Professionalization, Ethics, and Fidelity to an Evaluation Ethos

ERIC Educational Resources Information Center

Schwandt, Thomas A.

2017-01-01

Current discussion of the professionalization of the practice of evaluation is focused on matters of competencies and credentialing and largely overlooks several significant issues. These include conflating professionalizing the practice with promoting the value of evaluation as a social good, assuming there is widespread agreement on what the…

Evaluation of Administrators: Issues and Practices. OSSC Bulletin Vol. 19, No. 10.

ERIC Educational Resources Information Center

Wills, Lewis A.

In this review of current practices it is observed that administrators are evaluated for two major purposes--(1) to provide a basis for school districts' decisions at the conclusion of the evaluation period, and (2) to provide feedback on performance to allow administrator improvement. A comparison is made of evaluation material from five school…

Evaluation in New Jersey Education: A Survey of Present Practices and Recommendations for Future Action.

ERIC Educational Resources Information Center

Pinkowski, Francis; And Others

Current evaluation activities in the New Jersey school system are surveyed, and recommendations for future evaluation efforts are made. The current activities and future developments of school (or school district), statewide, and project (or program) evaluation are discussed individually. The following program objectives are suggested: to raise…

Cervical Screening for Women with Learning Disability: Current Practice and Attitudes within Primary Care in Edinburgh

ERIC Educational Resources Information Center

Wood, Rachael; Douglas, Margaret

2007-01-01

This study aimed to evaluate current practice in, and to explore primary care professionals' views about, providing cervical screening to women with learning disability, in two areas of Edinburgh. A postal questionnaire was sent to all 24 GP practices in the project area: 20 responded. Seven respondents were invited to participate in follow up…

Development and evaluation of best management practices (BMPS) for highway runoff pollution control.

DOT National Transportation Integrated Search

2013-12-01

Polluted storm water runoff is commonly transported through Municipal Separate Storm Sewer Systems (MS4s). Currently, : sufficient information is not available on development and evaluation of Best Management Practices (BMPs) within an MS4 : boundary...

Current Evaluation Practices of Diversity Trainers in German-Speaking Countries

ERIC Educational Resources Information Center

Rohmann, Anette; Froncek, Benjamin; Mazziotta, Agostino; Piper, Verena

2017-01-01

Diversity training has been greatly expanded in recent years in order to help people deal with the challenges of increased social diversity. However, little is known about the systematic evaluation of diversity training. The present research surveyed 172 diversity trainers concerning their evaluation practices with regard to diversity training.…

Evaluating educational interventions for information literacy.

PubMed

Stevenson, Paul

2012-03-01

This article considers how information literacy training initiatives delivered by health library services are evaluated. It presents three validated assessment and evaluation models, and using examples from practice, discusses how these can be used to establish the impact of information literacy training and to improve current evaluation practices. HS. © 2012 The authors. Health Information and Libraries Journal © 2012 Health Libraries Group.

A View of Current Evaluative Practices in Instrumental Music Teacher Education

ERIC Educational Resources Information Center

Peterson, Amber Dahlén

2014-01-01

The purpose of this study was to examine how instrumental music educator skills are being evaluated in current undergraduate programs. While accrediting organizations mandate certain elements of these programs, they provide limited guidance on what evaluative approaches should be used. Instrumental music teacher educators in the College Music…

3 CFR - Demonstration Grants for the Development, Implementation, and Evaluation of Alternatives to the...

Code of Federal Regulations, 2010 CFR

2010-01-01

..., Implementation, and Evaluation of Alternatives to the Current Medical Liability System Presidential Documents..., Implementation, and Evaluation of Alternatives to the Current Medical Liability System Memorandum for the... report that fear of lawsuits leads them to practice defensive medicine, which may contribute to higher...

Critical evaluation of international health programs: Reframing global health and evaluation.

PubMed

Chi, Chunhuei; Tuepker, Anaïs; Schoon, Rebecca; Núñez Mondaca, Alicia

2018-04-01

Striking changes in the funding and implementation of international health programs in recent decades have stimulated debate about the role of communities in deciding which health programs to implement. An important yet neglected piece of that discussion is the need to change norms in program evaluation so that analysis of community ownership, beyond various degrees of "participation," is seen as central to strong evaluation practices. This article challenges mainstream evaluation practices and proposes a framework of Critical Evaluation with 3 levels: upstream evaluation assessing the "who" and "how" of programming decisions; midstream evaluation focusing on the "who" and "how" of selecting program objectives; and downstream evaluation, the focus of current mainstream evaluation, which assesses whether the program achieved its stated objectives. A vital tenet of our framework is that a community possesses the right to determine the path of its health development. A prerequisite of success, regardless of technical outcomes, is that programs must address communities' high priority concerns. Current participatory methods still seldom practice community ownership of program selection because they are vulnerable to funding agencies' predetermined priorities. In addition to critiquing evaluation practices and proposing an alternative framework, we acknowledge likely challenges and propose directions for future research. Copyright © 2018 John Wiley & Sons, Ltd.

The Educational Predicament Confronting Taiwan's Gifted Programs: An Evaluation of Current Practices and Future Challenges

ERIC Educational Resources Information Center

Kao, Chen-yao

2012-01-01

This study examines the current problems affecting Taiwan's gifted education through a large-scale gifted program evaluation. Fifty-one gifted classes at 15 elementary schools and 62 gifted classes at 18 junior high schools were evaluated. The primary activities included in this biennial evaluation were document review, observation of…

Crack sealing and filling: best practices.

DOT National Transportation Integrated Search

2015-10-01

This study investigated the current state of practice for crack sealing/filling. In addition, the INDOT crack sealing/filling practice was : experimentally evaluated for the effectiveness of crack sealing/filling, the effectiveness of routing, the pe...

Evaluation of best practices in traffic operations and safety : phase I : flashing LED stop sign and optical speed bars.

DOT National Transportation Integrated Search

2007-01-01

In a previous extensive review of overseas literature, researchers identified 42 traffic operations and safety technologies and practices that were not currently deployed in Virginia. These were evaluated for their potential application in Virginia, ...

Examining Teacher Perceptions of the Relationship between Evaluation Policy and Teacher Practice in a North Carolina School System

ERIC Educational Resources Information Center

Frasier, Amanda Marie Slaten

2017-01-01

Examining the justification for current evaluation policy reveals that such policy rests on two assumptions related to the impact on the work of teachers: (1) evaluations are necessary because teachers need to be rated, sanctioned, or rewarded in order to be motivated to improve their practice; and (2) evaluations yield information that is useful…

Diagnosing acute and prevalent HIV-1 infection in young African adults seeking care for fever: a systematic review and audit of current practice

PubMed Central

Prins, Henrieke A.B.; Mugo, Peter; Wahome, Elizabeth; Mwashigadi, Grace; Thiong'o, Alexander; Smith, Adrian; Sanders, Eduard J.; Graham, Susan M.

2014-01-01

Fever is a common complaint in HIV-1 infected adults and may be a presenting sign of acute HIV-1 infection (AHI). We investigated the extent to which HIV-1 infection was considered in the diagnostic evaluation of febrile adults in sub-Saharan Africa (SSA) through a systematic review of published literature and guidelines in the period 2003–2014. We also performed a detailed audit of current practice for the evaluation of febrile young adults in coastal Kenya. Our review identified 43 studies investigating the aetiology of fever in adult outpatients in SSA. While the guidelines identified recommend testing for HIV-1 infection, none mentioned AHI. In our audit of current practice at nine health facilities, only 189 out of 1173 (16.1%) patients, aged 18–29 years, were tested for HIV-1. In a detailed record review, only 2 out of 39 (5.1%) young adults seeking care for fever were tested for HIV-1, and the possibility of AHI was not mentioned. Available literature on adult outpatients presenting with fever is heavily focused on diagnosing malaria and guidelines are poorly defined in terms of evaluating aetiologies other than malaria. Current practice in coastal Kenya shows poor uptake of provider-initiated HIV-1 testing and AHI is not currently considered in the differential diagnosis. PMID:24842982

Oversight of fare collection practices : summary report

DOT National Transportation Integrated Search

1997-11-01

This report document an oversight study of fare collection practices in the transit industry. The oversight was designed as an investigation of practices currently used in the transit industry to evaluate the impact of farebox revenue collection and ...

School Evaluation: Current Practices in OECD Countries and a Literature Review. OECD Education Working Papers, No. 42

ERIC Educational Resources Information Center

Faubert, Violaine

2009-01-01

This paper examines the current academic and policy literatures concerning school evaluation in primary and secondary education within the OECD countries. First, it provides a typology of the existing systems of school evaluation across the OECD. It encompasses the diverse criteria and instruments commonly used to carry out schools evaluation, as…

Articulating current service development practices: a qualitative analysis of eleven mental health projects

PubMed Central

2014-01-01

Background The utilisation of good design practices in the development of complex health services is essential to improving quality. Healthcare organisations, however, are often seriously out of step with modern design thinking and practice. As a starting point to encourage the uptake of good design practices, it is important to understand the context of their intended use. This study aims to do that by articulating current health service development practices. Methods Eleven service development projects carried out in a large mental health service were investigated through in-depth interviews with six operation managers. The critical decision method in conjunction with diagrammatic elicitation was used to capture descriptions of these projects. Stage-gate design models were then formed to visually articulate, classify and characterise different service development practices. Results Projects were grouped into three categories according to design process patterns: new service introduction and service integration; service improvement; service closure. Three common design stages: problem exploration, idea generation and solution evaluation - were then compared across the design process patterns. Consistent across projects were a top-down, policy-driven approach to exploration, underexploited idea generation and implementation-based evaluation. Conclusions This study provides insight into where and how good design practices can contribute to the improvement of current service development practices. Specifically, the following suggestions for future service development practices are made: genuine user needs analysis for exploration; divergent thinking and innovative culture for idea generation; and fail-safe evaluation prior to implementation. Better training for managers through partnership working with design experts and researchers could be beneficial. PMID:24438471

Articulating current service development practices: a qualitative analysis of eleven mental health projects.

PubMed

Jun, Gyuchan Thomas; Morrison, Cecily; Clarkson, P John

2014-01-17

The utilisation of good design practices in the development of complex health services is essential to improving quality. Healthcare organisations, however, are often seriously out of step with modern design thinking and practice. As a starting point to encourage the uptake of good design practices, it is important to understand the context of their intended use. This study aims to do that by articulating current health service development practices. Eleven service development projects carried out in a large mental health service were investigated through in-depth interviews with six operation managers. The critical decision method in conjunction with diagrammatic elicitation was used to capture descriptions of these projects. Stage-gate design models were then formed to visually articulate, classify and characterise different service development practices. Projects were grouped into three categories according to design process patterns: new service introduction and service integration; service improvement; service closure. Three common design stages: problem exploration, idea generation and solution evaluation - were then compared across the design process patterns. Consistent across projects were a top-down, policy-driven approach to exploration, underexploited idea generation and implementation-based evaluation. This study provides insight into where and how good design practices can contribute to the improvement of current service development practices. Specifically, the following suggestions for future service development practices are made: genuine user needs analysis for exploration; divergent thinking and innovative culture for idea generation; and fail-safe evaluation prior to implementation. Better training for managers through partnership working with design experts and researchers could be beneficial.

Teacher Evaluation in Illinois: School Leaders' Perceptions and Practices

ERIC Educational Resources Information Center

Lavigne, Alyson Leah; Chamberlain, Roger Wade

2017-01-01

The aim of the current study is to assess school leaders' perceptions and practices in the context of a new policy that emphasizes teacher evaluation. The study draws from survey data of 606 K-12 school leaders in the USA in a state implementing a new teacher evaluation model under Race to the Top. Findings illustrate that school leaders spent…

Evaluation of a youth agency's supervision practices: A mixed-method approach.

PubMed

Gosselin, Julie; Valiquette-Tessier, Sophie-Claire; Vandette, Marie-Pier; Romano, Elisa

2015-10-01

This research presents the findings from an evaluation and organizational development initiative that was requested by a Canadian youth agency working in a large urban setting. A team of four researchers affiliated with the Center for Research on Educational and Community Services (CRECS) at the University of Ottawa conducted the evaluation. The purpose of the evaluation was to identify the supervision needs and challenges of coordinators and front line staff, assess the efficiency of the current supervision practices, and evaluate the supervisors' and supervisees' satisfaction with these current practices. A literature review was performed to help provide a clear definition of 'supervision' and the different professional roles it encompasses. Additionally, research evidence pertaining both to what contributes to supervision efficacy and supervisor competency was reviewed to distill the most robust findings in the existing literature. The lines of evidence consisted of a document and file review, an online employee survey, group discussions (i.e. focus groups), and interviews with key informants. The results of the evaluation helped the research team formulate recommendations to the agency for the development of enhanced supervision practices across its various service areas. Copyright © 2015 Elsevier Ltd. All rights reserved.

Evaluation of clinical practice guidelines.

PubMed Central

Basinski, A S

1995-01-01

Compared with the current focus on the development of clinical practice guidelines the effort devoted to their evaluation is meagre. Yet the ultimate success of guidelines depends on routine evaluation. Three types of evaluation are identified: evaluation of guidelines under development and before dissemination and implementation, evaluation of health care programs in which guidelines play a central role, and scientific evaluation, through studies that provide the scientific knowledge base for further evolution of guidelines. Identification of evaluation and program goals, evaluation design and a framework for evaluation planning are discussed. PMID:7489550

Management of tinnitus in English NHS audiology departments: an evaluation of current practice

PubMed Central

Hoare, Derek J; Gander, Phillip E; Collins, Luke; Smith, Sandra; Hall, Deborah A

2012-01-01

Rationale, aim and objective In 2009, the UK Department of Health formalized recommended National Health Service practices for the management of tinnitus from primary care onwards. It is timely therefore to evaluate the perceived practicality, utility and impact of those guidelines in the context of current practice. Methods We surveyed current practice by posting a 36-item questionnaire to all audiology and hearing therapy staff that we were able to identify as being involved in tinnitus patient care in England. Results In total, 138 out of 351 clinicians responded (39% response rate). The findings indicate a consensus opinion that management should be tailored to individual symptom profiles but that there is little standardization of assessment procedures or tools in use. Conclusions While the lack of standardized practice might provide flexibility to meet local demand, it has drawbacks. It makes it difficult to ascertain key standards of best practice, it complicates the process of clinical audit, it implies unequal patient access to care, and it limits the implementation of translational research outcomes. We recommend that core elements of practice should be standardized, including use of a validated tinnitus questionnaires and an agreed pathway for decision making to better understand the rationale for management strategies offered. PMID:21087449

Evaluation of pavement markings under wet-night road conditions : best practices study : draft final report.

DOT National Transportation Integrated Search

2016-05-01

This study was conducted on behalf of the Utah Department of Transportation (UDOT), to identify best practices by other governmental agencies in comparison to UDOTs current practices for the selection of pavement marking materials and produc...

Incorporating Computer-Aided Language Sample Analysis into Clinical Practice

ERIC Educational Resources Information Center

Price, Lisa Hammett; Hendricks, Sean; Cook, Colleen

2010-01-01

Purpose: During the evaluation of language abilities, the needs of the child are best served when multiple types and sources of data are included in the evaluation process. Current educational policies and practice guidelines further dictate the use of authentic assessment data to inform diagnosis and treatment planning. Language sampling and…

Accessibility-based evaluation of transportation and land-use planning : from laboratory to practice : USDOT Region V Regional University Transportation Center final report.

DOT National Transportation Integrated Search

2016-12-16

The concept of accessibility has made inroads into planning practice, largely at the system level. That is, accessibility is measured or modeled for current or future regional transportation and land-use scenarios for evaluation or broad policy guida...

Psychotic Disorders in Learning Disabilities--Outcome of an Audit across Community Teams

ERIC Educational Resources Information Center

Varghese, Susan; Banerjee, Subimal

2011-01-01

The aim of the audit was to evaluate the current clinical practice for learning-disabled individuals with psychotic disorders. We evaluated the existing clinical practice in 910 individuals who were under the care of learning disability psychiatrists in Buckinghamshire (population of 480 000). This was compared with the National Institute for…

A Document Analysis of Teacher Evaluation Systems Specific to Physical Education

ERIC Educational Resources Information Center

Norris, Jason M.; van der Mars, Hans; Kulinna, Pamela; Kwon, Jayoun; Amrein-Beardsley, Audrey

2017-01-01

Purpose: The purpose of this document analysis study was to examine current teacher evaluation systems, understand current practices, and determine whether the instrumentation is a valid measure of teaching quality as reflected in teacher behavior and effectiveness specific to physical education (PE). Method: An interpretive document analysis…

A note on evaluating model tidal currents against observations

NASA Astrophysics Data System (ADS)

Cummins, Patrick F.; Thupaki, Pramod

2018-01-01

The root-mean-square magnitude of the vector difference between modeled and observed tidal ellipses is a comprehensive metric to evaluate the representation of tidal currents in ocean models. A practical expression for this difference is given in terms of the harmonic constants that are routinely used to specify current ellipses for a given tidal constituent. The resulting metric is sensitive to differences in all four current ellipse parameters, including phase.

Practice Patterns of Speech-Language Pathologists in Pediatric Vocal Health.

PubMed

Hartley, Naomi A; Braden, Maia; Thibeault, Susan L

2017-05-17

The purpose of this study was to investigate current practices of speech-language pathologists (SLPs) in the management of pediatric vocal health, with specific analysis of the influence of clinical specialty and workplace setting on management approaches. American Speech-Language-Hearing Association-certified clinicians providing services within the United States (1%-100% voice caseload) completed an anonymous online survey detailing clinician demographics; employment location and service delivery models; approaches to continuing professional development; and specifics of case management, including assessment, treatment, and discharge procedures. Current practice patterns were analyzed for 100 SLPs (0-42 years of experience; 77 self-identifying as voice specialists) providing services in 34 U.S. states across a range of metropolitan and nonmetropolitan workplace settings. In general, SLPs favored a multidisciplinary approach to management; included perceptual, instrumental, and quality of life measures during evaluation; and tailored intervention to the individual using a combination of therapy approaches. In contrast with current practice guidelines, only half reported requiring an otolaryngology evaluation prior to initiating treatment. Both clinical specialty and workplace setting were found to affect practice patterns. SLPs in school settings were significantly less likely to consider themselves voice specialists compared with all other work environments. Those SLPs who considered themselves voice specialists were significantly more likely to utilize voice-specific assessment and treatment approaches. SLP practice largely mirrors current professional practice guidelines; however, potential exists to further enhance client care. To ensure that SLPs are best able to support children in successful communication, further research, education, and advocacy are required.

Research and recommendations for a statewide sign retroreflectivity maintenance program.

DOT National Transportation Integrated Search

2012-04-01

This study evaluated TxDOT's current sign retroreflectivity maintenance practices, assessed their : effectiveness, and recommended statewide sign retroreflectivity maintenance practices that could be easily : and effectively implemented to ensure tha...

Current Practices in Constructing and Evaluating Assurance Cases With Applications to Aviation

NASA Technical Reports Server (NTRS)

Rinehart, David J.; Knight, John C.; Rowanhill, Jonathan

2015-01-01

This report introduces and provides an overview of assurance cases including theory, practice, and evaluation. This report includes a section that introduces the principles, terminology, and history of assurance cases. The core of the report presents twelve example uses of assurance cases from a range of domains, using a novel classification scheme. The report also reviews the state of the art in assurance case evaluation methods.

Development, Implementation, and Evaluation of a Strategic Plan for Improving Physical Plant Management at Southwest Texas Junior College.

ERIC Educational Resources Information Center

Box, Wilford Winston

A study was conducted at Southwest Texas Junior College (STJC) to assess current management practices used by the physical plant maintenance department (PPMD) and to develop a strategic plan for physical plant management. Procedures included an analysis of current management practices and systems that affect physical resources, and periodic and…

Identifying g: A Review of Current Factor Analytic Practices in the Science of Mental Abilities

ERIC Educational Resources Information Center

Reeve, Charlie L.; Blacksmith, Nikki

2009-01-01

Factor analysis is arguably one of the most important tools in the science of mental abilities. While many studies have been conducted to make recommendations regarding "best practices" concerning its use, it is unknown the degree to which contemporary ability researchers abide by those standards. The current study sought to evaluate the typical…

Mental Health Evaluations for Adolescents Prior to Bariatric Surgery: A Review of Existing Practices and a Specific Example of Assessment Procedures.

PubMed

Sysko, Robyn; Zandberg, Laurie J; Devlin, Michael J; Annunziato, Rachel A; Zitsman, Jeffrey L; Walsh, B Timothy

2013-06-01

Best practice guidelines for adolescents considering bariatric surgery recommend a pre-operative mental health evaluation. However, only general information about these assessments appears in the literature, which makes consistency of administration challenging. This review proposes a specific empirically-derived format for pre-surgical mental health evaluations and summarizes currently available data on the psychiatric functioning of adolescents seeking bariatric surgery. Studies of mental health evaluations for adults preparing for bariatric surgery are reviewed, as is the limited literature relevant to adolescent evaluations. A specific and detailed example of an evaluation (clinical interview, self-report questionnaires, cognitive assessment) used for younger patients at a major metropolitan hospital center is presented, followed by data from an initial group of adolescents completing this evaluation. 200 adolescents (n=139 female; age: 14-18 y, BMI: 35.4-83.3 kg/m 2 ) presenting for bariatric surgery. A notable subset of adolescents reported current Axis I conditions (31.5%) and current mental health treatment (29.5%), but reports of current illicit drug use (1.5%) and regular alcohol use (0.5%) were relatively rare. Procedures for using the completed evaluation and post-surgery monitoring of psychosocial issues are discussed. Adolescents considering weight loss surgery should receive comprehensive pre-surgical mental health evaluations, but additional data are needed to develop specific recommendations the use of these evaluations in post-operative care.

An Evaluation of the University of Pennsylvania's Practice Doctorate (DSW) Program

ERIC Educational Resources Information Center

Hartocollis, Lina; Solomon, Phyllis; Doyle, Andrea; Ditty, Matthew

2015-01-01

This article reports on an evaluation of the University of Pennsylvania's doctorate in social work (DSW), the first of the newly emerging practice doctorates. The study sample was current students and program alumni. Data were from program records and from an online survey of DSW alumni with an 81.6% response rate. Overall, the program is…

New clinical practice guidelines on the classification, evaluation and management of childhood interstitial lung disease in infants: what do they mean?

PubMed

Wambach, Jennifer A; Young, Lisa R

2014-12-01

The American Thoracic Society (ATS) recently published a clinical practice guideline regarding the classification, evaluation, and management of childhood interstitial lung disease in infancy (chILD). As disease entities among infants with ILD are often distinct from forms seen in older children and adults, the guideline encourages an age-based classification system and focuses on the diagnostic approach to neonates and infants <2 years of age. The guideline reviews current evidence and recommendations for the evaluation, relevant genetic studies, and management of symptomatic infants. Here, we summarize the ATS guideline, highlight the major concepts, and discuss future strategies aimed at addressing current gaps in knowledge.

Making Research Delicious: An Evaluation of Nurses' Knowledge, Attitudes, and Practice Using the Great American Cookie Experiment With Mobile Device Gaming.

PubMed

Hayes Lane, Susan; Serafica, Reimund; Huffman, Carolyn; Cuddy, Alyssa

2016-01-01

In the current healthcare environment, nurses must have a basic understanding of research to lead change and implement evidence-based practice. The purpose of this study was to evaluate the effectiveness of an educational intervention formulated on the framework of the Great American Cookie Experiment measuring nurses' research knowledge, attitudes, and practice using mobile device gaming. This multisite quantitative study provides insight into promotion of research and information about best practices on innovative teaching strategies for nurses.

The Future of Principal Evaluation

ERIC Educational Resources Information Center

Clifford, Matthew; Ross, Steven

2012-01-01

The need to improve the quality of principal evaluation systems is long overdue. Although states and districts generally require principal evaluations, research and experience tell that many state and district evaluations do not reflect current standards and practices for principals, and that evaluation is not systematically administered. When…

Toward Building a Typology for the Evaluation of Services in Family Support Programs.

ERIC Educational Resources Information Center

Manalo, Victor; Meezan, William

2000-01-01

Articulates how the family support movement emerged in the last 20 years, and describes the philosophical premises, principles, and practices that currently guide it. Considers the inability of current family support program typologies to guide outcome evaluations, and introduces a typology that deconstructs family support programs into their…

Current Evaluation of Upper Oesophageal Sphincter Opening in Dysphagia Practice: An International SLT Survey

ERIC Educational Resources Information Center

Regan, Julie; Walshe, Margaret; McMahon, Barry P.

2012-01-01

Background: The assessment of adequate upper oesophageal sphincter (UOS) opening during swallowing is an integral component of dysphagia evaluation. Aims: To ascertain speech and language therapists' (SLTs) satisfaction with current methods for assessing UOS function in people with dysphagia and to identify challenges encountered by SLTs with UOS…

Grain Size of Recall Practice for Lengthy Text Material: Fragile and Mysterious Effects on Memory

ERIC Educational Resources Information Center

Wissman, Kathryn T.; Rawson, Katherine A.

2015-01-01

The current research evaluated the extent to which the grain size of recall practice for lengthy text material affects recall during practice and subsequent memory. The "grain size hypothesis" states that a smaller vs. larger grain size will increase retrieval success during practice that in turn will enhance subsequent memory for…

Transforming nursing education: a review of current curricular practices in relation to Benner's latest work.

PubMed

Handwerker, Sarah M

2012-09-12

Current societal and healthcare system trends highlight the need to transform nursing education to prepare nurses capable of outstanding practice in the 21st century. Patricia Benner and colleagues urged nurse educators to transform their practice in the 2010 publication Educating Nurses, A Call to Radical Transformation. Frequently utilized pedagogical frameworks in nursing education include behaviorism and constructivism. Much of the structure and basis for instruction and evaluation can be found rooted in these philosophies. By first exploring both behaviorism and constructivism and then relating their use in nursing education to the call to transform, educators can be encourage to examine current practice and possibly modify aspects to include more rich experiential learning.

Evaluation Methods Sourcebook.

ERIC Educational Resources Information Center

Love, Arnold J., Ed.

The chapters commissioned for this book describe key aspects of evaluation methodology as they are practiced in a Canadian context, providing representative illustrations of recent developments in evaluation methodology as it is currently applied. The following chapters are included: (1) "Program Evaluation with Limited Fiscal and Human…

22 CFR 1701.110 - Self-evaluation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Self-evaluation. 1701.110 Section 1701.110...-evaluation. (a) The agency shall, by November 28, 1994, evaluate its current policies and practices, and the... handicaps or organizations representing individuals with handicaps, to participate in the self-evaluation...

25 CFR 720.110 - Self-evaluation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 2 2010-04-01 2010-04-01 false Self-evaluation. 720.110 Section 720.110 Indians THE...-evaluation. (a) The agency shall, by August 24, 1987, evaluate its current policies and practices, and the... or organizations representing handicapped persons, to participate in the self-evaluation process by...

Adaptation, Evaluation and Inclusion

ERIC Educational Resources Information Center

Basson, R.

2011-01-01

In this article I reflect on a recent development currently shaping programme evaluation as field, which makes the case for evaluators facilitating evaluation training evaluees to self-evaluate and improve the programmes they teach. Fetterman argues persuasively that the practice was incipient in the field and required formalization and acceptance…

Calorie postings in chain restaurants in a low-income urban neighborhood: measuring practical utility and policy compliance.

PubMed

Cohn, Elizabeth Gross; Larson, Elaine L; Araujo, Christina; Sawyer, Vanessa; Williams, Olajide

2012-08-01

Current strategies for combating obesity include recent federal legislation mandating calorie count postings in chain restaurants. This study describes the current practice of menu board calorie postings in a low-income urban neighborhood, identifies the extent to which current practice complies with existing policy, and evaluates the practical utility of menu boards to consumers. We conclude that although most postings were legally compliant, they did not demonstrate utility. Menu postings for individual servings are easily understood, but complex math skills are needed to interpret meals designed to serve more than one person. In some items, calories doubled depending on flavor and the calorie posting did not give enough information to make healthier selections. We identified specific strategies to improve practical utility and provide recommendations for policy implementation.

Minnesota low volume road design 1998

DOT National Transportation Integrated Search

1999-09-01

In this project, researchers examined the current practices that local agencies use and evaluated the thickness design procedures by comparing predicted lives for the current designs with those obtained from the mechanistic-empirical design procedure...

Working group reports: Evaluation of the evidence to support practice guidelines for nutritional care of preterm infants-the Pre-B Project

USDA-ARS?s Scientific Manuscript database

The "Evaluation of the Evidence to Support Practice Guidelines for the Nutritional Care of Preterm Infants: The Pre-B Project" is the first phase in a process to present the current state of knowledge and to support the development of evidence-informed guidance for the nutritional care of preterm an...

Evaluator and Program Manager Perceptions of Evaluation Capacity and Evaluation Practice

ERIC Educational Resources Information Center

Fierro, Leslie A.; Christie, Christina A.

2017-01-01

The evaluation community has demonstrated an increased emphasis and interest in evaluation capacity building in recent years. A need currently exists to better understand how to measure evaluation capacity and its potential outcomes. In this study, we distributed an online questionnaire to managers and evaluation points of contact working in…

Economic evaluation of nurse practitioner and clinical nurse specialist roles: A methodological review.

PubMed

Lopatina, Elena; Donald, Faith; DiCenso, Alba; Martin-Misener, Ruth; Kilpatrick, Kelley; Bryant-Lukosius, Denise; Carter, Nancy; Reid, Kim; Marshall, Deborah A

2017-07-01

Advanced practice nurses (e.g., nurse practitioners and clinical nurse specialists) have been introduced internationally to increase access to high quality care and to tackle increasing health care expenditures. While randomised controlled trials and systematic reviews have demonstrated the effectiveness of nurse practitioner and clinical nurse specialist roles, their cost-effectiveness has been challenged. The poor quality of economic evaluations of these roles to date raises the question of whether current economic evaluation guidelines are adequate when examining their cost-effectiveness. To examine whether current guidelines for economic evaluation are appropriate for economic evaluations of nurse practitioner and clinical nurse specialist roles. Our methodological review was informed by a qualitative synthesis of four sources of information: 1) narrative review of literature reviews and discussion papers on economic evaluation of advanced practice nursing roles; 2) quality assessment of economic evaluations of nurse practitioner and clinical nurse specialist roles alongside randomised controlled trials; 3) review of guidelines for economic evaluation; and, 4) input from an expert panel. The narrative literature review revealed several challenges in economic evaluations of advanced practice nursing roles (e.g., complexity of the roles, variability in models and practice settings where the roles are implemented, and impact on outcomes that are difficult to measure). The quality assessment of economic evaluations of nurse practitioner and clinical nurse specialist roles alongside randomised controlled trials identified methodological limitations of these studies. When we applied the Guidelines for the Economic Evaluation of Health Technologies: Canada to the identified challenges and limitations, discussed those with experts and qualitatively synthesized all findings, we concluded that standard guidelines for economic evaluation are appropriate for economic evaluations of nurse practitioner and clinical nurse specialist roles and should be routinely followed. However, seven out of 15 current guideline sections (describing a decision problem, choosing type of economic evaluation, selecting comparators, determining the study perspective, estimating effectiveness, measuring and valuing health, and assessing resource use and costs) may require additional role-specific considerations to capture costs and effects of these roles. Current guidelines for economic evaluation should form the foundation for economic evaluations of nurse practitioner and clinical nurse specialist roles. The proposed role-specific considerations, which clarify application of standard guidelines sections to economic evaluation of nurse practitioner and clinical nurse specialist roles, may strengthen the quality and comprehensiveness of future economic evaluations of these roles. Copyright © 2017 Elsevier Ltd. All rights reserved.

Current State of Test Development, Administration, and Analysis: A Study of Faculty Practices.

PubMed

Bristol, Timothy J; Nelson, John W; Sherrill, Karin J; Wangerin, Virginia S

Developing valid and reliable test items is a critical skill for nursing faculty. This research analyzed the test item writing practice of 674 nursing faculty. Relationships between faculty characteristics and their test item writing practices were analyzed. Findings reveal variability in practice and a gap in implementation of evidence-based standards when developing and evaluating teacher-made examinations.

Nurse education regarding agitated patients and its effects on clinical practice.

PubMed

Ozdemir, Leyla; Karabulut, Erdem

This study identified the impact of an education program on nurses' practices for agitated patients and documented the changes in practice after completion of the training. Eighteen cardiac intensive care nurses were included to the study. Prior to nurses' participation in an education program, a pre-test indicating nurses' current practices for 40 agitated patients was evaluated with the 'Nurse Practice Form'. After the pre-test data collection period was completed, the 2-day training program on caring for agitated patients was conducted. The last step of the study was evaluation of post-test nurses' practices for 40 agitated patients using the 'Nurse Practice Form'. The findings indicated that instead of pre-test nurses' use of physical restraints for controlling agitated patients without a physician order, none of post-test nurses applied them. The training program provided nurses the knowledge and skills needed to evaluate and to manage the causes of agitation.

Orthopaedic Resident Practice Management and Health Policy Education: Evaluation of Experience and Expectations.

PubMed

Stautberg Iii, Eugene F; Romero, Jose; Bender, Sean; DeHart, Marc

2018-04-11

Introduction Practice management and health policy have generally not been considered integral to orthopaedic resident education. Our objective was to evaluate residents' current experience and knowledge, formal training, and desire for further education in practice management and health policy. Methods We developed a 29-question survey that was divided into three sections: practice management, initial employment opportunity, and health policy. Within each section, questions were directed at a resident's current experience and knowledge, formal training, and interest in further education. The survey was distributed at the end of the academic year through an Internet-based survey tool (www.surveymonkey.com) to orthopaedic residents representing multiple programs and all postgraduate years. Results The survey was distributed to 121 residents representing eight residency programs. Of those, 87 residents responded, resulting in a 72% response rate. All postgraduate years were represented. Regarding practice management, 66% had "no confidence" or "some confidence" in coding clinical encounters. When asked if practice models, finance management, and coding should be taught in residency, 95%, 93%, and 97% responded "yes," respectively. When evaluating first employment opportunities, the three most important factors were location, operating room block time, and call. Regarding health policy, 28% were "moderately familiar" or "very familiar" with the Physician Payments Sunshine Act, and 72% were "not familiar" or "somewhat familiar" with bundled payments for arthroplasty. Finally, when asked if yearly lectures in political activities would enhance resident education, 90% responded "yes." Discussion and conclusion Regarding practice management, the survey suggests that current orthopaedic residents are not familiar with basic topics, do not receive formal training, and want further education. The survey suggests that residents also receive minimal training in health policy. Residents feel that health policy will be important in their careers, and they would benefit from formal training in residency.

Mental Health Evaluations for Adolescents Prior to Bariatric Surgery: A Review of Existing Practices and a Specific Example of Assessment Procedures

PubMed Central

Sysko, Robyn; Zandberg, Laurie J.; Devlin, Michael J.; Annunziato, Rachel A.; Zitsman, Jeffrey L.; Walsh, B. Timothy

2013-01-01

Objective Best practice guidelines for adolescents considering bariatric surgery recommend a pre-operative mental health evaluation. However, only general information about these assessments appears in the literature, which makes consistency of administration challenging. This review proposes a specific empirically-derived format for pre-surgical mental health evaluations and summarizes currently available data on the psychiatric functioning of adolescents seeking bariatric surgery. Design Studies of mental health evaluations for adults preparing for bariatric surgery are reviewed, as is the limited literature relevant to adolescent evaluations. A specific and detailed example of an evaluation (clinical interview, self-report questionnaires, cognitive assessment) used for younger patients at a major metropolitan hospital center is presented, followed by data from an initial group of adolescents completing this evaluation. Subjects 200 adolescents (n=139 female; age: 14–18 y, BMI: 35.4–83.3 kg/m2) presenting for bariatric surgery. Results A notable subset of adolescents reported current Axis I conditions (31.5%) and current mental health treatment (29.5%), but reports of current illicit drug use (1.5%) and regular alcohol use (0.5%) were relatively rare. Procedures for using the completed evaluation and post-surgery monitoring of psychosocial issues are discussed. Conclusions Adolescents considering weight loss surgery should receive comprehensive pre-surgical mental health evaluations, but additional data are needed to develop specific recommendations the use of these evaluations in post-operative care. PMID:24073019

Evaluation of Long-Life Concrete Pavement Practices for Use in Florida

DOT National Transportation Integrated Search

2012-11-01

Current Florida construction practices produce asphalt pavements with a service life of 12 to 20 years before needing rehabilitation; concrete pavements are typically designed for 20 years. However, pavements with much longer design lives are possibl...

Evaluation of thin asphalt overlay practice preserving Nebraska's asphalt pavements.

DOT National Transportation Integrated Search

2015-06-01

This study examined the current thin asphalt overlay practices implemented in Nebraska. To that end, the mechanical : properties and performance characteristics of the two mixtures (i.e., SLX and SPH) were compared by carrying out : laboratory tests ...

DISINFECTION PROCESSES AND STABILITY REFINEMENTS TO BIOSOLIDS TREATMENT TECHNOLOGIES

EPA Science Inventory

This paper reviews the current US sewage sludge disinfection regulations and their associated practices; discusses the limitations of the practices; discusses the criteria employed in evaluating a new (innovative or alternative) disinfection process and both notes some processes ...

Evaluation of community pharmacy-based services for type-2 diabetes in an Indonesian setting: pharmacist survey.

PubMed

Wibowo, Yosi; Parsons, Richard; Sunderland, Bruce; Hughes, Jeffery

2015-10-01

Diabetes is an emerging chronic disease in developing countries. Currently the management of diabetes in developing countries is mainly hospital or clinic based. With burgeoning numbers of patients with diabetes, other models need to be evaluated for service delivery in developing countries. Community pharmacists are an important option for provision of diabetes care. Currently, data regarding practices of community pharmacists in diabetes care have been limited to developed countries. To evaluate current community pharmacy-based services and perceived roles of pharmacists in type 2 diabetes care, and characteristics (pharmacist and pharmacy) associated with current practice. Community pharmacies in a developing country setting (Surabaya, Indonesia). A questionnaire was administered to pharmacists managing a random sample of 400 community pharmacies in Surabaya, Indonesia. Current practice and pharmacists' perceived roles were rated using Likert scales, whilst an open-ended question was used to identify priority roles. Logistic regression models determined characteristics associated with current practice. A response rate of 60% was achieved. Dispensing (100%) and education on how to use medications (72.6%) were common current pharmacy practices. More than 50% of pharmacists were supportive towards providing additional services beyond dispensing. The highest priorities for services beyond dispensing were education on medications [i.e. directions for use (58.6%) and common/important adverse effects (25.7%)], education on exercise (36.5%), education on diet (47.7%), and monitoring medication compliance (27.9%). Facilitators identified were: being perceived as part of a pharmacist's role (for all priority services), pharmacies with more than 50 diabetes customers per month (for diet education), and pharmacists' involvement in diabetes training (for compliance monitoring). The key barrier identified was lower pharmacist availability (for diet education as well as compliance monitoring). Most community pharmacies in Surabaya, Indonesia have only provided a basic service of dispensing for type 2 diabetes patients. Many pharmacists believed that they should extend their roles particularly regarding patient education and monitoring. The development of pharmacist professional roles would assist in managing the burgeoning burden of diabetes. The identified facilitators/barriers provide baseline data to support the development of community pharmacy-based diabetes services.

Positioning Mentoring as a Coach Development Tool: Recommendations for Future Practice and Research

ERIC Educational Resources Information Center

McQuade, Sarah; Davis, Louise; Nash, Christine

2015-01-01

Current thinking in coach education advocates mentoring as a development tool to connect theory and practice. However, little empirical evidence exists to evaluate the effectiveness of mentoring as a coach development tool. Business, education, and nursing precede the coaching industry in their mentoring practice, and research findings offered in…

Use of Research for Transforming Youth Agencies

ERIC Educational Resources Information Center

Baizerman, Michael; Rence, Emily; Johnson, Sean

2013-01-01

Current philosophy and practice urge, even require for funding, that programs be empirically based and grounded in empirically proven emerging, promising, or best practices. In most of the human services, including youth programs, services, and practices, this requirement is a goal as well as an ideal. Empirical research and evaluation can be used…

From royal wet nurses to Facebook: The evolution of breastmilk sharing.

PubMed

Baumgartel, Kelley L; Sneeringer, Larissa; Cohen, Susan M

2016-11-01

Wet-nursing was an essential practice that allowed for infant survival after many mothers died in childbirth. The story of wet-nursing is complicated by both religious pressures and cultural expectations of women. It is likely that these historical practices have shaped our current social, political and legislative environments regarding breastfeeding. The aim of this article is to provide a historical perspective on the practice of wet-nursing, with a focus on: 1) social views of wet nurses, 2) breastmilk evaluation and 3) the ideal wet nurse. Historical perspectives from Ancient Egypt, Ancient Greece and Rome, 19th and 20th century America and current practices are examined. An appreciation for the evolution of breastmilk sharing provides clinicians and lactation advocates with the historical origins which provided the template for current practice as it relates to donor milk, breastfeeding culture and relevant legislation.

From royal wet nurses to Facebook: The evolution of breastmilk sharing

PubMed Central

Baumgartel, Kelley L; Sneeringer, Larissa; Cohen, Susan M

2017-01-01

Wet-nursing was an essential practice that allowed for infant survival after many mothers died in childbirth. The story of wet-nursing is complicated by both religious pressures and cultural expectations of women. It is likely that these historical practices have shaped our current social, political and legislative environments regarding breastfeeding. The aim of this article is to provide a historical perspective on the practice of wet-nursing, with a focus on: 1) social views of wet nurses, 2) breastmilk evaluation and 3) the ideal wet nurse. Historical perspectives from Ancient Egypt, Ancient Greece and Rome, 19th and 20th century America and current practices are examined. An appreciation for the evolution of breastmilk sharing provides clinicians and lactation advocates with the historical origins which provided the template for current practice as it relates to donor milk, breastfeeding culture and relevant legislation. PMID:28936030

Evaluation of Long-Life Concrete Pavement Practices for Use in Florida : [Summary

DOT National Transportation Integrated Search

2012-01-01

Current Florida construction practices produce asphalt pavements with a service life of 12 to 20 years before needing rehabilitation; concrete pavements are typically designed for 20 years. However, pavements with much longer design lives are possibl...

Contemporary Play Therapy: Theory, Research, and Practice

ERIC Educational Resources Information Center

Schaefer, Charles E., Ed.; Gerard Kaduson, Heidi, Ed.

2006-01-01

This highly practical book presents current developments in play therapy, including innovative applications for particular problems and populations. Contributors first discuss the latest ideas and techniques emerging from object-relations, experiential, dynamic, and narrative perspectives. Next, research evaluating the effectiveness of play…

The Evaluation of Instruction.

ERIC Educational Resources Information Center

Kanaga, Kim

Some of the theoretical and methodological problems with current practices in evaluating instruction at the higher education level are reviewed. Controversy over the evaluation of instruction in higher education has resulted at least in part from inadequate instrumentation. The instruments for instructional rating now used include administrator…

Selection, Placement and Instatement of School Managers in Turkey: Evaluation of the Current Situation

ERIC Educational Resources Information Center

Memisoglu, Salih Pasa

2015-01-01

The aim of this study is to evaluate the new regulations and current practices in terms of how they apply--to the selection, training and instatement of school administrators in Turkey. The successful implementation of Turkish National Development Plans is closely related to the knowledge and skills of managers working at various levels in every…

Making the Grade: Using Instructional Feedback and Evaluation to Inspire Evidence-Based Teaching

PubMed Central

Brickman, Peggy; Gormally, Cara; Martella, Amedee Marchand

2016-01-01

Typically, faculty receive feedback about teaching via two mechanisms: end-of-semester student evaluations and peer observation. However, instructors require more sustained encouragement and constructive feedback when implementing evidence-based teaching practices. Our study goal was to characterize the landscape of current instructional-feedback practices in biology and uncover faculty perceptions about these practices. Findings from a national survey of 400 college biology faculty reveal an overwhelming dissatisfaction with student evaluations, regardless of self-reported teaching practices, institution type, or position. Faculty view peer evaluations as most valuable, but less than half of faculty at doctoral-granting institutions report participating in peer evaluation. When peer evaluations are performed, they are more supportive of evidence-based teaching than student evaluations. Our findings reveal a large, unmet desire for greater guidance and assessment data to inform pedagogical decision making. Informed by these findings, we discuss alternate faculty-vetted feedback strategies for providing formative instructional feedback. PMID:27909025

Enfranchising the Profession through Evaluation: A Story from Australia

ERIC Educational Resources Information Center

Clinton, Janet; Dawson, Georgia

2018-01-01

Educational reform in Australia recognizes the need for an effective teacher evaluation system but has fallen short of actually prescribing one. Current practice does not align to policy intent, with teacher evaluation largely an exercise in compliance around performance management as opposed to a process that promotes evaluative thinking,…

Practicality of Evaluating Soft Errors in Commercial sub-90 nm CMOS for Space Applications

NASA Technical Reports Server (NTRS)

Pellish, Jonathan A.; LaBel, Kenneth A.

2010-01-01

The purpose of this presentation is to: Highlight space memory evaluation evolution, Review recent developments regarding low-energy proton direct ionization soft errors, Assess current space memory evaluation challenges, including increase of non-volatile technology choices, and Discuss related testing and evaluation complexities.

Evaluating the Reference Interview: A Theoretical Discussion of the Desirability and Achievability of Evaluation.

ERIC Educational Resources Information Center

Smith, Lisa L.

1991-01-01

Review and examination of the current literature on reference interview evaluation explores the degree to which such evaluative practices are both desirable and achievable. It is concluded that, if both quantitative and qualitative techniques are appropriately used, accurate mechanisms of evaluation are possible and desirable. (17 references) (LRW)

The Future of Evaluation: Catching Rocks with Cauldrons.

ERIC Educational Resources Information Center

Love, Arnold J.

2001-01-01

Explores the effects evidence-based practice and the guideline movement will have on evaluation in the future and discusses the impact on evaluation of three aspects of the current information revolution: (1) e-government; (2) new approaches to data access; and (3) real-time evaluation. Also considers the sources of evaluation innovation and the…

How Quality Improvement Practice Evidence Can Advance the Knowledge Base.

PubMed

OʼRourke, Hannah M; Fraser, Kimberly D

2016-01-01

Recommendations for the evaluation of quality improvement interventions have been made in order to improve the evidence base of whether, to what extent, and why quality improvement interventions affect chosen outcomes. The purpose of this article is to articulate why these recommendations are appropriate to improve the rigor of quality improvement intervention evaluation as a research endeavor, but inappropriate for the purposes of everyday quality improvement practice. To support our claim, we describe the differences between quality improvement interventions that occur for the purpose of practice as compared to research. We then carefully consider how feasibility, ethics, and the aims of evaluation each impact how quality improvement interventions that occur in practice, as opposed to research, can or should be evaluated. Recommendations that fit the evaluative goals of practice-based quality improvement interventions are needed to support fair appraisal of the distinct evidence they produce. We describe a current debate on the nature of evidence to assist in reenvisioning how quality improvement evidence generated from practice might complement that generated from research, and contribute in a value-added way to the knowledge base.

Evaluation Use: Results from a Survey of U.S. American Evaluation Association Members

ERIC Educational Resources Information Center

Fleischer, Dreolin N.; Christie, Christina A.

2009-01-01

This paper presents the results of a cross-sectional survey on evaluation use completed by 1,140 U.S. American Evaluation Association members. This study had three foci: evaluators' current attitudes, perceptions, and experiences related to evaluation use theory and practice, how these data are similar to those reported in a previous study…

Representational Practices by the Numbers: How Kindergarten and First-Grade Students Create, Evaluate, and Modify Their Science Representations

ERIC Educational Resources Information Center

Danish, Joshua Adam; Phelps, David

2011-01-01

A productive approach to studying the role of representations in supporting students' learning of science content is to examine their actions from a practice perspective. The current study examines kindergarten and first-grade students' representational practices across a consistent context--the creation of storyboards--both before and after a…

Standard Test Methods for Textile Composites

NASA Technical Reports Server (NTRS)

Masters, John E.; Portanova, Marc A.

1996-01-01

Standard testing methods for composite laminates reinforced with continuous networks of braided, woven, or stitched fibers have been evaluated. The microstructure of these textile' composite materials differs significantly from that of tape laminates. Consequently, specimen dimensions and loading methods developed for tape type composites may not be applicable to textile composites. To this end, a series of evaluations were made comparing testing practices currently used in the composite industry. Information was gathered from a variety of sources and analyzed to establish a series of recommended test methods for textile composites. The current practices established for laminated composite materials by ASTM and the MIL-HDBK-17 Committee were considered. This document provides recommended test methods for determining both in-plane and out-of-plane properties. Specifically, test methods are suggested for: unnotched tension and compression; open and filled hole tension; open hole compression; bolt bearing; and interlaminar tension. A detailed description of the material architectures evaluated is also provided, as is a recommended instrumentation practice.

Teacher Evaluation: The Limits of Looking.

ERIC Educational Resources Information Center

Stodolsky, Susan S.

1984-01-01

Reviews current teacher evaluation practices with particular focus on the use of observation. Argues that direct observation is an inadequate evaluation technique because it assumes that stability and consistency are necessary for effective teaching. Presents data showing that flexibility is a more accurate characterization of elementary level…

Social work, technology, and ethical practices: a review and evaluation of the national association of social workers' technology standards.

PubMed

Lopez, Amy

2014-10-01

Information and communication technologies (ICTs) are becoming essential to social work practice by providing increased treatment possibilities and reducing barriers to service. While recognizing the importance of ICTs in practice, social work practitioners have had concerns about ethical use. In response, NASW compiled the Standards for Technology and Social Work Practice. While the guidelines set the groundwork, they were not embedded in a process that would allow them to adapt to the swift pace of ICT changes. This article reviews the current Standards, evaluates how these have been implemented by practitioners, and offers suggestions for updates.

A critical appraisal of guidelines for electronic communication between patients and clinicians: the need to modernize current recommendations.

PubMed

Lee, Joy L; Matthias, Marianne S; Menachemi, Nir; Frankel, Richard M; Weiner, Michael

2018-04-01

Patient-provider electronic communication has proliferated in recent years, yet there is a dearth of published research either leading to, or including, recommendations that improve clinical care and prevent unintended negative consequences. We critically appraise published guidelines and suggest an agenda for future work in this area. To understand how existing guidelines align with current practice, evidence, and technology. We performed a narrative review of provider-targeted guidelines for electronic communication between patients and providers, searching Ovid MEDLINE, Embase, and PubMed databases using relevant terms. We limited the search to articles published in English, and manually searched the citations of relevant articles. For each article, we identified and evaluated the suggested practices. Across 11 identified guidelines, the primary focus was on technical and administrative concerns, rather than on relational communication. Some of the security practices recommended by the guidelines are no longer needed because of shifts in technology. It is unclear the extent to which the recommendations that are still relevant are being followed. Moreover, there is no guideline-cited evidence of the effectiveness of the practices that have been proposed. Our analysis revealed major weaknesses in current guidelines for electronic communication between patients and providers: the guidelines appear to be based on minimal evidence and offer little guidance on how best to use electronic tools to communicate effectively. Further work is needed to systematically evaluate and identify effective practices, create a framework to evaluate quality of communication, and assess the relationship between electronic communication and quality of care.

45 CFR 1181.110 - Self-evaluation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HUMANITIES INSTITUTE OF MUSEUM AND LIBRARY SERVICES ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE INSTITUTE OF MUSEUM AND LIBRARY SERVICES § 1181.110 Self-evaluation. (a) The agency shall, by April 9, 1987, evaluate its current policies and practices, and the...

41 CFR 101-8.313 - Self-evaluation.

Code of Federal Regulations, 2014 CFR

2014-07-01

... FINANCIAL ASSISTANCE 8.3-Discrimination Prohibited on the Basis of Handicap § 101-8.313 Self-evaluation. (a..., evaluate, with the assistance of interested persons, including handicapped persons or organizations representing handicapped persons, its current policies and practices and the effects thereof that do not or may...

41 CFR 101-8.313 - Self-evaluation.

Code of Federal Regulations, 2012 CFR

2012-07-01

... FINANCIAL ASSISTANCE 8.3-Discrimination Prohibited on the Basis of Handicap § 101-8.313 Self-evaluation. (a..., evaluate, with the assistance of interested persons, including handicapped persons or organizations representing handicapped persons, its current policies and practices and the effects thereof that do not or may...

41 CFR 101-8.313 - Self-evaluation.

Code of Federal Regulations, 2013 CFR

2013-07-01

... FINANCIAL ASSISTANCE 8.3-Discrimination Prohibited on the Basis of Handicap § 101-8.313 Self-evaluation. (a..., evaluate, with the assistance of interested persons, including handicapped persons or organizations representing handicapped persons, its current policies and practices and the effects thereof that do not or may...

Aspects of Successful Evaluation Practice at an Established Private Evaluation Firm

ERIC Educational Resources Information Center

Brandon, Paul R.; Smith, Nick L.; Hwalek, Melanie

2011-01-01

This article is third in a series of exemplary cases under the two current section editors. The first two cases (Brandon, Smith, Trenholm, & Devaney, 2010; Smith, Brandon, Lawton, & Krohn-Ching, 2010) profiled evaluations that had been designated as exemplary by professional associations. The present case profiles an evaluation organization:…

Staffing for Success: Linking Teacher Evaluation and School Personnel Management in Practice

ERIC Educational Resources Information Center

Master, Benjamin

2014-01-01

Teacher evaluation is at the center of current education policy reform. Most evaluation systems rely at least in part on principals' assessments of teachers, and their discretionary judgments carry substantial weight. However, we know relatively little about what they value when determining evaluations and high stakes personnel decisions.…

Nighttime construction: evaluation of construction operations : final report.

DOT National Transportation Integrated Search

2004-05-01

The different aspects that should be considered in making decisions on nighttime construction operations are identified and investigated in light of the current state of knowledge and practice. A state-of-the-art review was conducted of the current p...

[Oxidative stress. Should it be measured in the diabetic patient?].

PubMed

Villa-Caballero, L; Nava-Ocampo, A A; Frati-Munari, A C; Ponce-Monter, H

2000-01-01

Oxidative stress has been defined as a loss of counterbalance between free radical or reactive oxygen species production and the antioxidant systems, with negative effects on carbohydrates, lipids, and proteins. It is also involved in the progression of different chronic diseases and apoptosis. Diabetes mellitus is associated to a high oxidative stress level through different biochemical pathways, i.e. protein glycosylation, glucose auto-oxidation, and the polyol pathway, mainly induced by hyperglycemia. Oxidative stress could also be involved in the pathogenesis of atherosclerotic lesions and other chronic diabetic complications. Measurement of oxidative stress could be useful to investigate its role in the initiation and development processes of chronic diabetic complications and also to evaluate preventive actions, including antioxidative therapy. Different attempts have been made to obtain a practical, accurate, specific, and sensitive method to evaluate oxidative stress in clinical practice. However, this ideal method is not currently available to date and the usefulness of the current methods needs to be confirmed in daily practice. We suggest quantifying oxidated and reduced glutation (GSSG/GSH) and the thiobarbituric reactive substances (TBARS) with currently alternatives. Currently available alternative methods while we await better options.

Adaptability Evaluation of GCPVS under Voltage Sag

NASA Astrophysics Data System (ADS)

Wang, Li

2018-03-01

A basic LVRT strategy widely used in engineering practice is taken in this paper and manages to ride through both symmetrical and asymmetrical sag conditions. Precise current reference is calculate based on the reactive current curve in China National Grid Code, deration of current is realized in this way by eliminating NS current. The role of hardware protection has been discussed in detail.

Organizational determinants of evaluation practice in Australian prevention agencies.

PubMed

Schwarzman, J; Bauman, A; Gabbe, B; Rissel, C; Shilton, T; Smith, B J

2018-06-01

Program evaluation is essential to inform decision making, contribute to the evidence base for strategies, and facilitate learning in health promotion and disease prevention organizations. Theoretical frameworks of organizational learning, and studies of evaluation capacity building describe the organization as central to evaluation capacity. Australian prevention organizations recognize limitations to current evaluation effectiveness and are seeking guidance to build evaluation capacity. This qualitative study identifies organizational facilitators and barriers to evaluation practice, and explores their interactions in Australian prevention organizations. We conducted semi-structured interviews with 40 experienced practitioners from government and non-government organizations. Using thematic analysis, we identified seven key themes that influence evaluation practice: leadership, organizational culture, organizational systems and structures, partnerships, resources, workforce development and training and recruitment and skills mix. We found organizational determinants of evaluation to have multi-level interactions. Leadership and organizational culture influenced organizational systems, resource allocation and support of staff. Partnerships were important to overcome resource deficits, and systems were critical to embed evaluation within the organization. Organizational factors also influenced the opportunities for staff to develop skills and confidence. We argue that investment to improve these factors would allow organizations to address evaluation capacity at multiple levels, and ultimately facilitate effective evaluation practice.

Evaluating group purchasing organizations.

PubMed

Kaldor, Dennis C; Kowalski, Jamie C; Tankersley, Mark A

2003-01-01

A formal evaluation process can help healthcare organizations assess the current and/or potential value of a group purchasing organization (GPO). Healthcare organizations should approach a GPO evaluation as if they were entering into a new relationship. The evaluation should include purchasing and financial services, value-added services, and corporate relations/business practices. Healthcare organizations should consider the potential economies of scale and other services offered by a GPO. Healthcare organizations should consider using acceptable substitutes for products currently used or seeking products through alternative sources if doing so achieves greater value.

Caution and Warning Alarm Design and Evaluation for NASA CEV Auditory Displays: SHFE Information Presentation Directed Research Project (DRPP) report 12.07

NASA Technical Reports Server (NTRS)

Begault, Durand R.; Godfroy, Martine; Sandor, Aniko; Holden, Kritina

2008-01-01

The design of caution-warning signals for NASA s Crew Exploration Vehicle (CEV) and other future spacecraft will be based on both best practices based on current research and evaluation of current alarms. A design approach is presented based upon cross-disciplinary examination of psychoacoustic research, human factors experience, aerospace practices, and acoustical engineering requirements. A listening test with thirteen participants was performed involving ranking and grading of current and newly developed caution-warning stimuli under three conditions: (1) alarm levels adjusted for compliance with ISO 7731, "Danger signals for work places - Auditory Danger Signals", (2) alarm levels adjusted to an overall 15 dBA s/n ratio and (3) simulated codec low-pass filtering. Questionnaire data yielded useful insights regarding cognitive associations with the sounds.

Assessment of general education teachers' Tier 1 classroom practices: contemporary science, practice, and policy.

PubMed

Reddy, Linda A; Fabiano, Gregory A; Jimerson, Shane R

2013-12-01

Progress monitoring is a type of formative assessment. Most work on progress monitoring in elementary school settings has been focused on students. However, teachers also can benefit from frequent evaluations. Research addressing teacher progress monitoring is critically important given the recent national focus on teacher evaluation and effectiveness. This special topic section of School Psychology Quarterly is the first to showcase the current research on measuring Tier 1 instructional and behavioral management practices used by prekindergarten and elementary school teachers in general education settings. The three studies included in the special section describe the development and validation efforts of several teacher observational and self-report measures of instruction and/or behavioral management. These studies provide evidence for the utility of such assessments for documenting the use of classroom practices, and these assessment results may be leveraged in innovative coaching models to promote best practice. These articles also offer insight and ideas for the next generation of teacher practice assessment for the field. Finally, the special topic is capped by a commentary synthesizing the current work and offers "big ideas" for future measurement development, policy, and professional development initiatives. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Cutaneous T cell lymphoma: Current practices in blood assessment and the utility of T-cell receptor Vβ chain restriction

PubMed Central

Gibson, Juliet F; Huang, Jing; Liu, Kristina J; Carlson, Kacie R; Foss, Francine; Choi, Jaehyuk; Edelson, Richard; Hussong, Jerry W.; Mohl, Ramsey; Hill, Sally; Girardi, Sally

2016-01-01

Background Accurate quantification of malignant cells in the peripheral blood of patients with cutaneous T cell lymphoma (CTCL) is important for early detection, prognosis, and monitoring disease burden. Objective Determine the spectrum of current clinical practices; critically evaluate elements of current ISCL B1 and B2 staging criteria; and assess the potential role of TCR-Vβ analysis by flow cytometry. Methods We assessed current clinical practices by survey, and performed a retrospective analysis of 161 patients evaluated at Yale (2011-2014) to compare the sensitivity, specificity, PPV, and NPV of parameters for ISCL B2 staging. Results There was heterogeneity in clinical practices among institutions. ISCL B1 criteria did not capture five Yale cohort patients with immunophenotypic abnormalities who later progressed. TCR-Vβ testing was more specific than PCR and aided diagnosis in detecting clonality, but was of limited benefit in quantification of tumor burden. Limitations Because of limited follow-up involving a single center, further investigation will be necessary to conclude whether our proposed diagnostic algorithm is of general clinical benefit. Conclusion We propose further study of “modified B1 criteria”: CD4/CD8 ratio ≥5, %CD4+/CD26- ≥ 20%, %CD4+/CD7- ≥ 20%, with evidence of clonality. TCR-Vβ testing should be considered in future diagnostic and staging algorithms. PMID:26874819

Economic impact of converting an interventional pain medicine physician office-based practice into a provider-based ambulatory pain practice.

PubMed

Grider, Jay S; Findley, Kelley A; Higdon, Courtney; Curtright, Jonathan; Clark, Don P

2014-01-01

One consequence of the shifting economic health care landscape is the growing trend of physician employment and practice acquisition by hospitals. These acquired practices are often converted into hospital- or provider-based clinics. This designation brings the increased services of the hospital, the accreditation of the hospital, and a new billing structure verses the private clinic (the combination of the facility and professional fee billing). One potential concern with moving to a provider-based designation is that this new structure might make the practice less competitive in a marketplace that may still be dominated by private physician office-based practices. The aim of the current study was to evaluate the impact of the provider-based/hospital fee structure on clinical volume. Determine the effect of transition to a hospital- or provider-based practice setting (with concomitant cost implications) on patient volume in the current practice milieu.   Community hospital-based academic interventional pain medicine practice. Economic analysis of effect of change in price structure on clinical volumes. The current study evaluates the effect of a change in designation with price implications on the demand for clinical services that accompany the transition to a hospital-based practice setting from a physician office setting in an academic community hospital. Clinical volumes of both procedures and clinic volumes increased in a mature practice setting following transition to a provider-based designation and the accompanying facility and professional fee structure. Following transition to a provider-based designation clinic visits were increased 24% while procedural volume demand did not change. Single practice entity and single geographic location in southeastern United States. The conversion to a hospital- or provider-based setting does not negatively impact clinical volume and referrals to community-based pain medicine practice. These results imply that factors other than price are a driver of patient choice.  

Juvenile offenders: competence to stand trial.

PubMed

Soulier, Matthew

2012-12-01

This article details the legal background and assists the reader in the preparation and practical conduct of evaluations regarding juvenile adjudicative competency. The material is presented to be useful as a guide to direct questions of competency and covers aspects of evaluation that include: legal standard for competency to stand trial, developmental immaturity, current practice in juvenile competency to stand trial, forensic evaluation of juvenile competency to stand trial, organizing the evaluation, collateral sources of information, psychiatric evaluation of juvenile adjudicative competency, assessment of mental disorder and intellectual disability, assessment of developmental status, assessment of functional abilities for adjudicative competence, and reaching the forensic opinion. Copyright © 2012 Elsevier Inc. All rights reserved.

Evaluation of Integrated Planning Systems in California Community Colleges

ERIC Educational Resources Information Center

Buckley, Jerry L.; Piland, William E.

2012-01-01

California community colleges are experiencing unprecedented levels of sanctions from their accrediting agency. A survey of planners in these colleges reveals a wide gap between current practice and perceived importance of integrated planning practices, as well as misalignment in budgeting methods. Statistically significant gaps were identified…

Evaluation of Current Practice for Illumination at Roundabouts : Safety and Illumination of Roundabouts (Phase I)

DOT National Transportation Integrated Search

2016-03-01

This report is for the first phase of a two-phase research program to develop recommended practices for GDOT for lighting rural roundabouts. Phase I of the study was designed to improve our understanding of the relationship between roundabout illumin...

Teacher Evaluation: Archiving Teaching Effectiveness

ERIC Educational Resources Information Center

Nielsen, Lance D.

2014-01-01

Teacher evaluation is a current hot topic within music education. This article offers strategies for K-12 music educators on how to promote their effectiveness as teachers through archival documentation in a teacher portfolio. Using the Danielson evaluation model (based on four domains of effective teaching practices), examples of music teaching…

Participants' Evaluation of Consultation: Implications for Training in School Psychology

ERIC Educational Resources Information Center

Klose, Laurie McGarry; Plotts, Cynthia; Lasser, Jon

2012-01-01

Evaluation of graduate students' consultation skills is essential to competent practice in school settings. Congruence of evaluation of the consultation experience has been shown as an important factor in the development of competent consultants in other, related disciplines. The current study analysed student consultant and teacher consultee…

Metrics for Evaluation of Student Models

ERIC Educational Resources Information Center

Pelanek, Radek

2015-01-01

Researchers use many different metrics for evaluation of performance of student models. The aim of this paper is to provide an overview of commonly used metrics, to discuss properties, advantages, and disadvantages of different metrics, to summarize current practice in educational data mining, and to provide guidance for evaluation of student…

A Survey of Model Evaluation Approaches with a Tutorial on Hierarchical Bayesian Methods

ERIC Educational Resources Information Center

Shiffrin, Richard M.; Lee, Michael D.; Kim, Woojae; Wagenmakers, Eric-Jan

2008-01-01

This article reviews current methods for evaluating models in the cognitive sciences, including theoretically based approaches, such as Bayes factors and minimum description length measures; simulation approaches, including model mimicry evaluations; and practical approaches, such as validation and generalization measures. This article argues…

Current practices for evaluation of resonance disorders in North America.

PubMed

Stelck, Elizabeth Huebert; Boliek, Carol A; Hagler, Paul H; Rieger, Jana M

2011-02-01

Improving treatment outcomes for people with resonance problems (due to velopharyngeal disorders) is a priority for many speech-language pathologists (SLPs), but there exists a limited understanding of the practices SLPs are using to assess and monitor therapeutic effects in this population. The current study was designed to answer the following questions: (1) What are current clinical practices versus best practices for assessing resonance disorders, tracking therapeutic effects, and determining discharge criteria? (2) What assessment practices would SLPs prefer to use with clients who have resonance disorders? (3) What are barriers to SLPs' use of best practices? and (4) What effects do SLP demographics have on clinical practices? Thirty-eight SLPs, specializing in the treatment of resonance disorders, participated in the study. Responses were compared with best practice recommendations derived from the literature. Most clinicians were using low-tech assessment tools, often because they lacked access to high-tech tools. Demographics and training did not affect clinical assessment practices. There is a need to increase the availability of high-tech assessment tools to SLPs practicing in the area of resonance disorders, as consistent use of sophisticated assessment devices would exemplify contemporary thinking about the transfer of knowledge to practice in this area. © Thieme Medical Publishers.

EMCDDA Best Practice Promotion in Europe: an internet based dissemination tool.

PubMed

Ferri, Marica; Bo, Alessandra

2013-01-01

Best practice is the best application of available evidence to current activities in the drugs field. The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) created a web-based tool aimed at bridging together scientific evidence and current practices in the drug addiction field. Beyond dissemination of evidence, the scope is to share best practice among the European countries. The synthesis of the evidence is based on the methods of the Cochrane collaboration (the Drugs and Alcohol Group) and the Grade working group. As of February 2013 the portal encompasses four modules on the effectiveness of demand reduction interventions, a collection of European projects on prevention, treatment, harm reduction and social reintegration and an inventory of European Guidelines and Standards including a bank of instruments to evaluate interventions (http://www.emcdda.europa.eu/bestpractice). The summaries of evidence are presented in a plain language format and include brief explanation of the measures of effect supporting the evidence, but do not provide specific recommendations. The main future challenge of EMCDDA's best practice promotion is to become a service for those willing to implement best practice. The Best Practice Portal should become a platform where to find all is needed for successful implementation (handbooks, training materials, guidelines for evaluation and contacts for mentoring).

Regulatory aspects of oncology drug safety evaluation: past practice, current issues, and the challenge of new drugs.

PubMed

Rosenfeldt, Hans; Kropp, Timothy; Benson, Kimberly; Ricci, M Stacey; McGuinn, W David; Verbois, S Leigh

2010-03-01

The drug development of new anti-cancer agents is streamlined in response to the urgency of bringing effective drugs to market for patients with limited life expectancy. FDA's regulation of oncology drugs has evolved from the practices set forth in Arnold Lehman's seminal work published in the 1950s through the current drafting of a new International Conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH) safety guidance for anti-cancer drug nonclinical evaluations. The ICH combines the efforts of the regulatory authorities of Europe, Japan, and the United States and the pharmaceutical industry from these three regions to streamline the scientific and technical aspects of drug development. The recent development of new oncology drug classes with novel mechanisms of action has improved survival rates for some cancers but also brings new challenges for safety evaluation. Here we present the legacy of Lehman and colleagues in the context of past and present oncology drug development practices and focus on some of the current issues at the center of an evolving harmonization process that will generate a new safety guidance for oncology drugs, ICH S9. The purpose of this new guidance will be to facilitate oncology drug development on a global scale by standardizing regional safety requirements.

A nationwide survey of patient centered medical home demonstration projects.

PubMed

Bitton, Asaf; Martin, Carina; Landon, Bruce E

2010-06-01

The patient centered medical home has received considerable attention as a potential way to improve primary care quality and limit cost growth. Little information exists that systematically compares PCMH pilot projects across the country. Cross-sectional key-informant interviews. Leaders from existing PCMH demonstration projects with external payment reform. We used a semi-structured interview tool with the following domains: project history, organization and participants, practice requirements and selection process, medical home recognition, payment structure, practice transformation, and evaluation design. A total of 26 demonstrations in 18 states were interviewed. Current demonstrations include over 14,000 physicians caring for nearly 5 million patients. A majority of demonstrations are single payer, and most utilize a three component payment model (traditional fee for service, per person per month fixed payments, and bonus performance payments). The median incremental revenue per physician per year was $22,834 (range $720 to $91,146). Two major practice transformation models were identified--consultative and implementation of the chronic care model. A majority of demonstrations did not have well-developed evaluation plans. Current PCMH demonstration projects with external payment reform include large numbers of patients and physicians as well as a wide spectrum of implementation models. Key questions exist around the adequacy of current payment mechanisms and evaluation plans as public and policy interest in the PCMH model grows.

Current practice patterns in conservative thumb CMC joint care: survey results.

PubMed

O'Brien, Virginia H; McGaha, Jamie L

2014-01-01

Cross-sectional descriptive survey Best practice for conservative clinical care pathways is not well outlined in the literature for patients with thumb carpometacarpal joint (CMCJ) pain. This self-report survey investigated the current practice patterns of assessments and conservative interventions for the painful thumb CMCJ among hand therapists. An online survey was distributed to members of the American Society of Hand Therapists (ASHT). Questions were included about evaluation measures and intervention techniques used for this population. A descriptive analysis was completed of the results. A total of 23.5% of the ASHT membership responded to the survey. Results were categorized using the International Classification of Functioning and Disability domains as a framework. The survey results report varying use of evaluation measures, therapeutic interventions, including orthotic fabrication, joint protection and patient education all therapeutic interventional techniques, and modalities. Therapists use a comprehensive array of evaluation measures and interventions for body functions and structures in the care of thumb CMC pain. In contrast, more consistent use is needed of psychometrically-sound functional outcome measures that show change in activities and participation. This survey highlights areas to employ current evidence, as well as, future research should address environmental factors and personal factors for this population Not applicable. Copyright © 2014 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Embedding technology into inter-professional best practices in home safety evaluation.

PubMed

Burns, Suzanne Perea; Pickens, Noralyn Davel

2017-08-01

To explore inter-professional home evaluators' perspectives and needs for building useful and acceptable decision-support tools for the field of home modifications. Twenty semi-structured interviews were conducted with a range of home modification professionals from different regions of the United States. The interview transcripts were analyzed with a qualitative, descriptive, perspective approach. Technology supports current best practice and has potential to inform decision making through features that could enhance home evaluation processes, quality, efficiency and inter-professional communication. Technological advances with app design have created numerous opportunities for the field of home modifications. Integrating technology and inter-professional best practices will improve home safety evaluation and intervention development to meet client-centred and societal needs. Implications for rehabilitation Understanding home evaluators technology needs for home safety evaluations contributes to the development of app-based assessments. Integrating inter-professional perspectives of best practice and technological needs in an app for home assessments improves processes. Novice and expert home evaluators would benefit from decision support systems embedded in app-based assessments. Adoption of app-based assessment would improve efficiency while remaining client-centred.

Effectiveness study of UNL's crack routing device (CRD) - phase II.

DOT National Transportation Integrated Search

2016-12-31

This project evaluated the crack routing device (CRD) for effectiveness in improving current crack-cutting : practices and for possible adoption as a standard in the Nebraska Department of Roads (NDOR). To enact these : evaluations of CRD, the resear...

Methodologies for Evaluating Environmental Benefits of Intelligent Transportation Systems

DOT National Transportation Integrated Search

2001-05-01

This report provides an overview of the current state of practice in evaluation of air quality impacts and also in emissions modeling. This report also describes the recent developments in emissions modeling. The air quality impacts of various ITS st...

A critical review of current nursing faculty practice.

PubMed

Sawyer, M J; Alexander, I M; Gordon, L; Juszczak, L J; Gilliss, C

2000-12-01

To critically examine the current literature on nursing faculty practice, using the National Organization of Nurse Practitioner Faculties (NONPF) Guidelines for Evaluation of Faculty Practice, and to examine faculty practice models' strengths, weaknesses, and barriers. Thirty-five articles describing models of faculty practice were identified through an exhaustive search on CINAHL and Medline. Two NONPF monographs on nursing faculty practice were used as guidelines for the critical review. Faculty practice has become an integral component of faculty-role expectations at many schools of nursing. Workload, especially without adequate compensation, remains a hindrance to practice. The value of faculty practice time and expertise has not been sufficiently demonstrated. Integration of practitioner, educator and researcher roles remains extremely difficult and sometimes elusive. Faculty practice offers many advantages to schools of nursing, including educational and research opportunities for faculty and students, as well as practice sites and affordable community healthcare. Providing health care in the community presents an opportunity for independent and collaborative practice. To fully utilize the great research opportunities provided by faculty practice, more emphasis must be placed on gathering and analyzing descriptive data.

The Ethics of Western Rhetoric as a Basis for Teaching Foreign Students.

ERIC Educational Resources Information Center

Schliessmann, Michael R.

An increase in foreign student enrollment and subsequent questioning of traditional concepts of western rhetorical practice, particularly freedom of speech, resulted in an evaluation of current teaching practices in South Dakota State University's basic speech communication course. In a summer session course, 36 international students responded to…

Knowing Foucault, Knowing You: "Raced"/Classed and Gendered Subjectivities in the Pedagogical State

ERIC Educational Resources Information Center

Burman, Erica

2016-01-01

This article evaluates the continuing contemporary relevance of Foucauldian analyses for critical educational and social research practice. Framed around examples drawn from everyday cultural and educational practices, I argue that current intensifications of psychologisation under neoliberal capitalism not only produce and constrain increasingly…

Multisite evaluation of APEX for water quality: 1. Best professional judgement parameterization

USDA-ARS?s Scientific Manuscript database

The Agricultural and Policy Environmental Extender (APEX) model is capable of estimating edge-of-field water, nutrient, and sediment transport and is used to assess the environmental impacts of management practices. The current practice is to fully calibrate the model for each site simulation, a tas...

Survey of Information Literacy Instructional Practices in U.S. Academic Libraries

ERIC Educational Resources Information Center

Julien, Heidi; Gross, Melissa; Latham, Don

2018-01-01

An online survey sent to the community of professional librarians in the United States who provide information literacy instruction in academic libraries provided insights into their practices and the challenges they face. Data include current pedagogical methods, client groups of focus, assessment and evaluation, marketing, instructional…

Connecting to Collections in Florida: Current Conditions and Critical Needs in Libraries, Archives, and Museums

ERIC Educational Resources Information Center

Jorgensen, Corinne; Marty, Paul F.; Braun, Kathy

2012-01-01

This article presents results from an IMLS-funded project to evaluate the current state of collections in Florida's libraries, archives, and museums, current practices to preserve and conserve these collections, and perceived needs to maintain and improve these collections for future generations. The survey, modeled after the Heritage Health Index…

Putting principals back into practice: an evaluation of a re-entry course for vocationally trained doctors.

PubMed Central

Baker, M; Williams, J; Petchey, R

1997-01-01

BACKGROUND: Current recruitment difficulties in general practice have sharpened the interest of the profession in non-principals. No re-entry course for general practice has previously been run in the UK. AIM: To design and evaluate a re-entry course for general practice. METHOD: A re-entry course was developed to help doctors return to general practice as principals. A telephone interview was carried out with each delegate prior to their attendance on the course and was repeated one month and six months after the course to measure any change in career intentions and the perceived benefit of attending the course. RESULTS: Six months after the course, 11 out of 14 delegates had taken positive steps to return to general practice or had increased their time commitment to medicine. This contrasts with only one of the control group having made any steps to change career. CONCLUSION: The course was evaluated and found to be beneficial, particularly in terms of increasing the confidence of the delegates. PMID:9463984

Clinical practice guidelines and consensus statements in oncology--an assessment of their methodological quality.

PubMed

Jacobs, Carmel; Graham, Ian D; Makarski, Julie; Chassé, Michaël; Fergusson, Dean; Hutton, Brian; Clemons, Mark

2014-01-01

Consensus statements and clinical practice guidelines are widely available for enhancing the care of cancer patients. Despite subtle differences in their definition and purpose, these terms are often used interchangeably. We systematically assessed the methodological quality of consensus statements and clinical practice guidelines published in three commonly read, geographically diverse, cancer-specific journals. Methods Consensus statements and clinical practice guidelines published between January 2005 and September 2013 in Current Oncology, European Journal of Cancer and Journal of Clinical Oncology were evaluated. Each publication was assessed using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) rigour of development and editorial independence domains. For assessment of transparency of document development, 7 additional items were taken from the Institute of Medicine's standards for practice guidelines and the Journal of Clinical Oncology guidelines for authors of guidance documents. Consensus statements and clinical practice guidelines published between January 2005 and September 2013 in Current Oncology, European Journal of Cancer and Journal of Clinical Oncology were evaluated. Each publication was assessed using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) rigour of development and editorial independence domains. For assessment of transparency of document development, 7 additional items were taken from the Institute of Medicine's standards for practice guidelines and the Journal of Clinical Oncology guidelines for authors of guidance documents. Thirty-four consensus statements and 67 clinical practice guidelines were evaluated. The rigour of development score for consensus statements over the three journals was 32% lower than that of clinical practice guidelines. The editorial independence score was 15% lower for consensus statements than clinical practice guidelines. One journal scored consistently lower than the others over both domains. No journals adhered to all the items related to the transparency of document development. One journal's consensus statements endorsed a product made by the sponsoring pharmaceutical company in 64% of cases. Guidance documents are an essential part of oncology care and should be subjected to a rigorous and validated development process. Consensus statements had lower methodological quality than clinical practice guidelines using AGREE II. At a minimum, journals should ensure that that all consensus statements and clinical practice guidelines adhere to AGREE II criteria. Journals should consider explicitly requiring guidelines to declare pharmaceutical company sponsorship and to identify the sponsor's product to enhance transparency.

Clinical balance assessment: perceptions of commonly-used standardized measures and current practices among physiotherapists in Ontario, Canada.

PubMed

Sibley, Kathryn M; Straus, Sharon E; Inness, Elizabeth L; Salbach, Nancy M; Jaglal, Susan B

2013-03-20

Balance impairment is common in multiple clinical populations, and comprehensive assessment is important for identifying impairments, planning individualized treatment programs, and evaluating change over time. However, little information is available regarding whether clinicians who treat balance are satisfied with existing assessment tools. In 2010 we conducted a cross-sectional survey of balance assessment practices among physiotherapists in Ontario, Canada, and reported on the use of standardized balance measures (Sibley et al. 2011 Physical Therapy; 91: 1583-91). The purpose of this study was to analyse additional survey data and i) evaluate satisfaction with current balance assessment practices and standardized measures among physiotherapists who treat adult or geriatric populations with balance impairment, and ii) identify factors associated with satisfaction. The questionnaire was distributed to 1000 practicing physiotherapists. This analysis focuses on questions in which respondents were asked to rate their general perceptions about balance assessment, the perceived utility of individual standardized balance measures, whether they wanted to improve balance assessment practices, and why. Data were summarized with descriptive statistics and utility of individual measures was compared across clinical practice areas (orthopaedic, neurological, geriatric or general rehabilitation). The questionnaire was completed by 369 respondents, of which 43.4% of respondents agreed that existing standardized measures of balance meet their needs. In ratings of individual measures, the Single Leg Stance test and Berg Balance Scale were perceived as useful for clinical decision-making and evaluating change over time by over 70% of respondents, and the Timed Up-and-Go test was perceived as useful for decision-making by 56.9% of respondents and useful for evaluating change over time by 62.9% of respondents, but there were significant differences across practice groups. Seventy-nine percent of respondents wanted to improve their assessments, identifying individual, environmental and measure-specific barriers. The most common barriers were lack of time and knowledge. This study offers new information on issues affecting the evaluation of balance in clinical settings from a broad sample of physiotherapists. Continued work to address barriers by specific practice area will be critical for the success of any intervention attempting to implement optimal balance assessment practices in the clinical setting.

Peer Review Practices for Evaluating Biomedical Research Grants: A Scientific Statement From the American Heart Association.

PubMed

Liaw, Lucy; Freedman, Jane E; Becker, Lance B; Mehta, Nehal N; Liscum, Laura

2017-08-04

The biomedical research enterprise depends on the fair and objective peer review of research grants, leading to the distribution of resources through efficient and robust competitive methods. In the United States, federal funding agencies and foundations collectively distribute billions of dollars annually to support biomedical research. For the American Heart Association, a Peer Review Subcommittee is charged with establishing the highest standards for peer review. This scientific statement reviews the current literature on peer review practices, describes the current American Heart Association peer review process and those of other agencies, analyzes the strengths and weaknesses of American Heart Association peer review practices, and recommends best practices for the future. © 2017 American Heart Association, Inc.

Clinical supervision: from rhetoric to accident and emergency practice.

PubMed

Castille, K

1996-01-01

Clinical supervision is firmly on the nursing agenda and, when implemented, will affect every practising nurse. However, current literature offers little in the way of advice on the practical application in a setting like the Accident and Emergency department (A & E). The aim of this article is to encourage A & E nurses to consider how clinical supervision can best be implemented into their current practice. A framework is presented to show how one A & E department has embraced the concept of clinical supervision and incorporated in into their A & E nursing practice. The evaluation, to date, has been positive and A & E nurses have reported that they enjoy the sessions and consider clinical supervision to be a useful learning experience.

The "wins" of change: evaluating the impact of predicted changes on case management practice.

PubMed

Stanton, Marietta P; Barnett Lammon, Carol Ann

2008-01-01

A variety of strategies were employed to identify current and future trends that would impact the practice of case management. Historical review, consultation with case management experts, literature review, and environmental scanning by practicing case managers were strategies employed to determine the impact of current and future trends on case management. The trends identified in this article have implications for case managers in a variety of settings. Case managers participating in the environmental scanning process to evaluate the impact of the identified trends on their organization included representation from acute care, home care, behavioral health, workers' compensation, and private insurance settings. The top 7 trends identified by experts in the field of case management included pay for performance, recovery audit contractors, Medicare demonstration projects, transitions of care, informatics in healthcare and case management, metrics for case management, and the impact of an aging population in case management. Practicing case managers were asked to react to these trends in terms of likelihood of occurrence in their organization and impact of these trends on their case management practice. Case management will ultimately have a higher degree of accountability for its practice if metrics to evaluate and reimbursement for case management become a reality. A multitude of performance measures exist that will be monitored and be tied to reimbursement. To ensure that agencies are accomplishing these performance measures, case management will potentially have a growing importance. Case managers perceive that these trends have a predominantly positive impact on case management.

Recruitment and Hiring Strategies of Private Practitioners and Implications for Practice Management Training of Veterinary Students.

PubMed

Kogan, Lori R; Hellyer, Peter W; Stewart, Sherry M; Dowers, Kristy L

2015-01-01

Hiring new employees is one of the most important and difficult decisions all veterinary practice managers and owners face. In an effort to improve hiring decisions, many employers are choosing to screen potential employees more thoroughly through the use of interviews, background checks, personality assessments, and online research including social and professional networking websites. The current study reports results from an anonymous online survey created to evaluate practicing veterinarians' attitudes and practices related to the use of recruitment and hiring tools. Results suggest that, compared to those in other professions, veterinarians underutilize these evaluative tools. The profession could benefit from more opportunities for both practitioners and veterinary students to learn how to utilize a broader range of hiring and recruitment techniques. One area of particular and growing concern is the use of Internet social media for evaluation of potential employees. Despite the fairly low number of participants who indicated they currently research applicants online, a significant number plan to implement this practice in the future. Many students are unaware of how their online postings can affect their future job possibilities and career. It is therefore important to designate time within continuing education programs and professional veterinary curricula to educate these populations about hiring and recruitment tool options and about how to manage their personal Internet interactions (especially social media) to enhance and maintain their professional image (e-professionalism).

Plastics processing: statistics, current practices, and evaluation.

PubMed

Cooke, F

1993-11-01

The health care industry uses a huge quantity of plastic materials each year. Much of the machinery currently used, or supplied, for plastics processing is unsuitable for use in a clean environment. In this article, the author outlines the reasons for the current situation and urges companies to re-examine their plastic-processing methods, whether performed in-house or subcontracted out. Some of the factors that should be considered when evaluating plastics-processing equipment are outlined to assist companies in remaining competitive and complying with impending EC regulations on clean room standards for manufacturing areas.

Evaluating Liberal Learning: Doubts and Explorations.

ERIC Educational Resources Information Center

Green, Thomas F.

1982-01-01

In current evaluation practice, the implicit philosophy of value, appraisal, and action is seen as a form of Benthamite utilitarianism. A domain of value called "educational worth" is described. Ways of detecting the presence of educational worth in liberal learning programs are identified. (MLW)

Evaluation of Online Education about Diabetes Management in the School Setting

ERIC Educational Resources Information Center

Bachman, Jean A.; Hsueh, Kuei-Hsiang

2008-01-01

There are a variety of initiatives to provide education to improve the quality of care for children with diabetes in the school setting. This study piloted and evaluated an online continuing education program for school nurses about diabetes management for children in schools using current practice principles. The evaluation determined if…

Teaching Emotions in Higher Education: An Emotional Rollercoaster

ERIC Educational Resources Information Center

Evans, Thomas Rhys; Steptoe-Warren, Gail

2015-01-01

Emotions are fundamental to understanding many phenomena in psychology; however, there are currently no emotion-specific evidence-based teaching practices. The current study evaluates an innovative new active learning-based teaching activity, designed to provide a structure for discussions around emotion. Small groups of third-year psychology…

Radiological health risk evaluation of radium contaminated land: a real life implementation.

PubMed

Paridaens, J

2005-01-01

A plot of land, currently used for dairy farming, has been contaminated over the years with radium due to the operation of one of the world's largest radium production plants. Within the framework of a global remediation approach for the plant surroundings, the land owner needed advice for a future destination of the land. Therefore, the radium contamination was accurately mapped, and on the basis of its severity a practically feasible subdivision of the land into four plots was proposed. For all four plots, the radiological risk was evaluated for the current type of land use and for possible alternative types. Hence a clear and useable advice could be formulated to the authorities reconciling public health, economic and practical issues.

Orientation and mobility training for adults with low vision: a new standardized approach

PubMed Central

Ballemans, Judith; Kempen, Gertrudis IJM

2013-01-01

Background: Orientation and mobility training aims to facilitate independent functioning and participation in the community of people with low vision. Objective: (1) To gain insight into current practice regarding orientation and mobility training, and (2) to develop a theory-driven standardized version of this training to teach people with low vision how to orientate and be safe in terms of mobility. Study of current practice: Insight into current practice and its strengths and weaknesses was obtained via reviewing the literature, observing orientation and mobility training sessions (n = 5) and interviewing Dutch mobility trainers (n = 18). Current practice was mainly characterized by an individual, face-to-face orientation and mobility training session concerning three components: crystallizing client’s needs, providing information and training skills. A weakness was the lack of a (structured) protocol based on evidence or theory. New theory-driven training: A new training protocol comprising two face-to-face sessions and one telephone follow-up was developed. Its content is partly based on the components of current practice, yet techniques from theoretical frameworks (e.g. social-cognitive theory and self-management) are incorporated. Discussion: A standardized, tailor-made orientation and mobility training for using the identification cane is available. The new theory-driven standardized training is generally applicable for teaching the use of every low-vision device. Its acceptability and effectiveness are currently being evaluated in a randomized controlled trial. PMID:22734105

The current state of cancer family history collection tools in primary care: a systematic review.

PubMed

Qureshi, Nadeem; Carroll, June C; Wilson, Brenda; Santaguida, Pasqualina; Allanson, Judith; Brouwers, Melissa; Raina, Parminder

2009-07-01

Systematic collection of family history is a prerequisite for identifying genetic risk. This study reviewed tools applicable to the primary care assessment of family history of breast, colorectal, ovarian, and prostate cancer. MEDLINE, EMBASE, CINAHL, and Cochrane Central were searched for publications. All primary study designs were included. Characteristics of the studies, the family history collection tools, and the setting were evaluated. Of 40 eligible studies, 18 relevant family history tools were identified, with 11 developed for use in primary care. Most collected information on more than one cancer and on affected relatives used self-administered questionnaires and paper-based formats. Eleven tools had been evaluated relative to current practice, demonstrating 46-78% improvement in data recording over family history recording in patient charts and 75-100% agreement with structured genetic interviews. Few tools have been developed specifically for primary care settings. The few that have been evaluated performed well. The very limited evidence, which depends in part on extrapolation from studies in settings other than primary care, suggests that systematic tools may add significant family health information compared with current primary care practice. The effect of their use on health outcomes has not been evaluated.

General practice registrars' intentions for future practice: implications for rural medical workforce planning.

PubMed

Harding, Catherine; Seal, Alexa; McGirr, Joe; Caton, Tim

2016-11-01

The models of practice that general practice registrars (GPRs) envisage undertaking will affect workforce supply. The aim of this research was to determine practice intentions of current GPRs in a regional general practice training program (Coast City Country General Practice Training). Questionnaires were circulated to 220 GPRs undertaking general practice placements to determine characteristics of ideal practice models and intentions for future practice. Responses were received for 99 participants (45%). Current GPRs intend to work an average of less than eight half-day sessions/week, with male participants intending to work more hours (t(91)=3.528, P=0.001). More than one-third of this regional cohort intends to practice in metropolitan centres. Proximity to family and friends was the most important factor influencing the choice of practice location. Men ranked remuneration for work as more important (t (88)=-4.280, P<0.001) and women ranked the ability to work part-time higher (t(94)=3.697, P<0.001). Fee-for-service payment alone, or in combination with capitation, was the preferred payment system. Only 22% of Australian medical graduates intend to own their own practice compared with 52% of international medical graduates (χ 2 (1)=8.498, P=0.004). Future general practitioners (GPs) intend to work fewer hours than current GPs. Assumptions about lifestyle factors, practice models and possible professional roles should be carefully evaluated when developing strategies to recruit GPs and GPRs into rural practice.

The who, what, and how of evaluation within online nursing education: state of the science.

PubMed

Russell, Bedelia H

2015-01-01

The resource capacity in nursing programs has a direct impact on student admissions and number of graduates who enter the nursing workforce. Online delivery of nursing education is identified as a solution to expand nursing program capacity. As nursing programs continue to address capacity with online course delivery, it is essential that nurse educators maintain consistent evaluation practices to ensure successful and positive outcomes, compared with traditional models. Evaluation is a central component to determine program quality and mastery of learning outcomes. This article examines the state of the science around the current evaluation of educational practices, instructional strategies, and outcomes within the context of online nursing education. Thirty-six articles met the inclusion criteria. Despite substantive contributions to the state of the science, the findings reflect evaluation practices that are diffuse and superficial and serve as the basis for future recommendations and research opportunities. Copyright 2015, SLACK Incorporated.

Clinical endpoints for developing pharmaceuticals to manage patients with sporadic or genetic risk of colorectal cancer

PubMed Central

Rial, Nathaniel S.; Zell, Jason A.; Cohen, Alfred M.; Gerner, Eugene W.

2013-01-01

To reduce the morbidity and mortality from colorectal cancer, current clinical practice focuses on screening for early detection and polypectomy as a form of secondary prevention, complemented with surgical interventions when appropriate. No pharmaceutical agent is currently approved for use in clinical practice for the management of patients with risk of colorectal cancer. This article will review earlier attempts to develop pharmaceuticals for use in managing patients with sporadic or genetic risk of colorectal cancer. It will also discuss therapeutic endpoints under evaluation in current efforts to develop drugs for treating colorectal cancer risk factors. PMID:22928902

Multi-site evaluation of APEX for crop and grazing land in the Heartland region of the US

USDA-ARS?s Scientific Manuscript database

The Agricultural and Policy Environmental Extender (APEX) is capable of estimating edge-of-field water, nutrient, and sediment transport and is used to assess the environmental impacts of management practices. Current practice is to fully calibrate the model for each site simulation, which requires ...

Leveraging Observation Tools for Instructional Improvement: Exploring Variability in Uptake of Ambitious Instructional Practices

ERIC Educational Resources Information Center

Cohen, Julie; Schuldt, Lorien Chambers; Brown, Lindsay; Grossman, Pamela

2016-01-01

Background/Context: Current efforts to build rigorous teacher evaluation systems has increased interest in standardized classroom observation tools as reliable measures for assessing teaching. However, many argue these instruments can also be used to effect change in classroom practice. This study investigates a model of professional development…

Professional Learning Communities: Teachers Working Collaboratively for Continuous Improvement

ERIC Educational Resources Information Center

Griffith, Louise Ann

2009-01-01

Current research indicates that a professional learning community (PLC) is an effective means for helping teachers to bridge the gap between research and practice. A PLC is a team of educators systematically working together to improve teaching practice and student learning. This study evaluated the PLC formed by teachers at a public elementary…

Multicultural Integration in British and Dutch Societies: Education and Citizenship

ERIC Educational Resources Information Center

Bagley, Christopher Adam; Al-Refai, Nader

2017-01-01

Purpose: The purpose of this paper is to review and synthesize published studies and practice in the "integration" of ethnic and religious minorities in Britain and The Netherlands, 1965-2015, drawing out implications for current policy and practice. Design/methodology/approach: This paper is an evaluative review and report of results of…

Developing Leadership for Life: Outcomes from a Collegiate Student-Alumni Mentoring Program

ERIC Educational Resources Information Center

Priest, Kerry L.; Donley, Sarah

2014-01-01

This application brief describes the exploratory assessment of a mentoring program between current students and alumni of a leadership studies minor program. We connect leadership education research and practice in two ways: first, we describe a process of qualitative program evaluation to inform program best practices and improvement. In doing…

Evaluating the Strength of School Tobacco Policies: The Development of a Practical Rating System

ERIC Educational Resources Information Center

Boyce, Jennifer C.; Mueller, Nancy B.; Hogan-Watts, Melissa; Luke, Douglas A.

2009-01-01

Background: School tobacco control policies vary widely in their strength, extensiveness, and enforcement. Currently, no standardized method exists to assess the comprehensiveness of school tobacco policies. The purpose of this study was to develop a new practical rating system for school tobacco policies, assess its reliability, and present…

Mild Intellectual Disabilities: Legacies and Trends in Concepts and Educational Practices

ERIC Educational Resources Information Center

Polloway, Edward A.; Lubin, Jacqueline; Smith, J. David; Patton, James R.

2010-01-01

Intellectual disability has been considered a high incidence disability in special education since the inception of the field in the United States. The purpose of this article is to evaluate current educational programs and practices for students who historically and commonly have been referred to as having mild mental retardation. The article…

Measuring the impact of the advanced practitioner role: a practical approach.

PubMed

Neville, Lillian; Swift, Juliette

2012-04-01

This paper aims to illuminate difficulties in evaluating the advanced practitioner role and to offer a practical solution. The advanced practice role has been part of the workforce strategy in the Northwest of England since 2005. However capturing hard evidence of the impact of this role has been problematic. Current restrictions on resources require the provision of evidence of the value of roles and services. Critical analysis of literature has identified challenges in evaluating the advanced practice role. The case study design takes account of current policy initiatives, notably QIPP. There is no common approach to evaluating the role of advanced practitioners. The case study has the potential to be a useful tool to organise evidence of the impact of advanced practitioner roles. Advanced practitioners need to have appropriate knowledge and skills to provide evidence of the impact of their role. There is potential for this work to be applied to other roles across the NHS. Managers need to work in partnership with workforce planners and educationalists to support advanced practitioners to utilise their skills in methods of providing evidence that they do work of value. Clear strategic direction for advanced practitioners is advised as part of the workforce strategy. © 2012 Blackwell Publishing Ltd.

Maintenance of Certification: How Performance in Practice Changes Improve Tobacco Cessation in Addiction Psychiatrists’ Practice

PubMed Central

Ford, James H.; Oliver, Karen A.; Giles, Miriam; Cates-Wessel, Kathryn; Krahn, Dean; Levin, Frances R.

2017-01-01

Background and Objectives In 2000, the American Board of Medical Specialties implemented the Maintenance of Certification (MOC), a structured process to help physicians identify and implement a quality improvement project to improve patient care. This study reports on findings from an MOC Performance in Practice (PIP) module designed and evaluated by addiction psychiatrists who are members of the American Academy of Addiction Psychiatry (AAAP). Method A 3-phase process was utilized to recruit AAAP members to participate in the study. The current study utilized data from 154 self-selected AAAP members who evaluated the effectiveness of the MOC Tobacco Cessation PIP. Results Of the physicians participating, 76% (n 120) completed the Tobacco PIP. A paired t-test analysis revealed that reported changes in clinical measure documentation were significant across all six measures. Targeted improvement efforts focused on a single clinical measure. Results found that simple change projects designed to improve clinical practice led to substantial changes in self-reported chart documentation for the selected measure. Conclusions The current findings suggest that addiction psychiatrists can leverage the MOC process to improve clinical care. PMID:27973746

Carbon Offset Forestry: Forecasting Ecosystem Effects (COFFEE) Project Implementation Plan

EPA Science Inventory

COFFEE will evaluate the environmental impacts of implementing various COF practices by using the amount of total ecosystem C (TEC) sequestered in forests as the integrative response metric. These evaluations will be done for current-climate and future-climate scenarios and will...

Student-Centered Classrooms: Past Initiatives, Future Practices

ERIC Educational Resources Information Center

Hansen, Dee; Imse, Leslie A.

2016-01-01

Music teacher evaluations traditionally examine how teachers develop student music-learning objectives, assess cognitive and performance skills, and direct classroom learning experiences and behavior. A convergence of past and current educational ideas and directives is changing how teachers are evaluated on their use of student-centered…

75 FR 25852 - Agency Information Collection Activities; Proposed Collection; Comment Request; Stormwater...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-10

... order to evaluate current stormwater management practices, the scope of the current State and local...; Stormwater Management Including Discharges From Developed Sites Questionnaires AGENCY: Environmental... forwarded to the Office of Management and Budget (OMB) for review and approval. This is a request for a new...

Reflective Practice in Healthcare Education: An Umbrella Review

ERIC Educational Resources Information Center

Fragkos, Konstantinos C.

2016-01-01

Reflection in healthcare education is an emerging topic with many recently published studies and reviews. This current systematic review of reviews (umbrella review) of this field explores the following aspects: which definitions and models are currently in use; how reflection impacts design, evaluation, and assessment; and what future challenges…

Evaluating best practices for Campylobacter and Salmonella reduction in poultry processing plants.

PubMed

Wideman, N; Bailey, M; Bilgili, S F; Thippareddi, H; Wang, L; Bratcher, C; Sanchez-Plata, M; Singh, M

2016-02-01

Poultry processing plants in the United States were surveyed on their current Campylobacter and Salmonella control practices. Following surveys, data were collected to develop a baseline for prevalence rates of Salmonella and Campylobacter; then changes in practices were implemented and evaluated for improvements in pathogen control. Surveys were sent to the plant Quality Assurance managers to determine production levels, antimicrobial interventions, and current pathogen testing practices. Initial sampling was performed at 6 plants with similar production volumes, at sites that included carcass samples before any pre-evisceration intervention, after exiting the inside-outside bird washer (IOBW), after exiting the pre-chiller, after exiting the primary chiller, and after exiting any post-chill intervention, as well as a water sample from each scalder, pre-chiller, primary chiller, and post-chill dip tank or finishing chiller. Enumerations and enrichments were performed for Campylobacter and Salmonella. Following the baseline sampling, changes in practices were suggested for each plant and a second sampling was conducted to determine their effectiveness. Results demonstrated that peracetic acid (PAA) was the most effective (P < 0.05) antimicrobial currently in use. The use of a post-chill antimicrobial immersion tank and/or use of a cetylpyridinium chloride (CPC) spray cabinet also displayed a further reduction in microbial levels (P < 0.05) when the primary chiller was not sufficient (P > 0.05). Microbial buildup in the immersion tanks demonstrates the need for effective cleaning, sanitation practices, and chiller maintenance to reduce contamination of poultry with Campylobacter and Salmonella. © 2015 Poultry Science Association Inc.

Evidence-based Medicine in Facial Plastic Surgery: Current State and Future Directions.

PubMed

Dedhia, Raj; Hsieh, Tsung-Yen; Tollefson, Travis T; Ishii, Lisa E

2016-08-01

Evidence-based medicine (EBM) encompasses the evaluation and application of best available evidence, incorporation of clinical experience, and emphasis on patient preference and values. Different scales are used to rate levels of evidence. Translating available data for interventions to clinical practice guidelines requires an assessment of both the quality of evidence and the strength of recommendation. Essential to the practice of EBM is evaluating the effectiveness of an intervention through outcome measures. This article discusses principles essential to EBM, resources commonly used in EBM practice, and the strengths and limitations of EBM in facial plastic and reconstructive surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

Organizational context associated with time spent evaluating language and cognitive-communicative impairments in skilled nursing facilities: Survey results within an implementation science framework.

PubMed

Douglas, Natalie F

2016-01-01

The Consolidated Framework for Implementation Research (CFIR) was developed to merge research and practice in healthcare by accounting for the many elements that influence evidence-based treatment implementation. These include characteristics of the individuals involved, features of the treatment itself, and aspects of the organizational culture where the treatment is being provided. The purpose of this study was to apply the CFIR to a measurement of current practice patterns of speech-language pathologists (SLPs) working in the skilled nursing facility (SNF) environment. In an effort to inform future evidence-based practice implementation interventions, research questions addressed current practice patterns, clinician treatment use and preferences, and perceptions of the organizational context including leadership, resources, and other staff. Surveys were mailed to each SLP working in a SNF in the state of Michigan. Participants (N=77, 19% response rate) completed a survey mapping on to CFIR components impacting evidence-based practice implementation. Quantitative descriptive and nonparametric correlational analyses were completed. Use of evidence-based treatments by SLPs in SNFs was highly variable. Negative correlations between treating speech and voice disorders and treating swallowing disorders (rs=-.35, p<.01), evaluating language and cognitive-communicative disorders and treating swallowing disorders (rs=-.30, p<.01), treating language and cognitive-communicative disorders and treating swallowing disorders (rs=-.67, p<.01), and evaluating swallowing disorders and treating language and cognitive-communicative disorders (rs=-.37, p<.01) were noted. A positive correlation between the SLPs' perception of organizational context and time spent evaluating language and other cognitive-communicative disorders (rs=.27, p<.05) was also present. Associative data suggest that the more an SLP in the SNF evaluates and treats swallowing disorders, the less he or she will evaluate speech, voice, language or other cognitive-communicative disorders. Further, SLPs in this sample spent more time evaluating language and cognitive-communicative impairments if they perceived their organizational context in a more positive way. The CFIR may guide treatment and implementation research to increase the uptake of evidence-based practices for SLPs working in the SNF setting. Copyright © 2015 Elsevier Inc. All rights reserved.

Feedback about Teaching in Higher Ed: Neglected Opportunities to Promote Change

PubMed Central

Evans, Mara; Brickman, Peggy

2014-01-01

Despite ongoing dissemination of evidence-based teaching strategies, science teaching at the university level is less than reformed. Most college biology instructors could benefit from more sustained support in implementing these strategies. One-time workshops raise awareness of evidence-based practices, but faculty members are more likely to make significant changes in their teaching practices when supported by coaching and feedback. Currently, most instructional feedback occurs via student evaluations, which typically lack specific feedback for improvement and focus on teacher-centered practices, or via drop-in classroom observations and peer evaluation by other instructors, which raise issues for promotion, tenure, and evaluation. The goals of this essay are to summarize the best practices for providing instructional feedback, recommend specific strategies for providing feedback, and suggest areas for further research. Missed opportunities for feedback in teaching are highlighted, and the sharing of instructional expertise is encouraged. PMID:26086652

Patient-centred care in general dental practice - a systematic review of the literature

PubMed Central

2014-01-01

Background Delivering improvements in quality is a key objective within most healthcare systems, and a view which has been widely embraced within the NHS in the United Kingdom. Within the NHS, quality is evaluated across three key dimensions: clinical effectiveness, safety and patient experience, with the latter modelled on the Picker Principles of Patient-Centred Care (PCC). Quality improvement is an important feature of the current dental contract reforms in England, with “patient experience” likely to have a central role in the evaluation of quality. An understanding and appreciation of the evidence underpinning PCC within dentistry is highly relevant if we are to use this as a measure of quality in general dental practice. Methods A systematic review of the literature was undertaken to identify the features of PCC relevant to dentistry and ascertain the current research evidence base underpinning its use as a measure of quality within general dental practice. Results Three papers were identified which met the inclusion criteria and demonstrated the use of primary research to provide an understanding of the key features of PCC within dentistry. None of the papers identified were based in general dental practice and none of the three studies sought the views of patients. Some distinct differences were noted between the key features of PCC reported within the dental literature and those developed within the NHS Patient Experience Framework. Conclusions This systematic review reveals a lack of understanding of PCC within dentistry, and in particular general dental practice. There is currently a poor evidence base to support the use of the current patient reported outcome measures as indicators of patient-centredness. Further research is necessary to understand the important features of PCC in dentistry and patients’ views should be central to this research. PMID:24902842

Voices from the Field: Evaluation as Part of a Learning Culture

ERIC Educational Resources Information Center

Hoole, Emily; Patterson, Tracy E.

2008-01-01

The authors present the argument that evaluation as currently practiced is failing the needs of the social sector, if the goal is to help organizations achieve their mission. Three case studies are presented in which evaluation played a key role in the development of a learning culture within the organization. Each case highlights the positive…

An Analysis of the Process of Teacher Evaluation in the Community College.

ERIC Educational Resources Information Center

Menzie, John Carroll

An analysis of teacher evaluation as practiced during 1971-1972 and 1972-1973 in community colleges throughout the United States is presented. To identify the concepts and outcomes of teacher evaluation a survey was made of current literature, two questionnaires were sent to 226 community colleges, and 67 interviews were conducted. There are…

Partnerships Enhancing Practice: A Preliminary Model of Technology-Based Peer-to-Peer Evaluations of Teaching in Higher Education

ERIC Educational Resources Information Center

Servilio, Kathryn L.; Hollingshead, Aleksandra; Hott, Brittany L.

2017-01-01

In higher education, current teaching evaluation models typically involve senior faculty evaluating junior faculty. However, there is evidence that peer-to-peer junior faculty observations and feedback may be just as effective. This descriptive case study utilized an inductive analysis to examine experiences of six special education early career…

Connecting Math Website Evaluation to an Authentic Learning Activity for Teaching Candidates

ERIC Educational Resources Information Center

Ziegenfus, Robert G.; Smith, Michael

2015-01-01

This article will discuss two teacher training functions: One function is to give the teacher candidates practice in evaluating currently available mathematics websites used in grades K-8 for mathematics instruction. The second function is the evaluation of data by teaching candidates of 13 commonly used math sites by middle and elementary…

Best practices for evaluating the capability of nondestructive evaluation (NDE) and structural health monitoring (SHM) techniques for damage characterization

NASA Astrophysics Data System (ADS)

Aldrin, John C.; Annis, Charles; Sabbagh, Harold A.; Lindgren, Eric A.

2016-02-01

A comprehensive approach to NDE and SHM characterization error (CE) evaluation is presented that follows the framework of the `ahat-versus-a' regression analysis for POD assessment. Characterization capability evaluation is typically more complex with respect to current POD evaluations and thus requires engineering and statistical expertise in the model-building process to ensure all key effects and interactions are addressed. Justifying the statistical model choice with underlying assumptions is key. Several sizing case studies are presented with detailed evaluations of the most appropriate statistical model for each data set. The use of a model-assisted approach is introduced to help assess the reliability of NDE and SHM characterization capability under a wide range of part, environmental and damage conditions. Best practices of using models are presented for both an eddy current NDE sizing and vibration-based SHM case studies. The results of these studies highlight the general protocol feasibility, emphasize the importance of evaluating key application characteristics prior to the study, and demonstrate an approach to quantify the role of varying SHM sensor durability and environmental conditions on characterization performance.

Occupational Interests and Mentally Retarded People: Review and Recommendations.

ERIC Educational Resources Information Center

Stodden, Robert A.; And Others

1979-01-01

The article reviews several studies regarding the choice of occupational interests for the mentally retarded adolescent. Several concerns about current evaluation practices are discussed. Recommendations are offered for a client centered, developmental model, making the evaluation of occupational interests a viable part of the client's…

Advisory Committee Evaluation of Vocational Education Programs.

ERIC Educational Resources Information Center

Orr, William T., Jr.

1985-01-01

Program advisory committees in vocational education have traditionally been charged with the responsibility of evaluating programs for the purpose of keeping them up to date with business and industry practices and current technology. Rapid technological development and accountability requirements have led to state mandates that the advisory…

The Impact of Peer Mentoring on Levels of Student Wellbeing, Integration and Retention: A Controlled Comparative Evaluation of Residential Students in UK Higher Education

ERIC Educational Resources Information Center

Collings, R.; Swanson, V.; Watkins, R.

2014-01-01

Peer mentoring is becoming increasingly popular in UK higher education, however, there remains little good quality, theoretically driven and evaluative research. The current study aims to bridge the gap between theory, practice and evaluation by providing a controlled evaluation of a peer mentoring scheme within UK universities. 109 first year…

A cost-effectiveness analysis comparing different strategies to implement noninvasive prenatal testing into a Down syndrome screening program.

PubMed

Ayres, Alice C; Whitty, Jennifer A; Ellwood, David A

2014-10-01

Currently, noninvasive prenatal testing (NIPT) is only recommended in high-risk women following conventional Down syndrome (DS) screening, and it has not yet been included in the Australian DS screening program. To evaluate the cost-effectiveness of different strategies of NIPT for DS screening in comparison with current practice. A decision-analytic approach modelled a theoretical cohort of 300,000 singleton pregnancies. The strategies compared were the following: current practice, NIPT as a second-tier investigation, NIPT only in women >35 years, NIPT only in women >40 years and NIPT for all women. The direct costs (low and high estimates) were derived using both health system costs and patient out-of-pocket expenses. The number of DS cases detected and procedure-related losses (PRL) were compared between strategies. The incremental cost per case detected was the primary measure of cost-effectiveness. Universal NIPT costs an additional $134,636,832 compared with current practice, but detects 123 more DS cases (at an incremental cost of $1,094,608 per case) and avoids 90 PRL. NIPT for women >40 years was the most cost-effective strategy, costing an incremental $81,199 per additional DS case detected and avoiding 95 PRL. The cost of NIPT needs to decrease significantly if it is to replace current practice on a purely cost-effectiveness basis. However, it may be beneficial to use NIPT as first-line screening in selected high-risk patients. Further evaluation is needed to consider the longer-term costs and benefits of screening. © 2014 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Body composition and functional assessment of nutritional status in adults: a narrative review of imaging, impedance, strength and functional techniques.

PubMed

Smith, S; Madden, A M

2016-12-01

The accurate and valid assessment of body composition is essential for the diagnostic evaluation of nutritional status, identifying relevant outcome measures, and determining the effectiveness of current and future nutritional interventions. Developments in technology and our understanding of the influences of body composition on risk and outcome will provide practitioners with new opportunities to enhance current practice and to lead future improvements in practice. This is the second of a two-part narrative review that aims to critically evaluate body composition methodology in diverse adult populations, with a primary focus on its use in the assessment and monitoring of under-nutrition. Part one focused on anthropometric variables [Madden and Smith (2016) J Hum Nutr Diet 29: 7-25] and part two focuses on the use of imaging techniques, bioelectrical impedance analysis, markers of muscle strength and functional status, with particular reference to developments relevant to practice. © 2016 The British Dietetic Association Ltd.

How the Chemistry Modeling Curriculum Engages Students in Seven Science Practices Outlined by the College Board

ERIC Educational Resources Information Center

Posthuma-Adams, Erica

2014-01-01

As advanced placement (AP) teachers strive to implement the changes outlined in the AP chemistry redesign, they will have the opportunity to reflect on and evaluate their current practices. For many AP teachers, the new focus on conceptual understanding, reasoning, inquiry, and critical thinking over memorization and algorithmic problem solving…

Using Critical Incidents of Instructional Design and Multimedia Production Activities to Investigate Instructional Designers' Current Practices and Roles

ERIC Educational Resources Information Center

Sugar, William A.; Luterbach, Kenneth J.

2016-01-01

Through consideration of critical incidents, this study analyzed 106 effective, ineffective and extraordinary instructional design and multimedia production (MP) activities discussed by 36 instructional design professionals. This evaluation provided insights into these professionals' best and not so best practices during the past 6 months.…

Practices and Procedures in the Administration of ITV Distance Learning Programs at Selected Institutions in Higher Education.

ERIC Educational Resources Information Center

Koontz, F. R.

The purpose of this study was to obtain current data on practices and procedures in the administration of distance learning programs in the areas of: (1) needs assessment; (2) student demographics; (3) telecourse acquisition procedures and sources; (4) criteria used to evaluate credit telecourses; (5) institutional approval procedures; (6)…

Assessing Suturing Skills in a Self-Guided Learning Setting: Absolute Symmetry Error

ERIC Educational Resources Information Center

Brydges, Ryan; Carnahan, Heather; Dubrowski, Adam

2009-01-01

Directed self-guidance, whereby trainees independently practice a skill-set in a structured setting, may be an effective technique for novice training. Currently, however, most evaluation methods require an expert to be present during practice. The study aim was to determine if absolute symmetry error, a clinically important measure that can be…

Practice Parameter for the Assessment and Treatment of Children and Adolescents with Attention-Deficit/Hyperactivity Disorder

ERIC Educational Resources Information Center

Journal of the American Academy of Child & Adolescent Psychiatry, 2007

2007-01-01

This practice parameter describes the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder (ADHD) based on the current scientific evidence and clinical consensus of experts in the field. This parameter discusses the clinical evaluation for ADHD, comorbid conditions associated with ADHD, research on the…

Moving to the Next Generation of Standards for Science: Building on Recent Practices. CRESST Report 762

ERIC Educational Resources Information Center

Herman, Joan L.

2009-01-01

In this report, Joan Herman, director for the National Center for Research, on Evaluation, Standards, & Student Testing (CRESST) recommends that the new generation of science standards be based on lessons learned from current practice and on recent examples of standards-development methodology. In support of this, recent, promising efforts to…

Colorado's AgrAbility Project's Effects on KASA and Practice Changes with Agricultural Producers and Professionals

ERIC Educational Resources Information Center

Fetsch, Robert J.; Jackman, Danielle M.

2015-01-01

Disability rates resulting from work-related injuries remain steadily high among farmers and ranchers. To address the gap in services within this population, USDA implemented AgrAbility nationally. Using part of Bennett's hierarchical model, the current study evaluated the KASA and practice change levels of 401 farmers and ranchers and compared…

Lung magnetic resonance imaging for pneumonia in children.

PubMed

Liszewski, Mark C; Görkem, Süreyya; Sodhi, Kushaljit S; Lee, Edward Y

2017-10-01

Technical factors have historically limited the role of MRI in the evaluation of pneumonia in children in routine clinical practice. As imaging technology has advanced, recent studies utilizing practical MR imaging protocols have shown MRI to be an accurate potential alternative to CT for the evaluation of pneumonia and its complications. This article provides up-to-date MR imaging techniques that can be implemented in most radiology departments to evaluate pneumonia in children. Imaging findings in pneumonia on MRI are also reviewed. In addition, the current literature describing the diagnostic performance of MRI for pneumonia is discussed. Furthermore, potential risks and limitations of MRI for the evaluation of pneumonia in children are described.

Regional Information System for Educators: Installation and Evaluation.

ERIC Educational Resources Information Center

Kromer, Charles

This document describes the installation and evaluation of the Regional Information System within the Michigan-Ohio Regional Educational Laboratory (MOREL). MOREL is an agency established to develop and test alternatives to current educational practice under Title IV of ESEA. The Regional Information System was established to provide referrals to…

A Parent-Oriented Approach to Rapid Toilet Training

ERIC Educational Resources Information Center

Doan, Dai; Toussaint, Karen A.

2016-01-01

The current evaluation assessed the effectiveness of a rapid toilet training procedure for three young males with autism. The evaluation extended the research on rapid toilet training procedures by assessing parents' preference to include two common toilet training components, a urine alarm and positive practice. In addition, we assessed child…

Evaluation of partial depth pavement repairs on routes heavily traveled by Amish horse and buggies : phase 1 : final report.

DOT National Transportation Integrated Search

2017-02-01

This report summarizes Phase 1 research work that was completed to: 1-document Ohio Department of Transportation (ODOT) : current practices for partial depth repairs performed on roadways with and without Amish buggy traffic, 2- identify and evaluate...

Evaluating the Effectiveness of Student Assistance Programs in Pennsylvania.

ERIC Educational Resources Information Center

Fertman, Carl I.; Fichter, Cele; Schlesinger, Jo; Tarasevich, Susan; Wald, Holly; Zhang, Xiaoyan

2001-01-01

This evaluation of the Pennsylvania Student Assistance Program (SAP) was conducted to determine overall efficacy of SAPs and, more specifically, how SAP is currently implemented. Findings indicate that SAP is being implemented as designed. Recommended is the development of benchmarks and indicators focusing on best SAP practices and effectiveness.…

Making the Grade: Using Instructional Feedback and Evaluation to Inspire Evidence-Based Teaching

ERIC Educational Resources Information Center

Brickman, Peggy; Gormally, Cara; Martella, Amedee Marchand

2016-01-01

Typically, faculty receive feedback about teaching via two mechanisms: end-of-semester student evaluations and peer observation. However, instructors require more sustained encouragement and constructive feedback when implementing evidence-based teaching practices. Our study goal was to characterize the landscape of current instructional-feedback…

Collection Evaluation Techniques: A Short, Selective, Practical, Current, Annotated Bibliography, 1990-1998. RUSA Occasional Papers Number 24.

ERIC Educational Resources Information Center

Strohl, Bonnie, Comp.

This bibliography contains annotations of 110 journal articles on topics related to library collection evaluation techniques, including academic library collections, access-vs-ownership, "Books for College Libraries," business collections, the OCLC/AMIGOS Collection Analysis CD, circulation data, citation-checking, collection bias,…

Defining, Discussing, and Evaluating Mobile Learning: The Moving Finger Writes and Having Writ...

ERIC Educational Resources Information Center

Traxler, John

2007-01-01

Since the start of the current millennium, experience and expertise in the development and delivery of mobile learning have blossomed and a community of practice has evolved that is distinct from the established communities of "tethered" e-Learning. This community is currently visible mainly through dedicated international conference…

A Review of Meta-Analyses in Education: Methodological Strengths and Weaknesses

ERIC Educational Resources Information Center

Ahn, Soyeon; Ames, Allison J.; Myers, Nicholas D.

2012-01-01

The current review addresses the validity of published meta-analyses in education that determines the credibility and generalizability of study findings using a total of 56 meta-analyses published in education in the 2000s. Our objectives were to evaluate the current meta-analytic practices in education, identify methodological strengths and…

Incorporating equity considerations in transport infrastructure evaluation: Current practice and a proposed methodology.

PubMed

Thomopoulos, N; Grant-Muller, S; Tight, M R

2009-11-01

Interest has re-emerged on the issue of how to incorporate equity considerations in the appraisal of transport projects and large road infrastructure projects in particular. This paper offers a way forward in addressing some of the theoretical and practical concerns that have presented difficulties to date in incorporating equity concerns in the appraisal of such projects. Initially an overview of current practice within transport regarding the appraisal of equity considerations in Europe is offered based on an extensive literature review. Acknowledging the value of a framework approach, research towards introducing a theoretical framework is then presented. The proposed framework is based on the well established MCA Analytic Hierarchy Process and is also contrasted with the use of a CBA based approach. The framework outlined here offers an additional support tool to decision makers who will be able to differentiate choices based on their views on specific equity principles and equity types. It also holds the potential to become a valuable tool for evaluators as a result of the option to assess predefined equity perspectives of decision makers against both the project objectives and the estimated project impacts. This framework may also be of further value to evaluators outside transport.

Identification of Evaluated, Exemplary Activities in Career Education (K-12). Executive Summary of Final Technical Report.

ERIC Educational Resources Information Center

Hamilton, Jack A.; Mitchell, Anita M.

A study was conducted to identify and describe evaluated, exemplary activities in career education (K-12) which represent the best of the current career education programs and practices referred to in Public Law 93-380. The major tasks of the study were to: (1) establish criteria for identifying evaluated, exemplary activities; (2) search for…

Cutaneous T-cell lymphoma (CTCL): Current practices in blood assessment and the utility of T-cell receptor (TCR)-Vβ chain restriction.

PubMed

Gibson, Juliet F; Huang, Jing; Liu, Kristina J; Carlson, Kacie R; Foss, Francine; Choi, Jaehyuk; Edelson, Richard; Hussong, Jerry W; Mohl, Ramsey; Hill, Sally; Girardi, Michael

2016-05-01

Accurate quantification of malignant cells in the peripheral blood of patients with cutaneous T-cell lymphoma is important for early detection, prognosis, and monitoring disease burden. We sought to determine the spectrum of current clinical practices; critically evaluate elements of current International Society for Cutaneous Lymphomas (ISCL) B1 and B2 staging criteria; and assess the potential role of T-cell receptor-Vβ analysis by flow cytometry. We assessed current clinical practices by survey, and performed a retrospective analysis of 161 patients evaluated at Yale (2011-2014) to compare the sensitivity, specificity, positive predictive value, and negative predictive value of parameters for ISCL B2 staging. There was heterogeneity in clinical practices among institutions. ISCL B1 criteria did not capture 5 Yale cohort cases with immunophenotypic abnormalities that later progressed. T-cell receptor-Vβ testing was more specific than polymerase chain reaction and aided diagnosis in detecting clonality, but was of limited benefit in quantification of tumor burden. Because of limited follow-up involving a single center, further investigation will be necessary to conclude whether our proposed diagnostic algorithm is of general clinical benefit. We propose further study of modified B1 criteria: CD4/CD8 ratio 5 or greater, %CD4(+) CD26(-) 20% or greater, or %CD4(+) CD7(-) 20% or greater, with evidence of clonality. T-cell receptor-Vβ testing should be considered in future diagnostic and staging algorithms. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Infective endocarditis prophylaxis: current practice trend among paediatric cardiologists: are we following the 2007 guidelines?

PubMed

Naik, Ronak J; Patel, Neil R; Wang, Ming; Shah, Nishant C

2016-08-01

In 2007, the American Heart Association modified the infective endocarditis prophylaxis guidelines by limiting the use of antibiotics in patients with cardiac conditions associated with the highest risk of adverse outcomes after infective endocarditis. Our objective was to evaluate current practice for infective endocarditis prophylaxis among paediatric cardiologists. A web-based survey focussing on current practice, describing the use of antibiotics for infective endocarditis prophylaxis in various congenital and acquired heart diseases, was distributed via e-mail to paediatric cardiologists. The survey was kept anonymous and was distributed twice. Data from 253 participants were analysed. Most paediatric cardiologists discontinued infective endocarditis prophylaxis in patients with simple lesions such as small ventricular septal defect, patent ductus arteriosus, and bicuspid aortic valve without stenosis or regurgitation; however, significant disagreement persists in prescribing infective endocarditis prophylaxis in certain conditions such as rheumatic heart disease, Fontan palliation without fenestration, and the Ross procedure. Use of antibiotic prophylaxis in certain selected conditions for which infective endocarditis prophylaxis has been indicated as per the current guidelines varies from 44 to 83%. Only 44% follow the current guidelines exclusively, and 34% regularly discuss the importance of oral hygiene with their patients at risk for infective endocarditis. Significant heterogeneity still persists in recommending infective endocarditis prophylaxis for several cardiac lesions among paediatric cardiologists. More than half of the participants (56%) do not follow the current guidelines exclusively in their practice. Counselling for optimal oral health in patients at risk for infective endocarditis needs to be optimised in the current practice.

Clinical balance assessment: perceptions of commonly-used standardized measures and current practices among physiotherapists in Ontario, Canada

PubMed Central

2013-01-01

Background Balance impairment is common in multiple clinical populations, and comprehensive assessment is important for identifying impairments, planning individualized treatment programs, and evaluating change over time. However, little information is available regarding whether clinicians who treat balance are satisfied with existing assessment tools. In 2010 we conducted a cross-sectional survey of balance assessment practices among physiotherapists in Ontario, Canada, and reported on the use of standardized balance measures (Sibley et al. 2011 Physical Therapy; 91: 1583-91). The purpose of this study was to analyse additional survey data and i) evaluate satisfaction with current balance assessment practices and standardized measures among physiotherapists who treat adult or geriatric populations with balance impairment, and ii) identify factors associated with satisfaction. Methods The questionnaire was distributed to 1000 practicing physiotherapists. This analysis focuses on questions in which respondents were asked to rate their general perceptions about balance assessment, the perceived utility of individual standardized balance measures, whether they wanted to improve balance assessment practices, and why. Data were summarized with descriptive statistics and utility of individual measures was compared across clinical practice areas (orthopaedic, neurological, geriatric or general rehabilitation). Results The questionnaire was completed by 369 respondents, of which 43.4% of respondents agreed that existing standardized measures of balance meet their needs. In ratings of individual measures, the Single Leg Stance test and Berg Balance Scale were perceived as useful for clinical decision-making and evaluating change over time by over 70% of respondents, and the Timed Up-and-Go test was perceived as useful for decision-making by 56.9% of respondents and useful for evaluating change over time by 62.9% of respondents, but there were significant differences across practice groups. Seventy-nine percent of respondents wanted to improve their assessments, identifying individual, environmental and measure-specific barriers. The most common barriers were lack of time and knowledge. Conclusions This study offers new information on issues affecting the evaluation of balance in clinical settings from a broad sample of physiotherapists. Continued work to address barriers by specific practice area will be critical for the success of any intervention attempting to implement optimal balance assessment practices in the clinical setting. PMID:23510277

Framework for Evaluating the Impact of Advanced Practice Nursing Roles.

PubMed

Bryant-Lukosius, Denise; Spichiger, Elisabeth; Martin, Jacqueline; Stoll, Hansruedi; Kellerhals, Sabine Degen; Fliedner, Monica; Grossmann, Florian; Henry, Morag; Herrmann, Luzia; Koller, Antje; Schwendimann, René; Ulrich, Anja; Weibel, Lukas; Callens, Betty; De Geest, Sabina

2016-03-01

To address the gap in evidence-based information required to support the development of advanced practice nursing (APN) roles in Switzerland, stakeholders identified the need for guidance to generate strategic evaluation data. This article describes an evaluation framework developed to inform decisions about the effective utilization of APN roles across the country. A participatory approach was used by an international group of stakeholders. Published literature and an evidenced-based framework for introducing APN roles were analyzed and applied to define the purpose, target audiences, and essential elements of the evaluation framework. Through subsequent meetings and review by an expert panel, the framework was developed and refined. A framework to evaluate different types of APN roles as they evolve to meet dynamic population health, practice setting, and health system needs was created. It includes a matrix of key concepts to guide evaluations across three stages of APN role development: introduction, implementation, and long-term sustainability. For each stage, evaluation objectives and questions examining APN role structures, processes, and outcomes from different perspectives (e.g., patients, providers, managers, policy-makers) were identified. A practical, robust framework based on well-established evaluation concepts and current understanding of APN roles can be used to conduct systematic evaluations. The evaluation framework is sufficiently generic to allow application in developed countries globally, both for evaluation as well as research purposes. © 2016 Sigma Theta Tau International.

Perceptions about Training during Endocrinology Residency Programs in India over the Years: A Cross-sectional Study (PEER India Study)

PubMed Central

Khandelwal, Deepak; Dutta, Deep; Singla, Rajiv; Surana, Vineet; Aggarwal, Sameer; Gupta, Yashdeep; Kalra, Sanjay; Khadgawat, Rajesh; Tandon, Nikhil

2017-01-01

Background: Residents' perception on quality of endocrinology training in India is not known. This study aimed to evaluate the perceptions about endocrinology residency programs in India among current trainees as compared to practicing endocrinologists. Methods: Trainees attending a preconference workshop at the annual conference of Endocrine Society of India (ESI) were given a questionnaire designed to evaluate their perceptions on their training. These evaluated the reasons for choosing endocrinology, their experiences during residency, and career plans. Practicing endocrinologists attending ESICON with at least 5-year experience were evaluated as controls. Results: Questionnaires from 63 endocrine trainees and 78 practicing endocrinologists were analyzed. Endocrinology is perceived to be the super-specialty with the best quality of life (QOL) but fair with regard to financial remuneration. Among current trainees, 61.89%, 31.74%, and 34.91% are satisfied with training in clinical endocrinology, laboratory endocrinology, and clinical/translational research, respectively. The corresponding figures for practicing endocrinologists are 71.78%, 25.63%, and 30.75%, respectively. Exposure to national endocrinology conferences during their endocrinology residency was adequate. However, exposure to international endocrinology conferences, research publications, project writing, and grant application are limited. Laboratory endocrinology is rated as the most neglected aspect during endocrine residency. Most of the trainees want to establish their own clinical practice in the long run. Very few trainees (17.46%) wish to join the medical education services. Conclusion: There is a good perception of QOL in endocrinology in spite of average financial remuneration. There is dissatisfaction with the quality of training in laboratory endocrinology and clinical research. Very few endocrine trainees consider academics as a long-term career option in India. PMID:28459024

21 CFR 26.10 - Regulatory authorities not listed as currently equivalent.

Code of Federal Regulations, 2010 CFR

2010-04-01

... SERVICES GENERAL MUTUAL RECOGNITION OF PHARMACEUTICAL GOOD MANUFACTURING PRACTICE REPORTS, MEDICAL DEVICE QUALITY SYSTEM AUDIT REPORTS, AND CERTAIN MEDICAL DEVICE PRODUCT EVALUATION REPORTS: UNITED STATES AND THE...

21 CFR 886.1400 - Maddox lens.

Code of Federal Regulations, 2014 CFR

2014-04-01

... intended to be handheld or placed in a trial frame to evaluate eye muscle dysfunction. (b) Classification... the current good manufacturing practice requirements of the quality system regulation in part 820 of...

21 CFR 886.1400 - Maddox lens.

Code of Federal Regulations, 2010 CFR

2010-04-01

... intended to be handheld or placed in a trial frame to evaluate eye muscle dysfunction. (b) Classification... the current good manufacturing practice requirements of the quality system regulation in part 820 of...

21 CFR 886.1400 - Maddox lens.

Code of Federal Regulations, 2011 CFR

2011-04-01

... intended to be handheld or placed in a trial frame to evaluate eye muscle dysfunction. (b) Classification... the current good manufacturing practice requirements of the quality system regulation in part 820 of...

21 CFR 886.1400 - Maddox lens.

Code of Federal Regulations, 2013 CFR

2013-04-01

... intended to be handheld or placed in a trial frame to evaluate eye muscle dysfunction. (b) Classification... the current good manufacturing practice requirements of the quality system regulation in part 820 of...

21 CFR 886.1400 - Maddox lens.

Code of Federal Regulations, 2012 CFR

2012-04-01

... intended to be handheld or placed in a trial frame to evaluate eye muscle dysfunction. (b) Classification... the current good manufacturing practice requirements of the quality system regulation in part 820 of...

Values and principles evident in current health promotion practice.

PubMed

Gregg, Jane; O'Hara, Lily

2007-04-01

Modern health promotion practice needs to respond to complex health issues that have multiple interrelated determinants. This requires an understanding of the values and principles of health promotion. A literature review was undertaken to explore the values and principles evident in current health promotion theory and practice. A broad range of values and principles are espoused as being integral to modern health promotion theory and practice. Although there are some commonalities across these lists, there is no recognised, authoritative set of values and principles accepted as fundamental and applicable to modern health promotion. There is a continuum of values and principles evident in health promotion practice from those associated with holistic, ecological, salutogenic health promotion to those more in keeping with conventional health promotion. There is a need for a system of values and principles consistent with modern health promotion that enables practitioners to purposefully integrate these values and principles into their understanding of health, as well as their needs assessment, planning, implementation and evaluation practice.

A Clinician-Centered Evaluation of the Usability of AHLTA and Automated Clinical Practice Guidelines at TAMC

DTIC Science & Technology

2011-03-31

evidence based medicine into clinical practice. It will decrease costs and enable multiple stakeholders to work in an open content/source environment to exchange clinical content, develop and test technology and explore processes in applied CDS. Design: Comparative study between the KMR infrastructure and capabilities developed as an open source, vendor agnostic solution for aCPG execution within AHLTA and the current DoD/MHS standard evaluating: H1: An open source, open standard KMR and Clinical Decision Support Engine can enable organizations to share domain

Evaluation of the general public's knowledge, views and practices relating to appropriate antibiotic use in Qatar.

PubMed

Moienzadeh, Atefeh; Massoud, Tasnim; Black, Emily

2017-04-01

Studies completed internationally have demonstrated an alarming number of patients believed antibiotics are indicated in the treatment of viral infections and other self-limited illnesses. Evaluation of patient practices relating to antibiotics have also demonstrated inappropriate use. Antibiotic misuse by patients and practitioners has been identified as a factor in the development of resistance. Current knowledge, views and practices relating to antibiotic use in Qatar is unknown. The primary objective of this study was to evaluate the general population's current antimicrobial knowledge, views and practices in Qatar. This study was designed as a self-administered cross-sectional survey. Eligible participants were residents of Qatar who were over the age of 18 and spoke English or Arabic. The questionnaire was developed based on previously published literature and objectives of this study. Data were collected at community pharmacies in Doha, Qatar. The majority of participants (95.8%) had taken antibiotics in the past. The median knowledge score of the study population was 4/8. Misconceptions relating to use of antibiotics for treatment of viral infections were common. Inappropriate use as evident by hoarding of antibiotics for future use and sharing antibiotics with family or friends was also identified in this study population. Community pharmacists in Qatar have an opportunity to improve knowledge of the general population regarding appropriate indications of antibiotics and risk of resistance with inappropriate use. © 2015 Royal Pharmaceutical Society.

Psychometric Assessment and Reporting Practices: Incongruence between Theory and Practice

ERIC Educational Resources Information Center

Slaney, Kathleen L.; Tkatchouk, Masha; Gabriel, Stephanie M.; Maraun, Michael D.

2009-01-01

The aim of the current study is twofold: (a) to investigate the rates at which researchers assess and report on the psychometric properties of the measures they use in their research and (b) to examine whether or not researchers appear to be generally employing sound/unsound rationales when it comes to how they conduct test evaluations. Based on a…

A Survey of Rank, Salary, Promotion, and Tenure Policies in Fifteen Colleges and Universities. A Survey of Current Practices.

ERIC Educational Resources Information Center

Southeast Missouri State Univ., Cape Girardeau.

Questionnaires designed to find out how institutional policies for evaluating special degrees affected institutional practices in determining initial rank, salary level, tenure status, and eligibility for promotion of faculty members were sent to 27 institutions. The special degrees fell in 4 categories: (1) faculty members with a degree in law…

School-Wide Discipline Policies: In-School Suspension in One Middle School.

ERIC Educational Resources Information Center

Chung, Gloria; Paul, Rachel

One of the more perplexing problems facing middle schools is the use of in-school suspension (ISS). So as to understand better the effects of this practice, one middle school's ISS program was studied and evaluated. Current research on ISS polices and practices is limited, and there is little evidence that supports its use or reform; however, in…

Marketing your equine practice.

PubMed

Magnus, Robert P

2009-12-01

The take-home message in marketing your equine practice is simple: understand your position in the target market and the buying behavior of your current and prospective customers. Time well spent on analysis and evaluation of options can maximize customer value in the services and products you offer. This allows you to capture profit and to attain your personal and professional goals as an equine practitioner.

Calculating Clinically Significant Change: Applications of the Clinical Global Impressions (CGI) Scale to Evaluate Client Outcomes in Private Practice

ERIC Educational Resources Information Center

Kelly, Peter James

2010-01-01

The Clinical Global Impressions (CGI) scale is a therapist-rated measure of client outcome that has been widely used within the research literature. The current study aimed to develop reliable and clinically significant change indices for the CGI, and to demonstrate its application in private psychological practice. Following the guidelines…

Sight-Singing Assessment: A Study of Current Beliefs and Practices of Georgia Middle and High School Choral Directors

ERIC Educational Resources Information Center

Goss, Douglass Anthony

2010-01-01

This study sought to ascertain the specific assessment strategies used by middle- and high-school choral directors in Georgia to evaluate sight-singing. Data was further gathered to determine which assessment practices choral directors considered to be the most effective. Although there had been previous studies that attempted to determine the…

Towards an Understanding of Factors Influencing Early Years Professionals' Practice of Consultation with Young Children

ERIC Educational Resources Information Center

Davies, Sarah; Artaraz, Kepa

2009-01-01

Recent Government agendas in England highlight a need to involve children in policy and service design, provision and evaluation of services they use or which affect them. While consultation with older children has become more common, this is not the case for younger children. This article reports on a study exploring the current practice and…

The evaluation of bulbar dysfunction in amyotrophic lateral sclerosis: survey of clinical practice patterns in the United States.

PubMed

Plowman, Emily K; Tabor, Lauren C; Wymer, James; Pattee, Gary

2017-08-01

Speech and swallowing impairments are highly prevalent in individuals with amyotrophic lateral sclerosis (ALS) and contribute to reduced quality of life, malnutrition, aspiration, pneumonia and death. Established practice parameters for bulbar dysfunction in ALS do not currently exist. The aim of this study was to identify current practice patterns for the evaluation of speech and swallowing function within participating Northeast ALS clinics in the United States. A 15-item survey was emailed to all registered NEALS centres. Thirty-eight sites completed the survey. The majority (92%) offered Speech-Language Pathology, augmentative and alternative communication (71%), and dietician (92%) health care services. The ALS Functional Rating Scale-Revised and body weight represented the only parameters routinely collected in greater then 90% of responding sites. Referral for modified barium swallow study was routinely utilised in only 27% of sites and the use of percutaneous gastrostomy tubes in ALS patient care was found to vary considerably. This survey reveals significant variability and inconsistency in the management of bulbar dysfunction in ALS across NEALS sites. We conclude that a great need exists for the development of bulbar practice guidelines in ALS clinical care to accurately detect and monitor bulbar dysfunction.

Changing the individual to promote health-enhancing physical activity: the difficulties of producing evidence and translating it into practice.

PubMed

Blamey, Avril; Mutrie, Nanette

2004-08-01

This paper presents conclusions from recent systematic reviews and highlights individually targeted interventions that are effective at increasing physical activity. It discusses the limitations of currently available evidence, considers what factors lead to these limitations and what barriers exist in terms of implementing the evidence as part of local and national policy and practice. Barriers present themselves in terms of getting evidence into practice and in terms of ensuring that practice informs the evidence base. These barriers include difficulties in conducting systematic reviews, disaggregating knowledge from complex interventions, making local adaptations to existing evidence, the lack of an evaluation culture, ethical and pragmatic difficulties in designing interventions, selecting appropriate outcome measures, poor designs and implementation of evidence and, finally, a recognition that policy making is not only based on the available evidence. New and more integrated approaches to evaluation and to practice are needed.

An Evaluation of the Development of MFT Competencies and the Influence of the Supervisory Relationship

ERIC Educational Resources Information Center

Burke, Jay Evan

2017-01-01

Practicum training is an essential part of The Chicago School of Professional Psychology (TCSPP) Marriage and Family Therapy (MFT) Master's degree program, and the cornerstone for preparing students for clinical practice. To characterize the development across clinical competency areas, the current study examined midpoint and final evaluation data…

Evaluating and Training Substance Abuse Counselors: A Pilot Study Assessing Standardized Patients as Authentic Clients

ERIC Educational Resources Information Center

Fussell, Holly E.; Lewy, Colleen S.; McFarland, Bentson H.

2009-01-01

Clinician training and supervision are needed to transfer evidence-based practices to community-based treatment organizations. Standardized patients (SPs) are used for clinician training and evaluating. However, to be effective for substance abuse counselors, SPs must realistically portray substance abuse treatment clients. The current study…

Using Video-Stimulated Recall to Enhance Preservice-Teacher Reflection

ERIC Educational Resources Information Center

Endacott, Jason L.

2016-01-01

Teacher-education programs are under increasing pressure to demonstrate the effectiveness of their graduates at a time in which many states have adopted a new generation of formal teacher-evaluation systems. Despite the current emphasis on the evaluation of teacher proficiency, the opportunity to reflect upon practice remains a vital aspect of…

Investigating the Impacts of Previous and Current Learning Experiences on Student Teachers' Teaching Experiences

ERIC Educational Resources Information Center

Ögeyik, Muhlise Cosgun

2016-01-01

This study investigated the impacts of the previous and current learning experiences of the student teachers on their microteaching practices. The study pursued threefold research goals: to diagnose the microteaching stance, to treat it, and to explore and evaluate the progress. The participants were 24 undergraduate third year student teachers…

High frequencies of elevated alkaline phosphatase activity and rickets exist in extremely low birth weight infants despite current nutritional support

USDA-ARS?s Scientific Manuscript database

Osteopenia and rickets are common among extremely low birth weight infants (ELBW, <1000 g birth weight) despite current practices of vitamin and mineral supplementation. Few data are available evaluating the usual course of markers of mineral status in this population. Our objectives in this study w...

Making the Grade: Using Instructional Feedback and Evaluation to Inspire Evidence-Based Teaching.

PubMed

Brickman, Peggy; Gormally, Cara; Martella, Amedee Marchand

2016-01-01

Typically, faculty receive feedback about teaching via two mechanisms: end-of-semester student evaluations and peer observation. However, instructors require more sustained encouragement and constructive feedback when implementing evidence-based teaching practices. Our study goal was to characterize the landscape of current instructional-feedback practices in biology and uncover faculty perceptions about these practices. Findings from a national survey of 400 college biology faculty reveal an overwhelming dissatisfaction with student evaluations, regardless of self-reported teaching practices, institution type, or position. Faculty view peer evaluations as most valuable, but less than half of faculty at doctoral-granting institutions report participating in peer evaluation. When peer evaluations are performed, they are more supportive of evidence-based teaching than student evaluations. Our findings reveal a large, unmet desire for greater guidance and assessment data to inform pedagogical decision making. Informed by these findings, we discuss alternate faculty-vetted feedback strategies for providing formative instructional feedback. © 2016 P. Brickman et al. CBE—Life Sciences Education © 2016 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

Evaluating road delineation practices in Michigan : final report.

DOT National Transportation Integrated Search

2017-03-31

This research was conducted to assist the Michigan Department of Transportation in assessing the States : current delineation program. Opus International Consultants (Opus) and Western Michigan University : (WMU) were retained to undertake this re...

Storm Water Control Management & Monitoring

DOT National Transportation Integrated Search

2017-11-30

Temple and Villanova universities collected monitoring and assessment data along the I-95 corridor to evaluate the performance of current stormwater control design and maintenance practices. An extensive inventory was developed that ranks plants in t...

Applied genetic evaluations for production and functional traits in dairy cattle.

PubMed

Mark, T

2004-08-01

The objective of this study was to review the current status of genetic evaluation systems for production and functional traits as practiced in different Interbull member countries and to discuss that status in relation to research results and potential improvements. Thirty-one countries provided information. Substantial variation was evident for number of traits considered per country, trait definition, genetic evaluation procedure within trait, effects included, and how these were treated in genetic evaluation models. All countries lacked genetic evaluations for one or more economically important traits. Improvement in the genetic evaluation models, especially for many functional traits, could be achieved by closing the gaps between research and practice. More detailed and up to date information about national genetic evaluation systems for traits in different countries is available at www.interbull.org. Female fertility and workability traits were considered in many countries and could be next in line for international genetic evaluations.

Evaluation of LOINC for Representing Constitutional Cytogenetic Test Result Reports

PubMed Central

Heras, Yan Z.; Mitchell, Joyce A.; Williams, Marc S.; Brothman, Arthur R.; Huff, Stanley M.

2009-01-01

Genetic testing is becoming increasingly important to medical practice. Integrating genetics and genomics data into electronic medical records is crucial in translating genetic discoveries into improved patient care. Information technology, especially Clinical Decision Support Systems, holds great potential to help clinical professionals take full advantage of genomic advances in their daily medical practice. However, issues relating to standard terminology and information models for exchanging genetic testing results remain relatively unexplored. This study evaluates whether the current LOINC standard is adequate to represent constitutional cytogenetic test result reports using sample result reports from ARUP Laboratories. The results demonstrate that current standard terminology is insufficient to support the needs of coding cytogenetic test results. The terminology infrastructure must be developed before clinical information systems will be able to handle the high volumes of genetic data expected in the near future. PMID:20351857

Evaluation of LOINC for representing constitutional cytogenetic test result reports.

PubMed

Heras, Yan Z; Mitchell, Joyce A; Williams, Marc S; Brothman, Arthur R; Huff, Stanley M

2009-11-14

Genetic testing is becoming increasingly important to medical practice. Integrating genetics and genomics data into electronic medical records is crucial in translating genetic discoveries into improved patient care. Information technology, especially Clinical Decision Support Systems, holds great potential to help clinical professionals take full advantage of genomic advances in their daily medical practice. However, issues relating to standard terminology and information models for exchanging genetic testing results remain relatively unexplored. This study evaluates whether the current LOINC standard is adequate to represent constitutional cytogenetic test result reports using sample result reports from ARUP Laboratories. The results demonstrate that current standard terminology is insufficient to support the needs of coding cytogenetic test results. The terminology infrastructure must be developed before clinical information systems will be able to handle the high volumes of genetic data expected in the near future.

Practical Framework for an Electron Beam Induced Current Technique Based on a Numerical Optimization Approach

NASA Astrophysics Data System (ADS)

Yamaguchi, Hideshi; Soeda, Takeshi

2015-03-01

A practical framework for an electron beam induced current (EBIC) technique has been established for conductive materials based on a numerical optimization approach. Although the conventional EBIC technique is useful for evaluating the distributions of dopants or crystal defects in semiconductor transistors, issues related to the reproducibility and quantitative capability of measurements using this technique persist. For instance, it is difficult to acquire high-quality EBIC images throughout continuous tests due to variation in operator skill or test environment. Recently, due to the evaluation of EBIC equipment performance and the numerical optimization of equipment items, the constant acquisition of high contrast images has become possible, improving the reproducibility as well as yield regardless of operator skill or test environment. The technique proposed herein is even more sensitive and quantitative than scanning probe microscopy, an imaging technique that can possibly damage the sample. The new technique is expected to benefit the electrical evaluation of fragile or soft materials along with LSI materials.

Development of a cost-effectiveness analysis of leafy green marketing agreement irrigation water provisions.

PubMed

Jensen, Helen H; Pouliot, Sébastien; Wang, Tong; Jay-Russell, Michele T

2014-06-01

An analysis of the effectiveness of meeting the irrigation water provisions of the Leafy Green Marketing Agreement (LGMA) relative to its costs provides an approach to evaluating the cost-effectiveness of good agricultural practices that uses available data. A case example for lettuce is used to evaluate data requirements and provide a methodological example to determine the cost-effectiveness of the LGMA water quality provision. Both cost and field data on pathogen or indicator bacterial levels are difficult and expensive to obtain prospectively. Therefore, methods to use existing field and experimental data are required. Based on data from current literature and experimental studies, we calculate a cost-efficiency ratio that expresses the reduction in E. coli concentration per dollar expenditure on testing of irrigation water. With appropriate data, the same type of analysis can be extended to soil amendments and other practices and to evaluation of public benefits of practices used in production. Careful use of existing and experimental data can lead to evaluation of an expanded set of practices.

Salary discrepancies between practicing male and female physician assistants.

PubMed

Coplan, Bettie; Essary, Alison C; Virden, Thomas B; Cawley, James; Stoehr, James D

2012-01-01

Salary discrepancies between male and female physicians are well documented; however, gender-based salary differences among clinically practicing physician assistants (PAs) have not been studied since 1992 (Willis, 1992). Therefore, the objectives of the current study are to evaluate the presence of salary discrepancies between clinically practicing male and female PAs and to analyze the effect of gender on income and practice characteristics. Using data from the 2009 American Academy of Physician Assistants' (AAPA) Annual Census Survey, we evaluated the salaries of PAs across multiple specialties. Differences between men and women were compared for practice characteristics (specialty, experience, etc) and salary (total pay, base pay, on-call pay, etc) in orthopedic surgery, emergency medicine, and family practice. Men reported working more years as a PA in their current specialty, working more hours per month on-call, providing more direct care to patients, and more funding available from their employers for professional development (p < .001, all comparisons). In addition, men reported a higher total income, base pay, overtime pay, administrative pay, on-call pay, and incentive pay based on productivity and performance (p < .001, all comparisons). Multivariate analysis of covariance and analysis of variance revealed that men reported higher total income (p < .0001) and base pay (p = .001) in orthopedic surgery, higher total income (p = .011) and base pay (p = .005) in emergency medicine, and higher base pay in family practice (p < .001), independent of clinical experience or workload. These results suggest that certain salary discrepancies remain between employed male and female PAs regardless of specialty, experience, or other practice characteristics. Copyright © 2012. Published by Elsevier Inc.

Music therapy services for individuals with autism spectrum disorder: a survey of clinical practices and training needs.

PubMed

Kern, Petra; Rivera, Nicole R; Chandler, Alie; Humpal, Marcia

2013-01-01

Over the past decade, the definitions, diagnoses, prevalence rates, theories about the causes, evidence-based treatment options, and practice guidelines pertaining to Autism Spectrum Disorder (ASD) have undergone numerous changes. While several recent studies evaluate the effects of music therapy interventions for individuals with ASD, no current review reflects the latest music therapy practices and trends. The purpose of this study was to evaluate the status of music therapy practices for serving clients with ASD, the implementation of national ASD standards and guidelines, the awareness of recent developments, and training needs of music therapists. Professional members of the American Music Therapy Association who are working with individuals with ASD served as the sample for this national cross-sectional survey study (N = 328). A 45-item online questionnaire was designed and distributed through email and social media. Participants accessed the online survey through SurveyMonkey®. Findings suggest music therapy practices and services for individuals with ASD have shifted and now reflect a slightly higher percentage of caseload, a broader age range of clients, and a trend to serve clients in home and community settings. Most therapeutic processes align with recommended practices for ASD and incorporate several of the recognized evidence-based practices. Less understood or recognized are inclusion practices and latest developments in the field of ASD. Music therapists have a solid understanding of providing services for individuals with ASD, but would benefit from advanced online training and improved information dissemination to stay current with the rapidly changing aspects pertinent to this population. © 2013 by the American Music Therapy Association.

EVALUATION OF A NURSE-LED HYPERTENSION MANAGEMENT INTERVENTION IN AUSTRALIAN GENERAL PRACTICE: THE IMPRESS INTERVENTION.

PubMed

Stephen, Catherine

2016-08-01

Hypertension is currently the most frequently seen condition in Australian general practice (Britt et al. 2015). Of the 4.6 million Australians living with hypertension, many struggle to keep their blood pressure under control and are at increased risk of renal failure, cardiovascular disease and premature death (Australian Institute of Health and Welfare, 2015; Cadilhac et al. 2012). The General Practice Nurse (GPN) has a significant role to play in supporting self-management and lifestyle risk factor reduction.

Developing Best Practices for Detecting Change at Marine Renewable Energy Sites

NASA Astrophysics Data System (ADS)

Linder, H. L.; Horne, J. K.

2016-02-01

In compliance with the National Environmental Policy Act (NEPA), an evaluation of environmental effects is mandatory for obtaining permits for any Marine Renewable Energy (MRE) project in the US. Evaluation includes an assessment of baseline conditions and on-going monitoring during operation to determine if biological conditions change relative to the baseline. Currently, there are no best practices for the analysis of MRE monitoring data. We have developed an approach to evaluate and recommend analytic models used to characterize and detect change in biological monitoring data. The approach includes six steps: review current MRE monitoring practices, identify candidate models to analyze data, fit models to a baseline dataset, develop simulated scenarios of change, evaluate model fit to simulated data, and produce recommendations on the choice of analytic model for monitoring data. An empirical data set from a proposed tidal turbine site at Admiralty Inlet, Puget Sound, Washington was used to conduct the model evaluation. Candidate models that were evaluated included: linear regression, time series, and nonparametric models. Model fit diagnostics Root-Mean-Square-Error and Mean-Absolute-Scaled-Error were used to measure accuracy of predicted values from each model. A power analysis was used to evaluate the ability of each model to measure and detect change from baseline conditions. As many of these models have yet to be applied in MRE monitoring studies, results of this evaluation will generate comprehensive guidelines on choice of model to detect change in environmental monitoring data from MRE sites. The creation of standardized guidelines for model selection enables accurate comparison of change between life stages of a MRE project, within life stages to meet real time regulatory requirements, and comparison of environmental changes among MRE sites.

Business and Practice Management Knowledge Deficiencies in Graduating Orthopedic Residents.

PubMed

Miller, D Joshua; Throckmorton, Thomas W; Azar, Frederick M; Beaty, James H; Canale, S Terry; Richardson, David R

2015-10-01

We conducted a study to determine the general level of knowledge that orthopedic residents have on business and practice management topics at graduation and to evaluate the level of knowledge that practicing orthopedic surgeons need in order to function effectively in a medical practice. Residency graduates from a single training program were asked to complete a survey that gathered demographic information and had surgeons rate their understanding of 9 general business and practice management skills and the importance of these skills in their current practice situation. The amount of necessary business knowledge they lacked at graduation was defined as a functional knowledge deficiency (FKD) and was calculated as the difference between the reported importance of a topic in current practice and the level of understanding of that topic at graduation (larger FKD indicates greater deficiency). Those in physician-managed practices reported significantly higher levels of understanding of economic analytical tools than those in nonphysician-managed practices. There were no other statistically significant differences among groups. Hospital-employed physicians had the lowest overall FKD (4.0), followed by those in academic practices (5.1) and private practices (5.9). Graduating orthopedic surgeons appear to be inadequately prepared to effectively manage business issues in their practices, as evidenced by the low overall knowledge levels and high FKDs.

Concussion Care Practices and Utilization of Evidence-Based Guidelines in the Evaluation and Management of Concussion: A Survey of New England Emergency Departments.

PubMed

Stern, Robert A; Seichepine, Daniel; Tschoe, Christine; Fritts, Nathan G; Alosco, Michael L; Berkowitz, Oren; Burke, Peter; Howland, Jonathan; Olshaker, Jonathan; Cantu, Robert C; Baugh, Christine M; Holsapple, James W

2017-02-15

Evidence-based clinical practice guidelines can facilitate proper evaluation and management of concussions in the emergency department (ED), often the initial and primary point of contact for concussion care. There is no universally adopted set of guidelines for concussion management, and extant evidence suggests that there may be variability in concussion care practices and limited application of clinical practice guidelines in the ED. This study surveyed EDs throughout New England to examine current practices of concussion care and utilization of evidence-based clinical practice guidelines in the evaluation and management of concussions. In 2013, a 32-item online survey was e-mailed to 149/168 EDs throughout New England (Connecticut, Rhode Island, Massachusetts, Vermont, New Hampshire, Maine). Respondents included senior administrators asked to report on their EDs use of clinical practice guidelines, neuroimaging decision-making, and discharge instructions for concussion management. Of the 72/78 respondents included, 35% reported absence of clinical practice guidelines, and 57% reported inconsistency in the type of guidelines used. Practitioner preference guided neuroimaging decision-making for 57%. Although 94% provided written discharge instructions, there was inconsistency in the recommended time frame for follow-up care (13% provided no specific time frame), the referral specialist to be seen (25% did not recommend any specialist), and return to activity instructions were inconsistent. There is much variability in concussion care practices and application of evidence-based clinical practice guidelines in the evaluation and management of concussions in New England EDs. Knowledge translational efforts will be critical to improve concussion management in the ED setting.

State of family medicine practice in Lebanon

PubMed Central

Helou, Mariana; Rizk, Grace Abi

2016-01-01

Background: Many difficulties are encountered in family medicine practice and were subject to multinational studies. To date, no study was conducted in Lebanon to assess the challenges that family physicians face. This study aims to evaluate the family medicine practice in Lebanon stressing on the difficulties encountered by Lebanese family physicians. Materials and Methods: A questionnaire was sent to all 96 family medicine physicians practicing in Lebanon. Participants answered questions about characteristics of family medicine practice, evaluation of the quality of work, identification of obstacles, and their effect on the medical practice. Results: The response rate was 59%, and the average number of years of practice was 10.7 years. Physicians complain mainly of heavy load at work, too many bureaucratic tasks, demanding patients, and being undervalued by the specialists. Most physicians are able to adapt between their professional and private life. Conclusion: Despite all the obstacles encountered, Lebanese family physicians have a moderate satisfaction toward their practice. They remain positive and enthusiastic about their profession. Until the ministry of public health revises its current health system, the primary care profession in Lebanon will remain fragile as a profession. PMID:27453843

State of family medicine practice in Lebanon.

PubMed

Helou, Mariana; Rizk, Grace Abi

2016-01-01

Many difficulties are encountered in family medicine practice and were subject to multinational studies. To date, no study was conducted in Lebanon to assess the challenges that family physicians face. This study aims to evaluate the family medicine practice in Lebanon stressing on the difficulties encountered by Lebanese family physicians. A questionnaire was sent to all 96 family medicine physicians practicing in Lebanon. Participants answered questions about characteristics of family medicine practice, evaluation of the quality of work, identification of obstacles, and their effect on the medical practice. The response rate was 59%, and the average number of years of practice was 10.7 years. Physicians complain mainly of heavy load at work, too many bureaucratic tasks, demanding patients, and being undervalued by the specialists. Most physicians are able to adapt between their professional and private life. Despite all the obstacles encountered, Lebanese family physicians have a moderate satisfaction toward their practice. They remain positive and enthusiastic about their profession. Until the ministry of public health revises its current health system, the primary care profession in Lebanon will remain fragile as a profession.

Evaluation of educational preparation for cancer and palliative care nursing for children and adolescents in England.

PubMed

Long, Tony; Hale, Claire; Sanderson, Linda; Tomlinson, Peter; Carr, Kristina

2008-02-01

This paper reports the findings of a study which was carried out to evaluate the educational preparation of cancer and palliative care nurses in England. The study was carried out in three stages and covered the following areas; documentary analysis of curriculae, assessment of practice, patients and professionals views of threshold and expert practice. The findings suggested that although there was widespread compliance with a national standard for cancer nursing, this was not the case for palliative care nursing. There was uncertainty about what should be assessed in practice and ambiguity about what was actually assessed. Partnership with children and their parents, clinical skills, multi-disciplinary working, and personal attributes were the main foci for expectations of threshold practice but an expert panel had difficulty in describing the attributes of higher level practice. The paper also describes how some of recommendations from the study are being taken forward in current policy and practice.

Certifying leaders? high-quality management practices and healthy organisations: an ISO-9000 based standardisation approach

PubMed Central

MONTANO, Diego

2016-01-01

The present study proposes a set of quality requirements to management practices by taking into account the empirical evidence on their potential effects on health, the systemic nature of social organisations, and the current conceptualisations of management functions within the framework of comprehensive quality management systems. Systematic reviews and meta-analyses focusing on the associations between leadership and/or supervision and health in occupational settings are evaluated, and the core elements of an ISO 9001 standardisation approach are presented. Six major occupational health requirements to high-quality management practices are identified pertaining to communication processes, organisational justice, role clarity, decision making, social influence processes and management support. It is concluded that the quality of management practices may be improved by developing a quality management system of management practices that ensures not only conformity to product but also to occupational safety and health requirements. Further research may evaluate the practicability of the proposed approach. PMID:26860787

Certifying leaders? high-quality management practices and healthy organisations: an ISO-9000 based standardisation approach.

PubMed

Montano, Diego

2016-08-05

The present study proposes a set of quality requirements to management practices by taking into account the empirical evidence on their potential effects on health, the systemic nature of social organisations, and the current conceptualisations of management functions within the framework of comprehensive quality management systems. Systematic reviews and meta-analyses focusing on the associations between leadership and/or supervision and health in occupational settings are evaluated, and the core elements of an ISO 9001 standardisation approach are presented. Six major occupational health requirements to high-quality management practices are identified pertaining to communication processes, organisational justice, role clarity, decision making, social influence processes and management support. It is concluded that the quality of management practices may be improved by developing a quality management system of management practices that ensures not only conformity to product but also to occupational safety and health requirements. Further research may evaluate the practicability of the proposed approach.

Research on evaluation methods for water regulation ability of dams in the Huai River Basin

NASA Astrophysics Data System (ADS)

Shan, G. H.; Lv, S. F.; Ma, K.

2016-08-01

Water environment protection is a global and urgent problem that requires correct and precise evaluation. Evaluation methods have been studied for many years; however, there is a lack of research on the methods of assessing the water regulation ability of dams. Currently, evaluating the ability of dams has become a practical and significant research orientation because of the global water crisis, and the lack of effective ways to manage a dam's regulation ability has only compounded this. This paper firstly constructs seven evaluation factors and then develops two evaluation approaches to implement the factors according to the features of the problem. Dams of the Yin Shang ecological control section in the Huai He River basin are selected as an example to demonstrate the method. The results show that the evaluation approaches can produce better and more practical suggestions for dam managers.

Biomaterials Evaluation: Conceptual Refinements and Practical Reforms.

PubMed

Masaeli, Reza; Zandsalimi, Kavosh; Tayebi, Lobat

2018-01-01

Regarding the widespread and ever-increasing applications of biomaterials in different medical fields, their accurate assessment is of great importance. Hence the safety and efficacy of biomaterials is confirmed only through the evaluation process, the way it is done has direct effects on public health. Although every biomaterial undergoes rigorous premarket evaluation, the regulatory agencies receive a considerable number of complications and adverse event reports annually. The main factors that challenge the process of biomaterials evaluation are dissimilar regulations, asynchrony of biomaterials evaluation and biomaterials development, inherent biases of postmarketing data, and cost and timing issues. Several pieces of evidence indicate that current medical device regulations need to be improved so that they can be used more effectively in the evaluation of biomaterials. This article provides suggested conceptual refinements and practical reforms to increase the efficiency and effectiveness of the existing regulations. The main focus of the article is on strategies for evaluating biomaterials in US, and then in EU.

Maternally Mediated Developmental Toxicity

EPA Science Inventory

The current practice for the assessment of an agent’s potential effects on the developing embryo/fetus includes administration of high, maternally toxic doses to pregnant laboratory animals. For most agents evaluated, developmental effects occur concomitant with maternal toxicity...

Maternally Mediated Developmental Toxicity

EPA Science Inventory

The current practice for the assessment of an agent’s potential effects on the developing embryo/fetus includes administration of high, maternally toxic doses to pregnant laboratory animals. For most agents evaluated, developmental effects occur concomitant with maternal to...

Elementary Principal Leadership Practices, Attitudes, and Self-Efficacy about Teacher Evaluation in Title I Urban Schools Making Gains in Student Achievement

ERIC Educational Resources Information Center

Ames, Karen Cohen

2013-01-01

Current school reform efforts aim to improve teaching and learning with emphasis on accountability for student achievement. The success of school reform depends on the motivation and capacities of school leaders. It is important to know what effective leadership practices look like to understand the direct impact to student achievement,…

The gap between currently available evidence and awareness in clinical practice of wound care: It is the time to shower earlier.

PubMed

Yu, Ya-Hsuan; Chao, Sylvia; Lin, Yen-Kuang; Chou, Yun-Yun; Liao, Hsun-Hsiang; Loh, El-Wui; Wong, Chung-Shun; Tam, Ka-Wai

2018-03-01

A postoperative water-forbidden strategy has been used for many decades. However, evidence shows that early contact with water postoperatively does not increase the infection rate. Our study evaluated the gap between currently available evidence and awareness in clinical practice of postoperative wound care. We conducted a systematic review to compare the outcomes between postoperative water-contact and water-forbidden groups. PubMed, EMBASE, and Cochrane databases were searched. A meta-analysis was conducted to calculate a pooled effect size by using random-effects models. On the basis of pooling results, a questionnaire survey was conducted to evaluate the gap from systematic review to clinical practice by clinical staff and patients. We reviewed 12 trials including 4,086 patients. Incidence of infection and wound complications did not differ significantly between water-contact and water-forbidden groups. Satisfaction was significantly higher in water-contact group than in water-forbidden group (risk ratio: 17.33; 95% confidence interval, 11.11-27.03). A survey of clinicians showed that awareness, acceptance of the evidence, and the current water-contact strategy differed among departments. However, many clinicians showed no willingness to apply the water-contact strategy for various reasons. A survey of patients showed low awareness of the issue and variety in willingness to contact water. Water-forbidden strategy causes inconvenience to patients. However, a majority of patients and clinicians still hesitated to apply the early water-contact strategy, even after viewing the results of the current review. Establishment of local clinical practice guidelines, advocacy from authorities, and promotion by social media for this strategy are warranted. Copyright © 2018 Elsevier Inc. All rights reserved.

Strategic planning: how medical practices can succeed in a post-healthcare-reform world.

PubMed

Howrigon, Ron

2013-01-01

This article addresses the recent trend of physicians being pressured to sell to hospitals in order to stay in practice. The author utilizes his experience in the healthcare industry to identify causes of this trend and ways in which physician groups can avoid finding themselves in these situations. The author uses real data from an existing medical practice to support his ideas and demonstrate how implementing change now will be beneficial for the success of this medical practice in the future. Objective practice evaluation and the execution of an efficient strategic plan are cited as the most important factors contributing to the financial solvency of medical practices in the current and future healthcare environment.

Evidence-based practice for pain identification in cognitively impaired nursing home residents.

PubMed

Sacoco, Christina; Ishikawa, Sally

2014-09-01

Pain identification of cognitively impaired elderly is very challenging. This project aimed to identify best practices for pain assessment in nursing home residents with cognitive impairment and to establish a standardized pain assessment guide to optimize nursing practice and resident outcomes. The Iowa Model of Evidence-Based Practice to Promote Quality of Care guided the project's process. Phase I of the project analyzed data gained from chart reviews on current practices of pain assessment, and Phase II used the results of Phase I to develop, implement, and evaluate an evidence-based practice standard for nursing assessment of pain for cognitively impaired residents. Copyright © 2014 Elsevier Inc. All rights reserved.

[Progress in methodological characteristics of clinical practice guideline for osteoarthritis].

PubMed

Xing, D; Wang, B; Lin, J H

2017-06-01

At present, several clinical practice guidelines for the treatment of osteoarthritis have been developed by institutes or societies. The ultimate purpose of developing clinical practice guidelines is to formulate the process in the treatment of osteoarthritis effectively. However, the methodologies used in developing clinical practice guidelines may place an influence on the transformation and application of that in treating osteoarthritis. The present study summarized the methodological features of individual clinical practice guideline and presented the tools for quality evaluation of clinical practice guideline. The limitations of current osteoarthritis guidelines of China are also indicated. The review article might help relevant institutions improve the quality in developing guide and clinical transformation.

Animal Health and Welfare Issues Facing Organic Production Systems.

PubMed

Sutherland, Mhairi A; Webster, Jim; Sutherland, Ian

2013-10-31

The demand for organically-grown produce is increasing worldwide, with one of the drivers being an expectation among consumers that animals have been farmed to a high standard of animal welfare. This review evaluates whether this expectation is in fact being met, by describing the current level of science-based knowledge of animal health and welfare in organic systems. The primary welfare risk in organic production systems appears to be related to animal health. Organic farms use a combination of management practices, alternative and complementary remedies and convenional medicines to manage the health of their animals and in many cases these are at least as effective as management practices employed by non-organic producers. However, in contrast to non-organic systems, there is still a lack of scientifically evaluated, organically acceptable therapeutic treatments that organic animal producers can use when current management practices are not sufficient to maintain the health of their animals. The development of such treatments are necessary to assure consumers that organic animal-based food and fibre has not only been produced with minimal or no chemical input, but under high standards of animal welfare.

GN&C Engineering Best Practices for Human-Rated Spacecraft Systems

NASA Technical Reports Server (NTRS)

Dennehy, Cornelius J.; Lebsock, Kenneth; West, John

2007-01-01

The NASA Engineering and Safety Center (NESC) recently completed an in-depth assessment to identify a comprehensive set of engineering considerations for the Design, Development, Test and Evaluation (DDT&E) of safe and reliable human-rated spacecraft systems. Reliability subject matter experts, discipline experts, and systems engineering experts were brought together to synthesize the current "best practices" both at the spacecraft system and subsystems levels. The objective of this paper is to summarize, for the larger Community of Practice, the initial set of Guidance, Navigation and Control (GN&C) engineering Best Practices as identified by this NESC assessment process.

GN&C Engineering Best Practices for Human-Rated Spacecraft System

NASA Technical Reports Server (NTRS)

Dennehy, Cornelius J.; Lebsock, Kenneth; West, John

2008-01-01

The NASA Engineering and Safety Center (NESC) recently completed an in-depth assessment to identify a comprehensive set of engineering considerations for the Design, Development, Test and Evaluation (DDT&E) of safe and reliable human-rated spacecraft systems. Reliability subject matter experts, discipline experts, and systems engineering experts were brought together to synthesize the current "best practices" both at the spacecraft system and subsystems levels. The objective of this paper is to summarize, for the larger Community of Practice, the initial set of Guidance, Navigation and Control (GN&C) engineering Best Practices as identified by this NESC assessment process.

GN&C Engineering Best Practices For Human-Rated Spacecraft Systems

NASA Technical Reports Server (NTRS)

Dennehy, Cornelius J.; Lebsock, Kenneth; West, John

2007-01-01

The NASA Engineering and Safety Center (NESC) recently completed an in-depth assessment to identify a comprehensive set of engineering considerations for the Design, Development, Test and Evaluation (DDT&E) of safe and reliable human-rated spacecraft systems. Reliability subject matter experts, discipline experts, and systems engineering experts were brought together to synthesize the current "best practices" both at the spacecraft system and subsystems levels. The objective of this paper is to summarize, for the larger Community of Practice, the initial set of Guidance, Navigation and Control (GN&C) engineering Best Practices as identified by this NESC assessment process.

An Analysis of Evaluation Plans in a Federally Funded Leadership Preparation Program: Implications for the Improvement of Practice

ERIC Educational Resources Information Center

Sanzo, Karen L.

2012-01-01

This study is a content analysis of selected federally funded leadership preparation program evaluation proposals for the 2008, 2009, and 2010 School Leadership Program grants. The United States Department of Education (USDE) began awarding funding in 2002 to develop and implement preparation programs for aspiring and current assistant principals…

Consumer Evaluation of Educational Programs: Using Questionnaires Completed by Alumni.

ERIC Educational Resources Information Center

Copeland, H. L.; Hewson, M.; Weiker, G.

This paper describes a method used to evaluate 48 medical residency programs at one institution. It presents the background rationale, logistics, and results obtained by surveying alumni, in the context of their current practice, for relevant data on the value of their training experience. Surveys were sent for 3 years to all alumni of Cleveland…

Twinning "Practices of Change" with "Theory of Change": Room for Emergence in Advocacy Evaluation

ERIC Educational Resources Information Center

Arensman, Bodille; van Waegeningh, Cornelie; van Wessel, Margit

2018-01-01

Theory of change (ToC) is currently "the" approach for the evaluation and planning of international development programs. This approach is considered especially suitable for complex interventions. We question this assumption and argue that ToC's focus on cause-effect logic and intended outcomes does not do justice to the recursive nature…

A Study of Changes in the Library and Information Science Curriculum with Evaluation of Its Practicality

ERIC Educational Resources Information Center

Noh, Younghee; Ahn, In-Ja; Choi, Sang-Ki

2012-01-01

Purpose: This study analyzed the process of changes in Korean Library and Information Science curriculum and evaluated the courses currently available by using a perception survey of librarians in the field. It also explored a possible demand for new courses, while suggesting compulsory, core, and optional courses for Bachelor's degree curriculum…

Second-level post-occupancy evaluation (POE) analysis

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

Collins, B.; Fisher, W.; Marans, R.W.

1989-02-14

Findings from a detailed analysis of post-occupancy evaluation data, sponsored by LRI, which involved thirteen office buildings typical of current design practice, will be discussed. Analysis of the data indicates that occupant satisfaction can be related to type of lighting system, presence of daylight, and patterns of luminance in the office. 15 refs., 9 figs., 3 tabs.

Business-IT Alignment: A Current-State Evaluation of Strategic Alignment within the Hospital Organization

ERIC Educational Resources Information Center

Evers, Kevin W.

2010-01-01

More than thirty years of research has shown that the practical value of business-IT alignment is significant and that its importance derives from strategic impact on business outcomes. The purpose of this exploratory study is to identify the current-state of business-IT alignment maturity within the hospital organization. Data for this study was…

Toward building a typology for the evaluation of services in family support programs.

PubMed

Manalo, V; Meezan, W

2000-01-01

This article briefly reviews the history, philosophy, practice principles, and foci of family support programs, examines the typologies currently in use to classify these programs, and discusses the difficulties these classifications pose for program evaluators. The authors introduce a new typology that deconstructs family support programs into their component services and discuss the potential of this typology for evaluation of family support services.

Evidence-based use of electronic clinical tracking systems in advanced practice registered nurse education: an integrative review.

PubMed

Branstetter, M Laurie; Smith, Lynette S; Brooks, Andrea F

2014-07-01

Over the past decade, the federal government has mandated healthcare providers to incorporate electronic health records into practice by 2015. This technological update in healthcare documentation has generated a need for advanced practice RN programs to incorporate information technology into education. The National Organization of Nurse Practitioner Faculties created core competencies to guide program standards for advanced practice RN education. One core competency is Technology and Information Literacy. Educational programs are moving toward the utilization of electronic clinical tracking systems to capture students' clinical encounter data. The purpose of this integrative review was to evaluate current research on advanced practice RN students' documentation of clinical encounters utilizing electronic clinical tracking systems to meet advanced practice RN curriculum outcome goals in information technology as defined by the National Organization of Nurse Practitioner Faculties. The state of the science depicts student' and faculty attitudes, preferences, opinions, and data collections of students' clinical encounters. Although electronic clinical tracking systems were utilized to track students' clinical encounters, these systems have not been evaluated for meeting information technology core competency standards. Educational programs are utilizing electronic clinical tracking systems with limited evidence-based literature evaluating the ability of these systems to meet the core competencies in advanced practice RN programs.

Usability Prediction & Ranking of SDLC Models Using Fuzzy Hierarchical Usability Model

NASA Astrophysics Data System (ADS)

Gupta, Deepak; Ahlawat, Anil K.; Sagar, Kalpna

2017-06-01

Evaluation of software quality is an important aspect for controlling and managing the software. By such evaluation, improvements in software process can be made. The software quality is significantly dependent on software usability. Many researchers have proposed numbers of usability models. Each model considers a set of usability factors but do not cover all the usability aspects. Practical implementation of these models is still missing, as there is a lack of precise definition of usability. Also, it is very difficult to integrate these models into current software engineering practices. In order to overcome these challenges, this paper aims to define the term `usability' using the proposed hierarchical usability model with its detailed taxonomy. The taxonomy considers generic evaluation criteria for identifying the quality components, which brings together factors, attributes and characteristics defined in various HCI and software models. For the first time, the usability model is also implemented to predict more accurate usability values. The proposed system is named as fuzzy hierarchical usability model that can be easily integrated into the current software engineering practices. In order to validate the work, a dataset of six software development life cycle models is created and employed. These models are ranked according to their predicted usability values. This research also focuses on the detailed comparison of proposed model with the existing usability models.

Sustainability performance evaluation: Literature review and future directions.

PubMed

Büyüközkan, Gülçin; Karabulut, Yağmur

2018-07-01

Current global economic activities are increasingly being perceived as unsustainable. Despite the high number of publications, sustainability science remains highly dispersed over diverse approaches and topics. This article aims to provide a structured overview of sustainability performance evaluation related publications and to document the current state of literature, categorize publications, analyze and link trends, as well as highlight gaps and provide research recommendations. 128 articles between 2007 and 2018 are identified. The results suggest that sustainability performance evaluation models shall be more balanced, suitable criteria and their interrelations shall be well defined and subjectivity of qualitative criteria inherent to sustainability indicators shall be considered. To address this subjectivity, group decision-making techniques and other analytical methods that can deal with uncertainty, conflicting indicators, and linguistic evaluations can be used in future works. By presenting research gaps, this review stimulates researchers to establish practically applicable sustainability performance evaluation frameworks to help assess and compare the degree of sustainability, leading to more sustainable business practices. The review is unique in defining corporate sustainability performance evaluation for the first time, exploring the gap between sustainability accounting and sustainability assessment, and coming up with a structured overview of innovative research recommendations about integrating analytical assessment methods into conceptual sustainability frameworks. Copyright © 2018 Elsevier Ltd. All rights reserved.

Expert system verification and validation study. Delivery 1: Survey and interview questions

NASA Technical Reports Server (NTRS)

1990-01-01

The NASA funded questionnaire is presented to help define the state-of-the-practice in the formal evaluation of Expert Systems on current NASA and industry applications. The answers to this questionnaire, together with follow-up interviews, will provide realistic answers to the following questions: (1) How much evaluation is being performed; (2) What evaluation techniques are in use; and (3) What, if any, are the unique issues in evaluating Expert Systems.

An evaluation of IDOT's current underdrain systems

DOT National Transportation Integrated Search

1995-12-01

The use of pavement underdrains became common practice in Illinois following the issuance of a Department underdrain policy in December 1970. Since that time, a variety of materials have been incorporated as underdrains. As these materials evolved, I...

Evaluating the use of waste-to-energy bottom ash as road construction materials.

DOT National Transportation Integrated Search

2014-02-01

Current management practice, existing regulations, and environmental consequences of municipal solid : waste incineration (MSWI) ash utilization were comprehensively reviewed worldwide and nationwide : in the U.S. Efforts were made to physically and ...

Guidelines for the Bioremediation of Marine Shorelines and Freshwater Wetlands

EPA Pesticide Factsheets

For oil spill responders:presents rational approach, evaluates current practices and state-of-the-art research results pertaining to bioremediation of hydrocarbon contamination relative to types and amounts of amendments used, application frequency, extent

75 FR 9432 - Civil Rights Division, Disability Rights Section; Agency Information Collection Activities Under...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-02

... Division, by calling (800) 514-0301 (Voice) or (800) 514- 0383 (TTY) (the Division's ADA Information Line... to evaluate their current services, policies, and practices for compliance with the ADA. Under...

Accounting for Induced Travel in Evaluation of Urban Highway Expansion

DOT National Transportation Integrated Search

2013-02-01

The US DOT sponsored Dynamic Mobility Applications (DMA) program seeks to identify, develop, and deploy applications that leverage the full potential of connected vehicles, travelers and infrastructure to enhance current operational practices and tra...

Developing a tool to support diagnostic delivery of dementia.

PubMed

Bennett, Claire E; De Boos, Danielle; Moghaddam, Nima G

2018-01-01

It is increasingly recognised that there are challenges affecting the current delivery of dementia diagnoses. Steps are required to address this. Current good practice guidelines provide insufficient direction and interventions from other healthcare settings do not appear to fully translate to dementia care settings. This project has taken a sequential two-phase design to developing a tool specific to dementia diagnostic delivery. Interviews with 14 participants explored good diagnostic delivery. Thematic analysis produced key themes (overcoming barriers, navigation of multiple journeys and completing overt and covert tasks) that were used to inform the design of a tool for use by clinicians, patients and companions. The tool was evaluated for acceptability in focused group discussions with 13 participants, which indicated a desire to use the tool and that it could encourage good practice. Adaptations were highlighted and incorporated to improve acceptability. Future research is now required to further evaluate the tool.

Evaluating Cost-effectiveness of Interventions That Affect Fertility and Childbearing: How Health Effects Are Measured Matters.

PubMed

Goldhaber-Fiebert, Jeremy D; Brandeau, Margaret L

2015-10-01

Current guidelines for economic evaluations of health interventions define relevant outcomes as those accruing to individuals receiving interventions. Little consensus exists on counting health impacts on current and future fertility and childbearing. Our objective was to characterize current practices for counting such health outcomes. We developed a framework characterizing health interventions with direct and/or indirect effects on fertility and childbearing and how such outcomes are reported. We identified interventions spanning the framework and performed a targeted literature review for economic evaluations of these interventions. For each article, we characterized how the potential health outcomes from each intervention were considered, focusing on quality-adjusted life-years (QALYs) associated with fertility and childbearing. We reviewed 108 studies, identifying 7 themes: 1) Studies were heterogeneous in reporting outcomes. 2) Studies often selected outcomes for inclusion that tend to bias toward finding the intervention to be cost-effective. 3) Studies often avoided the challenges of assigning QALYs for pregnancy and fertility by instead considering cost per intermediate outcome. 4) Even for the same intervention, studies took heterogeneous approaches to outcome evaluation. 5) Studies used multiple, competing rationales for whether and how to include fertility-related QALYs and whose QALYs to include. 6) Studies examining interventions with indirect effects on fertility typically ignored such QALYs. 7) Even recent studies had these shortcomings. Limitations include that the review was targeted rather than systematic. Economic evaluations inconsistently consider QALYs from current and future fertility and childbearing in ways that frequently appear biased toward the interventions considered. As the Panel on Cost-Effectiveness in Health and Medicine updates its guidelines, making the practice of cost-effectiveness analysis more consistent is a priority. Our study contributes to harmonizing methods in this respect. © The Author(s) 2015.

Evaluating Cost-Effectiveness of Interventions that Affect Fertility and Childbearing: How Health Effects are Measured Matters

PubMed Central

Goldhaber-Fiebert, Jeremy D.; Brandeau, Margaret L.

2015-01-01

Background Current guidelines for economic evaluations of health interventions define relevant outcomes as those accruing to individuals receiving interventions. Little consensus exists on counting health impacts on current and future fertility and childbearing. Objective To characterize current practices for counting such health outcomes. Design We developed a framework characterizing health interventions with direct and/or indirect effects on fertility and childbearing and how such outcomes are reported. We identified interventions spanning the framework and performed a targeted literature review for economic evaluations of these interventions. For each article, we characterized how the potential health outcomes from each intervention were considered, focusing on QALYs associated with fertility and childbearing. Results We reviewed 108 studies, identifying seven themes: 1) Studies were heterogeneous in reporting outcomes. 2) Studies often selected outcomes for inclusion that tend to bias toward finding the intervention to be cost-effective. 3) Studies often avoided the challenges of assigning QALYs for pregnancy and fertility by instead considering cost per intermediate outcome. 4) Even for the same intervention, studies took heterogeneous approaches to outcome evaluation. 5) Studies employed multiple, competing rationales for whether and how to include fertility-related QALYs and whose QALYs to include. 6) Studies examining interventions with indirect effects on fertility typically ignored such QALYs. 7) Even recent studies had these shortcomings. Limitations The review was targeted rather than systematic. Conclusions Economic evaluations inconsistently consider QALYs from current and future fertility and childbearing in ways that frequently appear biased towards the interventions considered. As the Panel on Cost-Effectiveness in Health and Medicine updates its guidelines, making the practice of cost-effectiveness analysis more consistent is a priority. Our study contributes to harmonizing methods in this respect. PMID:25926281

Discussion of examination of a cored hydraulic fracture in a deep gas well

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

Nolte, K.G.

Warpinski et al. document information found from a core through a formation after a hydraulic fracture treatment. As they indicate, the core provides the first detailed evaluation of an actual propped hydraulic fracture away from the well and at a significant depth, and this evaluation leads to findings that deviate substantially from the assumptions incorporated into current fracturing models. In this discussion, a defense of current fracture design assumptions is developed. The affirmation of current assumptions, for general industry applications, is based on an assessment of the global impact of the local complexity found in the core. The assessment leadsmore » to recommendations for the evolution of fracture design practice.« less

Pectus carinatum treatment in Canada: current practices.

PubMed

Emil, Sherif; Laberge, Jean-Martin; Sigalet, David; Baird, Robert

2012-05-01

Multiple treatment options currently exist for the correction of pectus carinatum (PC). We performed a survey of Canadian pediatric surgeons to define current practices. All active members of Canadian Association of Paediatric Surgeons were surveyed online during winter 2011 through the Canadian Association of Paediatric Surgeons Web site. The survey assessed multiple facets of PC evaluation and treatment, with particular emphasis on the practice of bracing. Forty-five active members (85%) responded, of whom 32 (71%) currently treat PC. Fifty-three percent of practices are low volume (<5 patients annually). In terms of preferred or most used treatment modality, 69% of surgeons used bracing, 25% performed Ravitch repairs, 3% performed open minimal cartilage resections, and 3% performed reverse Nuss procedures. Of 23 surgeons (72%) who used bracing, 83% used it for most or the patients. Fifty-seven percent judged their bracing results as good or excellent, and 74% felt that most or all patients braced were satisfied; 80% and 88% agreed or strongly agreed that bracing was generally preferable to surgical repair and that bracing should be first line treatment, respectively. Bracing is the preferred treatment for PC by most Canadian pediatric surgeons, despite lack of prospective outcome data. This presents an opportunity for a multicenter prospective study. Copyright © 2012 Elsevier Inc. All rights reserved.

Physical and Chemical Implications of Mid-Winter Pumping of Trunda Lakes - North Slope, Alaska

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

Hinzman, Larry D.; Lilly, Michael R.; Kane, Douglas L.

2005-09-30

Tundra lakes on the North Slope, Alaska, are an important resource for energy development and petroleum field operations. A majority of exploration activities, pipeline maintenance, and restoration activities take place on winter ice roads that depend on water availability at key times of the winter operating season. These same lakes provide important fisheries and ecosystem functions. In particular, overwintering habitat for fish is one important management concern. This study focused on the evaluation of winter water use in the current field operating areas to provide a better understanding of the current water use practices. It found that under the currentmore » water use practices, there were no measurable negative effects of winter pumping on the lakes studied and current water use management practices were appropriately conservative. The study did find many areas where improvements in the understanding of tundra lake hydrology and water usage would benefit industry, management agencies, and the protection of fisheries and ecosystems.« less

Improving medical students' knowledge of genetic disease: a review of current and emerging pedagogical practices.

PubMed

Wolyniak, Michael J; Bemis, Lynne T; Prunuske, Amy J

2015-01-01

Genetics is an essential subject to be mastered by health professional students of all types. However, technological advances in genomics and recent pedagogical research have changed the way in which many medical training programs teach genetics to their students. These advances favor a more experience-based education focused primarily on developing student's critical thinking skills. In this review, we examine the current state of genetics education at both the preclinical and clinical levels and the ways in which medical and pedagogical research have guided reforms to current and emerging teaching practices in genetics. We discover exciting trends taking place in which genetics is integrated with other scientific disciplines both horizontally and vertically across medical curricula to emphasize training in scientific critical thinking skills among students via the evaluation of clinical evidence and consultation of online databases. These trends will produce future health professionals with the skills and confidence necessary to embrace the new tools of medical practice that have emerged from scientific advances in genetics, genomics, and bioinformatics.

Assessing Dimensions of Inquiry Practice by Middle School Science Teachers Engaged in a Professional Development Program

NASA Astrophysics Data System (ADS)

Lakin, Joni M.; Wallace, Carolyn S.

2015-03-01

Inquiry-based teaching promotes students' engagement in problem-solving and investigation as they learn science concepts. Current practice in science teacher education promotes the use of inquiry in the teaching of science. However, the literature suggests that many science teachers hold incomplete or incorrect conceptions of inquiry. Teachers, therefore, may believe they are providing more inquiry experiences than they are, reducing the positive impact of inquiry on science interest and skills. Given the prominence of inquiry in professional development experiences, educational evaluators need strong tools to detect intended use in the classroom. The current study focuses on the validity of assessments developed for evaluating teachers' use of inquiry strategies and classroom orientations. We explored the relationships between self-reported inquiry strategy use, preferences for inquiry, knowledge of inquiry practices, and related pedagogical content knowledge. Finally, we contrasted students' and teachers' reports of the levels of inquiry-based teaching in the classroom. Self-reports of inquiry use, especially one specific to the 5E instructional model, were useful, but should be interpreted with caution. Teachers tended to self-report higher levels of inquiry strategy use than their students perceived. Further, there were no significant correlations between either knowledge of inquiry practices or PCK and self-reported inquiry strategy use.

Concussion Care Practices and Utilization of Evidence-Based Guidelines in the Evaluation and Management of Concussion: A Survey of New England Emergency Departments

PubMed Central

Seichepine, Daniel; Tschoe, Christine; Fritts, Nathan G.; Alosco, Michael L.; Berkowitz, Oren; Burke, Peter; Howland, Jonathan; Olshaker, Jonathan; Cantu, Robert C.; Baugh, Christine M.; Holsapple, James W.

2017-01-01

Abstract Evidence-based clinical practice guidelines can facilitate proper evaluation and management of concussions in the emergency department (ED), often the initial and primary point of contact for concussion care. There is no universally adopted set of guidelines for concussion management, and extant evidence suggests that there may be variability in concussion care practices and limited application of clinical practice guidelines in the ED. This study surveyed EDs throughout New England to examine current practices of concussion care and utilization of evidence-based clinical practice guidelines in the evaluation and management of concussions. In 2013, a 32-item online survey was e-mailed to 149/168 EDs throughout New England (Connecticut, Rhode Island, Massachusetts, Vermont, New Hampshire, Maine). Respondents included senior administrators asked to report on their EDs use of clinical practice guidelines, neuroimaging decision-making, and discharge instructions for concussion management. Of the 72/78 respondents included, 35% reported absence of clinical practice guidelines, and 57% reported inconsistency in the type of guidelines used. Practitioner preference guided neuroimaging decision-making for 57%. Although 94% provided written discharge instructions, there was inconsistency in the recommended time frame for follow-up care (13% provided no specific time frame), the referral specialist to be seen (25% did not recommend any specialist), and return to activity instructions were inconsistent. There is much variability in concussion care practices and application of evidence-based clinical practice guidelines in the evaluation and management of concussions in New England EDs. Knowledge translational efforts will be critical to improve concussion management in the ED setting. PMID:27112592

A Nationwide Survey of Patient Centered Medical Home Demonstration Projects

PubMed Central

Bitton, Asaf; Martin, Carina

2010-01-01

Background The patient centered medical home has received considerable attention as a potential way to improve primary care quality and limit cost growth. Little information exists that systematically compares PCMH pilot projects across the country. Design Cross-sectional key-informant interviews. Participants Leaders from existing PCMH demonstration projects with external payment reform. Measurements We used a semi-structured interview tool with the following domains: project history, organization and participants, practice requirements and selection process, medical home recognition, payment structure, practice transformation, and evaluation design. Results A total of 26 demonstrations in 18 states were interviewed. Current demonstrations include over 14,000 physicians caring for nearly 5 million patients. A majority of demonstrations are single payer, and most utilize a three component payment model (traditional fee for service, per person per month fixed payments, and bonus performance payments). The median incremental revenue per physician per year was $22,834 (range $720 to $91,146). Two major practice transformation models were identified—consultative and implementation of the chronic care model. A majority of demonstrations did not have well-developed evaluation plans. Conclusion Current PCMH demonstration projects with external payment reform include large numbers of patients and physicians as well as a wide spectrum of implementation models. Key questions exist around the adequacy of current payment mechanisms and evaluation plans as public and policy interest in the PCMH model grows. Electronic supplementary material The online version of this article (doi:10.1007/s11606-010-1262-8) contains supplementary material, which is available to authorized users. PMID:20467907

Management of obstetric postpartum hemorrhage: a national service evaluation of current practice in the UK

PubMed Central

Al Wattar, Bassel H; Tamblyn, Jennifer A; Parry-Smith, William; Prior, Mathew; Van Der Nelson, Helen

2017-01-01

Background Postpartum hemorrhage (PPH) continues to be one of the major causes of maternal mortality and morbidity in obstetrics. Variations in practice often lead to adverse maternity outcomes following PPH. Our objective was to assess the current practice in managing PPH in the UK. Methods We performed a national multicenter prospective service evaluation study over one calendar month and compared the current performance to national standards for managing PPH. We used a standardized data collection tool and collected data on patients’ demographics, incidence of PPH, estimated blood loss (EBL), prophylactic and treatment measures, onset of labor, and mode of delivery. Results We collected data from 98 obstetric units, including 3663 cases of primary PPH. Fifty percent of cases were minor PPH (EBL 500–1000 mL, n=1900/3613, 52.6%) and the remaining were moderate PPH (EBL >1000 to <2000 mL, n=1424/3613, 39.4%) and severe PPH (EBL >2000 mL, n=289/3613, 8%). The majority of women received active management of the third stage of labor (3504/3613, 97%) most commonly with Syntometrine intramuscular (1479/3613, 40.9%). More than half required one additional uterotonic agent (2364/3613, 65.4%) most commonly with Syntocinon intravenous infusion (1155/2364, 48.8%). There was a poor involvement of consultant obstetricians and anesthetists in managing PPH cases, which was more prevalent when managing major PPH (p=0.0001). Conclusion There are still variations in managing PPH in the UK against national guidelines. More senior doctor involvement and regular service evaluation are needed to improve maternal outcomes following PPH. PMID:28176919

Variations among Primary Care Physicians in Exercise Advice, Imaging, and Analgesics for Musculoskeletal Pain: Results from a Factorial Experiment

PubMed Central

Maserejian, Nancy N.; Fischer, Michael A.; Trachtenberg, Felicia L.; Yu, Jing; Marceau, Lisa D.; McKinlay, John B.; Katz, Jeffrey N.

2014-01-01

Objective To examine whether medical decisions regarding evaluation and management of musculoskeletal pain conditions varied systematically by characteristics of the patient or provider. Methods We conducted a balanced factorial experiment among primary care physicians in the U.S. Physicians (N=192) viewed two videos of different patients (actors) presenting with pain: (1) undiagnosed sciatica symptoms or (2) diagnosed knee osteoarthritis. Systematic variations in patient gender, socioeconomic status (SES), race, physician gender and experience (<20 vs. ≥20 years in practice) permitted estimation of unconfounded effects. Analysis of variance was used to evaluate associations between patient or provider attributes and clinical decisions. Quality of decisions was defined based on the current recommendations of the ACR, American Pain Society, and clinical expert consensus. Results Despite current recommendations, under one-third of physicians would provide exercise advice (30.2% for osteoarthritis, 32.8% for sciatica). Physicians with fewer years in practice were more likely to provide advice on lifestyle changes, particularly exercise (P<0.01), and to prescribe NSAIDs for pain relief, both of which were appropriate and consistent with current recommendations for care. Newer physicians ordered fewer tests, particularly basic laboratory investigations or urinalysis. Test ordering decreased as organizational emphasis on business or profits increased. Patient factors and physician gender had no consistent effects on pain evaluation or treatment. Conclusion Physician education on disease management recommendations regarding exercise and analgesics, and implementation of quality measures may be useful, particularly for physicians with more years in practice. PMID:24376249

Developing an advanced practice nurse-led liver clinic.

PubMed

McAfee, Jean L

2012-01-01

End-stage liver disease (ESLD) is a leading cause of digestive disease deaths in the United States and continues to increase exponentially every year. Best practice does not currently recognize or utilize a clinic practice model for ESLD management. Advanced practice registered nurses (APRNs) can impact ESLD disease management by implementing an outpatient clinic care model to focus on treatment compliance, patient education, improvement of patient outcomes, and reduction in hospital admission rates for ESLD patients. A review of 15 research articles was completed to determine the impact APRNs can make on chronic care of ESLD patients. Results from the review support APRN analysis, assessment, diagnosis, treatment, intervention, and evaluation of ESLD patients. The literature reviewed also demonstrates that ESLD patients have improved symptom management when maintained in an outpatient setting, allowing for decreased hospital and insurance expenditures. Following evaluation of the evidence, it was concluded that an APRN-led ESLD clinic merits further study.

A flight test of laminar flow control leading-edge systems

NASA Technical Reports Server (NTRS)

Fischer, M. C.; Wright, A. S., Jr.; Wagner, R. D.

1983-01-01

NASA's program for development of a laminar flow technology base for application to commercial transports has made significant progress since its inception in 1976. Current efforts are focused on development of practical reliable systems for the leading-edge region where the most difficult problems in applying laminar flow exist. Practical solutions to these problems will remove many concerns about the ultimate practicality of laminar flow. To address these issues, two contractors performed studies, conducted development tests, and designed and fabricated fully functional leading-edge test articles for installation on the NASA JetStar aircraft. Systems evaluation and performance testing will be conducted to thoroughly evaluate all system capabilities and characteristics. A simulated airline service flight test program will be performed to obtain the operational sensitivity, maintenance, and reliability data needed to establish that practical solutions exist for the difficult leading-edge area of a future commercial transport employing laminar flow control.

Interrater reliability of visually evaluated high frequency oscillations.

PubMed

Spring, Aaron M; Pittman, Daniel J; Aghakhani, Yahya; Jirsch, Jeffrey; Pillay, Neelan; Bello-Espinosa, Luis E; Josephson, Colin; Federico, Paolo

2017-03-01

High frequency oscillations (HFOs) and interictal epileptiform discharges (IEDs) have been shown to be markers of epileptogenic regions. However, there is currently no 'gold standard' for identifying HFOs. Accordingly, we aimed to formally characterize the interrater reliability of HFO markings to validate the current practices. A morphology detector was implemented to detect events (candidate HFOs, lower-threshold events, and distractors) from the intracranial EEG (iEEG) of ten patients. Six electroencephalographers visually evaluated these events for the presence of HFOs and IEDs. Interrater reliability was calculated using pairwise Cohen's Kappa (κ) and intraclass correlation coefficients (ICC). The HFO evaluation distributions were significantly different for most pairs of reviewers (p<0.05; 11/15 pairs). Interrater reliability was poor for HFOs alone (κ mean =0.403; ICC=0.401) and HFO+IEDs (κ mean =0.568; ICC=0.570). The current practice of using two visual reviewers to identify HFOs is prone to bias arising from the poor agreement between reviewers, limiting the extrinsic validity of studies using these markers. The poor interrater reliability underlines the need for a framework to reconcile the important findings of existing studies. The present epoched design is an ideal candidate for the implementation of such a framework. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

Building Assessment Survey and Evaluation Study: Summarized Data - Test Space Pollutant Sources

EPA Pesticide Factsheets

information collected regarding sources that may have potential impact on the building in terms of indoor air quality including sources such as past or current water damage, pesticide application practices, special use spaces, etc.

Evaluation of high intensity sheeting for overhead highway signs.

DOT National Transportation Integrated Search

1974-01-01

The current practice in Virginia is to reflectorize and illuminate all overhead highway signs because of their important role in the safe and orderly flow of traffic. Reflectorization is obtained by using reflective sheeting as background and legend ...

Evaluation of Urban Freight Deliveries using Microsimulation and Surrogate Safety Measures

DOT National Transportation Integrated Search

2018-02-01

Freight deliveries on signalized urban streets are known to cause lane blockages during deliveries. When delivery vehicles block lanes of traffic near signalized intersections, the capacity of the intersection is affected. Current practice is for tra...

Toxicogenomics Applied to Ecotoxicology

EPA Science Inventory

This chapter focuses on evaluation of the current practice of ecotoxicogenomics, less than a decade after the term was coined, as the field continues to evolve. We describe major applications of genomic approaches to define modes/mechanisms of action and derive biologically-base...

Center/TRACON Automation System: Development and Evaluation in the Field

DOT National Transportation Integrated Search

1993-10-01

Technological advances are changing the way that advanced air traffic control : automation should be developed and assessed. Current standards and practices of : system development place field testing at the end of the development process. : While su...

In-service inspection methods for graphite-epoxy structures on commercial transport aircraft

NASA Technical Reports Server (NTRS)

Phelps, M. L.

1981-01-01

In-service inspection methods for graphite-epoxy composite structures on commercial transport aircraft are determined. Graphite/epoxy structures, service incurred defects, current inspection practices and concerns of the airline and manufacturers, and other related information were determind by survey. Based on this information, applicable inspection nondestructive inspection methods are evaluated and inspection techniques determined. Technology is developed primarily in eddy current inspection.

Developing a Self-Report-Based Sequential Analysis Method for Educational Technology Systems: A Process-Based Usability Evaluation

ERIC Educational Resources Information Center

Lin, Yi-Chun; Hsieh, Ya-Hui; Hou, Huei-Tse

2015-01-01

The development of a usability evaluation method for educational systems or applications, called the self-report-based sequential analysis, is described herein. The method aims to extend the current practice by proposing self-report-based sequential analysis as a new usability method, which integrates the advantages of self-report in survey…

Using the SAMR Model as a Framework for Evaluating mLearning Activities and Supporting a Transformation of Learning

ERIC Educational Resources Information Center

Pfaffe, Linda D.

2017-01-01

An examination of the perceptions of mLearning held by secondary teachers as well as mLearning best practices and professional development. Using the SAMR model (Puentedura, 2013) along with Romrell's (2014) definition of mLearning, this study evaluated mLearning activities (tools and applications) currently being used by secondary school…

In Harmony: A Technology-Based Music Education Model to Enhance Musical Understanding and General Learning Skills

ERIC Educational Resources Information Center

Portowitz, Adena; Peppler, Kylie A.; Downton, Mike

2014-01-01

This article reports on the practice and evaluation of a music education model, In Harmony, which utilizes new technologies and current theories of learning to mediate the music learning experience. In response to the needs of twenty-first century learners, the educational software programs Teach, Learn, Evaluate! and Impromptu served as central…

Unsustainable Growth, Hyper-Competition, and Worth in Life Science Research: Narrowing Evaluative Repertoires in Doctoral and Postdoctoral Scientists' Work and Lives

ERIC Educational Resources Information Center

Fochler, Maximilian; Felt, Ulrike; Müller, Ruth

2016-01-01

There is a crisis of valuation practices in the current academic life sciences, triggered by unsustainable growth and "hyper-competition." Quantitative metrics in evaluating researchers are seen as replacing deeper considerations of the quality and novelty of work, as well as substantive care for the societal implications of research.…

The ideal moisturizer: a survey of parental expectations and practice in childhood-onset eczema.

PubMed

Hon, Kam-Lun Ellis; Wang, Shuxin Susan; Pong, Nga Hin; Leung, Ting Fan

2013-02-01

We evaluated the moisturizing and bathing practices and preferences of patients with childhood-onset eczema. The attitudes and practice of patients with eczema managed at a pediatric dermatology clinic were evaluated, using children with non-eczematous skin diseases as controls. Disease severity of eczema in the preceding 12 months was evaluated by the Nottingham Eczema Severity Score (NESS). Skin hydration (SH) and transepidermal water loss (TEWL) were assessed. Majority of patients took shower instead of bath and spent 12-13 min in shower. Most eczema patients applied emollients after shower/bath. Air-conditioning use was frequent, and patients with eczema maintained a lower ambient temperature than non-eczema patients (p = 0.001). Most eczema patients reported regular emollient usage (1.8 times/day for mild vs 2.8 times/day for moderate-to-severe eczema, p = 0.001), and acceptability of the current product was good to fair. Parents reported that the current emollients were most often recommended by doctors. Majority of parents/patients with mild eczema thought an ideal emollient needs only to be used twice a day whereas moderate-to-severe patients preferred more frequent usage (p = 0.001), and most of them preferred a non-fragrant, non-herbal white cream. Agreements concerning ideal emollient usage were only "moderate-to-fair" (kappa values <0.61), implying what parents/patients practiced was not the same as what they preferred. This study helps better understand the emolliation practices and preferences of eczema patients. Doctors remain the most important source of recommendation. Majority think an ideal moisturizer is a non-fragrant, non-herbal, white or transparent cream which needs only to be used two to three times per day. Compliance may be enhanced if the recommended moisturizer conforms to the parents/patients preference.

Exploring Vocational Evaluation Practices following Traumatic Brain Injury.

PubMed

Dillahunt-Aspillaga, Christina; Jorgensen Smith, Tammy; Hanson, Ardis; Ehlke, Sarah; Stergiou-Kita, Mary; Dixon, Charlotte G; Quichocho, Davina

2015-01-01

Individuals with traumatic brain injury (TBI) face many challenges when attempting to return to work (RTW). Vocational evaluation (VE) is a systematic process that involves assessment and appraisal of an individual's current work-related characteristics and abilities. The aims of this study are to (1) examine demographic and employment characteristics of vocational rehabilitation providers (VRPs), (2) identify the specific evaluation methods that are used in the VE of individuals with TBI, and (3) examine the differences in assessment method practices based upon evaluator assessment preferences. This exploratory case study used a forty-six-item online survey which was distributed to VRPs. One hundred and nine VRPs accessed the survey. Of these, 74 completed the survey. A majority of respondents were female (79.7%), Caucasian (71.6%), and holding a master's degree (74.3%), and more than half (56.8%) were employed as state vocational rehabilitation counselors (VRCs). In addition, over two-thirds (67.6%) were certified rehabilitation counselors (CRCs). Respondents reported using several specific tools and assessments during the VE process. Study findings reveal differences in use of and rationales for specific assessments amongst VRPs. Understanding VRP assessment practices and use of an evidence-based framework for VE following TBI may inform and improve VE practice.

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

PubMed

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

2015-01-01

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

Research-Based Implementation of Peer Instruction: A Literature Review

PubMed Central

Vickrey, Trisha; Rosploch, Kaitlyn; Rahmanian, Reihaneh; Pilarz, Matthew; Stains, Marilyne

2015-01-01

Current instructional reforms in undergraduate science, technology, engineering, and mathematics (STEM) courses have focused on enhancing adoption of evidence-based instructional practices among STEM faculty members. These practices have been empirically demonstrated to enhance student learning and attitudes. However, research indicates that instructors often adapt rather than adopt practices, unknowingly compromising their effectiveness. Thus, there is a need to raise awareness of the research-based implementation of these practices, develop fidelity of implementation protocols to understand adaptations being made, and ultimately characterize the true impact of reform efforts based on these practices. Peer instruction (PI) is an example of an evidence-based instructional practice that consists of asking students conceptual questions during class time and collecting their answers via clickers or response cards. Extensive research has been conducted by physics and biology education researchers to evaluate the effectiveness of this practice and to better understand the intricacies of its implementation. PI has also been investigated in other disciplines, such as chemistry and computer science. This article reviews and summarizes these various bodies of research and provides instructors and researchers with a research-based model for the effective implementation of PI. Limitations of current studies and recommendations for future empirical inquiries are also provided. PMID:25713095

Evaluating How to Alter Design Processes to Consider Sustainable Practices

NASA Astrophysics Data System (ADS)

Liew, V.

2017-12-01

The Design Cycle is a well established design methodology featuring four major criterion (Investigating, Planning, Creating, and Evaluating), adopted by International Baccalaureate education foundation. However, as sustainability has become an alarmingly relevant issue, the Design Cycle is not a sufficient guide in its current form. With the the excessive quantities of waste entering Hong Kong's landfills as well as the worldwide issue of rapidly depleting resources, it is imperative that products reduce waste via adaptive or mitigative methods, and that an environmental sector be integrated into the existing Design Cycle. In this piece of research, sustainable design practices will be evaluated to form a list of specifications that products can be assessed against to reduce waste and repurpose materials.

Practice patterns of image guided particle therapy in Europe: A 2016 survey of the European Particle Therapy Network (EPTN).

PubMed

Bolsi, Alessandra; Peroni, Marta; Amelio, Dante; Dasu, Alexandru; Stock, Markus; Toma-Dasu, Iuliana; Nyström, Petra Witt; Hoffmann, Aswin

2018-03-28

Image guidance is critical in achieving accurate and precise radiation delivery in particle therapy, even more than in photon therapy. However, equipment, quality assurance procedures and clinical workflows for image-guided particle therapy (IGPT) may vary substantially between centres due to a lack of standardization. A survey was conducted to evaluate the current practice of IGPT in European particle therapy centres. In 2016, a questionnaire was distributed among 19 particle therapy centres in 12 European countries. The questionnaire consisted of 30 open and 37 closed questions related to image guidance in the general clinical workflow, for moving targets, current research activities and future perspectives of IGPT. All centres completed the questionnaire. The IGPT methods used by the 10 treating centres varied substantially. The 9 non-treating centres were in the process to introduce IGPT. Most centres have developed their own IGPT strategies, being tightly connected to their specific technical implementation and dose delivery methods. Insight into the current clinical practice of IGPT in European particle therapy centres was obtained. A variety in IGPT practices and procedures was confirmed, which underlines the need for harmonisation of practice parameters and consensus guidelines. Copyright © 2018 Elsevier B.V. All rights reserved.

Evaluation of low-dose CT implementation for lung cancer screening in a general practice hospital

NASA Astrophysics Data System (ADS)

Karostik, D. V.; Kamyshanskaya, I. G.; Cheremisin, V. M.; Drozdov, A. A.; Vodovatov, A. V.

2018-02-01

The aim of the current study was to evaluate the possibility of the implementation of LDCT for the screening for lung cancer and tuberculosis in a typical general hospital practice. Diagnostic and economic effectiveness, patient doses and the corresponding radiation risks for LDCT were compared with the existing digital chest screening radiography. The results of the study indicate that the implementation of LDCT allowed verifying false-positive cases or providing additional excessive diagnostic information, but did not significantly improve the sensitivity of screening. Per capita costs for LDCT were higher compared to digital radiography up to a factor of 12; corresponding radiation risk - by a factor of 4. Hence, it was considered unjustified to implement LDCT in a general practice hospital.

Ergonomic best practices in masonry: regional differences, benefits, barriers, and recommendations for dissemination.

PubMed

Hess, Jennifer; Weinstein, Marc; Welch, Laura

2010-08-01

Within construction the masonry trade has particularly high rates of musculoskeletal disorders (MSDs). A NIOSH-sponsored meeting of masonry stakeholders explored current and potential "Best Practices" for reducing MSDs in masonry and identified potential regional differences in use of practices. To verify and better understand the regional effects and other factors associated with differences in practice use, a national telephone survey of masonry contractors was conducted. The United States was divided into four regions for evaluation: Northeast, Southeast, Midwest, and West Coast. Nine practices with the potential to reduce MSDs in masonry workers were evaluated. Masonry contractors, owners, and foremen completed 183 surveys. The results verify regional differences in use of best practices in masonry. Half-weight cement bags and autoclave aerated concrete were rarely used anywhere, while lightweight block and mortar silos appear to be diffusing across the country. The Northeast uses significantly fewer best practices than other regions. This article examines reasons for regional differences in masonry best practice, and findings provide insight into use and barriers to adoption that can be used by safety managers, researchers, and other safety advocates to more effectively disseminate ergonomic solutions across the masonry industry.

A comparison of results of empirical studies of supplementary search techniques and recommendations in review methodology handbooks: a methodological review.

PubMed

Cooper, Chris; Booth, Andrew; Britten, Nicky; Garside, Ruth

2017-11-28

The purpose and contribution of supplementary search methods in systematic reviews is increasingly acknowledged. Numerous studies have demonstrated their potential in identifying studies or study data that would have been missed by bibliographic database searching alone. What is less certain is how supplementary search methods actually work, how they are applied, and the consequent advantages, disadvantages and resource implications of each search method. The aim of this study is to compare current practice in using supplementary search methods with methodological guidance. Four methodological handbooks in informing systematic review practice in the UK were read and audited to establish current methodological guidance. Studies evaluating the use of supplementary search methods were identified by searching five bibliographic databases. Studies were included if they (1) reported practical application of a supplementary search method (descriptive) or (2) examined the utility of a supplementary search method (analytical) or (3) identified/explored factors that impact on the utility of a supplementary method, when applied in practice. Thirty-five studies were included in this review in addition to the four methodological handbooks. Studies were published between 1989 and 2016, and dates of publication of the handbooks ranged from 1994 to 2014. Five supplementary search methods were reviewed: contacting study authors, citation chasing, handsearching, searching trial registers and web searching. There is reasonable consistency between recommended best practice (handbooks) and current practice (methodological studies) as it relates to the application of supplementary search methods. The methodological studies provide useful information on the effectiveness of the supplementary search methods, often seeking to evaluate aspects of the method to improve effectiveness or efficiency. In this way, the studies advance the understanding of the supplementary search methods. Further research is required, however, so that a rational choice can be made about which supplementary search strategies should be used, and when.

Clinical review: Thinking outside the box - an iconoclastic view of current practice

PubMed Central

2011-01-01

Many advances in medicine have been achieved through challenging established dogma with revolutionary thought and novel practices. Each and every specialty is reinvigorated by regular re-evaluation of processes and practices in the light of new evidence and fresh conceptualization. Challenge can galvanize fresh thinking and new approaches, yet may also reinforce and strengthen traditional paradigms if the prevailing orthodoxy is subsequently revalidated. This article is a synopsis of a roundtable meeting held in Brussels in March 2010 designed specifically to confront doctrine with reasoned scientific argument, and to propose new ideas for advancing critical care practices and outcomes. PMID:21888690

Summary of performance data for technologies to control gaseous, odor, and particulate emissions from livestock operations: Air management practices assessment tool (AMPAT)

PubMed Central

Maurer, Devin L.; Koziel, Jacek A.; Harmon, Jay D.; Hoff, Steven J.; Rieck-Hinz, Angela M.; Andersen, Daniel S.

2016-01-01

The livestock and poultry production industry, regulatory agencies, and researchers lack a current, science-based guide and data base for evaluation of air quality mitigation technologies. Data collected from science-based review of mitigation technologies using practical, stakeholders-oriented evaluation criteria to identify knowledge gaps/needs and focuses for future research efforts on technologies and areas with the greatest impact potential is presented in the Literature Database tab on the air management practices tool (AMPAT). The AMPAT is web-based (available at www.agronext.iastate.edu/ampat) and provides an objective overview of mitigation practices best suited to address odor, gaseous, and particulate matter (PM) emissions at livestock operations. The data was compiled into Excel spreadsheets from a literature review of 265 papers was performed to (1) evaluate mitigation technologies performance for emissions of odor, volatile organic compounds (VOCs), ammonia (NH3), hydrogen sulfide (H2S), particulate matter (PM), and greenhouse gases (GHGs) and to (2) inform future research needs. PMID:27158660

Improving and ensuring best practice continence management in residential aged care.

PubMed

Heckenberg, Gayle

2008-06-01

Background  Continence Management within residential aged care is an every day component of care that requires assessment, implementation of strategies, resource allocation and evaluation. At times the management of incontinence of aged residents can be challenging and unsuccessful. The project chosen through the Clinical Fellowship program was Continence Management with the aim of raising awareness of best practice to assist in improving and providing person-centred resident care. Aims/objectives •  Review the literature on best practice management of incontinence •  Evaluate current practice in continence management for elderly residents within residential aged care services •  Improve adherence to best practice strategies of care for incontinence •  Raise awareness within the nursing home of the best practice management of incontinence •  Promote appropriate and effective use of resources for continence management •  Deliver individualised person-centred care to residents. •  Ensure best practice in continence management Methods  The Joanna Briggs Institute (JBI) Practical Application of Clinical Evidence System clinical audit tool was utilised to measure current practice against best practice. The results identify gaps that require improvement. The Getting Research into Practice process then allowed analysis of the level of compliance with each of the audit criteria, which would identify any barriers in implementing a selected course of action and aim to improve compliance. The project team was consulted with additional stakeholder consultation to form an action plan and implement strategies to improve practice. Results  Although 100% compliance with all audit criteria in audit 1 and 2 was not achieved, there was improvement in the criteria concerning the documented fluid intake for residents. Further strategies have been identified and implemented and this continues to be a 'work in progress'. Staff now have an acute awareness of what best practice means and the impact their practices have on continence management. The JBI clinical audit and feedback cycle will continue to facilitate the measuring and implementation of best practice for resident outcomes in residential aged care. © 2008 The Author. Journal Compilation © Blackwell Publishing Asia Pty Ltd.

Evaluation of the midwifery pilot projects in Quebec: an overview. L'Equipe d'Evaluation des Projets-Pilotes Sages-Femmes.

PubMed

Blais, R; Joubert, P

2000-01-01

In 1990, the province of Quebec adopted a law authorizing the evaluation of the practice of midwifery through eight pilot projects. The projects, which took the form of birth centres outside hospitals, started operating in 1994. The objectives of the evaluation were 1) to compare midwives' services to current physician services with regard to maternal and neonatal mortality and morbidity, the use of obstetrical intervention, individualization and continuity of care as perceived by clients, and cost; and 2) to identify the professional and organizational factors associated with the integration of midwives into the health care system. A mixed evaluative design was used: a multiple case study with each pilot project representing a case and a cohort study where 1,000 women followed by midwives in the birth centres were matched with 1,000 women followed by physicians in the usual hospital-based services. Various quantitative and qualitative data collection instruments were used. Overall, many results were favourable to midwifery practice, while some were favourable to medical care. Following the evaluation, the Government of Quebec decided to legalize the practice of midwifery.

Multisite evaluation of APEX for water quality: II. Regional parameterization

USDA-ARS?s Scientific Manuscript database

Phosphorus (P) index assessment requires independent estimates of long-term average annual P loss from multiple locations, management practices, soils, and landscape positions. Because currently available measured data are insufficient, calibrated and validated process-based models have been propos...

Assessment of classification instruments designed to detect alcohol abuse

DOT National Transportation Integrated Search

1988-12-01

The report summarizes an effort to identify and evaluate instruments currently in use to assess substance abuse problems in driving while impaired (DWI) offenders. The results of a national survey of DWI assessment practices in the United States are ...

Evaluation of the cost-effectiveness of illumination as a safety treatment at rural intersections.

DOT National Transportation Integrated Search

2016-09-01

This research study seeks to improve current understanding of the relationship between rural intersection safety and different illumination levels. It uses three parallel studies: a survey of rural intersection illumination practices among US state d...

Applying instructional design practices to evaluate and improve the roadway characteristics inventory (RCI) training curriculum.

DOT National Transportation Integrated Search

2010-07-01

The Transportation Statistics Office (TranStat) of the Florida Department of Transportation (FDOT) provides training for district data collection technicians in both office- and field-based Roadway Characteristics Inventory (RCI) methods. The current...

Evaluation of TxDOT'S traffic data collection and load forecasting process

DOT National Transportation Integrated Search

2001-01-01

This study had two primary objectives: (1) compare current Texas Department of Transportation (TxDOT) procedures and protocols with the state-of-the-practice and the needs of its data customers; and (2) develop enhanced traffic collection, archival, ...

Phase I: Evaluation of Low Flexural Strength for Northern Nevada Concrete Paving Mixtures

DOT National Transportation Integrated Search

2017-07-01

Production paving grade concrete in Northern Nevada having acceptable strength is universally acknowledged to be difficult; however understanding why this is true remains elusive. Current practice is to meet flexural strength requirements by using mi...

Evaluating non-detection risk associated with metabarcoding approaches for rare metabarcoding approaches

EPA Science Inventory

Early detection of non-indigenous species (NIS), newly introduced species at low abundance in the monitoring area, can strengthen current management strategies including NIS control and eradication. A practical early detection strategy requires achieving balance between efficient...

Aligning oversize/overweight permit fees with agency costs : critical issues.

DOT National Transportation Integrated Search

2013-08-01

This project provides an elementary analysis of issues and a proposed framework for the state to evaluate cost recovery options : due to OSOW operations. The authors provide a review of current permitting practices, provide a sampling of fee structur...

Aligning oversize/overweight fees with agency costs : critical issues.

DOT National Transportation Integrated Search

2013-08-01

This project provides an elementary analysis of issues and a proposed framework for the state to evaluate cost recovery options : due to OSOW operations. The authors provide a review of current permitting practices, provide a sampling of fee structur...

Effectiveness study of UNL's pneumatic crack/joint preparation device.

DOT National Transportation Integrated Search

2014-03-01

The aim of this project was to evaluate the effectiveness of the crack cleaning device (CCD) for improving the current crack/joint preparation practices and for possible adoption as a standard in Nebraska Department of Roads (NDOR). Through the colla...

ALTERNATE METHODS OF MANURE HANDLING

EPA Science Inventory

The objectives of this research project were to (a) construct an inexpensive storage facility for solid dairy cow manure, (b) evaluate its performance and the extent of pollutants in runoff from storage facilities, and (c) determine current manure handling practices in Vermont an...

Redesigning Journal Clubs to Staying Current with the Literature.

PubMed

Dickerson, Roland N; Wood, G Christopher; Swanson, Joseph M; Brown, Rex O

2017-11-06

Staying current with the literature is of paramount importance to the pharmacist engaged in an evidence-based clinical practice. Given the expanding roles and responsibilities of today's pharmacists combined with exponential growth in new medical and health sciences literature, staying current has become an extremely daunting task. Traditional journal clubs have focused upon their role as a training vehicle for teaching critical reading skills to residents. However, schools of pharmacy are now required to provide instruction in biostatistics, research design, and interpretation. We present a paradigm shift in the traditional journal club model whereby a collection of periodicals is screened and a short synopsis of the pertinent articles is provided. The associated tasks for screening and presenting of the primary literature are shared among a group of clinicians and trainees with similar practice interests resulting in a more reasonable workload for the individual. This journal club method was effective in identifying a significant majority of articles judged to be pertinent by independent groups of clinicians in the same practice arenas. Details regarding the shared core practice and knowledge base elements, journal club format, identification of journals, and evaluation of the success of the journal club technique are provided.

Redesigning Journal Clubs to Staying Current with the Literature

PubMed Central

Dickerson, Roland N.; Wood, G. Christopher; Swanson, Joseph M.; Brown, Rex O.

2017-01-01

Staying current with the literature is of paramount importance to the pharmacist engaged in an evidence-based clinical practice. Given the expanding roles and responsibilities of today’s pharmacists combined with exponential growth in new medical and health sciences literature, staying current has become an extremely daunting task. Traditional journal clubs have focused upon their role as a training vehicle for teaching critical reading skills to residents. However, schools of pharmacy are now required to provide instruction in biostatistics, research design, and interpretation. We present a paradigm shift in the traditional journal club model whereby a collection of periodicals is screened and a short synopsis of the pertinent articles is provided. The associated tasks for screening and presenting of the primary literature are shared among a group of clinicians and trainees with similar practice interests resulting in a more reasonable workload for the individual. This journal club method was effective in identifying a significant majority of articles judged to be pertinent by independent groups of clinicians in the same practice arenas. Details regarding the shared core practice and knowledge base elements, journal club format, identification of journals, and evaluation of the success of the journal club technique are provided. PMID:29113107

Aligning Practice to Policies: Changing the Culture to Recognize and Reward Teaching at Research Universities

PubMed Central

Dennin, Michael; Schultz, Zachary D.; Feig, Andrew; Finkelstein, Noah; Greenhoot, Andrea Follmer; Hildreth, Michael; Leibovich, Adam K.; Martin, James D.; Moldwin, Mark B.; O’Dowd, Diane K.; Posey, Lynmarie A.; Smith, Tobin L.; Miller, Emily R.

2017-01-01

Recent calls for improvement in undergraduate education within STEM (science, technology, engineering, and mathematics) disciplines are hampered by the methods used to evaluate teaching effectiveness. Faculty members at research universities are commonly assessed and promoted mainly on the basis of research success. To improve the quality of undergraduate teaching across all disciplines, not only STEM fields, requires creating an environment wherein continuous improvement of teaching is valued, assessed, and rewarded at various stages of a faculty member’s career. This requires consistent application of policies that reflect well-established best practices for evaluating teaching at the department, college, and university levels. Evidence shows most teaching evaluation practices do not reflect stated policies, even when the policies specifically espouse teaching as a value. Thus, alignment of practice to policy is a major barrier to establishing a culture in which teaching is valued. Situated in the context of current national efforts to improve undergraduate STEM education, including the Association of American Universities Undergraduate STEM Education Initiative, this essay discusses four guiding principles for aligning practice with stated priorities in formal policies: 1) enhancing the role of deans and chairs; 2) effectively using the hiring process; 3) improving communication; and 4) improving the understanding of teaching as a scholarly activity. In addition, three specific examples of efforts to improve the practice of evaluating teaching are presented as examples: 1) Three Bucket Model of merit review at the University of California, Irvine; (2) Evaluation of Teaching Rubric, University of Kansas; and (3) Teaching Quality Framework, University of Colorado, Boulder. These examples provide flexible criteria to holistically evaluate and improve the quality of teaching across the diverse institutions comprising modern higher education. PMID:29196430

Bariatric surgery and the changing current scope of general surgery practice: implications for general surgery residency training.

PubMed

Mostaedi, Rouzbeh; Ali, Mohamed R; Pierce, Jonathan L; Scherer, Lynette A; Galante, Joseph M

2015-02-01

The scope of general surgery practice has evolved tremendously in the last 20 years. However, clinical experience in general surgery residency training has undergone relatively little change. To evaluate the current scope of academic general surgery and its implications on surgical residency. The University HealthSystem Consortium and Association of American Medical Colleges established the Faculty Practice Solution Center (FPSC) to characterize physician productivity. The FPSC is a benchmarking tool for academic medical centers created from revenue data collected from more than 90,000 physicians who practice at 95 institutions across the United States. The FPSC database was queried to evaluate the annual mean procedure frequency per surgeon (PFS) in each calendar year from 2006 through 2011. The associated work relative value units (wRVUs) were also examined to measure physician effort and skill. During the 6-year period, 146 distinct Current Procedural Terminology codes were among the top 100 procedures, and 16 of these procedures ranked in the top 10 procedures in at least 1 year. The top 10 procedures accounted for more than half (range, 52.5%-57.2%) of the total 100 PFS evaluated for each year. Laparoscopic Roux-en-Y gastric bypass was consistently among the top 10 procedures in each year (PFS, 18.2-24.6). The other most frequently performed procedures included laparoscopic cholecystectomy (PFS, 30.3-43.5), upper gastrointestinal tract endoscopy (PFS, 26.5-34.3), mastectomy (PFS, 16.5-35.0), inguinal hernia repair (PFS, 15.5-22.1), and abdominal wall hernia repair (PFS, 21.6-26.1). In all years, laparoscopic Roux-en-Y gastric bypass generated the highest number of wRVUs (wRVUs, 491.0-618.2), and laparoscopic cholecystectomy was regularly the next highest (wRVUs, 335.8-498.7). A significant proportion of academic general surgery is composed of bariatric surgery, yet surgical training does not sufficiently emphasize the necessary exposure to technical expertise and clinical management of the patient undergoing bariatric surgery. As the scope of general surgery practice continues to evolve, general surgery residency training will need to better integrate the exposure to bariatric surgery.

The hierarchy of environmental health and safety practices in the U.S. nanotechnology workplace.

PubMed

Engeman, Cassandra D; Baumgartner, Lynn; Carr, Benjamin M; Fish, Allison M; Meyerhofer, John D; Satterfield, Terre A; Holden, Patricia A; Harthorn, Barbara Herr

2013-01-01

Manufacturing of nanoscale materials (nanomaterials) is a major outcome of nanotechnology. However, the potential adverse human health effects of manufactured nanomaterial exposure are not yet fully understood, and exposures in humans are mostly uncharacterized. Appropriate exposure control strategies to protect workers are still being developed and evaluated, and regulatory approaches rely largely on industry self-regulation and self-reporting. In this context of soft regulation, the authors sought to: 1) assess current company-reported environmental health and safety practices in the United States throughout the product life cycle, 2) consider their implications for the manufactured nanomaterial workforce, and 3) identify the needs of manufactured nanomaterial companies in developing nano-protective environmental health and safety practices. Analysis was based on the responses of 45 U.S.-based company participants in a 2009-2010 international survey of private companies that use and/or produce nanomaterials. Companies reported practices that span all aspects of the current government-recommended hierarchical approach to manufactured nanomaterials' exposure controls. However, practices that were tailored to current manufactured nanomaterials' hazard and exposure knowledge, whether within or outside the hierarchical approach, were reported less frequently than general chemical hygiene practices. Product stewardship and waste management practices-the influences of which are substantially downstream-were reported less frequently than most other environmental health and safety practices. Larger companies had more workers handling nanomaterials, but smaller companies had proportionally more employees handling nanomaterials and more frequently identified impediments to implementing nano-protective practices. Company-reported environmental health and safety practices suggest more attention to environmental health and safety is necessary, especially with regard to practices that can cause external effects. Given reported impediments, smaller companies may especially benefit from more attention. However, the manufactured nanomaterial workforce within smaller companies is particularly difficult to identify and hence locate, posing challenges to developing and enforcing appropriate workplace environmental health and safety. [Supplementary materials are available for this article. Go to the publisher's online edition of Journal of Occupational and Environmental Hygiene for the following free supplemental resource: a file containing Survey of Current Health and Safety Practices in the Nanomaterial Industry and a file containing figures.].

Evaluation of nanoparticle immunotoxicity

NASA Astrophysics Data System (ADS)

Dobrovolskaia, Marina A.; Germolec, Dori R.; Weaver, James L.

2009-07-01

The pharmaceutical industry is developing increasing numbers of drugs and diagnostics based on nanoparticles, and evaluating the immune response to these diverse formulations has become a challenge for scientists and regulatory agencies alike. An international panel of scientists and representatives from various agencies and companies reviewed the imitations of current tests at a workshop held at the National Cancer Institute in Frederick, Maryland. This article outlines practical strategies for identifying and controlling interferences in common evaluation methods and the implications for regulation.

Evaluation of thermal sprayed metallic coatings for use on the structures at Launch Complex 39

NASA Technical Reports Server (NTRS)

Welch, Peter J.

1990-01-01

The current status of the evaluation program is presented. The objective was to evaluate the applicability of Thermal Sprayed Coatings (TSC) to protect the structures in the high temperature acid environment produced by exhaust of the Solid Rocket Boosters during the launches of the Shuttle Transportation System. Only the relatively low cost aluminum TSC which provides some cathodic protection for steel appears to be a practical candidate for further investigation.

The Canadian Preterm Birth Network: a study protocol for improving outcomes for preterm infants and their families

PubMed Central

Shah, Prakesh S.; McDonald, Sarah D.; Barrett, Jon; Synnes, Anne; Robson, Kate; Foster, Jonathan; Pasquier, Jean-Charles; Joseph, K.S.; Piedboeuf, Bruno; Lacaze-Masmonteil, Thierry; O'Brien, Karel; Shivananda, Sandesh; Chaillet, Nils; Pechlivanoglou, Petros

2018-01-01

Background: Preterm birth (birth before 37 wk of gestation) occurs in about 8% of pregnancies in Canada and is associated with high mortality and morbidity rates that substantially affect infants, their families and the health care system. Our overall goal is to create a transdisciplinary platform, the Canadian Preterm Birth Network (CPTBN), where investigators, stakeholders and families will work together to improve childhood outcomes of preterm neonates. Methods: Our national cohort will include 24 maternal-fetal/obstetrical units, 31 neonatal intensive care units and 26 neonatal follow-up programs across Canada with planned linkages to provincial health information systems. Three broad clusters of projects will be undertaken. Cluster 1 will focus on quality-improvement efforts that use the Evidence-based Practice for Improving Quality method to evaluate information from the CPTBN database and review the current literature, then identify potentially better health care practices and implement identified strategies. Cluster 2 will assess the impact of current practices and practice changes in maternal, perinatal and neonatal care on maternal, neonatal and neurodevelopmental outcomes. Cluster 3 will evaluate the effect of preterm birth on babies, their families and the health care system by integrating CPTBN data, parent feedback, and national and provincial database information in order to identify areas where more parental support is needed, and also generate robust estimates of resource use, cost and cost-effectiveness around preterm neonatal care. Interpretation: These collaborative efforts will create a flexible, transdisciplinary, evaluable and informative research and quality-improvement platform that supports programs, projects and partnerships focused on improving outcomes of preterm neonates. PMID:29348260

Current practices of commercial cryobanks in screening prospective donors for genetic disease and reproductive risk.

PubMed

Conrad, E A; Fine, B; Hecht, B R; Pergament, E

1996-01-01

To determine how the screening practices of commercial semen banks vary from published guidelines, which factors influence cryobanks to exclude prospective semen donors for genetic reasons, and the current role of clinical geneticists/genetic counselors in evaluating prospective semen donors. The genetic screening of prospective donors by commercial semen banks was evaluated using written questionnaires completed by bank directors. Responses were analyzed to determine exclusion criteria, adherence to published guidelines, and contribution of genetic professionals. Semen banks were selected on the basis of membership in the American Association of Tissue Banks and commercial use of semen for artificial insemination by donor. Semen bank practices as reported by commercial semen bank directors. Of 37 eligible banks, 16 responded. All screen prospective donors by medical/family history and physical examination, 94% have upper age limits; 63% examine for minor physical defects; 56% routinely karyotype; 81% screen men of ethnic groups at risk for Tay Sachs disease, sickle cell disease and thalassemia; 19% screen all donors; 25% screen all donors for cystic fibrosis and 50% only screen if family history positive. Donor rejection was based on three criteria: mode of inheritance of familial disorder, severity of disease, and availability of carrier/confirmatory testing of donor genotype. Ten of 16 banks have no genetic professional on staff. Commercial semen banks primarily rely on family history as the major exclusion criterion in genetic screening of donors. Considerable differences exist among semen bank practices in accordance with guidelines published by national agencies. Genetic professionals have a minimal effect overall on evaluation of semen donors.

Evaluation and Validation (E&V) Team Public Report. Volume 5

DTIC Science & Technology

1990-10-31

aspects, software engineering practices, etc. The E&V requirements which are developed will be used to guide the E&V technical effort. The currently...interoperability of Ada software engineering environment tools and data. The scope of the CAIS-A includes the functionality affecting transportability that is...requirement that they be CAIS conforming tools or data. That is, for example numerous CIVC data exist on special purpose software currently available

Implementation workshop of WHO guidelines on evaluation of malaria vaccines: Current regulatory concepts and issues related to vaccine quality, Pretoria, South Africa 07 Nov 2014.

PubMed

Ho, Mei Mei; Baca-Estrada, Maria; Conrad, Christoph; Karikari-Boateng, Eric; Kang, Hye-Na

2015-08-26

The current World Health Organization (WHO) guidelines on the quality, safety and efficacy of recombinant malaria vaccines targeting the pre-erythrocytic and blood stages of Plasmodium falciparum were adopted by the WHO Expert Committee on Biological Standardization in 2012 to provide guidance on the quality, nonclinical and clinical aspects of recombinant malaria vaccines. A WHO workshop was organised to facilitate implementation into African (national/regional) regulatory practices, of the regulatory evaluation principles outlined in the guidelines regarding quality aspects. The workshop was used also to share knowledge and experience on regulatory topics of chemistry, manufacturing and control with a focus on vaccines through presentations and an interactive discussion using a case study approach. The basic principles and concepts of vaccine quality including consistency of production, quality control and manufacturing process were presented and discussed in the meeting. By reviewing and practicing a case study, better understanding on the relationship between consistency of production and batch release tests of an adjuvanted pre-erythrocytic recombinant malaria vaccine was reached. The case study exercise was considered very useful to understand regulatory evaluation principles of vaccines and a suggestion was made to WHO to provide such practices also through its Global Learning Opportunities for Vaccine Quality programme. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Redefining evidence in the management of acute post-cataract surgery endophthalmitis in India - The 2014 Adenwalla Oration, All India Ophthalmological Society.

PubMed

Das, Taraprasad

2017-12-01

The current evidence of postoperative endophthalmitis management in three important components of care-infection control, inflammation control, and prevention was reviewed, and their current relevance and application in an Indian context were evaluated. The publications from India indicated that Gram-negative bacterial and filamentous fungal infections are relatively higher. There are increasing instances of resistance to ceftazidime by Gram-negative microorganisms. Intravitreal dexamethasone limits inflammation in bacterial endophthalmitis when given together with the intravitreal antibiotics. Intracameral antibiotic could reduce postcataract surgery infection at least in less rigorous surgical environment. Systematic collection of data and periodic evaluation of the current practice against the new evidence are necessary to prevent or treat postcataract surgery endophthalmitis.

Are individuals with Parkinson's disease capable of speech-motor learning? - A preliminary evaluation.

PubMed

Kaipa, Ramesh; Jones, Richard D; Robb, Michael P

2016-07-01

The benefits of different practice conditions in limb-based rehabilitation of motor disorders are well documented. Conversely, the role of practice structure in the treatment of motor-based speech disorders has only been minimally investigated. Considering this limitation, the current study aimed to investigate the effectiveness of selected practice conditions in spatial and temporal learning of novel speech utterances in individuals with Parkinson's disease (PD). Participants included 16 individuals with PD who were randomly and equally assigned to constant, variable, random, and blocked practice conditions. Participants in all four groups practiced a speech phrase for two consecutive days, and reproduced the speech phrase on the third day without further practice or feedback. There were no significant differences (p > 0.05) between participants across the four practice conditions with respect to either spatial or temporal learning of the speech phrase. Overall, PD participants demonstrated diminished spatial and temporal learning in comparison to healthy controls. Tests of strength of association between participants' demographic/clinical characteristics and speech-motor learning outcomes did not reveal any significant correlations. The findings from the current study suggest that repeated practice facilitates speech-motor learning in individuals with PD irrespective of the type of practice. Clinicians need to be cautious in applying practice conditions to treat speech deficits associated with PD based on the findings of non-speech-motor learning tasks. Copyright © 2016 Elsevier Ltd. All rights reserved.

The manned transportation system study - Defining human pathways into space

NASA Technical Reports Server (NTRS)

Lance, Nick; Geyer, Mark S.; Gaunce, Michael T.; Anson, H. W.; Bienhoff, D. G.; Carey, D. A.; Emmett, B. R.; Mccandless, B.; Wetzel, E. D.

1992-01-01

Substantiating data developed by a NASA-industry team (NIT) for subsequent NASA decisions on the 'right' set of manned transportation elements needed for human access to space are discussed. Attention is given to the framework for detailed definition of these manned transportation elements. Identifying and defining architecture evaluation criteria, i.e., attributes, specified the amount and type of data needed for each concept under consideration. Several architectures, each beginning with today's transportation systems, were defined using representative systems to explore future options and address specific questions currently being debated. The present solutions emphasize affordability, safety, routineness, and reliability. Key issues associated with current business practices were challenged and the impact associated with these practices quantified.

Stemming the Tide of Antibiotic Resistance (STAR): A protocol for a trial of a complex intervention addressing the 'why' and 'how' of appropriate antibiotic prescribing in general practice

PubMed Central

Simpson, Sharon A; Butler, Christopher C; Hood, Kerry; Cohen, David; Dunstan, Frank; Evans, Meirion R; Rollnick, Stephen; Moore, Laurence; Hare, Monika; Bekkers, Marie-Jet; Evans, John

2009-01-01

Background After some years of a downward trend, antibiotic prescribing rates in the community have tended to level out in many countries. There is also wide variation in antibiotic prescribing between general practices, and between countries. There are still considerable further gains that could be made in reducing inappropriate antibiotic prescribing, but complex interventions are required. Studies to date have generally evaluated the effect of interventions on antibiotic prescribing in a single consultation and pragmatic evaluations that assess maintenance of new skills are rare. This paper describes the protocol for a pragmatic, randomized evaluation of a complex intervention aimed at reducing antibiotic prescribing by primary care clinicians. Methods and design We developed a Social Learning Theory based, blended learning program (on-line learning, a practice based seminar, and context bound learning) called the STAR Educational Program. The 'why of change' is addressed by providing clinicians in general practice with information on antibiotic resistance in urine samples submitted by their practice and their antibiotic prescribing data, and facilitating a practice-based seminar on the implications of this data. The 'how of change' is addressed through context-bound communication skills training and information on antibiotic indication and choice. This intervention will be evaluated in a trial involving 60 general practices, with general practice as the unit of randomization (clinicians from each practice to either receive the STAR Educational Program or not) and analysis. The primary outcome will be the number of antibiotic items dispensed over one year. An economic and process evaluation will also be conducted. Discussion This trial will be the first to evaluate the effectiveness of this type of theory-based, blended learning intervention aimed at reducing antibiotic prescribing by primary care clinicians. Novel aspects include feedback of practice level data on antimicrobial resistance and prescribing, use of principles from motivational interviewing, training in enhanced communication skills that incorporates context-bound experience and reflection, and using antibiotic dispensing over one year (as opposed to antibiotic prescribing in a single consultation) as the main outcome. Trial registration Current Controlled Trials ISRCTN63355948. PMID:19309493

Stemming the Tide of Antibiotic Resistance (STAR): a protocol for a trial of a complex intervention addressing the 'why' and 'how' of appropriate antibiotic prescribing in general practice.

PubMed

Simpson, Sharon A; Butler, Christopher C; Hood, Kerry; Cohen, David; Dunstan, Frank; Evans, Meirion R; Rollnick, Stephen; Moore, Laurence; Hare, Monika; Bekkers, Marie-Jet; Evans, John

2009-03-23

After some years of a downward trend, antibiotic prescribing rates in the community have tended to level out in many countries. There is also wide variation in antibiotic prescribing between general practices, and between countries. There are still considerable further gains that could be made in reducing inappropriate antibiotic prescribing, but complex interventions are required. Studies to date have generally evaluated the effect of interventions on antibiotic prescribing in a single consultation and pragmatic evaluations that assess maintenance of new skills are rare. This paper describes the protocol for a pragmatic, randomized evaluation of a complex intervention aimed at reducing antibiotic prescribing by primary care clinicians. We developed a Social Learning Theory based, blended learning program (on-line learning, a practice based seminar, and context bound learning) called the STAR Educational Program. The 'why of change' is addressed by providing clinicians in general practice with information on antibiotic resistance in urine samples submitted by their practice and their antibiotic prescribing data, and facilitating a practice-based seminar on the implications of this data. The 'how of change' is addressed through context-bound communication skills training and information on antibiotic indication and choice. This intervention will be evaluated in a trial involving 60 general practices, with general practice as the unit of randomization (clinicians from each practice to either receive the STAR Educational Program or not) and analysis. The primary outcome will be the number of antibiotic items dispensed over one year. An economic and process evaluation will also be conducted. This trial will be the first to evaluate the effectiveness of this type of theory-based, blended learning intervention aimed at reducing antibiotic prescribing by primary care clinicians. Novel aspects include feedback of practice level data on antimicrobial resistance and prescribing, use of principles from motivational interviewing, training in enhanced communication skills that incorporates context-bound experience and reflection, and using antibiotic dispensing over one year (as opposed to antibiotic prescribing in a single consultation) as the main outcome. Current Controlled Trials ISRCTN63355948.

Practice patterns of academic general thoracic and adult cardiac surgeons.

PubMed

Ingram, Michael T; Wisner, David H; Cooke, David T

2014-10-01

We hypothesized that academic adult cardiac surgeons (CSs) and general thoracic surgeons (GTSs) would have distinct practice patterns of, not just case-mix, but also time devoted to outpatient care, involvement in critical care, and work relative value unit (wRVU) generation for the procedures they perform. We queried the University Health System Consortium-Association of American Medical Colleges Faculty Practice Solution Center database for fiscal years 2007-2008, 2008-2009, and 2009-2010 for the frequency of inpatient and outpatient current procedural terminology coding and wRVU data of academic GTSs and CSs. The Faculty Practice Solution Center database is a compilation of productivity and payer data from 86 academic institutions. The greatest wRVU generating current procedural terminology codes for CSs were, in order, coronary artery bypass grafting, aortic valve replacement, and mitral valve replacement. In contrast, open lobectomy, video-assisted thoracic surgery wedge, and video-assisted thoracic surgery lobectomy were greatest for GTSs. The 10 greatest wRVU-generating procedures for CSs generated more wRVUs than those for GTSs (P<.001). Although CSs generated significantly more hospital inpatient evaluation and management (E & M) wRVUs than did GTSs (P<.001), only 2.5% of the total wRVUs generated by CSs were from E & M codes versus 18.8% for GTSs. Critical care codes were 1.5% of total evaluation and management billing for both CSs and GTSs. Academic CSs and GTSs have distinct practice patterns. CSs receive greater reimbursement for services because of the greater wRVUs of the procedures performed compared with GTSs, and evaluation and management coding is a more important wRVU generator for GTSs. The results of our study could guide academic CS and GTS practice structure and time prioritization. Copyright © 2014 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Using expert opinion to quantify accuracy and reliability of nondestructive evaluation on bridges : [project brief].

DOT National Transportation Integrated Search

2015-08-01

Research is currently being conducted to improve bridge inspection practices. One potential : improvement is the use of nondestructive testing equipment to supplement visual inspection. To : consider the costs and benefits of this equipment, data abo...

An Historical Perspective on the Theory and Practice of Soil Mechanical Analysis.

ERIC Educational Resources Information Center

Miller, W. P.; And Others

1988-01-01

Traces the history of soil mechanical analysis. Evaluates this history in order to place current concepts in perspective, from both a research and teaching viewpoint. Alternatives to traditional separation techniques for use in soils teaching laboratories are discussed. (TW)

Water Resources and Supply Adaptation: A paradigm Shifting for Future Climate?

EPA Science Inventory

Climate change adds another layer of complexity in planning, engineering and management of water resources and urban water infrastructures. Yet our current practice is confined to the traditional approach that evaluates developmental scenarios and their sustainability mostly by a...

An evaluation of a teaching intervention to improve the practice of endotracheal suctioning in intensive care units.

PubMed

Day, T; Wainwright, S P; Wilson-Barnett, J

2001-09-01

Endotracheal suctioning is a frequently performed procedure that has many associated risks and complications. It is imperative that nurses are aware of these risks and are able to practise according to current research recommendations. This study was designed to examine to what extent intensive care nurses' knowledge and practice of endotracheal suctioning is based on research evidence, to investigate the relationships between knowledge and practice, and to evaluate the effectiveness of a research-based teaching programme. This quasi-experimental study was a randomized, controlled, single-blinded comparison of two research-based teaching programmes, with 16 intensive care nurses, using non-participant observation and a self-report questionnaire. Initial baseline data revealed a low level of knowledge for many participants, which was also reflected in practice, as suctioning was performed against many of the research recommendations. Following teaching, significant improvements were seen in both knowledge and practice. Four weeks later these differences were generally sustained, and provide evidence of the effectiveness of the educational intervention. The study raised concern about all aspects of endotracheal suctioning and highlighted the need for changes in nursing practice, with clinical guidelines and focused practice-based education.

Unpaid work in health economic evaluations.

PubMed

Krol, Marieke; Brouwer, Werner

2015-11-01

Given its societal importance, unpaid work should be included in economic evaluations of health care technology aiming to take a societal perspective. However, in practice this does not often appear to be the case. This paper provides an overview of the current place of unpaid work in economic evaluations in theory and in practice. It does so first by summarizing recommendations regarding the inclusion of unpaid labor reported in health economic textbooks and national guidelines for economic evaluations. In total, three prominent health economic text-books were studied and 28 national health economic guidelines. The paper, moreover, provides an overview of the instruments available to measure lost unpaid labor and reports on a review of the place of unpaid labor in applied economic evaluations in the area of rheumatoid arthritis. The review was conducted by examining methodology of evaluations published between 1 March 2008 and 1 March 2013. The results of this study show that little guidance is offered regarding the inclusion of unpaid labor in economic evaluations in textbooks and guidelines. The review identified five productivity costs instruments including questions about unpaid work and 33 economic evaluations of treatments for rheumatoid arthritis of which only one included unpaid work. The results indicate that unpaid work is rarely included in applied economic evaluations of treatments for rheumatoid arthritis, despite this disease expecting to be associated with lost unpaid work. Given the strong effects of certain diseases and treatments on the ability to perform unpaid work, unpaid work currently receives less attention in economic evaluations than it deserves. Copyright © 2015 Elsevier Ltd. All rights reserved.

The current status of theory evaluation in nursing.

PubMed

Im, Eun-Ok

2015-10-01

To identify the current status of theory evaluation in nursing and provide directions for theory evaluation for future development of theoretical bases of nursing discipline. Theory evaluation is an essential component in development of nursing knowledge, which is a critical element in development of nursing discipline. Despite earlier significant efforts for theory evaluation in nursing, a recent decline in the number of theory evaluation articles was noted and there have been few updates on theory evaluation in nursing. Discussion paper. A total of 58 articles published from 2003-2014 were retrieved through searches using the PUBMED, PsyInfo and CINAHL. The articles were sorted by the area of evaluation and analysed to identify themes reflecting the theory evaluation process. Diverse ways of theory evaluation need to be continuously used in future theory evaluation efforts. Six themes reflecting the theory evaluation process were identified: (a) rarely using existing theory evaluation criteria; (b) evaluating specifics; (c) using various statistical analysis methods; (d) developing instruments; (e) adopting in practice and education; and (f) evaluating mainly middle-range theories and situation-specific theories. © 2015 John Wiley & Sons Ltd.

Chapter 21: Estimating Net Savings - Common Practices. The Uniform Methods Project: Methods for Determining Energy Efficiency Savings for Specific Measures

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

Kurnik, Charles W; Violette, Daniel M.; Rathbun, Pamela

This chapter focuses on the methods used to estimate net energy savings in evaluation, measurement, and verification (EM and V) studies for energy efficiency (EE) programs. The chapter provides a definition of net savings, which remains an unsettled topic both within the EE evaluation community and across the broader public policy evaluation community, particularly in the context of attribution of savings to a program. The chapter differs from the measure-specific Uniform Methods Project (UMP) chapters in both its approach and work product. Unlike other UMP resources that provide recommended protocols for determining gross energy savings, this chapter describes and comparesmore » the current industry practices for determining net energy savings but does not prescribe methods.« less

Supporting Worth Mapping with Sentence Completion

NASA Astrophysics Data System (ADS)

Cockton, Gilbert; Kujala, Sari; Nurkka, Piia; Hölttä, Taneli

Expectations for design and evaluation approaches are set by the development practices within which they are used. Worth-Centred Development (WCD) seeks to both shape and fit such practices. We report a study that combined two WCD approaches. Sentence completion gathered credible quantitative data on user values, which were used to identify relevant values and aversions of two player groups for an on-line gambling site. These values provided human value elements for a complementary WCD approach of worth mapping. Initial worth maps were extended in three workshops, which focused on outcomes and user experiences that could be better addressed in the current product and associated marketing materials. We describe how worth maps were prepared for, and presented in, workshops, and how product owners and associated business roles evaluated the combination of WCD approaches. Based on our experiences, we offer practical advice on this combinination.

Treatment of Lipoma by Injection Lipolysis

PubMed Central

Nanda, Soni

2011-01-01

Injection lipolysis or lipodissolve is the practice of injecting phosphatidyl choline/ sodium deoxycholate (PDC/DC) compounds in the subcutaneous fat. Though this practice is being used extensively for nonsurgical contouring of body and dissolving localized collections of excess fat, it's use as a treatment modality for lipomas needs further evaluation. We present a case where this technique was used for treating a lipoma, with no recurrence after 9 months of follow up. Injection lipolysis as a treatment modality for lipomas needs to be evaluated for safety and efficacy in trials on larger population. This could prove to be a very valuable adjunct to the current practice of excision, if done by a trained person in a properly selected patient. Also the side effects and the controversies regarding this procedure have been discussed in detail in the present paper. PMID:21976907

Early economic evaluation of emerging health technologies: protocol of a systematic review

PubMed Central

2014-01-01

Background The concept of early health technology assessment, discussed well over a decade, has now been collaboratively implemented by industry, government, and academia to select and expedite the development of emerging technologies that may address the needs of patients and health systems. Early economic evaluation is essential to assess the value of emerging technologies, but empirical data to inform the current practice of early evaluation is limited. We propose a systematic review of early economic evaluation studies in order to better understand the current practice. Methods/design This protocol describes a systematic review of economic evaluation studies of regulated health technologies in which the evaluation is conducted prior to regulatory approval and when the technology effectiveness is not well established. Included studies must report an economic evaluation, defined as the comparative analysis of alternatives with respect to their associated costs and health consequences, and must evaluate some regulated health technology such as pharmaceuticals, biologics, high-risk medical devices, or biomarkers. We will conduct the literature search on multiple databases, including MEDLINE, EMBASE, the Centre for Reviews and Dissemination Databases, and EconLit. Additional citations will be identified via scanning reference lists and author searching. We suspect that many early economic evaluation studies are unpublished, especially those conducted for internal use only. Additionally, we use a chain-referral sampling approach to identify authors of unpublished studies who work in technology discovery and development, starting out with our contact lists and authors who published relevant studies. Citation screening and full-text review will be conducted by pairs of reviewers. Abstracted data will include those related to the decision context and decision problem of the early evaluation, evaluation methods (e.g., data sources, methods, and assumptions used to identify, measure, and value the likely effectiveness and the costs and consequences of the new technology, handling of uncertainty), and whether the study results adequately address the main study question or objective. Data will be summarized overall and stratified by publication status. Discussion This study is timely to inform early economic evaluation practice, given the international trend in early health technology assessment initiatives. PMID:25055987

Early economic evaluation of emerging health technologies: protocol of a systematic review.

PubMed

Pham, Ba'; Tu, Hong Anh Thi; Han, Dolly; Pechlivanoglou, Petros; Miller, Fiona; Rac, Valeria; Chin, Warren; Tricco, Andrea C; Paulden, Mike; Bielecki, Joanna; Krahn, Murray

2014-07-23

The concept of early health technology assessment, discussed well over a decade, has now been collaboratively implemented by industry, government, and academia to select and expedite the development of emerging technologies that may address the needs of patients and health systems. Early economic evaluation is essential to assess the value of emerging technologies, but empirical data to inform the current practice of early evaluation is limited. We propose a systematic review of early economic evaluation studies in order to better understand the current practice. This protocol describes a systematic review of economic evaluation studies of regulated health technologies in which the evaluation is conducted prior to regulatory approval and when the technology effectiveness is not well established. Included studies must report an economic evaluation, defined as the comparative analysis of alternatives with respect to their associated costs and health consequences, and must evaluate some regulated health technology such as pharmaceuticals, biologics, high-risk medical devices, or biomarkers. We will conduct the literature search on multiple databases, including MEDLINE, EMBASE, the Centre for Reviews and Dissemination Databases, and EconLit. Additional citations will be identified via scanning reference lists and author searching. We suspect that many early economic evaluation studies are unpublished, especially those conducted for internal use only. Additionally, we use a chain-referral sampling approach to identify authors of unpublished studies who work in technology discovery and development, starting out with our contact lists and authors who published relevant studies. Citation screening and full-text review will be conducted by pairs of reviewers. Abstracted data will include those related to the decision context and decision problem of the early evaluation, evaluation methods (e.g., data sources, methods, and assumptions used to identify, measure, and value the likely effectiveness and the costs and consequences of the new technology, handling of uncertainty), and whether the study results adequately address the main study question or objective. Data will be summarized overall and stratified by publication status. This study is timely to inform early economic evaluation practice, given the international trend in early health technology assessment initiatives.

Practice-based research networks, part II: a descriptive analysis of the athletic training practice-based research network in the secondary school setting.

PubMed

Valovich McLeod, Tamara C; Lam, Kenneth C; Bay, R Curtis; Sauers, Eric L; Snyder Valier, Alison R

2012-01-01

Analysis of health care service models requires the collection and evaluation of basic practice characterization data. Practice-based research networks (PBRNs) provide a framework for gathering data useful in characterizing clinical practice. To describe preliminary secondary school setting practice data from the Athletic Training Practice-Based Research Network (AT-PBRN). Descriptive study. Secondary school athletic training facilities within the AT-PBRN. Clinicians (n = 22) and their patients (n = 2523) from the AT-PBRN. A Web-based survey was used to obtain data on clinical practice site and clinician characteristics. Patient and practice characteristics were obtained via deidentified electronic medical record data collected between September 1, 2009, and April 1, 2011. Descriptive data regarding the clinician and CPS practice characteristics are reported as percentages and frequencies. Descriptive analysis of patient encounters and practice characteristic data was performed, with the percentages and frequencies of the type of injuries recorded at initial evaluation, type of treatment received at initial evaluation, daily treatment, and daily sign-in procedures. The AT-PBRN had secondary school sites in 7 states, and most athletic trainers at those sites (78.2%) had less than 5 years of experience. The secondary school sites within the AT-PBRN documented 2523 patients treated across 3140 encounters. Patients most frequently sought care for a current injury (61.3%), followed by preventive services (24.0%), and new injuries (14.7%). The most common diagnoses were ankle sprain/strain (17.9%), hip sprain/strain (12.5%), concussion (12.0%), and knee pain (2.5%). The most frequent procedures were athletic trainer evaluation (53.9%), hot- or cold-pack application (26.0%), strapping (10.3%), and therapeutic exercise (5.7%). The median number of treatments per injury was 3 (interquartile range = 2, 4; range = 2-19). These preliminary data describe services provided by clinicians within the AT-PBRN and demonstrate the usefulness of the PBRN model for obtaining such data.

Gestational diabetes mellitus: an evaluation of gynecologists' knowledge of guidelines and counseling behavior.

PubMed

Schmitz, Sophie; Groten, Tanja; Schleussner, Ekkehard; Battefeld, Wilgard; Hillemanns, Peter; Schippert, Cordula; von Versen-Höynck, Frauke

2016-11-01

Knowledge of risks, adequate pre- and post-partum care, and counseling is essential to reduce short- and long-term consequences for women with gestational diabetes mellitus (GDM) and their offspring. Our study explored the current GDM guideline knowledge and practiced patient counseling of private gynecologists in Germany. A survey assessing the GDM guidelines and patient counseling was mailed to 775 practicing gynecologists. We evaluated the knowledge of maternal and offspring disease risks, counseling practice, and guideline awareness. Descriptive statistics were used to analyze the responses and Chi-Square or Fisher exact test to explore differences between groups. Of the 418 private gynecologists (54.1 % response rate) who responded, the majority was aware of obesity and GDM in the previous pregnancy as risk factors for GDM. To a lesser extent, risk factors like recurrent miscarriages and stillbirth were recalled. Eighty percent stated that GDM was associated with a higher risk for the development for hypertension and 96 % with type 2 diabetes in the mother. Respondents with knowledge of the current GDM guidelines were more often aware of the development of chronic diseases, counseled patients more frequently, and performed post-partum glucose screenings more regularly compared with private gynecologists with no knowledge of the guidelines. The majority of participants incorporated recent recommendations into their practice patterns for GDM. Providing private gynecologists with additional training may further improve care for women with GDM-affected pregnancies.

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.

Empowerment through agency-promoting dialogue: an explicit application of harm reduction theory to reframe HIV test counseling.

PubMed

Mattson, M

2000-01-01

The counseling that accompanies HIV testing can be an important prevention tool for encouraging people to practice safer sex to avoid AIDS, but there is scant research about how HIV test counseling operates in practice. This article critiques the current Centers for Disease Control and Prevention (CDC) protocol for HIV test counseling for not being genuinely client centered and ignoring the unique needs of clients and offers an alternative approach that adapts and explicitly applies the tenets of harm reduction theory (HRT). Excerpts from actual HIV test counseling sessions illustrate both the weaknesses in the current approach to HIV test counseling and project how the alternative theoretical perspective offered could provide counseling that encourages agency-promoting and empowering dialogue. The implications for the development of HRT as a health communication heuristic and a practical training and evaluation strategy are discussed along with limitations and future research directions.

Vending machine assessment methodology. A systematic review.

PubMed

Matthews, Melissa A; Horacek, Tanya M

2015-07-01

The nutritional quality of food and beverage products sold in vending machines has been implicated as a contributing factor to the development of an obesogenic food environment. How comprehensive, reliable, and valid are the current assessment tools for vending machines to support or refute these claims? A systematic review was conducted to summarize, compare, and evaluate the current methodologies and available tools for vending machine assessment. A total of 24 relevant research studies published between 1981 and 2013 met inclusion criteria for this review. The methodological variables reviewed in this study include assessment tool type, study location, machine accessibility, product availability, healthfulness criteria, portion size, price, product promotion, and quality of scientific practice. There were wide variations in the depth of the assessment methodologies and product healthfulness criteria utilized among the reviewed studies. Of the reviewed studies, 39% evaluated machine accessibility, 91% evaluated product availability, 96% established healthfulness criteria, 70% evaluated portion size, 48% evaluated price, 52% evaluated product promotion, and 22% evaluated the quality of scientific practice. Of all reviewed articles, 87% reached conclusions that provided insight into the healthfulness of vended products and/or vending environment. Product healthfulness criteria and complexity for snack and beverage products was also found to be variable between the reviewed studies. These findings make it difficult to compare results between studies. A universal, valid, and reliable vending machine assessment tool that is comprehensive yet user-friendly is recommended. Copyright © 2015 Elsevier Ltd. All rights reserved.

Evaluating health care interventions in the European Union.

PubMed

McDaid, David; Cookson, Richard

2003-02-01

This paper examines the current state of evaluations of health care interventions in the European Union, from the identification and commissioning of research through to its impact on policy and practice. Material is drawn from a survey conducted for the ASTEC project as well as a review of literature. Although the use of evaluative research has increased substantially in the last decade, both the pace of change and preferred research methodologies employed differ markedly. Much research still concentrates on issues of safety, efficacy and effectiveness, although there is evidence of an increasing emphasis on cost-effectiveness. Many countries are beginning to introduce systems linking economic evaluation to the decision-making process, while networks for the exchange of information continue to evolve. Research capacity in the public sector, although improving, is uneven, in part due to the uncertainty over long term career prospects and competition from industry. Capacity building measures should in particular ensure that dissemination expertise is strengthened, and that more emphasis is placed on developing receptor capacity within different stakeholder groups. Linking knowledge production to changes in practice remains a key challenge. Further research on implementation and impact assessment is required, to help demonstrate the value of evaluations on both policy and practice.

Mixed-methods research in nursing - a critical review.

PubMed

Bressan, Valentina; Bagnasco, Annamaria; Aleo, Giuseppe; Timmins, Fiona; Barisone, Michela; Bianchi, Monica; Pellegrini, Ramona; Sasso, Loredana

2017-10-01

To review the use of mixed-methods research in nursing with a particular focus on the extent to which current practice informs nurse researchers. It also aimed to highlight gaps in current knowledge, understanding and reporting of this type of research. Mixed-methods research is becoming increasingly popular among nurses and healthcare professionals. Emergent findings from this type of research are very useful for nurses in practice. The combination of both quantitative and qualitative methods provides a scientific base for practice but also richness from the qualitative enquiry. However, at the same time mixed-methods research is underdeveloped. This study identified mixed-methods research papers and critically evaluated their usefulness for research practice. To support the analysis, we performed a two-stage search using CINAHL to find papers with titles that included the key term 'mixed method'. An analysis of studies that used mixed-methods research revealed some inconsistencies in application and reporting. Attempts to use two distinct research methods in these studies often meant that one or both aspects had limitations. Overall methods were applied in a less rigorous way. This has implications for providing somewhat limited direction for novice researchers. There is also potential for application of evidence in healthcare practice that limited validity. This study highlights current gaps in knowledge, understanding and reporting of mixed-methods research. While these methods are useful to gain insight into clinical problems nurses lack guidance with this type of research. This study revealed that the guidance provided by current mixed-methods research is inconsistent and incomplete and this compounds the lack of available direction. There is an urgent need to develop robust guidelines for using mixed-methods research so that findings may be critically implemented in practice. © 2016 John Wiley & Sons Ltd.

Drilled shaft bridge foundation design parameters and procedures for bearing in SGC soils.

DOT National Transportation Integrated Search

2006-04-01

This report provides a simplified method to be used for evaluating the skin friction and tip resistance of : axially loaded drilled shafts. A summary of literature and current practice was completed and then a : comprehensive set of field and laborat...

Gifted Education and the Spectre of Elitism.

ERIC Educational Resources Information Center

Howley, Aimee

1986-01-01

Explains current practices in gifted education as they relate to the schools' role in legitimating existing patterns of social stratification. Argues that schools provide noncognitive instruction to gifted students to thwart their development as intellectuals. Evaluates the extent to which gifted education programs are elitist. (KH)

Evaluation of mechanical cotton seed delinter for breeders

USDA-ARS?s Scientific Manuscript database

Delinting seed is common practice in cotton breeding programs. The predominant method of delinting cotton seed is acid delinting. Acid delinting can be dangerous and effluent disposal is difficult and costly. Current research on mechanical delinting proposes an alternative to acid delinting. A pr...

Rearchitecting IT: Simplify. Simplify

ERIC Educational Resources Information Center

Panettieri, Joseph C.

2006-01-01

Simplifying and securing an IT infrastructure is not easy. It frequently requires rethinking years of hardware and software investments, and a gradual migration to modern systems. Even so, writes the author, universities can take six practical steps to success: (1) Audit software infrastructure; (2) Evaluate current applications; (3) Centralize…

Non-Standard Assessment Practices in the Evaluation of Communication in Australian Aboriginal Children

ERIC Educational Resources Information Center

Gould, Judith

2008-01-01

Australian Aboriginal children typically receive communication assessment services from Standard Australian English (SAE) speaking non-Aboriginal speech-language pathologists (SLPs). Educational assessments, including intelligence testing, are also primarily conducted by non-Aboriginal educational professionals. While the current paper will show…

Processing of Brassica seeds for feedstock in biofuels production

USDA-ARS?s Scientific Manuscript database

Several Brassica species are currently being evaluated to develop regionalized production systems based on their suitability to the environment and with the prevailing practices of growing commodity food crops like wheat, corn, and soybeans. This integrated approach to farming will provide high qual...

Information Structure, Information Technology, and the Human Services Organizational Environment.

ERIC Educational Resources Information Center

Semke, Jeanette I.; Nurius, Paula S.

1991-01-01

Examines current trends in data collection and information use in human services organizations. Describes issues for managers who are planning information systems, including practitioner resistance to automation. Proposes that conceptual integration of agendas for human services automation, practice evaluation, and service effectiveness enables…

Evaluation of Project Processes in Relation to Transportation System Management and Operations (TSM&O)

DOT National Transportation Integrated Search

2018-01-01

This study was conducted to explore the current state-of-the-practice of Transportation Systems Management and Operations (TSM&O) in the Florida Department of Transportation (FDOT) and determine what would be required to mainstream TSM&O throughout t...

Utilizing the long-term pavement performance database in evaluating the effectiveness of pavement smoothness

DOT National Transportation Integrated Search

2002-03-01

This research project was performed in two phases. The first phase concentrated on previous related literature review and a nationwide survey to find out the current practices of smoothness specifications. The second phase dealt with collecting and a...

Reconstruction and systemization of the methodologies for strategic environmental assessment in Taiwan

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

Liou, M.-L.; Yeh, S.-C.; Yu, Y.-H.

2006-03-15

This paper discusses the current SEA procedures and assessment methodologies, aiming to propose strategies that can lead to effective improvement in a newly industrialized Asian country, Taiwan. Institutional and practical problems with regard to the regulations and tools of SEA in Taiwan are compared to those in other countries. According to the research results, it is suggested that extra evaluation processes should be incorporated into the current assessment procedures to improve their scientific validity and integrity. Moreover, it is also suggested that the sustainability appraisal approaches be included in the SEA framework. In this phase, revised evaluation indicators associated withmore » corresponding targets can be the first attempt for modifying the SEA system. It is believed that these can promote the operability in practice and also lead the whole assessment procedures to a direction closer to sustainable development. The trails that Taiwan has followed can help other countries that are going to adopt SEA to find a more effective and efficient way to follow.« less

Current practice in assessment and treatment of bronchial asthma in young males in Italy.

PubMed

Ferrante, E; Pantaleo, C; Quatela, M; Fuso, L; Basso, S; Pistelli, R

2000-10-01

The aim of the study was to evaluate, in a sample of young asthmatics in Italy, the current practice in assessment and treatment of asthma after the publication of guidelines. Young soldiers who declared bronchial asthma at the beginning of the compulsory military service were evaluated. One-hundred and thirty-eight subjects with confirmed asthma were selected. Sixty-seven subjects (48.5%) had had at last one spirometry, and only one subject had underwent peak flow monitoring at home; most of the subjects (96.8%) had had prick tests. More of the 50% of the subjects with bronchial obstruction or with severe bronchial hyperresponsiveness, with clinical moderate or severe asthma, had used only bronchodilators or no therapy at all in the preceding year. In this sample of young asthmatics, the lung function tests were still underutilized for the diagnosis and follow-up of bronchial asthma; moreover, the inhaled anti-inflammatory drugs were still underutilized.

Artificial neural networks in gynaecological diseases: current and potential future applications.

PubMed

Siristatidis, Charalampos S; Chrelias, Charalampos; Pouliakis, Abraham; Katsimanis, Evangelos; Kassanos, Dimitrios

2010-10-01

Current (and probably future) practice of medicine is mostly associated with prediction and accurate diagnosis. Especially in clinical practice, there is an increasing interest in constructing and using valid models of diagnosis and prediction. Artificial neural networks (ANNs) are mathematical systems being used as a prospective tool for reliable, flexible and quick assessment. They demonstrate high power in evaluating multifactorial data, assimilating information from multiple sources and detecting subtle and complex patterns. Their capability and difference from other statistical techniques lies in performing nonlinear statistical modelling. They represent a new alternative to logistic regression, which is the most commonly used method for developing predictive models for outcomes resulting from partitioning in medicine. In combination with the other non-algorithmic artificial intelligence techniques, they provide useful software engineering tools for the development of systems in quantitative medicine. Our paper first presents a brief introduction to ANNs, then, using what we consider the best available evidence through paradigms, we evaluate the ability of these networks to serve as first-line detection and prediction techniques in some of the most crucial fields in gynaecology. Finally, through the analysis of their current application, we explore their dynamics for future use.

Improving medical students’ knowledge of genetic disease: a review of current and emerging pedagogical practices

PubMed Central

Wolyniak, Michael J; Bemis, Lynne T; Prunuske, Amy J

2015-01-01

Genetics is an essential subject to be mastered by health professional students of all types. However, technological advances in genomics and recent pedagogical research have changed the way in which many medical training programs teach genetics to their students. These advances favor a more experience-based education focused primarily on developing student’s critical thinking skills. In this review, we examine the current state of genetics education at both the preclinical and clinical levels and the ways in which medical and pedagogical research have guided reforms to current and emerging teaching practices in genetics. We discover exciting trends taking place in which genetics is integrated with other scientific disciplines both horizontally and vertically across medical curricula to emphasize training in scientific critical thinking skills among students via the evaluation of clinical evidence and consultation of online databases. These trends will produce future health professionals with the skills and confidence necessary to embrace the new tools of medical practice that have emerged from scientific advances in genetics, genomics, and bioinformatics. PMID:26604852

Exploring Vocational Evaluation Practices following Traumatic Brain Injury

PubMed Central

Dillahunt-Aspillaga, Christina; Jorgensen Smith, Tammy; Hanson, Ardis; Ehlke, Sarah; Stergiou-Kita, Mary; Dixon, Charlotte G.; Quichocho, Davina

2015-01-01

Background. Individuals with traumatic brain injury (TBI) face many challenges when attempting to return to work (RTW). Vocational evaluation (VE) is a systematic process that involves assessment and appraisal of an individual's current work-related characteristics and abilities. Objective. The aims of this study are to (1) examine demographic and employment characteristics of vocational rehabilitation providers (VRPs), (2) identify the specific evaluation methods that are used in the VE of individuals with TBI, and (3) examine the differences in assessment method practices based upon evaluator assessment preferences. Methods. This exploratory case study used a forty-six-item online survey which was distributed to VRPs. Results. One hundred and nine VRPs accessed the survey. Of these, 74 completed the survey. A majority of respondents were female (79.7%), Caucasian (71.6%), and holding a master's degree (74.3%), and more than half (56.8%) were employed as state vocational rehabilitation counselors (VRCs). In addition, over two-thirds (67.6%) were certified rehabilitation counselors (CRCs). Respondents reported using several specific tools and assessments during the VE process. Conclusions. Study findings reveal differences in use of and rationales for specific assessments amongst VRPs. Understanding VRP assessment practices and use of an evidence-based framework for VE following TBI may inform and improve VE practice. PMID:26494945

Alumni-based evaluation of a novel veterinary curriculum: are Nottingham graduates prepared for clinical practice?

PubMed Central

Cobb, K. A.; Brown, G. A.; Hammond, R. H.; Mossop, L. H.

2015-01-01

Introduction Outcomes-based education has been the core of the curriculum strategy of the Nottingham School of Veterinary Medicine and Science (SVMS) since its inception in 2006. As part of the ongoing curriculum evaluation, the first two graduating cohorts were invited to provide an appraisal of their preparation by the SVMS curriculum for their role in clinical practice. This paper provides brief accounts of the SVMS curriculum model, the development of the evaluation instrument and the findings of the alumni survey. Materials and Methods The evaluation instrument contained 25 attributes expected of SVMS graduates. Alumni rated their preparation for practice in relation to each attribute. Results The four highest rated characteristics were compassion for animals and the application of ethics to animal welfare; communication skills; recognising own limitations and seeking help and advice where needed and clinical examination skills. The four lowest rated were clinical case management and therapeutic strategies; dealing with veterinary public health and zoonotic issues; knowledge of current veterinary legislation and dealing with emergency and critical care cases. Free text responses were in line with these quantitative findings. Conclusion The results indicate that this sample of SVMS graduates were satisfied with their undergraduate education and felt well prepared for their role in clinical practice. PMID:26392910

Evaluation of a Digital Consultation and Self-Care Advice Tool in Primary Care: A Multi-Methods Study

PubMed Central

Bowers, Gillian; Bowers, John

2018-01-01

Digital services are often regarded as a solution to the growing demands on primary care services. Provision of a tool offering advice to support self-management as well as the ability to digitally consult with a General Practitioner (GP) has the potential to alleviate some of the pressure on primary care. This paper reports on a Phase II, 6-month evaluation of eConsult, a web-based triage and consultation system that was piloted across 11 GP practices across Scotland. Through a multi-method approach the evaluation explored eConsult use across practices, exposing both barriers and facilitators to its adoption. Findings suggest that expectations that eConsult would offer an additional and alternative method of accessing GP services were largely met. However, there is less certainty that it has fulfilled expectations of promoting self-help. In addition, low uptake meant that evaluation of current effectiveness was difficult for practices to quantify. The presence of an eConsult champion(s) within the practice was seen to be a significant factor in ensuring successful integration of the tool. A lack of patient and staff engagement, insufficient support and lack of protocols around processes were seen as barriers to its success. PMID:29724040

Dissemination 2.0: closing the gap between knowledge and practice with new media and marketing.

PubMed

Bernhardt, Jay M; Mays, Darren; Kreuter, Matthew W

2011-01-01

Despite substantial investments in public health and clinical research at the national level, and significant advancements in these areas of science, few evidence-based programs and services are rapidly implemented in health care or public health practice as a result of failures of dissemination. A significant gap in current processes to disseminate and implement effective programs relates to the lack of systems and infrastructure to facilitate distribution of scientific research products to potential end users, including clinicians and other practitioners. In this article, the authors assert that Web 2.0 technologies can be leveraged to enhance dissemination efforts and increase the implementation of evidence-based programs and services in everyday practice. The authors describe the research-to-practice delivery process and highlight gaps in the supply chain necessary to translate research findings into evidence-based practice. The authors critically evaluate the 4 most prominent strategies currently used to promote dissemination and implementation of research evidence in practice, and they detail how each can be improved by leveraging Web 2.0 technologies to enhance dissemination of research evidence. Last, the authors provide examples and suggestions for capitalizing on Web 2.0 technologies to enhance dissemination efforts and ensure that evidence-based research products reach intended end users and are implemented in clinical practice.

Impact of an Event Reporting System on Resident Complication Reporting in Plastic Surgery Training: Addressing an ACGME and Plastic Surgery Milestone Project Core Competency.

PubMed

Parikh, Rajiv P; Snyder-Warwick, Alison; Naidoo, Sybill; Skolnick, Gary B; Patel, Kamlesh B

2017-11-01

The Accreditation Council for Graduate Medical Education and Plastic Surgery Milestone Project has identified practice-based learning and improvement, which involves systematically analyzing current practices and implementing changes, as a core competency in residency education. In surgical care, complication reporting is an essential component of practice-based learning and improvement as complications are analyzed in morbidity and mortality conference for quality improvement. Unfortunately, current methods for capturing a comprehensive profile of complications may significantly underestimate the true occurrence of complications. Therefore, the objectives of this study are to evaluate an intervention for complication reporting and compare this to current practice, in a plastic surgery training program. This is a preintervention and postintervention study evaluating resident reporting of complications on a plastic surgery service. The intervention was an online event reporting system developed by department leadership and patient safety experts. The cohorts consisted of all patients undergoing surgery during two separate 3-month blocks bridged by an implementation period. A trained reviewer recorded complications, and this served as the reference standard. Fisher's exact test was used for binary comparisons. There were 32 complications detected in 219 patients from June to August of 2015 and 35 complications in 202 patients from October to December of 2015. The proportion of complications reported in the preintervention group was nine of 32 (28.1 percent). After the intervention, this significantly increased to 32 of 35 (91.4 percent) (p < 0.001). An intervention using an event reporting system, supported by departmental leadership, led to significant improvements in complication reporting by plastic surgery residents.

Management of Pediatric Delirium in Pediatric Cardiac Intensive Care Patients: An International Survey of Current Practices.

PubMed

Staveski, Sandra L; Pickler, Rita H; Lin, Li; Shaw, Richard J; Meinzen-Derr, Jareen; Redington, Andrew; Curley, Martha A Q

2018-06-01

The purpose of this study was to describe how pediatric cardiac intensive care clinicians assess and manage delirium in patients following cardiac surgery. Descriptive self-report survey. A web-based survey of pediatric cardiac intensive care clinicians who are members of the Pediatric Cardiac Intensive Care Society. Pediatric cardiac intensive care clinicians (physicians and nurses). None. One-hundred seventy-three clinicians practicing in 71 different institutions located in 13 countries completed the survey. Respondents described their clinical impression of the occurrence of delirium to be approximately 25%. Most respondents (75%) reported that their ICU does not routinely screen for delirium. Over half of the respondents (61%) have never attended a lecture on delirium. The majority of respondents (86%) were not satisfied with current delirium screening, diagnosis, and management practices. Promotion of day/night cycle, exposure to natural light, deintensification of care, sleep hygiene, and reorientation to prevent or manage delirium were among nonpharmacologic interventions reported along with the use of anxiolytic, antipsychotic, and medications for insomnia. Clinicians responding to the survey reported a range of delirium assessment and management practices in postoperative pediatric cardiac surgery patients. Study results highlight the need for improvement in delirium education for pediatric cardiac intensive care clinicians as well as the need for systematic evaluation of current delirium assessment and management practices.

Evaluating mediation and moderation effects in school psychology: A presentation of methods and review of current practice

PubMed Central

Fairchild, Amanda J.; McQuillin, Samuel D.

2017-01-01

Third variable effects elucidate the relation between two other variables, and can describe why they are related or under what conditions they are related. This article demonstrates methods to analyze two third-variable effects: moderation and mediation. The utility of examining moderation and mediation effects in school psychology is described and current use of the analyses in applied school psychology research is reviewed and evaluated. Proper statistical methods to test the effects are presented, and different effect size measures for the models are provided. Extensions of the basic moderator and mediator models are also described. PMID:20006988

Evaluating mediation and moderation effects in school psychology: a presentation of methods and review of current practice.

PubMed

Fairchild, Amanda J; McQuillin, Samuel D

2010-02-01

Third variable effects elucidate the relation between two other variables, and can describe why they are related or under what conditions they are related. This article demonstrates methods to analyze two third-variable effects: moderation and mediation. The utility of examining moderation and mediation effects in school psychology is described and current use of the analyses in applied school psychology research is reviewed and evaluated. Proper statistical methods to test the effects are presented, and different effect size measures for the models are provided. Extensions of the basic moderator and mediator models are also described.

Cast Stone Formulation for Nuclear Waste Immobilization at Higher Sodium Concentrations

DOE PAGES

Fox, Kevin; Cozzi, Alex; Roberts, Kimberly; ...

2014-11-01

Low activity radioactive waste at U.S. Department of Energy sites can be immobilized for permanent disposal using cementitious waste forms. This study evaluated waste forms produced with simulated wastes at concentrations up to twice that of currently operating processes. The simulated materials were evaluated for their fresh properties, which determine processability, and cured properties, which determine waste form performance. The results show potential for greatly reducing the volume of material. Fresh properties were sufficient to allow for processing via current practices. Cured properties such as compressive strength meet disposal requirements. Leachability indices provide an indication of expected long-term performance.

Video and Visualization to Communicate Current Geoscience at Museums and Science Centers

NASA Astrophysics Data System (ADS)

Allen, L.; Trakinski, V.; Gardiner, N.; Foutz, S.; Pisut, D.

2012-12-01

Science Bulletins, a current-science video exhibition program produced by the American Museum of Natural History, was developed to communicate scientific concepts and results to a wide public and educator audience. Funded by a NOAA Environmental Literacy Grant and developed in collaboration with scientists, a series of Science Bulletins pieces mixes data visualization, video, and non-narrated text to highlight recent issues and findings relevant to short and long-term change in the Earth system. Some of the pieces have been evaluated with audiences to assess learning outcomes and improve practices. Videos, evaluation results, and multiplatform dissemination strategies from this series will be shared and discussed.

Cognitive Rehabilitation: ACTION Training for Soldiers with Executive Dysfunction

DTIC Science & Technology

2015-10-01

failing to comply with a collection of information if it does not display a currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO... controlled trial. Aim 1: Finalize ACTION curriculum/ manuals; field test Aim 2: Evaluate ACTION instructional methods (the extent to which SM with...metacognitive strategy instruction (MSI), together called Target Acquisition Practices ( Group 1) by evaluating the extent to which training 1) improves

Development and Initial Evaluation of an Acceptance Testing Procedure for Air Supply and Distribution Systems in New Army Facilities

DTIC Science & Technology

1988-09-01

Unfortunately, although current construction practices can produce functional HVAC systems that provide adequate heating and cooling , they do not guarantee...developed by interviewing heating, ventilating, and air-conditioning ( HVAC ) profes- sionals, reviewing technical literature, and consolidating these...for recording this information. A glossary of possibly unfamiliar HVAC terms is included. An informal evaluation of the procedure showed that

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

PubMed Central

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

2015-01-01

An important part of the application of sociotechnical systems theory (STS) is the development of methods, tools and techniques to assess human factors and ergonomics workplace requirements. We focus in this paper on describing and evaluating current STS methods for workplace safety, as well as outlining a set of six case studies covering the application of these methods to a range of safety contexts. We also describe an evaluation of the methods in terms of ratings of their ability to address a set of theoretical and practical questions (e.g. the degree to which methods capture static/dynamic aspects of tasks and interactions between system levels). The outcomes from the evaluation highlight a set of gaps relating to the coverage and applicability of current methods for STS and safety (e.g. coverage of external influences on system functioning; method usability). The final sections of the paper describe a set of future challenges, as well as some practical suggestions for tackling these. Practitioner Summary: We provide an up-to-date review of STS methods, a set of case studies illustrating their use and an evaluation of their strengths and weaknesses. The paper concludes with a ‘roadmap’ for future work. PMID:25832121

Knowledge, Attitudes, and Practices of Pediatric Dentists Regarding Speech Evaluation of Patients: Implications for Dental Education.

PubMed

Van Eyndhoven, Lisa; Chussid, Steven; Yoon, Richard K

2015-11-01

The aim of this cross-sectional study was to determine pediatric dentists' attitudes about speech evaluation in the dental setting and assess their knowledge of speech development and pathology. In October 2013, members of the American Academy of Pediatric Dentistry were invited to participate in an electronic questionnaire. Categories of questions were demographics, attitudes and confidence in speech pathology, and theoretical and practical knowledge of speech development and speech pathology. Theoretical knowledge was assessed using questions about phonetics and speech milestones. Practical knowledge was determined with three 30-second interview-style video clips. A total of 539 responses were received for a response rate of 10.4%. The majority of respondents reported feeling that speech evaluation should be part of the pediatric dental visit (72.8%) and felt confident in their ability to detect speech issues (73.2%). However, they did poorly on the theoretical knowledge questions (41.9%) as well as the practical knowledge questions (8.5%). There was a statistically significant difference in theoretical score between gender and type of occupation (p<0.05). This difference was not observed when examining practical knowledge. This study suggests that although pediatric dentists are in an ideal position to aid in the detection of speech issues, they currently have insufficient training and knowledge to do so.

Improving public health evaluation: a qualitative investigation of practitioners' needs.

PubMed

Denford, Sarah; Lakshman, Rajalakshmi; Callaghan, Margaret; Abraham, Charles

2018-01-30

In 2011, the House of Lords published a report on Behaviour Change, in which they report that "a lot more could, and should, be done to improve the evaluation of interventions." This study aimed to undertake a needs assessment of what kind of evaluation training and materials would be of most use to UK public health practitioners by conducting interviews with practitioners about everyday evaluation practice and needed guidance and materials. Semi-structured interviews were conducted with 32 public health practitioners in two UK regions, Cambridgeshire and the South West. Participants included directors of public health, consultants in public health, health improvement advisors, public health intelligence, and public health research officers. A topic guide included questions designed to explore participants existing evaluation practice and their needs for further training and guidance. Data were analysed using thematic analyses. Practitioners highlighted the need for evaluation to defend the effectiveness of existing programs and protect funding provisions. However, practitioners often lacked training in evaluation, and felt unqualified to perform such a task. The majority of practitioners did not use, or were not aware of many existing evaluation guidance documents. They wanted quality-assured, practical guidance that relate to the real world settings in which they operate. Practitioners also mentioned the need for better links and support from academics in public health. Whilst numerous guidance documents supporting public health evaluation exist, these documents are currently underused by practitioners - either because they are not considered useful, or because practitioners are not aware of them. Integrating existing guides into a catalogue of guidance documents, and developing a new-quality assured, practical and useful document may support the evaluation of public health programs. This in turn has the potential to identify those programs that are effective; thus improving public health and reducing financial waste.

OERL: A Tool For Geoscience Education Evaluators

NASA Astrophysics Data System (ADS)

Zalles, D. R.

2002-12-01

The Online Evaluation Resource Library (OERL) is a Web-based set of resources for improving the evaluation of projects funded by the Directorate for Education and Human Resources (EHR) of the National Science Foundation (NSF). OERL provides prospective project developers and evaluators with material that they can use to design, conduct, document, and review evaluations. OERL helps evaluators tackle the challenges of seeing if a project is meeting its implementation and outcome-related goals. Within OERL is a collection of exemplary plans, instruments, and reports from evaluations of EHR-funded projects in the geosciences and in other areas of science and mathematics. In addition, OERL contains criteria about good evaluation practices, professional development modules about evaluation design and questionnaire development, a dictionary of key evaluation terms, and links to evaluation standards. Scenarios illustrate how the resources can be used or adapted. Currently housed in OERL are 137 instruments, and full or excerpted versions of 38 plans and 60 reports. 143 science and math projects have contributed to the collection so far. OERL's search tool permits the launching of precise searches based on key attributes of resources such as their subject area and the name of the sponsoring university or research institute. OERL's goals are to 1) meet the needs for continuous professional development of evaluators and principal investigators, 2) complement traditional vehicles of learning about evaluation, 3) utilize the affordances of current technologies (e.g., Web-based digital libraries, relational databases, and electronic performance support systems) for improving evaluation practice, 4) provide anytime/anyplace access to update-able resources that support evaluators' needs, and 5) provide a forum by which professionals can interact on evaluation issues and practices. Geoscientists can search the collection of resources from geoscience education projects that have been funded by NSF to carry out curriculum development, teacher education, faculty development, and increased access, retention, and preparation of under-represented student populations in science. Over the next two years, additional plans, instruments, and reports from other projects will be added to the OERL collection. Also to be added are more professional development modules and online coaches for constructing key evaluation documents. The presentation overviews the structure of OERL, describes some of the geoscience projects in the collection, and provides some examples of how its resources can be used and adapted for other geoscience education evaluations.

A Review on Community-Based Knowledge Transfer and Exchange (KTE) Initiatives for Promoting Well-Being in Older Adults.

PubMed

Syed, M Anum; Moorhouse, Aynsley; McDonald, Lynn; Hitzig, Sander L

2017-01-01

Knowledge transfer and exchange (KTE) processes can facilitate evidence-informed community-based care for seniors, but understanding effective KTE in gerontology is limited. A scoping review was conducted to evaluate the current state of KTE in the community-based sector for seniors. Twelve articles met the inclusion criteria, which addressed a broad variety of topics including caregiving, elder abuse, falls prevention, home-rehabilitation, hospice and dementia care. Studies evaluated KTE practices (n = 8), developed a KTE intervention (n = 3), or explored research uptake (n = 1). Community-based initiatives for seniors informed by KTE processes are scarce, requiring further efforts at the research, practice and policy levels.

Evaluating an audit and feedback intervention for reducing antibiotic prescribing behaviour in general dental practice (the RAPiD trial): a partial factorial cluster randomised trial protocol.

PubMed

Prior, Maria; Elouafkaoui, Paula; Elders, Andrew; Young, Linda; Duncan, Eilidh M; Newlands, Rumana; Clarkson, Jan E; Ramsay, Craig R

2014-04-24

Antibiotic prescribing in dentistry accounts for 9% of total antibiotic prescriptions in Scottish primary care. The Scottish Dental Clinical Effectiveness Programme (SDCEP) published guidance in April 2008 (2nd edition, August 2011) for Drug Prescribing in Dentistry, which aims to assist dentists to make evidence-based antibiotic prescribing decisions. However, wide variation in prescribing persists and the overall use of antibiotics is increasing. RAPiD is a 12-month partial factorial cluster randomised trial conducted in NHS General Dental Practices across Scotland. Its aim is to compare the effectiveness of individualised audit and feedback (A&F) strategies for the translation into practice of SDCEP recommendations on antibiotic prescribing. The trial uses routinely collected electronic healthcare data in five aspects of its design in order to: identify the study population; apply eligibility criteria; carry out stratified randomisation; generate the trial intervention; analyse trial outcomes. Eligibility was determined on contract status and a minimum level of recent NHS treatment provision. All eligible dental practices in Scotland were simultaneously randomised at baseline either to current audit practice or to an intervention group. Randomisation was stratified by single-handed/multi-handed practices. General dental practitioners (GDPs) working at intervention practices will receive individualised graphical representations of their antibiotic prescribing rate from the previous 14 months at baseline and an update at six months. GDPs could not be blinded to their practice allocation. Intervention practices were further randomised using a factorial design to receive feedback with or without: a health board comparator; a supplementary text-based intervention; additional feedback at nine months. The primary outcome is the total antibiotic prescribing rate per 100 courses of treatment over the year following delivery of the baseline intervention. A concurrent qualitative process evaluation will apply theory-based approaches using the Consolidated Framework for Implementation Research to explore the acceptability of the interventions and the Theoretical Domains Framework to identify barriers and enablers to evidence-based antibiotic prescribing behaviour by GDPs. RAPiD will provide a robust evaluation of A&F in dentistry in Scotland. It also demonstrates that linked administrative datasets have the potential to be used efficiently and effectively across all stages of an randomised controlled trial. Current Controlled Trials ISRCTN49204710.

Evaluating an audit and feedback intervention for reducing antibiotic prescribing behaviour in general dental practice (the RAPiD trial): a partial factorial cluster randomised trial protocol

PubMed Central

2014-01-01

Background Antibiotic prescribing in dentistry accounts for 9% of total antibiotic prescriptions in Scottish primary care. The Scottish Dental Clinical Effectiveness Programme (SDCEP) published guidance in April 2008 (2nd edition, August 2011) for Drug Prescribing in Dentistry, which aims to assist dentists to make evidence-based antibiotic prescribing decisions. However, wide variation in prescribing persists and the overall use of antibiotics is increasing. Methods RAPiD is a 12-month partial factorial cluster randomised trial conducted in NHS General Dental Practices across Scotland. Its aim is to compare the effectiveness of individualised audit and feedback (A&F) strategies for the translation into practice of SDCEP recommendations on antibiotic prescribing. The trial uses routinely collected electronic healthcare data in five aspects of its design in order to: identify the study population; apply eligibility criteria; carry out stratified randomisation; generate the trial intervention; analyse trial outcomes. Eligibility was determined on contract status and a minimum level of recent NHS treatment provision. All eligible dental practices in Scotland were simultaneously randomised at baseline either to current audit practice or to an intervention group. Randomisation was stratified by single-handed/multi-handed practices. General dental practitioners (GDPs) working at intervention practices will receive individualised graphical representations of their antibiotic prescribing rate from the previous 14 months at baseline and an update at six months. GDPs could not be blinded to their practice allocation. Intervention practices were further randomised using a factorial design to receive feedback with or without: a health board comparator; a supplementary text-based intervention; additional feedback at nine months. The primary outcome is the total antibiotic prescribing rate per 100 courses of treatment over the year following delivery of the baseline intervention. A concurrent qualitative process evaluation will apply theory-based approaches using the Consolidated Framework for Implementation Research to explore the acceptability of the interventions and the Theoretical Domains Framework to identify barriers and enablers to evidence-based antibiotic prescribing behaviour by GDPs. Discussion RAPiD will provide a robust evaluation of A&F in dentistry in Scotland. It also demonstrates that linked administrative datasets have the potential to be used efficiently and effectively across all stages of an randomised controlled trial. Trial registration Current Controlled Trials ISRCTN49204710 PMID:24758164

Identifying research priorities for effective retention strategies in clinical trials.

PubMed

Kearney, Anna; Daykin, Anne; Shaw, Alison R G; Lane, Athene J; Blazeby, Jane M; Clarke, Mike; Williamson, Paula; Gamble, Carrol

2017-08-31

The failure to retain patients or collect primary-outcome data is a common challenge for trials and reduces the statistical power and potentially introduces bias into the analysis. Identifying strategies to minimise missing data was the second highest methodological research priority in a Delphi survey of the Directors of UK Clinical Trial Units (CTUs) and is important to minimise waste in research. Our aim was to assess the current retention practices within the UK and priorities for future research to evaluate the effectiveness of strategies to reduce attrition. Seventy-five chief investigators of NIHR Health Technology Assessment (HTA)-funded trials starting between 2009 and 2012 were surveyed to elicit their awareness about causes of missing data within their trial and recommended practices for improving retention. Forty-seven CTUs registered within the UKCRC network were surveyed separately to identify approaches and strategies being used to mitigate missing data across trials. Responses from the current practice surveys were used to inform a subsequent two-round Delphi survey with registered CTUs. A consensus list of retention research strategies was produced and ranked by priority. Fifty out of seventy-five (67%) chief investigators and 33/47 (70%) registered CTUs completed the current practice surveys. Seventy-eight percent of trialists were aware of retention challenges and implemented strategies at trial design. Patient-initiated withdrawal was the most common cause of missing data. Registered CTUs routinely used newsletters, timeline of participant visits, and telephone reminders to mitigate missing data. Whilst 36 out of 59 strategies presented had been formally or informally evaluated, some frequently used strategies, such as site initiation training, have had no research to inform practice. Thirty-five registered CTUs (74%) participated in the Delphi survey. Research into the effectiveness of site initiation training, frequency of patient contact during a trial, the use of routinely collected data, the frequency and timing of reminders, triggered site training and the time needed to complete questionnaires was deemed critical. Research into the effectiveness of Christmas cards for site staff was not of critical importance. The surveys of current practices demonstrates that a variety of strategies are being used to mitigate missing data but with little evidence to support their use. Six retention strategies were deemed critically important within the Delphi survey and should be a primary focus of future retention research.

Guidelines for the Design and Conduct of Clinical Studies in Knee Articular Cartilage Repair

PubMed Central

Mithoefer, Kai; Saris, Daniel B.F.; Farr, Jack; Kon, Elizaveta; Zaslav, Kenneth; Cole, Brian J.; Ranstam, Jonas; Yao, Jian; Shive, Matthew; Levine, David; Dalemans, Wilfried; Brittberg, Mats

2011-01-01

Objective: To summarize current clinical research practice and develop methodological standards for objective scientific evaluation of knee cartilage repair procedures and products. Design: A comprehensive literature review was performed of high-level original studies providing information relevant for the design of clinical studies on articular cartilage repair in the knee. Analysis of cartilage repair publications and synopses of ongoing trials were used to identify important criteria for the design, reporting, and interpretation of studies in this field. Results: Current literature reflects the methodological limitations of the scientific evidence available for articular cartilage repair. However, clinical trial databases of ongoing trials document a trend suggesting improved study designs and clinical evaluation methodology. Based on the current scientific information and standards of clinical care, detailed methodological recommendations were developed for the statistical study design, patient recruitment, control group considerations, study endpoint definition, documentation of results, use of validated patient-reported outcome instruments, and inclusion and exclusion criteria for the design and conduct of scientifically sound cartilage repair study protocols. A consensus statement among the International Cartilage Repair Society (ICRS) and contributing authors experienced in clinical trial design and implementation was achieved. Conclusions: High-quality clinical research methodology is critical for the optimal evaluation of current and new cartilage repair technologies. In addition to generally applicable principles for orthopedic study design, specific criteria and considerations apply to cartilage repair studies. Systematic application of these criteria and considerations can facilitate study designs that are scientifically rigorous, ethical, practical, and appropriate for the question(s) being addressed in any given cartilage repair research project. PMID:26069574

Evaluating Student Performance and Qualifications in Rehabilitation Counseling

ERIC Educational Resources Information Center

Fleming, Allison R.; Kline, Katherine M.; Phillips, Brian N.

2017-01-01

Purpose: To determine methods of student learning assessment and clinical training in rehabilitation counseling programs. With many shifts occurring in postsecondary education and in rehabilitation counseling, it is critical to understand these current practices. Method: The authors used an Internet-based survey design to solicit program…

Best practices for modifying transportation design, planning, and project evaluation in Texas.

DOT National Transportation Integrated Search

2017-03-01

This guidebook is a desktop guide for TxDOT staff to facilitate an understanding of CAV technologies and the current trends in development and deployment. The overview should aid in anticipating the evolution of the Texas fleet and its use under vari...

Defining and Applying a Functionality Approach to Intellectual Disability

ERIC Educational Resources Information Center

Luckasson, R.; Schalock, R. L.

2013-01-01

Background: The current functional models of disability do not adequately incorporate significant changes of the last three decades in our understanding of human functioning, and how the human functioning construct can be applied to clinical functions, professional practices and outcomes evaluation. Methods: The authors synthesise current…

Rewards and Supports

ERIC Educational Resources Information Center

Hershberg, Theodore; Robertson-Kraft, Claire

2010-01-01

Pay-for-performance systems in public schools have long been burdened with controversy. Critics of performance pay systems contend that because teachers' impact cannot be measured without error, it is impossible to create fair and accurate systems for evaluating and rewarding performance. By this standard, however, current practice fails on both…

Emergy Analysis for the Sustainable Utilization of Biosolids Generated in a Municipal Wastewater Treatment Plant

EPA Science Inventory

This contribution describes the application of an emergy-based methodology for comparing two management alternatives of biosolids produced in a wastewater treatment plant. The current management practice of using biosolids as soil fertilizers was evaluated and compared to another...

Accreditation of Engineering Programs: An Evaluation of Current Practices in Malaysia

ERIC Educational Resources Information Center

Said, Suhana Mohd; Chow, Chee-Onn; Mokhtar, N.; Ramli, Rahizar; Ya, Tuan Mohd Yusoff Shah Tuan; Sabri, Mohd Faizul Mohd

2013-01-01

The curriculum for undergraduate engineering courses in Malaysia is becoming increasingly structured, following the global trend for quality assurance in engineering education, through accreditation schemes. Generally, the accreditation criteria call for the graduates from engineering programs to demonstrate a range of skills, from technical…

Revisiting the Rural Superintendency: Rethinking Guiding Theories for Contemporary Practice

ERIC Educational Resources Information Center

McHenry-Sorber, Erin; Budge, Kathleen

2018-01-01

This conceptual article challenges researchers and practitioners to reconsider the utility of current constructs used to understand the rural school superintendency. We evaluate the rural leadership literature through two waves of scholarship: insider/outsider conceptions and place-conscious/critical place-conscious constructs. We assert critical…

Evaluation of Various Tack Coat Materials Using Interface Shear Device and Recommendations on a Simplified Device

DOT National Transportation Integrated Search

2017-12-01

The performance of pavement interface bonds affects the integrity of pavement structures. In current practice, tack coats are used to ensure sufficient bonding between asphalt concrete (AC) layers as well as AC and concrete or aggregate base layers. ...

Applying Theory to the Design of Cultural Competency Training for Medical Students: A Case Study.

ERIC Educational Resources Information Center

Crandall, Sonia J.; George, Geeta; Marion, Gail S.; Davis, Steve

2003-01-01

Summarizes the current practice of cultural competency training within medical education and describes the design, implementation, and evaluation of a theoretically based, year-long cultural competency training course for second-year students at Wake Forest University School of Medicine. (EV)

Evaluation and analysis of current compaction methods for FDOT pipe trench backfills in areas of high water tables

DOT National Transportation Integrated Search

1999-01-01

This research project was undertaken to examine the practicality and adequacy of the FDOT specifications regarding compaction methods for pipe trench backfills under high water table. Given the difficulty to determine density and to attain desired de...

Develop guidelines for pavement preservation treatments and for building a pavement preservation program platform for Alaska.

DOT National Transportation Integrated Search

2012-11-01

This reports summarizes the project findings including the following: : An evaluation of the current pavement preservation program used in Alaska and a roadmap to grow the program : A summary of the best practices in terms of pavement preserv...

Evaluation of Educator & Student Use of & Attitudes toward Dissection & Dissection Alternatives

ERIC Educational Resources Information Center

Osenkowski, Pamela; Green, Che; Tjaden, Anne; Cunniff, Peggy

2015-01-01

Animal dissection has been routinely practiced in American biology classrooms for decades. With technological advancements, more states adopting student choice measures, and increased awareness about ethical concerns surrounding dissection, many useful dissection alternatives have been developed. To understand the current use of animal dissection…

Educational Resource Management: An International Perspective

ERIC Educational Resources Information Center

Glover, Derek; Levacic, Rosalind

2007-01-01

This book offers practical guidance on management of financial and real resources in schools and college, and critically evaluates current tensions involved in the area of educational resource management. It is essential reading for educational leaders who wish to improve the effectiveness, efficiency and equity of their resource utilisation…

Evaluation utilization research--developing a theory and putting it to use.

PubMed

Neuman, Ari; Shahor, Neria; Shina, Ilan; Sarid, Anat; Saar, Zehava

2013-02-01

This article presents the findings of a two-stage study that had two key objectives: to develop a theory about evaluation utilization in an educational organization and to apply this theory to promote evaluation utilization within the organization. The first stage involved a theoretical conceptualization using a participatory method of concept mapping. This process identified the modes of evaluation utilization within the organization, produced a representation of the relationship between them and led to a theory. The second stage examined the practical implications of this conceptualization in terms of how different stakeholders in the organization perceive the actual and preferable state of evaluation utilization within the organization (i.e. to what extent is evaluation utilized and to what extent should it be utilized). The participatory process of the study promoted the evaluation utilization by involving stakeholders, thus giving them a sense of ownership and improving communication between the evaluation unit and the stakeholders. In addition, understanding the evaluation needs of the stakeholders in the organization helped generate relevant and realizable evaluation processes. On a practical level, the results are currently shaping the evaluation plan and the place of evaluations within the organization. Copyright © 2012 Elsevier Ltd. All rights reserved.

A multi-method evaluation of interprofessional education for healthcare professionals caring for women during and after pregnancy.

PubMed

Olander, Ellinor; Coates, Rose; Brook, Judy; Ayers, Susan; Salmon, Debra

2018-02-09

This multi-method evaluation assessed the perceived impact of interprofessional workshops targeting enhanced collaboration between healthcare professionals who care for women during and after pregnancy. Current policy recommends partnership working to improve care for women and babies, however, there is little interprofessional education in this area. Five one-day workshops were delivered to 18 healthcare professionals (47.4% of the 38 healthcare professionals registered). The workshop was evaluated through questionnaires before and after the workshop measuring attitudes and willingness towards collaboration; observations of the workshops by a researcher and follow-up interviews 2 months' post-workshop to explore changes in practice. Workshops were attended by midwives, health visitors (trained nurses specialising in community care for children 0-5 years), dietitians, nurses, a general practitioner and a breastfeeding specialist. Attitudes and willingness to participate in interprofessional collaborative practice improved after the workshop. Observations made at the workshop included engaged participants who reported numerous barriers towards collaboration. Follow-up contact with 12 participants identified several examples of collaboration in practice resulting from workshop attendance. These findings suggest that the workshops influenced attendees to change their practice towards more collaborative working. Future work needs to confirm these results with more participants.

The medical practice of euthanasia in Belgium and The Netherlands: legal notification, control and evaluation procedures.

PubMed

Smets, Tinne; Bilsen, Johan; Cohen, Joachim; Rurup, Mette L; De Keyser, Els; Deliens, Luc

2009-05-01

To describe and compare current legal procedures for notifying, controlling and evaluating (NCE-procedures) euthanasia in Belgium and the Netherlands, and to discuss the implications for a safe and controllable euthanasia practice. We systematically studied and compared official documents relating to the Belgian and the Dutch NCE-procedures for euthanasia. In both countries, physicians are required to notify their cases to a review Committee, stimulating them to safeguard the quality of their euthanasia practice and to make societal control over the practice of euthanasia possible. However, the procedures in both countries differ. The main differences are that the Dutch notification and control procedures are more elaborate and transparent than the Belgian, and that the Belgian procedures are primarily anonymous, whereas the Dutch are not. Societal evaluation is made in both countries through the Committees' summary reports to Parliament. Transparent procedures like the Dutch may better facilitate societal control. Informing physicians about the law and the due care requirements for euthanasia, and systematic feedback about their medical actions are both pivotal to achieving efficient societal control and engendering the level of care needed when performing such far-reaching medical acts.

Nurse manager succession planning: synthesis of the evidence.

PubMed

Titzer, Jennifer; Phillips, Tracy; Tooley, Stephanie; Hall, Norma; Shirey, Maria

2013-10-01

The literature supporting nurse manager succession planning is reviewed and synthesised to discover best practice for identifying and developing future nurse managers. Healthcare succession planning practices are lacking. Nurse managers are historically selected based on clinical skills and lack formal leadership preparation. A systematic literature search appraises and summarises the current literature supporting nurse manager succession planning. Multiple reviewers were used to increase the reliability and validity of article selection and analysis. New nurse managers require months to adapt to their positions. Deliberate nurse manager succession planning should be integrated in the organisation's strategic plan and provide a proactive method for identifying and developing potential leaders. Organisations that identify and develop internal human capital can improve role transition, reduce nurse manager turnover rates and decrease replacement costs. Despite the clear benefits of succession planning, studies show that resource allocation for proactive, deliberate development of current and future nurse leaders is lacking. Additionally, systematic evaluation of succession planning is limited. Deliberate succession planning efforts and appropriate resource allocation require strategic planning and evaluation methods. Detailed evaluation methods demonstrating a positive return on investment utilising a cost-benefit analysis and empirical outcomes are necessary. © 2013 John Wiley & Sons Ltd.

Hospital waste management in Brazil: a case study.

PubMed

Mattoso, V D; Schalch, V

2001-12-01

The evaluation of the current definition, classification and quantification of hospital waste being carried out by hospitals in different countries is extremely important to avoid improper waste management practices. In this work, the waste management from a 400-bed Brazilian hospital which generates about 386 kg per day of hospital waste was studied. The generation rate of just over one kg per bed per day was considered small, although more than 50% of the waste from non-isolation wards consisted of food waste. It was also interesting to note that the highest generation rate per patient per day was found in private rooms and the lowest rate in the public ones. The waste practices used in this hospital are discussed in terms of current Brazilian legislation.

Simulation in teaching regional anesthesia: current perspectives.

PubMed

Udani, Ankeet D; Kim, T Edward; Howard, Steven K; Mariano, Edward R

2015-01-01

The emerging subspecialty of regional anesthesiology and acute pain medicine represents an opportunity to evaluate critically the current methods of teaching regional anesthesia techniques and the practice of acute pain medicine. To date, there have been a wide variety of simulation applications in this field, and efficacy has largely been assumed. However, a thorough review of the literature reveals that effective teaching strategies, including simulation, in regional anesthesiology and acute pain medicine are not established completely yet. Future research should be directed toward comparative-effectiveness of simulation versus other accepted teaching methods, exploring the combination of procedural training with realistic clinical scenarios, and the application of simulation-based teaching curricula to a wider range of learner, from the student to the practicing physician.

Simulation in teaching regional anesthesia: current perspectives

PubMed Central

Udani, Ankeet D; Kim, T Edward; Howard, Steven K; Mariano, Edward R

2015-01-01

The emerging subspecialty of regional anesthesiology and acute pain medicine represents an opportunity to evaluate critically the current methods of teaching regional anesthesia techniques and the practice of acute pain medicine. To date, there have been a wide variety of simulation applications in this field, and efficacy has largely been assumed. However, a thorough review of the literature reveals that effective teaching strategies, including simulation, in regional anesthesiology and acute pain medicine are not established completely yet. Future research should be directed toward comparative-effectiveness of simulation versus other accepted teaching methods, exploring the combination of procedural training with realistic clinical scenarios, and the application of simulation-based teaching curricula to a wider range of learner, from the student to the practicing physician. PMID:26316812

Implementation of the Strengths Model at an area mental health service.

PubMed

Chopra, Prem; Hamilton, Bridget; Castle, David; Smith, Jenny; Mileshkin, Cris; Deans, Michael; Wynne, Brad; Prigg, Glenn; Toomey, Nigel; Wilson, Michael

2009-06-01

The objectives of this paper are to provide an overview of recovery-focused models of care and discuss the implementation of the Strengths Model at St. Vincent's Mental Health Melbourne (SVMH), Victoria, Australia. The implementation of the Strengths Model at SVMH is discussed with particular emphasis on the process of implementation, service implications, practical challenges and dilemmas that have arisen, and proposed evaluation. Recovery-focused care is feasible and can enhance current practice of mental health services.

Evaluation of outdoor-to-indoor response to minimized sonic booms

NASA Technical Reports Server (NTRS)

Brown, David; Sutherland, Louis C.

1992-01-01

Various studies were conducted by NASA and others on the practical limitations of sonic boom signature shaping/minimization for the High-Speed Civil Transport (HSCT) and on the effects of these shaped boom signatures on perceived loudness. This current effort is a further part of this research with emphasis on examining shaped boom signatures which are representative of the most recent investigations of practical limitations on sonic boom minimization, and on examining and comparing the expected response to these signatures when experienced indoors and outdoors.

Theoretical links supporting the use of problem-based learning in the education of the nurse practitioner.

PubMed

Chikotas, Noreen Elaine

2008-01-01

The need to evaluate current strategies in educating the advanced practice nurse, specifically the nurse practitioner, is becoming more and more imperative due to the ever-changing health care environment. This article addresses the role of problem-based learning (PBL) as an instructional strategy in educating and preparing the nurse practitioner for future practice.Two theoretical frameworks supporting PBL, andragogy and constructivism, are presented as important to the use of PBL in the education of the nurse practitioner.

Knowing for Nursing Practice: Patterns of Knowledge and Their Emulation in Expert Systems

PubMed Central

Abraham, Ivo L.; Fitzpatrick, Joyce J.

1987-01-01

This paper addresses the issue of clinical knowledge in nursing, and the feasibility of emulating this knowledge into expert system technology. The perspective on patterns of knowing for nursing practice, advanced by Carper (1978), serves as point of departure. The four patterns of knowing -- empirics, esthetics, ethics, personal knowledge -- are evaluated as to the extent to which they can be emulated in clinical expert systems, given constraints imposed by the current technology of these systems.

The national occupational therapy practice analysis: findings and implications for competence.

PubMed

Dunn, W; Cada, E

1998-10-01

This article reports some of the findings from a national study of occupational therapy practice conducted by the National Board for Certification in Occupational Therapy (NBCOT) as part of its fiduciary responsibility to ensure that its entry-level certification examination is formulated on the basis of current practice. The NBCOT developed a survey with input from approximately 200 occupational therapy leaders and then used it to solicit information about current practice from 4,000 occupational therapists and 3,000 occupational therapy assistants. The sample included geographical location, experience level, and practice area distributions. Approximately 50% of the sample responded to the survey. Data indicate similarities and differences in occupational therapist and occupational therapy assistant practice (e.g., occupational therapists spend more time conducting evaluations, planning interventions, and supervising, whereas occupational therapy assistants spend more time providing interventions), an increased emphasis on population-based services (e.g., serving a business or industry rather than an individual worker), and an emphasis on occupation as a core knowledge base for practice. From a continuing competency perspective, the data can be useful to the profession; we can plan continuing education to address topics that practitioners have indicated are critical to their practice. The findings will be useful for revising the entry-level certification examination and may guide thinking about the parameters of continuing competence because the responses represent a cross-section of the profession.

Appraising the methodological quality of the clinical practice guideline for diabetes mellitus using the AGREE II instrument: a methodological evaluation.

PubMed

Radwan, Mahmoud; Akbari Sari, Ali; Rashidian, Arash; Takian, Amirhossein; Abou-Dagga, Sanaa; Elsous, Aymen

2017-02-01

To evaluate the methodological quality of the Palestinian Clinical Practice Guideline for Diabetes Mellitus using the Translated Arabic Version of the AGREE II. Methodological evaluation. A cross-cultural adaptation framework was followed to translate and develop a standardised Translated Arabic Version of the AGREE II. Palestinian Primary Healthcare Centres. Sixteen appraisers independently evaluated the Clinical Practice Guideline for Diabetes Mellitus using the Translated Arabic Version of the AGREE II. Methodological quality of diabetic guideline. The Translated Arabic Version of the AGREE II showed an acceptable reliability and validity. Internal consistency ranged between 0.67 and 0.88 (Cronbach's α). Intra-class coefficient among appraisers ranged between 0.56 and 0.88. The quality of this guideline is low. Both domains 'Scope and Purpose' and 'Clarity of Presentation' had the highest quality scores (66.7% and 61.5%, respectively), whereas the scores for 'Applicability', 'Stakeholder Involvement', 'Rigour of Development' and 'Editorial Independence' were the lowest (27%, 35%, 36.5%, and 40%, respectively). The findings suggest that the quality of this Clinical Practice Guideline is disappointingly low. To improve the quality of current and future guidelines, the AGREE II instrument is extremely recommended to be incorporated as a gold standard for developing, evaluating or updating the Palestinian Clinical Practice Guidelines. Future guidelines can be improved by setting specific strategies to overcome implementation barriers with respect to economic considerations, engaging of all relevant end-users and patients, ensuring a rigorous methodology for searching, selecting and synthesising the evidences and recommendations, and addressing potential conflict of interests within the development group.

Animal Health and Welfare Issues Facing Organic Production Systems

PubMed Central

Sutherland, Mhairi A.; Webster, Jim; Sutherland, Ian

2013-01-01

Simple Summary The demand for organically grown, animal derived produce is increasing due to a growing desire for consumer products that have minimal chemical inputs and high animal welfare standards. Evaluation of the scientific literature suggests that a major challenge facing organic animal production systems is the management and treatment of health-related issues. However, implementation of effective management practices can help organic animal producers achieve and maintain high standards of health and welfare, which is necessary to assure consumers that organic animal-based food and fibre has not only been produced with minimal or no chemical input, but under high standards of animal welfare. Abstract The demand for organically-grown produce is increasing worldwide, with one of the drivers being an expectation among consumers that animals have been farmed to a high standard of animal welfare. This review evaluates whether this expectation is in fact being met, by describing the current level of science-based knowledge of animal health and welfare in organic systems. The primary welfare risk in organic production systems appears to be related to animal health. Organic farms use a combination of management practices, alternative and complementary remedies and convenional medicines to manage the health of their animals and in many cases these are at least as effective as management practices employed by non-organic producers. However, in contrast to non-organic systems, there is still a lack of scientifically evaluated, organically acceptable therapeutic treatments that organic animal producers can use when current management practices are not sufficient to maintain the health of their animals. The development of such treatments are necessary to assure consumers that organic animal-based food and fibre has not only been produced with minimal or no chemical input, but under high standards of animal welfare. PMID:26479750

Arts practices in unreasonable doubt? Reflections on understandings of arts practices in healthcare contexts.

PubMed

Broderick, Sheelagh

2011-09-01

This article suggests that the discourse on arts and health encompass contemporary arts practices as an active and engaged analytical activity. Distinctions between arts therapy and arts practice are made to suggest that clinical evidence-based evaluation, while appropriate for arts therapy, is not appropriate for arts practice and in effect cast them in unreasonable doubt. Themes in current discourse on "arts" and "health" are broadly sketched to provide a context for discussion of arts practices. Approaches to knowledge validation in relation to each domain are discussed. These discourses are applied to the Irish healthcare context, offering a reading of three different art projects; it suggests a multiplicity of analyses beyond causal positive health gains. It is suggested that the social turn in medicine and the social turn in arts practices share some similar pre-occupations that warrant further attention.

A Chronic Disease Management Student-Faculty Collaborative Practice: Educating Students on Innovation in Health Care Delivery.

PubMed

Remus, Kristin E; Honigberg, Michael; Tummalapalli, Sri Lekha; Cohen, Laura P; Fazio, Sara; Weinstein, Amy R

2016-07-01

In the current transformative health care landscape, it is imperative that clinician educators inspire future clinicians to practice primary care in a dynamic environment. A focus on patient-centered, goal-oriented care for patients with chronic conditions is critical. In 2009, Harvard Medical School founded the Crimson Care Collaborative, a student-faculty collaborative practice (SFCP) network. With the aim of expanding clinical and educational opportunities for medical students and improving patient control of chronic disease (i.e., hypertension, obesity, and diabetes) in an innovative learning environment, in 2012, the authors developed a novel SFCP at their hospital-based academic primary care practice. In this SFCP, students learn to explore patient priorities, provide focused counseling and education, and assist patients with self-management goals during clinical visits. From 2012 to 2014, 250 student volunteers participated in the SFCP as clinicians, innovators, educators, and leaders, with between 80 and 95 medical students engaging each semester. Between January 2012 and March 2014, there were 476 urgent care or chronic disease management visits. Patients with chronic diseases were seen at least twice on average, and by 2014, chronic disease management visits accounted for approximately 74% of visits. Work is under way to create assessment tools to evaluate the practice's educa tional impact and student understanding of the current health care system, develop interdisciplinary care teams, expand efforts in registry management and broaden the patient recruitment scope, further emphasize patient engage ment and retention, and evaluate chronic disease management and patient satisfaction effectiveness.

Transnational gestational surrogacy: does it have to be exploitative?

PubMed

Kirby, Jeffrey

2014-01-01

This article explores the controversial practice of transnational gestational surrogacy and poses a provocative question: Does it have to be exploitative? Various existing models of exploitation are considered and a novel exploitation-evaluation heuristic is introduced to assist in the analysis of the potentially exploitative dimensions/elements of complex health-related practices. On the basis of application of the heuristic, I conclude that transnational gestational surrogacy, as currently practiced in low-income country settings (such as rural, western India), is exploitative of surrogate women. Arising out of consideration of the heuristic's exploitation conditions, a set of public education and enabled choice, enhanced protections, and empowerment reforms to transnational gestational surrogacy practice is proposed that, if incorporated into a national regulatory framework and actualized within a low income country, could possibly render such practice nonexploitative.

[Method for the evaluation of the stability and usability after opening packages of orally disintegrating tablets: case of amlodipine besilate products].

PubMed

Hori, Katsuhito; Yoshida, Naoko; Okumura, Tomonori; Okamura, Yasufumi; Kawakami, Junichi

2010-08-01

Orally disintegrating (OD) tablets are widely used in clinical practice. However, drug information on the choice and dispensing based on their stability after opening packages and usability in patients and dispensaries is not sufficient. The aim of this study was to investigate possible evaluation methods of the stability and usability of amlodipine OD tablets. Additives of the brand were changed in April 2009, and therefore the previous and current forms and two generics, current and newly marketed (in November 2009) products of different firms, were used. OD tablets were stored at 25 degrees C and 75% relative humidity for 3 months after opening the packages, and their physicochemical properties were evaluated. Their weight, diameter, thickness, and color difference increased slightly from the initial state. The extent of the change in their hardness, disintegration time, and friability was different among products. These physicochemical changes were acceptable in dispensary practice. Storage after opening the packages did not affect their dissolution rate. The dissolution rate at the initial state of the current brand was slower than that of the previous one. All products used were able to be dispensed by an automatic tablet-packing machine and applied to the so-called simple suspension method for intubational administration. Sensory evaluation tests revealed no major difference in the oral disintegration time, taste, impression, and preference among products. In conclusion, the stability and usability of amlodipine OD tablets used in this study were examined using several methods, and they can be used equivalently from the stability and usability viewpoints.

Hydrodechlorination of TCE in a circulated electrolytic column at high flow rate.

PubMed

Fallahpour, Noushin; Yuan, Songhu; Rajic, Ljiljana; Alshawabkeh, Akram N

2016-02-01

Palladium-catalytic hydrodechlorination of trichloroethylene (TCE) by cathodic H2 produced from water electrolysis has been tested. For a field in-well application, the flow rate is generally high. In this study, the performance of Pd-catalytic hydrodechlorination of TCE using cathodic H2 is evaluated under high flow rate (1 L min(-1)) in a circulated column system, as expected to occur in practice. An iron anode supports reduction conditions and it is used to enhance TCE hydrodechlorination. However, the precipitation occurs and high flow rate was evaluated to minimize its adverse effects on the process (electrode coverage, clogging, etc.). Under the conditions of 1 L min(-1) flow, 500 mA current, and 5 mg L(-1) initial TCE concentration, removal efficacy using iron anodes (96%) is significantly higher than by mixed metal oxide (MMO) anodes (66%). Two types of cathodes (MMO and copper foam) in the presence of Pd/Al2O3 catalyst under various currents (250, 125, and 62 mA) were used to evaluate the effect of cathode materials on TCE removal efficacy. The similar removal efficiencies were achieved for both cathodes, but more precipitation generated with copper foam cathode (based on the experiments done by authors). In addition to the well-known parameters such as current density, electrode materials, and initial TCE concentration, the high velocities of groundwater flow can have important implications, practically in relation to the flush out of precipitates. For potential field application, a cost-effective and sustainable in situ electrochemical process using a solar panel as power supply is being evaluated. Published by Elsevier Ltd.

Hydrodechlorination of TCE in a circulated electrolytic column at high flow rate

PubMed Central

Fallahpour, Noushin; Yuan, Songhu; Rajic, Ljiljana; Alshawabkeh, Akram N.

2015-01-01

Palladium-catalytic hydrodechlorination of trichloroethylene (TCE) by cathodic H2 produced from water electrolysis has been tested. For a field in-well application, the flow rate is generally high. In this study, the performance of Pd-catalytic hydrodechlorination of TCE using cathodic H2 is evaluated under high flow rate (1 L min−1) in a circulated column system, as expected to occur in practice. An iron anode supports reduction conditions and it is used to enhance TCE hydrodechlorination. However, the precipitation occurs and high flow rate was evaluated to minimize its advers effects on the process (electrode coverage, clogging, etc.). Under the conditions of 1 L min−1 flow, 500 mA current, and 5 mg L−1 initial TCE concentration, removal efficacy using iron anodes (96%) is significantly higher than by mixed metal oxide (MMO) anodes (66%). Two types of cathodes (MMO and copper foam) in the presence of Pd/Al2O3 catalyst under various currents (250, 125, and 62 mA) were used to evaluate the effect of cathode materials on TCE removal efficacy. The similar removal efficiencies were achieved for both cathodes, but more precipitation generated with copper foam cathode (based on the experiments done by authors). In addition to the well-known parameters such as current density, electrode materials, and initial TCE concentration, the high velocities of groundwater flow can have important implications, practically in relation to the flush out of precipitates. For potential field application, a cost-effective and sustainable in situ electrochemical process using a solar panel as power supply is being evaluated. PMID:26344148

Non-cultural methods of human microflora evaluation for the benefit of crew medical control in confined habitat

NASA Astrophysics Data System (ADS)

Viacheslav, Ilyin; Lana, Moukhamedieva; Georgy, Osipov; Aleksey, Batov; Zoya, Soloviova; Robert, Mardanov; Yana, Panina; Anna, Gegenava

2011-05-01

Current control of human microflora is a great problem not only for the space medicine but also for practical health care. Due to many reasons its realization by classical bacteriological method is difficult in practical application or cannot be done. To evaluate non-cultural methods of microbial control of crews in a confined habitat we evaluated two different methods. The first method is based on digital treatment of microbial visual images, appearing after gram staining of microbial material from natural sample. This way the rate between gram-positive and gram-negative microbe could be gained as well as differentiation of rods and cocci could be attained, which is necessary for primary evaluation of human microbial cenosis in remote confined habitats. The other non-culture method of human microflora evaluation is gas chromatomass spectrometry (gcms) analysis of swabs gathered from different body sites. Gc-ms testing of swabs allows one to validate quantitative and special microflora based on specific lipid markers analysis.

Assuring data transparency through design methodologies

NASA Technical Reports Server (NTRS)

Williams, Allen

1990-01-01

This paper addresses the role of design methodologies and practices in the assurance of technology transparency. The development of several subsystems on large, long life cycle government programs was analyzed to glean those characteristics in the design, development, test, and evaluation that precluded or enabled the insertion of new technology. The programs examined were Minuteman, DSP, B1-B, and space shuttle. All these were long life cycle, technology-intensive programs. The design methodologies (or lack thereof) and design practices for each were analyzed in terms of the success or failure in incorporating evolving technology. Common elements contributing to the success or failure were extracted and compared to current methodologies being proposed by the Department of Defense and NASA. The relevance of these practices to the design and deployment of Space Station Freedom were evaluated. In particular, appropriate methodologies now being used on the core development contract were examined.

Multi-centre parallel arm randomised controlled trial to assess the effectiveness and cost-effectiveness of a group-based cognitive behavioural approach to managing fatigue in people with multiple sclerosis.

PubMed

Thomas, Peter W; Thomas, Sarah; Kersten, Paula; Jones, Rosemary; Nock, Alison; Slingsby, Vicky; Green, Colin; Baker, Roger; Galvin, Kate; Hillier, Charles

2010-06-16

Fatigue is one of the most commonly reported and debilitating symptoms of multiple sclerosis (MS); approximately two-thirds of people with MS consider it to be one of their three most troubling symptoms. It may limit or prevent participation in everyday activities, work, leisure, and social pursuits, reduce psychological well-being and is one of the key precipitants of early retirement. Energy effectiveness approaches have been shown to be effective in reducing MS-fatigue, increasing self-efficacy and improving quality of life. Cognitive behavioural approaches have been found to be effective for managing fatigue in other conditions, such as chronic fatigue syndrome, and more recently, in MS. The aim of this pragmatic trial is to evaluate the clinical and cost-effectiveness of a recently developed group-based fatigue management intervention (that blends cognitive behavioural and energy effectiveness approaches) compared with current local practice. This is a multi-centre parallel arm block-randomised controlled trial (RCT) of a six session group-based fatigue management intervention, delivered by health professionals, compared with current local practice. 180 consenting adults with a confirmed diagnosis of MS and significant fatigue levels, recruited via secondary/primary care or newsletters/websites, will be randomised to receive the fatigue management intervention or current local practice. An economic evaluation will be undertaken alongside the trial. Primary outcomes are fatigue severity, self-efficacy and disease-specific quality of life. Secondary outcomes include fatigue impact, general quality of life, mood, activity patterns, and cost-effectiveness. Outcomes in those receiving the fatigue management intervention will be measured 1 week prior to, and 1, 4, and 12 months after the intervention (and at equivalent times in those receiving current local practice). A qualitative component will examine what aspects of the fatigue management intervention participants found helpful/unhelpful and barriers to change. This trial is the fourth stage of a research programme that has followed the Medical Research Council guidance for developing and evaluating complex interventions. What makes the intervention unique is that it blends cognitive behavioural and energy effectiveness approaches. A potential strength of the intervention is that it could be integrated into existing service delivery models as it has been designed to be delivered by staff already working with people with MS. Service users will be involved throughout this research. Current Controlled Trials ISRCTN76517470.

Laboratory and Field Evaluation of Rapid Setting Cementitious Materials for Large Crater Repair

DTIC Science & Technology

2010-05-01

frame used within which to complete the repair was the current NATO standard of 4 hr. A total of 6 simulated craters were prepared, with each repair...Combat Command 129 Andrews Street Langley Air Force Base, VA 23665 ERDC TR-10-4 ii Abstract: Current practice for expedient runway repair...penalty. Numerous commercial products are available. A full-scale field test was conducted using rapid setting materials to repair simulated bomb craters

ASCCP Colposcopy Standards: How Do We Perform Colposcopy? Implications for Establishing Standards.

PubMed

Waxman, Alan G; Conageski, Christine; Silver, Michelle I; Tedeschi, Candice; Stier, Elizabeth A; Apgar, Barbara; Huh, Warner K; Wentzensen, Nicolas; Massad, L Stewart; Khan, Michelle J; Mayeaux, Edward J; Einstein, Mark H; Schiffman, Mark H; Guido, Richard S

2017-10-01

The American Society for Colposcopy and Cervical Pathology (ASCCP) Colposcopy Standards recommendations address the role of and approach to colposcopy and biopsy for cervical cancer prevention in the United States. The recommendations were developed by an expert working group appointed by ASCCP's Board of Directors. Working group 3 defined colposcopy procedure guidelines for minimum and comprehensive colposcopy practice and evaluated the use of colposcopy adjuncts. The working group performed a systematic literature review to identify best practices in colposcopy methodology and to evaluate the use of available colposcopy adjuncts. The literature provided little evidence to support specific elements of the procedure. The working group, therefore, implemented a national survey of current and recent ASCCP members to evaluate common elements of the colposcopy examination. The findings of this survey were modified by expert consensus from the ASCCP Colposcopy Standards Committee members to create guidelines for performing colposcopy. The draft recommendations were posted online for public comment and presented at an open session of the International Federation for Cervical Pathology and Colposcopy 2017 World Congress for further comment. All comments were considered in the development of final recommendations. Minimum and comprehensive colposcopy practice guidelines were developed. These guidelines represent recommended practice in all parts of the examination including the following: precolposcopy evaluation, performing the procedure, documentation of findings, biopsy practice, and postprocedure follow-up. These guidelines are intended to serve as a guide to standardize colposcopy across the United States.

Teachers' Journeys: A Case of Teachers of Learners Aged Five to Six

ERIC Educational Resources Information Center

Feza, Nosisi N.

2018-01-01

South Africa's esteem is low with regard to current learner achievement in mathematics. Results from international studies, such as TIMMS and SACMEQ, continuously indicate that South African learners perform below international benchmarks in mathematics. Research and evaluation studies assert that teacher practices and poor early mathematics…

Online Faculty Development and Assessment System (OFDAS)

ERIC Educational Resources Information Center

Villar, Luis M.; Alegre, Olga M.

2006-01-01

The rapid growth of online learning has led to the development of faculty inservice evaluation models focused on quality improvement of degree programs. Based on current "best practices" of student online assessment, the Online Faculty Development and Assessment System (OFDAS), created at the Canary Islands, was designed to serve the…

Policy, Systems, and Environmental Change in the Mississippi Delta: Considerations for Evaluation Design

ERIC Educational Resources Information Center

Kegler, Michelle C.; Honeycutt, Sally; Davis, Melvin; Dauria, Emily; Berg, Carla; Dove, Cassandra; Gamble, Abigail; Hawkins, Jackie

2015-01-01

Community-level policy, systems, and environmental (PSE) change strategies may offer an economical and sustainable approach to chronic disease prevention. The rapidly growing number of untested but promising PSE strategies currently underway offers an exciting opportunity to establish practice-based evidence for this approach. This article…

Contemporary Career Development Issues.

ERIC Educational Resources Information Center

Morrison, Robert F., Ed.; Adams, Jerome, Ed.

This book provides practical guidance and examples for human resource development (HRD) specialists to use in the evaluation of their current career development programs and the design of new ones. "Issues in the Management of Careers" (Jerome Adams) provides a summary of each chapter and points out specific questions the chapter can answer.…

The Health and Wellbeing of International Students at an Australian University

ERIC Educational Resources Information Center

Rosenthal, Doreen Anne; Russell, Jean; Thomson, Garry

2008-01-01

A representative sample of undergraduate and postgraduate international students at a large Australian university (n=979, 64% females) completed a mail-back survey of their health and wellbeing. Most students evaluated their current and previous physical and mental health positively. Health-related risk practices such as unprotected sexual…

Newborn Hearing Screening: An Analysis of Current Practices

ERIC Educational Resources Information Center

Houston, K. Todd; Bradham, Tamala S.; Munoz, Karen F.; Guignard, Gayla Hutsell

2011-01-01

State coordinators of early hearing detection and intervention (EHDI) programs completed a strengths, weaknesses, opportunities, and threats, or SWOT, analysis that consisted of 12 evaluative areas of EHDI programs. For the newborn hearing screening area, a total of 293 items were listed by 49 EHDI coordinators, and themes were identified within…

Embedded C Programming: A Practical Course Introducing Programmable Microprocessors

ERIC Educational Resources Information Center

Laverty, David M.; Milliken, Jonny; Milford, Matthew; Cregan, Michael

2012-01-01

This paper presents a new laboratory-based module for embedded systems teaching, which addresses the current lack of consideration for the link between hardware development, software implementation, course content and student evaluation in a laboratory environment. The course introduces second year undergraduate students to the interface between…

CRITICAL EVALUATION OF THE EFFECTIVENESS OF SEWAGE SLUDGE DISINFECTION AND VECTOR ATTRACTION REDUCTION PROCESSES

EPA Science Inventory

What is the current state of management practices for biosolids production and application, and how can those be made more effective? How effective are Class B disinfection and vector attraction processes, and public access and harvesting restrictions at reducing the public's exp...

The Forgotten: Formal Assessment of the Adult Writer

ERIC Educational Resources Information Center

McNair, Daniel J.; Curry, Toi L.

2013-01-01

This review of current writing assessment practices focuses upon the adult population, an area significantly underrepresented within psychoeducational literature. As compared to other populations, such as K-12 students, there are few options for the practitioner wishing to evaluate adult writers by means of standardized assessment instruments.…

The Wisdom of Scientific Inquiry on Education

ERIC Educational Resources Information Center

Glass, Gene V.

1972-01-01

Under current conditions evaluative research based on curriculum products of master teachers using basic knowledge from the social and natural sciences is more likely to contribute to the improvement of educational practice than is an attempt to build theories of teaching based upon rapidly changing philosophy and technique. (AL)

Soil quality evaluation using Soil Management Assessment Framework (SMAF) in Brazilian oxisols with contrasting texture

USDA-ARS?s Scientific Manuscript database

To ensure current land use strategies and management practices are economically, environmentally, and socially sustainable, tools and techniques for assessing and quantifying changes in soil quality/health (SQ) need to be developed through rigorous research and potential use by consultants, and othe...

The Use of Documentation in a Participatory System of Evaluation

ERIC Educational Resources Information Center

Picchio, Mariacristina; Di Giandomenico, Isabella; Musatti, Tullia

2014-01-01

Pedagogical documentation is a practice currently used in Italian early childhood education and care (ECEC) services to make visible children's learning processes in ECEC, to promote parents' participation and to support professionals' reflexive competences. These functions of pedagogical documentation have been enhanced within a system of…

AN EVALUATION OF HYDROLOGIC RESPONSE TO 25 YEARS OF LANDSCAPE CHANGE IN A SEMI-ARID WATERSHED

EPA Science Inventory

The assessment of land use and land cover is an extremely important activity for contemporary land management. A large body of current literature suggests that human land-use practices are the most important factor influencing natural resource management at multiple scales. D...

21 CFR 886.1350 - Keratoscope.

Code of Federal Regulations, 2013 CFR

2013-04-01

...-powered or battery-powered device intended to measure and evaluate the corneal curvature of the eye. Lines and circles within the keratoscope are used to observe the corneal reflex. This generic type of device... subject to § 886.9. The battery-powered device is exempt from the current good manufacturing practice...

21 CFR 886.1350 - Keratoscope.

Code of Federal Regulations, 2012 CFR

2012-04-01

...-powered or battery-powered device intended to measure and evaluate the corneal curvature of the eye. Lines and circles within the keratoscope are used to observe the corneal reflex. This generic type of device... subject to § 886.9. The battery-powered device is exempt from the current good manufacturing practice...

21 CFR 886.1350 - Keratoscope.

Code of Federal Regulations, 2014 CFR

2014-04-01

...-powered or battery-powered device intended to measure and evaluate the corneal curvature of the eye. Lines and circles within the keratoscope are used to observe the corneal reflex. This generic type of device... subject to § 886.9. The battery-powered device is exempt from the current good manufacturing practice...

21 CFR 886.1350 - Keratoscope.

Code of Federal Regulations, 2011 CFR

2011-04-01

...-powered or battery-powered device intended to measure and evaluate the corneal curvature of the eye. Lines and circles within the keratoscope are used to observe the corneal reflex. This generic type of device... subject to § 886.9. The battery-powered device is exempt from the current good manufacturing practice...

21 CFR 886.1350 - Keratoscope.

Code of Federal Regulations, 2010 CFR

2010-04-01

...-powered or battery-powered device intended to measure and evaluate the corneal curvature of the eye. Lines and circles within the keratoscope are used to observe the corneal reflex. This generic type of device... subject to § 886.9. The battery-powered device is exempt from the current good manufacturing practice...

Emergy baseline for the Earth: A historical review of the science and a new calculation

EPA Science Inventory

Quantifying the emergy baseline of the Earth is a practical necessity for emergy evaluations, because it serves as a unified basis for determining transformities of the available energy storages and flows of the geobiosphere. The current debate over the value and significance of ...

Writing Exercises from "Exercise Exchange." Volume II.

ERIC Educational Resources Information Center

Duke, Charles R., Ed.

Reflecting current practices in the teaching of writing, the exercises in this compilation were drawn from the journal "Exercise Exchange." The articles are arranged into six sections: sources for writing; prewriting; modes for writing; writing and reading; language, mechanics, and style; and revising, responding, and evaluating. Among the topics…

Award-Winning Faculty at a Faith-Based Institution

ERIC Educational Resources Information Center

Livingston, Jennifer; Jun, Alexander

2011-01-01

Exploring the development of excellent teachers could contribute to the revision of current practices in faculty recruitment, evaluation, workload expectations, and reward systems. This grounded theory study examined the professional careers of nine award-winning faculty members of a faith-based institution of higher education. The data, collected…

Reclamation: what about trees

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

Kolar, C.A.; Ashby, W.C.

A five-year research programme was started in 1978 in the Botany Department of Southern Illinois University to evaluate the effect of reclamation practices on tree survival and growth. The project was initiated as a direct result of reports from Illinois and Indiana of tree-planting failures on mined lands reclaimed to current regulation standards.

An Initial Attempt at Operationalizing and Testing the Community Coalition Action Theory

ERIC Educational Resources Information Center

Kegler, Michelle C.; Swan, Deanne W.

2011-01-01

The Community Coalition Action Theory (CCAT) blends practice wisdom with empirical data to explain how community coalitions achieve community change and community capacity outcomes. The current study uses data from an evaluation of 20 "California Healthy Cities" and "Communities" coalitions to test relationships between…

WETLANDS AND WATER QUALITY TRADING: REVIEW OF CURRENT SCIENCE AND ECONOMIC PRACTICES WITH SELECTED CASE STUDIES

EPA Science Inventory

The study evaluates the technical, economic, and administrative aspects of establishing water quality trading (WQT) programs where the nutrient removal capacity of wetlands is used to improve water quality. WQT is a potentially viable approach for wastewater dischargers to cost-e...

Deep Venous Thrombosis Prophylaxis in Anterior Cruciate Ligament Reconstructive Surgery: What Is the Current State of Practice?

PubMed

Keller, Robert A; Moutzouros, Vasilios; Dines, Joshua S; Bush-Joseph, Charles A; Limpisvasti, Orr

Venous thromboembolism (VTE) is a significant perioperative risk with many common orthopaedic procedures. Currently, there is no standardized recommendation for the use of VTE prophylaxis during anterior cruciate ligament (ACL) reconstruction. This study sought to evaluate the current prophylactic practices of fellowship-trained sports medicine orthopaedic surgeons in the United States. Very few surgeons use perioperative VTE prophylaxis for ACL reconstructive surgery. Survey. Surveys were emailed to the alumni networks of 4 large ACGME-accredited sports medicine fellowship programs. Questions were focused on their current use of chemical and nonchemical VTE prophylaxis. Surveys were completed by 142 surgeons in the United States, yielding a response rate of 32%. Of those who responded, 50.7% stated that they routinely use chemical prophylaxis, with 95.5% of those using aspirin (acetylsalicylic acid [ASA]). There was no standardized dosing protocol, with respondents using ASA 325 mg once (46%) or twice daily (26%) or ASA 81 mg once (18%) or twice (10%) daily. The most common reason for not including chemical prophylaxis within the reconstruction procedure was that it is unnecessary given the low risk of VTE. Physicians also based their prophylaxis regimen more on their own clinical experience than concern for litigation. Half of all sports medicine fellowship-trained surgeons surveyed routinely use chemical VTE prophylaxis after ACL reconstruction, with more than 90% of those using ASA. Of those using ASA, there was no prevailing dosing protocol. For those not using chemical prophylaxis, the most important reason was that it was felt to be unnecessary due to the risks outweighing the benefits. Those who do not regularly use chemical prophylaxis would be willing to, however, if a patient had a personal or family history of clotting disorder or is currently on birth control. Additionally, clinical experience was the primary driver for a current prophylaxis protocol. This survey study evaluating the use of VTE prophylaxis with ACL reconstruction lends clinical insight to the current practice of a large, geographically diverse group of fellowship-trained sports medicine orthopaedic surgeons in the United States.

Evaluation of Military Trauma System Practices Related to Complications After Injury

DTIC Science & Technology

2012-01-01

and ventilator- associated pneumonia (VAP).3Y5 This current analysis illustrates three key examples of trauma system PI initiatives related to...the Abbreviated Injury Scale (AIS) body re- gion of 7 (upper extremity) or 8 (lower extremity). Compartment syndrome patients were identified in the...queried met the inclusion criteria for the VAP evaluation study. Of the total study popu- lation, 1.7% of patients (n = 107) acquired VAP, whereas

Current beliefs and practice patterns among urologists regarding prostate magnetic resonance imaging and magnetic resonance-targeted biopsy.

PubMed

Muthigi, Akhil; Sidana, Abhinav; George, Arvin K; Kongnyuy, Michael; Maruf, Mahir; Valayil, Subin; Wood, Bradford J; Pinto, Peter A

2017-01-01

Multiparametric magnetic resonance imaging (MRI) and magnetic resonance (MR) -targeted biopsy have a growing role in the screening and evaluation of prostate cancer. We aim to evaluate the current knowledge, attitude, and practice patterns of urologists regarding this new technique. An anonymous online questionnaire was designed to collect information on urologists' beliefs and use of prostate multiparametric MRI and MR-targeted biopsy. The survey was sent to members of the Society of Urologic Oncology, the Endourological Society, and European Association of Urology. Multivariate logistic regression analysis was performed to determine predictors for use of prostate MRI and MR-targeted biopsy. A total of 302 responses were received (Endourological Society: 175, European Association of Urology: 23, and Society of Urologic Oncology: 104). Most respondents (83.6%) believe MR-targeted biopsy to be moderately to extremely beneficial in the evaluation of prostate cancer. Overall, 85.7% of responders use prostate MRI in their practice, and 63.0% use MR-targeted biopsy. The 2 most common settings for use of MR-targeted biopsy include patients with history of prior negative biopsy result (96.3%) and monitoring patients on active surveillance (72.5%). In those who do not use MR-targeted biopsy, the principal reasons were lack of necessary infrastructure (64.1%) and prohibitive costs (48.1%). On multivariate logistic regression analysis, practice in an academic setting (1.86 [1.02-3.40], P = 0.043) and performing greater than 25 radical prostatectomies per year (2.32 [1.18-4.56], P = 0.015) remained independent predictors for using MR-targeted biopsy. Most respondents of our survey look favorably on use of prostate MRI and MR-targeted biopsy in clinical practice. Over time, reduction in fixed costs and easier access to equipment may lead to further dissemination of this novel and potentially transformative technology. Published by Elsevier Inc.

Improving opioid safety practices in primary care: protocol for the development and evaluation of a multifaceted, theory-informed pilot intervention for healthcare providers

PubMed Central

Leece, Pamela; Buchman, Daniel Z; Hamilton, Michael; Timmings, Caitlyn; Shantharam, Yalnee; Moore, Julia; Furlan, Andrea D

2017-01-01

Introduction In North America, drug overdose deaths are reaching unprecedented levels, largely driven by increasing prescription opioid-related deaths. Despite the development of several opioid guidelines, prescribing behaviours still contribute to poor patient outcomes and societal harm. Factors at the provider and system level may hinder or facilitate the application of evidence-based guidelines; interventions designed to address such factors are needed. Methods and analysis Using implementation science and behaviour change theory, we have planned the development and evaluation of a comprehensive Opioid Self-Assessment Package, designed to increase adherence to the Canadian Opioid Guideline among family physicians. The intervention uses practical educational and self-assessment tools to provide prescribers with feedback on their current knowledge and practices, and resources to improve their practice. The evaluation approach uses a pretest and post-test design and includes both quantitative and qualitative methods at baseline and 6 months. We will recruit a purposive sample of approximately 10 family physicians in Ontario from diverse practice settings, who currently treat patients with long-term opioid therapy for chronic pain. Quantitative data will be analysed using basic descriptive statistics, and qualitative data will be analysed using the Framework Method. Ethics and dissemination The University Health Network Research Ethics Board approved this study. Dissemination plan includes publications, conference presentations and brief stakeholder reports. This evidence-informed, theory-driven intervention has implications for national application of opioid quality improvement tools in primary care settings. We are engaging experts and end users in advisory and stakeholder roles throughout our project to increase its national relevance, application and sustainability. The performance measures could be used as the basis for health system quality improvement indicators to monitor opioid prescribing. Additionally, the methods and approach used in this study could be adapted for other opioid guidelines, or applied to other areas of preventive healthcare and clinical guideline implementation processes. PMID:28446522

Rehabilitation technologies and interventions for individuals with spinal cord injury: translational potential of current trends.

PubMed

Musselman, Kristin E; Shah, Meeral; Zariffa, José

2018-05-16

In the past, neurorehabilitation for individuals with neurological damage, such as spinal cord injury (SCI), was focused on learning compensatory movements to regain function. Presently, the focus of neurorehabilitation has shifted to functional neurorecovery, or the restoration of function through repetitive movement training of the affected limbs. Technologies, such as robotic devices and electrical stimulation, are being developed to facilitate repetitive motor training; however, their implementation into mainstream clinical practice has not been realized. In this commentary, we examined how current SCI rehabilitation research aligns with the potential for clinical implementation. We completed an environmental scan of studies in progress that investigate a physical intervention promoting functional neurorecovery. We identified emerging interventions among the SCI population, and evaluated the strengths and gaps of the current direction of SCI rehabilitation research. Seventy-three study postings were retrieved through website and database searching. Study objectives, outcome measures, participant characteristics and the mode(s) of intervention being studied were extracted from the postings. The FAME (Feasibility, Appropriateness, Meaningfulness, Effectiveness, Economic Evidence) Framework was used to evaluate the strengths and gaps of the research with respect to likelihood of clinical implementation. Strengths included aspects of Feasibility, as the research was practical, aspects of Appropriateness as the research aligned with current scientific literature on motor learning, and Effectiveness, as all trials aimed to evaluate the effect of an intervention on a clinical outcome. Aspects of Feasibility were also identified as a gap; with two thirds of the studies examining emerging technologies, the likelihood of successful clinical implementation was questionable. As the interventions being studied may not align with the preferences of clinicians and priorities of patients, the Appropriateness of these interventions for the current health care environment was questioned. Meaningfulness and Economic Evidence were also identified as gaps since few studies included measures reflecting the perceptions of the participants or economic factors, respectively. The identified gaps will likely impede the clinical uptake of many of the interventions currently being studied. Future research may lessen these gaps through a staged approach to the consideration of the FAME elements as novel interventions and technologies are developed, evaluated and implemented.

Application of theory to enhance audit and feedback interventions to increase the uptake of evidence-based transfusion practice: an intervention development protocol.

PubMed

Gould, Natalie J; Lorencatto, Fabiana; Stanworth, Simon J; Michie, Susan; Prior, Maria E; Glidewell, Liz; Grimshaw, Jeremy M; Francis, Jill J

2014-07-29

Audits of blood transfusion demonstrate around 20% transfusions are outside national recommendations and guidelines. Audit and feedback is a widely used quality improvement intervention but effects on clinical practice are variable, suggesting potential for enhancement. Behavioural theory, theoretical frameworks of behaviour change and behaviour change techniques provide systematic processes to enhance intervention. This study is part of a larger programme of work to promote the uptake of evidence-based transfusion practice. The objectives of this study are to design two theoretically enhanced audit and feedback interventions; one focused on content and one on delivery, and investigate the feasibility and acceptability. Study A (Content): A coding framework based on current evidence regarding audit and feedback, and behaviour change theory and frameworks will be developed and applied as part of a structured content analysis to specify the key components of existing feedback documents. Prototype feedback documents with enhanced content and also a protocol, describing principles for enhancing feedback content, will be developed. Study B (Delivery): Individual semi-structured interviews with healthcare professionals and observations of team meetings in four hospitals will be used to specify, and identify views about, current audit and feedback practice. Interviews will be based on a topic guide developed using the Theoretical Domains Framework and the Consolidated Framework for Implementation Research. Analysis of transcripts based on these frameworks will form the evidence base for developing a protocol describing an enhanced intervention that focuses on feedback delivery. Study C (Feasibility and Acceptability): Enhanced interventions will be piloted in four hospitals. Semi-structured interviews, questionnaires and observations will be used to assess feasibility and acceptability. This intervention development work reflects the UK Medical Research Council's guidance on development of complex interventions, which emphasises the importance of a robust theoretical basis for intervention design and recommends systematic assessment of feasibility and acceptability prior to taking interventions to evaluation in a full-scale randomised study. The work-up includes specification of current practice so that, in the trials to be conducted later in this programme, there will be a clear distinction between the control (usual practice) conditions and the interventions to be evaluated.

Coding for urologic office procedures.

PubMed

Dowling, Robert A; Painter, Mark

2013-11-01

This article summarizes current best practices for documenting, coding, and billing common office-based urologic procedures. Topics covered include general principles, basic and advanced urologic coding, creation of medical records that support compliant coding practices, bundled codes and unbundling, global periods, modifiers for procedure codes, when to bill for evaluation and management services during the same visit, coding for supplies, and laboratory and radiology procedures pertinent to urology practice. Detailed information is included for the most common urology office procedures, and suggested resources and references are provided. This information is of value to physicians, office managers, and their coding staff. Copyright © 2013 Elsevier Inc. All rights reserved.

Evidence-Based Biosafety: a Review of the Principles and Effectiveness of Microbiological Containment Measures

PubMed Central

Kimman, Tjeerd G.; Smit, Eric; Klein, Michèl R.

2008-01-01

We examined the available evidence on the effectiveness of measures aimed at protecting humans and the environment against the risks of working with genetically modified microorganisms (GMOs) and with non-GMO pathogenic microorganisms. A few principles and methods underlie the current biosafety practice: risk assessment, biological containment, concentration and enclosure, exposure minimization, physical containment, and hazard minimization. Many of the current practices are based on experience and expert judgment. The effectiveness of biosafety measures may be evaluated at the level of single containment equipment items and procedures, at the level of the laboratory as a whole, or at the clinical-epidemiological level. Data on the containment effectiveness of equipment and laboratories are scarce and fragmented. Laboratory-acquired infections (LAIs) are therefore important for evaluating the effectiveness of biosafety. For the majority of LAIs there appears to be no direct cause, suggesting that failures of biosafety were not noticed or that containment may have been insufficient. The number of reported laboratory accidents associated with GMOs is substantially lower than that of those associated with non-GMOs. It is unknown to what extent specific measures contribute to the overall level of biosafety. We therefore recommend that the evidence base of biosafety practice be strengthened. PMID:18625678

Evidence-based biosafety: a review of the principles and effectiveness of microbiological containment measures.

PubMed

Kimman, Tjeerd G; Smit, Eric; Klein, Michèl R

2008-07-01

We examined the available evidence on the effectiveness of measures aimed at protecting humans and the environment against the risks of working with genetically modified microorganisms (GMOs) and with non-GMO pathogenic microorganisms. A few principles and methods underlie the current biosafety practice: risk assessment, biological containment, concentration and enclosure, exposure minimization, physical containment, and hazard minimization. Many of the current practices are based on experience and expert judgment. The effectiveness of biosafety measures may be evaluated at the level of single containment equipment items and procedures, at the level of the laboratory as a whole, or at the clinical-epidemiological level. Data on the containment effectiveness of equipment and laboratories are scarce and fragmented. Laboratory-acquired infections (LAIs) are therefore important for evaluating the effectiveness of biosafety. For the majority of LAIs there appears to be no direct cause, suggesting that failures of biosafety were not noticed or that containment may have been insufficient. The number of reported laboratory accidents associated with GMOs is substantially lower than that of those associated with non-GMOs. It is unknown to what extent specific measures contribute to the overall level of biosafety. We therefore recommend that the evidence base of biosafety practice be strengthened.

Transmasculine People's Voice Function: A Review of the Currently Available Evidence.

PubMed

Azul, David; Nygren, Ulrika; Södersten, Maria; Neuschaefer-Rube, Christiane

2017-03-01

This study aims to evaluate the currently available discursive and empirical data relating to those aspects of transmasculine people's vocal situations that are not primarily gender-related, to identify restrictions to voice function that have been observed in this population, and to make suggestions for future voice research and clinical practice. We conducted a comprehensive review of the voice literature. Publications were identified by searching six electronic databases and bibliographies of relevant articles. Twenty-two publications met inclusion criteria. Discourses and empirical data were analyzed for factors and practices that impact on voice function and for indications of voice function-related problems in transmasculine people. The quality of the evidence was appraised. The extent and quality of studies investigating transmasculine people's voice function was found to be limited. There was mixed evidence to suggest that transmasculine people might experience restrictions to a range of domains of voice function, including vocal power, vocal control/stability, glottal function, pitch range/variability, vocal endurance, and voice quality. More research into the different factors and practices affecting transmasculine people's voice function that takes account of a range of parameters of voice function and considers participants' self-evaluations is needed to establish how functional voice production can be best supported in this population. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Employee absenteeism measures reflecting current work practices may be instrumental in a re-evaluation of the relationship between psychological distress/mental health and absenteeism.

PubMed

Hilton, Michael F; Sheridan, Judith; Cleary, Catherine M; Whiteford, Harvey A

2009-01-01

Absenteeism rates are the cornerstone metrics guiding corporate policy for health care investment in employees. However, traditional absenteeism measures do not reflect the contemporary workplace milieu. It is accepted practice that employees work evenings or weekends to makeup time. Using a hours-based absenteeism measure, that accounts for time made-up as well as time lost, this paper evaluates the impact of psychological distress on employee absenteeism.Psychological distress and absenteeism data were collected from 54,264 full-time employees. Consistent with traditional approaches, employees indicated how many days they were absent. Hours based absenteeism was formulated from the ratio of how many hours the employees worked and how many hours were they expected to work in the past seven-days.Concordant with previous concinnous evidence, traditional absenteeism computation indicated that elevated psychological distress is associated with increasing absenteeism. Using the hours-based method psychological distress did not significantly influence absenteeism.Traditional calculations of absenteeism do not reflect the current work practices of the majority of employees. Employees with psychological distress may take time off work but it appears that they make up for lost time possibly to stay up to speed with task driven occupations and avoid performance review.

Evidence and resources to implement Pharmacogenetic Knowledge for Precision Medicine

PubMed Central

Caudle, Kelly E.; Gammal, Roseann S.; Whirl-Carrillo, Michelle; Hoffman, James M.; Relling, Mary V.; Klein, Teri E.

2016-01-01

Purpose Implementation of pharmacogenetics into clinical practice has been relatively slow despite substantial scientific progress over the last decade. One barrier that inhibits uptake of pharmacogenetics into routine clinical practice is the lack of knowledge of how to translate a genetic test into a clinical action based on current evidence. The purpose of this paper is to describe the current state of pharmacogenetic evidence and evidence-based resources that facilitate the uptake of pharmacogenetics into clinical practice. Summary Controversy exists over the required evidence threshold needed for routine clinical implementation of pharmacogenetics. Large randomized controlled trials are not clinically feasible or necessary for many pharmacogenetic applications. Online resources exist like the Clinical Pharmacogenetics Implementation Consortium (CPIC) and the Pharmacogenomics Knowledgebase (PharmGKB) that provide freely available, evidence-based resources that facilitate the translation of genetic laboratory test results into actionable prescribing recommendations for specific drugs. Conclusion Resources provided by organizations such as CPIC and PharmGKB that use standardized approaches to evaluate the literature and provide clinical guidance are essential for the implementation of pharmacogenetics into routine clinical practice. PMID:27864205

Toward Mixed Method Evaluations of Scientific Visualizations and Design Process as an Evaluation Tool.

PubMed

Jackson, Bret; Coffey, Dane; Thorson, Lauren; Schroeder, David; Ellingson, Arin M; Nuckley, David J; Keefe, Daniel F

2012-10-01

In this position paper we discuss successes and limitations of current evaluation strategies for scientific visualizations and argue for embracing a mixed methods strategy of evaluation. The most novel contribution of the approach that we advocate is a new emphasis on employing design processes as practiced in related fields (e.g., graphic design, illustration, architecture) as a formalized mode of evaluation for data visualizations. To motivate this position we describe a series of recent evaluations of scientific visualization interfaces and computer graphics strategies conducted within our research group. Complementing these more traditional evaluations our visualization research group also regularly employs sketching, critique, and other design methods that have been formalized over years of practice in design fields. Our experience has convinced us that these activities are invaluable, often providing much more detailed evaluative feedback about our visualization systems than that obtained via more traditional user studies and the like. We believe that if design-based evaluation methodologies (e.g., ideation, sketching, critique) can be taught and embraced within the visualization community then these may become one of the most effective future strategies for both formative and summative evaluations.

Toward Mixed Method Evaluations of Scientific Visualizations and Design Process as an Evaluation Tool

PubMed Central

Jackson, Bret; Coffey, Dane; Thorson, Lauren; Schroeder, David; Ellingson, Arin M.; Nuckley, David J.

2017-01-01

In this position paper we discuss successes and limitations of current evaluation strategies for scientific visualizations and argue for embracing a mixed methods strategy of evaluation. The most novel contribution of the approach that we advocate is a new emphasis on employing design processes as practiced in related fields (e.g., graphic design, illustration, architecture) as a formalized mode of evaluation for data visualizations. To motivate this position we describe a series of recent evaluations of scientific visualization interfaces and computer graphics strategies conducted within our research group. Complementing these more traditional evaluations our visualization research group also regularly employs sketching, critique, and other design methods that have been formalized over years of practice in design fields. Our experience has convinced us that these activities are invaluable, often providing much more detailed evaluative feedback about our visualization systems than that obtained via more traditional user studies and the like. We believe that if design-based evaluation methodologies (e.g., ideation, sketching, critique) can be taught and embraced within the visualization community then these may become one of the most effective future strategies for both formative and summative evaluations. PMID:28944349

The path to impact of operational research on tuberculosis control policies and practices in Indonesia

PubMed Central

Probandari, Ari; Widjanarko, Bagoes; Mahendradhata, Yodi; Sanjoto, Hary; Cerisha, Ancila; Nungky, Saverina; Riono, Pandu; Simon, Sumanto; Farid, Muhammad Noor; Giriputra, Sardikin; Putra, Artawan Eka; Burhan, Erlina; Wahyuni, Chatarina U.; Mustikawati, Dyah; Widianingrum, Christina; Tiemersma, Edine W.; Alisjahbana, Bachti

2016-01-01

Background Operational research is currently one of the pillars of the global strategy to control tuberculosis. Indonesia initiated capacity building for operational research on tuberculosis over the last decade. Although publication of the research in peer-reviewed journals is an important indicator for measuring the success of this endeavor, the influence of operational research on policy and practices is considered even more important. However, little is known about the process by which operational research influences tuberculosis control policy and practices. Objective We aimed to investigate the influence of operational research on tuberculosis control policy and practice in Indonesia between 2004 and 2014. Design Using a qualitative study design, we conducted in-depth interviews of 50 researchers and 30 policy makers/program managers and performed document reviews. Transcripts of these interviews were evaluated while applying content analysis. Results Operational research contributed to tuberculosis control policy and practice improvements, including development of new policies, introduction of new practices, and reinforcement of current program policies and practices. However, most of these developments had limited sustainability. The path from the dissemination of research results and recommendations to policy and practice changes was long and complex. The skills, interests, and political power of researchers and policy makers, as well as health system response, could influence the process. Conclusions Operational research contributed to improving tuberculosis control policy and practices. A systematic approach to improve the sustainability of the impact of operational research should be explored. PMID:26928217

The path to impact of operational research on tuberculosis control policies and practices in Indonesia.

PubMed

Probandari, Ari; Widjanarko, Bagoes; Mahendradhata, Yodi; Sanjoto, Hary; Cerisha, Ancila; Nungky, Saverina; Riono, Pandu; Simon, Sumanto; Farid, Muhammad Noor; Giriputra, Sardikin; Putra, Artawan Eka; Burhan, Erlina; Wahyuni, Chatarina U; Mustikawati, Dyah; Widianingrum, Christina; Tiemersma, Edine W; Alisjahbana, Bachti

2016-01-01

Operational research is currently one of the pillars of the global strategy to control tuberculosis. Indonesia initiated capacity building for operational research on tuberculosis over the last decade. Although publication of the research in peer-reviewed journals is an important indicator for measuring the success of this endeavor, the influence of operational research on policy and practices is considered even more important. However, little is known about the process by which operational research influences tuberculosis control policy and practices. We aimed to investigate the influence of operational research on tuberculosis control policy and practice in Indonesia between 2004 and 2014. Using a qualitative study design, we conducted in-depth interviews of 50 researchers and 30 policy makers/program managers and performed document reviews. Transcripts of these interviews were evaluated while applying content analysis. Operational research contributed to tuberculosis control policy and practice improvements, including development of new policies, introduction of new practices, and reinforcement of current program policies and practices. However, most of these developments had limited sustainability. The path from the dissemination of research results and recommendations to policy and practice changes was long and complex. The skills, interests, and political power of researchers and policy makers, as well as health system response, could influence the process. Operational research contributed to improving tuberculosis control policy and practices. A systematic approach to improve the sustainability of the impact of operational research should be explored.

The West Virginia Occupational Safety and Health Initiative: practicum training for a new marketplace.

PubMed

Meyer, J D; Becker, P E; Stockdale, T; Ducatman, A M

1999-05-01

Occupational medicine practice has experienced a shift from larger corporate medical departments to organizations providing services for a variety of industries. Specific training needs will accompany this shift in practice patterns; these may differ from those developed in the traditional industrial or corporate medical department setting. The West Virginia Occupational Health and Safety Initiative involves occupational medicine residents in consultation to a variety of small industries and businesses. It uses the expertise of occupational physicians, health and safety extension faculty, and faculty in engineering and industrial hygiene. Residents participate in multidisciplinary evaluations of worksites, and develop competencies in team-building, workplace health and safety evaluation, and occupational medical consulting. Specific competencies that address requirements for practicum training are used to measure the trainee's acquisition of knowledge and skills. Particular attention is paid to the acquisition of group problem-solving expertise, skills relevant to the current market in practice opportunities, and the specific career interests of the resident physician. Preliminary evaluation indicates the usefulness of training in evaluation of diverse industries and worksites. We offer this program as a training model that can prepare residents for the challenges of a changing marketplace for occupational health and safety services.

Prioritizing guideline topics: development and evaluation of a practical tool.

PubMed

Ketola, Eeva; Toropainen, Erja; Kaila, Minna; Luoto, Riitta; Mäkelä, Marjukka

2007-08-01

A clear process for selecting and adopting clinical practice guidelines in the new topic areas is needed. The aim of this study is to design and develop a practical tool to assess guideline topics that have been suggested to the organization responsible for producing guidelines. We carried out an iterative development, feasibility and validation study of a guideline topic prioritization tool. The setting included the guideline producer organization and the tax-funded health care system. In the first stage of the tool development, participants were researchers, members of the Current Care Board and experts from health care organizations. In the second stage, the evaluation was done internally within the project by three independent reviewers. The main outcome measures were responses to an evaluation questionnaire, qualitative process feedback and analysis of the performance of the instrument on a random set of guidelines. Evaluations by three independent reviewers revealed good agreement and face validity with respect to its feasibility as a planning tool at the guideline board level. Feedback from board members suggested that the instrument is useful in prioritizing guideline topics. This instrument was accepted for use by the Board. Further developments are needed to ensure feedback and acceptability of the instrument by those proposing topics.

Common Practice Lightning Strike Protection Characterization Technique to Quantify Damage Mechanisms on Composite Substrates

NASA Technical Reports Server (NTRS)

Szatkowski, George N.; Dudley, Kenneth L.; Koppen, Sandra V.; Ely, Jay J.; Nguyen, Truong X.; Ticatch, Larry A.; Mielnik, John J.; Mcneill, Patrick A.

2013-01-01

To support FAA certification airworthiness standards, composite substrates are subjected to lightning direct-effect electrical waveforms to determine performance characteristics of the lightning strike protection (LSP) conductive layers used to protect composite substrates. Test results collected from independent LSP studies are often incomparable due to variability in test procedures & applied practices at different organizations, which impairs performance correlations between different LSP data sets. Under a NASA supported contract, The Boeing Company developed technical procedures and documentation as guidance in order to facilitate a test method for conducting universal common practice lightning strike protection test procedures. The procedures obtain conformity in future lightning strike protection evaluations to allow meaningful performance correlations across data sets. This universal common practice guidance provides the manufacturing specifications to fabricate carbon fiber reinforced plastic (CFRP) test panels, including finish, grounding configuration, and acceptable methods for pretest nondestructive inspection (NDI) and posttest destructive inspection. The test operations guidance elaborates on the provisions contained in SAE ARP5416 to address inconsistencies in the generation of damage protection performance data, so as to provide for maximum achievable correlation across capable lab facilities. In addition, the guidance details a direct effects test bed design to aid in quantification of the multi-physical phenomena surrounding a lightning direct attachment supporting validation data requirements for the development of predictive computational modeling. The lightning test bed is designed to accommodate a repeatable installation procedure to secure the test panel and eliminate test installation uncertainty. It also facilitates a means to capture the electrical waveform parameters in 2 dimensions, along with the mechanical displacement and thermal heating parameters which occur during lightning attachment. Following guidance defined in the universal common practice LSP test documents, protected and unprotected CFRP panels were evaluated at 20, 40 and 100KAmps. This report presents analyzed data demonstrating the scientific usefulness of the common practice approach. Descriptions of the common practice CFRP test articles, LSP test bed fixture, and monitoring techniques to capture the electrical, mechanical and thermal parameters during lightning attachment are presented here. Two methods of measuring the electrical currents were evaluated, inductive current probes and a newly developed fiberoptic sensor. Two mechanical displacement methods were also examined, optical laser measurement sensors and a digital imaging correlation camera system. Recommendations are provided to help users implement the common practice test approach and obtain LSP test characterizations comparable across data sets.

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

Outcome measures in European patients with haemophilia: Survey of implementation in routine clinical practice, perception of relevance and recommendations by European treaters in the EHTSB.

PubMed

Hermans, C; Klamroth, R; Richards, M; de Moerloose, P; Garrido, R P

2017-03-01

This study was conducted to evaluate the current implementation of outcome measures in routine clinical haemophilia practice and to explore and appreciate the perception of the relevance of such measures by treaters. A survey was completed by 19 of the 26 physicians involved in the European Haemophilia Therapy Strategy Board (EHTSB). Employing an extensive inventory of outcome measures used in patients with haemophilia, information was collected about the frequency of data collection and the subjective appreciation of their importance during clinic review. The survey revealed that most treaters currently collect data that are mainly related to the haemostatic treatment (consumption of concentrates) and the bleeding symptoms (number and location of bleeds) in a non-uniform and non-standardized way. By contrast, functional, physical and quality of life scorings are rarely used and show considerable heterogeneity between treaters. Also, many disparities emerged between practice and perception, in particular quality of life data that are perceived as being important but for most of the time are not collected. This survey represents, in our view, the first attempt to evaluate the actual utilization of outcome measures in haemophilia care. While the value of outcome measures is appreciated, they are not assessed regularly. Therefore, there is a need to include appropriate performance indicators (outcome measures) of haemophilia care in routine clinical practice. Consensus recommendations to provide a framework for achieving this aim are provided. © 2016 John Wiley & Sons Ltd.

Using modular psychotherapy in school mental health: Provider perspectives on intervention-setting fit

PubMed Central

Lyon, Aaron R.; Ludwig, Kristy; Romano, Evalynn; Koltracht, Jane; Stoep, Ann Vander; McCauley, Elizabeth

2013-01-01

Objective The “fit” or appropriateness of well-researched interventions within usual care contexts is among the most commonly-cited, but infrequently researched, factors in the successful implementation of new practices. The current study was initiated to address two exploratory research questions: (1) How do clinicians describe their current school mental health service delivery context? and (2) How do clinicians describe the fit between modular psychotherapy and multiple levels of the school mental health service delivery context? Method Following a year-long training and consultation program in an evidence-based, modular approach to psychotherapy, semi-structured qualitative interviews were conducted with seventeen school-based mental health providers to evaluate their perspectives on the appropriateness of implementing the approach within a system of school-based health centers. Interviews were transcribed and coded for themes using conventional and directed content analysis. Results Findings identified key elements of the school mental health context including characteristics of the clinicians, their practices, the school context, and the service recipients. Specific evaluation of intervention-setting appropriateness elicited many comments about both practical and value-based (e.g., cultural considerations) aspects at the clinician and client levels, but fewer comments at the school or organizational levels. Conclusions Results suggest that a modular approach may fit well with the school mental health service context, especially along practical aspects of appropriateness. Future research focused on the development of methods for routinely assessing appropriateness at different stages of the implementation process is recommended. PMID:24134063

Performance management in healthcare: a critical analysis.

PubMed

Hewko, Sarah J; Cummings, Greta G

2016-01-01

Purpose - The purpose of this paper is to explore the underlying theoretical assumptions and implications of current micro-level performance management and evaluation (PME) practices, specifically within health-care organizations. PME encompasses all activities that are designed and conducted to align employee outputs with organizational goals. Design/methodology/approach - PME, in the context of healthcare, is analyzed through the lens of critical theory. Specifically, Habermas' theory of communicative action is used to highlight some of the questions that arise in looking critically at PME. To provide a richer definition of key theoretical concepts, the authors conducted a preliminary, exploratory hermeneutic semantic analysis of the key words "performance" and "management" and of the term "performance management". Findings - Analysis reveals that existing micro-level PME systems in health-care organizations have the potential to create a workforce that is compliant, dependent, technically oriented and passive, and to support health-care systems in which inequalities and power imbalances are perpetually reinforced. Practical implications - At a time when the health-care system is under increasing pressure to provide high-quality, affordable services with fewer resources, it may be wise to investigate new sector-specific ways of evaluating and managing performance. Originality/value - In this paper, written for health-care leaders and health human resource specialists, the theoretical assumptions and implications of current PME practices within health-care organizations are explored. It is hoped that readers will be inspired to support innovative PME practices within their organizations that encourage peak performance among health-care professionals.

Quantitative Evaluation of Performance in Interventional Neuroradiology: An Integrated Curriculum Featuring Theoretical and Practical Challenges.

PubMed

Ernst, Marielle; Kriston, Levente; Romero, Javier M; Frölich, Andreas M; Jansen, Olav; Fiehler, Jens; Buhk, Jan-Hendrik

2016-01-01

We sought to develop a standardized curriculum capable of assessing key competencies in Interventional Neuroradiology by the use of models and simulators in an objective, quantitative, and efficient way. In this evaluation we analyzed the associations between the practical experience, theoretical knowledge, and the skills lab performance of interventionalists. We evaluated the endovascular skills of 26 participants of the Advanced Course in Endovascular Interventional Neuroradiology of the European Society of Neuroradiology with a set of three tasks (aneurysm coiling and thrombectomy in a virtual simulator and placement of an intra-aneurysmal flow disruptor in a flow model). Practical experience was assessed by a survey. Participants completed a written and oral examination to evaluate theoretical knowledge. Bivariate and multivariate analyses were performed. In multivariate analysis knowledge of materials and techniques in Interventional Neuroradiology was moderately associated with skills in aneurysm coiling and thrombectomy. Experience in mechanical thrombectomy was moderately associated with thrombectomy skills, while age was negatively associated with thrombectomy skills. We found no significant association between age, sex, or work experience and skills in aneurysm coiling. Our study gives an example of how an integrated curriculum for reasonable and cost-effective assessment of key competences of an interventional neuroradiologist could look. In addition to traditional assessment of theoretical knowledge practical skills are measured by the use of endovascular simulators yielding objective, quantitative, and constructive data for the evaluation of the current performance status of participants as well as the evolution of their technical competency over time.

Microcirculatory monitoring in septic patients: Where do we stand?

PubMed

Gruartmoner, G; Mesquida, J; Ince, C

Microcirculatory alterations play a pivotal role in sepsis-related morbidity and mortality. However, since the microcirculation has been a "black box", current hemodynamic management of septic patients is still guided by macrocirculatory parameters. In the last decades, the development of several technologies has shed some light on microcirculatory evaluation and monitoring, and the possibility of incorporating microcirculatory variables to clinical practice no longer seems to be beyond reach. The present review provides a brief summary of the current technologies for microcirculatory evaluation, and attempts to explore the potential role and benefits of their integration to the resuscitation process in critically ill septic patients. Copyright © 2016 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

Conceptual Knowledge Acquisition in Biomedicine: A Methodological Review

PubMed Central

Payne, Philip R.O.; Mendonça, Eneida A.; Johnson, Stephen B.; Starren, Justin B.

2007-01-01

The use of conceptual knowledge collections or structures within the biomedical domain is pervasive, spanning a variety of applications including controlled terminologies, semantic networks, ontologies, and database schemas. A number of theoretical constructs and practical methods or techniques support the development and evaluation of conceptual knowledge collections. This review will provide an overview of the current state of knowledge concerning conceptual knowledge acquisition, drawing from multiple contributing academic disciplines such as biomedicine, computer science, cognitive science, education, linguistics, semiotics, and psychology. In addition, multiple taxonomic approaches to the description and selection of conceptual knowledge acquisition and evaluation techniques will be proposed in order to partially address the apparent fragmentation of the current literature concerning this domain. PMID:17482521

Communication skills assessment in the final postgraduate years to established practice: a systematic review.

PubMed

Gillis, Amy E; Morris, Marie C; Ridgway, Paul F

2015-01-01

Communication breakdown is a factor in the majority of all instances of medical error. Despite the importance, a relative paucity of time is invested in communication skills in postgraduate curricula. Our objective is to systematically review the literature to identify the current tools used to assess communication skills in postgraduate trainees in the latter 2 years of training and in established practice. Two reviewers independently reviewed the literature identifying communication skill assessment tools, for postgraduate trainees in the latter 2 years of training and in established practice following Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework, and inclusion/exclusion criteria from January 1990 to 15 August 2014. PubMed/CINAHL/ERIC/EMBASE/PsycInfo/Psyc Articles/Cochrane. 222 articles were identified; after review, 34 articles fulfilled criteria for complete evaluation; the majority (26) had a high level of evidence scoring 3 or greater on the Best Evidence Medical Education guide. 22 articles used objective structured clinical examination/standardised patient (SP)-based formats in an assessment or training capacity. Evaluation tools included author-developed questionnaires and validated tools. Nineteen articles demonstrated an educational initiative. The reviewed literature is heterogeneous for objectives and measurement techniques for communication. Observed interactions, with patients or SPs, is the current favoured method of evaluation using author-developed questionnaires. The role of self-evaluation of skill level is questioned. The need for a validated assessment tool for communication skills is highlighted. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Transformational leadership training programme for charge nurses.

PubMed

Duygulu, Sergul; Kublay, Gulumser

2011-03-01

This paper is a report of an evaluation of the effects of a transformational leadership training programme on Unit Charge Nurses' leadership practices. Current healthcare regulations in the European Union and accreditation efforts of hospitals for their services mandate transformation in healthcare services in Turkey. Therefore, the transformational leadership role of nurse managers is vital in determining and achieving long-term goals in this process. The sample consisted of 30 Unit Charge Nurses with a baccalaureate degree and 151 observers at two university hospitals in Turkey. Data were collected using the Leadership Practices Inventory-Self and Observer (applied four times during a 14-month study process from December 2005 to January 2007). The transformational leadership training programme had theoretical (14 hours) and individual study (14 hours) in five sections. Means, standard deviations and percentages, repeated measure tests and two-way factor analysis were used for analysis. According the Leadership Practices Inventory-Self and Observer ratings, leadership practices increased statistically significantly with the implementation of the programme. There were no significant differences between groups in age, length of time in current job and current position. The Unit Charge Nurses Leadership Practices Inventory self-ratings were significantly higher than those of the observers. There is a need to develop similar programmes to improve the leadership skills of Unit Charge Nurses, and to make it mandatory for nurses assigned to positions of Unit Charge Nurse to attend this kind of leadership programme. © 2010 Blackwell Publishing Ltd.

Reporting and interpreting research in PSPB: practices, principles, and pragmatics.

PubMed

Kashy, Deborah A; Donnellan, M Brent; Ackerman, Robert A; Russell, Daniel W

2009-09-01

This article is designed to provide psychologists who publish articles in Personality and Social Psychology Bulletin (PSPB) with a set of basic issues to consider when reporting their analyses and results. We first assessed the current reporting practices of social and personality psychologists by conducting an analysis of PSPB articles published in the first half of 2007. We evaluated the completeness of these reports with respect to the level of detail in both the Method and Results sections. We then used this information to develop recommendations that we hope will enhance the reporting of quantitative research in social and personality psychology. These suggestions emphasize ways to increase transparency in research reports. Transparency facilitates replication and a critical evaluation of research, thereby promoting scientific progress.

Effectiveness of Current Practices for Disinfecting Medical Equipment in a Radiology Department.

PubMed

Hubble, William L; Turner, James Austin; Heuertz, Rita

2016-01-01

To evaluate the effectiveness of routine, daily disinfection practices on the control of microorganisms on nuclear medicine equipment in a radiology department. During phase 1, surface samples were collected from various sites in the nuclear medicine division of a radiology department at a single institution. These samples were transferred onto growth plates for evaluation and speciation by a clinical microbiologist. Collection sites that yielded potentially pathogenic bacteria or high numbers (> 100) of colonies of likely nonpathogenic bacteria were identified for resampling. During phase 2, secondary samples were taken at the resampling sites after disinfection. These secondary samples also were evaluated to determine the efficacy of the departmental disinfection practices on surface cleanliness. Phase 1 sampling identified 10 sites that harbored either potentially pathogenic bacteria or high numbers of likely nonpathogenic bacteria. Evaluation of postdisinfection samples indicated elimination of potentially pathogenic bacteria and reduction of likely nonpathogenic colonies. The variety of surfaces and equipment found in radiology departments can present unique challenges for effective disinfection. Porous materials and intricate imaging and peripheral devices require special consideration when designing and maintaining department cleaning policies. The disinfection practices in place at the institution were effective in reducing or eliminating bacteria; however, recolonization after cleaning was recognized as a possibility. Educating staff about the value of disinfecting contact surfaces between patients is necessary to achieve optimum sanitization in the radiology department. © 2016 American Society of Radiologic Technologists.

Fluid therapy and the hypovolemic microcirculation.

PubMed

Gruartmoner, G; Mesquida, J; Ince, Can

2015-08-01

In shock states, optimizing intravascular volume is crucial to promote an adequate oxygen delivery to the tissues. Our current practice in fluid management pivots on the Frank-Starling law of the heart, and the effects of fluids are measured according to the induced changes on stroke volume. The purpose of this review is to evaluate the boundaries of current macrohemodynamic approach to fluid administration, and to introduce the microcirculatory integration as a fundamental part of tissue perfusion monitoring. Macrocirculatory changes induced by volume expansion are not always coupled to proportional changes in microcirculatory perfusion. Loss of hemodynamic coherence limits the value of guiding fluid therapy according to macrohemodynamics, and highlights the importance of evaluating the ultimate target of volume administration, the microcirculation. Current approach to intravascular volume optimization is made from a macrohemodynamic perspective. However, several situations wherein macrocirculatory and microcirculatory coherence is lost have been described. Future clinical trials should explore the usefulness of integrating the microcirculatory evaluation in fluid optimization.

Pulmonary embolism in pediatric patients survey of CT pulmonary angiography practices and policies.

PubMed

Lee, Edward Y; Zurakowski, David; Boiselle, Phillip M

2010-12-01

To determine the current policies and practices of Society for Pediatric Radiology (SPR) members regarding the evaluation of pediatric patients with suspected pulmonary embolism (PE) with an emphasis on use of computed tomography pulmonary angiography (CTPA). Institutional review board exemption was granted for this study. Surveys were mailed electronically to the 1575 members of the SPR representing 416 institutions. Information gathered included the existence of written policies, the imaging study of choice for suspected PE, routine acquisition of chest radiographs before CTPA, currently used CTPA techniques, modifications of protocols for radiation dose reduction, typical DLP (dose-length-product) for CTPA, and estimated annual frequency of performing CTPA for evaluating PE in children. Survey items pertaining to policies and practices were compared between practice settings and populations using chi-square analysis. One hundred and sixty members representing 118 institutions responded, which resulted in a response rate of 28% (118/416), on an institutional basis. Of these 118 respondents, 104 (88%) perform CTPA in children with clinical suspicion of PE. Of the 104 respondents who perform CTPA, 26 (25%) have a written policy for CTPA, 93 (89%) perform CTPA as the first study choice, and 67 (64%) routinely obtain chest radiographs before CTPA. The most commonly used CTPA techniques in children with clinical suspicion of PE include intravenous contrast amount of 2 mL/kg, mechanical injection of intravenous contrast, and tailored bolus tracking method for CTPA scan initiation by observing the Hounsfield units of contrast in the central pulmonary artery on the monitoring scan. Sixty respondents (58%) modify CTPA imaging protocols for evaluating PE in children in order to decrease radiation dose. The two most common modifications for radiation dose reduction were reduced mAs in 41 (68%) and automatic exposure control in 38 (63%). The majority of respondents (88%) did not know the typical DLP for a 20-kg child during CTPA study performed to evaluate for PE. A significantly greater percentage of radiation dose-reduction techniques are performed within academic institutions compared with private institutions (P = .03). Most survey respondents perform CTPA as the study of choice for evaluating PE in children, but there is considerable variability in their policies and practices. Respondents from academic medical centers are more likely to employ radiation dose-reduction techniques for CTPA than those in private practice settings. Copyright © 2010 AUR. Published by Elsevier Inc. All rights reserved.

Communication strategies in acute health care: evaluation within the context of infection prevention and control.

PubMed

Edwards, R; Sevdalis, N; Vincent, C; Holmes, A

2012-09-01

Communication in healthcare settings has recently received significant attention in the literature. However, there continues to be a large gap in current understanding of the effectiveness of different communication channels used in acute healthcare settings, particularly in the context of infection prevention and control (IPC). To explore and evaluate the main communication channels used within hospitals to communicate with healthcare workers (HCWs) and to propose practical recommendations. Critical review of the main communication channels used within acute health care to communicate information to HCWs, and analysis of their impact on practice. The analysis covers verbal communications, standardization via guidelines, education and training, electronic communications and marketing strategies. Traditional communication channels have not been successful in changing and sustaining best practice in IPC, but newer approaches (electronic messages and marketing) also have pitfalls. A few simple recommendations are made in relation to the development, implementation and evaluation of communications to HCWs; top-down vs bottom-up communications; and the involvement of HCWs, particularly ward personnel. Copyright © 2012 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Forecasting biodiversity in breeding birds using best practices

PubMed Central

Taylor, Shawn D.; White, Ethan P.

2018-01-01

Biodiversity forecasts are important for conservation, management, and evaluating how well current models characterize natural systems. While the number of forecasts for biodiversity is increasing, there is little information available on how well these forecasts work. Most biodiversity forecasts are not evaluated to determine how well they predict future diversity, fail to account for uncertainty, and do not use time-series data that captures the actual dynamics being studied. We addressed these limitations by using best practices to explore our ability to forecast the species richness of breeding birds in North America. We used hindcasting to evaluate six different modeling approaches for predicting richness. Hindcasts for each method were evaluated annually for a decade at 1,237 sites distributed throughout the continental United States. All models explained more than 50% of the variance in richness, but none of them consistently outperformed a baseline model that predicted constant richness at each site. The best practices implemented in this study directly influenced the forecasts and evaluations. Stacked species distribution models and “naive” forecasts produced poor estimates of uncertainty and accounting for this resulted in these models dropping in the relative performance compared to other models. Accounting for observer effects improved model performance overall, but also changed the rank ordering of models because it did not improve the accuracy of the “naive” model. Considering the forecast horizon revealed that the prediction accuracy decreased across all models as the time horizon of the forecast increased. To facilitate the rapid improvement of biodiversity forecasts, we emphasize the value of specific best practices in making forecasts and evaluating forecasting methods. PMID:29441230

Protocol for the New Medicine Service Study: a randomized controlled trial and economic evaluation with qualitative appraisal comparing the effectiveness and cost effectiveness of the New Medicine Service in community pharmacies in England

PubMed Central

2013-01-01

Background Medication non-adherence is considered an important cause of morbidity and mortality in primary care. This study aims to determine the effectiveness, cost effectiveness and acceptability of a complex intervention delivered by community pharmacists, the New Medicine Service (NMS), compared with current practice in reducing non-adherence to, and problems with, newly prescribed medicines for chronic conditions. Methods/design Research subject group: patients aged 14 years and above presenting in a community pharmacy for a newly prescribed medicine for asthma/chronic obstructive pulmonary disease (COPD); hypertension; type 2 diabetes or anticoagulant/antiplatelet agents in two geographical regions in England. Design: parallel group patient-level pragmatic randomized controlled trial. Interventions: patients randomized to either: (i) current practice; or (ii) NMS intervention comprising pharmacist-delivered support for a newly prescribed medicine. Primary outcomes: proportion of adherent patients at six, ten and 26 weeks from the date of presenting their prescriptions at the pharmacy; cost effectiveness of the intervention versus current practice at 10 weeks and 26 weeks; in-depth qualitative understanding of the operationalization of NMS in pharmacies. Secondary outcomes: impact of NMS on: patients’ understanding of their medicines, pharmacovigilance, interprofessional and patient-professional relationships and experiences of service users and stakeholders. Economic analysis: Trial-based economic analysis (cost per extra adherent patient) and long-term modeling of costs and health effects (cost per quality-adjusted-life-year) will be conducted from the perspective of National Health Service (NHS) England, comparing NMS with current practice. Qualitative analysis: a qualitative study of NMS implementation in different community settings, how organizational influences affect NMS delivery, patterns of NMS consultations and experiences of professionals and patients participating in NMS, and patients receiving current practice. Sample size: 250 patients in each treatment arm would provide at least 80% power (two-tailed alpha of 0.05) to demonstrate a reduction in patient-reported non-adherence from 20% to 10% in the NMS arm compared with current practice, assuming a 20% drop-out rate. Discussion At the time of submission of this article, 58 community pharmacies have been recruited and the interventions are being delivered. Analysis has not yet been undertaken. Trial registration Current controlled trials: ISRCTN23560818 Clinical Trials US (clinicaltrials.gov): NCT01635361 PMID:24289059

Protocol for the New Medicine Service Study: a randomized controlled trial and economic evaluation with qualitative appraisal comparing the effectiveness and cost effectiveness of the New Medicine Service in community pharmacies in England.

PubMed

Boyd, Matthew; Waring, Justin; Barber, Nick; Mehta, Rajnikant; Chuter, Antony; Avery, Anthony J; Salema, Nde-Eshimuni; Davies, James; Latif, Asam; Tanajewski, Lukasz; Elliott, Rachel A

2013-12-01

Medication non-adherence is considered an important cause of morbidity and mortality in primary care. This study aims to determine the effectiveness, cost effectiveness and acceptability of a complex intervention delivered by community pharmacists, the New Medicine Service (NMS), compared with current practice in reducing non-adherence to, and problems with, newly prescribed medicines for chronic conditions. Research subject group: patients aged 14 years and above presenting in a community pharmacy for a newly prescribed medicine for asthma/chronic obstructive pulmonary disease (COPD); hypertension; type 2 diabetes or anticoagulant/antiplatelet agents in two geographical regions in England. parallel group patient-level pragmatic randomized controlled trial. patients randomized to either: (i) current practice; or (ii) NMS intervention comprising pharmacist-delivered support for a newly prescribed medicine. proportion of adherent patients at six, ten and 26 weeks from the date of presenting their prescriptions at the pharmacy; cost effectiveness of the intervention versus current practice at 10 weeks and 26 weeks; in-depth qualitative understanding of the operationalization of NMS in pharmacies. impact of NMS on: patients' understanding of their medicines, pharmacovigilance, interprofessional and patient-professional relationships and experiences of service users and stakeholders.Economic analysis: Trial-based economic analysis (cost per extra adherent patient) and long-term modeling of costs and health effects (cost per quality-adjusted-life-year) will be conducted from the perspective of National Health Service (NHS) England, comparing NMS with current practice.Qualitative analysis: a qualitative study of NMS implementation in different community settings, how organizational influences affect NMS delivery, patterns of NMS consultations and experiences of professionals and patients participating in NMS, and patients receiving current practice. 250 patients in each treatment arm would provide at least 80% power (two-tailed alpha of 0.05) to demonstrate a reduction in patient-reported non-adherence from 20% to 10% in the NMS arm compared with current practice, assuming a 20% drop-out rate. At the time of submission of this article, 58 community pharmacies have been recruited and the interventions are being delivered. Analysis has not yet been undertaken. Current controlled trials: ISRCTN23560818. Clinical Trials US (clinicaltrials.gov): NCT01635361.

An evaluation of post-campaign knowledge and practices of exclusive breastfeeding in Uganda.

PubMed

Gupta, Neeru; Katende, Charles; Bessinger, Ruth

2004-12-01

Despite the benefits of exclusive breastfeeding for the health of mothers and children, its practice has markedly declined throughout the developing world. Mass media-communication programmes could play an important role in reversing this trend. This study evaluated the extent to which exposure to behaviour change communication (BCC) messages in the media determined recent improvements in exclusive breastfeeding knowledge and practices in areas targeted by the Delivery of Improved Services for Health (DISH) Project of Uganda. Data were drawn from the 1999 DISH Evaluation Survey. The survey collected information from representative samples of women and men of reproductive age. Multiple logistic regressions were used for assessing the independent influences of BCC exposure on breastfeeding knowledge and practices, controlling for several confounding factors. The results indicated that the exposure to BCC messages was strongly associated with women's knowledge of six months as the ideal duration for exclusive breastfeeding. Positive influences on knowledge of men were also found. Media effects on women's current practice of exclusively breastfeeding their infants up to six months were less conclusive, possibly because of the short interval between the launch of the BCC campaign and survey implementation. While there was some evidence of bias of self-reported exposure, results of exploratory analysis of the indirect effects of communication campaigns suggest that impacts may be compounded as overall awareness is increased at the community level eventually leading to improved knowledge among individuals.

Development of a theory- and evidence-based intervention to enhance implementation of physical therapy guidelines for the management of low back pain

PubMed Central

2014-01-01

Background Systematic planning could improve the generally moderate effectiveness of interventions to enhance adherence to clinical practice guidelines. The aim of our study was to demonstrate how the process of Intervention Mapping was used to develop an intervention to address the lack of adherence to the national CPG for low back pain by Dutch physical therapists. Methods We systematically developed a program to improve adherence to the Dutch physical therapy guidelines for low back pain. Based on multi-method formative research, we formulated program and change objectives. Selected theory-based methods of change and practical applications were combined into an intervention program. Implementation and evaluation plans were developed. Results Formative research revealed influential determinants for physical therapists and practice quality managers. Self-regulation was appropriate because both the physical therapists and the practice managers needed to monitor current practice and make and implement plans for change. The program stimulated interaction between practice levels by emphasizing collective goal setting. It combined practical applications, such as knowledge transfer and discussion-and-feedback, based on theory-based methods, such as consciousness raising and active learning. The implementation plan incorporated the wider environment. The evaluation plan included an effect and process evaluation. Conclusions Intervention Mapping is a useful framework for formative data in program planning in the field of clinical guideline implementation. However, a decision aid to select determinants of guideline adherence identified in the formative research to analyse the problem may increase the efficiency of the application of the Intervention Mapping process. PMID:24428945

Development of a theory- and evidence-based intervention to enhance implementation of physical therapy guidelines for the management of low back pain.

PubMed

Rutten, Geert M; Harting, Janneke; Bartholomew, Leona K; Braspenning, Jozé C; van Dolder, Rob; Heijmans, Marcel Fgj; Hendriks, Erik Jm; Kremers, Stef Pj; van Peppen, Roland Ps; Rutten, Steven Tj; Schlief, Angelique; de Vries, Nanne K; Oostendorp, Rob Ab

2014-01-15

Systematic planning could improve the generally moderate effectiveness of interventions to enhance adherence to clinical practice guidelines. The aim of our study was to demonstrate how the process of Intervention Mapping was used to develop an intervention to address the lack of adherence to the national CPG for low back pain by Dutch physical therapists. We systematically developed a program to improve adherence to the Dutch physical therapy guidelines for low back pain. Based on multi-method formative research, we formulated program and change objectives. Selected theory-based methods of change and practical applications were combined into an intervention program. Implementation and evaluation plans were developed. Formative research revealed influential determinants for physical therapists and practice quality managers. Self-regulation was appropriate because both the physical therapists and the practice managers needed to monitor current practice and make and implement plans for change. The program stimulated interaction between practice levels by emphasizing collective goal setting. It combined practical applications, such as knowledge transfer and discussion-and-feedback, based on theory-based methods, such as consciousness raising and active learning. The implementation plan incorporated the wider environment. The evaluation plan included an effect and process evaluation. Intervention Mapping is a useful framework for formative data in program planning in the field of clinical guideline implementation. However, a decision aid to select determinants of guideline adherence identified in the formative research to analyse the problem may increase the efficiency of the application of the Intervention Mapping process.

Practice-Based Research Networks, Part II: A Descriptive Analysis of the Athletic Training Practice-Based Research Network in the Secondary School Setting

PubMed Central

McLeod, Tamara C. Valovich; Lam, Kenneth C.; Bay, R. Curtis; Sauers, Eric L.; Valier, Alison R. Snyder

2012-01-01

Context Analysis of health care service models requires the collection and evaluation of basic practice characterization data. Practice-based research networks (PBRNs) provide a framework for gathering data useful in characterizing clinical practice. Objective To describe preliminary secondary school setting practice data from the Athletic Training Practice-Based Research Network (AT-PBRN). Design Descriptive study. Setting Secondary school athletic training facilities within the AT-PBRN. Patients or Other Participants Clinicians (n = 22) and their patients (n = 2523) from the AT-PBRN. Main Outcome Measure(s) A Web-based survey was used to obtain data on clinical practice site and clinician characteristics. Patient and practice characteristics were obtained via deidentified electronic medical record data collected between September 1, 2009, and April 1, 2011. Descriptive data regarding the clinician and CPS practice characteristics are reported as percentages and frequencies. Descriptive analysis of patient encounters and practice characteristic data was performed, with the percentages and frequencies of the type of injuries recorded at initial evaluation, type of treatment received at initial evaluation, daily treatment, and daily sign-in procedures. Results The AT-PBRN had secondary school sites in 7 states, and most athletic trainers at those sites (78.2%) had less than 5 years of experience. The secondary school sites within the AT-PBRN documented 2523 patients treated across 3140 encounters. Patients most frequently sought care for a current injury (61.3%), followed by preventive services (24.0%), and new injuries (14.7%). The most common diagnoses were ankle sprain/strain (17.9%), hip sprain/strain (12.5%), concussion (12.0%), and knee pain (2.5%). The most frequent procedures were athletic trainer evaluation (53.9%), hot- or cold-pack application (26.0%), strapping (10.3%), and therapeutic exercise (5.7%). The median number of treatments per injury was 3 (interquartile range = 2, 4; range = 2–19). Conclusions These preliminary data describe services provided by clinicians within the AT-PBRN and demonstrate the usefulness of the PBRN model for obtaining such data. PMID:23068594

Providing specialist clinical skills in soft tissue and intra-articular injection through a postgraduate masters module.

PubMed

Stevenson, Kay; Waterfield, Jackie

2005-01-01

Current philosophy and policy changes in the National Health Service are encouraging healthcare practitioners to extend their clinical skills to create a more patient-centred approach thus allowing patients to be seen in a timely and more appropriate manner. This often requires further development of the practitioners' skills and knowledge. One approach to achieve this is through collaboration between employers and educational providers to ensure that educational experience is not only evidence based but also responsive to the needs of the current and future workforce. A postgraduate module was developed to raise critical and evaluative skills, as well as the technical skills of practitioners using injections in the management of joint and soft tissue pathology, while developing a professional responsibility towards injection practice. The module emphasized learning though experience by contextualizing the theoretical aspects of the module and by its student centred assessments. Further strengths of this module are that it has utilized academic and clinical expertise and knowledge to enable clinicians to gain additional skills and the multidisciplinary approach engendered good working practice Overall the module was evaluated positively by both tutors and students and not only met its aims but also addressed the current professional and policy issues around continuing professional development. Copyright (c) 2005 John Wiley & Sons, Ltd.

Best Practices for Robotic Surgery Programs

PubMed Central

Goldenberg, David; Winder, Joshua S.; Juza, Ryan M.; Lyn-Sue, Jerome R.

2017-01-01

Background and Objectives: Robotic surgical programs are increasing in number. Efficient methods by which to monitor and evaluate robotic surgery teams are needed. Methods: Best practices for an academic university medical center were created and instituted in 2009 and continue to the present. These practices have led to programmatic development that has resulted in a process that effectively monitors leadership team members; attending, resident, fellow, and staff training; credentialing; safety metrics; efficiency; and case volume recommendations. Results: Guidelines for hospitals and robotic directors that can be applied to one's own robotic surgical services are included with examples of management of all aspects of a multispecialty robotic surgery program. Conclusion: The use of these best practices will ensure a robotic surgery program that is successful and well positioned for a safe and productive environment for current clinical practice. PMID:28729780

Cholesterol Point-of-Care Testing for Community Pharmacies: A Review of the Current Literature.

PubMed

Haggerty, Lauren; Tran, Deanna

2017-08-01

To summarize the literature on cholesterol point-of-care tests (POCTs). This article would serve as a resource to assist community pharmacists in developing cholesterol point-of-care (POC) pharmacy services. A literature search was performed in MEDLINE Ovid, PubMed, EMBASE, and Cochrane database using the following medical subject headings (MeSH) terms: point-of-care test, cholesterol, blood chemical analysis, rapid testing, collaborative practice, community pharmacy, and ambulatory care. Additional resources including device manufacturer web sites were summarized to supplement the current literature. All human research articles, review articles, meta-analyses, and abstracts published in English through September 1, 2014, were considered. A total of 36 articles were applicable for review. Information was divided into the following categories to be summarized: devices, pharmacists' impact, and operational cost for the pharmacy. The current literature suggests that POCTs in community pharmacies assist with patient outcomes by providing screenings and referring patients with dyslipidemia for further evaluation. The majority of studies on cholesterol POC devices focused on accuracy, revealing the need for further studies to develop best practices and practice models with successful reimbursement. Accuracy, device specifications, required supplies, and patient preference should be considered when selecting a POC device for purchase.

Trout Creek, Oregon Watershed Assessment; Findings, Condition Evaluation and Action Opportunities, 2002 Technical Report.

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

Runyon, John

The purpose of the assessment is to characterize historical and current watershed conditions in the Trout Creek Watershed. Information from the assessment is used to evaluate opportunities for improvements in watershed conditions, with particular reference to improvements in the aquatic environment. Existing information was used, to the extent practicable, to complete this work. The assessment will aid the Trout Creek Watershed Council in identifying opportunities and priorities for watershed restoration projects.

Parallel Approach Separation and Controller Performance

DTIC Science & Technology

1989-11-01

adjacent runways from the current minimum of 2.0 to 1.5 nautical miles (nmi). The possible impact of this alteration included changes in the nature and...for aircraft in trail on the same approach. 4. Determine if a change in separation standard affects controller work effort and if so, how. SIMULATION...practice effects should be minimal. 2. They can evaluate the realism of the simulation. 3. They are better able to evaluate the impact of any changes