the public system, increase in low priority treatments, and conflicts of interest for physicians who may be competing for their own patients when working for private suppliers. In this article, we analyze both choice of dual practice among hospital physicians and the dual practices’ effect on work supply in public hospitals. Methods The sample consisted of 12,399 Norwegian hospital physicians working in public hospitals between 2001 and 2009. We linked hospital registry data on salaries and hospital working hours with data from national income and other registries covering non-hospital income, including income from dual work, cohabiting status, childbirths and socioeconomic characteristics. Our dataset also included hospital variables describing i.e. workload. We estimated odds ratio for choosing dual practice and the effects of dual practice on public working hours using different versions of mixed models. Results The percentage of physicians engaged in dual practice fell from 35.1% for men and 17.6% for women in 2001 to 25.0% and 14.2%, respectively, in 2009. For both genders, financial debt and interest payments were positively correlated and having a newborn baby was negatively correlated with engaging in dual practice. Larger family size and being cohabitating increased the odds ratio of dual practice among men but reduced it for women. The most significant internal hospital factor for choosing dual practice was high wages for extended working hours, which significantly reduced the odds ratio for dual practice. The total working hours in public hospitals were similar for both those who did and did not engage in dual practice; however, dual practice reduced public working hours in some specialties. Conclusion Economic factors followed by family variables are significant elements influencing dual practice. Although our findings indicate that engagement in dual practice by public hospital physicians in a well-regulated market may increase the total labor supply, this may vary significantly between medical specialties. PMID:25011448

Medical acupuncture in Germany: patterns of consumerism among physicians and patients.

PubMed

Frank, Robert; Stollberg, Gunnar

2004-04-01

Since the (re) emergence of heterodox medicine across the Western world, there have been numerous interpretations of this phenomenon by the social sciences. Heterodox patients were said to be active consumers holding postmodern values, while heterodox physicians were described as heretics. Medical doctors taking up heterodox medicine were criticised for acting in their own financial interests. To examine these notions, we selected the most prominent heterodox mode of treatment in the German healthcare system: acupuncture. Twenty-six semi-structured interviews with medical acupuncturists and their patients were conducted. On the physicians' side, we analyse their styles of practice. To what extent is acupuncture incorporated into biomedical models? Were there any doctors who completely converted to Chinese ideas about health and illness? The patients' activities before and during treatment are addressed. What made them choose acupuncture? How thoroughly did- and do- they collect information on heterodox treatment? The patients' perception of their relationship with their physicians and the decision-making processes during the consultations are also examined. Finally, we argue that while some modes of heterodox medicine resemble parallel forms of general practice, acupuncture tends to become a medical speciality in which physicians tailor their practice to the individual patient's (perceived) demands. From the patients' perspectives, a passive rather than active form of consumerism emerges, involving ideas on medical services that closely correspond to classical modernity.

Choice of Study Resources in General Chemistry by Students Who Have Little Time to Study

ERIC Educational Resources Information Center

Bunce, Diane M.; Komperda, Regis; Dillner, Debra K.; Lin, Shirley; Schroeder, Maria J.; Hartman, JudithAnn R.

2017-01-01

Students with an insufficient amount of time to study are becoming more prevalent in the general college population as many who enroll in college have competing responsibilities (full-time jobs, childcare, etc.). Such students are likely to choose study resources that they consider to be both effective and efficient. Students at the U.S. Naval…

How Do I Satisfy the General Education Language Requirement? University Students' Attitudes toward Language Study

ERIC Educational Resources Information Center

Thomas, Juan Antonio

2010-01-01

This study aims to identify the two principal reasons why college students choose a certain language to satisfy a general education second language requirement by polling 172 students enrolled in first-year language courses in 13 languages at a large Northeastern research university. Students answered a questionnaire and chose the two main reasons…

Gratitude as a psychotherapeutic intervention.

PubMed

Emmons, Robert A; Stern, Robin

2013-08-01

Gratitude practice can be a catalyzing and relational healing force, often untapped in clinical practice. In this article, we provide an overview of current thinking about gratitude's defining and beneficial properties, followed by a brief review of the research on mental health outcomes that result from gratitude practice. Following an analysis of our case study of the use of gratitude as a psychotherapeutic intervention, we present various self-strategies and techniques for consciously choosing and cultivating gratitude. We conclude by describing ways in which gratitude might be capitalized upon for beneficial outcomes in therapeutic settings. © 2013 Wiley Periodicals, Inc.

Statistical Diversions

ERIC Educational Resources Information Center

Petocz, Peter; Sowey, Eric

2012-01-01

The term "data snooping" refers to the practice of choosing which statistical analyses to apply to a set of data after having first looked at those data. Data snooping contradicts a fundamental precept of applied statistics, that the scheme of analysis is to be planned in advance. In this column, the authors shall elucidate the…

Student Perception of Online Learning in ESL Bilingual Teacher Preparation

ERIC Educational Resources Information Center

Daniel, Mayra C.; Schumacher, Gail; Stelter, Nicole; Riley, Carolyn

2016-01-01

Current technologies are changing delivery options for post-graduate teacher education. Many practicing teachers who return to school to prepare to educate English learners choose distance learning. This article explores teachers' perceived satisfaction with the quality of online courses, with the collaborative tasks required in these, and the…

A Critical View of Home Education

ERIC Educational Resources Information Center

Lubienski, Chris

2003-01-01

The remarkable spread of home education needs to be considered in light of the arguments driving its growth. While acknowledging that there are many good reasons for individuals to choose home education, this analysis examines some of the most prominent assumptions and claims that advance the practice as a mass movement. Specifically, arguments…

Design Principles Guide Educators in Choosing and Using Curriculum Materials. Research Review

ERIC Educational Resources Information Center

Foster, Elizabeth

2018-01-01

Engaging with materials can shape the teaching experience, teachers' practices and mindsets, and, ultimately, students' learning experiences. This issue of "Learning Professional" looks at an area of emerging interest: curriculum materials and the role they play in the daily work of educators and leaders. Educators, researchers, and…

Identifying Content Knowledge for Teaching Energy: Examples from High School Physics

ERIC Educational Resources Information Center

Robertson, Amy D.; Scherr, Rachel E.; Goodhew, Lisa M.; Daane, Abigail R.; Gray, Kara E.; Aker, Leanna B.

2017-01-01

"Content knowledge for teaching" is the specialized content knowledge that teachers use in practice the content knowledge that serves them for tasks of teaching such as revoicing students' ideas, choosing an instructional activity to address a student misunderstanding, and evaluating student statements. We describe a methodology for…

Gendered Divisions on Classed Routes to Vocational Education

ERIC Educational Resources Information Center

Lappalainen, Sirpa; Mietola, Reetta; Lahelma, Elina

2013-01-01

In this article our focus is on the persistent gendered divisions in educational routes of young people who choose a vocational path after compulsory education in Finland. We analyse how gendered subjectivities are constructed within the practices of educational and vocational guidance and within student cultures in the comprehensive school, as…

Oral Salmonella challenge alters feed preference in newly weaned pigs

USDA-ARS?s Scientific Manuscript database

Common industry practice is to segregate sick pigs; however, the same diet is provided. Due to the higher nutrient demand of the activated immune system, we hypothesized pigs would choose diets differing in nutrient content during an immune challenge when given choices. This study examined pig feed ...

Cultural Adaptation of Interventions in Real Practice Settings

ERIC Educational Resources Information Center

Marsiglia, Flavio F.; Booth, Jamie M.

2015-01-01

This article provides an overview of some common challenges and opportunities related to cultural adaptation of behavioral interventions. Cultural adaptation is presented as a necessary action to ponder when considering the adoption of an evidence-based intervention with ethnic and other minority groups. It proposes a roadmap to choose existing…

Building Blocks for a Healthy Life: Ages Birth to 3.

ERIC Educational Resources Information Center

Hensey, Edna R., Ed.; Relos, Ruth, Ed.

Focusing on services for infants and toddlers, this curriculum and resource guide for child caregivers provides information leading to the realization of three objectives by suggesting learning activities intended to help young children and their caregivers: (1) develop skills in choosing and practicing positive health behaviors; (2) become more…

76 FR 3815 - Religious Freedom Day, 2011

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-20

..., and by argument to maintain, their opinion in matters of religion.'' The fundamental principle of... ability of Americans to worship and practice religion as they choose, including the right to believe in no religion at all. However, these liberties are not self- sustaining, and require a stalwart commitment by...

Laboratory-Based and Autobiographical Retrieval Tasks Differ Substantially in Their Neural Substrates

ERIC Educational Resources Information Center

McDermott, Kathleen B.; Szpunar, Karl K.; Christ, Shawn E.

2009-01-01

In designing experiments to investigate retrieval of event memory, researchers choose between utilizing laboratory-based methods (in which to-be-remembered materials are presented to participants) and autobiographical approaches (in which the to-be-remembered materials are events from the participant's pre-experimental life). In practice, most…

Stage 2--Information Seeking Strategies

ERIC Educational Resources Information Center

Elsenberg, Michael B.

2005-01-01

A brief overview of one Big6 stage by Mike Eisenberg, followed by articles by two exemplary Big6 teachers, Barbara Jansen and Rob Darrow, offering practical uses of the Big6 in elementary and secondary situations is presented. The two-part nature of information seeking strategies that includes brainstorming and choosing is emphasized.

Transformative Learning in Practice: Examples from Extension Education

ERIC Educational Resources Information Center

Reichenbach, Michael R.; Muth, Allyson B.; Smith, Sanford S.

2013-01-01

Transformative learning can lead to great awareness of one's own and others' personal perspectives and result in changes in how participants understand important social issues and how they choose to take action or not. Three examples of Extension teaching that embrace transformative learning are presented: a phenomenological approach to…

Spirituality: Implications for Professional School Counselors' Ethical Practice

ERIC Educational Resources Information Center

Lambie, Glenn W.; Davis, Keith M.; Miller, Geri

2008-01-01

The separation between church and state (e.g., public education) is contentious. Furthermore, schools and many professional school counselors (PSCs) may choose to disregard and/or discount spirituality. This article (a) presents the importance of spirituality in counseling, (b) explores legal statutes and ethical standards relating to spirituality…

Hiring Quality School Leaders: Challenges and Emerging Practices

ERIC Educational Resources Information Center

Clifford, Matthew

2010-01-01

Leadership transitions provide opportunities for organizational growth and development. In the field of education, choosing an effective school principal is one of the most significant decisions that a superintendent or school board can make, as new leadership can propel a district forward in meeting its goals. Principals are responsible for…

Phau Xyaum Nyeem Zaj Lus = Beginning Hmong Reader.

ERIC Educational Resources Information Center

Xiong, Ge

A collection of lessons for beginning reading instruction in Hmong includes 22 lessons on (1) natural resources (soil, water, rock and stone, trees, non-flowering fruit trees, and flowering fruit trees); (2) Hmong agricultural practices (planting vegetable gardens, choosing seeds, seed development, corn, cuttings, and spreading and standing…

Appropriate Technology and Journal Writing: Structured Dialogues that Enhance Learning

ERIC Educational Resources Information Center

Longhurst, James; Sandage, Scott A.

2004-01-01

Of the many available options, instructors should choose "appropriate technology" that meets pedagogical goals with minimum disruption. Student journal assignments follow many teaching "best practices" but consume time and energy; we recommend e-mail as the most appropriate choice for journal assignments. E-mail encourages fast and personalized…

Using Assessment to Improve Practice: New Developments and Measures.

ERIC Educational Resources Information Center

Geron, Scott Miyake; And Others

1997-01-01

Theme issue contains 18 articles on (1) clients' role in assessment of the elderly in long-term care; (2) choosing assessment measures (physical, cognitive, quality-of-life, well-being, social support, multidimensional, culturally appropriate); and (3) making assessments useful (including using technology, assessment by telephone, and clinical…

Mentorship in Practice Program: An Effective School-Based Strategy

ERIC Educational Resources Information Center

Bradford, Brent; Kell, Shannon; Forsberg, Nick

2016-01-01

The development of fundamental movement skills is essential in quality physical education. It has become widely accepted that school-age children who fail to reach the automatic phase in fundamental movement-skill development may choose physically inactive and unhealthy lifestyles. Therefore, physical educators must continue to discover ways to…

Considering Visual Text Complexity: A Guide for Teachers

ERIC Educational Resources Information Center

Cappello, Marva

2017-01-01

Twenty-first century literacy requires students to analyze and create images for communication across and within academic disciplines. Thus, literacy teachers are now responsible for supporting students as they engage with visual texts. We must carefully and intentionally choose images for teaching practice and consider the reader, instructional…

Choosing and using a lawyer. What every medical practice administrator needs to know.

PubMed

Crow, N R

1994-01-01

Attorney Nancy Crow, J.D., L.L.M., writes about some of the legal issues encountered by medical groups, such as business law, real estate and land use, taxes and employee benefits, among many others, and what types of attorneys are more appropriate for particular concerns.

The Inequality Implications of Highly Selective Promotion Practices

ERIC Educational Resources Information Center

Mete, Cem

2004-01-01

Faced with the evident impossibility of providing free or significantly subsidized secondary and higher education to all, many poor and middle income countries choose to educate only those students who are most promising, using public examinations as means of distributing scarce resources. This paper investigates the inequality implications of…

[Comparison of the effects of exchange forms on social solidarity].

PubMed

Inaba, Misato; Takahashi, Nobuyuki

2012-04-01

Although social solidarity is an essential component that helps maintaining social order, what produces solidarity and how does it work have not been fully investigated. We conducted an experiment to examine whether experiencing different forms of social exchange produces different levels of solidarity. We compared four forms of social exchange: reciprocal exchange (exchange resources without negotiation), negotiated exchange (with negotiation), pure-generalized exchange (giver can choose who to give) and chain-generalized exchange (giver cannot choose who to give). Two dimensions classify these exchanges: the number of players (two vs. more than two), and involvement of negotiation. Reciprocal and negotiated exchanges occur within dyads, while pure- and chain-generalized exchanges involve three or more players. Only the negotiated exchange involves negotiation process; the other exchanges are purely unilateral giving. Participants played a one-shot social dilemma game (SDG) before and after social exchange session. The more the players cooperated in SDG, the stronger the social solidarity. Results show that the cooperation rate in SDG increased more in the reciprocal, pure- and chain-generalized exchange conditions than that in the negotiated exchange condition, suggesting that social solidarity is facilitated by experiencing social exchange which does not involve negotiation.

Smoothing Spline ANOVA Decomposition of Arbitrary Splines: An Application to Eye Movements in Reading

PubMed Central

Matuschek, Hannes; Kliegl, Reinhold; Holschneider, Matthias

2015-01-01

The Smoothing Spline ANOVA (SS-ANOVA) requires a specialized construction of basis and penalty terms in order to incorporate prior knowledge about the data to be fitted. Typically, one resorts to the most general approach using tensor product splines. This implies severe constraints on the correlation structure, i.e. the assumption of isotropy of smoothness can not be incorporated in general. This may increase the variance of the spline fit, especially if only a relatively small set of observations are given. In this article, we propose an alternative method that allows to incorporate prior knowledge without the need to construct specialized bases and penalties, allowing the researcher to choose the spline basis and penalty according to the prior knowledge of the observations rather than choosing them according to the analysis to be done. The two approaches are compared with an artificial example and with analyses of fixation durations during reading. PMID:25816246

Values and attitudes related to career preference and performance in the surgical clerkship.

PubMed

Linn, B S; Zeppa, R

1982-10-01

We investigated the values and attitudes of junior medical students in relation to career preference (particularly surgery), ward behavior, and cognitive performance in the surgical clerkship. Students choosing specialty surgery were more cynical and authoritarian than those selecting general surgery. Those choosing general surgery had more self-esteem, and along with those who selected specialty surgery, more intolerance for ambiguity than other students. None of the values or attitudes were associated with grades, but several were related to ward behavior as judged by faculty and house staff. Students who valued academic achievement more and independence and intellectualism less and those with more submissive authoritarian views and more ego strength were considered better ward performers. This raises the question of whether such values and attitudes should be reinforced in ward performance or whether such students are rated higher simply because they are less disruptive to busy ward routines.

Recombinative Generalization: An Exploratory Study in Musical Reading

PubMed Central

Perez, William Ferreira; de Rose, Julio C

2010-01-01

The present study aimed to extend the findings of recombinative generalization research in alphabetical reading and spelling to the context of musical reading. One participant was taught to respond discriminatively to six two-note sequences, choosing the corresponding notation on the staff in the presence of each sequence. When novel three- and four-note sequences were presented, she selected the corresponding notation. These results suggest the generality of previous research to the context of musical teaching. PMID:22477462

Choosing a reliability inspection plan for interval censored data

DOE PAGES

Lu, Lu; Anderson-Cook, Christine Michaela

2017-04-19

Reliability test plans are important for producing precise and accurate assessment of reliability characteristics. This paper explores different strategies for choosing between possible inspection plans for interval censored data given a fixed testing timeframe and budget. A new general cost structure is proposed for guiding precise quantification of total cost in inspection test plan. Multiple summaries of reliability are considered and compared as the criteria for choosing the best plans using an easily adapted method. Different cost structures and representative true underlying reliability curves demonstrate how to assess different strategies given the logistical constraints and nature of the problem. Resultsmore » show several general patterns exist across a wide variety of scenarios. Given the fixed total cost, plans that inspect more units with less frequency based on equally spaced time points are favored due to the ease of implementation and consistent good performance across a large number of case study scenarios. Plans with inspection times chosen based on equally spaced probabilities offer improved reliability estimates for the shape of the distribution, mean lifetime, and failure time for a small fraction of population only for applications with high infant mortality rates. The paper uses a Monte Carlo simulation based approach in addition to the common evaluation based on the asymptotic variance and offers comparison and recommendation for different applications with different objectives. Additionally, the paper outlines a variety of different reliability metrics to use as criteria for optimization, presents a general method for evaluating different alternatives, as well as provides case study results for different common scenarios.« less

Choosing a reliability inspection plan for interval censored data

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

Lu, Lu; Anderson-Cook, Christine Michaela

Reliability test plans are important for producing precise and accurate assessment of reliability characteristics. This paper explores different strategies for choosing between possible inspection plans for interval censored data given a fixed testing timeframe and budget. A new general cost structure is proposed for guiding precise quantification of total cost in inspection test plan. Multiple summaries of reliability are considered and compared as the criteria for choosing the best plans using an easily adapted method. Different cost structures and representative true underlying reliability curves demonstrate how to assess different strategies given the logistical constraints and nature of the problem. Resultsmore » show several general patterns exist across a wide variety of scenarios. Given the fixed total cost, plans that inspect more units with less frequency based on equally spaced time points are favored due to the ease of implementation and consistent good performance across a large number of case study scenarios. Plans with inspection times chosen based on equally spaced probabilities offer improved reliability estimates for the shape of the distribution, mean lifetime, and failure time for a small fraction of population only for applications with high infant mortality rates. The paper uses a Monte Carlo simulation based approach in addition to the common evaluation based on the asymptotic variance and offers comparison and recommendation for different applications with different objectives. Additionally, the paper outlines a variety of different reliability metrics to use as criteria for optimization, presents a general method for evaluating different alternatives, as well as provides case study results for different common scenarios.« less

Leadership survey. An evaluation of health care executives' challenges.

PubMed

Thrall, T H; Hoppszallern, S

2001-01-01

Locating and keeping employees represents one of the greatest challenges facing health care leaders today. This is a key finding of the third Leadership Survey of executives in physician practices, managed care organizations and hospitals. The survey is sponsored by the Medical Group Management Association and Hospitals & Health Networks magazine. Other significant results: Practices put the most emphasis on teamwork, training and staff development as methods to combat labor shortages; practice executives count adequacy of reimbursements and physician productivity as top leadership challenges, along with the availability of qualified workers; practices choose print advertising and the addition of new products and services as the best ways for them to build market share.

How to Choose a Therapist for Post-Traumatic Stress and Dissociative Conditions

MedlinePlus

... Loved Ones For Helpers / Professionals For Media For Students Essential Readings in Trauma Links Hotlines More Resources ... of a psychotherapist. A 1997 Consumer Reports readers’ survey showed people in therapy generally rated psychologists, clinical ...

Factors That Matter to Low-Income and Racial/Ethnic Minority Mothers When Choosing a Pediatric Practice: a Mixed Methods Analysis.

PubMed

Goff, Sarah L; Mazor, Kathleen M; Guhn-Knight, Haley; Budway, Yara Youssef; Murphy, Lorna; White, Katharine O; Lagu, Tara; Pekow, Penelope S; Priya, Aruna; Lindenauer, Peter K

2017-12-01

Pediatric practices' scores on healthcare quality measures are increasingly available to the public. However, patients from low-income and racial/ethnic minority populations rarely use these data. We sought to understand potential barriers to using quality data by assessing what factors mattered to women when choosing a pediatric practice. As part of a randomized trial to overcome barriers to using quality data, we recruited women from a prenatal clinic serving an underserved population. Women reported how much 12 factors mattered when they chose a pediatric practice (5-point Likert scale), what other factors mattered to them, and which factors mattered the most. We assessed whether factor importance varied with selected participant characteristics and qualitatively analyzed the "other" factors named. Participants' (n = 367) median age was 23 years, and they were largely Hispanic (60.4%), white (21.2%), or black (16.9%). Insurance acceptance "mattered a lot" to the highest percentage of women (93.2%), while online information about what other parents think of a practice "mattered a lot" to the fewest (7.4%). Major themes from our qualitative analysis of "other" factors that mattered included physicians' interpersonal skills and pediatrician-specific traits. Factors related to access "mattered the most" to the majority of women. Pediatrician characteristics and factors related to access to care may be more important to low-income and racial/ethnic minority women than more commonly reported quality metrics. Aligning both the content and delivery of publicly reported quality data with women's interests may increase use of pediatric quality data. Clinicaltrials.gov NCT01784575.

"I Love Knowing That What I'm Doing Has Purpose": Male Instrumentalists Who Choose to Teach Elementary General Music

ERIC Educational Resources Information Center

Shouldice, Heather Nelson

2017-01-01

Few entering music education students plan to teach in an elementary general music (EGM) setting, and the majority of those who teach EGM are female and have vocalist backgrounds. The purpose of this collective case study was to examine six male instrumentalists' decisions to pursue a career in EGM teaching rather than secondary instrumental…

The impact of flavour, device type and warning messages on youth preferences for electronic nicotine delivery systems: evidence from an online discrete choice experiment.

PubMed

Shang, Ce; Huang, Jidong; Chaloupka, Frank J; Emery, Sherry L

2017-11-02

To examine the impact of flavour, device type and health warning messages on youth preference for electronic nicotine delivery systems (ENDS), and to provide evidence and data to inform the Food and Drug Administration's potential regulatory actions on ENDS. An online discrete choice experiment was conducted in September 2015. Each participant was given nine choice sets and asked to choose one out of two alternative ENDS products, with varying characteristics in three attributes (flavour, device type and warning message). The impact of the attributes on the probability of choosing ENDS was analysed using conditional and nested logit regressions, controlling for individual sociodemographic characteristics and current smoking status. A general population sample of 515 participants (50 ever-users and 465 never-users of ENDS) aged 14-17 years were recruited to complete the experiment using an online panel. Fruit/sweets/beverage flavours significantly increase the probability of choosing ENDS among youth (p<0.01 for never-users and <0.1 for ever-users) and flavour has the most pronounced impact among three attributes. Among never-users, menthol flavour also increases (p<0.05) the probability of choosing ENDS compared with tobacco flavour. Vaping devices that are modifiable, compared with cigarette-like e-cigarettes, increase (p<0.05) the probability of choosing ENDS among adolescent never-users. Warning messages reduce (p<0.01) the probability of choosing ENDS among never-users. Restricting fruit/sweets/beverage flavours in ENDS, regulating modifiable vaping devices and adopting strong health warning messages may reduce the uptake of ENDS among youth. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Narrative medicine in surgical education.

PubMed

Pearson, A Scott; McTigue, Michael P; Tarpley, John L

2008-01-01

Narrative medicine is a patient-centered approach to the practice of medicine that rescues the patients' stories and integrates what is important to them into decisions regarding their health care. Our hypothesis is that narrative understanding enhances the patient-provider relationship and contributes to optimizing patient care. We propose to use written narrative reflection to capture and measure the general competencies of systems-based practice, practice-based learning, communication skills, and professionalism. DEVELOPMENT/METHODS: The development of this narrative-based project is based on a pilot study that we conducted at our institution with third-year surgical clerkship students. In the pilot, students produced in-depth narrative write-ups on a patient they had had the opportunity to "know." We plan a similar approach for surgical resident education. After a brief discussion of narrative medicine during our scheduled didactic conference, the residents are asked to initiate a written narrative reflection on a patient of their choosing. The narratives will be collected 1 week later. Our plan is to repeat this assessment quarterly so that 4 narratives will be generated annually from internship through the chief resident year. The narratives will be analyzed for content and recurring themes that capture the resident's communication skills, professionalism, as well as self-critique (practice-based learning) and value attributed to health-care teams (systems-based practice). After completion of the narratives, a 5-point Likert response survey will be given to the residents to assess their experience and the perceived value of written reflection. The written narratives will become part of the resident's ongoing portfolio. IMPLEMENTATION/EXPERIENCE TO DATE: Feedback from the medical student pilot study was favorable. When asked in a follow-up questionnaire, most students reported the experience to be valuable and recommended the use of narrative reflection in medical education. To assess the feasibility of this approach in surgical residency, we introduced the concept of narrative reflection to our residents during surgery grand rounds. Thirty-three narratives were collected 1 week later. CONCLUSION/NEXT STEPS: This preliminary experience suggests that acquisition of resident-authored narrative reflection is feasible during surgical residency. Use of this narrative-based approach in surgical resident education has the potential to capture and measure the general competencies of systems-based practice, practice-based learning, communication skills, and professionalism.

Personality traits and career choices among physicians in Finland: employment sector, clinical patient contact, specialty and change of specialty.

PubMed

Mullola, Sari; Hakulinen, Christian; Presseau, Justin; Gimeno Ruiz de Porras, David; Jokela, Markus; Hintsa, Taina; Elovainio, Marko

2018-03-27

Personality influences an individual's adaptation to a specific job or organization. Little is known about personality trait differences between medical career and specialty choices after graduating from medical school when actually practicing different medical specialties. Moreover, whether personality traits contribute to important career choices such as choosing to work in the private or public sector or with clinical patient contact, as well as change of specialty, have remained largely unexplored. In a nationally representative sample of Finnish physicians (N = 2837) we examined how personality traits are associated with medical career choices after graduating from medical school, in terms of employment sector, patient contact, medical specialty and change of specialty. Personality was assessed using the shortened version of the Big Five Inventory (S-BFI). An analysis of covariance with posthoc tests for pairwise comparisons was conducted, adjusted for gender and age with confounders (employment sector, clinical patient contact and medical specialty). Higher openness was associated with working in the private sector, specializing in psychiatry, changing specialty and not practicing with patients. Lower openness was associated with a high amount of patient contact and specializing in general practice as well as ophthalmology and otorhinolaryngology. Higher conscientiousness was associated with a high amount of patient contact and specializing in surgery and other internal medicine specialties. Lower conscientiousness was associated with specializing in psychiatry and hospital service specialties. Higher agreeableness was associated with working in the private sector and specializing in general practice and occupational health. Lower agreeableness and neuroticism were associated with specializing in surgery. Higher extraversion was associated with specializing in pediatrics and change of specialty. Lower extraversion was associated with not practicing with patients. The results showed distinctive personality traits to be associated with physicians' career and specialty choices after medical school independent of known confounding factors. Openness was the most consistent personality trait associated with physicians' career choices in terms of employment sector, amount of clinical patient contact, specialty choice and change of specialty. Personality-conscious medical career counseling and career guidance during and after medical education might enhance the person-job fit among physicians.

Practical Consequences of Item Response Theory Model Misfit in the Context of Test Equating with Mixed-Format Test Data

PubMed Central

Zhao, Yue; Hambleton, Ronald K.

2017-01-01

In item response theory (IRT) models, assessing model-data fit is an essential step in IRT calibration. While no general agreement has ever been reached on the best methods or approaches to use for detecting misfit, perhaps the more important comment based upon the research findings is that rarely does the research evaluate IRT misfit by focusing on the practical consequences of misfit. The study investigated the practical consequences of IRT model misfit in examining the equating performance and the classification of examinees into performance categories in a simulation study that mimics a typical large-scale statewide assessment program with mixed-format test data. The simulation study was implemented by varying three factors, including choice of IRT model, amount of growth/change of examinees’ abilities between two adjacent administration years, and choice of IRT scaling methods. Findings indicated that the extent of significant consequences of model misfit varied over the choice of model and IRT scaling methods. In comparison with mean/sigma (MS) and Stocking and Lord characteristic curve (SL) methods, separate calibration with linking and fixed common item parameter (FCIP) procedure was more sensitive to model misfit and more robust against various amounts of ability shifts between two adjacent administrations regardless of model fit. SL was generally the least sensitive to model misfit in recovering equating conversion and MS was the least robust against ability shifts in recovering the equating conversion when a substantial degree of misfit was present. The key messages from the study are that practical ways are available to study model fit, and, model fit or misfit can have consequences that should be considered when choosing an IRT model. Not only does the study address the consequences of IRT model misfit, but also it is our hope to help researchers and practitioners find practical ways to study model fit and to investigate the validity of particular IRT models for achieving a specified purpose, to assure that the successful use of the IRT models are realized, and to improve the applications of IRT models with educational and psychological test data. PMID:28421011

On computing the geoelastic response to a disk load

NASA Astrophysics Data System (ADS)

Bevis, M.; Melini, D.; Spada, G.

2016-06-01

We review the theory of the Earth's elastic and gravitational response to a surface disk load. The solutions for displacement of the surface and the geoid are developed using expansions of Legendre polynomials, their derivatives and the load Love numbers. We provide a MATLAB function called diskload that computes the solutions for both uncompensated and compensated disk loads. In order to numerically implement the Legendre expansions, it is necessary to choose a harmonic degree, nmax, at which to truncate the series used to construct the solutions. We present a rule of thumb (ROT) for choosing an appropriate value of nmax, describe the consequences of truncating the expansions prematurely and provide a means to judiciously violate the ROT when that becomes a practical necessity.

Relationship between personal characteristics of specialist physicians and choice of practice location in Iran.

PubMed

Taati Keley, Elham; Ravaghi, Hamid; Salehi, Masoud; Nasiripour, Amir Ashkan; Abdi, Zhaleh; Meshkini, Ali

2016-01-01

Uneven geographic distribution of physicians is a major healthcare issue in Iran. This study aimed to explore the relationship between personal characteristics of the recently graduated specialist physicians in Iran and their choice of practice location. A cross-sectional study was conducted to extract information with regard to 3825 recently graduated specialist physicians from all medical schools across Iran between 2009 and 2012. The relationship between physicians' personal attributes and their desire to practise in underdeveloped areas was analyzed using χ2 test and logistic regression analysis. Birthplace, sex, exposure to rural practice before residency program, place of residence, and year of graduation were associated with physicians' desire to practise in an underdeveloped area. The logistic regression showed that female physicians were less likely to choose underdeveloped areas to practise as compared with their male counterparts (OR=0.659, 95%CI, 0.557-0.781, p≤0.001). Physicians who lived in underdeveloped areas were nine times more likely to choose underdeveloped areas to practise as compared with those living in other areas (OR=8.966, 95%CI, 4.717-17.041, p≤0.001). Physicians who did not have previous exposure to rural practice were 28% less likely to choose to serve in the underdeveloped areas as compared to those who had such exposure (OR=0.780, 95%CI, 0.661-0.922, p=0.004). Neither physicians' marital status nor their success in the board certification exam was associated with their choice of practice location. It seems that increasing the enrollment of physicians with a rural background in residency programs may solve the problem of uneven distribution of specialist physicians in Iran. Because female physicians are less willing to work in the underdeveloped areas than male physicians, increasing the number of male student admissions to residency programs, particularly in certain specialties that are more in demand in the underdeveloped areas, could alleviate the problem of uneven distribution of physicians in the short run. Further, programs that support raising the admissions of female students with a rural background into local medical universities along with providing incentives to encourage them to live and work in rural areas should be put on the policy agenda.

Gardening: A Growing Activity

ERIC Educational Resources Information Center

McIntosh, Phyllis

2011-01-01

While Americans are as eager as ever to beautify their homes and yards with attractive landscaping, more and more gardeners are looking to the practical aspects of gardening--raising plants for food and choosing easy-care ornamental plants that are friendly to the environment. For some gardeners, raising their own food is a lifestyle choice. With…

Unlikely Teachers: Redefining the Best and the Brightest

ERIC Educational Resources Information Center

Fehr, Mary Cain

2010-01-01

Purpose: The purpose of this case study is to explore the unique perspectives of a teacher candidate who did not have the life experiences typical of most individuals who choose to become teachers. Specifically, the author was interested in exploring information that future teachers, practicing teachers, and teacher educators can learn from this…

Sure-Fire Presentations. Revised. Bar/School Partnership Programs.

ERIC Educational Resources Information Center

Gallagher, Arlene; And Others

Designed to give lawyers 12 practical suggestions that will make their presentations to elementary and secondary students more effective, this document also can be used by teachers. An introduction gives information about working with students: how to get to know students; how to make a presentation to students; how to choose a suitable topic; and…

Beliefs and Practices about Implementing Technology in Physical Education

ERIC Educational Resources Information Center

Cain, Donald E., II.

2010-01-01

There is little research in the field of physical education on whether technology can help decrease the level of childhood obesity in physical education classes or on why physical educators choose to use or not use technology in their programs. The purpose of this phenomenological study was to examine physical educators' beliefs and practices…

Beyond Test Preparation: Nurturing Successful Learners through Reading and Writing Workshops

ERIC Educational Resources Information Center

Miller, Melinda; Higgins, Betty

2008-01-01

Teachers are faced with a dilemma when they know what good teaching is but feel pressure from their colleagues and administrators to use published test preparation materials to teach reading and writing. However, effective instructional practices and mandated testing demands can coexist if teachers choose methods that not only provide authentic…

Teaching Quantum Interpretations: Revisiting the Goals and Practices of Introductory Quantum Physics Courses

ERIC Educational Resources Information Center

Baily, Charles; Finkelstein, Noah D.

2015-01-01

Most introductory quantum physics instructors would agree that transitioning students from classical to quantum thinking is an important learning goal, but may disagree on whether or how this can be accomplished. Although (and perhaps because) physicists have long debated the physical interpretation of quantum theory, many instructors choose to…

Choosing Assessment Instruments for Bulimia Practice and Outcome Research

ERIC Educational Resources Information Center

Sandberg, Katie; Erford, Bradley T.

2013-01-01

Six commonly used instruments for assessment of eating disorders were analyzed. Effect size results from Erford et al.'s (2013) meta-analysis for the treatment of bulimia nervosa were used to compare each scale's ability to measure treatment outcomes for bulimia nervosa. Effect size comparisons indicated higher overall effect sizes using the…

The Criterion of Historical Knowledge

ERIC Educational Resources Information Center

Frazier, A. M.

1976-01-01

What then is the principle of selection operative in the mind of the historian as he sifts among the documents and records, choosing this source of evidence as vital to this study, and that record as irrelevant? Article considered the dramatically diverse ways that the practicing historian defined the "hard" evidence for historical thought.…

Going Native in the Academy: Choosing the Exotic over the Critical.

ERIC Educational Resources Information Center

Marker, Michael

1998-01-01

Examines some of the problems and contradictions that arise when nonnative instructors attempt to perform aboriginal ceremonies and rituals in the higher-education classroom. Such practices often promote an indulgence in the exotic, rather than taking a more genuine approach to the history and reality of native people. (SLD)

Qualified, but Not Choosing STEM at University: Unconscious Influences on Choice of Study

ERIC Educational Resources Information Center

Rodd, Melissa; Reiss, Michael; Mujtaba, Tamjid

2014-01-01

This article offers explanations as to why good candidates for mathematics or physics degrees might opt to study subjects other than STEM (science, technology, engineering, mathematics) subjects at university. Results come from analysis, informed by psychoanalytic theory and practice, of narrative-style interviews conducted with first-year…

Manager's handbook for black spruce in the north-central states.

Treesearch

William F. Johnston

1977-01-01

Presents the resource manager with a key for choosing silvicultural practices to manage black spruce stands, especially for pulpwood on organic soil sites. Discusses control of growth, establishment, composition, and damaging agents; also discusses managing for Christmas trees, wildlife habitat, water, and esthetics. Includes yield and growth data, and broadcast...

Manager's handbook for northern white cedar in the north-central states.

Treesearch

William F. Johnston

1977-01-01

Presents the resource manager with a key for choosing silvicultural practices to manage northern white cedar stands, especially for timber and deeryards on organic soil sites. Discusses control of growth, composition, establishment, and damaging agents; also discusses managing for other wildlife habitat, water, and esthetics. Includes yield data and broadcast burning...

The Subliminal Impact and Hidden Agendas of Training.

ERIC Educational Resources Information Center

Costley, Dan L.; Moore, Faye A.

1986-01-01

The author suggests that training program developers be upfront about the training purpose, be sure the training creates a positive experience for trainees, consider not only what happens during the training, but what occurs before and after, and ensure that program content is something the trainees will choose to put into practice. (CT)

Workpapers in English as a Second Language, [Volume II].

ERIC Educational Resources Information Center

Rand, Earl, Ed.

This volume presents the 1968 collection of working papers in the field of teaching English as a second language (TESL). It includes discussions of several practicalities in the field of English language teaching such as choosing literature and short stories for non-native speakers, criteria for selecting textbooks, educational problems involved…

40 CFR 63.8236 - How do I demonstrate initial compliance with the emission limitations and work practice standards?

Code of Federal Regulations, 2010 CFR

2010-07-01

...). (2) You choose the continuous cell room monitoring program option, you certify in your Notification... Hazardous Air Pollutants: Mercury Emissions From Mercury Cell Chlor-Alkali Plants Initial Compliance... standards? (a) For each mercury cell chlor-alkali production facility, you have demonstrated initial...

Language Maintenance and the Deaf Child

ERIC Educational Resources Information Center

Willoughby, Louisa

2012-01-01

For all families with deaf children, choosing communication methods is a complex and evolving business. This process is particularly complex for migrant background families, who must not only negotiate the role that speaking or signing will play in their communication practices, but also which spoken language(s) will be used--that of the host…

Career Practice Skills through Global eLearning.

ERIC Educational Resources Information Center

Stevens, Paul

This paper describes the College of Career Practitioners, a program designed for the people who choose to deliver career support services to others. It operates on a combination of computer-mediated communication and printed materials. Students interact with tutors on-line and conduct most of their guided research for assignments on the Internet.…

Canada's Schools Abroad: Expanding the Pathways. CBIE Market Reports Number 1

ERIC Educational Resources Information Center

Canadian Bureau for International Education (CBIE) - Bureau canadien de l’éducation internationale (BCEI), 2014

2014-01-01

This CBIE pathways study, jointly supported by the Global Opportunities for Associations (GOA) program and by CBIE, aims to support recruitment efforts by Canadian institutions in priority markets by outlining the current situation and identifying best practices for increasing the number of Canadian offshore school graduates choosing a Canadian…

Baby Basics: A Guide to Your First Weeks as Parents.

ERIC Educational Resources Information Center

Postpartum Education for Parents, Inc., Santa Barbara, CA.

To prepare expectant parents for the practical and emotional demands of the first few weeks with their newborn child, this book discusses automobile passenger safety, preparation for the infant's arrival, and caring for the infant. Specifically, Part 1 discusses child passenger safety and terms of law, how to restrain children safely, choosing a…

Final-Year Education Projects for Undergraduate Chemistry Students

ERIC Educational Resources Information Center

Page, Elizabeth

2011-01-01

The Undergraduate Ambassadors Scheme provides an opportunity for students in their final year of the chemistry degree course at the University of Reading to choose an educational project as an alternative to practical research. The undergraduates work in schools where they can be regarded as role models and offer one way of inspiring pupils to…

Instructional Design as Knowledge Management: A Knowledge-in-Practice Approach to Choosing Instructional Methods

ERIC Educational Resources Information Center

McIver, Derrick; Fitzsimmons, Stacey; Flanagan, David

2016-01-01

Decisions about instructional methods are becoming more complex, with options ranging from problem sets to experiential service-learning projects. However, instructors not trained in instructional design may make these important decisions based on convenience, comfort, or trends. Instead, this article draws on the knowledge management literature…

The Dalhousie University Experience of Training Residents in Many Small Communities.

ERIC Educational Resources Information Center

Gray, Jean D.; And Others

1994-01-01

A study of Dalhousie University (Nova Scotia) medical school primary care residency graduates (n=200) and other specialty graduates (n=371) suggests that the institution's policy of requiring first-year residencies in small community health services may cause more graduates, both primary care and specialists, to choose rural practice locations.…

The Mystery of Motivation: A Synthesis of Clues for Its Solution.

ERIC Educational Resources Information Center

Williams, Marium Thomas

Organizational theorists have long pondered answers to the question of how best to move people toward effective purpose. This paper synthesizes literature that focuses on ways to promote autonomy among workers. The autonomous worker chooses practical efficiency and moral responsibility. Findings are listed in the following areas: motivation and…

Using Cooperative Education and Work-Integrated Education to Provide Career Clarification

ERIC Educational Resources Information Center

Zegwaard, Karsten E.; Coll, Richard K.

2011-01-01

When students commence university studies they typically choose subjects that are of interest to them, and hold only vague notions of intended career paths. However, some universities offer work-integrated learning degrees (WIL), programs that require students to undertake relevant practical work experience by way of work placements, internships…

Developing an Analytical Framework for Argumentation on Energy Consumption Issues

ERIC Educational Resources Information Center

Jin, Hui; Mehl, Cathy E.; Lan, Deborah H.

2015-01-01

In this study, we aimed to develop a framework for analyzing the argumentation practice of high school students and high school graduates. We developed the framework in a specific context--how energy consumption activities such as changing diet, converting forests into farmlands, and choosing transportation modes affect the carbon cycle. The…

Choosing to Be Positive

ERIC Educational Resources Information Center

Jones, Stephanie M.; Bailey, Rebecca; Brion-Meisels, Gretchen; Partee, Ann

2016-01-01

Schools can view challenging student behavior in one of two ways: (1) as a failure on the part of the student or teacher that distracts from the work of learning, or (2) as a normal developmental occurrence that provides an opportunity for the student to practice new or emerging skills. The authors of this article, researchers at the Harvard…

Drug packaging. A key factor to be taken into account when choosing a treatment.

PubMed

2011-10-01

A drug's packaging contributes to its harm-benefit balance. Highlighting the key practical information and identifying potential sources of error or mix-ups is part and parcel of the correct use of medicines. Select labelling that clearly and prominently displays the important information, including the international nonproprietary name (INN).

Characteristics that Predict Physician Participation in a Web-Based CME Activity: The MI-Plus Study

ERIC Educational Resources Information Center

Schoen, Michael J.; Tipton, Edmond F.; Houston, Thomas K.; Funkhouser, Ellen; Levine, Deborah A.; Estrada, Carlos A.; Allison, Jeroan J.; Williams, O. Dale; Kiefe, Catarina I.

2009-01-01

Introduction: Physician use of the Internet for practice improvement has increased dramatically over the last decade, but research shows that many physicians choose not to participate. The current study investigated the association of specific physician characteristics with enrollment rates and intensity of participation in a specific…

EPIC: A Framework for Using Video Games in Ethics Education

ERIC Educational Resources Information Center

Schrier, Karen

2015-01-01

Ethics education can potentially be supplemented through the use of video games. This article proposes a novel framework (Ethics Practice and Implementation Categorization [EPIC] Framework), which helps educators choose games to be used for ethics education purposes. The EPIC Framework is derived from a number of classic moral development,…

Ideas Plus: A Collection of Practical Teaching Ideas. Book Eleven.

ERIC Educational Resources Information Center

National Council of Teachers of English, Urbana, IL.

Contributed by English teachers across the United States, the activities contained in this booklet are intended to promote the effective teaching of literature and writing. Teaching strategies offered in the first section of the booklet are designed to stimulate language exploration and include activities in which students choose their favorite…

Should we reconsider the routine use of placebo controls in clinical research?

PubMed

Avins, Andrew L; Cherkin, Daniel C; Sherman, Karen J; Goldberg, Harley; Pressman, Alice

2012-04-27

Modern clinical-research practice favors placebo controls over usual-care controls whenever a credible placebo exists. An unrecognized consequence of this preference is that clinicians are more limited in their ability to provide the benefits of the non-specific healing effects of placebos in clinical practice. We examined the issues in choosing between placebo and usual-care controls. We considered why placebo controls place constraints on clinicians and the trade-offs involved in the choice of control groups. We find that, for certain studies, investigators should consider usual-care controls, even if an adequate placebo is available. Employing usual-care controls would be of greatest value for pragmatic trials evaluating treatments to improve clinical care and for which threats to internal validity can be adequately managed without a placebo-control condition. Intentionally choosing usual-care controls, even when a satisfactory placebo exists, would allow clinicians to capture the value of non-specific therapeutic benefits that are common to all interventions. The result could be more effective, patient-centered care that makes the best use of both specific and non-specific benefits of medical interventions.

Diverse strategy-learning styles promote cooperation in evolutionary spatial prisoner's dilemma game

NASA Astrophysics Data System (ADS)

Liu, Run-Ran; Jia, Chun-Xiao; Rong, Zhihai

2015-11-01

Observational learning and practice learning are two important learning styles and play important roles in our information acquisition. In this paper, we study a spacial evolutionary prisoner's dilemma game, where players can choose the observational learning rule or the practice learning rule when updating their strategies. In the proposed model, we use a parameter p controlling the preference of players choosing the observational learning rule, and found that there exists an optimal value of p leading to the highest cooperation level, which indicates that the cooperation can be promoted by these two learning rules collaboratively and one single learning rule is not favor the promotion of cooperation. By analysing the dynamical behavior of the system, we find that the observational learning rule can make the players residing on cooperative clusters more easily realize the bad sequence of mutual defection. However, a too high observational learning probability suppresses the players to form compact cooperative clusters. Our results highlight the importance of a strategy-updating rule, more importantly, the observational learning rule in the evolutionary cooperation.

Attitudes of experiential education directors regarding tobacco sales in pharmacies in the USA.

PubMed

Rider, Katherine; Kaya, Hatice; Jha, Vinayak; Hudmon, Karen Suchanek

2016-04-01

Accreditation guidelines in the USA suggest that experiential sites for pharmacy students should demonstrate 'a strong commitment to health promotion and illness prevention'; however, most community pharmacies sell tobacco products. This study aimed to determine the proportion of students rotating through advanced pharmacy practice experience (APPE) sites where tobacco is sold and experiential education directors' perception regarding the sales of tobacco in APPE sites. A brief survey was distributed by mail to experiential education directors at US pharmacy schools. The survey characterized the proportion of students who rotate at practice sites where tobacco is sold, directors' perceptions of tobacco sales in experiential sites, and the number of hours of tobacco education in their pharmacy curricula. Directors (n = 81; 63%) estimated that 69% of students rotate through sites where tobacco is sold. If given the opportunity to choose between two potential sites, where one sells tobacco and the other does not, 40% of directors would be unlikely to choose a site that sold tobacco. With respect to tobacco sales, pharmacy schools are largely noncompliant with guidelines and resolutions of professional organizations. © 2015 Royal Pharmaceutical Society.

Dental students' motivation and the context of learning.

PubMed

Kristensen, Bettina Tjagvad; Netterstrom, Ingeborg; Kayser, Lars

2009-02-01

This qualitative study shows dental students' motives for choosing the dental education and how the motives influence their motivation at the first semester of study. Further the study demonstrates the relevance of the context of learning. This issue is of importance when planning a curriculum for the dental education. The material consists of interviews with eight dental students. The results show that dental students were focused on their future professional role, its practical dimensions and their future working conditions. Their motivation for choosing the dental education was found to influence their motivation for studying and their experience of the relevance of the first semester. The dental students who had co-education with the medical students at the first year of study missed a dental context and courses with clinically relevant contents. In conclusion, our data signify the importance of the context of learning. It is recommended that a future curriculum for the dental school should be designed in a way where basic science subjects are taught with both theoretically as well as practically oriented subjects and in a context which is meaningful for the students.

Dynamics of a village--marketing strategies for a new millennium.

PubMed

Farran, H

1999-06-01

Successfully marketing a dental practice involves more than an ad in the yellow pages. Choosing a dentist is a decision based on emotion. Dentists who take steps to become involved in their communities and interact with people will reap the personal and professional rewards necessary for a successful practice. From the beginning of recorded time, humans have been strongly influenced by personal recommendations. It started in the Garden of Eden. Eve said to Adam, "Go ahead, taste this fruit." He didn't read about the fruit in a slick, full-color brochure. He didn't hear about it on television in a strategically placed commercial. He made his decision based on only one thing: Eve's recommendation. The power of a personal recommendation is still one of the strongest motivating factors in our society. People do not choose a good restaurant based on the size of its ad in the telephone directory. How many times have you told someone about a movie, and they saw it based on your recommendation? The synergy of human communication is the most powerful component of economic stability in a village.

29 CFR 531.52 - General characteristics of “tips.”

Code of Federal Regulations, 2010 CFR

2010-07-01

... customer. Only tips actually received by an employee as money belonging to him which he may use as he chooses free of any control by the employer, may be counted in determining whether he is a “tipped...

Choosing Accommodations: Signed Language Interpreting and the Absence of Choice.

PubMed

Burke, Teresa Blankmeyer

This paper carves out a topic space for discussion about the ethical question of whether input from signing Deaf consumers of interpreting services ought to be included in the provision of signed language interpreter accommodations. The first section provides background about disability accommodations and practices, including how signed language interpreting accommodations are similar and dissimilar to other kinds of disability accommodations. In the second section, I offer a personal narrative of my experience as a Deaf academic who has been excluded from the interpreter selection process, highlighting some of the harmful consequences of such exclusion. In the subsequent two sections, I describe and analyze the process of choosing interpreter accommodations, starting with the process of requesting signed language interpreters and the institutionalization of this process, followed by a brief overview of privacy and autonomy concerns from the standpoint of the signing Deaf consumer. The penultimate section considers some objections to the proposal of involving more consumer choice in signed language accommodations. I conclude the paper with some concrete suggestions for a more Deaf-centered, inclusive process for choosing interpreter accommodations.

Physician Dismissal of Families Who Refuse Vaccination: An Ethical Assessment.

PubMed

Diekema, Douglas S

2015-01-01

Thousands of U.S. parents choose to refuse or delay the administration of selected vaccines to their children each year, and some choose not to vaccinate their children at all. While most physicians continue to provide care to these families over time, using each visit as an opportunity to educate and encourage vaccination, an increasing number of physicians are choosing to dismiss these families from their practice unless they agree to vaccinate their children. This paper will examine this emerging trend along with the reasons given by those who advocate such an approach. I will argue that the strategy of refusing to allow families into a clinic unless they agree to vaccinate their children is misguided, and the arguments for doing so fail to stand up to close scrutiny. Such a strategy does not benefit the child or the health of the community, and may have a negative impact on both. Furthermore, some of the arguments in support of dismissal policies ignore the importance of professional obligation and appear to favor self-interest over the interest of the patient. © 2015 American Society of Law, Medicine & Ethics, Inc.

Patient choice of a hospital: implications for health policy and management.

PubMed

Mosadeghrad, Ali Mohammad

2014-01-01

The purpose of this study was to identify the most important influencing factors in choosing a hospital by a patient. This study involved a mixed research design. Focus groups and in-depth individual interviews were conducted with patients to explore reasons for choosing a hospital. In addition, this study involved survey-based research on the patient choice. Type of the hospital, type of the service, word of mouth, cost of services, the health insurance programme, location, physical environment, facilities, providers' expertise and interpersonal behaviour, and reputation of the hospital influenced patients' choice of a hospital. Doctor recommendations and health insurance programme were the main reasons for choosing a hospital for inpatients and outpatients respectively. Identifying and understanding key factors that influence a patient choice of a healthcare setting helps managers and policy makers invest their resources in those critical areas and improve those aspects of their services to attract more patients. This article contributes to healthcare theory and practice by developing a conceptual framework for understanding the factors that influence a patient choice of a healthcare setting.

An orthopedic surgeon survey on the treatment of displaced femoral neck fracture: opposing views

PubMed Central

Chua, David; Jaglal, Susan B.; Schatzker, Joseph

1997-01-01

Objective To examine the reasons for practice variation in the treatment of displaced femoral neck fractures. Design A survey, asking surgeons to choose either hemiarthroplasty or internal fixation for 2 different female patients with a displaced femoral neck fracture. Setting The Canadian Orthopaedic Association Meeting, Halifax, May 1995. Patients The scenario in the first patient was of an independent 70-year-old woman with no pre-existing medical conditions. The scenario in the second patient was of a housebound 84-year-old woman with co-morbidity. Main outcome measures Proportion of surgeons choosing either hemiarthroplasty or internal fixation for each case scenario. Distribution of reasons to explain the treatment decision. Results Ninety-nine surgeons responded. For the case of the 70-year-old woman, 47% chose hemiarthroplasty and 53% chose internal fixation (p = 0.60), and for the 84-year-old woman, 96% chose hemiarthroplasty. These findings were consistent within the subgroups of teaching surgeons and community practice surgeons. Surgeons with 10 years or less of practice tended to favour hemiarthroplasty whereas those with more than 15 years’ practice favoured internal fixation. Important reasons for treatment choice were avoidance of reoperation in the hemiarthroplasty group (85%) and better hip function in the fixation group (83%), durability (83%) and ease of revision (77%). Conclusion The surgeon’s interpretation of the importance of reoperation and function underlies the differences in treatment decision regarding the management of femoral neck fractures in elderly patients. PMID:9267295

Computerized accounting for the dental office. Using horizontal applications general ledger software.

PubMed

Garsson, B

1988-01-01

Remember that computer software is designed for accrual accounting, whereas your business operates and reports income on a cash basis. The rules of tax law stipulate that professional practices may use the cash method of accounting, but if accrual accounting is ever used to report taxable income the government may not permit a switch back to cash accounting. Therefore, always consider the computer as a bookkeeper, not a substitute for a qualified accountant. (Your accountant will have readily accessible payroll and general ledger data available for analysis and tax reports, thanks to the magic of computer processing.) Accounts Payable reports are interfaced with the general ledger and are of interest for transaction detail, open invoice and cash flow analysis, and for a record of payments by vendor. Payroll reports, including check register and withholding detail are provided and interfaced with the general ledger. The use of accounting software expands the use of in-office computers to areas beyond professional billing and insurance form generation. It simplifies payroll recordkeeping; maintains payables details; integrates payables, receivables, and payroll with general ledger files; provides instantaneous information on all aspects of the business office; and creates a continuous "audit-trail" following the entering of data. The availability of packaged accounting software allows the professional business office an array of choices. The person(s) responsible for bookkeeping and accounting should choose carefully, ensuring that any system is easy to use, has been thoroughly tested, and provides at least as much control over office records as has been outlined in this article.

An Evaluation of Permit L Local Anesthesia within Dental Hygiene Practice in Massachusetts.

PubMed

Soal, Katherine A; Boyd, Linda; Jenkins, Susan; November-Rider, Debra; Rothman, Andrew

2016-06-01

The purpose of this descriptive study was to assess data pertinent to the Permit L local anesthesia license among practicing dental hygienists in Massachusetts, providing an overview of characteristics, practice behaviors, barriers for obtaining the permit and self-perceived competency. A convenience sample of dental hygienists (n=6,167) identified through a publically available data base were invited to participate in a web-based survey. The survey consisted of demographic and Permit L specific questions. Items regarding opinions were rated using a 5-point Likert scale while frequencies and percentiles were used to evaluate demographics and practice-based information. Spearman's Rank correlation was performed to determine association between variables. A 10% (n=615) response rate was attained with (n=245) non-Permit L holders and (n=370) Permit L holders. Respondents reported significant differences in demographics and opinions between non-Permit L holders and Permit L holders (p<0.01) and between those certified through continuing education or curriculum based programs (p<0.01). Significant relationships were found in demographics (p<0.01) and practice (p<0.05) items in relation to the length of time the Permit L has been held. Themes from the data and comments indicate multiple factors influencing obtaining or not obtaining the Permit L. The results of this study provide an overview of Permit L local anesthesia administration that is generally comparable to previous studies and offers new insights into why some Massachusetts dental hygienists choose not to pursue certification. This study highlights the potential to increase the prevalence of the Permit L, address barriers to pursuing the Permit L, and further evaluate self-perceived barriers. Copyright © 2016 The American Dental Hygienists’ Association.

Job stress and job satisfaction of physicians in private practice: comparison of German and Norwegian physicians.

PubMed

Voltmer, Edgar; Rosta, Judith; Siegrist, Johannes; Aasland, Olaf G

2012-10-01

This study examined job satisfaction and job stress of German compared to Norwegian physicians in private practice. A representative sample of physicians in private practice of Schleswig-Holstein, Germany (N = 414) and a nationwide sample of Norwegian general practitioners and private practice specialists (N = 340) were surveyed in a cross-sectional design in 2010. The questionnaire comprised the standard instruments "Job Satisfaction Scale (JSS)" and a short form of the "Effort-Reward Imbalance Questionnaire (ERI)". Norwegian physicians scored significantly higher (<0.01) on all items of the job satisfaction scale compared to German physicians (M 5.57, SD 0.74 vs. M 4.78, SD 1.01). The effect size was highest for the items freedom to choose method (d = 1.012), rate of pay (d = 0.941), and overall job satisfaction (d = 0.931). While there was no significant difference in the mean of the overall effort scale between German and Norwegian physicians, Norwegian physicians scored significantly higher (p < 0.01) on the reward scale. A larger proportion of German physicians (27.6%) presented with an effort/reward ratio beyond 1.0, indicating a risky level of work-related stress, compared to only 10.3% of Norwegian physicians. Working hours, effort, reward, and country differences accounted for 37.4% of the explained variance of job satisfaction. Job satisfaction and reward were significantly higher in Norwegian than in German physicians. An almost threefold higher proportion of German physicians exhibited a high level of work-related stress. Findings call for active prevention and health promotion among stressed practicing physicians, with a special focus on improved working conditions.

Active learning: learning a motor skill without a coach.

PubMed

Huang, Vincent S; Shadmehr, Reza; Diedrichsen, Jörn

2008-08-01

When we learn a new skill (e.g., golf) without a coach, we are "active learners": we have to choose the specific components of the task on which to train (e.g., iron, driver, putter, etc.). What guides our selection of the training sequence? How do choices that people make compare with choices made by machine learning algorithms that attempt to optimize performance? We asked subjects to learn the novel dynamics of a robotic tool while moving it in four directions. They were instructed to choose their practice directions to maximize their performance in subsequent tests. We found that their choices were strongly influenced by motor errors: subjects tended to immediately repeat an action if that action had produced a large error. This strategy was correlated with better performance on test trials. However, even when participants performed perfectly on a movement, they did not avoid repeating that movement. The probability of repeating an action did not drop below chance even when no errors were observed. This behavior led to suboptimal performance. It also violated a strong prediction of current machine learning algorithms, which solve the active learning problem by choosing a training sequence that will maximally reduce the learner's uncertainty about the task. While we show that these algorithms do not provide an adequate description of human behavior, our results suggest ways to improve human motor learning by helping people choose an optimal training sequence.

The dynamism of professional and business identities.

PubMed

Gillis, Martin R

2011-01-01

Dr. Martin Gillis, a practitioner in Nova Scotia, was worried about the intrusion of commercial values in dentistry. Rather than complain, he sought advanced training in medical education, focusing on methods for revealing the practical influences of the school and practice environments on value formation. Today he teaches part-time and serves as an oral health liaison for diabetes with the International Diabetes Federation, in addition to his practice. He shares his thoughts about the issues facing the profession being similar to those in play more than 100 years ago and how our character is shaped by the way we choose to respond to economic pressures.

Choose and choose again: appearance-reality errors, pragmatics and logical ability.

PubMed

Deák, Gedeon O; Enright, Brian

2006-05-01

In the Appearance/Reality (AR) task some 3- and 4-year-old children make perseverative errors: they choose the same word for the appearance and the function of a deceptive object. Are these errors specific to the AR task, or signs of a general question-answering problem? Preschoolers completed five tasks: AR; simple successive forced-choice question pairs (QP); flexible naming of objects (FN); working memory (WM) span; and indeterminacy detection (ID). AR errors correlated with QP errors. Insensitivity to indeterminacy predicted perseveration in both tasks. Neither WM span nor flexible naming predicted other measures. Age predicted sensitivity to indeterminacy. These findings suggest that AR tests measure a pragmatic understanding; specifically, different questions about a topic usually call for different answers. This understanding is related to the ability to detect indeterminacy of each question in a series. AR errors are unrelated to the ability to represent an object as belonging to multiple categories, to working memory span, or to inhibiting previously activated words.

The experience of freedom in decisions - Questioning philosophical beliefs in favor of psychological determinants.

PubMed

Lau, Stephan; Hiemisch, Anette; Baumeister, Roy F

2015-05-01

Six experiments tested two competing models of subjective freedom during decision-making. The process model is mainly based on philosophical conceptions of free will and assumes that features of the process of choosing affect subjective feelings of freedom. In contrast, the outcome model predicts that subjective freedom is due to positive outcomes that can be expected or are achieved by a decision. Results heavily favored the outcome model over the process model. For example, participants felt freer when choosing between two equally good than two equally bad options. Process features including number of options, complexity of decision, uncertainty, having the option to defer the decision, conflict among reasons, and investing high effort in choosing generally had no or even negative effects on subjective freedom. In contrast, participants reported high freedom with good outcomes and low freedom with bad outcomes, and ease of deciding increased subjective freedom, consistent with the outcome model. Copyright © 2014 Elsevier Inc. All rights reserved.

Fear or greed? Oxytocin regulates inter-individual conflict by enhancing fear in men.

PubMed

Zheng, Huimin; Kendrick, Keith M; Yu, Rongjun

2016-09-01

People may choose non-cooperation in social dilemmas either out of fear (if others choose to defect) or out of greed (when others choose to cooperate). Previous studies have shown that exogenous oxytocin motivates a "tend and defend" pattern in inter-group conflict in which oxytocin stimulates in-group cooperation and out-group defense. Using a double-blind placebo-controlled design combined with a modified Prisoner's dilemma game (PDG), we examined the effect of oxytocin on social motivations in inter-individual conflict in men. Results showed that compared with the placebo group, oxytocin-exposed participants were less cooperative in general. Specifically, oxytocin amplified the effect of fear on defection but did not influence the effect of greed. Another non-social control study confirmed participants' decisions were sensitive to social factors. Our findings suggest that even when social group conflict is removed, oxytocin promotes distrust of strangers in "me and you" inter-individual conflict by elevating social fear in men. Copyright © 2016 Elsevier Inc. All rights reserved.

Preference reversal in quantum decision theory.

PubMed

Yukalov, Vyacheslav I; Sornette, Didier

2015-01-01

We consider the psychological effect of preference reversal and show that it finds a natural explanation in the frame of quantum decision theory. When people choose between lotteries with non-negative payoffs, they prefer a more certain lottery because of uncertainty aversion. But when people evaluate lottery prices, e.g., for selling to others the right to play them, they do this more rationally, being less subject to behavioral biases. This difference can be explained by the presence of the attraction factors entering the expression of quantum probabilities. Only the existence of attraction factors can explain why, considering two lotteries with close utility factors, a decision maker prefers one of them when choosing, but evaluates higher the other one when pricing. We derive a general quantitative criterion for the preference reversal to occur that relates the utilities of the two lotteries to the attraction factors under choosing vs. pricing and test successfully its application on experiments by Tversky et al. We also show that the planning paradox can be treated as a kind of preference reversal.

Social preferences of future physicians

PubMed Central

Li, Jing; Dow, William H.

2017-01-01

We measure the social preferences of a sample of US medical students and compare their preferences with those of the general population sampled in the American Life Panel (ALP). We also compare the medical students with a subsample of highly educated, wealthy ALP subjects as well as elite law school students and undergraduate students. We further associate the heterogeneity in social preferences within medical students to the tier ranking of their medical schools and their expected specialty choice. Our experimental design allows us to rigorously distinguish altruism from preferences regarding equality–efficiency tradeoffs and accurately measure both at the individual level rather than pooling data or assuming homogeneity across subjects. This is particularly informative, because the subjects in our sample display widely heterogeneous social preferences in terms of both their altruism and equality–efficiency tradeoffs. We find that medical students are substantially less altruistic and more efficiency focused than the average American. Furthermore, medical students attending the top-ranked medical schools are less altruistic than those attending lower-ranked schools. We further show that the social preferences of those attending top-ranked medical schools are statistically indistinguishable from the preferences of a sample of elite law school students. The key limitation of this study is that our experimental measures of social preferences have not yet been externally validated against actual physician practice behaviors. Pending this future research, we probed the predictive validity of our experimental measures of social preferences by showing that the medical students choosing higher-paying medical specialties are less altruistic than those choosing lower-paying specialties. PMID:29146826

Genotype Imputation with Thousands of Genomes

PubMed Central

Howie, Bryan; Marchini, Jonathan; Stephens, Matthew

2011-01-01

Genotype imputation is a statistical technique that is often used to increase the power and resolution of genetic association studies. Imputation methods work by using haplotype patterns in a reference panel to predict unobserved genotypes in a study dataset, and a number of approaches have been proposed for choosing subsets of reference haplotypes that will maximize accuracy in a given study population. These panel selection strategies become harder to apply and interpret as sequencing efforts like the 1000 Genomes Project produce larger and more diverse reference sets, which led us to develop an alternative framework. Our approach is built around a new approximation that uses local sequence similarity to choose a custom reference panel for each study haplotype in each region of the genome. This approximation makes it computationally efficient to use all available reference haplotypes, which allows us to bypass the panel selection step and to improve accuracy at low-frequency variants by capturing unexpected allele sharing among populations. Using data from HapMap 3, we show that our framework produces accurate results in a wide range of human populations. We also use data from the Malaria Genetic Epidemiology Network (MalariaGEN) to provide recommendations for imputation-based studies in Africa. We demonstrate that our approximation improves efficiency in large, sequence-based reference panels, and we discuss general computational strategies for modern reference datasets. Genome-wide association studies will soon be able to harness the power of thousands of reference genomes, and our work provides a practical way for investigators to use this rich information. New methodology from this study is implemented in the IMPUTE2 software package. PMID:22384356

Lived Experiences of Novice Male Nurses in Taiwan.

PubMed

Cheng, Mei-Li; Tseng, Ying-Hua; Hodges, Eric; Chou, Fan-Hao

2016-11-03

Nursing remains a female-dominated profession around the world. The masculinity and male identity of men who choose nursing careers is questioned by the general public in many countries. Few studies report the situation of novice male nurses at their first year. The purpose of this study was to explore the lived experience of novice male nurses when they first enter the workplace. A qualitative descriptive study was conducted using purposive and snowball sampling for recruitment. Fourteen participants, 21 to 25 years old, were recruited, all of whom had at least 5 months of work experience. On average, in-depth, face-to-face interviews lasted 1 hour, with more than one follow-up telephone interview per participant. The following six themes emerged from the transcribed verbatim data based on content analysis: choosing appropriate work departments based on personality and needs, facing the pressure and frustration of independent work, getting help, obtaining acceptance among female cliques, reflecting on the relationship between gender and profession, and concerns about dependents and financial needs. This study addresses masculinity issues and gender stereotyping. In addition, male nurses were very concerned about their career options and development and the likelihood of promotion. This research not only has implications for better understanding of novice male nurses' needs and the challenges in their social life but also makes suggestions for nursing practice to attract and keep more male nurses in the nursing profession. The results illustrate how culturally congruent nursing care can be achieved when we more concern male nurses' role pressure and address traditional gender sensitivity to promote male nurses' career development. © The Author(s) 2016.

Risks and opportunities for plastic surgeons in a widening cosmetic medicine market: future demand, consumer preferences, and trends in practitioners' services.

PubMed

D'Amico, Richard A; Saltz, Renato; Rohrich, Rod J; Kinney, Brian; Haeck, Phillip; Gold, Alan H; Singer, Robert; Jewell, Mark L; Eaves, Felmont

2008-05-01

The American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery launched a joint Cosmetic Medicine Task Force to address the growing trend of non-plastic surgeons entering the cosmetic medicine field. The task force commissioned two surveys in 2007 to determine consumer attitudes about choosing cosmetic medicine providers and to learn about the cosmetic services that plastic surgeons offer. The first survey obtained responses from 1015 women who had undergone a cosmetic procedure or were considering having one within 2 years. The second survey obtained responses from 260 members of the two societies. Compared with other practitioners, plastic surgeons enjoy higher rates of satisfaction among their patients who undergo noninvasive procedures. Injectables present a particularly promising market for plastic surgeons. Half of consumers surveyed said they were very concerned about complications associated with injectables, and generally, the higher the perceived risk of the procedure, the higher the likelihood that a patient would choose a plastic surgeon to perform it. In addition, injectables were among the noninvasive treatments most frequently being considered by consumers. However, almost half of consumers said that if they had a positive experience with a non-plastic surgeon core provider for a noninvasive procedure, that physician would likely be their first choice for a surgical procedure. These findings suggest that plastic surgeons, and especially those who are building young practices, must expand their offerings of nonsurgical cosmetic services to remain at the core of the cosmetic medicine field.

Library-Specific Microcomputer Software.

ERIC Educational Resources Information Center

Levert, Virginia M.

1985-01-01

Discusses number and type of microcomputer software programs useful to libraries and types of hardware on which they run, as identified by Nolan Information Management Services. Highlights include general application programs, applications designed to support library technical processes, producers of library software, and choosing among options.…

An efficient algorithm for choosing the degree of a polynomial to approximate discrete nonoscillatory data

NASA Technical Reports Server (NTRS)

Hedgley, D. R.

1978-01-01

An efficient algorithm for selecting the degree of a polynomial that defines a curve that best approximates a data set was presented. This algorithm was applied to both oscillatory and nonoscillatory data without loss of generality.

Guideline 3: Psychosocial Treatment.

ERIC Educational Resources Information Center

American Journal on Mental Retardation, 2000

2000-01-01

The third in seven sets of guidelines based on the consensus of experts in the treatment of psychiatric and behavioral problems in mental retardation (MR) focuses on psychosocial treatment. Guidelines cover general principles, choosing among psychosocial treatments, severity of MR and psychiatric/behavior symptoms, diagnosable disorders, target…

An Introduction to Document Imaging in the Financial Aid Office.

ERIC Educational Resources Information Center

Levy, Douglas A.

2001-01-01

First describes the components of a document imaging system in general and then addresses this technology specifically in relation to financial aid document management: its uses and benefits, considerations in choosing a document imaging system, and additional sources for information. (EV)

Time to Talk: 6 Things to Know When Selecting a Complementary Health Practitioner

MedlinePlus

... conditions. Choose a practitioner who understands how to work with people with your specific needs, even if general well-being is your goal. And, remember that health conditions can affect the safety of complementary approaches; for example, if ...

Prevention as Public Policy.

ERIC Educational Resources Information Center

Reno, Janet

2002-01-01

The former United States Attorney General articulated her vision of how our communities can act in creative ways to choose prevention instead of prisons for our troubled children and youth at the Spirit of Crazy Horse Award Ceremony held July 1, 2001, in Custer, South Dakota. (Author)

7 CFR 650.12 - NRCS decisionmaking.

Code of Federal Regulations, 2010 CFR

2010-01-01

... the project area. The RFO may choose to publish the entire ROD. (d) Environmental Assessments and... Regulations of the Department of Agriculture (Continued) NATURAL RESOURCES CONSERVATION SERVICE, DEPARTMENT OF... decisionmaking. (a) General. The purpose of these procedures is to insure that environmental information is...

On the use of log-transformation vs. nonlinear regression for analyzing biological power laws.

PubMed

Xiao, Xiao; White, Ethan P; Hooten, Mevin B; Durham, Susan L

2011-10-01

Power-law relationships are among the most well-studied functional relationships in biology. Recently the common practice of fitting power laws using linear regression (LR) on log-transformed data has been criticized, calling into question the conclusions of hundreds of studies. It has been suggested that nonlinear regression (NLR) is preferable, but no rigorous comparison of these two methods has been conducted. Using Monte Carlo simulations, we demonstrate that the error distribution determines which method performs better, with NLR better characterizing data with additive, homoscedastic, normal error and LR better characterizing data with multiplicative, heteroscedastic, lognormal error. Analysis of 471 biological power laws shows that both forms of error occur in nature. While previous analyses based on log-transformation appear to be generally valid, future analyses should choose methods based on a combination of biological plausibility and analysis of the error distribution. We provide detailed guidelines and associated computer code for doing so, including a model averaging approach for cases where the error structure is uncertain.

Business process performance measurement: a structured literature review of indicators, measures and metrics.

PubMed

Van Looy, Amy; Shafagatova, Aygun

2016-01-01

Measuring the performance of business processes has become a central issue in both academia and business, since organizations are challenged to achieve effective and efficient results. Applying performance measurement models to this purpose ensures alignment with a business strategy, which implies that the choice of performance indicators is organization-dependent. Nonetheless, such measurement models generally suffer from a lack of guidance regarding the performance indicators that exist and how they can be concretized in practice. To fill this gap, we conducted a structured literature review to find patterns or trends in the research on business process performance measurement. The study also documents an extended list of 140 process-related performance indicators in a systematic manner by further categorizing them into 11 performance perspectives in order to gain a holistic view. Managers and scholars can consult the provided list to choose the indicators that are of interest to them, considering each perspective. The structured literature review concludes with avenues for further research.

Health education using video recordings in a general practice waiting area: an evaluation.

PubMed Central

Koperski, M

1989-01-01

With the help of a patient participation group video recordings of health education programmes were shown in the waiting area of a health centre. Patients could choose whether or not to watch the programmes. When asked their views on the project 87% of patients responded positively, and 50% of those who watched could recall specific facts presented. There were no significant differences in age or sex between those who chose and chose not to watch the video recordings. However, unemployed patients and those in social classes 4 and 5 were significantly less likely to watch the programmes than those in social classes 1-3. The use of video recordings in both primary care and hospital waiting areas and the possible role of the health education authority as a central resource is discussed. This system could provide a useful means of extending health education, although further research is needed on the response of different social classes to different forms of health education. PMID:2556560

Postdoctoral program guidelines.

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

Teich-McGoldrick, Stephanie; Miller, Andrew W.; Sava, Dorina Florentina

2012-04-01

We, the Postdoc Professional Development Program (PD2P) leadership team, wrote these postdoc guidelines to be a starting point for communication between new postdocs, their staff mentors, and their managers. These guidelines detail expectations and responsibilities of the three parties, as well as list relevant contacts. The purpose of the Postdoc Program is to bring in talented, creative people who enrich Sandia's environment by performing innovative R&D, as well as by stimulating intellectual curiosity and learning. Postdocs are temporary employees who come to Sandia for career development and advancement reasons. In general, the postdoc term is 1 year, renewable up tomore » five times for a total of six years. However, center practices may vary; check with your manager. At term, a postdoc may apply for a staff position at Sandia or choose to move to university, industry or another lab. It is our vision that those who leave become long-term collaborators and advocates whose relationships with Sandia have a positive effect upon our national constituency.« less

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

Henning, Brian; Lu, Xiaochuan; Murayama, Hitoshi

Here, we present a practical three-step procedure of using the Standard Model effective field theory (SM EFT) to connect ultraviolet (UV) models of new physics with weak scale precision observables. With this procedure, one can interpret precision measurements as constraints on a given UV model. We give a detailed explanation for calculating the effective action up to one-loop order in a manifestly gauge covariant fashion. This covariant derivative expansion method dramatically simplifies the process of matching a UV model with the SM EFT, and also makes available a universal formalism that is easy to use for a variety of UVmore » models. A few general aspects of RG running effects and choosing operator bases are discussed. Finally, we provide mapping results between the bosonic sector of the SM EFT and a complete set of precision electroweak and Higgs observables to which present and near future experiments are sensitive. Many results and tools which should prove useful to those wishing to use the SM EFT are detailed in several appendices.« less

First-year engineering students' views of the nature of engineering: implications for engineering programmes

NASA Astrophysics Data System (ADS)

Karataş, F. Ö.; Bodner, G. M.; Unal, Suat

2016-01-01

A study was conducted on the views of the nature of engineering held by 114 first-year engineering majors; the study built on prior work on views of the nature of science held by students, their instructors, and the general public. Open-coding analysis of responses to a 12-item questionnaire suggested that the participants held tacit beliefs that engineering (1) involves problem solving; (2) is a form of applied science; (3) involves the design of artefacts or systems; (4) is subject to various constraints; and (5) requires teamwork. These beliefs, however, were often unsophisticated, and significant aspects of the field of engineering as described in the literature on engineering practices were missing from the student responses. The results of this study are important because students' beliefs have a strong influence on what they value in a classroom situation, what they attend to in class, and how they choose to study for a course.

NASA systems engineering handbook. Draft

NASA Technical Reports Server (NTRS)

Shishko, Robert; Chamberlain, Robert G.; Aster, Robert; Bilardo, Vincent; Forsberg, Kevin; Hammond, Walter E.; Mooz, Harold; Polaski, Lou; Wade, Ron; Cassingham, Randy (Editor)

1992-01-01

This handbook is intended to provide information on systems engineering that will be useful to NASA system engineers, especially new ones. Its primary objective is to provide a generic description of systems engineering as it should be applied throughout NASA. Field Center Handbooks are encouraged to provide center-specific details of implementation. For NASA system engineers to choose to keep a copy of this handbook at their elbows, it must provide answers that cannot be easily found elsewhere. Consequently, it provides NASA-relevant perspectives and NASA-particular data. NASA management instructions (NMI's) are referenced when applicable. This handbook's secondary objective is to serve as a useful companion to all of the various courses in systems engineering that are being offered under NASA's auspices. The coverage of systems engineering is general to techniques, concepts, and generic descriptions of processes, tools, and techniques. It provides good systems engineering practices, and pitfalls to avoid. This handbook describes systems engineering as it should be applied to the development of major NASA product and producing systems.

The Power of Proofs-of-Possession: Securing Multiparty Signatures against Rogue-Key Attacks

NASA Astrophysics Data System (ADS)

Ristenpart, Thomas; Yilek, Scott

Multiparty signature protocols need protection against rogue-key attacks, made possible whenever an adversary can choose its public key(s) arbitrarily. For many schemes, provable security has only been established under the knowledge of secret key (KOSK) assumption where the adversary is required to reveal the secret keys it utilizes. In practice, certifying authorities rarely require the strong proofs of knowledge of secret keys required to substantiate the KOSK assumption. Instead, proofs of possession (POPs) are required and can be as simple as just a signature over the certificate request message. We propose a general registered key model, within which we can model both the KOSK assumption and in-use POP protocols. We show that simple POP protocols yield provable security of Boldyreva's multisignature scheme [11], the LOSSW multisignature scheme [28], and a 2-user ring signature scheme due to Bender, Katz, and Morselli [10]. Our results are the first to provide formal evidence that POPs can stop rogue-key attacks.

Multinational survey of chiropractic patients: reasons for seeking care

PubMed Central

Blum, Charles; Globe, Gary; Terre, Lisa; Mirtz, Timothy A.; Greene, Leon; Globe, Denise

2008-01-01

Introduction This study explores the extent to which consumers seek wellness care when choosing chiropractors whose practice methods are known to include periodic evaluative and interventional methods to maintain wellness and prevent illness. Methods Using an international convenience sample of Sacro-Occipital Technique (SOT) practitioners, 1316 consecutive patients attending 27 different chiropractic clinics in the USA, Europe and Australia completed a one-page survey on intake to assess reason for seeking care. A forced choice response was obtained characterizing the patient’s reason for seeking chiropractic care. Results More than 40% of chiropractic patient visits were initiated for the purposes of health enhancement and/or disease prevention. Conclusion Although prudence dictates great caution when generalizing from this study, if confirmed by subsequent research among other similar cohorts, the present results may lend support to continued arguments of consumer demand for a more comprehensive paradigm of chiropractic care, beyond routine musculoskeletal complaints, that conceptualizes the systemic, nonspecific effects of the chiropractic encounter in much broader terms. PMID:18769601

Multinational survey of chiropractic patients: reasons for seeking care.

PubMed

Blum, Charles; Globe, Gary; Terre, Lisa; Mirtz, Timothy A; Greene, Leon; Globe, Denise

2008-08-01

This study explores the extent to which consumers seek wellness care when choosing chiropractors whose practice methods are known to include periodic evaluative and interventional methods to maintain wellness and prevent illness. Using an international convenience sample of Sacro-Occipital Technique (SOT) practitioners, 1316 consecutive patients attending 27 different chiropractic clinics in the USA, Europe and Australia completed a one-page survey on intake to assess reason for seeking care. A forced choice response was obtained characterizing the patient's reason for seeking chiropractic care. More than 40% of chiropractic patient visits were initiated for the purposes of health enhancement and/or disease prevention. Although prudence dictates great caution when generalizing from this study, if confirmed by subsequent research among other similar cohorts, the present results may lend support to continued arguments of consumer demand for a more comprehensive paradigm of chiropractic care, beyond routine musculoskeletal complaints, that conceptualizes the systemic, nonspecific effects of the chiropractic encounter in much broader terms.

Generalized Weierstrass-Mandelbrot Function Model for Actual Stocks Markets Indexes with Nonlinear Characteristics

NASA Astrophysics Data System (ADS)

Zhang, L.; Yu, C.; Sun, J. Q.

2015-03-01

It is difficult to simulate the dynamical behavior of actual financial markets indexes effectively, especially when they have nonlinear characteristics. So it is significant to propose a mathematical model with these characteristics. In this paper, we investigate a generalized Weierstrass-Mandelbrot function (WMF) model with two nonlinear characteristics: fractal dimension D where 2 > D > 1.5 and Hurst exponent (H) where 1 > H > 0.5 firstly. And then we study the dynamical behavior of H for WMF as D and the spectrum of the time series γ change in three-dimensional space, respectively. Because WMF and the actual stock market indexes have two common features: fractal behavior using fractal dimension and long memory effect by Hurst exponent, we study the relationship between WMF and the actual stock market indexes. We choose a random value of γ and fixed value of D for WMF to simulate the S&P 500 indexes at different time ranges. As shown in the simulation results of three-dimensional space, we find that γ is important in WMF model and different γ may have the same effect for the nonlinearity of WMF. Then we calculate the skewness and kurtosis of actual Daily S&P 500 index in different time ranges which can be used to choose the value of γ. Based on these results, we choose appropriate γ, D and initial value into WMF to simulate Daily S&P 500 indexes. Using the fit line method in two-dimensional space for the simulated values, we find that the generalized WMF model is effective for simulating different actual stock market indexes in different time ranges. It may be useful for understanding the dynamical behavior of many different financial markets.

Cross-validation pitfalls when selecting and assessing regression and classification models.

PubMed

Krstajic, Damjan; Buturovic, Ljubomir J; Leahy, David E; Thomas, Simon

2014-03-29

We address the problem of selecting and assessing classification and regression models using cross-validation. Current state-of-the-art methods can yield models with high variance, rendering them unsuitable for a number of practical applications including QSAR. In this paper we describe and evaluate best practices which improve reliability and increase confidence in selected models. A key operational component of the proposed methods is cloud computing which enables routine use of previously infeasible approaches. We describe in detail an algorithm for repeated grid-search V-fold cross-validation for parameter tuning in classification and regression, and we define a repeated nested cross-validation algorithm for model assessment. As regards variable selection and parameter tuning we define two algorithms (repeated grid-search cross-validation and double cross-validation), and provide arguments for using the repeated grid-search in the general case. We show results of our algorithms on seven QSAR datasets. The variation of the prediction performance, which is the result of choosing different splits of the dataset in V-fold cross-validation, needs to be taken into account when selecting and assessing classification and regression models. We demonstrate the importance of repeating cross-validation when selecting an optimal model, as well as the importance of repeating nested cross-validation when assessing a prediction error.

The constraints satisfaction problem approach in the design of an architectural functional layout

NASA Astrophysics Data System (ADS)

Zawidzki, Machi; Tateyama, Kazuyoshi; Nishikawa, Ikuko

2011-09-01

A design support system with a new strategy for finding the optimal functional configurations of rooms for architectural layouts is presented. A set of configurations satisfying given constraints is generated and ranked according to multiple objectives. The method can be applied to problems in architectural practice, urban or graphic design-wherever allocation of related geometrical elements of known shape is optimized. Although the methodology is shown using simplified examples-a single story residential building with two apartments each having two rooms-the results resemble realistic functional layouts. One example of a practical size problem of a layout of three apartments with a total of 20 rooms is demonstrated, where the generated solution can be used as a base for a realistic architectural blueprint. The discretization of design space is discussed, followed by application of a backtrack search algorithm used for generating a set of potentially 'good' room configurations. Next the solutions are classified by a machine learning method (FFN) as 'proper' or 'improper' according to the internal communication criteria. Examples of interactive ranking of the 'proper' configurations according to multiple criteria and choosing 'the best' ones are presented. The proposed framework is general and universal-the criteria, parameters and weights can be individually defined by a user and the search algorithm can be adjusted to a specific problem.

Nurturing Future Generations: Household Food Practices of Canadian Children and Family Meal Participation.

PubMed

Slater, Joyce; Mudryj, Adriana N

2016-09-01

Food knowledge and skills appear to have declined in the general population over recent decades and may be contributing to negative outcomes and poor nutritional health. It is pertinent to observe the food skills and habits of Canadians, particularly Canadian youth. Data from the Canadian Community Health Survey 2013 Rapid Response on Food Skills (n = 10 098) were used to examine the involvement of children in food preparation processes by identifying and describing the role of children in meal preparation as well as the practice of family meals. Variables were examined to assess differentiations between socio-demographic groupings (marital status, education, and income). Results indicate a moderate to high level of child participation in Canadian household food-related activities, with two-thirds of households with children having children involved in choosing meals and grocery shopping and one-third of children helping with meal preparation. Some differences were observed between region, education level, and Aboriginal and immigration status. Seventy-five percent of respondents participated in family meals. Data from this study contribute to the current discussion regarding loss of food skills and the significance of family meals on social and health indicators. Results suggest a range of interventions for dietitians including improving the quality of foods prepared at home and campaigns to promote family meals.

Accreditation of ambulatory facilities.

PubMed

Urman, Richard D; Philip, Beverly K

2014-06-01

With the continued growth of ambulatory surgical centers (ASC), the regulation of facilities has evolved to include new standards and requirements on both state and federal levels. Accreditation allows for the assessment of clinical practice, improves accountability, and better ensures quality of care. In some states, ASC may choose to voluntarily apply for accreditation from a recognized organization, but in others it is mandated. Accreditation provides external validation of safe practices, benchmarking performance against other accredited facilities, and demonstrates to patients and payers the facility's commitment to continuous quality improvement. Copyright © 2014 Elsevier Inc. All rights reserved.

[A system of introduction of the results of scientific research on hygiene into practical health care and national economics].

PubMed

Eksler, N D; Vishnevskaia, S S

1989-01-01

The country's socio-economic development necessitates further elaboration of new approaches to the introduction of hygienic research results into practice. The main criterion for choosing proper research techniques lies in their economy-type efficiency, both social, medical and economic. A new system of hygienic research introduction should be based on financial and economic stimuli, establishment of a network of inventive firms, as well as supported by an effective mechanisms of information feed-back with due account of health indices.

Evaluation of Practice Trials to Increase Self-Drinking in a Child with a Feeding Disorder.

PubMed

Peterson, Kathryn M; Volkert, Valerie M; Milnes, Suzanne M

2017-06-01

Self-drinking is an important skill for children to acquire as they transition from infancy to early childhood; however, the literature is limited (e.g., Collins, Gast, Wolery, Holcombe, & Leatherby, 1991; Peterson, Volkert, & Zeleny, 2015). We manipulated the consequences associated with self-drinking relative to those associated with being fed along the dimension of response effort. Results demonstrated that self-drinking increased when the child could either choose to self-feed one drink or be fed one drink and 5 practice trials with an empty cup.

Parental acceptance of behaviour-management techniques used in paediatric dentistry and its relation to parental dental anxiety and experience.

PubMed

Boka, V; Arapostathis, K; Vretos, N; Kotsanos, N

2014-10-01

The aim of this study was to examine the acceptance by Greek parents of nine behaviour-management techniques and its association with several possible confounding factors. Following ethical approval, 106 parents whose 3- to 12-year-old children had been receiving treatment in a university postgraduate paediatric dental clinic, and 123 parents of children from a private paediatric dental practice agreed to participate. After being shown a video with nine behaviour-management techniques, parents rated the acceptance of each technique on a 0-10 scale. They were then asked to complete a questionnaire about demographics, their previous dental experience and dental anxiety (modified Corah dental anxiety scale). The best accepted technique was tell-show-do (9.76 ± 0.69), followed by parental presence/absence (PPA) technique (7.83 ± 3.06) and nitrous oxide inhalation sedation (7.09 ± 3.02). The least accepted techniques were passive restraint (4.21 ± 3.84) and general anaesthesia (4.21 ± 4.02). No correlations were found between acceptance of any individual management technique and parental age, gender, income, education, dental experience and dental anxiety or the child's age, gender and dental experience. Parents whose children had been treated at the University clinic had lower income and educational levels, and rated passive restraint, oral sedation and general anaesthesia higher than those from the private practice. When the parents were specifically asked to choose between general anaesthesia over any of the active or passive restraint, hand-over-mouth and voice control techniques, 10% preferred general anaesthesia, and these parents reported statistically significant more negative dental experience but not higher dental anxiety. Statistical significance of differences was explored using the Tukey-Kramer method. There was no correlation between parental dental experience and dental anxiety and the acceptance of any specific behaviour-management technique. However, parents with negative dental experience would prefer general anaesthesia over any of active or passive restraint, hand-over-mouth and voice control techniques. PPA is a highly acceptable technique for Greek parents.

What Types of Text Are Novice Teachers Choosing to Teach Mathematics?

ERIC Educational Resources Information Center

Barry, Arlene L.; Gay, A. Susan; Pelkey, M. Lisa; Rothrock, Katrina

2017-01-01

Student teachers informed their professors that it was no longer the practice to use traditional textbooks to teach mathematics to teens. This notion caused the authors to undertake a nationwide survey to inquire about the types of math text used by novice teachers. Responses showed that a textbook did continue dominance. A majority said they…

Information Disclosure in Postsecondary Vocational Education: Possibilities and Practices. Revised.

ERIC Educational Resources Information Center

Brown, Cynthia L.; Choy, Susan P.

When students choose postsecondary vocational education programs, they pay, in both money and in income lost during the time they are in the program. The public also pays by tax support for many educational programs. However, students often have little information about the effectiveness of these programs in terms of job placement, wage rates, and…

Beyond Super Heroes and Talking Animals: Social Justice in Graphic Novels in Education

ERIC Educational Resources Information Center

Greenfield, David

2017-01-01

The primary goal of this study was to investigate, document, and understand the reasons that educators who use graphic novels in their classrooms choose to use them, rather than traditional text. Secondary goals were to identify the classes they teach, and to identify commonalities and shared best practices. Interviews were scheduled, to provide…

SLD Identification: A Survey of Methods Used by School Psychologists

ERIC Educational Resources Information Center

Watson, Michael D., Jr.; Simon, Joan B.; Nunnley, Lenora

2016-01-01

IDEA 2004 opened the door for states, and in some cases districts, to choose among three different methods for identifying children with Specific Learning Disabilities (SLDs). This study provides an in-depth look at SLD identification practices in a state that allows school psychologists to use any of the three methods. Eighty-four school…

Physics Practical Work and Its Influence on Students' Academic Achievement

ERIC Educational Resources Information Center

Musasia, Amadalo Maurice; Ocholla, Alphayo Abacha; Sakwa, Thomas Welikhe

2016-01-01

In Kenyan secondary schools, form two is an important class for all students. The students choose relevant subjects to study in form three and four. Physics is compulsory at form one and two but optional thereafter. Performance in the subject at the end of the secondary school is usually dismal. Majority of students lack motivation for most…

Creating More "Elbow Room" for Collaborative Reflective Practice in the Competitive, Performative Culture of Today's University

ERIC Educational Resources Information Center

Kennelly, Robert; McCormack, Coralie

2015-01-01

We live in "a world of clashing interests" [Zinn, H. (1991). "Declarations of independence: Cross-examining American ideology." Toronto: Harper Collins, p. xx]. In a grapple for survival, universities choose to spend less money and time on teaching and learning, less time on robust evaluation of student learning and…

The Rural Physician Associate Program: The Value of Immersion Learning for Third-Year Medical Students

ERIC Educational Resources Information Center

Zink, Therese; Halaas, Gwen W.; Finstad, Deborah; Brooks, Kathleen D.

2008-01-01

Context: Changes in health care and new theories of learning have prompted significant changes in medical education. Some US medical schools employ immersion learning in rural communities to increase the number of physicians who choose to practice in these areas. Founded in 1971, the rural physician associate program (RPAP) is a longitudinal…

Everyday Observations: Developing a Sociological Perspective through a Portfolio Term Project

ERIC Educational Resources Information Center

Johnson, David R.; Renzulli, Linda; Bunch, Jackson; Paino, Maria

2013-01-01

We describe a semester-long active learning project in which students practice the skills of synthesis and analysis by developing portfolios organized around a topic of their own choosing (relevant to their substantive course). We build on prior contributions in four ways. First, we offer a project that is indicative of basic skills in the…

Item Response Models for Examinee-Selected Items

ERIC Educational Resources Information Center

Wang, Wen-Chung; Jin, Kuan-Yu; Qiu, Xue-Lan; Wang, Lei

2012-01-01

In some tests, examinees are required to choose a fixed number of items from a set of given items to answer. This practice creates a challenge to standard item response models, because more capable examinees may have an advantage by making wiser choices. In this study, we developed a new class of item response models to account for the choice…

Real Jobs for Real People. An Employer's Guide to Youth Apprenticeship.

ERIC Educational Resources Information Center

Byrne, Sandra; And Others

Based on the experience of the National Alliance of Business' youth apprenticeship program (the Quality Connection Consortium), this guide offers practical advice on how employers can begin a youth apprenticeship program that will serve their labor needs. It addresses the internal support that a business must generate and gives tips on choosing an…

The African American Student's Guide to Surviving Graduate School. Graduate Survival Skills, Volume 5.

ERIC Educational Resources Information Center

Isaac, Alicia

This book offers African American graduate students practical advice concerning all aspects of graduate study. It is organized into 11 chapters which address the following topics: (1) what graduate school is, advanced degrees, and the importance for African Americans of obtaining graduate degrees; (2) choosing a graduate school and financing…

Helping Students with Autism Spectrum Disorder at the Community College: What Does the Research Say? What Can You Do?

ERIC Educational Resources Information Center

Highlen, Douglas

2017-01-01

While more and more individuals with Autism Spectrum Disorders (ASD) are choosing to pursue higher education, comparatively little research has been conducted on the success of these students. Even less practical information has been developed and promulgated to classroom educators. This article reviews trade publications, peer-reviewed journal…

Graduate Student Dissonance: Graduate Students of Color in a U. S. Research University

ERIC Educational Resources Information Center

Levin, John S.; Jaeger, Audrey J.; Haley, Karen J.

2013-01-01

This qualitative investigation examined the experiences of a population of graduate students--graduate students of color--in a U. S. research university (a) to indicate reasons for their dilemmas, ambiguities, and decisions about choosing an academic career, and (b) to identify the practices of one research university's graduate programs that have…

Cultivating Change: Disseminating Innovation in Higher Education Teaching and Learning

ERIC Educational Resources Information Center

Gannaway, Deanne; Hinton, Tilly; Berry, Bianca; Moore, Kaitlin

2013-01-01

Effective dissemination is crucial if innovation and development in teaching and learning in higher education are to lead to sustainable changes in practice. In 2003, King used an agricultural metaphor to challenge innovators to understand the purposes behind their dissemination aims. Similar to the way that seed can be spread, one could choose to…

The Advantages and Disadvantages of Five Common Computer Assisted Instruction Modes.

ERIC Educational Resources Information Center

Davidson, Robert L.; Traylor, Karen

1987-01-01

This article reviews five modes of computer-assisted software so that teachers will be more aware of them and use computers more in their classrooms. The five modes are the following: (1) drill and practice; (2) tutorial; (3) simulation; (4) demonstration; and (5) instructional games. Teachers should review softwares and choose those that meet…

Evaluating Educational Practices for Positively Affecting Student Perceptions of a Sales Career

ERIC Educational Resources Information Center

Cummins, Shannon; Peltier, James W.; Pomirleanu, Nadia; Cross, James; Simon, Rob

2015-01-01

Despite demand for new graduates seeking a sales position, student reticence toward pursuing a sales career remains. While all students will not choose a sales career, diminishing the existence of sales-related misconceptions among the student population should establish sales as a viable career path for a larger number of students. We test six…

Toward Best Practices in Analyzing Datasets with Missing Data: Comparisons and Recommendations

ERIC Educational Resources Information Center

Johnson, David R.; Young, Rebekah

2011-01-01

Although several methods have been developed to allow for the analysis of data in the presence of missing values, no clear guide exists to help family researchers in choosing among the many options and procedures available. We delineate these options and examine the sensitivity of the findings in a regression model estimated in three random…

Principles of Classroom Management: A Professional Decision-Making Model, 7th Edition

ERIC Educational Resources Information Center

Levin, James; Nolan, James F.

2014-01-01

This text takes a decision-making model approach to classroom management. It provides teachers with a very practical system to influence students to choose to behave productively and to strive for academic success. This widely used text presents an array of decision-making options that guide teachers in developing positive, pro-social classroom…

Are You Ready to Assess Social and Emotional Development? SEL Solutions Tools Index

ERIC Educational Resources Information Center

American Institutes for Research, 2015

2015-01-01

Assessing individuals' social and emotional (SE) knowledge, attitudes, and skills is a complex task. It requires careful consideration of the assessment purpose, rigor, practicality, burden, and ethics. Once you have considered these factors and have determined that you are, in fact, "Ready to Assess," you are ready to act and choose an…

"Other" Boys: Negotiating Non-Hegemonic Masculinities in the Primary School

ERIC Educational Resources Information Center

Renold, Emma

2004-01-01

Focusing on the experiences of boys who choose not to cultivate their masculinities through hegemonic discourses and practices, this paper seeks to empirically explore and theorize the extent to which it is possible to live out the category 'boy' in non-hegemonic ways in the primary school setting. Drawing upon a year-long ethnography of…

Choosing Assessment Instruments for Depression Outcome Research with School-Age Youth

ERIC Educational Resources Information Center

Muller, Brooke E.; Erford, Bradley T.

2012-01-01

Using effect size results from Erford et al.'s (2011) meta-analysis for treatment of depression in school-age youth, the authors analyzed 6 commonly used instruments for practical and technical strengths and weaknesses. Effect size estimates from these 6 instruments were compared to indicate likely results when used in future depression outcome…

The Rise of the Teleworker: False Promises and Responsive Solutions

ERIC Educational Resources Information Center

Kanuka, Heather; Jugdev, Kam; Heller, Robert; West, Dan

2008-01-01

The purpose of this exploratory study was to gain a better understanding of how to provide learning opportunities to improve teaching practices for the increasing numbers of academics who are choosing to work online from remote offices, sometimes called e-academics, remote workers, or teleworkers. The objectives of the study were twofold: (1) to…

Impacts of Metal Detector Use in Schools: Insights from 15 Years of Research

ERIC Educational Resources Information Center

Hankin, Abigail; Hertz, Marci; Simon, Thomas

2011-01-01

Background: Multiple approaches exist, both in theory and in practice, to reduce young people's risk of violent victimization when they are in school. Among these approaches, a growing number of school districts are choosing to install metal detectors. We sought to review the literature available on the impacts of metal detectors on school…

AV Instructional Materials Manual; A Sslf-Instructional Guide to AV Laboratory Experiences. Third Edition.

ERIC Educational Resources Information Center

Brown, James W., Ed.; Lewis, Richard B., Ed.

This self-instructional guide to audiovisual laboratory experiences contains 50 exercises designed to give the user active experiences in the practical problems of choosing, using, and inventing instructional materials and in operating and audiovisual equipment. With the exception of the first four exercises (which introduce the user to the manual…

Children Who Choose Not to Eat Meat: A Study of Early Moral Decision-Making

ERIC Educational Resources Information Center

Hussar, Karen M.; Harris, Paul L.

2010-01-01

Can young children frame their own choices in terms of moral considerations, particularly when those choices do not match the practices of immediate authority figures? To answer this question, we studied 6- to 10-year-old independent vegetarians--children who have elected to become vegetarians, despite being raised in non-vegetarian families. In…

Enhancing Academic Engagement: Providing Opportunities for Responding and Influencing Students to Choose to Respond

ERIC Educational Resources Information Center

Skinner, Christopher H.; Pappas, Danielle N.; Davis, Kai A.

2005-01-01

Although educators often provide opportunities for students to engage in active academic responding, in many situations, students either cannot or will not respond. In the current article, we analyze the reasons students fail to respond. Practical procedures educators can use to prevent "can't do" problems are provided. "Won't do" problems are…

Using Media Advocacy to Promote Detention Reform: A Practice Guide to Juvenile Detention Reform

ERIC Educational Resources Information Center

Annie E. Casey Foundation, 2009

2009-01-01

Written specifically for juvenile justice advocates and officials, this handbook provides step-by-step media approaches to promote the system reforms achieved through the Juvenile Detention Alternatives Initiative (JDAI). Those interested in learning all the nuts and bolts of media advocacy may choose to read this guide from cover to cover. Others…

Opting in and Creating Demand: Why Young People Choose to Teach Mathematics to Each Other

ERIC Educational Resources Information Center

Tucker-Raymond, Eli; Lewis, Naama; Moses, Maisha; Milner, Chad

2016-01-01

Access to science, technology, engineering, and mathematics fields serves as a key entry point to economic mobility and civic enfranchisement. Such access must take seriously the intellectual power of the knowledge and practices of non-dominant youth. In our case, this has meant to shift epistemic authority in mathematics from academic…

A Sense of Place: Rural Training at a Regional Medical School Campus

ERIC Educational Resources Information Center

Crump, William J.; Barnett, Darel; Fricker, Steve

2004-01-01

Traditionally, rural students experience urban disruption during the many years of education and training in urban environments before choosing a practice site. Regional rural campuses that allow students to live and work in small towns during the last 2 years of medical school are one strategy to address this issue. Purpose: To report the…

42 CFR 441.20 - Family planning services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Family planning services. 441.20 Section 441.20... General Provisions § 441.20 Family planning services. For recipients eligible under the plan for family... free to choose the method of family planning to be used. ...

42 CFR 441.20 - Family planning services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Family planning services. 441.20 Section 441.20... General Provisions § 441.20 Family planning services. For recipients eligible under the plan for family... free to choose the method of family planning to be used. ...

32 CFR 310.15 - General considerations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... individual's rights, privileges, or benefits under any Federal program. (b) Collecting social security... regardless of the medium used to collect the information (forms, personal interviews, telephonic interviews... mandatory (See paragraph (e) of this section); and (v) The effects on the individual if he or she chooses...

32 CFR 310.15 - General considerations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... individual's rights, privileges, or benefits under any Federal program. (b) Collecting social security... regardless of the medium used to collect the information (forms, personal interviews, telephonic interviews... mandatory (See paragraph (e) of this section); and (v) The effects on the individual if he or she chooses...

32 CFR 310.15 - General considerations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... individual's rights, privileges, or benefits under any Federal program. (b) Collecting social security... regardless of the medium used to collect the information (forms, personal interviews, telephonic interviews... mandatory (See paragraph (e) of this section); and (v) The effects on the individual if he or she chooses...

An audit of a cervical smear screening programme.

PubMed

Moodie, P J; Kljakovic, M; McLeod, D K

1989-07-26

An audit of a computer based screening and recall programme in a Wellington group general practice is reported (practice population 13,866). The records of all women aged between 20 and 59 years (4133 women) were checked to determine if they had had a cervical smear test in the previous two years. A random sample of women who had a cervical smear result recorded in the notes (107 women called "responders") showed that 71% gave "familiarity with the family doctor" and "acting in response to a recall letter" as reasons for choosing the place of their last smear. Satisfaction with the service was indicated by 95% of these women stating they would have their next smear at the medical centre. In the audit of all the records, a group of 667 women who had been sent a letter inviting them to have a smear done and who had apparently declined the procedure was identified (called "nonresponders"). A random sample of this group (168 women) was taken and an attempt made to interview them. In fact only 38 women could be identified as requiring a smear and even if those who refused to be interviewed (13) and those unable to be contacted (23) are added, then less than half of this sample were "true nonresponders". This suggests that the percentage of women in the practice who have been offered a smear and have refused to have one is less than 8%.

Sharing best practices in teaching biomedical engineering design.

PubMed

Allen, R H; Acharya, S; Jancuk, C; Shoukas, A A

2013-09-01

In an effort to share best practices in undergraduate engineering design education, we describe the origin, evolution and the current status of the undergraduate biomedical engineering design team program at Johns Hopkins University. Specifically, we describe the program and judge the quality of the pedagogy by relating it to sponsor feedback, project outcomes, external recognition and student satisfaction. The general pedagogic practices, some of which are unique to Hopkins, that have worked best include: (1) having a hierarchical team structure, selecting team leaders the Spring semester prior to the academic year, and empowering them to develop and manage their teams, (2) incorporating a longitudinal component that incudes freshmen as part of the team, (3) having each team choose from among pre-screened clinical problems, (4) developing relationships and fostering medical faculty, industry and government to allow students access to engineers, clinicians and clinical environments as needed, (5) providing didactic sessions on topics related to requirements for the next presentation, (6) employing judges from engineering, medicine, industry and government to evaluate designs and provide constructive criticisms approximately once every 3-4 weeks and (7) requiring students to test the efficacy of their designs. Institutional support and resources are crucial for the design program to flourish. Most importantly, our willingness and flexibility to change the program each year based on feedback from students, sponsors, outcomes and judges provides a mechanism for us to test new approaches and continue or modify those that work well, and eliminate those that did not.

Understanding continuous professional development participation and choice of mid-career general dental practitioners.

PubMed

Brown, T; Wassif, H S

2017-02-01

Participating in continuing professional development (CPD) activities is a requirement for dental practitioners to keep their skills and knowledge up to date. Understanding the ways dental practitioners engage with professional development and the impact on practice is not fully known (Eaton et al. 2011, http://www.gdc-uk.org/Aboutus/policy/Documents/Impact%20Of%20CPD%20In%20Dentistry.pdf). The aim of this study was to gain insights into the ways that dentists reflect on their professional development and what may be influencing their choices. Empirical qualitative data were collected by semi-structured interviewing of five mid-career dentists. Using grounded theory, the data were analysed for themes about CPD choice and participation. Three themes were identified as influences to dentists' choices of CPD with pragmatic considerations of how new learning could benefit their patients and their practices. Dental practitioners were influenced by the requirements of external regulatory bodies which they did not consider to necessarily improve practice. Dentists working in primary care in the UK are undertaking CPD which is influenced by the pragmatic requirements of running a small business and to meet regulatory requirements. In this sample, dentists are not critically reflecting on their education needs when choosing their CPD activity. Protected learning time and organisational feedback and support are recommended as a way to promote more meaningful reflection on learning and to improve professional development. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Guidelines for seizure management in palliative care: Proposal for an updated clinical practice model based on a systematic literature review.

PubMed

León Ruiz, M; Rodríguez Sarasa, M L; Sanjuán Rodríguez, L; Pérez Nieves, M T; Ibáñez Estéllez, F; Arce Arce, S; García-Albea Ristol, E; Benito-León, J

2017-02-27

Very little has been written on seizure management in palliative care (PC). Given this situation, and considering the forthcoming setting up of the Palliative Care Unit at our neurorehabilitation centre, the Clínica San Vicente, we decided to establish a series of guidelines on the use of antiepileptic drugs (AEDs) for handling seizures in PC. We conducted a literature search in PubMed to identify articles, recent manuals, and clinical practice guidelines on seizure management in PC published by the most relevant scientific societies. Clinical practice guidelines are essential to identify patients eligible for PC, manage seizures adequately, and avoid unnecessary distress to these patients and their families. Given the profile of these patients, we recommend choosing AEDs with a low interaction potential and which can be administered by the parenteral route, preferably intravenously. Diazepam and midazolam appear to be the most suitable AEDs during the acute phase whereas levetiracetam, valproic acid, and lacosamide are recommended for refractory cases and long-term treatment. These guidelines provide general recommendations that must be adapted to each particular clinical case. Nevertheless, we will require further well-designed randomised controlled clinical trials including large samples of patients eligible for PC to draft a consensus document recommending adequate, rational, and effective use of AEDs, based on a high level of evidence, in this highly complex area of medical care. Copyright © 2017 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.

Choosing the Right Systems Integration

NASA Astrophysics Data System (ADS)

Péči, Matúš; Važan, Pavel

2014-12-01

The paper examines systems integration and its main levels at higher levels of control. At present, the systems integration is one of the main aspects participating in the consolidation processes and financial flows of a company. Systems Integration is a complicated emotionconsuming process and it is often a problem to choose the right approach and level of integration. The research focused on four levels of integration, while each of them is characterized by specific conditions. At each level, there is a summary of recommendations and practical experience. The paper also discusses systems integration between the information and MES levels. The main part includes user-level integration where we describe an example of such integration. Finally, we list recommendations and also possible predictions of the systems integration as one of the important factors in the future.

Selecting a Laboratory Information Management System for Biorepositories in Low- and Middle-Income Countries: The H3Africa Experience and Lessons Learned

PubMed Central

Musinguzi, Henry; Lwanga, Newton; Kezimbira, Dafala; Kigozi, Edgar; Katabazi, Fred Ashaba; Wayengera, Misaki; Joloba, Moses Lutaakome; Abayomi, Emmanuel Akin; Swanepoel, Carmen; Croxton, Talishiea; Ozumba, Petronilla; Thankgod, Anazodo; van Zyl, Lizelle; Mayne, Elizabeth Sarah; Kader, Mukthar; Swartz, Garth

2017-01-01

Biorepositories in Africa need significant infrastructural support to meet International Society for Biological and Environmental Repositories (ISBER) Best Practices to support population-based genomics research. ISBER recommends a biorepository information management system which can manage workflows from biospecimen receipt to distribution. The H3Africa Initiative set out to develop regional African biorepositories where Uganda, Nigeria, and South Africa were successfully awarded grants to develop the state-of-the-art biorepositories. The biorepositories carried out an elaborate process to evaluate and choose a laboratory information management system (LIMS) with the aim of integrating the three geographically distinct sites. In this article, we review the processes, African experience, lessons learned, and make recommendations for choosing a biorepository LIMS in the African context.

How to know and choose online games: differences between current and potential players.

PubMed

Teng, Ching-I; Lo, Shao-Kang; Wang, Pe-Cheng

2007-12-01

This study investigated how different adolescent players acquire game information and the criteria they use in choosing online games and found that (1) current players generally use comprehensive information sources more than potential players do; (2) current players rely on free trials and smooth display of motion graphics as choice criteria more than potential players do; (3) potential players rely on the look of advertisements more than current players do; (4) both current and potential players most likely use word-of-mouth and gaming programs on TV as information sources; and (5) endorser attractiveness is ranked the least important among six choice criteria by both current and potential players.

Business intelligence for the radiologist: making your data work for you.

PubMed

Cook, Tessa S; Nagy, Paul

2014-12-01

Although it remains absent from most programs today, business intelligence (BI) has become an integral part of modern radiology practice management. BI facilitates the transition away from lack of understanding about a system and the data it produces toward incrementally more sophisticated comprehension of what has happened, could happen, and should happen. The individual components that make up BI are common across industries and include data extraction and transformation, process analysis and improvement, outcomes measures, performance assessment, graphical dashboarding, alerting, workflow analysis, and scenario modeling. As in other fields, these components can be directly applied in radiology to improve workflow, throughput, safety, efficacy, outcomes, and patient satisfaction. When approaching the subject of BI in radiology, it is important to know what data are available in your various electronic medical records, as well as where and how they are stored. In addition, it is critical to verify that the data actually represent what you think they do. Finally, it is critical for success to identify the features and limitations of the BI tools you choose to use and to plan your practice modifications on the basis of collected data. It is equally important to remember that BI plays a critical role in continuous process improvement; whichever BI tools you choose should be flexible to grow and evolve with your practice. Published by Elsevier Inc.

Individualized Materials for the Handicapped: A Guide for Selection.

ERIC Educational Resources Information Center

Eastern Pennsylvania Regional Resources Center for Special Education, King of Prussia.

Intended for teachers of the handicapped, the booklet provides a guide for choosing individualized instructional materials. Materials are noted to generally fall into six program categories: reading, mathematics, language arts, social studies, science, and other resources. Information on each instructional kit/program (listed alphabetically under…

21 CFR 209.11 - Dispensing and distributing the side effects statement.

Code of Federal Regulations, 2011 CFR

2011-04-01

... SERVICES (CONTINUED) DRUGS: GENERAL REQUIREMENT FOR AUTHORIZED DISPENSERS AND PHARMACIES TO DISTRIBUTE A...) Each authorized dispenser or pharmacy must distribute the side effects statement with each prescription... distributed with new and refill prescriptions. (b) An authorized dispenser or pharmacy must choose one or more...

21 CFR 209.11 - Dispensing and distributing the side effects statement.

Code of Federal Regulations, 2013 CFR

2013-04-01

... SERVICES (CONTINUED) DRUGS: GENERAL REQUIREMENT FOR AUTHORIZED DISPENSERS AND PHARMACIES TO DISTRIBUTE A...) Each authorized dispenser or pharmacy must distribute the side effects statement with each prescription... distributed with new and refill prescriptions. (b) An authorized dispenser or pharmacy must choose one or more...

21 CFR 209.11 - Dispensing and distributing the side effects statement.

Code of Federal Regulations, 2010 CFR

2010-04-01

... SERVICES (CONTINUED) DRUGS: GENERAL REQUIREMENT FOR AUTHORIZED DISPENSERS AND PHARMACIES TO DISTRIBUTE A...) Each authorized dispenser or pharmacy must distribute the side effects statement with each prescription... distributed with new and refill prescriptions. (b) An authorized dispenser or pharmacy must choose one or more...

21 CFR 209.11 - Dispensing and distributing the side effects statement.

Code of Federal Regulations, 2014 CFR

2014-04-01

... SERVICES (CONTINUED) DRUGS: GENERAL REQUIREMENT FOR AUTHORIZED DISPENSERS AND PHARMACIES TO DISTRIBUTE A...) Each authorized dispenser or pharmacy must distribute the side effects statement with each prescription... distributed with new and refill prescriptions. (b) An authorized dispenser or pharmacy must choose one or more...

21 CFR 209.11 - Dispensing and distributing the side effects statement.

Code of Federal Regulations, 2012 CFR

2012-04-01

... SERVICES (CONTINUED) DRUGS: GENERAL REQUIREMENT FOR AUTHORIZED DISPENSERS AND PHARMACIES TO DISTRIBUTE A...) Each authorized dispenser or pharmacy must distribute the side effects statement with each prescription... distributed with new and refill prescriptions. (b) An authorized dispenser or pharmacy must choose one or more...

Gendered Post-Compulsory Educational Choices of Non-Heterosexual Youth

ERIC Educational Resources Information Center

Lehtonen, Jukka

2010-01-01

Gender and socio-economic background are widely acknowledged factors influencing the educational choices of young people. Following their compulsory education, young people in Finland choose between academically oriented general upper secondary schools and vocational upper secondary schools. Gender and class intertwine in these choices in many…

Waiting in the surgery.

PubMed

Fry, F

1994-07-01

The concise Oxford English Dictionary defines 'dilemma' as an argument forcing one to choose one of two alternatives, both of which are unfavourable. This is a situation that frequently confronts the general practitioner. This paper will present one practitioner's view on the subject of patients waiting to see the doctor.

Learning Resources Evaluation: A Considerate Framework for Educators. How Teachers Can Choose Appropriate Materials for Integrated Classrooms.

ERIC Educational Resources Information Center

Peat, David; And Others

1997-01-01

Stresses the importance of designing and evaluating curriculum in terms of student learning characteristics; overviews principles for analyzing the level of "curricular" mediation of instructional materials (contextualization, concretization, controlled redundancy, student engagement); and reviews general learning characteristics of…

[Practical advices in choosing local anesthesia tools in dentistry. Management of carpule's quality in local anesthesia in dentistry].

PubMed

Kuzin, A V

2014-01-01

The equipment for local anesthesia is described in this article. Practical recommendations for the selection of the injection needle length, size, bevel type is given. Using dental needle for local anesthesia should be guided by the "one injection - one needle" rule, as a needle tends to deform by even the slightest contact with jawbone. Some of the shortcomings of carpule quality may be detected before use: signs of cup corrosion, the presence of sediment, air bubbles, rubber plunger disposition. In the case of such defects being identified all the package should not be used. The use of such carpule in clinical practice is unsafe.

Why do you keep them there? A qualitative assessment of firearms storage practices.

PubMed

Barton, Benjamin K; Kologi, Susan M

2015-01-01

Thousands of children are killed or injured each year in the United States after gaining access to firearms. Storage methods are inconsistent and influenced by various contextual factors in the home. We explored reasons underlying parents' choices of firearm storage. Thirty individuals were interviewed regarding firearm storage methods used in their homes and reasons for choosing those methods. Storage practices varied within and across households. Qualitative results suggested that storage practices were related to child presence and age, intended use of firearms, and perception of risk associated with potential access by unsafe individuals. Implications for injury prevention are discussed. Copyright © 2015 Elsevier Inc. All rights reserved.

Commitment to Celibacy in German Catholic Priests: Its Relation to Religious Practices, Psychosomatic Health and Psychosocial Resources.

PubMed

Baumann, Klaus; Jacobs, Christoph; Frick Sj, Eckhard; Büssing, Arndt

2017-04-01

We aimed to investigate Catholic priests' commitment to celibacy and its relation to their religious practices, life and work satisfaction, and psychosomatic health. Results of our cross-sectional study of 2549 priests show that the majority finds living in celibacy helpful to minister more effectively. Nevertheless, a large proportion see it as a burden and would not choose celibate life again. Commitment to celibacy was predicted best by the frequency of religious practices (liturgy), work engagement and personal relation with God, explaining 39 % of variance. These resources are predictors for maintaining a celibate lifestyle and facilitate priests' satisfaction with life and commitment to their ministry.

Transfer-of-Care Communication: Nursing Best Practices.

PubMed

Chard, Robin; Makary, Martin A

2015-10-01

The successful and safe transfer of the patient from one phase of care to another is contingent on optimal communication by all team members. Nurses are often in a natural leadership position to improve safe practices during hand overs. A holistic understanding of the patient allows the perioperative nurse the opportunity to identify issues and choose a nursing diagnosis based on key elements of a patient's needs and goals--information that should be relayed during patient transfers. This article reviews best practices in transfer-of-care communication to enable perioperative RNs to take an active, leading role in hand-over processes. Copyright © 2015 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Follow-up on family practice residents' perspectives on length and content of training.

PubMed

Duane, Marguerite; Dovey, Susan M; Klein, Lisa S; Green, Larry A

2004-01-01

The structure of family practice residency programs remains essentially unchanged from the model first proposed more than 35 years ago. Advances in medical technology and knowledge combined with increasing restrictions on resident work hours and decreasing medical student interest invite reconsideration of how family physicians are trained. We resurveyed 442 third-year family practice residents who had participated in a prior study in 2000 to determine whether their opinions about the length and content of residency had changed and whether they would still choose to be a physician and a family physician. Thirty-seven percent of responding third-year residents favored extending family practice residency to 4 years. Compared as groups, there was relatively little change in opinion between first- and third-year residents. However, residents' individual responses about the settings and content areas for which they would be willing to consider extending training varied considerably between years 1 and 3. Personal characteristics did not seem to influence residents' opinions about length and content of training. Reasons for favoring a 4-year program and barriers to change were similar to those reported previously. Residents' commitment to medicine and family medicine was still strong and was not associated with their opinions about length of training. Although most surveyed residents favored a 3-year residency program, a substantial minority still supported extending training to 4 years, and the majority would still choose to enter family medicine programs if they were extended. Given a lack of consensus about specific content areas, family medicine should consider a period of experimentation to determine how to best prepare future family physicians.

Precommitting to choose wisely about low-value services: a stepped wedge cluster randomised trial.

PubMed

Kullgren, Jeffrey Todd; Krupka, Erin; Schachter, Abigail; Linden, Ariel; Miller, Jacquelyn; Acharya, Yubraj; Alford, James; Duffy, Richard; Adler-Milstein, Julia

2018-05-01

Little is known about how to discourage clinicians from ordering low-value services. Our objective was to test whether clinicians committing their future selves (ie, precommitting) to follow Choosing Wisely recommendations with decision supports could decrease potentially low-value orders. We conducted a 12-month stepped wedge cluster randomised trial among 45 primary care physicians and advanced practice providers in six adult primary care clinics of a US community group practice.Clinicians were invited to precommit to Choosing Wisely recommendations against imaging for uncomplicated low back pain, imaging for uncomplicated headaches and unnecessary antibiotics for acute sinusitis. Clinicians who precommitted received 1-6 months of point-of-care precommitment reminders as well as patient education handouts and weekly emails with resources to support communication about low-value services.The primary outcome was the difference between control and intervention period percentages of visits with potentially low-value orders. Secondary outcomes were differences between control and intervention period percentages of visits with possible alternate orders, and differences between control and 3-month postintervention follow-up period percentages of visits with potentially low-value orders. The intervention was not associated with a change in the percentage of visits with potentially low-value orders overall, for headaches or for acute sinusitis, but was associated with a 1.7% overall increase in alternate orders (p=0.01). For low back pain, the intervention was associated with a 1.2% decrease in the percentage of visits with potentially low-value orders (p=0.001) and a 1.9% increase in the percentage of visits with alternate orders (p=0.007). No changes were sustained in follow-up. Clinician precommitment to follow Choosing Wisely recommendations was associated with a small, unsustained decrease in potentially low-value orders for only one of three targeted conditions and may have increased alternate orders. NCT02247050; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Impact of peer delivered wellness coaching.

PubMed

Swarbrick, Margaret; Gill, Kenneth J; Pratt, Carlos W

2016-09-01

People receiving publicly funded behavioral health services for severe mental disorders have shorter lifespans and significantly impaired health-related quality of life compared to the general population. The aim of this article was to explore how peer wellness coaching (PWC), a manualized approach to pursue specific physical wellness goals, impacted goal attainment and overall health related quality of life. Deidentified archival program evaluation data were examined to explore whether peer delivered wellness coaching had an impact on 33 service recipients with regard to goal attainment and health-related quality of life. Participants were served by 1 of 12 wellness coach trainees from a transformation transfer initiative grant who had been trained in the manualized approach. Coaching participants and their coaches reported significant progress toward the attainment of individually chosen goals, 2 to 4 weeks after establishing their goals. After 8 to 10 weeks of peer delivered wellness coaching, improvements were evident in the self-report of physical health, general health, and perceived health. These improvements were sustained 90 days later. PWC is potentially a promising practice for helping people choose and pursue individual goals and facilitating positive health and wellness changes. Rigorous controlled research with larger samples is needed to evaluate the benefits of peer delivered wellness coaching. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Intensive Language Action Therapy in Chronic Aphasia: A Randomized Clinical Trial Examining Guidance by Constraint

PubMed Central

Stanek,, Edward J.; Stokes, Polly; Li, Minming; Andrianopoulos, Mary

2016-01-01

Purpose Intensive language action therapy (ILAT) can be effective in overcoming learned nonuse in chronic aphasia. It is suggested that all three guiding principles (constraint, communication embedding, massed practice) are essential to ILAT's success. We examined whether one of these, guidance by constraint, is critical. Method Twenty-four participants with aphasia (PWAs) were assigned to ILAT or a modified version of promoting aphasic communicative effectiveness (PACE) in a randomized block, single-blind, parallel-group treatment study. Blocking was by severity (mild/moderate, moderate to severe, severe). Both groups received intensive treatment in the context of therapeutic language action games. Whereas the ILAT group was guided toward spoken responses, the PACE group could choose any response modality. Results All participants, whether assigned to ILAT or PACE groups, improved on the primary outcome measure, picture naming. There was a Severity × Treatment interaction, with the largest effects estimated for PWAs with mild/moderate and moderate to severe aphasia. Regardless of severity, the ILAT group outperformed the PACE group on untrained pictures, suggesting some benefit of ILAT to generalization. However, this difference was not statistically significant. Conclusion Although the groups differed in subtle ways, including better generalization to untrained pictures for ILAT, the study was inconclusive on the influence of guidance by constraint. PMID:27997954

Bayesian Optimal Interval Design: A Simple and Well-Performing Design for Phase I Oncology Trials

PubMed Central

Yuan, Ying; Hess, Kenneth R.; Hilsenbeck, Susan G.; Gilbert, Mark R.

2016-01-01

Despite more than two decades of publications that offer more innovative model-based designs, the classical 3+3 design remains the most dominant phase I trial design in practice. In this article, we introduce a new trial design, the Bayesian optimal interval (BOIN) design. The BOIN design is easy to implement in a way similar to the 3+3 design, but is more flexible for choosing the target toxicity rate and cohort size and yields a substantially better performance that is comparable to that of more complex model-based designs. The BOIN design contains the 3+3 design and the accelerated titration design as special cases, thus linking it to established phase I approaches. A numerical study shows that the BOIN design generally outperforms the 3+3 design and the modified toxicity probability interval (mTPI) design. The BOIN design is more likely than the 3+3 design to correctly select the maximum tolerated dose (MTD) and allocate more patients to the MTD. Compared to the mTPI design, the BOIN design has a substantially lower risk of overdosing patients and generally a higher probability of correctly selecting the MTD. User-friendly software is freely available to facilitate the application of the BOIN design. PMID:27407096

Comparison of female and male graduates of southern Appalachian family practice residencies.

PubMed

Rosenfeld, J A; Zaborlik, P M

1996-11-01

One aim of Southern Appalachian family practice residencies is to produce graduates for surrounding physician-needy areas. Some evidence suggests that women are less likely to go to rural areas and that they practice differently than men. This study investigated the practice patterns and location of Appalachian family practice residency female and male graduates. Surveys were sent to graduates of seven family practice residencies from 1984 to 1994 in the Southern Appalachian area to determine practice patterns, locations, and reasons for choosing practices. Women were more likely than men to be single and not to have children. More women worked part-time. Women's and men's practice patterns and characteristics were similar except that women were more likely to provide prenatal care and do vaginal deliveries. Women in similar percentages practiced in small towns, and a greater percentage of women practiced in rural areas with populations of less than 2,500. Female family practice residency graduates from Appalachian residencies are fulfilling the purposes of their residencies as well as male graduates, although more of them are working part-time.

Gender Associated with the Intention to Choose a Medical Specialty in Medical Students: A Cross-Sectional Study in 11 Countries in Latin America

PubMed Central

Mayta-Tristán, Percy; Pereyra-Elías, Reneé; Montenegro-Idrogo, Juan José; Inga-Berrospi, Fiorella; Ancalli, Felix; Bonilla-Escobar, Francisco; Diaz-Velez, Cristian; Gutierrez-Quezada, Erick; Gomez-Alhach, Jennifer; Muñoz-Medina, Carlos E.; Sanchez-Pozo, Adriana; Vidal, Milisen

2016-01-01

Introduction The selection of a medical specialty has been associated with multiple factors, such as personal preferences, academic exposure, motivational factors and sociodemographic factors, such as gender. The number of women in the medical field has increased in recent years. In Latin America, we have not found any studies that explore this relationship. Objective To determine whether there is an association between gender and the intention to choose a medical specialty in medical students from 11 countries in Latin America. Methods Secondary analysis of the Collaborative Working Group for the Research of Human Resources for Health (Red-LIRHUS) data; a multi-country project of students in their first year and fifth year of study, from 63 medical schools in 11 Latin American countries. All students who referred intention to choose a certain medical specialty were considered as participants. Results Of the 11073 surveyed students, 9235 indicated the name of a specific specialty. The specialties chosen most often in the fifth year were General Surgery (13.0%), Pediatrics (11.0%), Internal Medicine (10.3%) and Obstetrics/Gynecology (9.0%). For women, the top choices were Pediatrics (15.8%), Obstetrics/Gynecology (11.0%), Cardiology (8.7%), General Surgery (8.6%), and Oncology (6.4%). In the adjusted analysis, the female gender was associated with the choice of Obstetrics/Gynecology (RP: 2.75; IC95%: 2.24–3.39); Pediatric Surgery (RP: 2.19; IC95%: 1.19–4.00), Dermatology (RP: 1.91; IC95%:1.24–2.93), Pediatrics (RP: 1.83; IC95%: 1.56–2.17), and Oncology (RP: 1.37; IC95%: 1.10–1.71). Conclusions There is an association between the female gender and the intention to choose Obstetrics/Gynecology, Pediatrics, Pediatric Surgery, Dermatology, and Oncology. We recommend conducting studies that consider other factors that can influence the choice of a medical specialty. PMID:27519055

Designing your office for technology.

PubMed

Unthank, Michael

2004-10-01

To practice efficiently, dentists need to consider the successful integration of technologies, which can benefit their practice of dentistry. The physical environment of the office must be developed to accommodate not only the appropriate placement of computer hardware and high-tech dental devices, but their interconnectivity, as well. Dentists need to make appropriate decisions regarding the types of technology they choose to integrate into their offices, and they need to understand how the technology will be installed and integrated. An office designed to optimize the use of technology will produce ongoing benefits for dentists, their staff members and their patients throughout the lives of their practices. A dentist's practice must be planned to accommodate networks of systems hidden below floors, above ceilings and within walls, as well as to support and connect diverse technology items throughout the office.

Are health journalists' practices tied to their perceptions of audience? An attribution and expectancy-value approach.

PubMed

Hinnant, Amanda; Len-Ríos, María E; Oh, Hyun Jee

2012-01-01

This study examines a national survey of U.S. health journalists (N = 774) to ascertain how journalists' perceptions of audience use of health news shapes their journalistic practices. We establish a framework through attribution theory and expectancy-value theory for how journalists choose to fulfill their roles as providers of health information. Using these theoretical lenses, we look at whether health journalists' audience orientation is associated with their use of accessibility-oriented or credibility-focused practices. Our findings show that, overall, journalists believe readers are individually responsible for their health outcomes and that journalists focus on providing accessibility-oriented information when they feel their audience's ability to understand information may be compromised. Journalists' beliefs about audience behavior are associated with their attitudes toward communication practices.

Job sharing as an employment alternative in group medical practice.

PubMed

Vanek, E P; Vanek, J A

2001-01-01

Although physicians discuss quality-of-life and employment issues with their patients, they often fail to consider flexible scheduling and reduced employment options to lessen their own job stress. We examined one of these options by surveying two community-based, private practice groups with a combined 13-year experience with job sharing. We found that a majority of respondents rated job sharing as successful, and most wanted it to continue. Job sharers derived considerable personal benefit from the arrangement and had significantly more positive attitudes toward work than full-time physicians. Job sharing appeared to have little impact on practice parameters. Dependability, flexibility and willingness to cooperate were the most important attributes in choosing a job-sharing partner. Job sharing is an employment alternative worth exploring to retain physicians in medical group practice.

Make the Most of Every Day: Examine your Practice to Sift out Time Wasters

ERIC Educational Resources Information Center

Powell, William; Kusuma-Powell, Ochan

2015-01-01

It is a truism to say that intelligence and happiness depend almost exclusively on what we choose to pay attention to. However, this is much easier said than done. The individual and collective attention of teachers is often drawn in many different directions. Paying attention to what is truly important is becoming more and more…

Choosing methods and equipment for logging

Treesearch

Fred C. Simmons

1948-01-01

A logging job is one of the most difficult types of business to manage efficiently. In practically everything the logger does he is compelled to make a choice between several methods of operation and types of equipment. The conditions under which he works are constantly changing, particularly when he is forced to move fairly often from one timber tract to another. But...

Presidential Primaries of 1976: Where? When? What? Why? Grass Roots Guides on Democracy and Practical Politics.

ERIC Educational Resources Information Center

Eisenstein, James

The purpose of this guide is to describe primary election changes, clarify some of the questions people ask about primaries, and help readers understand the primaries' role in choosing the president in 1976. Primaries in 1976 differ in three important respects; the number of states that hold primaries has increased substantially, the rules used to…

Ethics in the Classroom: Bridging the Gap between Theory and Practice

ERIC Educational Resources Information Center

Mahoney, Dan

2008-01-01

Examining ourselves, why we do what we do, is the essence of human psychology and of ethics. The purpose of this book is to show how educators might choose among ethical approaches to decision-making as they face the choices they make each day. Features include the theory-based ethics and case studies of real and significant issues that teachers…

What Strategies Do Resistive Readers Use to Fake Their Way through School Assigned Texts?

ERIC Educational Resources Information Center

Krieger, Courtney M.

2012-01-01

A trend among adolescent readers is the practice of fake-reading. Fake-reading occurs when students who can read choose not to, and develop strategies to fake their way through school-assigned texts to earn good grades. This study examines four resistive readers, or fake-readers, assigned to read Neal Shusterman's "Unwind" (2007)…

EFFECTIVE COLLECTION AGENCY USE: THE IMPORTANCE OF INTERNAL POLICIES.

PubMed

Scroggins, Robert C

2014-11-25

Increasing patient accountability for the cost of healthcare means physician practices likely will need to improve their internal collection processes and consider contracting with an outside collection agency. But choosing a good collection agency is the second priority. The first is establishing well-thought-out and specific internal procedures for collecting as much as possible before turning to an outside collection agency.

Real Life Calls for Real Books: Literature to Help Children Cope with Family Stressors

ERIC Educational Resources Information Center

Roberts, Sherron Killingsworth; Crawford, Patricia A.

2008-01-01

This article provides a rationale and related practical suggestions for using literature as a support system for social-emotional development as children cope with the stresses, anxieties, and feelings of loss that can occur in family life. The authors discusses types of books, how to choose them, and how teachers can use authentic literature to…

Selecting Students for Training in Health Care. A Practical Guide to Improving Selection Procedures. WHO Offset Publication No. 74.

ERIC Educational Resources Information Center

Bennett, Mick; Wakeford, Richard

This guide is intended to help those responsible for choosing health care trainees to develop and improve their selection procedures. Special reference is given to health workers in maternal and child health. Chapter 1 deals with health care policy implications for selection of trainees, the different functions of selection and conflicts that…