Identifying conservation priorities and management strategies based on ecosystem services to improve urban sustainability in Harbin, China

PubMed Central

2018-01-01

Rapid urbanization and agricultural development has resulted in the degradation of ecosystems, while also negatively impacting ecosystem services (ES) and urban sustainability. Identifying conservation priorities for ES and applying reasonable management strategies have been found to be effective methods for mitigating this phenomenon. The purpose of this study is to propose a comprehensive framework for identifying ES conservation priorities and associated management strategies for these planning areas. First, we incorporated 10 ES indicators within a systematic conservation planning (SCP) methodology in order to identify ES conservation priorities with high irreplaceability values based on conservation target goals associated with the potential distribution of ES indicators. Next, we assessed the efficiency of the ES conservation priorities for meeting the designated conservation target goals. Finally, ES conservation priorities were clustered into groups using a K-means clustering analysis in an effort to identify the dominant ES per location before formulating management strategies. We effectively identified 12 ES priorities to best represent conservation target goals for the ES indicators. These 12 priorities had a total areal coverage of 13,364 km2 representing 25.16% of the study area. The 12 priorities were further clustered into five significantly different groups (p-values between groups < 0.05), which helped to refine management strategies formulated to best enhance ES across the study area. The proposed method allows conservation and management plans to easily adapt to a wide variety of quantitative ES target goals within urban and agricultural areas, thereby preventing urban and agriculture sprawl and guiding sustainable urban development. PMID:29682412

Seeking informed consent to Phase I cancer clinical trials: identifying oncologists' communication strategies.

PubMed

Brown, Richard; Bylund, Carma L; Siminoff, Laura A; Slovin, Susan F

2011-04-01

Phase I clinical trials are the gateway to effective new cancer treatments. Many physicians have difficulty when discussing Phase I clinical trials. Research demonstrates evidence of suboptimal communication. Little is known about communication strategies used by oncologists when recruiting patients for Phase I trials. We analyzed audio recorded Phase I consultations to identify oncologists' communication strategies. Subjects were consecutive cancer patients from six medical oncologists attending one of three outpatient clinics at a major Cancer Center in the United States. Sixteen patients signed informed consent for audio recording of their consultations in which a Phase I study was discussed. These were transcribed in full and analyzed to identify communication strategies. Six communication themes emerged from the analysis: (1) orienting, (2) educating patients, (3) describing uncertainty and prognosis, (4) persuading, (5) decision making, and (6) making a treatment recommendation. As expected, although there was some common ground between communication in Phase I and the Phase II and III settings, there were distinct differences. Oncologists used persuasive communication, made explicit recommendations, or implicitly expressed a treatment preference and were choice limiting. This highlights the complexity of discussing Phase I trials and the need to develop strategies to aid oncologists and patients in these difficult conversations. Patient centered communication that values patient preferences while preserving the oncologist's agenda can be a helpful approach to these discussions. Copyright © 2010 John Wiley & Sons, Ltd.

The Effects of Metacognitive Strategy in Reading Expository Text

ERIC Educational Resources Information Center

Othman, Yahya; Mahamud, Zamri; Jaidi, Noradinah

2014-01-01

The purpose of this study is to evaluate the performance of student achievement during comprehension lesson using metacognitive strategy and examine the effects of the strategy used in reading and understanding expository text lessons. Besides, this study also identified metacognitive strategy used by students in all three reading processes…

Three Effective Strategies of Internationalization in American Universities

ERIC Educational Resources Information Center

Cantu, Maria P.

2013-01-01

In higher education research internationalization is described as strategies by which colleges and universities respond to globalization. The objective of this paper was to review some of the current literature on internationalization in Higher Education. It sought to identify some of the effective educational strategies that are being implemented…

Consumer-identified barriers and strategies for optimizing technology use in the workplace.

PubMed

De Jonge, Desleigh M; Rodger, Sylvia A

2006-01-01

This article explores the experiences of 26 assistive technology (AT) users having a range of physical impairments as they optimized their use of technology in the workplace. A qualitative research design was employed using in-depth, open-ended interviews and observations of AT users in the workplace. Participants identified many factors that limited their use of technology such as discomfort and pain, limited knowledge of the technology's features, and the complexity of the technology. The amount of time required for training, limited work time available for mastery, cost of training and limitations of the training provided, resulted in an over-reliance on trial and error and informal support networks and a sense of isolation. AT users enhanced their use of technology by addressing the ergonomics of the workstation and customizing the technology to address individual needs and strategies. Other key strategies included tailored training and learning support as well as opportunities to practice using the technology and explore its features away from work demands. This research identified structures important for effective AT use in the workplace which need to be put in place to ensure that AT users are able to master and optimize their use of technology.

Intervention Strategies Used in Sport Injury Prevention Studies: A Systematic Review Identifying Studies Applying the Haddon Matrix.

PubMed

Vriend, Ingrid; Gouttebarge, Vincent; Finch, Caroline F; van Mechelen, Willem; Verhagen, Evert A L M

2017-10-01

Prevention of sport injuries is crucial to maximise the health and societal benefits of a physically active lifestyle. To strengthen the translation and implementation of the available evidence base on effective preventive measures, a range of potentially relevant strategies should be considered. Our aim was to identify and categorise intervention strategies for the prevention of acute sport injuries evaluated in the scientific literature, applying the Haddon matrix, and identify potential knowledge gaps. Five electronic databases were searched (PubMed, EMBASE, SPORTDiscus, CINAHL, Cochrane) for studies that evaluated the effect of interventions on the occurrence of acute sport injuries. Studies were required to include a control group/condition, prospective data collection, and a quantitative injury outcome measure. A total of 155 studies were included, mostly randomised controlled trials (43%). The majority of studies (55%) focussed on strategies requiring a behavioural change on the part of athletes. Studies predominantly evaluated the preventive effect of various training programmes targeted at the 'pre-event' phase (n = 73) and the use of equipment to avoid injury in the 'event phase' (n = 29). A limited number of studies evaluated the preventive effect of strategies geared at rules and regulations (n = 14), and contextual modifications (n = 18). Studies specifically aimed at preventing re-injuries were a minority (n = 8), and were mostly related to ankle sprains (n = 5). Valuable insight into the extent of the evidence base of sport injury prevention studies was obtained for 20 potential intervention strategies. This approach can be used to monitor potential gaps in the knowledge base on sport injury prevention.

Assessment of Current Knowledge about the Effectiveness of School Desegregation Strategies. Summary. Volume I: Strategies for Effective Desegregation: A Synthesis of Findings.

ERIC Educational Resources Information Center

Hawley, Willis D.; And Others

This project report examines strategies for effective school desegregation based on case studies of individual schools, national school surveys, ethnographic studies of classrooms, trend analyses, opinion surveys and conference interviews, and court documents. The strategies identified in the report include the attainment of one or more of the…

Methodology to explore interactions between the water system and society in order to identify adaptation strategies

NASA Astrophysics Data System (ADS)

Offermans, A. G. E.; Haasnoot, M.

2009-04-01

Development of sustainable water management strategies involves analysing current and future vulnerability, identification of adaptation possibilities, effect analysis and evaluation of the strategies under different possible futures. Recent studies on water management often followed the pressure-effect chain and compared the state of social, economic and ecological functions of the water systems in one or two future situations with the current situation. The future is, however, more complex and dynamic. Water management faces major challenges to cope with future uncertainties in both the water system as well as the social system. Uncertainties in our water system relate to (changes in) drivers and pressures and their effects on the state, like the effects of climate change on discharges. Uncertainties in the social world relate to changing of perceptions, objectives and demands concerning water (management), which are often related with the aforementioned changes in the physical environment. The methodology presented here comprises the 'Perspectives method', derived from the Cultural Theory, a method on analyzing and classifying social response to social and natural states and pressures. The method will be used for scenario analysis and to identify social responses including changes in perspectives and management strategies. The scenarios and responses will be integrated within a rapid assessment tool. The purpose of the tool is to provide users with insight about the interaction of the social and physical system and to identify robust water management strategies by analysing the effectiveness under different possible futures on the physical, social and socio-economic system. This method allows for a mutual interaction between the physical and social system. We will present the theoretical background of the perspectives method as well as a historical overview of perspective changes in the Dutch Meuse area to show how social and physical systems interrelate. We

Exploring critical pathways for urban water management to identify robust strategies under deep uncertainties.

PubMed

Urich, Christian; Rauch, Wolfgang

2014-12-01

Long-term projections for key drivers needed in urban water infrastructure planning such as climate change, population growth, and socio-economic changes are deeply uncertain. Traditional planning approaches heavily rely on these projections, which, if a projection stays unfulfilled, can lead to problematic infrastructure decisions causing high operational costs and/or lock-in effects. New approaches based on exploratory modelling take a fundamentally different view. Aim of these is, to identify an adaptation strategy that performs well under many future scenarios, instead of optimising a strategy for a handful. However, a modelling tool to support strategic planning to test the implication of adaptation strategies under deeply uncertain conditions for urban water management does not exist yet. This paper presents a first step towards a new generation of such strategic planning tools, by combing innovative modelling tools, which coevolve the urban environment and urban water infrastructure under many different future scenarios, with robust decision making. The developed approach is applied to the city of Innsbruck, Austria, which is spatially explicitly evolved 20 years into the future under 1000 scenarios to test the robustness of different adaptation strategies. Key findings of this paper show that: (1) Such an approach can be used to successfully identify parameter ranges of key drivers in which a desired performance criterion is not fulfilled, which is an important indicator for the robustness of an adaptation strategy; and (2) Analysis of the rich dataset gives new insights into the adaptive responses of agents to key drivers in the urban system by modifying a strategy. Copyright © 2014 Elsevier Ltd. All rights reserved.

User-identified electronic cigarette behavioral strategies and device characteristics for cigarette smoking reduction.

PubMed

Soule, Eric K; Maloney, Sarah F; Guy, Mignonne C; Eissenberg, Thomas; Fagan, Pebbles

2018-04-01

There is limited evidence on how cigarette smokers use electronic cigarettes (ECIGs) for smoking cessation and reduction. This study used concept mapping, a participatory mixed-methods research approach, to identify ECIG use behaviors and device characteristics perceived to be associated with cigarette smoking cessation or reduction. Current ECIG users aged 18-64 were recruited from seven cities selected randomly from U.S. census tract regions. Participants were invited to complete concept mapping tasks: brainstorming, sorting and rating (n=72). During brainstorming, participants generated statements in response to a focus prompt ("A SPECIFIC WAY I HAVE USED electronic cigarettes to reduce my cigarette smoking or a SPECIFIC WAY electronic cigarettes help me reduce my cigarette smoking is…") and then sorted and rated the statements. Multidimensional scaling and hierarchical cluster analyses were used to generate a cluster map that was interpreted by the research team. Eight thematic clusters were identified: Convenience, Perceived Health Effects, Ease of Use, Versatility and Variety, Advantages of ECIGs over Cigarettes, Cigarette Substitutability, Reducing Harms to Self and Others, and Social Benefits. Participants generated several statements that related to specific behavioral strategies used when using ECIGs for smoking reduction/complete switching behaviors such as making rapid transitions from smoking to ECIG use or using certain ECIG liquids or devices. Former smokers rated the Perceived Health Effects cluster and several behavioral strategy statements higher than current smokers. These results help to identify ECIG use behaviors and characteristics perceived by ECIG users to aid in cigarette smoking cessation or reduction. Copyright © 2017 Elsevier Ltd. All rights reserved.

Landslides in Equatorial Africa: Identifying culturally, technically and economically feasible resilience strategies

NASA Astrophysics Data System (ADS)

Kervyn, Matthieu; de Hontheim, Astrid; Dewitte, Olivier; Jacobs, Liesbet; Maes, Jan; Mertens, Kewan; Trefois, Philippe; Vranken, Liesbet; Poesen, Jean

2014-05-01

Landslides (LS) cause significant impacts in many equatorial regions. Their impact depends on their size and speed, the elements at risk and the vulnerability of these elements. This problem is particularly acute in Equatorial Africa characterized by mountainous topography, intense rains, deep weathering profiles, high population density and high vulnerability to geohazards. Every year LS cause fatalities and result in structural and functional damage to infrastructure and properties. Losses from LS are expected to increase in the future in response to the demographic pressure causing more development in landslide-prone areas (LSPA), deforestation and associated changes in land use and land cover, and the changing climate causing higher or more intense rainfalls. Many studies investigated how natural factors and human activities control the occurrence or re-activation of LS. These studies typically delivered susceptibility maps but these are insufficient to lead to efficient risk management. Building resilience requires to have a true hazard estimate, accounting not only for the spatial distribution of future LS but also for their temporal occurrence and the hazard intensity, to quantitatively analyse the socio-economic consequences of LS and to identify effective resilience strategies that are cost-effective, technically efficient and that are culturally acceptable and adapted to the livelihoods of the vulnerable population. Such an analysis is crucial as it enables to provide practical recommendations for households and policy makers to mitigate LS-related damages. This project focuses on 4 representative study areas known for having suffered severely from rainfall-triggered LS in Uganda (Mount Elgon, Mount Rwenzori) and SW and NW Cameroon (Mount Cameroon, Bamenda). In two of these regions, some preliminary studies on LS characteristics and susceptibility mapping have been carried out, while hazard maps, a socio-economic impact analysis and resilience strategies

Identifying Multiple Levels of Discussion-Based Teaching Strategies for Constructing Scientific Models

ERIC Educational Resources Information Center

Williams, Grant; Clement, John

2015-01-01

This study sought to identify specific types of discussion-based strategies that two successful high school physics teachers using a model-based approach utilized in attempting to foster students' construction of explanatory models for scientific concepts. We found evidence that, in addition to previously documented dialogical strategies that…

Identifying Stride-To-Stride Control Strategies in Human Treadmill Walking

PubMed Central

Dingwell, Jonathan B.; Cusumano, Joseph P.

2015-01-01

Variability is ubiquitous in human movement, arising from internal and external noise, inherent biological redundancy, and from the neurophysiological control actions that help regulate movement fluctuations. Increased walking variability can lead to increased energetic cost and/or increased fall risk. Conversely, biological noise may be beneficial, even necessary, to enhance motor performance. Indeed, encouraging more variability actually facilitates greater improvements in some forms of locomotor rehabilitation. Thus, it is critical to identify the fundamental principles humans use to regulate stride-to-stride fluctuations in walking. This study sought to determine how humans regulate stride-to-stride fluctuations in stepping movements during treadmill walking. We developed computational models based on pre-defined goal functions to compare if subjects, from each stride to the next, tried to maintain the same speed as the treadmill, or instead stay in the same position on the treadmill. Both strategies predicted average behaviors empirically indistinguishable from each other and from that of humans. These strategies, however, predicted very different stride-to-stride fluctuation dynamics. Comparisons to experimental data showed that human stepping movements were generally well-predicted by the speed-control model, but not by the position-control model. Human subjects also exhibited no indications they corrected deviations in absolute position only intermittently: i.e., closer to the boundaries of the treadmill. Thus, humans clearly do not adopt a control strategy whose primary goal is to maintain some constant absolute position on the treadmill. Instead, humans appear to regulate their stepping movements in a way most consistent with a strategy whose primary goal is to try to maintain the same speed as the treadmill at each consecutive stride. These findings have important implications both for understanding how biological systems regulate walking in general and

Cost-effectiveness of a new strategy to identify uncomplicated gallstone disease patients that will benefit from a cholecystectomy.

PubMed

Lamberts, Mark P; Özdemir, Cihan; Drenth, Joost P H; van Laarhoven, Cornelis J H M; Westert, Gert P; Kievit, Wietske

2017-06-01

The aim of this study was to determine the cost-effectiveness of a new strategy for the preoperative detection of patients that will likely benefit from a cholecystectomy, using simple criteria that can be applied by surgeons. Criteria for a cholecystectomy indication are: (1) having episodic pain; (2) onset of pain 1 year or less before the outpatient clinic visit. The cost-effectiveness of the new strategy was evaluated against current practice using a decision analytic model. The incremental cost-effectiveness of applying criteria for a cholecystectomy for a patient with abdominal pain and gallstones was compared to applying no criteria. The incremental cost-effectiveness ratio (ICER) was expressed as extra costs to be invested to gain one more patient with absence of pain. Scenarios were analyzed to assess the influence of applying different criteria. The new strategy of applying one out of two criteria resulted in a 4 % higher mean proportion of patients with absence of pain compared to current practice with similar costs. The 95 % upper limit of the ICER was €4114 ($4633) per extra patient with relief of upper abdominal pain. Application of two out of two criteria resulted in a 3 % lower mean proportion of patients with absence of pain with lower costs. The new strategy of using one out of two strict selection criteria may be an effective but also a cost-effective method to reduce the proportion of patients with pain after cholecystectomy.

Effectiveness and practicality of control strategies for African swine fever: what do we really know?

PubMed Central

Guinat, C.; Vergne, T.; Jurado-Diaz, C.; Sánchez-Vizcaíno, J. M.; Dixon, L.; Pfeiffer, D. U.

2017-01-01

African swine fever (ASF) is a major pig health problem, and the causative virus is moving closer to Western European regions where pig density is high. Stopping or slowing down the spread of ASF requires mitigation strategies that are both effective and practical. Based on the elicitation of ASF expert opinion, this study identified surveillance and intervention strategies for ASF that are perceived as the most effective by providing the best combination between effectiveness and practicality. Among the 20 surveillance strategies that were identified, passive surveillance of wild boar and syndromic surveillance of pig mortality were considered to be the most effective surveillance strategies for controlling ASF virus spread. Among the 22 intervention strategies that were identified, culling of all infected herds and movement bans for neighbouring herds were regarded as the most effective intervention strategies. Active surveillance and carcase removal in wild boar populations were rated as the most effective surveillance and intervention strategies, but were also considered to be the least practical, suggesting that more research is needed to develop more effective methods for controlling ASF in wild boar populations. PMID:27852963

Bullying - effects, prevalence and strategies for detection.

PubMed

Carr-Gregg, Michael; Manocha, Ramesh

2011-03-01

The mental, physical, social and academic consequences of bullying have an enormous impact on human and social capital. This article describes the effects and prevalence of bullying on young people and presents strategies for its detection. Strategies for the facilitation of a multidisciplinary approach to bullying in adolescents are also presented. Given the existing high rate of bullying, assessment should be incorporated into a standard psychosocial screening routine in the general practitioner's clinic. Effective management is a multidisciplinary effort, involving parents, teachers and school officials, the GP, and mental health professionals. Given the variable effectiveness of schools in tackling bullying, GPs play an important role in identifying at risk patients, screening for psychiatric comorbidities, counselling families about the problem, and advocating for bullying prevention in their communities.

The comparison of the performance of two screening strategies identifying newly-diagnosed HIV during pregnancy.

PubMed

Boer, Kees; Smit, Colette; van der Flier, Michiel; de Wolf, Frank

2011-10-01

In the Netherlands, a non-selective opt-out instead of a selective opt-in antenatal HIV screening strategy was implemented in 2004. In case of infection, screening was followed by prevention of mother-to-child-transmission (PMTCT). We compared the performance of the two strategies in terms of detection of new cases of HIV and vertical transmission. HIV-infected pregnant women were identified retrospectively from the Dutch HIV cohort ATHENA January 2000 to January 2008. Apart from demographic, virological and immunological data, the date of HIV infection in relation to the index pregnancy was established. Separately, all infants diagnosed with HIV born following implementation of the screening program were identified by a questionnaire via the paediatric HIV centres. 162/481 (33.7%) HIV-positive pregnant women were diagnosed with HIV before 2004 and 172/214 (80.3%) after January 2004. Multivariate analysis showed an 8-fold (95% confidence interval 5.47-11.87) increase in the odds of HIV detection during pregnancy after the national introduction of the opt-out strategy. Still, three children born during a 5-year period after July 2004 were infected due to de novo infection in pregnancy. Implementation of a nation-wide screening strategy based upon non-selective opt-out screening followed by effective PMTCT appeared to detect more HIV-infected women for the first time in pregnancy and to reduce vertical transmission of HIV substantially. Nonetheless, still few children are infected because of maternal infection after the first trimester. We propose the introduction of partner screening on HIV as part of the antenatal screening strategy.

Validation of a search strategy to identify nutrition trials in PubMed using the relative recall method.

PubMed

Durão, Solange; Kredo, Tamara; Volmink, Jimmy

2015-06-01

To develop, assess, and maximize the sensitivity of a search strategy to identify diet and nutrition trials in PubMed using relative recall. We developed a search strategy to identify diet and nutrition trials in PubMed. We then constructed a gold standard reference set to validate the identified trials using the relative recall method. Relative recall was calculated by dividing the number of references from the gold standard our search strategy identified by the total number of references in the gold standard. Our gold standard comprised 298 trials, derived from 16 included systematic reviews. The initial search strategy identified 242 of 298 references, with a relative recall of 81.2% [95% confidence interval (CI): 76.3%, 85.5%]. We analyzed titles and abstracts of the 56 missed references for possible additional terms. We then modified the search strategy accordingly. The relative recall of the final search strategy was 88.6% (95% CI: 84.4%, 91.9%). We developed a search strategy to identify diet and nutrition trials in PubMed with a high relative recall (sensitivity). This could be useful for establishing a nutrition trials register to support the conduct of future research, including systematic reviews. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Aging effects in sequential modulations of poorer-strategy effects during execution of memory strategies.

PubMed

Hinault, Thomas; Lemaire, Patrick; Touron, Dayna

2017-02-01

In this study, we asked young adults and older adults to encode pairs of words. For each item, they were told which strategy to use, interactive imagery or rote repetition. Data revealed poorer-strategy effects in both young adults and older adults: Participants obtained better performance when executing better strategies (i.e., interactive-imagery strategy to encode pairs of concrete words; rote-repetition strategy on pairs of abstract words) than with poorer strategies (i.e., interactive-imagery strategy on pairs of abstract words; rote-repetition strategy on pairs of concrete words). Crucially, we showed that sequential modulations of poorer-strategy effects (i.e., poorer-strategy effects being larger when previous items were encoded with better relative to poorer strategies), previously demonstrated in arithmetic, generalise to memory strategies. We also found reduced sequential modulations of poorer-strategy effects in older adults relative to young adults. Finally, sequential modulations of poorer-strategy effects correlated with measures of cognitive control processes, suggesting that these processes underlie efficient trial-to-trial modulations during strategy execution. Differences in correlations with cognitive control processes were also found between older adults and young adults. These findings have important implications regarding mechanisms underlying memory strategy execution and age differences in memory performance.

Cost-Effectiveness of Osteoporosis Screening Strategies for Men

PubMed Central

Nayak, Smita; Greenspan, Susan L.

2016-01-01

Osteoporosis affects many men, with significant morbidity and mortality. However, the best osteoporosis screening strategies for men are unknown. We developed an individual-level state-transition cost-effectiveness model with a lifetime time horizon to identify the cost-effectiveness of different osteoporosis screening strategies for U.S. men involving various screening tests (dual-energy x-ray absorptiometry (DXA); the Osteoporosis Self-Assessment Tool (OST); or a fracture risk assessment strategy using age, femoral neck bone mineral density (BMD), and Vertebral Fracture Assessment (VFA)); screening initiation ages (50, 60, 70, or 80); and repeat screening intervals (5 years or 10 years). In base-case analysis, no screening was a less effective option than all other strategies evaluated; furthermore, no screening was more expensive than all strategies that involved screening with DXA or the OST risk assessment instrument, and thus no screening was “dominated” by screening with DXA or OST at all evaluated screening initiation ages and repeat screening intervals. Screening strategies that most frequently appeared as most cost-effective in base-case analysis and one-way sensitivity analyses when assuming willingness-to-pay of $50,000/QALY or $100,000/QALY included screening initiation at age 50 with the fracture risk assessment strategy and repeat screening every 10 years; screening initiation at age 50 with fracture risk assessment and repeat screening every 5 years; and screening initiation at age 50 with DXA and repeat screening every 5 years. In conclusion, expansion of osteoporosis screening for U.S. men to initiate routine screening at age 50 or 60 would be expected to be effective and of good value for improving health outcomes. A fracture risk assessment strategy using variables of age, femoral neck BMD, and VFA is likely to be the most effective of the evaluated strategies within accepted cost-effectiveness parameters. DXA and OST are also reasonable

Evaluating Testing Strategies for Identifying Youths With HIV Infection and Linking Youths to Biomedical and Other Prevention Services

PubMed Central

Boyer, Cherrie B.; Chiaramonte, Danielle; Lindeman, Peter; Chutuape, Kate; Cooper-Walker, Bendu; Kapogiannis, Bill G.; Wilson, Craig M.; Fortenberry, J. Dennis

2017-01-01

identified through universal testing decreased to 1 (0.1%). Rates of new HIV-positive cases identified through targeted testing increased to 49 (6.3%). Youths who tested through targeted testing (416 [85.1%]) were more likely to link successfully to local HIV prevention services, including preexposure prophylaxis, compared with those who underwent universal testing (328 [34.1%]). Conclusions and Relevance The findings suggest that community-based targeted approaches to HIV testing are more effective than universal screening for reaching young sexual minority males (especially males of color), identifying previously undiagnosed HIV-positive youths, and linking HIV-negative youths to relevant prevention services. Targeted, community-based HIV testing strategies hold promise as a scalable and effective means to identify high-risk youths who are unaware of their HIV status. PMID:28418524

Workplace-based assessment: a review of user perceptions and strategies to address the identified shortcomings.

PubMed

Massie, Jonathan; Ali, Jason M

2016-05-01

Workplace based assessments (WBAs) are now commonplace in postgraduate medical training. User acceptability and engagement is essential to the success of any medical education innovation. To this end, possessing an insight into trainee and trainer perceptions towards WBAs will help identify the major problems, permitting strategies to be introduced to improve WBA implementation. A review of literature was performed to identify studies examining trainee and trainer perceptions towards WBAs. Studies were excluded if non-English or sampling a non-medical/dental population. The identified literature was synthesised for the purpose of this critical narrative review. It is clear that there is widespread negativity towards WBAs in the workplace. This has negatively impacted on the effectiveness of WBA tools as learning aids. This negativity exists in trainees but also to an extent in their trainers. Insight gained from the literature reveals three dominant problems with WBA implementation: poor understanding as to the purpose of WBAs; insufficient time available for undertaking these assessments; and inadequate training of trainers. Approaches to addressing these three problems with WBA implementation are discussed. It is likely that a variety of solutions will be required. The prevalence of negativity towards WBAs is substantial in both trainees and trainers, eroding the effectiveness of learning that is consequent upon them. The educational community must now listen to the concerns being raised by the users and consider the range of strategies being proposed to improve the experiences of trainees, and their trainers.

Identifying governance strategies that effectively support ecosystem services, resource sustainability, and biodiversity

PubMed Central

Kenward, R. E.; Whittingham, M. J.; Arampatzis, S.; Manos, B. D.; Hahn, T.; Terry, A.; Simoncini, R.; Alcorn, J.; Bastian, O.; Donlan, M.; Elowe, K.; Franzén, F.; Karacsonyi, Z.; Larsson, M.; Manou, D.; Navodaru, I.; Papadopoulou, O.; Papathanasiou, J.; von Raggamby, A.; Sharp, R. J. A.; Söderqvist, T.; Soutukorva, Å.; Vavrova, L.; Aebischer, N. J.; Leader-Williams, N.; Rutz, C.

2011-01-01

Conservation scientists, national governments, and international conservation groups seek to devise, and implement, governance strategies that mitigate human impact on the environment. However, few studies to date have systematically investigated the performance of different systems of governance in achieving successful conservation outcomes. Here, we use a newly-developed analytic framework to conduct analyses of a suite of case studies, linking different governance strategies to standardized scores for delivering ecosystem services, achieving sustainable use of natural resources, and conserving biodiversity, at both local and international levels. Our results: (i) confirm the benefits of adaptive management; and (ii) reveal strong associations for the role of leadership. Our work provides a critical step toward implementing empirically justified governance strategies that are capable of improving the management of human-altered environments, with benefits for both biodiversity and people. PMID:21402916

Stakeholders' participatory diagnosis of climate change impacts on subsistence agriculture in Sikkim, India, for identifying adaptation strategies

NASA Astrophysics Data System (ADS)

Azhoni, A.; Goyal, M. K.

2017-12-01

Narrowing the gap between research, policy making and implementing adaptation remains a challenge in many parts of the world where climate change is likely to severely impact subsistence agriculture. This research aims to narrow this gap by matching the adaptation strategies being framed by policy makers and perspectives of consultants and researchers which are expected to be implemented by development agencies farmers in the state of Sikkim in India. Our case study examined the framing and implementation of State Action Plan on Climate Change through semi-structured interviews carried out with decision makers in the State Government, Scientific Organisations, consultants, local academia, implementing and development agencies, and farmers for whom the adaptation strategies are targeted. Using Social Network and Stakeholder Analysis approach, this research unravels the complexities of perceiving climate change impacts, identifying adaptation strategies, and implementing climate change adaptation strategies. While farmers are less aware about the global phenomenon of climate change impacts for their subsistence livelihood, their knowledge of the local conditions and their close interaction with the State Government Agriculture Department provides them an access to new and high value crops. Although important steps are initiated through the Sikkim State Action Plan on Climate Change it is yet to deliver effective means of adaptation implementation and identifying the networks of close coordination between the various implementing agencies will likely to pay rich dividends. While Sikkim being a small and hilly state with specific contextual challenges of climate change impacts, the results from this study highlights how the internal and external networks between various types of stakeholders informs decision makers in identifying local impacts of climate change and plan adaptation strategies.

Effective recruitment and retention strategies in community health programs.

PubMed

McCann, Jennifer; Ridgers, Nicola D; Carver, Alison; Thornton, Lukar E; Teychenne, Megan

2013-08-01

The aim of this project was to identify effective recruitment and retention strategies used by health-promotion organisations that focus on increasing physical activity and improving nutrition within the local community. Semistructured telephone or face-to-face interviews with 25 key informants from stakeholder organisations were conducted. Key informants discussed strategies used by their organisation to effectively recruit and retain participants into community-based healthy eating and/or physical activity programs. Transcribed data were analysed with NVivo software. Effective recruitment strategies included word of mouth, links with organisations, dissemination of printed materials, media, referrals, cross-promotion of programs and face-to-face methods. Effective retention strategies included encouraging a sense of community ownership, social opportunities, recruiting a suitable leader and offering flexibility and support. Fees and support for recruiting and retaining participants was also identified. This study provides novel insights to a greatly under researched topic in the field of health promotion. There are two key take-home messages from the present study that are applicable to health practitioners as well as developers and deliverers of community health-promotion programs: (1) it is imperative that all community health organisations report on the effectiveness of their recruitment and retention, both successes and failures; and (2) there is a clear need to tailor the recruitment and retention approach to the target population and the setting the program is occurring in. SO WHAT? These findings provide important insights for the development of future community-based healthy eating and physical activity programs.

CDC's DELTA FOCUS Program: Identifying Promising Primary Prevention Strategies for Intimate Partner Violence.

PubMed

Armstead, Theresa L; Rambo, Kirsten; Kearns, Megan; Jones, Kathryn M; Dills, Jenny; Brown, Pamela

2017-01-01

According to 2011 data, nearly one in four women and one in seven men in the United States experience severe physical violence by an intimate partner, creating a public health burden requiring population-level solutions. To prevent intimate partner violence (IPV) before it occurs, the CDC developed Domestic Violence Prevention Enhancements and Leadership Through Alliances, Focusing on Outcomes for Communities United with States to identify promising community- and societal-level prevention strategies to prevent IPV. The program funds 10 state domestic violence coalitions for 5 years to implement and evaluate programs and policies to prevent IPV by influencing the environments and conditions in which people live, work, and play. The program evaluation goals are to promote IPV prevention by identifying promising prevention strategies and describing those strategies using case studies, thereby creating a foundation for building practice-based evidence with a health equity approach.

Effective Teaching Strategies According to Fifth Grade Students: A Qualitative Study

ERIC Educational Resources Information Center

Gomez, Adlin Yanina

2009-01-01

This study identified learners' perspectives on the most effective teaching strategies. Professionals in the field of education have worked to increase educational achievement and success by exploring ways to match instructional strategies with individual learning styles. The voices of the learners have seldom been considered in this effort. The…

Identifying the Effects of Environmental and Policy Change Interventions on Healthy Eating

PubMed Central

Bowen, Deborah J.; Barrington, Wendy E.; Beresford, Shirley A.A.

2015-01-01

Obesity has been characterized as a disease. Strategies to change the incidence and prevalence of this disease include a focus on changing physical and social environments, over and above individual-level strategies, using a multilevel or systems approach. We focus our attention on evidence published between 2008 and 2013 on the effectiveness of interventions in nutrition environments, i.e., environmental interventions designed to influence the intake of healthful foods and amount of energy consumed. An overarching socioecological framework that has guided much of this research was used to characterize different types of environmental strategies. Intervention examples in each area of the framework are provided with a discussion of key findings and related conceptual and methodological issues. The emphasis in this review is on adults, but clearly this literature is only one part of the picture. Much research has been focused on child-specific interventions, including environmental interventions. Some evidence suggests effectiveness of policy-based or other types of interventions that aim to regulate or restructure environments to promote healthy dietary choices, and these strategies would apply to both children and adults. Opportunities to evaluate these policy changes in adults’ social and physical environments are rare. Much of the existing research has been with children. As conceptual and methodological issues continue to be identified and resolved, we hope that future research in this domain will identify environmental strategies that can be included in intervention toolboxes to build healthy nutrition environments for both adults and children. PMID:25785891

Identifying the effects of environmental and policy change interventions on healthy eating.

PubMed

Bowen, Deborah J; Barrington, Wendy E; Beresford, Shirley A A

2015-03-18

Obesity has been characterized as a disease. Strategies to change the incidence and prevalence of this disease include a focus on changing physical and social environments, over and above individual-level strategies, using a multilevel or systems approach. We focus our attention on evidence published between 2008 and 2013 on the effectiveness of interventions in nutrition environments, i.e., environmental interventions designed to influence the intake of healthful foods and amount of energy consumed. An overarching socioecological framework that has guided much of this research was used to characterize different types of environmental strategies. Intervention examples in each area of the framework are provided with a discussion of key findings and related conceptual and methodological issues. The emphasis in this review is on adults, but clearly this literature is only one part of the picture. Much research has been focused on child-specific interventions, including environmental interventions. Some evidence suggests effectiveness of policy-based or other types of interventions that aim to regulate or restructure environments to promote healthy dietary choices, and these strategies would apply to both children and adults. Opportunities to evaluate these policy changes in adults' social and physical environments are rare. Much of the existing research has been with children. As conceptual and methodological issues continue to be identified and resolved, we hope that future research in this domain will identify environmental strategies that can be included in intervention toolboxes to build healthy nutrition environments for both adults and children.

Failure or success of search strategies to identify adverse effects of medical devices: a feasibility study using a systematic review.

PubMed

Golder, Su; Wright, Kath; Rodgers, Mark

2014-10-13

Research has indicated that adverse effects terms are increasingly prevalent in the title, abstract or indexing terms of articles that contain adverse drug effects data in MEDLINE and Embase. However, it is unknown whether adverse effects terms are present in the database records of articles that contain adverse effects data of medical devices, and thus, to what extent the development of an adverse effects search filter for medical devices may be feasible. A case study systematic review of a medical device was selected. The included studies from a systematic review of the safety of recombinant human bone morphogenetic protein-2 (rhBMP-2) for spinal fusion were used in the analysis. For each included study, the corresponding database record on MEDLINE and Embase was assessed to measure the presence or absence of adverse effects terms in the title, abstract or indexing. The performance of each potential adverse effects search term was also measured and compared. There were 82 publications (49 studies) included in the systematic review with 51 of these indexed on MEDLINE and 55 on Embase. Ninety-four percent (48/51) of the records on MEDLINE and 95% (52/55) of the records on Embase contained at least one adverse effects related search term. The wide variety of adverse effects terms included in the title, abstract or indexing of bibliographic records, and the lack of any individual high-performing search terms suggests that a combination of terms in different fields is required to identify adverse effects of medical devices. In addition, the most successful search terms differed from the most successful terms for identifying adverse drug effects. The search filters currently available for adverse drug effects are not necessarily useful for searching adverse effects data of medical devices. The presence of adverse effects terms in the bibliographic records of articles on medical devices, however, indicates that combinations of adverse effects search terms may be useful

Identifying nurse staffing research in Medline: development and testing of empirically derived search strategies with the PubMed interface

PubMed Central

2010-01-01

Background The identification of health services research in databases such as PubMed/Medline is a cumbersome task. This task becomes even more difficult if the field of interest involves the use of diverse methods and data sources, as is the case with nurse staffing research. This type of research investigates the association between nurse staffing parameters and nursing and patient outcomes. A comprehensively developed search strategy may help identify nurse staffing research in PubMed/Medline. Methods A set of relevant references in PubMed/Medline was identified by means of three systematic reviews. This development set was used to detect candidate free-text and MeSH terms. The frequency of these terms was compared to a random sample from PubMed/Medline in order to identify terms specific to nurse staffing research, which were then used to develop a sensitive, precise and balanced search strategy. To determine their precision, the newly developed search strategies were tested against a) the pool of relevant references extracted from the systematic reviews, b) a reference set identified from an electronic journal screening, and c) a sample from PubMed/Medline. Finally, all newly developed strategies were compared to PubMed's Health Services Research Queries (PubMed's HSR Queries). Results The sensitivities of the newly developed search strategies were almost 100% in all of the three test sets applied; precision ranged from 6.1% to 32.0%. PubMed's HSR queries were less sensitive (83.3% to 88.2%) than the new search strategies. Only minor differences in precision were found (5.0% to 32.0%). Conclusions As with other literature on health services research, nurse staffing studies are difficult to identify in PubMed/Medline. Depending on the purpose of the search, researchers can choose between high sensitivity and retrieval of a large number of references or high precision, i.e. and an increased risk of missing relevant references, respectively. More standardized

Identifying nurse staffing research in Medline: development and testing of empirically derived search strategies with the PubMed interface.

PubMed

Simon, Michael; Hausner, Elke; Klaus, Susan F; Dunton, Nancy E

2010-08-23

The identification of health services research in databases such as PubMed/Medline is a cumbersome task. This task becomes even more difficult if the field of interest involves the use of diverse methods and data sources, as is the case with nurse staffing research. This type of research investigates the association between nurse staffing parameters and nursing and patient outcomes. A comprehensively developed search strategy may help identify nurse staffing research in PubMed/Medline. A set of relevant references in PubMed/Medline was identified by means of three systematic reviews. This development set was used to detect candidate free-text and MeSH terms. The frequency of these terms was compared to a random sample from PubMed/Medline in order to identify terms specific to nurse staffing research, which were then used to develop a sensitive, precise and balanced search strategy. To determine their precision, the newly developed search strategies were tested against a) the pool of relevant references extracted from the systematic reviews, b) a reference set identified from an electronic journal screening, and c) a sample from PubMed/Medline. Finally, all newly developed strategies were compared to PubMed's Health Services Research Queries (PubMed's HSR Queries). The sensitivities of the newly developed search strategies were almost 100% in all of the three test sets applied; precision ranged from 6.1% to 32.0%. PubMed's HSR queries were less sensitive (83.3% to 88.2%) than the new search strategies. Only minor differences in precision were found (5.0% to 32.0%). As with other literature on health services research, nurse staffing studies are difficult to identify in PubMed/Medline. Depending on the purpose of the search, researchers can choose between high sensitivity and retrieval of a large number of references or high precision, i.e. and an increased risk of missing relevant references, respectively. More standardized terminology (e.g. by consistent use of the

Identifying and ranking implicit leadership strategies to promote evidence-based practice implementation in addiction health services.

PubMed

Guerrero, Erick G; Padwa, Howard; Fenwick, Karissa; Harris, Lesley M; Aarons, Gregory A

2016-05-14

Despite a solid research base supporting evidence-based practices (EBPs) for addiction treatment such as contingency management and medication-assisted treatment, these services are rarely implemented and delivered in community-based addiction treatment programs in the USA. As a result, many clients do not benefit from the most current and efficacious treatments, resulting in reduced quality of care and compromised treatment outcomes. Previous research indicates that addiction program leaders play a key role in supporting EBP adoption and use. The present study expanded on this previous work to identify strategies that addiction treatment program leaders report using to implement new practices. We relied on a staged and iterative mixed-methods approach to achieve the following four goals: (a) collect data using focus groups and semistructured interviews and conduct analyses to identify implicit managerial strategies for implementation, (b) use surveys to quantitatively rank strategy effectiveness, (c) determine how strategies fit with existing theories of organizational management and change, and (d) use a consensus group to corroborate and expand on the results of the previous three stages. Each goal corresponded to a methodological phase, which included data collection and analytic approaches to identify and evaluate leadership interventions that facilitate EBP implementation in community-based addiction treatment programs. Findings show that the top-ranked strategies involved the recruitment and selection of staff members receptive to change, offering support and requesting feedback during the implementation process, and offering in vivo and hands-on training. Most strategies corresponded to emergent implementation leadership approaches that also utilize principles of transformational and transactional leadership styles. Leadership behaviors represented orientations such as being proactive to respond to implementation needs, supportive to assist staff members

Effective training strategies for teaching communication skills to physicians: an overview of systematic reviews.

PubMed

Berkhof, Marianne; van Rijssen, H Jolanda; Schellart, Antonius J M; Anema, Johannes R; van der Beek, Allard J

2011-08-01

Physicians need good communication skills to communicate effectively with patients. The objective of this review was to identify effective training strategies for teaching communication skills to qualified physicians. PubMED, PsycINFO, CINAHL, and COCHRANE were searched in October 2008 and in March 2009. Two authors independently selected relevant reviews and assessed their methodological quality with AMSTAR. Summary tables were constructed for data-synthesis, and results were linked to outcome measures. As a result, conclusions about the effectiveness of communication skills training strategies for physicians could be drawn. Twelve systematic reviews on communication skills training programmes for physicians were identified. Some focused on specific training strategies, whereas others emphasized a more general approach with mixed strategies. Training programmes were effective if they lasted for at least one day, were learner-centred, and focused on practising skills. The best training strategies within the programmes included role-play, feedback, and small group discussions. Training programmes should include active, practice-oriented strategies. Oral presentations on communication skills, modelling, and written information should only be used as supportive strategies. To be able to compare the effectiveness of training programmes more easily in the future, general agreement on outcome measures has to be established. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Inclusive Branding Strategies for Domestic Violence Agencies: Embracing Opportunities to Reach and Better Serve Male-Identified Survivors.

PubMed

Dewey, Morgan; Heiss, Sarah N

2018-05-01

Successful strategies for branding that are inclusive of male-identified survivors were identified in this qualitative study through semi-structured interviews with leaders from six domestic violence agencies across the United States: four represented traditional domestic violence agencies and two represented specialized agencies with expertise in providing services to nontraditional survivors. The strategic implementation of (a) inclusive language, (b) visual diversity, (c) community outreach, and (d) communication channels emerged as successful strategies in branding in an inclusive way for male-identified survivors. The implementation of these successful strategies provides the opportunity for domestic violence agencies to create an inclusive environment for male-identified survivors and would contribute to a paradigm shift in how domestic violence is viewed.

Preservice Teachers' Knowledge of Effective Classroom Management Strategies: Shy or Withdrawn Students.

ERIC Educational Resources Information Center

Lacina-Gifford, Lorna J.; Kher, Neelam; Besant, Kyesha

This study identified preservice teachers' knowledge about effective and ineffective classroom management strategies. A group of 108 preservice teachers at a southern rural public university generated classroom management strategies in response to hypothetical vignettes depicting shy and withdrawn student behavior. Researchers coded the extended…

Identifying influential spreaders in complex networks through local effective spreading paths

NASA Astrophysics Data System (ADS)

Wang, Xiaojie; Zhang, Xue; Yi, Dongyun; Zhao, Chengli

2017-05-01

How to effectively identify a set of influential spreaders in complex networks is of great theoretical and practical value, which can help to inhibit the rapid spread of epidemics, promote the sales of products by word-of-mouth advertising, and so on. A naive strategy is to select the top ranked nodes as identified by some centrality indices, and other strategies are mainly based on greedy methods and heuristic methods. However, most of those approaches did not concern the connections between nodes. Usually, the distances between the selected spreaders are very close, leading to a serious overlapping of their influence. As a consequence, the global influence of the spreaders in networks will be greatly reduced, which largely restricts the performance of those methods. In this paper, a simple and efficient method is proposed to identify a set of discrete yet influential spreaders. By analyzing the spreading paths in the network, we present the concept of effective spreading paths and measure the influence of nodes via expectation calculation. The numerical analysis in undirected and directed networks all show that our proposed method outperforms many other centrality-based and heuristic benchmarks, especially in large-scale networks. Besides, experimental results on different spreading models and parameters demonstrates the stability and wide applicability of our method.

Biased and unbiased strategies to identify biologically active small molecules.

PubMed

Abet, Valentina; Mariani, Angelica; Truscott, Fiona R; Britton, Sébastien; Rodriguez, Raphaël

2014-08-15

Small molecules are central players in chemical biology studies. They promote the perturbation of cellular processes underlying diseases and enable the identification of biological targets that can be validated for therapeutic intervention. Small molecules have been shown to accurately tune a single function of pluripotent proteins in a reversible manner with exceptional temporal resolution. The identification of molecular probes and drugs remains a worthy challenge that can be addressed by the use of biased and unbiased strategies. Hypothesis-driven methodologies employs a known biological target to synthesize complementary hits while discovery-driven strategies offer the additional means of identifying previously unanticipated biological targets. This review article provides a general overview of recent synthetic frameworks that gave rise to an impressive arsenal of biologically active small molecules with unprecedented cellular mechanisms. Copyright © 2014. Published by Elsevier Ltd.

The effectiveness of knowledge translation strategies used in public health: a systematic review

PubMed Central

2012-01-01

Background Literature related to the effectiveness of knowledge translation (KT) strategies used in public health is lacking. The capacity to seek, analyze, and synthesize evidence-based information in public health is linked to greater success in making policy choices that have the best potential to yield positive outcomes for populations. The purpose of this systematic review is to identify the effectiveness of KT strategies used to promote evidence-informed decision making (EIDM) among public health decision makers. Methods A search strategy was developed to identify primary studies published between 2000–2010. Studies were obtained from multiple electronic databases (CINAHL, Medline, EMBASE, and the Cochrane Database of Systematic Reviews). Searches were supplemented by hand searching and checking the reference lists of included articles. Two independent review authors screened studies for relevance, assessed methodological quality of relevant studies, and extracted data from studies using standardized tools. Results After removal of duplicates, the search identified 64, 391 titles related to KT strategies. Following title and abstract review, 346 publications were deemed potentially relevant, of which 5 met all relevance criteria on full text screen. The included publications were of moderate quality and consisted of five primary studies (four randomized controlled trials and one interrupted time series analysis). Results were synthesized narratively. Simple or single KT strategies were shown in some circumstances to be as effective as complex, multifaceted ones when changing practice including tailored and targeted messaging. Multifaceted KT strategies led to changes in knowledge but not practice. Knowledge translation strategies shown to be less effective were passive and included access to registries of pre-processed research evidence or print materials. While knowledge brokering did not have a significant effect generally, results suggested that it did

Clinicians with dyslexia: a systematic review of effects and strategies.

PubMed

Locke, Rachel; Scallan, Samantha; Mann, Richard; Alexander, Gail

2015-12-01

For educators, an awareness of the impact of dyslexia on learners in the clinical workplace is vital: first, to be able to identify whether dyslexia may underlie certain traits and behaviours; and second, to be able to provide appropriate advice and support when dyslexia is identified. We reviewed the primary research evidence concerning the effects of dyslexia on clinicians (in or after training) in the workplace, and adaptive strategies ('workarounds') that are presently in use. A systematic search of literature was undertaken, followed by a narrative review of studies selected as meeting the inclusion criteria. The review used a priori research questions and focused on studies based on primary research evidence. The review identified five key studies on qualified doctors or nurses with dyslexia. The impact of dyslexia on doctors can include: writing and calculating prescriptions, writing patient notes, and prioritising and making referrals. Strategies to minimise the effects of dyslexia include the use of adaptive technologies, the need for more time for mentors and supervisors, and an awareness of 'enabling' and 'disabling' environments. An awareness of the impact of dyslexia on learners in the clinical workplace is vital The difficulties associated with dyslexia are varied and may be unexpected. Medical educators must therefore be aware of dyslexia and its impact. When supporting a trainee with dyslexia, there is guidance available but educators may struggle to identify strategies and resources that are evidence based, so further research is required. © 2015 John Wiley & Sons Ltd.

The unique effects of environmental strategies in health promotion campaigns: a review.

PubMed

Randolph, Karen A; Whitaker, Pippin; Arellano, Adriana

2012-08-01

Various strategies are used as tools in health promotion campaigns to increase health-related outcomes among target populations. Evaluations of these campaigns examine effects on changing people's knowledge, attitudes, and/or behaviors. Most evaluations examine the combined impact of multiple strategies. Less is known about the unique effects of particular strategies. To address this gap, we used highly systematic methods to identify and review scientifically rigorous evaluations of 18 campaigns that examined the unique effects of three sets of intervention strategies (entertainment education, law enforcement, and mass media) on changes in knowledge, attitudes, and practice with regard to various health behaviors. Results showed differences in evaluation processes based on the type of strategy used to promote campaign messages. For instance, evaluations of mass-media based campaigns were more likely to examine changes in knowledge, relative to evaluations of campaigns that used law enforcement strategies. In addition, campaign effects varied by particular strategies. Mass media-based campaigns were more likely to affect knowledge, relative to behaviors. Law enforcement and entertainment education-based campaigns showed positive effects on behaviors. The implications for planning and evaluating health promotion campaigns are described. Copyright © 2012 Elsevier Ltd. All rights reserved.

Identifying Strategy Use in Category Learning Tasks: A Case for More Diagnostic Data and Models

ERIC Educational Resources Information Center

Donkin, Chris; Newell, Ben R.; Kalish, Mike; Dunn, John C.; Nosofsky, Robert M.

2015-01-01

The strength of conclusions about the adoption of different categorization strategies--and their implications for theories about the cognitive and neural bases of category learning--depend heavily on the techniques for identifying strategy use. We examine performance in an often-used "information-integration" category structure and…

An effective rumor-containing strategy

NASA Astrophysics Data System (ADS)

Pan, Cheng; Yang, Lu-Xing; Yang, Xiaofan; Wu, Yingbo; Tang, Yuan Yan

2018-06-01

False rumors can lead to huge economic losses or/and social instability. Hence, mitigating the impact of bogus rumors is of primary importance. This paper focuses on the problem of how to suppress a false rumor by use of the truth. Based on a set of rational hypotheses and a novel rumor-truth mixed spreading model, the effectiveness and cost of a rumor-containing strategy are quantified, respectively. On this basis, the original problem is modeled as a constrained optimization problem (the RC model), in which the independent variable and the objective function represent a rumor-containing strategy and the effectiveness of a rumor-containing strategy, respectively. The goal of the optimization problem is to find the most effective rumor-containing strategy subject to a limited rumor-containing budget. Some optimal rumor-containing strategies are given by solving their respective RC models. The influence of different factors on the highest cost effectiveness of a RC model is illuminated through computer experiments. The results obtained are instructive to develop effective rumor-containing strategies.

Strategies to identify and reduce opioid misuse among patients with gastrointestinal disorders: A systematic scoping review

PubMed Central

Balbale, Salva N.; Trivedi, Itishree; O’Dwyer, Linda C.; McHugh, Megan C.; Evans, Charlesnika T.; Jordan, Neil; Keefer, Laurie A.

2018-01-01

Background Scoping reviews are preliminary assessments intended to characterize the extent and nature of emerging research evidence, identify literature gaps, and offer directions for future research. We conducted a systematic scoping review to describe published scientific literature on strategies to identify and reduce opioid misuse among patients with gastrointestinal (GI) symptoms and disorders. Methods We performed structured keyword searches to identify manuscripts published through June 2016 in the PubMed MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Scopus, and Web of Science databases to extract original research articles that described health care practices, tools or interventions to identify and reduce opioid misuse among GI patients. The Chronic Care Model (CCM) was used to classify the strategies presented. Results Twelve articles met the inclusion criteria. A majority of studies used quasi-experimental or retrospective cohort study designs. Most studies addressed the CCM’s clinical information systems element. Seven studies involved identification of opioid misuse through prescription drug monitoring and opioid misuse screening tools. Four studies discussed reductions in opioid use by harnessing drug monitoring data and individual care plans, and implementing self-management and opioid detoxification interventions. One study described drug monitoring and an audit-and-feedback intervention to both identify and reduce opioid misuse. Greatest reductions in opioid misuse were observed when drug monitoring, self-management, or audit-and-feedback interventions were used. Conclusions Prescription drug monitoring and self-management interventions may be promising strategies to identify and reduce opioid misuse in gastrointestinal care. Rigorous, empirical research is needed to evaluate the longer-term impact of these strategies. PMID:28780607

Strategies to Identify and Reduce Opioid Misuse Among Patients with Gastrointestinal Disorders: A Systematic Scoping Review.

PubMed

Balbale, Salva N; Trivedi, Itishree; O'Dwyer, Linda C; McHugh, Megan C; Evans, Charlesnika T; Jordan, Neil; Keefer, Laurie A

2017-10-01

Scoping reviews are preliminary assessments intended to characterize the extent and nature of emerging research evidence, identify literature gaps, and offer directions for future research. We conducted a systematic scoping review to describe published scientific literature on strategies to identify and reduce opioid misuse among patients with gastrointestinal (GI) symptoms and disorders. We performed structured keyword searches to identify manuscripts published through June 2016 in the PubMed MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Scopus, and Web of Science databases to extract original research articles that described healthcare practices, tools, or interventions to identify and reduce opioid misuse among GI patients. The Chronic Care Model (CCM) was used to classify the strategies presented. Twelve articles met the inclusion criteria. A majority of studies used quasi-experimental or retrospective cohort study designs. Most studies addressed the CCM's clinical information systems element. Seven studies involved identification of opioid misuse through prescription drug monitoring and opioid misuse screening tools. Four studies discussed reductions in opioid use by harnessing drug monitoring data and individual care plans, and implementing self-management and opioid detoxification interventions. One study described drug monitoring and an audit-and-feedback intervention to both identify and reduce opioid misuse. Greatest reductions in opioid misuse were observed when drug monitoring, self-management, or audit-and-feedback interventions were used. Prescription drug monitoring and self-management interventions may be promising strategies to identify and reduce opioid misuse in GI care. Rigorous, empirical research is needed to evaluate the longer-term impact of these strategies.

Validity and Reliability of a Systematic Database Search Strategy to Identify Publications Resulting From Pharmacy Residency Research Projects.

PubMed

Kwak, Namhee; Swan, Joshua T; Thompson-Moore, Nathaniel; Liebl, Michael G

2016-08-01

This study aims to develop a systematic search strategy and test its validity and reliability in terms of identifying projects published in peer-reviewed journals as reported by residency graduates through an online survey. This study was a prospective blind comparison to a reference standard. Pharmacy residency projects conducted at the study institution between 2001 and 2012 were included. A step-wise, systematic procedure containing up to 8 search strategies in PubMed and EMBASE for each project was created using the names of authors and abstract keywords. In order to further maximize sensitivity, complex phrases with multiple variations were truncated to the root word. Validity was assessed by obtaining information on publications from an online survey deployed to residency graduates. The search strategy identified 13 publications (93% sensitivity, 100% specificity, and 99% accuracy). Both methods identified a similar proportion achieving publication (19.7% search strategy vs 21.2% survey, P = 1.00). Reliability of the search strategy was affirmed by the perfect agreement between 2 investigators (k = 1.00). This systematic search strategy demonstrated a high sensitivity, specificity, and accuracy for identifying publications resulting from pharmacy residency projects using information available in residency conference abstracts. © The Author(s) 2015.

Under What Assumptions Do Site-by-Treatment Instruments Identify Average Causal Effects?

ERIC Educational Resources Information Center

Reardon, Sean F.; Raudenbush, Stephen W.

2011-01-01

The purpose of this paper is to clarify the assumptions that must be met if this--multiple site, multiple mediator--strategy, hereafter referred to as "MSMM," is to identify the average causal effects (ATE) in the populations of interest. The authors' investigation of the assumptions of the multiple-mediator, multiple-site IV model demonstrates…

Identifying tacit strategies in aircraft maneuvers

NASA Technical Reports Server (NTRS)

Lewis, Charles M.; Heidorn, P. B.

1991-01-01

Two machine-learning methods are presently used to characterize the avoidance strategies used by skilled pilots in simulated aircraft encounters, and a general framework for the characterization of the strategic components of skilled behavior via qualitative representation of situations and responses is presented. Descriptions of pilot maneuvers that were 'conceptually equivalent' were ascertained by a concept-learning algorithm in conjunction with a classifier system that employed a generic algorithm; satisficing and 'buggy' strategies were thereby revealed.

Generating demand for pharmacist-provided medication therapy management: identifying patient-preferred marketing strategies.

PubMed

Garcia, Gladys M; Snyder, Margie E; McGrath, Stephanie Harriman; Smith, Randall B; McGivney, Melissa Somma

2009-01-01

To identify effective strategies for marketing pharmacist-provided medication therapy management (MTM) services to patients in a self-insured employer setting. Qualitative study. University of Pittsburgh during March through May 2008. 26 university employees taking at least one chronic medication. Three focus group sessions were conducted using a semistructured topic guide to facilitate the discussion. Employees' perceived medication-related needs, perceived benefits of pharmacist-provided MTM, potential barriers for employee participation in MTM, and effective strategies for marketing MTM. Participants reported concerns with timing of doses, medication costs, access, and ensuring adherence. Participants generally felt positively toward pharmacists; however, the level of reported patient contact with pharmacists varied among participants. Some participants questioned pharmacists' education and qualifications for this enhanced role in patient care. Perceived benefits of MTM noted by participants included the opportunity to obtain personalized information about their medications and the potential for improved communication among their health providers. Barriers to patient participation were out-of-pocket costs and lack of time for MTM visits. Participants suggested use of alternative words to describe MTM and marketing approaches that involve personal contact. Pharmacists should emphasize parts of MTM that patients feel are most beneficial (i.e., provision of a personal medication record) and use patient-friendly language to describe MTM when marketing their practice. Patients will need greater exposure to the concept of MTM and the pharmacists' role in order to correctly describe and assign value to this type of pharmacist patient care practice.

Challenges and Strategies for Building and Maintaining Effective Preceptor-Preceptee Relationships among Nurses.

PubMed

Matua, Gerald A; Seshan, Vidya; Savithri, Raman; Fronda, Dennis C

2014-11-01

This study aimed to determine the challenges encountered and strategies used by nurse preceptors to build effective professional relationships during the preceptorship of final year nursing students. This study was conducted in November 2012 at the College of Nursing in Sultan Qaboos University, Muscat, Oman. A qualitative research design consisting of focus group discussions was used to investigate the challenges that preceptors encounter and the strategies that they use to build effective relationships with preceptees. A total of 21 preceptors from Sultan Qaboos University Hospital participated in the study as part of a training workshop for nurse preceptors. The interviews were audio recorded, transcribed verbatim and thematically analysed. The main challenges faced by preceptors included discrepancies in applying theory to practice; lack of trust; lack of time, and perceived lack of knowledge. The effective strategies identified by the preceptors to be used in building a healthy preceptor-preceptee relationship were proper orientation; effective communication; preparation for complex situations; appreciation and acknowledgment; positive feedback; assurance of support; spending time together; knowing preceptors personally; giving breaks, and encouraging self-commitment. Preceptors should be encouraged to identify challenges that hinder the building of effective relationships with preceptees early during their preceptorship. The incorporation of appropriate and evidenced-based strategies, such as those identified in this study, can transform the preceptorship experience into one that is fulfilling for both preceptors and preceptees. This may lead to greater job satisfaction, personal and professional growth as well as higher self-esteem levels for preceptors and the realisation of clinical objectives for preceptees.

Challenges and Strategies for Building and Maintaining Effective Preceptor-Preceptee Relationships among Nurses

PubMed Central

Matua, Gerald A.; Seshan, Vidya; Savithri, Raman; Fronda, Dennis C.

2014-01-01

Objectives: This study aimed to determine the challenges encountered and strategies used by nurse preceptors to build effective professional relationships during the preceptorship of final year nursing students. Methods: This study was conducted in November 2012 at the College of Nursing in Sultan Qaboos University, Muscat, Oman. A qualitative research design consisting of focus group discussions was used to investigate the challenges that preceptors encounter and the strategies that they use to build effective relationships with preceptees. A total of 21 preceptors from Sultan Qaboos University Hospital participated in the study as part of a training workshop for nurse preceptors. The interviews were audio recorded, transcribed verbatim and thematically analysed. Results: The main challenges faced by preceptors included discrepancies in applying theory to practice; lack of trust; lack of time, and perceived lack of knowledge. The effective strategies identified by the preceptors to be used in building a healthy preceptor-preceptee relationship were proper orientation; effective communication; preparation for complex situations; appreciation and acknowledgment; positive feedback; assurance of support; spending time together; knowing preceptors personally; giving breaks, and encouraging self-commitment. Conclusion: Preceptors should be encouraged to identify challenges that hinder the building of effective relationships with preceptees early during their preceptorship. The incorporation of appropriate and evidenced-based strategies, such as those identified in this study, can transform the preceptorship experience into one that is fulfilling for both preceptors and preceptees. This may lead to greater job satisfaction, personal and professional growth as well as higher self-esteem levels for preceptors and the realisation of clinical objectives for preceptees. PMID:25364557

Cost-effectiveness of different screening strategies for osteoporosis in postmenopausal women.

PubMed

Nayak, Smita; Roberts, Mark S; Greenspan, Susan L

2011-12-06

The best strategies to screen postmenopausal women for osteoporosis are not clear. To identify the cost-effectiveness of various screening strategies. Individual-level state-transition cost-effectiveness model. Published literature. U.S. women aged 55 years or older. Lifetime. Payer. Screening strategies composed of alternative tests (central dual-energy x-ray absorptiometry [DXA], calcaneal quantitative ultrasonography [QUS], and the Simple Calculated Osteoporosis Risk Estimation [SCORE] tool) initiation ages, treatment thresholds, and rescreening intervals. Oral bisphosphonate treatment was assumed, with a base-case adherence rate of 50% and a 5-year on/off treatment pattern. Incremental cost-effectiveness ratios (2010 U.S. dollars per quality-adjusted life-year [QALY] gained). At all evaluated ages, screening was superior to not screening. In general, quality-adjusted life-days gained with screening tended to increase with age. At all initiation ages, the best strategy with an incremental cost-effectiveness ratio (ICER) of less than $50,000 per QALY was DXA screening with a T-score threshold of -2.5 or less for treatment and with follow-up screening every 5 years. Across screening initiation ages, the best strategy with an ICER less than $50,000 per QALY was initiation of screening at age 55 years by using DXA -2.5 with rescreening every 5 years. The best strategy with an ICER less than $100,000 per QALY was initiation of screening at age 55 years by using DXA with a T-score threshold of -2.0 or less for treatment and then rescreening every 10 years. No other strategy that involved treatment of women with osteopenia had an ICER less than $100,000 per QALY. Many other strategies, including strategies with SCORE or QUS prescreening, were also cost-effective, and in general the differences in effectiveness and costs between evaluated strategies was small. Probabilistic sensitivity analysis did not reveal a consistently superior strategy. Data were primarily from

A Quantitative Study Identifying Political Strategies Used by Principals of Dual Language Programs

ERIC Educational Resources Information Center

Girard, Guadalupe

2017-01-01

Purpose. The purpose of this quantitative study was to identify the external and internal political strategies used by principals that allow them to successfully navigate the political environment surrounding dual language programs. Methodology. This quantitative study used descriptive research to collect, analyze, and report data that identified…

Preservice Teachers' Knowledge of Effective Classroom Management Strategies: Defiant Behavior.

ERIC Educational Resources Information Center

Kher, Neelam; Lacina-Gifford, Lorna J.; Yandell, Sonya

This study identified preservice teachers' knowledge about effective and ineffective classroom management strategies for defiant behavior. Data in the form of extended written responses were obtained from student teachers in a rural, southern teacher education program at the end of their student teaching experience in the spring semester.…

Effectiveness and cost-effectiveness of behavioural strategies in the prevention of cigarette smoking

PubMed Central

Müller-Riemenschneider, Falk; Rasch, Andrej; Bockelbrink, Angelina; Vauth, Christoph; Willich, Stefan N.; Greiner, Wolfgang

2008-01-01

Background The hazardous health effects of smoking and second hand smoke have been confirmed in numerous studies. For Germany, the mortality attributable to smoking is estimated at 110,000 to 140,000 deaths per year, associated with annual smoking-related costs of 17 to 21 billion euro. Because the majority of smokers initiate this habit early in life, behavioural preventive strategies usually tried to prevent the uptake of smoking among children and youths. Objectives The goal of this HTA is to summarise the current literature on behavioural strategies for smoking prevention and to evaluate their medical effectiveness/efficacy and cost-effectiveness as well as the ethical, social and legal implications of smoking prevention programs. In addition, this report aims to compare the effectiveness and efficacy of different intervention components and to evaluate the reliability of results in the German context. Methods Relevant publications were identified by means of a structured search of databases accessed through the German Institute of Medical Documentation and Information (DIMDI). In addition a manual search of identified reference lists was conducted. The present report includes German and English literature published between August 2001 and August 2006 targeting youths up to 18 years old. The methodological quality of included studies was assessed according to pre-defined quality criteria, based on the criteria of evidence-based medicine. Results Among 3,580 publications 37 medical studies met the inclusion criteria. Overall study quality was satisfactory but only half the studies reported smoking uptake as an outcome, while the remaining studies reported alternative outcome parameters. The follow-up duration varied between twelve and 120 months. Although overall effectiveness of prevention programs showed considerable heterogeneity, there was evidence for the long-term effectiveness of behavioural smoking prevention programs. However, the reduction in smoking

Identifying protein complexes based on brainstorming strategy.

PubMed

Shen, Xianjun; Zhou, Jin; Yi, Li; Hu, Xiaohua; He, Tingting; Yang, Jincai

2016-11-01

Protein complexes comprising of interacting proteins in protein-protein interaction network (PPI network) play a central role in driving biological processes within cells. Recently, more and more swarm intelligence based algorithms to detect protein complexes have been emerging, which have become the research hotspot in proteomics field. In this paper, we propose a novel algorithm for identifying protein complexes based on brainstorming strategy (IPC-BSS), which is integrated into the main idea of swarm intelligence optimization and the improved K-means algorithm. Distance between the nodes in PPI network is defined by combining the network topology and gene ontology (GO) information. Inspired by human brainstorming process, IPC-BSS algorithm firstly selects the clustering center nodes, and then they are separately consolidated with the other nodes with short distance to form initial clusters. Finally, we put forward two ways of updating the initial clusters to search optimal results. Experimental results show that our IPC-BSS algorithm outperforms the other classic algorithms on yeast and human PPI networks, and it obtains many predicted protein complexes with biological significance. Copyright © 2016 Elsevier Inc. All rights reserved.

[Strategies to identify supernumerary chromosomal markers in constitutional cytogenetics].

PubMed

Douet-Guilbert, N; Basinko, A; Le Bris, M-J; Herry, A; Morel, F; De Braekeleer, M

2008-09-01

Supernumerary marker chromosomes (SMCs) are defined as extrastructurally abnormal chromosomes which origin and composition cannot be determined by conventional cytogenetics. SMCs are an heterogeneous group of abnormalities concerning all chromosomes with variable structure and size and are associated with phenotypic heterogeneity. The characterisation of SMCs is of utmost importance for genetic counselling. Different molecular techniques are used to identify chromosomal material present in markers such as 24-colour FISH (MFISH, SKY), centromere specific multicolour FISH (cenMFISH) and derivatives (acroMFISH, subcenMFISH), comparative genomic hybridisation (CGH), arrayCGH, and targeted FISH techniques (banding techniques, whole chromosome painting...). Based on the morphology of SMC with conventional cytogenetic and clinical data, we tried to set up different molecular strategies with all available techniques.

Engaging Communities in Identifying Local Strategies for Expanding Integrated Employment During and After High School.

PubMed

Carter, Erik W; Blustein, Carly L; Bumble, Jennifer L; Harvey, Sarah; Henderson, Lynnette M; McMillan, Elise D

2016-09-01

Amidst decades of attention directed toward improving employment outcomes for people with intellectual and developmental disabilities (IDD), few efforts have been made to engage communities in identifying local solutions for expanding integrated employment opportunities. We examined the implementation and outcomes of "community conversation" events held in 6 geographically and economically diverse locales. Each event used an asset-based dialogue approach called the World Café ( Brown & Isaacs, 2005 ) to solicit ideas from a broad cross-section of community members on improving integrated employment that reflect local priorities and possibilities. Six key themes encapsulated the 1,556 strategies generated by the almost 400 attendees. Although considerable consistency was found among the categories of strategies raised across events, the manner in which those individual strategies would be implemented locally reflected the unique accent of each community. Attendees also viewed these events as promising and productive pathways for identifying next steps for their community. We offer recommendations for community-level intervention efforts and suggest directions for future research.

A Strategy for Identifying Quantitative Trait Genes Using Gene Expression Analysis and Causal Analysis.

PubMed

Ishikawa, Akira

2017-11-27

Large numbers of quantitative trait loci (QTL) affecting complex diseases and other quantitative traits have been reported in humans and model animals. However, the genetic architecture of these traits remains elusive due to the difficulty in identifying causal quantitative trait genes (QTGs) for common QTL with relatively small phenotypic effects. A traditional strategy based on techniques such as positional cloning does not always enable identification of a single candidate gene for a QTL of interest because it is difficult to narrow down a target genomic interval of the QTL to a very small interval harboring only one gene. A combination of gene expression analysis and statistical causal analysis can greatly reduce the number of candidate genes. This integrated approach provides causal evidence that one of the candidate genes is a putative QTG for the QTL. Using this approach, I have recently succeeded in identifying a single putative QTG for resistance to obesity in mice. Here, I outline the integration approach and discuss its usefulness using my studies as an example.

Effectiveness of communication strategies for deaf or hard of hearing workers in group settings.

PubMed

Haynes, Scott

2014-01-01

In group settings, background noise and an obstructed view of the speaker are just a few of the issues that can make workplace communication difficult for an individual who is deaf or hard of hearing. Accommodation strategies such as amplification of the speaker's voice or the use of text-based alternatives exist to address these issues. However, recent studies have shown that there are still unmet needs related to workplace communication in group settings for individuals who are deaf or hard of hearing. Identify the most common strategies used by individuals who are deaf or hard of hearing to improve communication in group settings and gauge the perceived effectiveness of those strategies. An online survey was conducted with individuals who self-identified as deaf or hard of hearing. The survey presented specific communication strategies based on three functional approaches (aural/oral, text, visual). The strategies applied to both receptive and expressive communication in five different meeting types ranging in size and purpose. 161 adults (age 22-90 yrs.) with limited hearing ability completed the survey. Text-based strategies were typically the least frequently used strategies in group settings, yet they ranked high in perceived effectiveness for receptive and expressive communication. Those who used an interpreter demonstrated a strong preference for having a qualified interpreter present in the meeting rather than an interpreter acting remotely. For expressive communication, participants in general preferred to use their own voice or signing abilities and ranked those strategies as highly effective. A more accessible workplace for individuals who are deaf or hard of hearing would incorporate more ubiquitous text-based strategy options. Also, qualified interpreters, when used, should be present in the meeting for maximum effectiveness.

A new computational strategy for identifying essential proteins based on network topological properties and biological information.

PubMed

Qin, Chao; Sun, Yongqi; Dong, Yadong

2017-01-01

Essential proteins are the proteins that are indispensable to the survival and development of an organism. Deleting a single essential protein will cause lethality or infertility. Identifying and analysing essential proteins are key to understanding the molecular mechanisms of living cells. There are two types of methods for predicting essential proteins: experimental methods, which require considerable time and resources, and computational methods, which overcome the shortcomings of experimental methods. However, the prediction accuracy of computational methods for essential proteins requires further improvement. In this paper, we propose a new computational strategy named CoTB for identifying essential proteins based on a combination of topological properties, subcellular localization information and orthologous protein information. First, we introduce several topological properties of the protein-protein interaction (PPI) network. Second, we propose new methods for measuring orthologous information and subcellular localization and a new computational strategy that uses a random forest prediction model to obtain a probability score for the proteins being essential. Finally, we conduct experiments on four different Saccharomyces cerevisiae datasets. The experimental results demonstrate that our strategy for identifying essential proteins outperforms traditional computational methods and the most recently developed method, SON. In particular, our strategy improves the prediction accuracy to 89, 78, 79, and 85 percent on the YDIP, YMIPS, YMBD and YHQ datasets at the top 100 level, respectively.

4-H Alumni: Techniques and Strategies of Identifying and Involving 4-H Alumni.

ERIC Educational Resources Information Center

Reese, Cheryl C.

Techniques and strategies of identifying and involving 4-H alumni are discussed and described via a model of the Tennessee 4-H Alumni, Inc., which began in 1975. Following an introduction, the guide begins with a section on finding and organizing alumni which encompasses alumni organizers (organizational decisions, model alumni association);…

English Language Learners: Effective Teaching Strategies, Practices for FCS Teachers

ERIC Educational Resources Information Center

Allison, Barbara N.; Rehm, Marsha L.

2011-01-01

English language learners represent the fastest growing segment of the U.S. school-age population, raising the question of how best to teach this new and challenging group of students. The research and scholarly literature has identified a number of instructional strategies and classroom practices that have been shown to be effective in teaching…

The use of concept mapping to identify community-driven intervention strategies for physical and mental health.

PubMed

Vaughn, Lisa M; Jacquez, Farrah; McLinden, Daniel

2013-09-01

Research that partners with youth and community stakeholders increases contextual relevance and community buy-in and therefore maximizes the chance for intervention success. Concept mapping is a mixed-method participatory research process that accesses the input of the community in a collaborative manner. After a school-wide health needs assessment at a low-income, minority/immigrant K-8 school identified bullying and obesity as the most important health issues, concept mapping was used to identify and prioritize specific strategies to address these two areas. Stakeholders including 160 K-8 students, 33 college students working in the school, 35 parents, 20 academic partners, and 22 teachers/staff brainstormed strategies to reduce and prevent obesity and bullying. A smaller group of stakeholders worked individually to complete an unstructured sorting of these strategies into groups of similar ideas, once for obesity and again for bullying. Multidimensional scaling and cluster analysis was applied to the sorting data to produce a series of maps that illustrated the stakeholders' conceptual thinking about obesity and bullying prevention strategies. The maps for both obesity and bullying organized specific strategies into themes that included education, parental role, teacher/school supervision, youth role, expert/professional role, and school structure/support.

Cost-effectiveness of health research study participant recruitment strategies: a systematic review.

PubMed

Huynh, Lynn; Johns, Benjamin; Liu, Su-Hsun; Vedula, S Swaroop; Li, Tianjing; Puhan, Milo A

2014-10-01

A large fraction of the cost of conducting clinical trials is allocated to recruitment of participants. A synthesis of findings from studies that evaluate the cost and effectiveness of different recruitment strategies will inform investigators in designing cost-efficient clinical trials. To systematically identify, assess, and synthesize evidence from published comparisons of the cost and yield of strategies for recruitment of participants to health research studies. We included randomized studies in which two or more strategies for recruitment of participants had been compared. We focused our economic evaluation on studies that randomized participants to different recruitment strategies. We identified 10 randomized studies that compared recruitment strategies, including monetary incentives (cash or prize), direct contact (letters or telephone call), and medical referral strategies. Only two of the 10 studies compared strategies for recruiting participants to clinical trials. We found that allocating additional resources to recruit participants using monetary incentives or direct contact yielded between 4% and 23% additional participants compared to using neither strategy. For medical referral, recruitment of prostate cancer patients by nurses was cost-saving compared to recruitment by consultant urologists. For all underlying study designs, monetary incentives cost more than direct contact with potential participants, with a median incremental cost per recruitment ratio of Int$72 (Int$-International dollar, a theoretical unit of currency) for monetary incentive strategy compared to Int$28 for direct contact strategy. Only monetary incentives and source of referral were evaluated for recruiting participants into clinical trials. We did not review studies that presented non-monetary cost or lost opportunity cost. We did not adjust for the number of study recruitment sites or the study duration in our economic evaluation analysis. Systematic and explicit reporting of

Efficiency, equity and feasibility of strategies to identify the poor: an application to premium exemptions under National Health Insurance in Ghana.

PubMed

Jehu-Appiah, Caroline; Aryeetey, Genevieve; Spaan, Ernst; Agyepong, Irene; Baltussen, Rob

2010-05-01

This paper outlines the potential strategies to identify the poor, and assesses their feasibility, efficiency and equity. Analyses are illustrated for the case of premium exemptions under National Health Insurance (NHI) in Ghana. A literature search in Medline search was performed to identify strategies to identify the poor. Models were developed including information on demography and poverty, and costs and errors of in- and exclusion of these strategies in two regions in Ghana. Proxy means testing (PMT), participatory welfare ranking (PWR), and geographic targeting (GT) are potentially useful strategies to identify the poor, and vary in terms of their efficiency, equity and feasibility. Costs to exempt one poor individual range between US$11.63 and US$66.67, and strategies may exclude up to 25% of the poor. Feasibility of strategies is dependent on their aptness in rural/urban settings, and administrative capacity to implement. A decision framework summarizes the above information to guide policy making. We recommend PMT as an optimal strategy in relative low poverty incidence urbanized settings, PWR as an optimal strategy in relative low poverty incidence rural settings, and GT as an optimal strategy in high incidence poverty settings. This paper holds important lessons not only for NHI in Ghana but also for other countries implementing exemption policies. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

Strategy Instruction. ERIC Digest.

ERIC Educational Resources Information Center

Beckman, Pat

This digest discusses using strategy instruction to assist students with learning disabilities. It begins by describing strategy instruction as teaching students about strategies, teaching them how and when to use strategies, helping students identify personally effective strategies, and encouraging students to make strategic behaviors part of…

Adaptive Management as an Effective Strategy: Interdisciplinary Perceptions for Natural Resources Management

NASA Astrophysics Data System (ADS)

Dreiss, Lindsay M.; Hessenauer, Jan-Michael; Nathan, Lucas R.; O'Connor, Kelly M.; Liberati, Marjorie R.; Kloster, Danielle P.; Barclay, Janet R.; Vokoun, Jason C.; Morzillo, Anita T.

2017-02-01

Adaptive management is a well-established approach to managing natural resources, but there is little evidence demonstrating effectiveness of adaptive management over traditional management techniques. Peer-reviewed literature attempts to draw conclusions about adaptive management effectiveness using social perceptions, but those studies are largely restricted to employees of US federal organizations. To gain a more comprehensive insight into perceived adaptive management effectiveness, this study aimed to broaden the suite of disciplines, professional affiliations, and geographic backgrounds represented by both practitioners and scholars. A questionnaire contained a series of questions concerning factors that lead to or inhibit effective management, followed by another set of questions focused on adaptive management. Using a continuum representing strategies of both adaptive management and traditional management, respondents selected those strategies that they perceived as being effective. Overall, characteristics (i.e., strategies, stakeholders, and barriers) identified by respondents as contributing to effective management closely aligned with adaptive management. Responses were correlated to the type of adaptive management experience rather than an individual's discipline, occupational, or regional affiliation. In particular, perceptions of characteristics contributing to adaptive management effectiveness varied between respondents who identified as adaptive management scholars (i.e., no implementation experience) and adaptive management practitioners. Together, these results supported two concepts that make adaptive management effective: practitioners emphasized adaptive management's value as a long-term approach and scholars noted the importance of stakeholder involvement. Even so, more communication between practitioners and scholars regarding adaptive management effectiveness could promote interdisciplinary learning and problem solving for improved

Adaptive Management as an Effective Strategy: Interdisciplinary Perceptions for Natural Resources Management.

PubMed

Dreiss, Lindsay M; Hessenauer, Jan-Michael; Nathan, Lucas R; O'Connor, Kelly M; Liberati, Marjorie R; Kloster, Danielle P; Barclay, Janet R; Vokoun, Jason C; Morzillo, Anita T

2017-02-01

Adaptive management is a well-established approach to managing natural resources, but there is little evidence demonstrating effectiveness of adaptive management over traditional management techniques. Peer-reviewed literature attempts to draw conclusions about adaptive management effectiveness using social perceptions, but those studies are largely restricted to employees of US federal organizations. To gain a more comprehensive insight into perceived adaptive management effectiveness, this study aimed to broaden the suite of disciplines, professional affiliations, and geographic backgrounds represented by both practitioners and scholars. A questionnaire contained a series of questions concerning factors that lead to or inhibit effective management, followed by another set of questions focused on adaptive management. Using a continuum representing strategies of both adaptive management and traditional management, respondents selected those strategies that they perceived as being effective. Overall, characteristics (i.e., strategies, stakeholders, and barriers) identified by respondents as contributing to effective management closely aligned with adaptive management. Responses were correlated to the type of adaptive management experience rather than an individual's discipline, occupational, or regional affiliation. In particular, perceptions of characteristics contributing to adaptive management effectiveness varied between respondents who identified as adaptive management scholars (i.e., no implementation experience) and adaptive management practitioners. Together, these results supported two concepts that make adaptive management effective: practitioners emphasized adaptive management's value as a long-term approach and scholars noted the importance of stakeholder involvement. Even so, more communication between practitioners and scholars regarding adaptive management effectiveness could promote interdisciplinary learning and problem solving for improved

Achieving change in primary care—effectiveness of strategies for improving implementation of complex interventions: systematic review of reviews

PubMed Central

Lau, Rosa; Stevenson, Fiona; Ong, Bie Nio; Dziedzic, Krysia; Treweek, Shaun; Eldridge, Sandra; Everitt, Hazel; Kennedy, Anne; Qureshi, Nadeem; Rogers, Anne; Peacock, Richard; Murray, Elizabeth

2015-01-01

Objective To identify, summarise and synthesise available literature on the effectiveness of implementation strategies for optimising implementation of complex interventions in primary care. Design Systematic review of reviews. Data sources MEDLINE, EMBASE, CINAHL, Cochrane Library and PsychINFO were searched, from first publication until December 2013; the bibliographies of relevant articles were screened for additional reports. Eligibility criteria for selecting studies Eligible reviews had to (1) examine effectiveness of single or multifaceted implementation strategies, (2) measure health professional practice or process outcomes and (3) include studies from predominantly primary care in developed countries. Two reviewers independently screened titles/abstracts and full-text articles of potentially eligible reviews for inclusion. Data synthesis Extracted data were synthesised using a narrative approach. Results 91 reviews were included. The most commonly evaluated strategies were those targeted at the level of individual professionals, rather than those targeting organisations or context. These strategies (eg, audit and feedback, educational meetings, educational outreach, reminders) on their own demonstrated a small to modest improvement (2–9%) in professional practice or behaviour with considerable variability in the observed effects. The effects of multifaceted strategies targeted at professionals were mixed and not necessarily more effective than single strategies alone. There was relatively little review evidence on implementation strategies at the levels of organisation and wider context. Evidence on cost-effectiveness was limited and data on costs of different strategies were scarce and/or of low quality. Conclusions There is a substantial literature on implementation strategies aimed at changing professional practices or behaviour. It remains unclear which implementation strategies are more likely to be effective than others and under what conditions

A model-based assessment of the cost-utility of strategies to identify Lynch syndrome in early-onset colorectal cancer patients.

PubMed

Snowsill, Tristan; Huxley, Nicola; Hoyle, Martin; Jones-Hughes, Tracey; Coelho, Helen; Cooper, Chris; Frayling, Ian; Hyde, Chris

2015-04-25

Lynch syndrome is an autosomal dominant cancer predisposition syndrome caused by mutations in the DNA mismatch repair genes MLH1, MSH2, MSH6 and PMS2. Individuals with Lynch syndrome have an increased risk of colorectal cancer, endometrial cancer, ovarian and other cancers. Lynch syndrome remains underdiagnosed in the UK. Reflex testing for Lynch syndrome in early-onset colorectal cancer patients is proposed as a method to identify more families affected by Lynch syndrome and offer surveillance to reduce cancer risks, although cost-effectiveness is viewed as a barrier to implementation. The objective of this project was to estimate the cost-utility of strategies to identify Lynch syndrome in individuals with early-onset colorectal cancer in the NHS. A decision analytic model was developed which simulated diagnostic and long-term outcomes over a lifetime horizon for colorectal cancer patients with and without Lynch syndrome and for relatives of those patients. Nine diagnostic strategies were modelled which included microsatellite instability (MSI) testing, immunohistochemistry (IHC), BRAF mutation testing (methylation testing in a scenario analysis), diagnostic mutation testing and Amsterdam II criteria. Biennial colonoscopic surveillance was included for individuals diagnosed with Lynch syndrome and accepting surveillance. Prophylactic hysterectomy with bilateral salpingo-oophorectomy (H-BSO) was similarly included for women diagnosed with Lynch syndrome. Costs from NHS and Personal Social Services perspective and quality-adjusted life years (QALYs) were estimated and discounted at 3.5% per annum. All strategies included for the identification of Lynch syndrome were cost-effective versus no testing. The strategy with the greatest net health benefit was MSI followed by BRAF followed by diagnostic genetic testing, costing £5,491 per QALY gained over no testing. The effect of prophylactic H-BSO on health-related quality of life (HRQoL) is uncertain and could outweigh

Identifying optimal agricultural countermeasure strategies for a hypothetical contamination scenario using the strategy model.

PubMed

Cox, G; Beresford, N A; Alvarez-Farizo, B; Oughton, D; Kis, Z; Eged, K; Thørring, H; Hunt, J; Wright, S; Barnett, C L; Gil, J M; Howard, B J; Crout, N M J

2005-01-01

A spatially implemented model designed to assist the identification of optimal countermeasure strategies for radioactively contaminated regions is described. Collective and individual ingestion doses for people within the affected area are estimated together with collective exported ingestion dose. A range of countermeasures are incorporated within the model, and environmental restrictions have been included as appropriate. The model evaluates the effectiveness of a given combination of countermeasures through a cost function which balances the benefit obtained through the reduction in dose with the cost of implementation. The optimal countermeasure strategy is the combination of individual countermeasures (and when and where they are implemented) which gives the lowest value of the cost function. The model outputs should not be considered as definitive solutions, rather as interactive inputs to the decision making process. As a demonstration the model has been applied to a hypothetical scenario in Cumbria (UK). This scenario considered a published nuclear power plant accident scenario with a total deposition of 1.7x10(14), 1.2x10(13), 2.8x10(10) and 5.3x10(9)Bq for Cs-137, Sr-90, Pu-239/240 and Am-241, respectively. The model predicts that if no remediation measures were implemented the resulting collective dose would be approximately 36 000 person-Sv (predominantly from 137Cs) over a 10-year period post-deposition. The optimal countermeasure strategy is predicted to avert approximately 33 000 person-Sv at a cost of approximately 160 million pounds. The optimal strategy comprises a mixture of ploughing, AFCF (ammonium-ferric hexacyano-ferrate) administration, potassium fertiliser application, clean feeding of livestock and food restrictions. The model recommends specific areas within the contaminated area and time periods where these measures should be implemented.

Barriers and Effective Educational Strategies to Develop Extension Agents' Professional Competencies

ERIC Educational Resources Information Center

Lakai, Dona; Jayaratne, K. S. U.; Moore, Gary E.; Kistler, Mark J.

2012-01-01

The study reported here determined the barriers and effective educational strategies to develop Extension agents' professional competencies. This was a descriptive survey research conducted with a random sample of Extension agents. Increased workload and lack of time and funding were identified as the most constraining barriers of Extension agents…

Strategies to design clinical studies to identify predictive biomarkers in cancer research.

PubMed

Perez-Gracia, Jose Luis; Sanmamed, Miguel F; Bosch, Ana; Patiño-Garcia, Ana; Schalper, Kurt A; Segura, Victor; Bellmunt, Joaquim; Tabernero, Josep; Sweeney, Christopher J; Choueiri, Toni K; Martín, Miguel; Fusco, Juan Pablo; Rodriguez-Ruiz, Maria Esperanza; Calvo, Alfonso; Prior, Celia; Paz-Ares, Luis; Pio, Ruben; Gonzalez-Billalabeitia, Enrique; Gonzalez Hernandez, Alvaro; Páez, David; Piulats, Jose María; Gurpide, Alfonso; Andueza, Mapi; de Velasco, Guillermo; Pazo, Roberto; Grande, Enrique; Nicolas, Pilar; Abad-Santos, Francisco; Garcia-Donas, Jesus; Castellano, Daniel; Pajares, María J; Suarez, Cristina; Colomer, Ramon; Montuenga, Luis M; Melero, Ignacio

2017-02-01

The discovery of reliable biomarkers to predict efficacy and toxicity of anticancer drugs remains one of the key challenges in cancer research. Despite its relevance, no efficient study designs to identify promising candidate biomarkers have been established. This has led to the proliferation of a myriad of exploratory studies using dissimilar strategies, most of which fail to identify any promising targets and are seldom validated. The lack of a proper methodology also determines that many anti-cancer drugs are developed below their potential, due to failure to identify predictive biomarkers. While some drugs will be systematically administered to many patients who will not benefit from them, leading to unnecessary toxicities and costs, others will never reach registration due to our inability to identify the specific patient population in which they are active. Despite these drawbacks, a limited number of outstanding predictive biomarkers have been successfully identified and validated, and have changed the standard practice of oncology. In this manuscript, a multidisciplinary panel reviews how those key biomarkers were identified and, based on those experiences, proposes a methodological framework-the DESIGN guidelines-to standardize the clinical design of biomarker identification studies and to develop future research in this pivotal field. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Ownership strategies of multinational corporations: Towards designing effective global networks

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

Raghunathan, S.P.

1992-01-01

The thesis of this research is that MNCs, attempting to implement different international strategies in response to several environmental factors, let their global networks evolve. The ownership structure of the network is therefore a function of the international strategy and environment of a firm. A particular strategy (configuration/coordination), given a certain environment, may be effective if associated with the appropriate structure. This study is based on a survey of 318 US manufacturing-sector MNCs using a questionnaire. The ownership structure of an MNC network was identified by studying the nature of ownership - method and form - of overseas subsidiaries. Usingmore » network theoretic methods, ownership structure was empirically related to international environment, strategy, and performance. Results of this study throw light on the design of global networks and enable a general theory of the design of MNCs to be eventually developed.« less

A parallel genome-wide RNAi screening strategy to identify host proteins important for entry of Marburg virus and H5N1 influenza virus.

PubMed

Cheng, Han; Koning, Katie; O'Hearn, Aileen; Wang, Minxiu; Rumschlag-Booms, Emily; Varhegyi, Elizabeth; Rong, Lijun

2015-11-24

Genome-wide RNAi screening has been widely used to identify host proteins involved in replication and infection of different viruses, and numerous host factors are implicated in the replication cycles of these viruses, demonstrating the power of this approach. However, discrepancies on target identification of the same viruses by different groups suggest that high throughput RNAi screening strategies need to be carefully designed, developed and optimized prior to the large scale screening. Two genome-wide RNAi screens were performed in parallel against the entry of pseudotyped Marburg viruses and avian influenza virus H5N1 utilizing an HIV-1 based surrogate system, to identify host factors which are important for virus entry. A comparative analysis approach was employed in data analysis, which alleviated systematic positional effects and reduced the false positive number of virus-specific hits. The parallel nature of the strategy allows us to easily identify the host factors for a specific virus with a greatly reduced number of false positives in the initial screen, which is one of the major problems with high throughput screening. The power of this strategy is illustrated by a genome-wide RNAi screen for identifying the host factors important for Marburg virus and/or avian influenza virus H5N1 as described in this study. This strategy is particularly useful for highly pathogenic viruses since pseudotyping allows us to perform high throughput screens in the biosafety level 2 (BSL-2) containment instead of the BSL-3 or BSL-4 for the infectious viruses, with alleviated safety concerns. The screening strategy together with the unique comparative analysis approach makes the data more suitable for hit selection and enables us to identify virus-specific hits with a much lower false positive rate.

The effects of three concept mapping strategies on seventh-grade students' science achievement at an urban middle school

NASA Astrophysics Data System (ADS)

Dosanjh, Navdeep Kaur

2011-12-01

There is great concern over students' poor science achievement in the United States. Due to the lack of science achievement, students are not pursing science related careers resulting in an increase in outsourcing to other countries. Learning strategies such as concept mapping may ameliorate this situation by providing students with tools that encourage meaningful learning. The purpose of this quasi-experimental study was to measure the effects of three concept mapping learning strategies (concept identifying, proposition identifying, student generated) on urban middle school students' understanding of the circulatory system. Three intact classes of seventh-grade students were assigned to one of the three concept mapping strategies. The students were given a pretest on the circulatory system then learned and used their respective concept mapping strategies while learning about the circulatory system. At the conclusion of the study, students' science achievement was measured by performance on an achievement test and rubric scores of their respective concept identifying, proposition identifying, and student generated concept maps. The results of the study suggest that all three of the concept mapping strategies are effective in increasing students' science achievement. Additionally, the moderate significant correlations between the posttest and concept map scores of the current study established that concept maps are a useful measure of student knowledge. Lastly, the results of the current study also suggest that the concept identifying mapping strategy may be a useful scaffold in instructing students how to develop student generated concept maps.

Dealing with feeling: a meta-analysis of the effectiveness of strategies derived from the process model of emotion regulation.

PubMed

Webb, Thomas L; Miles, Eleanor; Sheeran, Paschal

2012-07-01

The present meta-analysis investigated the effectiveness of strategies derived from the process model of emotion regulation in modifying emotional outcomes as indexed by experiential, behavioral, and physiological measures. A systematic search of the literature identified 306 experimental comparisons of different emotion regulation (ER) strategies. ER instructions were coded according to a new taxonomy, and meta-analysis was used to evaluate the effectiveness of each strategy across studies. The findings revealed differences in effectiveness between ER processes: Attentional deployment had no effect on emotional outcomes (d(+) = 0.00), response modulation had a small effect (d(+) = 0.16), and cognitive change had a small-to-medium effect (d(+) = 0.36). There were also important within-process differences. We identified 7 types of attentional deployment, 4 types of cognitive change, and 4 types of response modulation, and these distinctions had a substantial influence on effectiveness. Whereas distraction was an effective way to regulate emotions (d(+) = 0.27), concentration was not (d(+) = -0.26). Similarly, suppressing the expression of emotion proved effective (d(+) = 0.32), but suppressing the experience of emotion or suppressing thoughts of the emotion-eliciting event did not (d(+) = -0.04 and -0.12, respectively). Finally, reappraising the emotional response proved less effective (d(+) = 0.23) than reappraising the emotional stimulus (d(+) = 0.36) or using perspective taking (d(+) = 0.45). The review also identified several moderators of strategy effectiveness including factors related to the (a) to-be-regulated emotion, (b) frequency of use and intended purpose of the ER strategy, (c) study design, and (d) study characteristics.

Constructing the effect of alternative intervention strategies on historic epidemics.

PubMed

Cook, A R; Gibson, G J; Gottwald, T R; Gilligan, C A

2008-10-06

Data from historical epidemics provide a vital and sometimes under-used resource from which to devise strategies for future control of disease. Previous methods for retrospective analysis of epidemics, in which alternative interventions are compared, do not make full use of the information; by using only partial information on the historical trajectory, augmentation of control may lead to predictions of a paradoxical increase in disease. Here we introduce a novel statistical approach that takes full account of the available information in constructing the effect of alternative intervention strategies in historic epidemics. The key to the method lies in identifying a suitable mapping between the historic and notional outbreaks, under alternative control strategies. We do this by using the Sellke construction as a latent process linking epidemics. We illustrate the application of the method with two examples. First, using temporal data for the common human cold, we show the improvement under the new method in the precision of predictions for different control strategies. Second, we show the generality of the method for retrospective analysis of epidemics by applying it to a spatially extended arboreal epidemic in which we demonstrate the relative effectiveness of host culling strategies that differ in frequency and spatial extent. Some of the inferential and philosophical issues that arise are discussed along with the scope of potential application of the new method.

Screening strategies to identify new chemical diversity for drug development to treat kinetoplastid infections.

PubMed

Don, Rob; Ioset, Jean-Robert

2014-01-01

The Drugs for Neglected Diseases initiative (DNDi) has defined and implemented an early discovery strategy over the last few years, in fitting with its virtual R&D business model. This strategy relies on a medium- to high-throughput phenotypic assay platform to expedite the screening of compound libraries accessed through its collaborations with partners from the pharmaceutical industry. We review the pragmatic approaches used to select compound libraries for screening against kinetoplastids, taking into account screening capacity. The advantages, limitations and current achievements in identifying new quality series for further development into preclinical candidates are critically discussed, together with attractive new approaches currently under investigation.

Comparative Effectiveness of STEMI Regionalization Strategies

PubMed Central

Concannon, Thomas W.; Kent, David M.; Normand, Sharon-Lise; Newhouse, Joseph P.; Griffith, John L.; Cohen, Joshua; Beshansky, Joni R.; Wong, John B.; Aversano, Thomas; Selker, Harry P.

2010-01-01

BACKGROUND Primary percutaneous coronary intervention (PCI) is more effective on average than fibrinolytic therapy (FT) in the treatment of ST-segment elevation myocardial infarction (STEMI). Yet most U.S. hospitals are not equipped for PCI and FT is still widely used. This study evaluated the comparative effectiveness of STEMI regionalization strategies to increase the use of PCI against standard emergency transport and care. METHODS AND RESULTS We estimated incremental treatment costs and quality-adjusted life expectancies of 2,000 patients with STEMI who received PCI or FT in simulations of emergency care in a regional hospital system. To increase access to PCI across the system, we compared a base case strategy to 12 hospital-based strategies of building new PCI labs or extending the hours of existing labs, and one emergency medical services (EMS)-based strategy of transporting all patients with STEMI to existing PCI-capable hospitals. The base case resulted in 609 (569, 647) patients getting PCI. Hospital-based strategies increased the number of patients receiving PCI, the costs of care, and quality-adjusted life years (QALYs) saved, and were cost effective under a variety of conditions. An EMS-based strategy of transporting every patient to an existing PCI facility was less costly and more effective than all hospital expansion options. CONCLUSION Our results suggest that new construction and staffing of PCI labs may not be warranted if an EMS strategy is both available and feasible. PMID:20664025

Effective recruitment of minority populations through community-led strategies.

PubMed

Horowitz, Carol R; Brenner, Barbara L; Lachapelle, Susanne; Amara, Duna A; Arniella, Guedy

2009-12-01

Traditional research approaches frequently fail to yield representative numbers of people of color in research. Community-based participatory research (CBPR) may be an important strategy for partnering with and reaching populations that bear a greater burden of illness but have been historically difficult to engage. The Community Action Board, consisting of 20 East Harlem residents, leaders, and advocates, used CBPR to compare the effectiveness of various strategies in recruiting and enrolling adults with prediabetes into a peer-led, diabetes prevention intervention. The board created five recruitment strategies: recruiting through clinicians; recruiting at large public events such as farmers markets; organizing special local recruitment events; recruiting at local organizations; and recruiting through a partner-led approach, in which community partners developed and managed the recruitment efforts at their sites. In 3 months, 555 local adults were approached; 249 were appropriate candidates for further evaluation (overweight, nonpregnant, East Harlem residents without known diabetes); 179 consented and returned in a fasting state for 1/2 day of prediabetes testing; 99 had prediabetes and enrolled in a pilot randomized trial. The partner-led approach was highly successful, recruiting 68% of those enrolled. This strategy was also the most efficient; 34% of those approached through partners were ultimately enrolled, versus 0%-17% enrolled through the other four strategies. Participants were predominantly low-income, uninsured, undereducated, Spanish-speaking women. This CBPR approach highlights the value of partner-led recruitment to identify, reach out to, and motivate a vulnerable population into participation in research, using techniques that may be unfamiliar to researchers but are nevertheless rigorous and effective.

Integrative strategies to identify candidate genes in rodent models of human alcoholism.

PubMed

Treadwell, Julie A

2006-01-01

The search for genes underlying alcohol-related behaviours in rodent models of human alcoholism has been ongoing for many years with only limited success. Recently, new strategies that integrate several of the traditional approaches have provided new insights into the molecular mechanisms underlying ethanol's actions in the brain. We have used alcohol-preferring C57BL/6J (B6) and alcohol-avoiding DBA/2J (D2) genetic strains of mice in an integrative strategy combining high-throughput gene expression screening, genetic segregation analysis, and mapping to previously published quantitative trait loci to uncover candidate genes for the ethanol-preference phenotype. In our study, 2 genes, retinaldehyde binding protein 1 (Rlbp1) and syntaxin 12 (Stx12), were found to be strong candidates for ethanol preference. Such experimental approaches have the power and the potential to greatly speed up the laborious process of identifying candidate genes for the animal models of human alcoholism.

Stakeholders identify similar barriers but different strategies to facilitate return-to-work: A vignette of a worker with an upper extremity condition.

PubMed

Peters, Susan E; Truong, Anthony P; Johnston, Venerina

2018-01-01

Stakeholders involved in the return-to-work (RTW) process have different roles and qualificationsOBJECTIVE:To explore the perspectives of Australian stakeholders of the RTW barriers and strategies for a worker with an upper extremity condition and a complex workers' compensation case. Using a case vignette, stakeholders were asked to identify barriers and recommend strategies to facilitate RTW. Content analysis was performed on the open-ended responses. The responses were categorised into RTW barriers and strategies using the biopsychosocial model. Pearson's Chi Square and ANOVA were performed to establish group differences. 621 participants (488 healthcare providers (HCPs), 62 employers, 55 insurers and 16 lawyers) identified 36 barriers (31 modifiable): 4 demographic; 8 biological; 15 psychological and 9 social barriers. 484 participants reported 16 RTW strategies: 4 biological; 6 psychological and 6 social strategies. 'Work relationship stressors' (83.4%) and 'Personal relationship stressors' (64.7%) were the most frequently nominated barriers. HCPs most frequently nominated 'Pain management' (49.6%), while employers, insurers and lawyers nominated 'RTW planning/Suitable duties programs' (40.5%; 42.9%; 80%). Stakeholders perceived similar barriers for RTW but recommended different strategies. Stakeholders appeared to be more proficient in identifying barriers than recommending strategies. Future research should focus on tools to both identify RTW barriers and direct intervention.

The quality of clinical maternal and neonatal healthcare - a strategy for identifying 'routine care signal functions'.

PubMed

Brenner, Stephan; De Allegri, Manuela; Gabrysch, Sabine; Chinkhumba, Jobiba; Sarker, Malabika; Muula, Adamson S

2015-01-01

A variety of clinical process indicators exists to measure the quality of care provided by maternal and neonatal health (MNH) programs. To allow comparison across MNH programs in low- and middle-income countries (LMICs), a core set of essential process indicators is needed. Although such a core set is available for emergency obstetric care (EmOC), the 'EmOC signal functions', a similar approach is currently missing for MNH routine care evaluation. We describe a strategy for identifying core process indicators for routine care and illustrate their usefulness in a field example. We first developed an indicator selection strategy by combining epidemiological and programmatic aspects relevant to MNH in LMICs. We then identified routine care process indicators meeting our selection criteria by reviewing existing quality of care assessment protocols. We grouped these indicators into three categories based on their main function in addressing risk factors of maternal or neonatal complications. We then tested this indicator set in a study assessing MNH quality of clinical care in 33 health facilities in Malawi. Our strategy identified 51 routine care processes: 23 related to initial patient risk assessment, 17 to risk monitoring, 11 to risk prevention. During the clinical performance assessment a total of 82 cases were observed. Birth attendants' adherence to clinical standards was lowest in relation to risk monitoring processes. In relation to major complications, routine care processes addressing fetal and newborn distress were performed relatively consistently, but there were major gaps in the performance of routine care processes addressing bleeding, infection, and pre-eclampsia risks. The identified set of process indicators could identify major gaps in the quality of obstetric and neonatal care provided during the intra- and immediate postpartum period. We hope our suggested indicators for essential routine care processes will contribute to streamlining MNH program

Nursing students' perspectives on clinical instructors' effective teaching strategies: A descriptive study.

PubMed

Valiee, Sina; Moridi, Glorokh; Khaledi, Shahnaz; Garibi, Fardin

2016-01-01

An important factor contributing to the quality of clinical education is instructors' teaching performance. The aim of this study was to identify clinical instructors' most effective teaching strategies from nursing and midwifery students' perspectives. This was a descriptive cross-sectional study. All third- and fourth-year bachelor's nursing and midwifery students studying at the Nursing and Midwifery Faculty of Kurdistan University of Medical Sciences were recruited to the study by using the census method. The study instrument consisted of a demographic questionnaire and the self-report 30-item Clinical Instructors' Effective Teaching Strategies Inventory. The SPSS v.16.0 was used for data analysis. The most effective teaching strategies of clinical instructors from nursing and midwifery students' perspectives were respectively 'treating students, clients, and colleagues with respect' and 'being eager for guiding students and manage their problems'. Clinical instructors need to be eager for education and also be able to establish effective communication with students. Empowering clinical instructors in specialized and technical aspects of clinical education seems necessary. Copyright © 2015 Elsevier Ltd. All rights reserved.

Identifying Service Delivery Strategies for Ethnically Diverse Users of a Wildland-Urban Recreation Site

Treesearch

John M. Baas

1992-01-01

Service delivery has become an increasingly important part of managing public lands for recreation. The range of preferences held by ethnically diverse users of recreation sites may warrant the development of more than one service delivery strategy. Two questions were examined: (1) Are there differences in site perceptions that can be identified on the basis on...

Effective recruitment strategies in primary care research: a systematic review.

PubMed

Ngune, Irene; Jiwa, Moyez; Dadich, Ann; Lotriet, Jaco; Sriram, Deepa

2012-01-01

Patient recruitment in primary care research is often a protracted and frustrating process, affecting project timeframes, budget and the dissemination of research findings. Yet, clear guidance on patient recruitment strategies in primary care research is limited. This paper addresses this issue through a systematic review. Articles were sourced from five academic databases - AustHealth, CINAHL, the Cochrane Methodology Group, EMBASE and PubMed/Medline; grey literature was also sourced from an academic library and the Primary Healthcare Research & Information Service (PHCRIS) website. Two reviewers independently screened the articles using the following criteria: (1) published in English, (2) reported empirical research, (3) focused on interventions designed to increase patient recruitment in primary care settings, and (4) reported patient recruitment in primary care settings. Sixty-six articles met the inclusion criteria. Of these, 23 specifically focused on recruitment strategies and included randomised trials (n = 7), systematic reviews (n = 8) and qualitative studies (n = 8). Of the remaining articles, 30 evaluated recruitment strategies, while 13 addressed the value of recruitment strategies using descriptive statistics and/or qualitative data. Among the 66 articles, primary care chiefly included general practice (n = 30); nursing and allied health services, multiple settings, as well as other community settings (n = 30); and pharmacy (n = 6). Effective recruitment strategies included the involvement of a discipline champion, simple patient eligibility criteria, patient incentives and organisational strategies that reduce practitioner workload. The most effective recruitment in primary care research requires practitioner involvement. The active participation of primary care practitioners in both the design and conduct of research helps to identify strategies that are congruent with the context in which patient care is delivered. This is reported to be the

Integrated Model to Assess Cloud Deployment Effectiveness When Developing an IT-strategy

NASA Astrophysics Data System (ADS)

Razumnikov, S.; Prankevich, D.

2016-04-01

Developing an IT-strategy of cloud deployment is a complex issue since even the stage of its formation necessitates revealing what applications will be the best possible to meet the requirements of a company business-strategy, evaluate reliability and safety of cloud providers and analyze staff satisfaction. A system of criteria, as well an integrated model to assess cloud deployment effectiveness is offered. The model makes it possible to identify what applications being at the disposal of a company, as well as new tools to be deployed are reliable and safe enough for implementation in the cloud environment. The data on practical use of the procedure to assess cloud deployment effectiveness by a provider of telecommunication services is presented. The model was used to calculate values of integral indexes of services to be assessed, then, ones, meeting the criteria and answering the business-strategy of a company, were selected.

Comprehensive review of the evidence regarding the effectiveness of community-based primary health care in improving maternal, neonatal and child health: 6. strategies used by effective projects.

PubMed

Perry, Henry B; Sacks, Emma; Schleiff, Meike; Kumapley, Richard; Gupta, Sundeep; Rassekh, Bahie M; Freeman, Paul A

2017-06-01

As part of our review of the evidence of the effectiveness of community-based primary health care (CBPHC) in improving maternal, neonatal and child health (MNCH), we summarize here the common delivery strategies of projects, programs and field research studies (collectively referred to as projects) that have demonstrated effectiveness in improving child mortality. Other articles in this series address specifically the effects of CBPHC on improving MNCH, while this paper explores the specific strategies used. We screened 12 166 published reports in PubMed of community-based approaches to improving maternal, neonatal and child health in high-mortality, resource-constrained settings from 1950-2015. A total of 700 assessments, including 148 reports from other publicly available sources (mostly unpublished evaluation reports and books) met the criteria for inclusion and were reviewed using a data extraction form. Here we identify and categorize key strategies used in project implementation. Six categories of strategies for program implementation were identified, all of which required working in partnership with communities and health systems: (a) program design and evaluation, (b) community collaboration, (c) education for community-level staff, volunteers, beneficiaries and community members, (d) health systems strengthening, (e) use of community-level workers, and (f) intervention delivery. Four specific strategies for intervention delivery were identified: (a) recognition, referral, and (when possible) treatment of serious childhood illness by mothers and/or trained community agents, (b) routine systematic visitation of all homes, (c) facilitator-led participatory women's groups, and (d) health service provision at outreach sites by mobile health teams. The strategies identified here provide useful starting points for program design in strengthening the effectiveness of CBPHC for improving MNCH.

Root Cause Analyses of Suicides of Mental Health Clients: Identifying Systematic Processes and Service-Level Prevention Strategies.

PubMed

Gillies, Donna; Chicop, David; O'Halloran, Paul

2015-01-01

The ability to predict imminent risk of suicide is limited, particularly among mental health clients. Root cause analysis (RCA) can be used by health services to identify service-wide approaches to suicide prevention. To (a) develop a standardized taxonomy for RCAs; (b) to quantitate service-related factors associated with suicides; and (c) to identify service-related suicide prevention strategies. The RCAs of all people who died by suicide within 1 week of contact with the mental health service over 5 years were thematically analyzed using a data collection tool. Data were derived from RCAs of all 64 people who died by suicide between 2008 and 2012. Major themes were categorized as individual, situational, and care-related factors. The most common factor was that clients had recently denied suicidality. Reliance on carers, recent changes in medication, communication problems, and problems in follow-through were also commonly identified. Given the difficulty in predicting suicide in people whose expressions of suicidal ideation change so rapidly, services may consider the use of strategies aimed at improving the individual, stressor, support, and care factors identified in this study.

Workplace-Based Assessment: A Review of User Perceptions and Strategies to Address the Identified Shortcomings

ERIC Educational Resources Information Center

Massie, Jonathan; Ali, Jason M.

2016-01-01

Workplace based assessments (WBAs) are now commonplace in postgraduate medical training. User acceptability and engagement is essential to the success of any medical education innovation. To this end, possessing an insight into trainee and trainer perceptions towards WBAs will help identify the major problems, permitting strategies to be…

Evaluation of testing strategies to identify infected animals at a single round of testing within dairy herds known to be infected with Mycobacterium avium ssp. paratuberculosis.

PubMed

More, S J; Cameron, A R; Strain, S; Cashman, W; Ezanno, P; Kenny, K; Fourichon, C; Graham, D

2015-08-01

As part of a broader control strategy within herds known to be infected with Mycobacterium avium ssp. paratuberculosis (MAP), individual animal testing is generally conducted to identify infected animals for action, usually culling. Opportunities are now available to quantitatively compare different testing strategies (combinations of tests) in known infected herds. This study evaluates the effectiveness, cost, and cost-effectiveness of different testing strategies to identify infected animals at a single round of testing within dairy herds known to be MAP infected. A model was developed, taking account of both within-herd infection dynamics and test performance, to simulate the use of different tests at a single round of testing in a known infected herd. Model inputs included the number of animals at different stages of infection, the sensitivity and specificity of each test, and the costs of testing and culling. Testing strategies included either milk or serum ELISA alone or with fecal culture in series. Model outputs included effectiveness (detection fraction, the proportion of truly infected animals in the herd that are successfully detected by the testing strategy), cost, and cost-effectiveness (testing cost per true positive detected, total cost per true positive detected). Several assumptions were made: MAP was introduced with a single animal and no management interventions were implemented to limit within-herd transmission of MAP before this test. In medium herds, between 7 and 26% of infected animals are detected at a single round of testing, the former using the milk ELISA and fecal culture in series 5 yr after MAP introduction and the latter using fecal culture alone 15 yr after MAP introduction. The combined costs of testing and culling at a single round of testing increases with time since introduction of MAP infection, with culling costs being much greater than testing costs. The cost-effectiveness of testing varied by testing strategy. It was also

Implementation of a cost-effective strategy to prevent neonatal early-onset group B haemolytic streptococcus disease in the Netherlands.

PubMed

Kolkman, Diny G E; Rijnders, Marlies E B; Wouters, Maurice G A J; van den Akker-van Marle, M Elske; van der Ploeg, Cpb Kitty; de Groot, Christianne J M; Fleuren, Margot A H

2013-07-30

Early-onset Group B haemolytic streptococcus infection (EOGBS) is an important cause of neonatal morbidity and mortality in the first week of life. Primary prevention of EOGBS is possible with intra-partum antibiotic prophylaxis (IAP.) Different prevention strategies are used internationally based on identifying pregnant women at risk, either by screening for GBS colonisation and/or by identifying risk factors for EOGBS in pregnancy or labour. A theoretical cost-effectiveness study has shown that a strategy with IAP based on five risk factors (risk-based strategy) or based on a positive screening test in combination with one or more risk factors (combination strategy) was the most cost-effective approach in the Netherlands. IAP for all pregnant women with a positive culture in pregnancy (screening strategy) and treatment in line with the current Dutch guideline (IAP after establishing a positive culture in case of pre-labour rupture of membranes or preterm birth and immediate IAP in case of intra-partum fever, previous sibling with EOGBS or GBS bacteriuria), were not cost-effective. Cost-effectiveness was based on the assumption of 100% adherence to each strategy. However, adherence in daily practice will be lower and therefore have an effect on cost-effectiveness. The aims are to: a.) implement the current Dutch guideline, the risk-based strategy and the combination strategy in three pilot regions and b.) study the effects of these strategies in daily practice. Regions where all the care providers in maternity care implement the allocated strategy will be randomised. Before the introduction of the strategy, there will be a pre-test (use of the current guideline) involving 105 pregnant women per region. This will be followed by a post-test (use of the allocated strategy) involving 315 women per region. The outcome measures are: 1.) adherence to the specific prevention strategy and the determinants of adherence among care providers and pregnant women, 2.) outcomes

Identifying the trends in wound-healing patents for successful investment strategies

PubMed Central

Gwak, Jae Ha

2017-01-01

Background Recently, the need for rapid wound-healing has significantly increased because of the increasing number of patients who are diagnosed with diabetes and obesity. These conditions have contributed to a surge in the number of patients with chronic wounds worldwide. Furthermore, many cost-effective wound-healing technologies have been developed in order to keep up with the increased demand. In this paper, we performed a quantitative study of the trends associated with wound-healing technologies using patent data. Methodology We analyzed the trends considering four different groups of patent applicants: firms, universities, research institutes, and individuals using a structural topic model. In addition, we analyzed the knowledge flow between patent applicants using citation analysis, and confirmed the role of applicants in the knowledge-flow network using k-means clustering. As a result, the primary wound-healing technology patents applied for by the four groups varied considerably, and we classified the roles of patent applicants were found in the knowledge-flow network. Conclusions Our results showed the organizations that are leading each area of wound-healing technology. Furthermore, from the results, we identified specific institutions that are efficient for spreading knowledge related to wound-healing technology based on the patents. This information can contribute to the planning of investment strategies and technology policies related to wound-healing. PMID:28306732

Strategies for effective collaborative manuscript development in interdisciplinary science teams

USGS Publications Warehouse

Oliver, Samantha K.; Fergus, C. Emi; Skaff, Nicholas K.; Wagner, Tyler; Tan, Pang-Ning; Cheruvelil, Kendra Spence; Soranno, Patricia A.

2018-01-01

Science is increasingly being conducted in large, interdisciplinary teams. As team size increases, challenges can arise during manuscript development, where achieving one team goal (e.g., inclusivity) may be in direct conflict with other goals (e.g., efficiency). Here, we present strategies for effective collaborative manuscript development that draw from our experiences in an interdisciplinary science team writing collaborative manuscripts for six years. These strategies are rooted in six guiding principles that were important to our team: to create a transparent, inclusive, and accountable research team that promotes and protects team members who have less power to influence decision‐making while fostering creativity and productivity. To help alleviate the conflicts that can arise in collaborative manuscript development, we present the following strategies: understand your team composition, create an authorship policy and discuss authorship early and often, openly announce manuscript ideas, identify and communicate the type of manuscript and lead author management style, and document and describe authorship contributions. These strategies can help reduce the probability of group conflict, uphold individual and team values, achieve fair authorship practices, and increase science productivity.

New cochlear implant research coding strategy based on the MP3(000™) strategy to reintroduce the virtual channel effect.

PubMed

Neben, Nicole; Lenarz, Thomas; Schuessler, Mark; Harpel, Theo; Buechner, Andreas

2013-05-01

Results for speech recognition in noise tests when using a new research coding strategy designed to introduce the virtual channel effect provided no advantage over MP3(000™). Although statistically significant smaller just noticeable differences (JNDs) were obtained, the findings for pitch ranking proved to have little clinical impact. The aim of this study was to explore whether modifications to MP3000 by including sequential virtual channel stimulation would lead to further improvements in hearing, particularly for speech recognition in background noise and in competing-talker conditions, and to compare results for pitch perception and melody recognition, as well as informally collect subjective impressions on strategy preference. Nine experienced cochlear implant subjects were recruited for the prospective study. Two variants of the experimental strategy were compared to MP3000. The study design was a single-blinded ABCCBA cross-over trial paradigm with 3 weeks of take-home experience for each user condition. Comparing results of pitch-ranking, a significantly reduced JND was identified. No significant effect of coding strategy on speech understanding in noise or competing-talker materials was found. Melody recognition skills were the same under all user conditions.

Identifying and Evaluating the Therapeutic Strategies Used During a Manualized Self- Advocacy Intervention for Transition-Age Youth.

PubMed

Kramer, Jessica M

2015-01-01

Prior to undertaking randomized control trials, pilot research should ensure that an intervention's active ingredients are operationalized in manuals or protocols. This study identified the strategies facilitators reported to use during the implementation of a problem-solving self-advocacy intervention, Project "Teens making Environment and Activity Modifications" (TEAM), with transition-age youth with developmental disabilities, and evaluated the alignment of strategies with the intervention's hypothesized mechanisms of change. An iterative process was used to conduct a content analysis of 106 field notes completed by six facilitators. Facilitators used 19 strategies. Findings suggest that facilitators used strategies simultaneously to ensure universal design for learning, maximize relevance for individual trainees, and maintain a safe and encouraging environment. Facilitators can individualize Project TEAM in a way that operationalizes the mechanisms of change underlying Project TEAM. The quality of the intervention may improve by explicitly incorporating these strategies into the intervention protocol. The strategies may also be applicable to therapists implementing interventions informed, by similar theoretical propositions.

Multiple strategies to identify HIV-positive black men who have sex with men and transgender women in New York City: a cross-sectional analysis of recruitment results.

PubMed

Franks, Julie; Mannheimer, Sharon B; Hirsch-Moverman, Yael; Hayes-Larson, Eleanor; Colson, Paul W; Ortega, Hugo; El-Sadr, Wafaa M

2018-03-01

Black men who have sex with men and transgender women are at high risk for HIV infection, but are more likely to be unaware of their infection or not in care for diagnosed HIV compared to other races. Respondent driven sampling has been advanced as a method to reach stigmatized and hidden populations for HIV testing. We compared strategies to recruit black, substance-using men who have sex with men and transgender women to identify newly diagnosed HIV infection, or those previously diagnosed but not in care. The STAR (Seek, Test, and Retain) study (ClinicalTrials.gov NCT01790360) used several recruitment strategies to identify black, substance-using men who have sex with men and transgender women with undiagnosed HIV infection or with previously diagnosed HIV infection but who were not in HIV care. Respondent-driven sampling, community-based recruitment and online advertising were used to recruit participants. Incentivized peer referral was integrated into all recruitment strategies. Participants completed interviewer-administered questionnaires and HIV testing. Demographic and HIV risk-related characteristics and recruitment strategy were summarized and stratified by HIV status. Associations were tested using Pearson's chi-squared, Fisher's exact, and Wilcoxon rank sum tests. Factors associated with HIV-positive diagnosis at p < 0.1 were included in a multivariable logistic regression model. From July 2012 through October 2015, the study enrolled 1929 participants; 96.3% men who have sex with men and 3.7% transgender women. Behavioural risk factors included recent condomless anal sex (55.6%) and recent substance use during sex (73.1%). HIV prevalence was 8.7%. In multivariable analysis, significant associations with HIV infection included being transgender; non-Hispanic black; gay/homosexual orientation; not homeless; and less likely to have insufficient income for necessities. Among recruitment strategies, respondent driven sampling was least effective in

Identifying determinants of effective complementary feeding behaviour change interventions in developing countries

PubMed Central

Fabrizio, Cecilia S; van Liere, Marti; Pelto, Gretel

2014-01-01

As stunting moves to the forefront of the global agenda, there is substantial evidence that behaviour change interventions (BCI) can improve infant feeding practices and growth. However, this evidence has not been translated into improved outcomes on a national level because we do not know enough about what makes these interventions work, for whom, when, why, at what cost and for how long. Our objective was to examine the design and implementation of complementary feeding BCI, from the peer-reviewed literature, to identify generalisable key determinants. We identified 29 studies that evaluated BCI efficacy or effectiveness, were conducted in developing countries, and reported outcomes on infant and young children aged 6–24 months. Two potential determinants emerged: (1) effective studies used formative research to identify cultural barriers and enablers to optimal feeding practices, to shape the intervention strategy, and to formulate appropriate messages and mediums for delivery; (2) effective studies delineated the programme impact pathway to the target behaviour change and assessed intermediary behaviour changes to learn what worked. We found that BCI that used these developmental and implementation processes could be effective despite heterogeneous approaches and design components. Our analysis was constrained, however, by the limited published data on how design and implementation were carried out, perhaps because of publishing space limits. Information on cost-effectiveness, sustainability and scalability was also very limited. We suggest a more comprehensive reporting process and a more strategic research agenda to enable generalisable evidence to accumulate. PMID:24798264

Identifying additional studies for a systematic review of retention strategies in randomised controlled trials: making contact with trials units and trial methodologists.

PubMed

Brueton, Valerie; Tierney, Jayne F; Stenning, Sally; Rait, Greta

2017-08-22

Search strategies for systematic reviews aim to identify all evidence relevant to the research question posed. Reports of methodological research can be difficult to find leading to biased results in systematic reviews of research methodology. Evidence suggests that contact with investigators can help to identify unpublished research. To identify additional eligible randomised controlled trials (RCTs) for a Cochrane systematic review of strategies to improve retention in RCTs, we conducted a survey of UK clinical trials units (CTUs) and made contact with RCT methodologists. Key contacts for all UK CTUs were sent a personalised email with a short questionnaire and summary protocol of the Cochrane methodology review. The questionnaire asked whether a RCT evaluating strategies to improve retention embedded in a RCT had ever been conducted by the CTU. Questions about the stage of completion and publication of such RCTs were included. The summary protocol outlined the aims, eligibility criteria, examples of types of retention strategies, and the primary outcome for the systematic review. Personal communication with RCT methodologists and presentations of preliminary results of the review at conferences were also used to identify additional eligible RCTs. We checked the results of our standard searches to see if eligible studies identified through these additional methods were also found using our standard searches. We identified 14 of the 38 RCTs included in the Cochrane methodology review by contacting trials units and methodologists. Eleven of the 14 RCTs identified by these methods were either published in grey literature, in press or unpublished. Three remaining RCTs were fully published at the time. Six of the RCTs identified were not found through any other searches. The RCTs identified represented data for 6 of 14 RCTs of incentive strategies (52% of randomised participants included in the review), and 6 of 14 RCTs of communication strategies (52% of randomised

Identifying multi-level culturally appropriate smoking cessation strategies for Aboriginal health staff: a concept mapping approach.

PubMed

Dawson, Anna P; Cargo, Margaret; Stewart, Harold; Chong, Alwin; Daniel, Mark

2013-02-01

Aboriginal Australians, including Aboriginal Health Workers (AHWs), smoke at rates double the non-Aboriginal population. This study utilized concept mapping methodology to identify and prioritize culturally relevant strategies to promote smoking cessation in AHWs. Stakeholder participants included AHWs, other health service employees and tobacco control personnel. Smoking cessation strategies (n = 74) were brainstormed using 34 interviews, 3 focus groups and a stakeholder workshop. Stakeholders sorted strategies into meaningful groups and rated them on perceived importance and feasibility. A concept map was developed using multi-dimensional scaling and hierarchical cluster analyses. Ten unique clusters of smoking cessation strategies were depicted that targeted individuals, family and peers, community, workplace and public policy. Smoking cessation resources and services were represented in addition to broader strategies addressing social and environmental stressors that perpetuate smoking and make quitting difficult. The perceived importance and feasibility of clusters were rated differently by participants working in health services that were government-coordinated compared with community-controlled. For health service workers within vulnerable populations, these findings clearly implicate a need for contextualized strategies that mitigate social and environmental stressors in addition to conventional strategies for tobacco control. The concept map is being applied in knowledge translation to guide development of smoking cessation programs for AHWs.

Nutritional strategies of Latino farmworker families with preschool children: Identifying leverage points for obesity prevention

PubMed Central

Quandt, Sara A.; Grzywacz, Joseph G.; Trejo, Grisel; Arcury, Thomas A.

2014-01-01

Obesity and overweight are significant problems for children in the US, particularly for Hispanic children. This paper focuses on the children in families of immigrant Hispanic farmworkers, as farm work is the portal though which many immigrants come to the US. This paper (1) describes a model of the nutritional strategies of child feeding in farmworker families; and (2) uses this model to identify leverage points for efforts to improve the nutritional status of these children. In-depth interviews were conducted in Spanish with 33 mothers of 2–5 year old children in farmworker families recruited in North Carolina in 2010–2011. The purposive sample was balanced by farmworker status (migrant or seasonal), child age, and child gender. Interviews were transcribed and translated. Multiple coders and a team approach to analysis were used. Nutritional strategies centered on domains of procuring food, using food, and maintaining food security. The content of these domains reflected environmental factors (e.g., rural isolation, shared housing), contextual factors (e.g., beliefs about appropriate food, parenting style), and available resources (e.g., income, government programs). Environmental isolation and limited access to resources decrease the amount and diversity of household food supplies. Parental actions (parental sacrifices, reduced dietary variety) attempt to buffer children. Use of government food sources is valuable for eligible families. Leverage points are suggested that would change nutritional strategy components and lower the risk of overweight and obesity. Further prospective research is needed to verify the nutritional strategy identified and to test the ability of leverage points to prevent childhood obesity in this vulnerable population. PMID:25462607

A New Strategy for Analyzing Time-Series Data Using Dynamic Networks: Identifying Prospective Biomarkers of Hepatocellular Carcinoma.

PubMed

Huang, Xin; Zeng, Jun; Zhou, Lina; Hu, Chunxiu; Yin, Peiyuan; Lin, Xiaohui

2016-08-31

Time-series metabolomics studies can provide insight into the dynamics of disease development and facilitate the discovery of prospective biomarkers. To improve the performance of early risk identification, a new strategy for analyzing time-series data based on dynamic networks (ATSD-DN) in a systematic time dimension is proposed. In ATSD-DN, the non-overlapping ratio was applied to measure the changes in feature ratios during the process of disease development and to construct dynamic networks. Dynamic concentration analysis and network topological structure analysis were performed to extract early warning information. This strategy was applied to the study of time-series lipidomics data from a stepwise hepatocarcinogenesis rat model. A ratio of lyso-phosphatidylcholine (LPC) 18:1/free fatty acid (FFA) 20:5 was identified as the potential biomarker for hepatocellular carcinoma (HCC). It can be used to classify HCC and non-HCC rats, and the area under the curve values in the discovery and external validation sets were 0.980 and 0.972, respectively. This strategy was also compared with a weighted relative difference accumulation algorithm (wRDA), multivariate empirical Bayes statistics (MEBA) and support vector machine-recursive feature elimination (SVM-RFE). The better performance of ATSD-DN suggests its potential for a more complete presentation of time-series changes and effective extraction of early warning information.

A New Strategy for Analyzing Time-Series Data Using Dynamic Networks: Identifying Prospective Biomarkers of Hepatocellular Carcinoma

NASA Astrophysics Data System (ADS)

Huang, Xin; Zeng, Jun; Zhou, Lina; Hu, Chunxiu; Yin, Peiyuan; Lin, Xiaohui

2016-08-01

Time-series metabolomics studies can provide insight into the dynamics of disease development and facilitate the discovery of prospective biomarkers. To improve the performance of early risk identification, a new strategy for analyzing time-series data based on dynamic networks (ATSD-DN) in a systematic time dimension is proposed. In ATSD-DN, the non-overlapping ratio was applied to measure the changes in feature ratios during the process of disease development and to construct dynamic networks. Dynamic concentration analysis and network topological structure analysis were performed to extract early warning information. This strategy was applied to the study of time-series lipidomics data from a stepwise hepatocarcinogenesis rat model. A ratio of lyso-phosphatidylcholine (LPC) 18:1/free fatty acid (FFA) 20:5 was identified as the potential biomarker for hepatocellular carcinoma (HCC). It can be used to classify HCC and non-HCC rats, and the area under the curve values in the discovery and external validation sets were 0.980 and 0.972, respectively. This strategy was also compared with a weighted relative difference accumulation algorithm (wRDA), multivariate empirical Bayes statistics (MEBA) and support vector machine-recursive feature elimination (SVM-RFE). The better performance of ATSD-DN suggests its potential for a more complete presentation of time-series changes and effective extraction of early warning information.

Inverse targeting —An effective immunization strategy

NASA Astrophysics Data System (ADS)

Schneider, C. M.; Mihaljev, T.; Herrmann, H. J.

2012-05-01

We propose a new method to immunize populations or computer networks against epidemics which is more efficient than any continuous immunization method considered before. The novelty of our method resides in the way of determining the immunization targets. First we identify those individuals or computers that contribute the least to the disease spreading measured through their contribution to the size of the largest connected cluster in the social or a computer network. The immunization process follows the list of identified individuals or computers in inverse order, immunizing first those which are most relevant for the epidemic spreading. We have applied our immunization strategy to several model networks and two real networks, the Internet and the collaboration network of high-energy physicists. We find that our new immunization strategy is in the case of model networks up to 14%, and for real networks up to 33% more efficient than immunizing dynamically the most connected nodes in a network. Our strategy is also numerically efficient and can therefore be applied to large systems.

Investigation of effective strategies for developing creative science thinking

NASA Astrophysics Data System (ADS)

Yang, Kuay-Keng; Lee, Ling; Hong, Zuway-R.; Lin, Huann-shyang

2016-09-01

The purpose of this study was to explore the effectiveness of the creative inquiry-based science teaching on students' creative science thinking and science inquiry performance. A quasi-experimental design consisting one experimental group (N = 20) and one comparison group (N = 24) with pretest and post-test was conducted. The framework of the intervention focused on potential strategies such as promoting divergent and convergent thinking and providing an open, inquiry-based learning environment that are recommended by the literature. Results revealed that the experimental group students outperformed their counterparts in the comparison group on the performances of science inquiry and convergent thinking. Additional qualitative data analyses from classroom observations and case teacher interviews identified supportive teaching strategies (e.g. facilitating associative thinking, sharing impressive ideas, encouraging evidence-based conclusions, and reviewing and commenting on group presentations) for developing students' creative science thinking.

Comprehensive review of the evidence regarding the effectiveness of community–based primary health care in improving maternal, neonatal and child health: 6. strategies used by effective projects

PubMed Central

Perry, Henry B; Sacks, Emma; Schleiff, Meike; Kumapley, Richard; Gupta, Sundeep; Rassekh, Bahie M; Freeman, Paul A

2017-01-01

Background As part of our review of the evidence of the effectiveness of community–based primary health care (CBPHC) in improving maternal, neonatal and child health (MNCH), we summarize here the common delivery strategies of projects, programs and field research studies (collectively referred to as projects) that have demonstrated effectiveness in improving child mortality. Other articles in this series address specifically the effects of CBPHC on improving MNCH, while this paper explores the specific strategies used. Methods We screened 12 166 published reports in PubMed of community–based approaches to improving maternal, neonatal and child health in high–mortality, resource–constrained settings from 1950–2015. A total of 700 assessments, including 148 reports from other publicly available sources (mostly unpublished evaluation reports and books) met the criteria for inclusion and were reviewed using a data extraction form. Here we identify and categorize key strategies used in project implementation. Results Six categories of strategies for program implementation were identified, all of which required working in partnership with communities and health systems: (a) program design and evaluation, (b) community collaboration, (c) education for community–level staff, volunteers, beneficiaries and community members, (d) health systems strengthening, (e) use of community–level workers, and (f) intervention delivery. Four specific strategies for intervention delivery were identified: (a) recognition, referral, and (when possible) treatment of serious childhood illness by mothers and/or trained community agents, (b) routine systematic visitation of all homes, (c) facilitator–led participatory women’s groups, and (d) health service provision at outreach sites by mobile health teams. Conclusions The strategies identified here provide useful starting points for program design in strengthening the effectiveness of CBPHC for improving MNCH. PMID:28685044

Case studies: the impact of nonanalyte components on LC-MS/MS-based bioanalysis: strategies for identifying and overcoming matrix effects.

PubMed

Li, Fumin; Ewles, Matthew; Pelzer, Mary; Brus, Theodore; Ledvina, Aaron; Gray, Nicholas; Koupaei-Abyazani, Mohammad; Blackburn, Michael

2013-10-01

Achieving sufficient selectivity in bioanalysis is critical to ensure accurate quantitation of drugs and metabolites in biological matrices. Matrix effects most classically refer to modification of ionization efficiency of an analyte in the presence of matrix components. However, nonanalyte or matrix components present in samples can adversely impact the performance of a bioanalytical method and are broadly considered as matrix effects. For the current manuscript, we expand the scope to include matrix elements that contribute to isobaric interference and measurement bias. These three categories of matrix effects are illustrated with real examples encountered. The causes, symptoms, and suggested strategies and resolutions for each form of matrix effects are discussed. Each case is presented in the format of situation/action/result to facilitate reading.

Cost-Effectiveness Analysis of Different Genetic Testing Strategies for Lynch Syndrome in Taiwan.

PubMed

Chen, Ying-Erh; Kao, Sung-Shuo; Chung, Ren-Hua

2016-01-01

Patients with Lynch syndrome (LS) have a significantly increased risk of developing colorectal cancer (CRC) and other cancers. Genetic screening for LS among patients with newly diagnosed CRC aims to identify mutations in the disease-causing genes (i.e., the DNA mismatch repair genes) in the patients, to offer genetic testing for relatives of the patients with the mutations, and then to provide early prevention for the relatives with the mutations. Several genetic tests are available for LS, such as DNA sequencing for MMR genes and tumor testing using microsatellite instability and immunohistochemical analyses. Cost-effectiveness analyses of different genetic testing strategies for LS have been performed in several studies from different countries such as the US and Germany. However, a cost-effectiveness analysis for the testing has not yet been performed in Taiwan. In this study, we evaluated the cost-effectiveness of four genetic testing strategies for LS described in previous studies, while population-specific parameters, such as the mutation rates of the DNA mismatch repair genes and treatment costs for CRC in Taiwan, were used. The incremental cost-effectiveness ratios based on discounted life years gained due to genetic screening were calculated for the strategies relative to no screening and to the previous strategy. Using the World Health Organization standard, which was defined based on Taiwan's Gross Domestic Product per capita, the strategy based on immunohistochemistry as a genetic test followed by BRAF mutation testing was considered to be highly cost-effective relative to no screening. Our probabilistic sensitivity analysis results also suggest that the strategy has a probability of 0.939 of being cost-effective relative to no screening based on the commonly used threshold of $50,000 to determine cost-effectiveness. To the best of our knowledge, this is the first cost-effectiveness analysis for evaluating different genetic testing strategies for LS in

Identifying and assessing strategies for evaluating the impact of mobile eye health units on health outcomes.

PubMed

Fu, Shiwan; Turner, Angus; Tan, Irene; Muir, Josephine

2017-12-01

To identify and assess strategies for evaluating the impact of mobile eye health units on health outcomes. Systematic literature review. Worldwide. Peer-reviewed journal articles that included the use of a mobile eye health unit. Journal articles were included if outcome measures reflected an assessment of the impact of a mobile eye health unit on health outcomes. Six studies were identified with mobile services offering diabetic retinopathy screening (three studies), optometric services (two studies) and orthoptic services (one study). This review identified and assessed strategies in existing literature used to evaluate the impact of mobile eye health units on health outcomes. Studies included in this review used patient outcomes (i.e. disease detection, vision impairment, treatment compliance) and/or service delivery outcomes (i.e. cost per attendance, hospital transport use, inappropriate referrals, time from diabetic retinopathy photography to treatment) to evaluate the impact of mobile eye health units. Limitations include difficulty proving causation of specific outcome measures and the overall shortage of impact evaluation studies. Variation in geographical location, service population and nature of eye care providers limits broad application. © 2017 National Rural Health Alliance Inc.

Identifying Multi-Level Culturally Appropriate Smoking Cessation Strategies for Aboriginal Health Staff: A Concept Mapping Approach

ERIC Educational Resources Information Center

Dawson, Anna P.; Cargo, Margaret; Stewart, Harold; Chong, Alwin; Daniel, Mark

2013-01-01

Aboriginal Australians, including Aboriginal Health Workers (AHWs), smoke at rates double the non-Aboriginal population. This study utilized concept mapping methodology to identify and prioritize culturally relevant strategies to promote smoking cessation in AHWs. Stakeholder participants included AHWs, other health service employees and tobacco…

A theoretical framework for biological control of soil-borne plant pathogens: Identifying effective strategies.

PubMed

Cunniffe, Nik J; Gilligan, Christopher A

2011-06-07

We develop and analyse a flexible compartmental model of the interaction between a plant host, a soil-borne pathogen and a microbial antagonist, for use in optimising biological control. By extracting invasion and persistence thresholds of host, pathogen and biological control agent, performing an equilibrium analysis, and numerical investigation of sensitivity to parameters and initial conditions, we determine criteria for successful biological control. We identify conditions for biological control (i) to prevent a pathogen entering a system, (ii) to eradicate a pathogen that is already present and, if that is not possible, (iii) to reduce the density of the pathogen. Control depends upon the epidemiology of the pathogen and how efficiently the antagonist can colonise particular habitats (i.e. healthy tissue, infected tissue and/or soil-borne inoculum). A sharp transition between totally effective control (i.e. eradication of the pathogen) and totally ineffective control can follow slight changes in biologically interpretable parameters or to the initial amounts of pathogen and biological control agent present. Effective biological control requires careful matching of antagonists to pathosystems. For preventative/eradicative control, antagonists must colonise susceptible hosts. However, for reduction in disease prevalence, the range of habitat is less important than the antagonist's bulking-up efficiency. Copyright © 2011 Elsevier Ltd. All rights reserved.

Uncovering effective strategies for hearing loss prevention

PubMed Central

Morata, Thais C.; Meinke, Deanna

2016-01-01

Occupational health agencies, researchers and policy makers have recognized the need for evidence on the effectiveness of interventions designed to reduce or prevent workplace injuries and illnesses. While many workplaces comply with legal or obligatory requirements and implement recommended interventions, few publications exist documenting the effectiveness of these actions. Additionally, some workplaces have discovered through their own processes, novel ways to reduce the risk of injury. Peer-reviewed information on the effectiveness of the many strategies and approaches currently in use could help correct weaknesses, or further encourage their adoption and expansion. The evaluation of intervention effectiveness would certainly contribute to improved worker health and safety. This need is particularly relevant regarding noise exposure in the workplace and hearing loss prevention interventions. In a 2006 review of the U.S. National Institute for Occupational Safety and Health (NIOSH) Hearing Loss Research Program, the independent National Academies of Sciences recommended that NIOSH place greater emphasis on identifying the effectiveness of hearing loss prevention measures on the basis of outcomes that are as closely related as possible to reducing noise exposure and work related hearing loss (http://www.nap.edu/openbook.php?record_id=11721). NIOSH used two different approaches to address that recommendation: the first one was to conduct research, including broad systematic reviews on the effectiveness of interventions to prevent occupational noise-induced hearing loss. The second was to create an award program, the Safe-In-Sound Excellence in Hearing Loss Prevention Award™, to identify and honor excellent real-world examples of noise control and other hearing loss prevention practices and innovations. PMID:27397968

Codemeshing in Academic Writing: Identifying Teachable Strategies of Translanguaging

ERIC Educational Resources Information Center

Canagarajah, Suresh

2011-01-01

Studies on translanguaging of multilingual students have turned their attention to teachable strategies in classrooms. This study is based on the assumption that it is possible to learn from students' translanguaging strategies while developing their proficiency through a dialogical pedagogy. Based on a classroom ethnography, this article…

Chromatographic fingerprinting as a strategy to identify regulated plants in illegal herbal supplements.

PubMed

Custers, D; Van Praag, N; Courselle, P; Apers, S; Deconinck, E

2017-03-01

Erectile dysfunction (ED) is a sexual disorder characterized by the inability to achieve or maintain a sufficiently rigid erection. Despite the availability of non-invasive oral treatment options, many patients turn to herbal alternatives. Furthermore, herbal supplements are increasingly gaining popularity in industrialized countries and, as a consequence, quality control is a highly important issue. Unfortunately, this is not a simple task since plants are often crushed and mixed with other plants, which complicates their identification by usage of classical approaches such as microscopy. The aim of this study was to explore the potential use of chromatographic fingerprinting to identify plants present in herbal preparations intended for the treatment of ED. To achieve this goal, a HPLC-PDA and a HPLC-MS method were developed, using a full factorial experimental design in order to acquire characteristic fingerprints of three plants which are potentially beneficial for treating ED: Epimedium spp., Pausinystalia yohimbe and Tribulus terrestris. The full factorial design demonstrated that for all three plant references a C8 column (250mm×4.6mm; 5µm particle size) is best suited; methanol and an ammonium formate buffer (pH 3) were found to be the best constituents for the mobile phase. The suitability of this strategy was demonstrated by analysing several self-made triturations in three different botanical matrices, which mimic the influential effects that could be expected when analysing herbal supplements. To conclude, this study demonstrates that chromatographic fingerprinting could provide a useful means to identify plants in a complex herbal mixture. Copyright © 2016 Elsevier B.V. All rights reserved.

Beware of Kinked Frontiers: A Systematic Review of the Choice of Comparator Strategies in Cost-Effectiveness Analyses of Human Papillomavirus Testing in Cervical Screening.

PubMed

O'Mahony, James F; Naber, Steffie K; Normand, Charles; Sharp, Linda; O'Leary, John J; de Kok, Inge M C M

2015-12-01

To systematically review the choice of comparator strategies in cost-effectiveness analyses (CEAs) of human papillomavirus testing in cervical screening. The PubMed, Web of Knowledge, and Scopus databases were searched to identify eligible model-based CEAs of cervical screening programs using human papillomavirus testing. The eligible CEAs were reviewed to investigate what screening strategies were chosen for analysis and how this choice might have influenced estimates of the incremental cost-effectiveness ratio (ICER). Selected examples from the reviewed studies are presented to illustrate how the omission of relevant comparators might influence estimates of screening cost-effectiveness. The search identified 30 eligible CEAs. The omission of relevant comparator strategies appears likely in 18 studies. The ICER estimates in these cases are probably lower than would be estimated had more comparators been included. Five of the 30 studies restricted relevant comparator strategies to sensitivity analyses or other subanalyses not part of the principal base-case analysis. Such exclusion of relevant strategies from the base-case analysis can result in cost-ineffective strategies being identified as cost-effective. Many of the CEAs reviewed appear to include insufficient comparator strategies. In particular, they omit strategies with relatively long screening intervals. Omitting relevant comparators matters particularly if it leads to the underestimation of ICERs for strategies around the cost-effectiveness threshold because these strategies are the most policy relevant from the CEA perspective. Consequently, such CEAs may not be providing the best possible policy guidance and lead to the mistaken adoption of cost-ineffective screening strategies. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Effectiveness of teaching strategies to improve critical thinking in nurses in clinical practice: a systematic review protocol.

PubMed

da Costa Carbogim, Fábio; de Oliveira, Larissa Bertacchini; de Campos, Guilherme Gushiken; de Araújo Nunes, Esther Alves; Alves, Katiusse Rezende; de Araújo Püschel, Vilanice Alves

2017-06-01

The aim of this review is to identify and synthesize the best available evidence on the effectiveness of teaching strategies aimed at improving critical thinking (CT) in registered nurses who provide direct patient care. Specifically, the research question is: What are the best teaching strategies to improve CT skills in registered nurses who provide direct patient care?

Effectiveness of Integration and Re-Integration into Work Strategies for Persons with Chronic Conditions: A Systematic Review of European Strategies

PubMed Central

Ito, Elizabeth; Scaratti, Chiara; Vlachou, Anastasia; Stavroussi, Panayiota; Brecelj, Valentina; Kovačič, Dare S.

2018-01-01

Due to low employment rates associated to chronic conditions in Europe, it is essential to foster effective integration and re-integration into work strategies. The objective of this systematic review is to summarize the evidence on the effectiveness of strategies for integration and re-integration to work for persons with chronic diseases or with musculoskeletal disorders, implemented in Europe in the past five years. A systematic search was conducted in MedLine, PsycINFO, CDR-HTA, CDR-DARE and Cochrane Systematic Reviews. Overall, 32 relevant publications were identified. Of these, 21 were considered eligible after a methodological assessment and included. Positive changes in employment status, return to work and sick leave outcomes were achieved with graded sickness-absence certificates, part-time sick leave, early ergonomic interventions for back pain, disability evaluation followed by information and advice, and with multidisciplinary, coordinated and tailored return to work interventions. Additionally, a positive association between the co-existence of active labour market policies to promote employment and passive support measures (e.g., pensions or benefits) and the probability of finding a job was observed. Research on the evaluation of the effectiveness of strategies targeting integration and re-integration into work for persons with chronic health conditions needs, however, to be improved and strengthened. PMID:29562715

Effective Teaching Strategies for English Language Learners

ERIC Educational Resources Information Center

Facella, Melissa A.; Rampino, Kristen M.; Shea, Elizabeth K.

2005-01-01

This paper provides effective strategies for early childhood teachers to use with children who are English language learners (ELLs). The strategies were compiled from interviews with 20 early childhood educators from two culturally and linguistically diverse communities in Massachusetts. Emphasis was placed on the strategies that the greatest…

Ensemble of surrogates-based optimization for identifying an optimal surfactant-enhanced aquifer remediation strategy at heterogeneous DNAPL-contaminated sites

NASA Astrophysics Data System (ADS)

Jiang, Xue; Lu, Wenxi; Hou, Zeyu; Zhao, Haiqing; Na, Jin

2015-11-01

The purpose of this study was to identify an optimal surfactant-enhanced aquifer remediation (SEAR) strategy for aquifers contaminated by dense non-aqueous phase liquid (DNAPL) based on an ensemble of surrogates-based optimization technique. A saturated heterogeneous medium contaminated by nitrobenzene was selected as case study. A new kind of surrogate-based SEAR optimization employing an ensemble surrogate (ES) model together with a genetic algorithm (GA) is presented. Four methods, namely radial basis function artificial neural network (RBFANN), kriging (KRG), support vector regression (SVR), and kernel extreme learning machines (KELM), were used to create four individual surrogate models, which were then compared. The comparison enabled us to select the two most accurate models (KELM and KRG) to establish an ES model of the SEAR simulation model, and the developed ES model as well as these four stand-alone surrogate models was compared. The results showed that the average relative error of the average nitrobenzene removal rates between the ES model and the simulation model for 20 test samples was 0.8%, which is a high approximation accuracy, and which indicates that the ES model provides more accurate predictions than the stand-alone surrogate models. Then, a nonlinear optimization model was formulated for the minimum cost, and the developed ES model was embedded into this optimization model as a constrained condition. Besides, GA was used to solve the optimization model to provide the optimal SEAR strategy. The developed ensemble surrogate-optimization approach was effective in seeking a cost-effective SEAR strategy for heterogeneous DNAPL-contaminated sites. This research is expected to enrich and develop the theoretical and technical implications for the analysis of remediation strategy optimization of DNAPL-contaminated aquifers.

Ensemble of Surrogates-based Optimization for Identifying an Optimal Surfactant-enhanced Aquifer Remediation Strategy at Heterogeneous DNAPL-contaminated Sites

NASA Astrophysics Data System (ADS)

Lu, W., Sr.; Xin, X.; Luo, J.; Jiang, X.; Zhang, Y.; Zhao, Y.; Chen, M.; Hou, Z.; Ouyang, Q.

2015-12-01

The purpose of this study was to identify an optimal surfactant-enhanced aquifer remediation (SEAR) strategy for aquifers contaminated by dense non-aqueous phase liquid (DNAPL) based on an ensemble of surrogates-based optimization technique. A saturated heterogeneous medium contaminated by nitrobenzene was selected as case study. A new kind of surrogate-based SEAR optimization employing an ensemble surrogate (ES) model together with a genetic algorithm (GA) is presented. Four methods, namely radial basis function artificial neural network (RBFANN), kriging (KRG), support vector regression (SVR), and kernel extreme learning machines (KELM), were used to create four individual surrogate models, which were then compared. The comparison enabled us to select the two most accurate models (KELM and KRG) to establish an ES model of the SEAR simulation model, and the developed ES model as well as these four stand-alone surrogate models was compared. The results showed that the average relative error of the average nitrobenzene removal rates between the ES model and the simulation model for 20 test samples was 0.8%, which is a high approximation accuracy, and which indicates that the ES model provides more accurate predictions than the stand-alone surrogate models. Then, a nonlinear optimization model was formulated for the minimum cost, and the developed ES model was embedded into this optimization model as a constrained condition. Besides, GA was used to solve the optimization model to provide the optimal SEAR strategy. The developed ensemble surrogate-optimization approach was effective in seeking a cost-effective SEAR strategy for heterogeneous DNAPL-contaminated sites. This research is expected to enrich and develop the theoretical and technical implications for the analysis of remediation strategy optimization of DNAPL-contaminated aquifers.

Cost-effectiveness of strategies to enhance mammography use.

PubMed

Fishman, P; Taplin, S; Meyer, D; Barlow, W

2000-01-01

To estimate the cost-effectiveness of three strategies to increase breast cancer screening with mammography (reminder postcard, reminder telephone call, and motivational telephone call). Cost accounting for each strategy followed by cost-effectiveness analysis. DATA SOURCE FOR EFFECTIVENESS: Randomized trial of three strategies conducted at Group Health Cooperative of Puget Sound (GHC). Women 50 to 79 years of age who were enrolled in GHC's breast cancer screening program who did not schedule screening mammography within 2 months after it was recommended by letter. Health plan. Marginal cost-effectiveness of each additional woman screened. Because of its high cost (about $26 per call) and intermediate effectiveness, the motivational call was the least cost-effective strategy. If it was assumed that 50% of the women who scheduled mammography after receiving the reminder postcard would have scheduled mammography within 10 months even without it, marginal cost-effectiveness for the postcard among all women was $22 per woman screened versus $92 for the reminder call. Among women with no previous mammography, the marginal cost-effectiveness for the postcard was $70 versus $100 for the reminder call. Among women with no previous mammography, the choice between the reminder postcard and the reminder call was sensitive to assumptions about the percentage of women expected to receive mammography in the absence of other promotional strategies. A simple reminder postcard is the most cost-effective way to increase mammography. Choices about how to promote mammography will ultimately depend on plan values and willingness to invest in promotional strategies that increase participation at higher unit costs.

Identifying mismatches between institutional perceptions of water-related risk drivers and water management strategies in three river basin areas

NASA Astrophysics Data System (ADS)

Räsänen, Aleksi; Juhola, Sirkku; Monge Monge, Adrián; Käkönen, Mira; Kanninen, Markku; Nygren, Anja

2017-07-01

Water-related risks and vulnerabilities are driven by variety of stressors, including climate and land use change, as well as changes in socio-economic positions and political landscapes. Hence, water governance, which addresses risks and vulnerabilities, should target multiple stressors. We analyze the institutional perceptions of the drivers and strategies for managing water-related risks and vulnerabilities in three regionally important river basin areas located in Finland, Mexico, and Laos. Our analysis is based on data gathered through participatory workshops and complemented by qualitative content analysis of relevant policy documents. The identified drivers and proposed risk reduction strategies showed the multidimensionality and context-specificity of water-related risks and vulnerabilities across study areas. Most of the identified drivers were seen to increase risks, but some of the drivers were positive trends, and drivers also included also policy instruments that can both increase or decrease risks. Nevertheless, all perceived drivers were not addressed with suggested risk reduction strategies. In particular, most of the risk reduction strategies were incremental adjustments, although many of the drivers classified as most important were large-scale trends, such as climate change, land use changes and increase in foreign investments. We argue that there is a scale mismatch between the identified drivers and suggested strategies, which questions the opportunity to manage the drivers by single-scale incremental adjustments. Our study suggests that for more sustainable risk and vulnerability reduction, the root causes of water-related risks and vulnerabilities should be addressed through adaptive multi-scale governance that carefully considers the context-specificity and the multidimensionality of the associated drivers and stressors.

THE EFFECT OF INTIMACY AND STATUS DISCREPANCY ON SALIENT AND NON-SALIENT CONFLICT STRATEGIES OF JAPANESE.

PubMed

Nakatsugawa, Satomi; Takai, Jiro

2015-10-01

It has been claimed that Japanese people prefer passive forms of conflict strategies to preserve interpersonal harmony. This study aimed to identify some conditions in which such passive strategies are used. The effects of target intimacy and status discrepancy on the intent and use of salient and non-salient conflict strategies were examined, along with respondent sex differences. Questionnaires were collected from 205 Japanese university students. Results indicated that women were more likely to have non-salient intents than men and that intimacy affected considerateness intent but not avoidance intent. Active non-salient strategy was affected by status while passive non-salient strategy was affected by intimacy. Overall, target characteristics proved to be a strong factor in the intents and strategies employed in conflict situations of Japanese.

Antibiotic discovery throughout the Small World Initiative: A molecular strategy to identify biosynthetic gene clusters involved in antagonistic activity.

PubMed

Davis, Elizabeth; Sloan, Tyler; Aurelius, Krista; Barbour, Angela; Bodey, Elijah; Clark, Brigette; Dennis, Celeste; Drown, Rachel; Fleming, Megan; Humbert, Allison; Glasgo, Elizabeth; Kerns, Trent; Lingro, Kelly; McMillin, MacKenzie; Meyer, Aaron; Pope, Breanna; Stalevicz, April; Steffen, Brittney; Steindl, Austin; Williams, Carolyn; Wimberley, Carmen; Zenas, Robert; Butela, Kristen; Wildschutte, Hans

2017-06-01

The emergence of bacterial pathogens resistant to all known antibiotics is a global health crisis. Adding to this problem is that major pharmaceutical companies have shifted away from antibiotic discovery due to low profitability. As a result, the pipeline of new antibiotics is essentially dry and many bacteria now resist the effects of most commonly used drugs. To address this global health concern, citizen science through the Small World Initiative (SWI) was formed in 2012. As part of SWI, students isolate bacteria from their local environments, characterize the strains, and assay for antibiotic production. During the 2015 fall semester at Bowling Green State University, students isolated 77 soil-derived bacteria and genetically characterized strains using the 16S rRNA gene, identified strains exhibiting antagonistic activity, and performed an expanded SWI workflow using transposon mutagenesis to identify a biosynthetic gene cluster involved in toxigenic compound production. We identified one mutant with loss of antagonistic activity and through subsequent whole-genome sequencing and linker-mediated PCR identified a 24.9 kb biosynthetic gene locus likely involved in inhibitory activity in that mutant. Further assessment against human pathogens demonstrated the inhibition of Bacillus cereus, Listeria monocytogenes, and methicillin-resistant Staphylococcus aureus in the presence of this compound, thus supporting our molecular strategy as an effective research pipeline for SWI antibiotic discovery and genetic characterization. © 2017 The Authors. MicrobiologyOpen published by John Wiley & Sons Ltd.

Talking out loud in class: utilizing discussion as an effective teaching strategy with adult learners.

PubMed

Hotler, Amy L

2013-09-01

Staff development is an important role of the school nurse, yet little is written to assist the nurse in this role. Though some obtain advanced degrees in education, most school nurses are not prepared for the staff development role without further education in pedagogy, teaching strategies, and evaluation methods. This article presents discussion as one of many active teaching strategies that can engage learners and promote critical thinking. More work is needed in the area of course design and implementation, as well as additional research to help identify the most effective teaching strategies for school employees.

Identifying optimal postmarket surveillance strategies for medical and surgical devices: implications for policy, practice and research.

PubMed

Gagliardi, Anna R; Umoquit, Muriah; Lehoux, Pascale; Ross, Sue; Ducey, Ariel; Urbach, David R

2013-03-01

Non-drug technologies offer many benefits, but have been associated with adverse events, prompting calls for improved postmarket surveillance. There is little empirical research to guide the development of such a system. The purpose of this study was to identify optimal postmarket surveillance strategies for medical and surgical devices. Qualitative methods were used for sampling, data collection and analysis. Stakeholders from Canada and the USA representing different roles and perspectives were first interviewed to identify examples and characteristics of different surveillance strategies. These stakeholders and others they recommended were then assembled at a 1-day nominal group meeting to discuss and prioritise the components of a postmarket device surveillance system, and research needed to achieve such a system. Consultations were held with 37 participants, and 47 participants attended the 1-day meeting. They recommended a multicomponent system including reporting by facilities, clinicians and patients, supported with some external surveillance for validation and real-time trials for high-risk devices. Many considerations were identified that constitute desirable characteristics of, and means by which to implement such a system. An overarching network was envisioned to broker linkages, establish a shared minimum dataset, and support communication and decision making. Numerous research questions were identified, which could be pursued in tandem with phased implementation of the system. These findings provide unique guidance for establishing a device safety network that is based on existing initiatives, and could be expanded and evaluated in a prospective, phased fashion as it was developed.

Characterizing the effects of intermittent faults on a processor for dependability enhancement strategy.

PubMed

Wang, Chao Saul; Fu, Zhong-Chuan; Chen, Hong-Song; Wang, Dong-Sheng

2014-01-01

As semiconductor technology scales into the nanometer regime, intermittent faults have become an increasing threat. This paper focuses on the effects of intermittent faults on NET versus REG on one hand and the implications for dependability strategy on the other. First, the vulnerability characteristics of representative units in OpenSPARC T2 are revealed, and in particular, the highly sensitive modules are identified. Second, an arch-level dependability enhancement strategy is proposed, showing that events such as core/strand running status and core-memory interface events can be candidates of detectable symptoms. A simple watchdog can be deployed to detect application running status (IEXE event). Then SDC (silent data corruption) rate is evaluated demonstrating its potential. Third and last, the effects of traditional protection schemes in the target CMT to intermittent faults are quantitatively studied on behalf of the contribution of each trap type, demonstrating the necessity of taking this factor into account for the strategy.

"URM candidates are encouraged to apply": a national study to identify effective strategies to enhance racial and ethnic faculty diversity in academic departments of medicine.

PubMed

Peek, Monica E; Kim, Karen E; Johnson, Julie K; Vela, Monica B

2013-03-01

There is little evidence regarding which factors and strategies are associated with high proportions of underrepresented minority (URM) faculty in academic medicine. The authors conducted a national study of U.S. academic medicine departments to better understand the challenges, successful strategies, and predictive factors for enhancing racial and ethnic diversity among faculty (i.e., physicians with an academic position or rank). This was a mixed-methods study using quantitative and qualitative methods. The authors conducted a cross-sectional study of eligible departments of medicine in 125 accredited U.S. medical schools, dichotomized into low-URM (bottom 50%) versus high-URM rank (top 50%). They used t tests and chi-squared tests to compare departments by geographic region, academic school rank, city type, and composite measures of "diversity best practices." The authors also conducted semistructured in-depth interviews with a subsample from the highest- and lowest-quartile medical schools in terms of URM rank. Eighty-two medical schools responded (66%). Geographic region and academic rank were statistically associated with URM rank, but not city type or composite measures of diversity best practices. Key themes emerged from interviews regarding successful strategies for URM faculty recruitment and retention, including institutional leadership, the use of human capital and social relationships, and strategic deployment of institutional resources. Departments of medicine with high proportions of URM faculty employ a number of successful strategies and programs for recruitment and retention. More research is warranted to identify new successful strategies and to determine the impact of specific strategies on establishing and maintaining workforce diversity.

Organisational change stressors and nursing job satisfaction: the mediating effect of coping strategies.

PubMed

Teo, Stephen T T; Pick, David; Newton, Cameron J; Yeung, Melissa E; Chang, Esther

2013-09-01

To examine the mediating effect of coping strategies on the consequences of nursing and non-nursing (administrative) stressors on the job satisfaction of nurses during change management. Organisational change can result in an increase in nursing and non-nursing-related stressors, which can have a negative impact on the job satisfaction of nurses employed in health-care organisations. Matched data were collected in 2009 via an online survey at two time-points (six months apart). Partial least squares path analysis revealed a significant causal relationship between Time 1 administrative and role stressors and an increase in nursing-specific stressors in Time 2. A significant relationship was also identified between job-specific nursing stressors and the adoption of effective coping strategies to deal with increased levels of change-induced stress and strain and the likelihood of reporting higher levels of job satisfaction in Time 2. The effectiveness of coping strategies is critical in helping nurses to deal with the negative consequences of organisational change. This study shows that there is a causal relationship between change, non-nursing stressors and job satisfaction. Senior management should implement strategies aimed at reducing nursing and non-nursing stress during change in order to enhance the job satisfaction of nurses. © 2013 John Wiley & Sons Ltd.

High quality diabetes care: testing the effectiveness of strategies of regional implementation teams.

PubMed

Drach-Zahavy, Anat; Shadmi, Efrat; Freund, Anat; Goldfracht, Margalit

2009-01-01

The purpose of this article is to identify and test the effectiveness of work strategies employed by regional implementation teams to attain high quality care for diabetes patients. The study was conducted in a major health maintenance organization (HMO) that provides care for 70 per cent of Israel's diabetes patients. A sequential mixed model design, combining qualitative and quantitative methods was employed. In-depth interviews were conducted with members of six regional implementation teams, each responsible for the care of 25,000-34,000 diabetic patients. Content analysis of the interviews revealed that teams employed four key strategies: task-interdependence, goal-interdependence, reliance on top-down standardised processes and team-learning. These strategies were used to predict the mean percentage performance of eight evidence-based indicators of diabetes care: percentage of patients with HbA1c < 7 per cent, blood pressure < or = 130/80 and cholesterol < or = 100; and performance of: HbA1c tests, LDL cholesterol tests, blood pressure measurements, urine protein tests, and ophthalmic examinations. Teams were found to vary in their use of the four strategies. Mixed linear models analysis indicated that type of indicator (simple process, compound process, and outcome) and goal interdependence were significantly linked to team effectiveness. For simple-process indicators, reliance on top-down standardised processes led to team effectiveness, but for outcome measures this strategy was ineffective, and even counter-effective. For outcome measures, team-learning was more beneficial. The findings have implications for the management of chronic diseases. The advantage of allowing team members flexibility in the choice of the best work strategy to attain high quality diabetes care is attested.

Clinicians' preventive strategies for children and adolescents identified as at high risk of developing caries.

PubMed

Sarmadi, Roxana; Gahnberg, Lars; Gabre, Pia

2011-05-01

Clinicians handle diagnosis and treatment planning of caries in different ways, and the underlying factors leading to management of risk and choice of treatment strategies are poorly understood. The aim of this study was to investigate dentists' and dental hygienists' choices of preventive strategies for children and adolescents identified as at high risk of developing caries. A sample of dental records from 432 of a total of 3372 children in a Swedish county identified as at high risk of developing caries, aged 3-19 years, was randomly selected for analysis in the study. Information of importance for the therapists' choice of caries management strategies were obtained from the dental records. The results showed that therapists considered tooth brushing instruction and fluoride treatment at the clinic to be of primary importance as treatment given in 60% of the cases, respectively. Fluoride treatment at home and diet counselling were both chosen in half of the cases. Fissure sealant therapy was used in 21% of the cases, and 15% of the patients did not receive any preventive treatment at all. The results also showed that girls more often received fluoride treatment, tooth brushing instruction and oral hygiene information than boys. In the majority of the children and adolescents, several preventive measures were given. The more background factors included in the risk assessment, the more preventive measures were given. The differences between the treatments given to girls and the boys need to be further investigated. © 2010 The Authors. International Journal of Paediatric Dentistry © 2010 BSPD, IAPD and Blackwell Publishing Ltd.

Identifying Effective Strategies to Providing Technical Support to One-to-One Programs

ERIC Educational Resources Information Center

Thomas, Mark W.

2013-01-01

The problem of this study was that while one-to-one initiatives in the K-12 environment are growing, the technical support personnel that work in these environments are experiencing problems supporting these initiatives. The purposes of this study were to: (a) identify common problems of providing technical support in a one-to-one laptop program,…

The effect of preparation strategies, qualification and professional background on clinical nurse educator confidence.

PubMed

Nguyen, Van N B; Forbes, Helen; Mohebbi, Mohammadreza; Duke, Maxine

2018-06-12

To describe how clinical nurse educators in Vietnam are prepared for their role; to identify which preparation strategies assist development of confidence in clinical teaching; and to measure the effect of educational qualifications and professional background on perceived confidence levels. The quality of clinical teaching can directly affect the quality of the student learning experience. The role of the clinical educator is complex and dynamic and requires a period of adjustment for successful role transition to occur. Planned orientation and specific preparation programs assist transition and reduce anxiety for new clinical nurse educators. There is, however, a lack of clear evidence to identify the form this preparation should take or which strategies are likely to facilitate the development of role confidence. Descriptive survey study. Cross-sectional surveys were used to collect data from 334 clinical nurse educators during January - March 2015. Eight preparation methods commonly used in Vietnam were identified. There was a small yet significant association between preparation and clinical nurse educators' perceived confidence. Formal preparation methods, as well as postgraduate qualifications and years of clinical teaching experience were linked to increased confidence in clinical teaching. Conversely, informal mentorship was found to hinder confidence development. This study identifies several preparation strategies that significantly enhance clinical educator confidence and readiness for their complex role. These preparation strategies drawn from the Vietnamese context, provide important examples for the wider nursing community to consider. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

The effectiveness of strategies to change organisational culture to improve healthcare performance

PubMed Central

Parmelli, Elena; Flodgren, Gerd; Schaafsma, Mary Ellen; Baillie, Nick; Beyer, Fiona R; Eccles, Martin P

2014-01-01

Background Organisational culture is an anthropological metaphor used to inform research and consultancy and to explain organisational environments. Great emphasis has been placed during the last years on the need to change organisational culture in order to pursue effective improvement of healthcare performance. However, the precise nature of organisational culture in healthcare policy often remains underspecified and the desirability and feasibility of strategies to be adopted has been called into question. Objectives To determine the effectiveness of strategies to change organisational culture in order to improve healthcare performance. To examine the effectiveness of these strategies according to different patterns of organisational culture. Search methods We searched the following electronic databases for primary studies: The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, Sociological Abstracts, Web of Knowledge, PsycINFO, Business and Management, EThOS, Index to Theses, Intute, HMIC, SIGLE, and Scopus until October 2009. The Database of Abstracts of Reviews of Effectiveness (DARE) was searched for related reviews. We also searched the reference lists of all papers and relevant reviews identified, and we contacted experts in the field for advice on further potential studies. Selection criteria We considered randomised controlled trials (RCTs) or well designed quasi-experimental studies, controlled clinical trials (CCTs), controlled before and after studies (CBAs) and interrupted time series analyses (ITS) meeting the quality criteria used by the Cochrane Effective Practice and Organisation of Care Group (EPOC). Studies should be set in any type of healthcare organisation in which strategies to change organisational culture in order to improve healthcare performance were applied. Our main outcomes were objective measures of professional performance and patient outcome. Data collection and analysis At least two review authors

The effectiveness of strategies to change organisational culture to improve healthcare performance.

PubMed

Parmelli, Elena; Flodgren, Gerd; Schaafsma, Mary Ellen; Baillie, Nick; Beyer, Fiona R; Eccles, Martin P

2011-01-19

Organisational culture is an anthropological metaphor used to inform research and consultancy and to explain organisational environments. Great emphasis has been placed during the last years on the need to change organisational culture in order to pursue effective improvement of healthcare performance. However, the precise nature of organisational culture in healthcare policy often remains underspecified and the desirability and feasibility of strategies to be adopted has been called into question. To determine the effectiveness of strategies to change organisational culture in order to improve healthcare performance.To examine the effectiveness of these strategies according to different patterns of organisational culture. We searched the following electronic databases for primary studies: The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, Sociological Abstracts, Web of Knowledge, PsycINFO, Business and Management, EThOS, Index to Theses, Intute, HMIC, SIGLE, and Scopus until October 2009. The Database of Abstracts of Reviews of Effectiveness (DARE) was searched for related reviews. We also searched the reference lists of all papers and relevant reviews identified, and we contacted experts in the field for advice on further potential studies. We considered randomised controlled trials (RCTs) or well designed quasi-experimental studies, controlled clinical trials (CCTs), controlled before and after studies (CBAs) and interrupted time series analyses (ITS) meeting the quality criteria used by the Cochrane Effective Practice and Organisation of Care Group (EPOC). Studies should be set in any type of healthcare organisation in which strategies to change organisational culture in order to improve healthcare performance were applied. Our main outcomes were objective measures of professional performance and patient outcome. At least two review authors independently applied the criteria for inclusion and exclusion criteria to scan titles and

The Quality of Clinical Maternal and Neonatal Healthcare – A Strategy for Identifying ‘Routine Care Signal Functions’

PubMed Central

Brenner, Stephan; De Allegri, Manuela; Gabrysch, Sabine; Chinkhumba, Jobiba; Sarker, Malabika; Muula, Adamson S.

2015-01-01

Background A variety of clinical process indicators exists to measure the quality of care provided by maternal and neonatal health (MNH) programs. To allow comparison across MNH programs in low- and middle-income countries (LMICs), a core set of essential process indicators is needed. Although such a core set is available for emergency obstetric care (EmOC), the ‘EmOC signal functions’, a similar approach is currently missing for MNH routine care evaluation. We describe a strategy for identifying core process indicators for routine care and illustrate their usefulness in a field example. Methods We first developed an indicator selection strategy by combining epidemiological and programmatic aspects relevant to MNH in LMICs. We then identified routine care process indicators meeting our selection criteria by reviewing existing quality of care assessment protocols. We grouped these indicators into three categories based on their main function in addressing risk factors of maternal or neonatal complications. We then tested this indicator set in a study assessing MNH quality of clinical care in 33 health facilities in Malawi. Results Our strategy identified 51 routine care processes: 23 related to initial patient risk assessment, 17 to risk monitoring, 11 to risk prevention. During the clinical performance assessment a total of 82 cases were observed. Birth attendants’ adherence to clinical standards was lowest in relation to risk monitoring processes. In relation to major complications, routine care processes addressing fetal and newborn distress were performed relatively consistently, but there were major gaps in the performance of routine care processes addressing bleeding, infection, and pre-eclampsia risks. Conclusion The identified set of process indicators could identify major gaps in the quality of obstetric and neonatal care provided during the intra- and immediate postpartum period. We hope our suggested indicators for essential routine care processes

A systematic review of the effectiveness of strategies and interventions to improve the transition from student to newly qualified nurse.

PubMed

Edwards, Deborah; Hawker, Clare; Carrier, Judith; Rees, Colin

2015-07-01

The transition from student to newly qualified nurse can be stressful for many newly qualified nurses who feel inadequately prepared. A variety of support strategies to improve the transition process have been reported across the international literature but the effectiveness of such strategies is unknown. To determine the effectiveness of the main strategies used to support newly qualified nurses during the transition into the clinical workplace and, where identified, evaluate the impact of these on individual and organisational outcomes. Systematic review. A search of electronic databases to identify published studies (CINAHL, MEDLINE, British Nursing Index, Cochrane Library, EMBASE, PsychLit, PsychINFO, PsychARTICLES, Web Of Science, EBM Reviews, BioMed, TRIP, ERIC, SCOPUS (January 2000-April 2011) was conducted. Relevant journals were hand-searched and reference lists from retrieved studies were reviewed to identify any further studies. The search was restricted to English language papers. The key words used were words that described new graduate nurses and support strategies (e.g. internship, residency, orientation programmes). The inclusion criteria were quantitative studies that investigated the effectiveness of support strategies for newly qualified graduate nurses. Studies that involved students in their final year of graduate study were excluded (for example extern programmes). Extraction of data was undertaken independently by two reviewers. A further two reviewers assessed the methodological quality against agreed criteria. A total of 8199 studies were identified from the database search and 30 met the inclusion criteria for the review. The evidence suggests that transition interventions/strategies do lead to improvements in confidence and competence, job satisfaction, critical thinking and reductions in stress and anxiety for the newly qualified nurse. This systematic review demonstrates the beneficial effects of transitional support strategies for

A strategy to identify linker-based modules for the allosteric regulation of antibody-antigen binding affinities of different scFvs

PubMed Central

Thie, Holger

2017-01-01

ABSTRACT Antibody single-chain variable fragments (scFvs) are used in a variety of applications, such as for research, diagnosis and therapy. Essential for these applications is the extraordinary specificity, selectivity and affinity of antibody paratopes, which can also be used for efficient protein purification. However, this use is hampered by the high affinity for the protein to be purified because harsh elution conditions, which may impair folding, integrity or viability of the eluted biomaterials, are typically required. In this study, we developed a strategy to obtain structural elements that provide allosteric modulation of the affinities of different antibody scFvs for their antigen. To identify suitable allosteric modules, a complete set of cyclic permutations of calmodulin variants was generated and tested for modulation of the affinity when substituting the linker between VH and VL. Modulation of affinity induced by addition of different calmodulin-binding peptides at physiologic conditions was demonstrated for 5 of 6 tested scFvs of different specificities and antigens ranging from cell surface proteins to haptens. In addition, a variety of different modulator peptides were tested. Different structural solutions were found in respect of the optimal calmodulin permutation, the optimal peptide and the allosteric effect for scFvs binding to different antigen structures. Significantly, effective linker modules were identified for scFvs with both VH-VL and VL-VH architecture. The results suggest that this approach may offer a rapid, paratope-independent strategy to provide allosteric regulation of affinity for many other antibody scFvs. PMID:28055297

Saltelli Global Sensitivity Analysis and Simulation Modelling to Identify Intervention Strategies to Reduce the Prevalence of Escherichia coli O157 Contaminated Beef Carcasses

PubMed Central

Brookes, Victoria J.; Jordan, David; Davis, Stephen; Ward, Michael P.; Heller, Jane

2015-01-01

Introduction Strains of Shiga-toxin producing Escherichia coli O157 (STEC O157) are important foodborne pathogens in humans, and outbreaks of illness have been associated with consumption of undercooked beef. Here, we determine the most effective intervention strategies to reduce the prevalence of STEC O157 contaminated beef carcasses using a modelling approach. Method A computational model simulated events and processes in the beef harvest chain. Information from empirical studies was used to parameterise the model. Variance-based global sensitivity analysis (GSA) using the Saltelli method identified variables with the greatest influence on the prevalence of STEC O157 contaminated carcasses. Following a baseline scenario (no interventions), a series of simulations systematically introduced and tested interventions based on influential variables identified by repeated Saltelli GSA, to determine the most effective intervention strategy. Results Transfer of STEC O157 from hide or gastro-intestinal tract to carcass (improved abattoir hygiene) had the greatest influence on the prevalence of contaminated carcases. Due to interactions between inputs (identified by Saltelli GSA), combinations of interventions based on improved abattoir hygiene achieved a greater reduction in maximum prevalence than would be expected from an additive effect of single interventions. The most effective combination was improved abattoir hygiene with vaccination, which achieved a greater than ten-fold decrease in maximum prevalence compared to the baseline scenario. Conclusion Study results suggest that effective interventions to reduce the prevalence of STEC O157 contaminated carcasses should initially be based on improved abattoir hygiene. However, the effect of improved abattoir hygiene on the distribution of STEC O157 concentration on carcasses is an important information gap—further empirical research is required to determine whether reduced prevalence of contaminated carcasses is

Development of a strategy to identify gastrointestinal epithelial membrane proteins induced by irradiation

NASA Astrophysics Data System (ADS)

Griffin, Kathleen P.

Radiotherapy is commonly used in the treatment of solid tumours but its use is limited by its damaging effects on normal healthy cells. The deleterious effects of radiation are predominantly due to the targeting of stem cells - cells with the remarkable potential to generate different cell types - as they share many of the characteristics of cancer cells. Consequently, when treating cancers of the abdomen and the pelvis, the gastrointestinal tract can ultimately be injured. The damage response of the intestinal epithelium to radiation insult is well characterised morphologically. Crypt stem cells are deleted and the capacity for their replacement is compromised. As a result, holes appear in the epithelium leading to ulceration, anorexia, vomiting and diarrhoea and septicaemia - a condition referred to as mucositis. However, less is known about the factors controlling the fate of radiation damaged cells. With this in mind, this thesis set out to develop a successful means to identify membrane protein regulators of the intestinal radiation response for commercial exploitation and clinical development as novel anti-mucositis agents. 151 target genes, chosen on the basis of a prior indication of radio-responsiveness or the availability of chemical tools, were screened for differential expression in normal and irradiated gastrointestinal tissues using quantitative PCR. To generate leads for functional characterisation, screening was performed in a stepwise fashion, and as methods improved, was refined from whole tissues to multiple microdissected crypts. Targets exhibiting overt changes in mRNA levels in response to radiation were further characterised until three were identified as likely candidates for functional analysis. The activity of one of these candidates, the ATP-sensitive potassium channel (K[ATP]) was chosen for investigation in a mouse primary culture model of the intestinal epithelium. The K[ATP] openers minoxidil and levcromakalim increased cell number by

Strategies for Effective Teaching in the Twenty-First Century: A Supplement for Special Education

ERIC Educational Resources Information Center

Louisiana Department of Education, 2004

2004-01-01

The long-range goal of Louisiana's teacher professional accountability programs is to enhance student learning by providing opportunities for teachers to strengthen skill areas and by identifying those aspects of teaching performance that may need improvement. "Strategies for Effective Teaching in the 21st Century" is intended to be used…

Relationship between incivility experiences and nursing professional values among nursing students: Moderating effects of coping strategies.

PubMed

Kim, Ji-Soo

2018-06-01

During clinical practice, nursing students develop their professional role and internalize the values of the nursing profession. Unfortunately, it also often exposes them uncivil behaviors from nurses. To identify the relationship between incivility experiences and nursing professional values, and investigate the potential moderating effects of coping strategies in this relationship. This was a descriptive, cross-sectional study. Data were collected from 203 nursing students using questionnaires. The questionnaire comprised sections assessing participant characteristics, incivility experiences, coping strategies, and nursing professional values. Multiple regression analysis was used to identify the relationship between incivility experiences and nursing professional values, as well as the interaction effect of incivility experiences and coping strategies on nursing professional values. Incivility experiences were negatively related to nursing professional values. Furthermore, seeking support moderated the relationship between incivility experiences and nursing professional values. In other words, as incivility experiences increased, nursing students who used more seeking social support tended to have stronger nursing professional values than did those who used this coping strategy less. To improve the nursing professional values of nursing students, educators must inform nursing managers when nurses direct uncivil behaviors towards students. Educators should also listen to students' experiences, support them emotionally, and encourage students to engage in seeking social support. Copyright © 2018 Elsevier Ltd. All rights reserved.

Resource Effective Strategies to Prevent and Treat Cardiovascular Disease

PubMed Central

Schwalm, Jon-David; McKee, Martin; Huffman, Mark D.; Yusuf, Salim

2016-01-01

Cardiovascular disease (CVD) is the leading cause of global deaths, with the majority occurring in low- and middle-income countries (LMIC). The primary and secondary prevention of CVD is suboptimal throughout the world, but the evidence-practice gaps are much more pronounced in LMIC. Barriers at the patient, health-care provider, and health system level prevent the implementation of optimal primary and secondary prevention. Identification of the particular barriers that exist in resource-constrained settings is necessary to inform effective strategies to reduce the identified evidence-practice gaps. Furthermore, targeting modifiable factors that contribute most significantly to the global burden of CVD, including tobacco use, hypertension, and secondary prevention for CVD will lead to the biggest gains in mortality reduction. We review a select number of novel, resource-efficient strategies to reduce premature mortality from CVD, including: (1) effective measures for tobacco control; (2) implementation of simplified screening and management algorithms for those with or at risk of CVD, (3) increasing the availability and affordability of simplified and cost-effective treatment regimens including combination CVD preventive drug therapy, and (4) simplified delivery of health care through task-sharing (non-physician health workers) and optimizing self-management (treatment supporters). Developing and deploying systems of care that address barriers related to the above, will lead to substantial reductions in CVD and related mortality. PMID:26903017

How Is Knowledge Generated about Memory Encoding Strategy Effectiveness?

ERIC Educational Resources Information Center

Hertzog, Christopher; Price, Jodi; Dunlosky, John

2008-01-01

This study evaluated how people learn about encoding strategy effectiveness in an associative memory task. Individuals studied two lists of paired associates under instructions to use either a normatively effective strategy (interactive imagery) or a normatively ineffective strategy (rote repetition) for each pair. Questionnaire ratings of imagery…

Optimal combinations of control strategies and cost-effective analysis for visceral leishmaniasis disease transmission.

PubMed

Biswas, Santanu; Subramanian, Abhishek; ELMojtaba, Ibrahim M; Chattopadhyay, Joydev; Sarkar, Ram Rup

2017-01-01

Visceral leishmaniasis (VL) is a deadly neglected tropical disease that poses a serious problem in various countries all over the world. Implementation of various intervention strategies fail in controlling the spread of this disease due to issues of parasite drug resistance and resistance of sandfly vectors to insecticide sprays. Due to this, policy makers need to develop novel strategies or resort to a combination of multiple intervention strategies to control the spread of the disease. To address this issue, we propose an extensive SIR-type model for anthroponotic visceral leishmaniasis transmission with seasonal fluctuations modeled in the form of periodic sandfly biting rate. Fitting the model for real data reported in South Sudan, we estimate the model parameters and compare the model predictions with known VL cases. Using optimal control theory, we study the effects of popular control strategies namely, drug-based treatment of symptomatic and PKDL-infected individuals, insecticide treated bednets and spray of insecticides on the dynamics of infected human and vector populations. We propose that the strategies remain ineffective in curbing the disease individually, as opposed to the use of optimal combinations of the mentioned strategies. Testing the model for different optimal combinations while considering periodic seasonal fluctuations, we find that the optimal combination of treatment of individuals and insecticide sprays perform well in controlling the disease for the time period of intervention introduced. Performing a cost-effective analysis we identify that the same strategy also proves to be efficacious and cost-effective. Finally, we suggest that our model would be helpful for policy makers to predict the best intervention strategies for specific time periods and their appropriate implementation for elimination of visceral leishmaniasis.

[Dietary intervention programs in the workplace: an effective prevention strategy].

PubMed

Barbato, D Lettieri; Sancini, A; Caciari, T; Rosati, M V; Tomei, G; Tomei, F

2010-01-01

The main purpose of our meta-analysis was to investigate the effect of workplace dietary intervention on several variables. We made a systematic literature search by selecting articles published up to September 2009. Only 18 studies were deemed suitable for inclusion criteria considered in our meta-analysis. Among the dietary variables there was significant difference between the two groups after the administration of nutritional intervention programs. A significant improvement was also observed between the anthropometric and metabolic variables. No significant change was instead documented in relation to functional variables (systolic and diastolic pressure). Workplace dietary intervention, improving nutritional, anthropometrical and metabolic variables, can be identified as effective prevention strategy toward chronic diseases.

Effective Behaviour Management Strategies for Australian Aboriginal and Torres Strait Islander Students: A Literature Review

ERIC Educational Resources Information Center

Llewellyn, Linda L.; Boon, Helen J.; Lewthwaite, Brian E.

2018-01-01

This paper reports findings from a systematic literature review conducted to identify effective behaviour management strategies which create a positive learning environment for Aboriginal and Torres Strait Islander students. The search criteria employed resulted in 103 documents which were analysed in response to this focus. Results identified…

Effectiveness of GNSS disposal strategies

NASA Astrophysics Data System (ADS)

Alessi, E. M.; Rossi, A.; Valsecchi, G. B.; Anselmo, L.; Pardini, C.; Colombo, C.; Lewis, H. G.; Daquin, J.; Deleflie, F.; Vasile, M.; Zuiani, F.; Merz, K.

2014-06-01

The management of the Global Navigation Satellite Systems (GNSS) and of the Medium Earth Orbit (MEO) region as a whole is a subject that cannot be deferred, due to the growing exploitation and launch rate in that orbital regime. The advent of the European Galileo and the Chinese Beidou constellations significantly added complexity to the system and calls for an adequate global view on the four constellations present in operation. The operation procedures, including maintenance and disposal practices, of the constellations currently deployed were analyzed in order to asses a proper reference simulation scenario. The complex dynamics of the MEO region with all the geopotential and lunisolar resonances was studied to better identify the proper end-of-life orbit for every proposed strategy, taking into account and, whenever possible, exploiting the orbital dynamics in this peculiar region of space. The possibility to exploit low thrust propulsion or non gravitational perturbations with passive de-orbiting devices (and a combination of the two) was analyzed, in view of possible applications in the design of the future generations of the constellations satellites. Several upgrades in the long-term evolution software SDM and DAMAGE were undertaken to properly handle the constellation simulations in every aspect from constellation maintenance to orbital dynamics. A thorough approach considering the full time evolving covariance matrix associated with every object was implemented in SDM to compute the collision risk and associated maneuver rate for the constellation satellites. Once the software upgrades will be completed, the effectiveness of the different disposal strategies will be analyzed in terms of residual collision risk and avoidance maneuvers rate. This work was performed under the ESA/GSP Contract no. 4000107201/12/F/MOS.

Struggling to be part of Swedish society: Strategies used by immigrants with late effects of polio.

PubMed

Santos Tavares Silva, Iolanda; Thorén-Jönsson, Anna-Lisa

2015-01-01

To explore and describe strategies in daily occupations among immigrants with late effects of polio. The strategies were explored by interviews with 12 immigrants from Eastern Africa with late effects of polio. Sampling and data analysis was carried out according to grounded theory. The participants struggled for occupational participation and normality in an effort to participate in, and be part of, society. The study identified 14 strategies used by the immigrants in their daily occupations. The strategies can be presented in the following four categories: managing physical capacity; promoting occupational performance; strategies for gaining respect; and preparing the ground for one's existence. The participants struggled to find a balance between physical capacity and meaningful occupations, conception of their own and others' norms and values, and living conditions in Swedish society. The strategies were related to the participants' will to manage daily occupations, maintain social relationships, and be part of society. The strategies revealed that the participants strive to participate in occupations and society. This study reinforces the importance of occupation for immigrants with disability. The results highlight the need for adequate health care and rehabilitation but should also alert other social institutions.

Optimal CINAHL search strategies for identifying therapy studies and review articles.

PubMed

Wong, Sharon S L; Wilczynski, Nancy L; Haynes, R Brian

2006-01-01

To design optimal search strategies for locating sound therapy studies and review articles in CiNAHL in the year 2000. An analytic survey was conducted, comparing hand searches of 75 journals with retrievals from CINAHL for 5,020 candidate search terms and 17,900 combinations for therapy and 5,977 combinations for review articles. All articles were rated with purpose and quality indicators. Candidate search strategies were used in CINAHL, and the retrievals were compared with results of the hand searches. The proposed search strategies were treated as "diagnostic tests" for sound studies and the manual review of the literature was treated as the "gold standard." Operating characteristics of the search strategies were calculated. Of the 1,383 articles about treatment, 506 (36.6%) met basic criteria for scientific merit and 127 (17.9%) of the 711 articles classified as a review met the criteria for systematic reviews. For locating sound treatment studies, a three-term strategy maximized sensitivity at 99.4% but with compromised specificity at 58.3%, and a two-term strategy maximized specificity at 98.5% but with compromised sensitivity at 52.0%. For detecting systematic reviews, a three-term strategy maximized sensitivity at 91.3% while keeping specificity high at 95.4%, and a single-term strategy maximized specificity at 99.6% but with compromised sensitivity at 42.5%. Three-term search strategies optimizing sensitivity and specificity achieved these values over 91% for detecting sound treatment studies and over 76% for detecting systematic reviews. Search strategies combining indexing terms and text words can achieve high sensitivity and specificity for retrieving sound treatment studies and review articles in CINAHL.

Diagnosing climate change impacts and identifying adaptation strategies by involving key stakeholder organisations and farmers in Sikkim, India: Challenges and opportunities.

PubMed

Azhoni, Adani; Goyal, Manish Kumar

2018-06-01

Narrowing the gap between research, policy making and implementing adaptation remains a challenge in many parts of the world where climate change is likely to severely impact water security. This research aims to narrow this gap by matching the adaptation strategies being framed by policy makers to that of the perspectives of development agencies, researchers and farmers in the Himalayan state of Sikkim in India. Our case study examined the perspectives of various stakeholders for climate change impacts, current adaptation strategies, knowledge gaps and adaptation barriers, particularly in the context of implementing the Sikkim State Action Plan on Climate Change through semi-structured interviews carried out with decision makers in the Sikkim State Government, researchers, consultants, local academia, development agencies and farmers. Using Stakeholders Network Analysis tools, this research unravels the complexities of perceiving climate change impacts, identifying strategies, and implementing adaptation. While farmers are less aware about the global phenomenon of climate change impacts for water security, their knowledge of the local conditions and their close interaction with the State Government Agriculture Department provides them opportunities. Although important steps are being initiated through the Sikkim State Action Plan on Climate Change it is yet to deliver effective means of adaptation implementation and hence, strengthening the networks of close coordination between the various implementing agencies will pay dividends. Knowledge gaps and the need for capacity building identified in this research, based on the understandings of key stakeholders are highly relevant to both the research community and for informing policy. Copyright © 2018 Elsevier B.V. All rights reserved.

Effect of stigma reduction intervention strategies on HIV test uptake in low- and middle-income countries: a realist review protocol.

PubMed

Thapa, Subash; Hannes, Karin; Cargo, Margaret; Buve, Anne; Mathei, Catharina

2015-11-02

Several stigma reduction intervention strategies have been developed and tested for effectiveness in terms of increasing human immunodeficiency virus (HIV) test uptake. These strategies have been more effective in some contexts and less effective in others. Individual factors, such as lack of knowledge and fear of disclosure, and social-contextual factors, such as poverty and illiteracy, might influence the effect of stigma reduction intervention strategies on HIV test uptake in low- and middle-income countries. So far, it is not clearly known how the stigma reduction intervention strategies interact with these contextual factors to increase HIV test uptake. Therefore, we will conduct a review that will synthesize existing studies on stigma reduction intervention strategies to increase HIV test uptake to better understand the mechanisms underlying this process in low- and middle-income countries. A realist review will be conducted to unpack context-mechanism-outcome configurations of the effect of stigma reduction intervention strategies on HIV test uptake. Based on a scoping review, we developed a preliminary theoretical framework outlining a potential mechanism of how the intervention strategies influence HIV test uptake. Our realist synthesis will be used to refine the preliminary theoretical framework to better reflect mechanisms that are supported by existing evidence. Journal articles and grey literature will be searched following a purposeful sampling strategy. Data will be extracted and tested against the preliminary theoretical framework. Data synthesis and analysis will be performed in five steps: organizing extracted data into evidence tables, theming, formulating chains of inference from the identified themes, linking the chains of inference and developing generative mechanisms, and refining the framework. This will be the first realist review that offers both a quantitative and a qualitative exploration of the available evidence to develop and propose

Comparison of genome-wide selection strategies to identify furfural tolerance genes in Escherichia coli.

PubMed

Glebes, Tirzah Y; Sandoval, Nicholas R; Gillis, Jacob H; Gill, Ryan T

2015-01-01

Engineering both feedstock and product tolerance is important for transitioning towards next-generation biofuels derived from renewable sources. Tolerance to chemical inhibitors typically results in complex phenotypes, for which multiple genetic changes must often be made to confer tolerance. Here, we performed a genome-wide search for furfural-tolerant alleles using the TRackable Multiplex Recombineering (TRMR) method (Warner et al. (2010), Nature Biotechnology), which uses chromosomally integrated mutations directed towards increased or decreased expression of virtually every gene in Escherichia coli. We employed various growth selection strategies to assess the role of selection design towards growth enrichments. We also compared genes with increased fitness from our TRMR selection to those from a previously reported genome-wide identification study of furfural tolerance genes using a plasmid-based genomic library approach (Glebes et al. (2014) PLOS ONE). In several cases, growth improvements were observed for the chromosomally integrated promoter/RBS mutations but not for the plasmid-based overexpression constructs. Through this assessment, four novel tolerance genes, ahpC, yhjH, rna, and dicA, were identified and confirmed for their effect on improving growth in the presence of furfural. © 2014 Wiley Periodicals, Inc.

Cognitive and Other Strategies to Mitigate the Effects of Fatigue. Lessons from Staff Physicians Working in Intensive Care Units.

PubMed

Henrich, Natalie; Ayas, Najib T; Stelfox, Henry T; Peets, Adam D

2016-09-01

Fatigue is common among physicians and adversely affects their performance. To identify strategies that attending physicians use when fatigued to maintain clinical performance in the intensive care unit (ICU). We conducted a qualitative study using focus groups and structured interviews of attending ICU physicians working in academic centers in Canada. In three focus group meetings, we engaged a total of 11 physicians to identify strategies used to prevent and cope with fatigue. In the focus groups, 21 cognitive strategies were identified and classified into 9 categories (minimizing number of tasks, using techniques to improve retention of details, using a structured approach to patient care, asking for help, improving opportunities for focusing, planning ahead, double-checking, adjusting expectations, and modulating alertness). In addition, various lifestyle strategies were mentioned as important in preventing fatigue (e.g., protecting sleep before call, adequate exercise, and limiting alcohol). Telephone interviews were then conducted (n = 15 physicians) with another group of intensivists. Structured questions were asked about the strategies identified in the focus groups that were most useful during ICU activities. In the interviews, the most useful and frequently used strategies were prioritizing tasks that need to be done immediately and postponing tasks that can wait, working systematically, using a structured approach, and avoiding distractions. ICU physicians reported using a variety of deliberate cognitive and lifestyle strategies to prevent and cope with fatigue. Given the low cost and intuitive nature of the majority of these strategies, further investigations should be done to better characterize their effectiveness in improving performance.

A cost-effective approach to the development of printed materials: a randomized controlled trial of three strategies.

PubMed

Paul, C L; Redman, S; Sanson-Fisher, R W

2004-12-01

Printed materials have been a primary mode of communication in public health education. Three major approaches to the development of these materials--the application of characteristics identified in the literature, behavioral strategies and marketing strategies--have major implications for both the effectiveness and cost of materials. However, little attention has been directed towards the cost-effectiveness of such approaches. In the present study, three pamphlets were developed using successive addition of each approach: first literature characteristics only ('C' pamphlet), then behavioral strategies ('C + B' pamphlet) and then marketing strategies ('C + B + M' pamphlet). Each pamphlet encouraged women to join a Pap Test Reminder Service (PTRS). Each pamphlet was mailed to a randomly selected sample of 2700 women aged 50-69 years. Registrations with the PTRS were monitored and 420 women in each pamphlet group were surveyed by telephone. It was reported that the 'C + B' and 'C + B + M' pamphlets were significantly more effective than the 'C' pamphlet. The 'C + B' pamphlet was the most cost-effective of the three pamphlets. There were no significant differences between any of the pamphlet groups on acceptability, knowledge or attitudes. It was suggested that the inclusion of behavioral strategies is likely to be a cost-effective approach to the development of printed health education materials.

Using Learning Strategies to Inhibit the Nocebo Effect.

PubMed

Quinn, Veronica F; Colagiuri, Ben

2018-01-01

Learning is a key mechanism underpinning the development of the nocebo effect. The learning literature has cataloged and explored numerous ways in which the environment can be manipulated to prevent, reduce, or eradicate learning. Knowledge of these processes could be used to both inhibit the development of nocebo effects and reduce already established nocebo learning. This review describes the available evidence on how such learning strategies have, or could be, applied to reduce the nocebo effect in both healthy participants and patients to date. These learning strategies include overshadowing, latent inhibition, extinction, and contingency degradation. These strategies represent important new avenues for investigation and should be used by researchers to design and test interventions to reduce nocebo effects. © 2018 Elsevier Inc. All rights reserved.

The Effect of Using Metacognitive Strategies for Solving Geometry Problems on Students' Achievement and Attitude

ERIC Educational Resources Information Center

Mandaci Sahin, Seher; Kendir, Fatma

2013-01-01

The purpose of this study is to identify the effect of using metacognitive strategies for problem solving in "geometry" on fifth grade students' achievement, metacognitive skills and attitude. Experimental method was used with a pretest/posttest control group design. Firstly, both groups were subject to a pretest that was comprised of…

The effectiveness of recruitment strategies on general practitioner's survey response rates - a systematic review.

PubMed

Pit, Sabrina Winona; Vo, Tham; Pyakurel, Sagun

2014-06-06

Low survey response rates in general practice are common and lead to loss of power, selection bias, unexpected budgetary constraints and time delays in research projects. To assess the effectiveness of recruitment strategies aimed at increasing survey response rates among GPs. Systematic review. MEDLINE (OVIDSP, 1948-2012), EMBASE (OVIDSP, 1980-2012), Evidence Based Medicine Reviews (OVIDSP, 2012) and references of included papers were searched. Major search terms included GPs, recruitment strategies, response rates, and randomised controlled trials (RCT). Cluster RCTs, RCTs and factorial trial designs that evaluate recruitment strategies aimed at increasing GP survey response rates. Abstracts identified by the search strategy were reviewed and relevant articles were retrieved. Each full-text publication was examined to determine whether it met the predetermined inclusion criteria. Data extraction and study quality was assessed by using predetermined checklists. Monetary and nonmonetary incentives were more effective than no incentive with monetary incentives having a slightly bigger effect than nonmonetary incentives. Large incentives were more effective than small incentives, as were upfront monetary incentives compared to promised monetary incentives. Postal surveys were more effective than telephone or email surveys. One study demonstrated that sequentially mixed mode (online survey followed by a paper survey with a reminder) was more effective than an online survey or the combination of an online and paper survey sent similtaneously in the first mail out. Pre-contact with a phonecall from a peer, personalised packages, sending mail on Friday, and using registered mail also increased response rates in single studies. Pre-contact by letter or postcard almost reached statistical signficance. GP survey response rates may improve by using the following strategies: monetary and nonmonetary incentives, larger incentives, upfront monetary incentives, postal surveys

Search strategies for identifying qualitative studies in CINAHL.

PubMed

Wilczynski, Nancy L; Marks, Susan; Haynes, R Brian

2007-05-01

Nurses, allied health professionals, clinicians, and researchers increasingly use online access to evidence in the course of patient care or when conducting reviews on a particular topic. Qualitative research has an important role in evidence-based health care. Online searching for qualitative studies can be difficult, however, resulting in the need to develop search filters. The objective of this study was to develop optimal search strategies to retrieve qualitative studies in CINAHL for the 2000 publishing year. The authors conducted an analytic survey comparing hand searches of journals with retrievals from CINAHL for candidate search terms and combinations. Combinations of search terms reached peak sensitivities of 98.9% and peak specificities of 99.5%. Combining search terms optimized both sensitivity and specificity at 94.2%. Empirically derived search strategies combining indexing terms and textwords can achieve high sensitivity and high specificity for retrieving qualitative studies from CINAHL.

Effective self-management strategies for bipolar disorder: A community-engaged Delphi Consensus Consultation study.

PubMed

Michalak, Erin E; Suto, Melinda J; Barnes, Steven J; Hou, Sharon; Lapsley, Sara; Scott, Mike W; Murray, Greg; Austin, Jehannine; Elliott, Nusha Balram; Berk, Lesley; Crest Bd

2016-12-01

Self-management represents an important complement to psychosocial treatments for bipolar disorder (BD), but research is limited. Specifically, little is known about self-management approaches for elevated mood states; this study investigated self-management strategies for: (1) maintaining balance in mood, and (2) stopping progression into hypomania/mania. To identify the common components of BD self-management, Delphi Consensus Consultation methods were combined with a Community-Based Participatory Research (CBPR) approach across five study phases: (1) Qualitative dataset content analysis; (2) Academic/grey literature reviews; (3) Content analysis; (4) Two Delphi rounds (rating strategies on a 5-point Likert scale, Very Unhelpful-Very Helpful), and; (5) Quantitative analysis and interpretation. Participants were people with BD and healthcare providers. Phases 1 and 2 identified 262 and 3940 candidate strategies, respectively; 3709 were discarded as duplicates/unintelligible. The remaining 493 were assessed via Delphi methods in Phase 4: 101 people with BD and 52 healthcare providers participated in Round 1; 83 of the BD panel (82%) and 43 of the healthcare provider panel (83%) participated in Round 2-exploratory factor analysis (EFA) was conducted on Round 2 results. EFA was underpowered and sample was not ethnically diverse, limiting generalizability. High concordance was observed in ratings of strategy effectiveness between the two panels. Future research could usefully investigate the provisional discovery here of underlying factors which link individual strategies. For example, 'maintaining hope' underpinned strategies for maintaining balance, and 'decreasing use of stimulants' underpinned strategies to interrupt hypo/manic ascent. There is merit in combining CBPR and Delphi methods. Copyright © 2016 Elsevier B.V. All rights reserved.

An integrative strategy to identify the entire protein coding potential of prokaryotic genomes by proteogenomics.

PubMed

Omasits, Ulrich; Varadarajan, Adithi R; Schmid, Michael; Goetze, Sandra; Melidis, Damianos; Bourqui, Marc; Nikolayeva, Olga; Québatte, Maxime; Patrignani, Andrea; Dehio, Christoph; Frey, Juerg E; Robinson, Mark D; Wollscheid, Bernd; Ahrens, Christian H

2017-12-01

Accurate annotation of all protein-coding sequences (CDSs) is an essential prerequisite to fully exploit the rapidly growing repertoire of completely sequenced prokaryotic genomes. However, large discrepancies among the number of CDSs annotated by different resources, missed functional short open reading frames (sORFs), and overprediction of spurious ORFs represent serious limitations. Our strategy toward accurate and complete genome annotation consolidates CDSs from multiple reference annotation resources, ab initio gene prediction algorithms and in silico ORFs (a modified six-frame translation considering alternative start codons) in an integrated proteogenomics database (iPtgxDB) that covers the entire protein-coding potential of a prokaryotic genome. By extending the PeptideClassifier concept of unambiguous peptides for prokaryotes, close to 95% of the identifiable peptides imply one distinct protein, largely simplifying downstream analysis. Searching a comprehensive Bartonella henselae proteomics data set against such an iPtgxDB allowed us to unambiguously identify novel ORFs uniquely predicted by each resource, including lipoproteins, differentially expressed and membrane-localized proteins, novel start sites and wrongly annotated pseudogenes. Most novelties were confirmed by targeted, parallel reaction monitoring mass spectrometry, including unique ORFs and single amino acid variations (SAAVs) identified in a re-sequenced laboratory strain that are not present in its reference genome. We demonstrate the general applicability of our strategy for genomes with varying GC content and distinct taxonomic origin. We release iPtgxDBs for B. henselae , Bradyrhizobium diazoefficiens and Escherichia coli and the software to generate both proteogenomics search databases and integrated annotation files that can be viewed in a genome browser for any prokaryote. © 2017 Omasits et al.; Published by Cold Spring Harbor Laboratory Press.

Comparison of search strategies in systematic reviews of adverse effects to other systematic reviews.

PubMed

Golder, Su; Loke, Yoon K; Zorzela, Liliane

2014-06-01

Research indicates that the methods used to identify data for systematic reviews of adverse effects may need to differ from other systematic reviews. To compare search methods in systematic reviews of adverse effects with other reviews. The search methodologies in 849 systematic reviews of adverse effects were compared with other reviews. Poor reporting of search strategies is apparent in both systematic reviews of adverse effects and other types of systematic reviews. Systematic reviews of adverse effects are less likely to restrict their searches to MEDLINE or include only randomised controlled trials (RCTs). The use of other databases is largely dependent on the topic area and the year the review was conducted, with more databases searched in more recent reviews. Adverse effects search terms are used by 72% of reviews and despite recommendations only two reviews report using floating subheadings. The poor reporting of search strategies in systematic reviews is universal, as is the dominance of searching MEDLINE. However, reviews of adverse effects are more likely to include a range of study designs (not just RCTs) and search beyond MEDLINE. © 2014 Crown Copyright.

Investigating strategies used by hospital pharmacists to effectively communicate with patients during medication counselling.

PubMed

Chevalier, Bernadette A M; Watson, Bernadette M; Barras, Michael A; Cottrell, William Neil

2017-10-01

Medication counselling opportunities are key times for pharmacists and patients to discuss medications and patients' concerns about their therapy. Communication Accommodation Theory (CAT) describes behavioural, motivational and emotional processes underlying communication exchanges. Five CAT strategies (approximation, interpretability, discourse management, emotional expression and interpersonal control) permit identification of effective communication. To invoke CAT to investigate communication strategies used by hospital pharmacists during patient medication counselling. This was a theory-based, qualitative study using transcribed audiorecordings of patients and hospital pharmacists engaged in medication counselling. Recruited pharmacists practised in inpatient or outpatient settings. Eligible patients within participating pharmacists' practice sites were prescribed at least three medications to manage chronic disease(s). The extent to which pharmacists accommodate, or not, to patients' conversational needs based on accommodative behaviour described within CAT strategies. Twelve pharmacists engaged four patients (48 total interactions). Exemplars provided robust examples of pharmacists effectively accommodating or meeting patients' conversational needs. Non-accommodation mainly occurred when pharmacists spoke too quickly, used terms not understood by patients and did not include patients in the agenda-setting phase. Multiple strategy use resulted in communication patterns such as "information-reassurance-rationale" sandwiches. Most pharmacists effectively employed all five CAT strategies to engage patients in discussions. Pharmacists' communication could be improved at the initial agenda-setting phase by asking open-ended questions to invite patients' input and allow patients to identify any medication-related concerns or issues. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

“URM Candidates Are Encouraged to Apply”: A National Study to Identify Effective Strategies to Enhance Racial and Ethnic Faculty Diversity in Academic Departments of Medicine

PubMed Central

Peek, Monica E.; Kim, Karen E.; Johnson, Julie K.; Vela, Monica B.

2016-01-01

Purpose There is little evidence regarding which factors and strategies are associated with high proportions of underrepresented minority (URM) faculty in academic medicine. The authors conducted a national study of U.S. academic medicine departments to better understand the challenges, successful strategies, and predictive factors for enhancing racial and ethnic diversity among faculty (i.e., physicians with an academic position or rank). Method This was a mixed-methods study using quantitative and qualitative methods. The authors conducted a cross-sectional study of eligible departments of medicine in 125 accredited U.S. medical schools, dichotomized into low-URM (bottom 50%) versus high-URM rank (top 50%). They used t tests and chi-squared tests to compare departments by geographic region, academic school rank, city type, and composite measures of “diversity best practices.” The authors also conducted semistructured in-depth interviews with a subsample from the highest-and lowest-quartile medical schools in terms of URM rank. Results Eighty-two medical schools responded (66%). Geographic region and academic rank were statistically associated with URM rank, but not city type or composite measures of diversity best practices. Key themes emerged from interviews regarding successful strategies for URM faculty recruitment and retention including institutional leadership, the use of human capital and social relationships and strategic deployment of institutional resources. Conclusions Departments of medicine with high proportions of URM faculty employ a number of successful strategies and programs for recruitment and retention. More research is warranted to identify new successful strategies and to determine the impact of specific strategies on establishing and maintaining workforce diversity. PMID:23348090

Systematic review of cost-effectiveness analyses for combinations of prevention strategies against human papillomavirus (HPV) infection: a general trend.

PubMed

Gervais, Frédéric; Dunton, Kyle; Jiang, Yiling; Largeron, Nathalie

2017-03-28

Due to the arrival of multi-valent HPV vaccines, it is more and more important to have a better understanding of the relationship between vaccination and screening programmes. This review aimed to: (1) collect published evidence on the cost-effectiveness profile of different HPV prevention strategies and, in particular, those combining vaccination with changes in screening practices; (2) explore the cost-effectiveness of alternative preventive strategies based on screening and vaccination. A systematic literature review was conducted in order to identify the relevant studies regarding the cost-effectiveness of prevention strategies against HPV infection. Analysis comparing the modelling approaches between studies was made along with an assessment of the magnitude of impact of several factors on the cost-effectiveness of different screening strategies. A total of 18 papers were quantitatively summarised within the narrative. A high degree of heterogeneity was found in terms of how HPV prevention strategies have been assessed in terms of their economic and epidemiological impact, with variation in screening practice and valence of HPV vaccination found to have large implications in terms of cost-effectiveness. This review demonstrated synergies between screening and vaccination. New prevention strategies involving multi-valence vaccination, HPV DNA test screening, delayed commencement and frequency of screening could be implemented in the future. Strategies implemented in the future should be chosen with care, and informed knowledge of the potential impact of all possible prevention strategies. Highlighted in this review is the difficulty in assessing multiple strategies. Appropriate modelling techniques will need to be utilised to assess the most cost-effective strategies.

Effectiveness of Web Quest Strategy in Acquiring Geographic Concepts among Eighth Grade Students in Jordan

ERIC Educational Resources Information Center

AL-Edwan, Zaid Suleiman

2014-01-01

This study aimed at identifying the Effectiveness of using Web Quest Strategy in acquiring the geographic concepts among eighth grade students in Jordan. The study individuals consisted of (119) students in the scholastic year 2013-2014. Four sections were randomly selected from two schools divided into experimental and control groups. They were…

Strategy for Identifying Repurposed Drugs for the Treatment of Cerebral Cavernous Malformation

PubMed Central

Gibson, Christopher C.; Zhu, Weiquan; Davis, Chadwick T.; Bowman-Kirigin, Jay A.; Chan, Aubrey C.; Ling, Jing; Walker, Ashley E.; Goitre, Luca; Monache, Simona Delle; Retta, Saverio Francesco; Shiu, Yan-Ting E.; Grossmann, Allie H.; Thomas, Kirk R.; Donato, Anthony J.; Lesniewski, Lisa A.; Whitehead, Kevin J.; Li, Dean Y.

2014-01-01

Background Cerebral cavernous malformation (CCM) is a hemorrhagic stroke disease affecting up to 0.5% of North Americans with no approved non-surgical treatment. A subset of patients have a hereditary form of the disease due primarily to loss-of-function mutations in KRIT1, CCM2, or PDCD10. We sought to identify known drugs that could be repurposed to treat CCM. Methods and Results We developed an unbiased screening platform based on both cellular and animal models of loss-of-function of CCM2. Our discovery strategy consisted of four steps: an automated immunofluorescence and machine-learning-based primary screen of structural phenotypes in human endothelial cells deficient in CCM2; a secondary screen of functional changes in endothelial stability in these same cells; a rapid in vivo tertiary screen of dermal microvascular leak in mice lacking endothelial Ccm2; and finally a quaternary screen of CCM lesion burden in these same mice. We screened 2,100 known drugs and bioactive compounds, and identified two candidates for further study, cholecalciferol (Vitamin D3) and tempol (a scavenger of superoxide). Each drug decreased lesion burden in a mouse model of CCM vascular disease by approximately 50%. Conclusions By identifying known drugs as potential therapeutics for CCM, we have decreased the time, cost, and risk of bringing treatments to patients. Each drug also prompts additional exploration of biomarkers of CCM disease. We further suggest that the structure-function screening platform presented here may be adapted and scaled to facilitate drug discovery for diverse loss-of-function genetic vascular disease. PMID:25486933

Dental and dental hygiene students' diagnostic accuracy in oral radiology: effect of diagnostic strategy and instructional method.

PubMed

Baghdady, Mariam T; Carnahan, Heather; Lam, Ernest W N; Woods, Nicole N

2014-09-01

There has been much debate surrounding diagnostic strategies and the most appropriate training models for novices in oral radiology. It has been argued that an analytic approach, using a step-by-step analysis of the radiographic features of an abnormality, is ideal. Alternative research suggests that novices can successfully employ non-analytic reasoning. Many of these studies do not take instructional methodology into account. This study evaluated the effectiveness of non-analytic and analytic strategies in radiographic interpretation and explored the relationship between instructional methodology and diagnostic strategy. Second-year dental and dental hygiene students were taught four radiographic abnormalities using basic science instructions or a step-by-step algorithm. The students were tested on diagnostic accuracy and memory immediately after learning and one week later. A total of seventy-three students completed both immediate and delayed sessions and were included in the analysis. Students were randomly divided into two instructional conditions: one group provided a diagnostic hypothesis for the image and then identified specific features to support it, while the other group first identified features and then provided a diagnosis. Participants in the diagnosis-first condition (non-analytic reasoning) had higher diagnostic accuracy then those in the features-first condition (analytic reasoning), regardless of their learning condition. No main effect of learning condition or interaction with diagnostic strategy was observed. Educators should be mindful of the potential influence of analytic and non-analytic approaches on the effectiveness of the instructional method.

Whole exome sequencing for familial bicuspid aortic valve identifies putative variants.

PubMed

Martin, Lisa J; Pilipenko, Valentina; Kaufman, Kenneth M; Cripe, Linda; Kottyan, Leah C; Keddache, Mehdi; Dexheimer, Phillip; Weirauch, Matthew T; Benson, D Woodrow

2014-10-01

Bicuspid aortic valve (BAV) is the most common congenital cardiovascular malformation. Although highly heritable, few causal variants have been identified. The purpose of this study was to identify genetic variants underlying BAV by whole exome sequencing a multiplex BAV kindred. Whole exome sequencing was performed on 17 individuals from a single family (BAV=3; other cardiovascular malformation, 3). Postvariant calling error control metrics were established after examining the relationship between Mendelian inheritance error rate and coverage, quality score, and call rate. To determine the most effective approach to identifying susceptibility variants from among 54 674 variants passing error control metrics, we evaluated 3 variant selection strategies frequently used in whole exome sequencing studies plus extended family linkage. No putative rare, high-effect variants were identified in all affected but no unaffected individuals. Eight high-effect variants were identified by ≥2 of the commonly used selection strategies; however, these were either common in the general population (>10%) or present in the majority of the unaffected family members. However, using extended family linkage, 3 synonymous variants were identified; all 3 variants were identified by at least one other strategy. These results suggest that traditional whole exome sequencing approaches, which assume causal variants alter coding sense, may be insufficient for BAV and other complex traits. Identification of disease-associated variants is facilitated by the use of segregation within families. © 2014 American Heart Association, Inc.

Increased vocal intensity due to the Lombard effect in speakers with Parkinson's disease: simultaneous laryngeal and respiratory strategies.

PubMed

Stathopoulos, Elaine T; Huber, Jessica E; Richardson, Kelly; Kamphaus, Jennifer; DeCicco, Devan; Darling, Meghan; Fulcher, Katrina; Sussman, Joan E

2014-01-01

The objective of the present study was to investigate whether speakers with hypophonia, secondary to Parkinson's disease (PD), would increases their vocal intensity when speaking in a noisy environment (Lombard effect). The other objective was to examine the underlying laryngeal and respiratory strategies used to increase vocal intensity. Thirty-three participants with PD were included for study. Each participant was fitted with the SpeechVive™ device that played multi-talker babble noise into one ear during speech. Using acoustic, aerodynamic and respiratory kinematic techniques, the simultaneous laryngeal and respiratory mechanisms used to regulate vocal intensity were examined. Significant group results showed that most speakers with PD (26/33) were successful at increasing their vocal intensity when speaking in the condition of multi-talker babble noise. They were able to support their increased vocal intensity and subglottal pressure with combined strategies from both the laryngeal and respiratory mechanisms. Individual speaker analysis indicated that the particular laryngeal and respiratory interactions differed among speakers. The SpeechVive™ device elicited higher vocal intensities from patients with PD. Speakers used different combinations of laryngeal and respiratory physiologic mechanisms to increase vocal intensity, thus suggesting that disease process does not uniformly affect the speech subsystems. Readers will be able to: (1) identify speech characteristics of people with Parkinson's disease (PD), (2) identify typical respiratory strategies for increasing sound pressure level (SPL), (3) identify typical laryngeal strategies for increasing SPL, (4) define the Lombard effect. Copyright © 2014 Elsevier Inc. All rights reserved.

Effects of HBV Genetic Variability on RNAi Strategies

PubMed Central

Panjaworayan, Nattanan; Brown, Chris M.

2011-01-01

RNAi strategies present promising antiviral strategies against HBV. RNAi strategies require base pairing between short RNAi effectors and targets in the HBV pregenome or other RNAs. Natural variation in HBV genotypes, quasispecies variation, or mutations selected by the RNAi strategy could potentially make these strategies less effective. However, current and proposed antiviral strategies against HBV are being, or could be, designed to avoid this. This would involve simultaneous targeting of multiple regions of the genome, or regions in which variation or mutation is not tolerated. RNAi strategies against single genotypes or against variable regions of the genome would need to have significant other advantages to be part of robust therapies. PMID:21760994

An innovative strategy for the molecular diagnosis of Usher syndrome identifies causal biallelic mutations in 93% of European patients.

PubMed

Bonnet, Crystel; Riahi, Zied; Chantot-Bastaraud, Sandra; Smagghe, Luce; Letexier, Mélanie; Marcaillou, Charles; Lefèvre, Gaëlle M; Hardelin, Jean-Pierre; El-Amraoui, Aziz; Singh-Estivalet, Amrit; Mohand-Saïd, Saddek; Kohl, Susanne; Kurtenbach, Anne; Sliesoraityte, Ieva; Zobor, Ditta; Gherbi, Souad; Testa, Francesco; Simonelli, Francesca; Banfi, Sandro; Fakin, Ana; Glavač, Damjan; Jarc-Vidmar, Martina; Zupan, Andrej; Battelino, Saba; Martorell Sampol, Loreto; Claveria, Maria Antonia; Catala Mora, Jaume; Dad, Shzeena; Møller, Lisbeth B; Rodriguez Jorge, Jesus; Hawlina, Marko; Auricchio, Alberto; Sahel, José-Alain; Marlin, Sandrine; Zrenner, Eberhart; Audo, Isabelle; Petit, Christine

2016-12-01

Usher syndrome (USH), the most prevalent cause of hereditary deafness-blindness, is an autosomal recessive and genetically heterogeneous disorder. Three clinical subtypes (USH1-3) are distinguishable based on the severity of the sensorineural hearing impairment, the presence or absence of vestibular dysfunction, and the age of onset of the retinitis pigmentosa. A total of 10 causal genes, 6 for USH1, 3 for USH2, and 1 for USH3, and an USH2 modifier gene, have been identified. A robust molecular diagnosis is required not only to improve genetic counseling, but also to advance gene therapy in USH patients. Here, we present an improved diagnostic strategy that is both cost- and time-effective. It relies on the sequential use of three different techniques to analyze selected genomic regions: targeted exome sequencing, comparative genome hybridization, and quantitative exon amplification. We screened a large cohort of 427 patients (139 USH1, 282 USH2, and six of undefined clinical subtype) from various European medical centers for mutations in all USH genes and the modifier gene. We identified a total of 421 different sequence variants predicted to be pathogenic, about half of which had not been previously reported. Remarkably, we detected large genomic rearrangements, most of which were novel and unique, in 9% of the patients. Thus, our strategy led to the identification of biallelic and monoallelic mutations in 92.7% and 5.8% of the USH patients, respectively. With an overall 98.5% mutation characterization rate, the diagnosis efficiency was substantially improved compared with previously reported methods.

An innovative strategy for the molecular diagnosis of Usher syndrome identifies causal biallelic mutations in 93% of European patients

PubMed Central

Bonnet, Crystel; Riahi, Zied; Chantot-Bastaraud, Sandra; Smagghe, Luce; Letexier, Mélanie; Marcaillou, Charles; Lefèvre, Gaëlle M; Hardelin, Jean-Pierre; El-Amraoui, Aziz; Singh-Estivalet, Amrit; Mohand-Saïd, Saddek; Kohl, Susanne; Kurtenbach, Anne; Sliesoraityte, Ieva; Zobor, Ditta; Gherbi, Souad; Testa, Francesco; Simonelli, Francesca; Banfi, Sandro; Fakin, Ana; Glavač, Damjan; Jarc-Vidmar, Martina; Zupan, Andrej; Battelino, Saba; Martorell Sampol, Loreto; Claveria, Maria Antonia; Catala Mora, Jaume; Dad, Shzeena; Møller, Lisbeth B; Rodriguez Jorge, Jesus; Hawlina, Marko; Auricchio, Alberto; Sahel, José-Alain; Marlin, Sandrine; Zrenner, Eberhart; Audo, Isabelle; Petit, Christine

2016-01-01

Usher syndrome (USH), the most prevalent cause of hereditary deafness–blindness, is an autosomal recessive and genetically heterogeneous disorder. Three clinical subtypes (USH1–3) are distinguishable based on the severity of the sensorineural hearing impairment, the presence or absence of vestibular dysfunction, and the age of onset of the retinitis pigmentosa. A total of 10 causal genes, 6 for USH1, 3 for USH2, and 1 for USH3, and an USH2 modifier gene, have been identified. A robust molecular diagnosis is required not only to improve genetic counseling, but also to advance gene therapy in USH patients. Here, we present an improved diagnostic strategy that is both cost- and time-effective. It relies on the sequential use of three different techniques to analyze selected genomic regions: targeted exome sequencing, comparative genome hybridization, and quantitative exon amplification. We screened a large cohort of 427 patients (139 USH1, 282 USH2, and six of undefined clinical subtype) from various European medical centers for mutations in all USH genes and the modifier gene. We identified a total of 421 different sequence variants predicted to be pathogenic, about half of which had not been previously reported. Remarkably, we detected large genomic rearrangements, most of which were novel and unique, in 9% of the patients. Thus, our strategy led to the identification of biallelic and monoallelic mutations in 92.7% and 5.8% of the USH patients, respectively. With an overall 98.5% mutation characterization rate, the diagnosis efficiency was substantially improved compared with previously reported methods. PMID:27460420

Effective teaching strategies and methods of delivery for patient education: a systematic review and practice guideline recommendations.

PubMed

Friedman, Audrey Jusko; Cosby, Roxanne; Boyko, Susan; Hatton-Bauer, Jane; Turnbull, Gale

2011-03-01

The objective of this study was to determine effective teaching strategies and methods of delivery for patient education (PE). A systematic review was conducted and reviews with or without meta-analyses, which examined teaching strategies and methods of delivery for PE, were included. Teaching strategies identified are traditional lectures, discussions, simulated games, computer technology, written material, audiovisual sources, verbal recall, demonstration, and role playing. Methods of delivery focused on how to deliver the teaching strategies. Teaching strategies that increased knowledge, decreased anxiety, and increased satisfaction included computer technology, audio and videotapes, written materials, and demonstrations. Various teaching strategies used in combination were similarly successful. Moreover, structured-, culturally appropriate- and patient-specific teachings were found to be better than ad hoc teaching or generalized teaching. Findings provide guidance for establishing provincial standards for the delivery of PE. Recommendations concerning the efficacy of the teaching strategies and delivery methods are provided.

Peer Response as an Effective Writing Strategy

ERIC Educational Resources Information Center

Austria, Mark Anthony B.

2017-01-01

This paper presents the peer response as an effective strategy in the teaching of college writing. In the textual analyses, feedback conference and through the evaluation questionnaire, peer response strategy was assessed as dynamic and successful and that editors and writers worked constantly with each other as a matter of scaffolding wherein…

The effectiveness of research implementation strategies for promoting evidence-informed policy and management decisions in healthcare: a systematic review.

PubMed

Sarkies, Mitchell N; Bowles, Kelly-Ann; Skinner, Elizabeth H; Haas, Romi; Lane, Haylee; Haines, Terry P

2017-11-14

It is widely acknowledged that health policy and management decisions rarely reflect research evidence. Therefore, it is important to determine how to improve evidence-informed decision-making. The primary aim of this systematic review was to evaluate the effectiveness of research implementation strategies for promoting evidence-informed policy and management decisions in healthcare. The secondary aim of the review was to describe factors perceived to be associated with effective strategies and the inter-relationship between these factors. An electronic search was developed to identify studies published between January 01, 2000, and February 02, 2016. This was supplemented by checking the reference list of included articles, systematic reviews, and hand-searching publication lists from prominent authors. Two reviewers independently screened studies for inclusion, assessed methodological quality, and extracted data. After duplicate removal, the search strategy identified 3830 titles. Following title and abstract screening, 96 full-text articles were reviewed, of which 19 studies (21 articles) met all inclusion criteria. Three studies were included in the narrative synthesis, finding policy briefs including expert opinion might affect intended actions, and intentions persisting to actions for public health policy in developing nations. Workshops, ongoing technical assistance, and distribution of instructional digital materials may improve knowledge and skills around evidence-informed decision-making in US public health departments. Tailored, targeted messages were more effective in increasing public health policies and programs in Canadian public health departments compared to messages and a knowledge broker. Sixteen studies (18 articles) were included in the thematic synthesis, leading to a conceptualisation of inter-relating factors perceived to be associated with effective research implementation strategies. A unidirectional, hierarchal flow was described from (1

Effective strategies for behavior change.

PubMed

Coleman, Mary Thoesen; Pasternak, Ryan H

2012-06-01

Strategies that are most effective in both prevention and management of chronic disease consider factors such as age, ethnicity, community, and technology. Most behavioral change strategies derive their components from application of the health belief model, the theory of reasoned action/theory of planned behavior, transtheoretical model, and social cognitive theory. Many tools such as the readiness ruler and personalized action plan form are available to assist health care teams to facilitate healthy behavior change. Primary care providers can support behavior changes by providing venues for peer interventions and family meetings and by making new partnerships with community organizations. Copyright © 2012 Elsevier Inc. All rights reserved.

Cost-effectiveness of different strategies to manage patients with sciatica.

PubMed

Fitzsimmons, Deborah; Phillips, Ceri J; Bennett, Hayley; Jones, Mari; Williams, Nefyn; Lewis, Ruth; Sutton, Alex; Matar, Hosam E; Din, Nafees; Burton, Kim; Nafees, Sadia; Hendry, Maggie; Rickard, Ian; Wilkinson, Claire

2014-07-01

The aim of this paper is to estimate the relative cost-effectiveness of treatment regimens for managing patients with sciatica. A deterministic model structure was constructed based on information from the findings from a systematic review of clinical effectiveness and cost-effectiveness, published sources of unit costs, and expert opinion. The assumption was that patients presenting with sciatica would be managed through one of 3 pathways (primary care, stepped approach, immediate referral to surgery). Results were expressed as incremental cost per patient with symptoms successfully resolved. Analysis also included incremental cost per utility gained over a 12-month period. One-way sensitivity analyses were used to address uncertainty. The model demonstrated that none of the strategies resulted in 100% success. For initial treatments, the most successful regime in the first pathway was nonopioids, with a probability of success of 0.613. In the second pathway, the most successful strategy was nonopioids, followed by biological agents, followed by epidural/nerve block and disk surgery, with a probability of success of 0.996. Pathway 3 (immediate surgery) was not cost-effective. Sensitivity analyses identified that the use of the highest cost estimates results in a similar overall picture. While the estimates of cost per quality-adjusted life year are higher, the economic model demonstrated that stepped approaches based on initial treatment with nonopioids are likely to represent the most cost-effective regimens for the treatment of sciatica. However, development of alternative economic modelling approaches is required. Copyright © 2014 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

The effectiveness of strategies to change organisational culture to improve healthcare performance: a systematic review.

PubMed

Parmelli, Elena; Flodgren, Gerd; Beyer, Fiona; Baillie, Nick; Schaafsma, Mary Ellen; Eccles, Martin P

2011-04-03

Organisational culture is an anthropological metaphor used to inform research and consultancy and to explain organisational environments. In recent years, increasing emphasis has been placed on the need to change organisational culture in order to improve healthcare performance. However, the precise function of organisational culture in healthcare policy often remains underspecified and the desirability and feasibility of strategies to be adopted have been called into question. The objective of this review was to determine the effectiveness of strategies to change organisational culture in order to improve healthcare performance. We searched the following electronic databases: The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, Sociological Abstracts, Web of Knowledge, PsycINFO, Business and Management, EThOS, Index to Theses, Intute, HMIC, SIGLE, and Scopus until October 2009. The Database of Abstracts of Reviews of Effectiveness (DARE) was searched for related reviews. We also searched the reference lists of all papers and relevant reviews identified, and we contacted experts in the field for advice on further potential studies. We considered randomised controlled trials (RCTs) or well designed quasi-experimental studies (controlled clinical trials (CCTs), controlled before and after studies (CBAs), and interrupted time series (ITS) analyses). Studies could be set in any type of healthcare organisation in which strategies to change organisational culture in order to improve healthcare performance were applied. Our main outcomes were objective measures of professional performance and patient outcome. The search strategy yielded 4,239 records. After the full text assessment, two CBA studies were included in the review. They both assessed the impact of interventions aimed at changing organisational culture, but one evaluated the impact on work-related and personal outcomes while the other measured clinical outcomes. Both were at high risk of

The effectiveness of strategies to change organisational culture to improve healthcare performance: a systematic review

PubMed Central

2011-01-01

Background Organisational culture is an anthropological metaphor used to inform research and consultancy and to explain organisational environments. In recent years, increasing emphasis has been placed on the need to change organisational culture in order to improve healthcare performance. However, the precise function of organisational culture in healthcare policy often remains underspecified and the desirability and feasibility of strategies to be adopted have been called into question. The objective of this review was to determine the effectiveness of strategies to change organisational culture in order to improve healthcare performance. Methods We searched the following electronic databases: The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, Sociological Abstracts, Web of Knowledge, PsycINFO, Business and Management, EThOS, Index to Theses, Intute, HMIC, SIGLE, and Scopus until October 2009. The Database of Abstracts of Reviews of Effectiveness (DARE) was searched for related reviews. We also searched the reference lists of all papers and relevant reviews identified, and we contacted experts in the field for advice on further potential studies. We considered randomised controlled trials (RCTs) or well designed quasi-experimental studies (controlled clinical trials (CCTs), controlled before and after studies (CBAs), and interrupted time series (ITS) analyses). Studies could be set in any type of healthcare organisation in which strategies to change organisational culture in order to improve healthcare performance were applied. Our main outcomes were objective measures of professional performance and patient outcome. Results The search strategy yielded 4,239 records. After the full text assessment, two CBA studies were included in the review. They both assessed the impact of interventions aimed at changing organisational culture, but one evaluated the impact on work-related and personal outcomes while the other measured clinical outcomes

Effects of a Self-Monitoring Strategy on Independent Work Behavior of Students with Mild Intellectual Disability

ERIC Educational Resources Information Center

Coughlin, Jennifer; McCoy, Kathleen M.; Kenzer, Amy; Mathur, Sarup R.; Zucker, Stanley H.

2012-01-01

This study evaluated the effectiveness of a self-monitoring strategy on independent work behavior. The three subjects were in first grade, seven years old, identified with mild intellectual disability (MID), and had an Individualized Education Plan (IEP) with targeted functional academic and behavior goals. The purpose of this study was to…

Cost-effectiveness of using social networks to identify undiagnosed HIV infection among minority populations.

PubMed

Shrestha, Ram K; Sansom, Stephanie L; Kimbrough, Lisa; Hutchinson, Angela B; Daltry, Daniel; Maldonado, Waleska; Simpson-May, Georgia M; Illemszky, Sean

2010-01-01

In 2003, the Centers for Disease Control and Prevention launched the Advancing HIV Prevention project to implement new strategies for diagnosing human immunodeficiency virus (HIV) infections outside medical settings and prevent new infections by working with HIV-infected persons and their partners. : To assess the cost and effectiveness of a social network strategy to identify new HIV diagnoses among minority populations. Four community-based organizations (CBOs) in Boston, Philadelphia, and Washington, District of Columbia, implemented a social network strategy for HIV counseling and testing from October 2003 to December 2005. We used standardized cost collection forms to collect program costs attributable to staff time, travel, incentives, test kits, testing supplies, office space, equipment, and utilities. The CBOs used the networks of high-risk and HIV-infected persons (recruiters) who referred their partners and associates for HIV counseling and testing. We obtained HIV-testing outcomes from project databases. Number of HIV tests, number of new HIV-diagnoses notified, total program cost, cost per person tested, cost per person notified of new HIV diagnosis. Two CBOs, both based in Philadelphia, identified 25 and 17 recruiters on average annually and tested 136 and 330 network associates, respectively. Among those tested, 12 and 13 associates were notified of new HIV diagnoses (seropositivity: 9.8%, 4.4%). CBOs in Boston, Massachusetts, and Washington, District of Columbia, identified 26 and 24 recruiters per year on average and tested 228 and 123 network associates. Among those tested, 12 and 11 associates were notified of new HIV diagnoses (seropositivity: 5.1%, 8.7%). The cost per associate notified of a new HIV diagnosis was $11 578 and $12 135 in Philadelphia, and $16 437 and $16 101 in Boston, Massachusetts, and Washington, District of Columbia. The cost of notifying someone with a new HIV diagnosis using social networks varied across sites. Our analysis

A comprehensive strategy for identifying long-distance mobile peptides in xylem sap.

PubMed

Okamoto, Satoru; Suzuki, Takamasa; Kawaguchi, Masayoshi; Higashiyama, Tetsuya; Matsubayashi, Yoshikatsu

2015-11-01

There is a growing awareness that secreted pemediate organ-to-organ communication in higher plants. Xylem sap peptidomics is an effective but challenging approach for identifying long-distance mobile peptides. In this study we developed a simple, gel-free purification system that combines o-chlorophenol extraction with HPLC separation. Using this system, we successfully identified seven oligopeptides from soybean xylem sap exudate that had one or more post-transcriptional modifications: glycosylation, sulfation and/or hydroxylation. RNA sequencing and quantitative PCR analyses showed that the peptide-encoding genes are expressed in multiple tissues. We further analyzed the long-distance translocation of four of the seven peptides using gene-encoding peptides with single amino acid substitutions, and identified these four peptides as potential root-to-shoot mobile oligopeptides. Promoter-GUS analysis showed that all four peptide-encoding genes were expressed in the inner tissues of the root endodermis. Moreover, we found that some of these peptide-encoding genes responded to biotic and/or abiotic factors. These results indicate that our purification system provides a comprehensive approach for effectively identifying endogenous small peptides and reinforce the concept that higher plants employ various peptides in root-to-shoot signaling. © 2015 The Authors The Plant Journal © 2015 John Wiley & Sons Ltd.

Age differences in perceptions of memory strategy effectiveness for recent and remote memory.

PubMed

Lineweaver, Tara T; Horhota, Michelle; Crumley, Jessica; Geanon, Catherine T; Juett, Jacqueline J

2018-03-01

We examined whether young and older adults hold different beliefs about the effectiveness of memory strategies for specific types of memory tasks and whether memory strategies are perceived to be differentially effective for young, middle-aged, and older targets. Participants rated the effectiveness of five memory strategies for 10 memory tasks at three target ages (20, 50, and 80 years old). Older adults did not strongly differentiate strategy effectiveness, viewing most strategies as similarly effective across memory tasks. Young adults held strategy-specific beliefs, endorsing external aids and physical health as more effective than a positive attitude or internal strategies, without substantial differentiation based on task. We also found differences in anticipated strategy effectiveness for targets of different ages. Older adults described cognitive and physical health strategies as more effective for older than middle-aged targets, whereas young adults expected these strategies to be equally effective for middle-aged and older target adults.

Cost-effectiveness of Alternative Colonoscopy Surveillance Strategies to Mitigate Metachronous Colorectal Cancer Incidence

PubMed Central

ERENAY, FATIH SAFA; ALAGOZ, OGUZHAN; BANERJEE, RITESH; SAID, ADNAN; CIMA, ROBERT

2016-01-01

BACKGROUND Metachronous Colorectal Cancer (MCRC) incidence amongst colorectal cancer (CRC) survivors varies significantly and the optimal colonoscopy surveillance practice to mitigate MCRC incidence is unknown. METHODS We conducted a cost-effectiveness analysis by comparing performances of the US Multi-Society Task Force guideline and all clinically-reasonable colonoscopy surveillance strategies among 50–79-year-old post-treatment CRC patients using a computer-simulation model. RESULTS The US guideline [(1,3,5)] recommends the first colonoscopy 1-year after treatment while the second and third colonoscopies are repeated with 3- and 5-year intervals. We identified some promising alternative cost-effective strategies. Compared to the US guideline under various scenarios for 20-year period, 1) reducing the surveillance interval of the guideline after the first colonoscopy by 1-year [(1,2,5)] saves/prevents up to 78 discounted-life-years and 23 MCRCs per 1000-patients (incremental cost-effectiveness ratio (ICER)≤$23,270/life-year); 2) reducing the intervals after the first and second negative colonoscopy by 1-year [(1,2,4)] saves/prevents up to 109 discounted-life-years and 36 MCRCs (ICER≤$52,155/life-year); 3) (1,2,3) saves/prevents up to 141 discounted-life-years and 50 MCRCs (ICER≤$68,822/life-year). These strategies require up to 1100 additional colonoscopies per 1000-patients. Although, the US guideline may not be cost-effective compared to less-intensive oncology guideline (3,3,5) (ICER can be as high as $140,000/LY), the promising strategies are cost-effective compared to such less-intensive guidelines unless cumulative MCRC incidence is very low. CONCLUSIONS The US guideline might be improved by slightly increasing the surveillance intensity at the expense of moderately increased cost. More research is warranted to explore the benefits/harms of such practices. PMID:27248907

Matched and mismatched appraisals of the effectiveness of communication strategies by family caregivers of persons with Alzheimer's disease.

PubMed

Savundranayagam, Marie Y; Orange, J B

2014-01-01

Communication problems stemming from Alzheimer's disease (AD) often result in misunderstandings that can be linked with problem behaviours and increased caregiver stress. Moreover, these communication breakdowns also can result either from caregivers' use of ineffective communication strategies, which paradoxically are perceived as helpful, or can occur as a result of not using effective communication strategies that are perceived as unhelpful. The two primary aims were to determine the effectiveness of strategies used to resolve communication breakdowns and to examine whether caregivers' ratings of strategy effectiveness were consistent with evidence from video-recorded conversations and with effective communication strategies documented in the literature. Twenty-eight mealtime conversations were recorded using a sample of 15 dyads consisting of individuals with early, middle and late clinical-stage AD and their family caregivers. Conversations were analysed using the trouble-source repair paradigm to identify the communication strategies used by caregivers to resolve breakdowns. Family caregivers also rated the helpfulness of communication strategies used to resolve breakdowns. Analyses were conducted to assess the overlap or match between the use and appraisals of the helpfulness of communication strategies. Matched and mismatched appraisals of communication strategies varied across stages of AD. Matched appraisals by caregivers of persons with early-stage AD were observed for 68% of 22 communication strategies, whereas caregivers of persons with middle- and late-stage AD had matched appraisals for 45% and 55% of the strategies, respectively. Moreover, caregivers of persons with early-stage AD had matched appraisals over and above making matched appraisals by chance alone, compared with caregivers of persons in middle- and late-stage AD. Mismatches illustrate the need for communication education and training, particularly to establish empirically derived

The Effects of Design Strategies for Promoting Students' Self-Regulated Learning Skills on Students' Self-Regulation and Achievements in Online Learning Environments

ERIC Educational Resources Information Center

Cho, Moon-Heum

2004-01-01

The purpose of this study was to investigate the effects of design strategies for promoting students' self-regulated learning skills on students' self-regulation and achievements. Seven strategies for promoting students' SRL are identified through the literature review and applied into the experimental group: goal setting, self-evaluation,…

The Syrian hamster embryo cells transformation assay identifies efficiently nongenotoxic carcinogens, and can contribute to alternative, integrated testing strategies.

PubMed

Benigni, Romualdo; Bossa, Cecilia; Tcheremenskaia, Olga; Battistelli, Chiara Laura; Giuliani, Alessandro

2015-02-01

The long-term carcinogenesis bioassays have played a central role in protecting human health, but for ethical and practical reasons their use is dramatically diminishing and the genotoxicity short-term tests have taken the pivotal role in the pre-screening of chemical carcinogenicity. However, this strategy cannot detect nongenotoxic carcinogens. Since up to 25% of IARC human carcinogens are recognized to have nongenotoxic mechanisms of action, the risk they pose to human health cannot be disregarded, and it is urgent to fill the gap in the tools for alternative testing. In this paper, we analyze from different perspectives the ability of Cell Transformation Assays to identify nongenotoxic carcinogens, and we conclude that the Syrian hamster embryo cells test is able to identify nongenotoxic carcinogens with 80-90% efficiency, and thus, can play an important role in integrated, alternative testing strategies. Copyright © 2015 Elsevier B.V. All rights reserved.

Developing a strategy to promote the generation and effective use of population health research for NSW Health: 2011-2015.

PubMed

Biggs, Janice S; Stickney, Beth

2011-04-01

The Population Health Division of the NSW Department of Health has developed a 5-year strategy to improve the effectiveness of its resource investment in population health research. This paper describes the development of the strategy, Promoting the generation and effective use of population health research in NSW: a Strategy for NSW Health 2011-2015. A review of Australian and international strategic research documents and stakeholder interviews was conducted to support the development of the strategy. The findings from these two processes influenced the structure of the document and supported the inclusion of strategies and actions to assist with identifying research priorities, improving communication, enhancing networks and partnerships, supporting workforce development initiatives, providing research infrastructure, enhancing research and the use of research evidence and streamlining research governance and ethics processes. Small group discussions and a detailed review of literature were conducted to refine the thinking around four of the more complex aspects of the strategy. Finally, a broad consultation process was used to test the face validity of the proposed strategy content.

The Effectiveness of Time Management Strategies Instruction on Students' Academic Time Management and Academic Self Efficacy

ERIC Educational Resources Information Center

Kader, Fathi Abdul Hamid Abdul; Eissa, Mourad Ali

2015-01-01

This study investigated the effect of using time management strategies instruction on improving first year learning disabled students' academic time management and academic self efficacy. A total of 60 students identified with LD participated. The sample was divided into two groups; experimental (n = 30 boys) and control (n = 30 boys). ANCOVA and…

Classroom Management Strategies of Highly Effective Teachers in Diverse Middle Schools: Be Strict and Calm, Not Mean

ERIC Educational Resources Information Center

McGregor, Katheryne L.

2012-01-01

This qualitative research study investigated and identified the classroom management strategies of 12 highly effective middle school teachers who served diverse student populations at two different school sites. In addition, this research explored the beliefs and experiences of 305 diverse middle school students regarding their experiences with…

Hemodialysis: stressors and coping strategies.

PubMed

Ahmad, Muayyad M; Al Nazly, Eman K

2015-01-01

End-stage renal disease (ESRD) is an irreversible and life-threatening condition. In Jordan, the number of ESRD patients treated with hemodialysis is on the rise. Identifying stressors and coping strategies used by patients with ESRD may help nurses and health care providers to gain a clearer understanding of the condition of these patients and thus institute effective care planning. The purpose of this study was to identify stressors perceived by Jordanian patients on hemodialysis, and the coping strategies used by them. A convenience sample of 131 Jordanian men and women was recruited from outpatients' dialysis units in four hospitals. Stressors perceived by participants on hemodialysis and the coping strategies were measured using Hemodialysis Stressor Scale, and Ways of Coping Scale-Revised. Findings showed that patients on hemodialysis psychosocial stressors scores mean was higher than the physiological stressors mean. Positive reappraisal coping strategy had the highest mean among the coping strategies and the lowest mean was accepting responsibility. Attention should be focused towards the psychosocial stressors of patients on hemodialysis and also helping patients utilize the coping strategies that help to alleviate the stressors. The most used coping strategy was positive reappraisal strategy which includes faith and prayer.

Costs, equity, efficiency and feasibility of identifying the poor in Ghana's National Health Insurance Scheme: empirical analysis of various strategies.

PubMed

Aryeetey, Genevieve Cecilia; Jehu-Appiah, Caroline; Spaan, Ernst; Agyepong, Irene; Baltussen, Rob

2012-01-01

To analyse the costs and evaluate the equity, efficiency and feasibility of four strategies to identify poor households for premium exemptions in Ghana's National Health Insurance Scheme (NHIS): means testing (MT), proxy means testing (PMT), participatory wealth ranking (PWR) and geographic targeting (GT) in urban, rural and semi-urban settings in Ghana. We conducted the study in 145-147 households per setting with MT as our gold standard strategy. We estimated total costs that included costs of household surveys and cost of premiums paid to the poor, efficiency (cost per poor person identified), equity (number of true poor excluded) and the administrative feasibility of implementation. The cost of exempting one poor individual ranged from US$15.87 to US$95.44; exclusion of the poor ranged between 0% and 73%. MT was most efficient and equitable in rural and urban settings with low-poverty incidence; GT was efficient and equitable in the semi-urban setting with high-poverty incidence. PMT and PWR were less equitable and inefficient although feasible in some settings. We recommend MT as optimal strategy in low-poverty urban and rural settings and GT as optimal strategy in high-poverty semi-urban setting. The study is relevant to other social and developmental programmes that require identification and exemptions of the poor in low-income countries. © 2011 Blackwell Publishing Ltd.

Past Strategies and Future Directions for Identifying AMP-Activated Protein Kinase (AMPK) Modulators

PubMed Central

Sinnett, Sarah E.; Brenman, Jay E.

2014-01-01

AMP-activated protein kinase (AMPK) is a promising therapeutic target for cancer, type II diabetes, and other illnesses characterized by abnormal energy utilization. During the last decade, numerous labs have published a range of methods for identifying novel AMPK modulators. The current understanding of AMPK structure and regulation, however, has propelled a paradigm shift in which many researchers now consider ADP to be an additional regulatory nucleotide of AMPK. How can the AMPK community apply this new understanding of AMPK signaling to translational research? Recent insights into AMPK structure, regulation, and holoenzyme-sensitive signaling may provide the hindsight needed to clearly evaluate the strengths and weaknesses of past AMPK drug discovery efforts. Improving future strategies for AMPK drug discovery will require pairing the current understanding of AMPK signaling with improved experimental designs. PMID:24583089

Screening strategies for atrial fibrillation: a systematic review and cost-effectiveness analysis.

PubMed

Welton, Nicky J; McAleenan, Alexandra; Thom, Howard Hz; Davies, Philippa; Hollingworth, Will; Higgins, Julian Pt; Okoli, George; Sterne, Jonathan Ac; Feder, Gene; Eaton, Diane; Hingorani, Aroon; Fawsitt, Christopher; Lobban, Trudie; Bryden, Peter; Richards, Alison; Sofat, Reecha

2017-05-01

Atrial fibrillation (AF) is a common cardiac arrhythmia that increases the risk of thromboembolic events. Anticoagulation therapy to prevent AF-related stroke has been shown to be cost-effective. A national screening programme for AF may prevent AF-related events, but would involve a substantial investment of NHS resources. To conduct a systematic review of the diagnostic test accuracy (DTA) of screening tests for AF, update a systematic review of comparative studies evaluating screening strategies for AF, develop an economic model to compare the cost-effectiveness of different screening strategies and review observational studies of AF screening to provide inputs to the model. Systematic review, meta-analysis and cost-effectiveness analysis. Primary care. Adults. Screening strategies, defined by screening test, age at initial and final screens, screening interval and format of screening {systematic opportunistic screening [individuals offered screening if they consult with their general practitioner (GP)] or systematic population screening (when all eligible individuals are invited to screening)}. Sensitivity, specificity and diagnostic odds ratios; the odds ratio of detecting new AF cases compared with no screening; and the mean incremental net benefit compared with no screening. Two reviewers screened the search results, extracted data and assessed the risk of bias. A DTA meta-analysis was perfomed, and a decision tree and Markov model was used to evaluate the cost-effectiveness of the screening strategies. Diagnostic test accuracy depended on the screening test and how it was interpreted. In general, the screening tests identified in our review had high sensitivity (> 0.9). Systematic population and systematic opportunistic screening strategies were found to be similarly effective, with an estimated 170 individuals needed to be screened to detect one additional AF case compared with no screening. Systematic opportunistic screening was more likely to be cost-effective

Cost-effective strategy to mitigate transportation disruptions in supply chain

NASA Astrophysics Data System (ADS)

Albertzeth, G.; Pujawan, I. N.

2018-04-01

Supply chain disruptions have gained significant attention by scholars. But, even though transportation plays a central role in supply chain, only few studies address transportation disruptions. This research demonstrates a real case of an order delivery process from a focal company (FC) to a single distributor, where transportation disruptions stochastically occurs. Considering the possibility of sales loss during the disruption duration, we proposed a redundant stock, flexible route, and combined flexibility-redundancy (ReFlex) as mitigation strategies and a base case as a risk acceptance strategy. The objective is to find out the best strategy that promotes cost-effectiveness against transportation disruptions. To fulfill this objective, we use simulation modeling and cost-effectiveness analysis (CEA) as our research method. We simulate the delivery process of 5 brands using each strategy to produce two different responses: loss of sales percentage and the incurred costs. Next, using these responses, we evaluate and compare the cost-effectiveness ratio of each strategy using CEA. We found that redundant stock gave the best effectiveness on all brands, ReFlex as the second best, while flexible route gave the least effectiveness. Finally, we recommend which strategy should be applied based on the decision maker willingness to pay.

Physical habitat monitoring strategy (PHAMS) for reach-scale restoration effectiveness monitoring

USGS Publications Warehouse

Jones, Krista L.; O'Daniel, Scott J.; Beechie, Tim J.; Zakrajsek, John; Webster, John G.

2015-04-14

Habitat restoration efforts by the Confederated Tribes of the Umatilla Indian Reservation (CTUIR) have shifted from the site scale (1-10 meters) to the reach scale (100-1,000 meters). This shift was in response to the growing scientific emphasis on process-based restoration and to support from the 2007 Accords Agreement with the Bonneville Power Administration. With the increased size of restoration projects, the CTUIR and other agencies are in need of applicable monitoring methods for assessing large-scale changes in river and floodplain habitats following restoration. The goal of the Physical Habitat Monitoring Strategy is to outline methods that are useful for capturing reach-scale changes in surface and groundwater hydrology, geomorphology, hydrologic connectivity, and riparian vegetation at restoration projects. The Physical Habitat Monitoring Strategy aims to avoid duplication with existing regional effectiveness monitoring protocols by identifying complimentary reach-scale metrics and methods that may improve the ability of CTUIR and others to detect instream and riparian changes at large restoration projects.

Strategies for Building Peer Surgical Coaching Relationships.

PubMed

Beasley, Heather L; Ghousseini, Hala N; Wiegmann, Douglas A; Brys, Nicole A; Pavuluri Quamme, Sudha R; Greenberg, Caprice C

2017-04-19

Peer surgical coaching is a promising approach for continuing professional development. However, scant guidance is available for surgeons seeking to develop peer-coaching skills. Executive coaching research suggests that effective coaches first establish a positive relationship with their coachees by aligning role and process expectations, establishing rapport, and cultivating mutual trust. To identify the strategies used by peer surgical coaches to develop effective peer-coaching relationships with their coachees. Drawing on executive coaching literature, a 3-part framework was developed to examine the strategies peer surgical coaches (n = 8) used to initially cultivate a relationship with their coachees (n = 11). Eleven introductory 1-hour meetings between coaching pairs participating in a statewide surgical coaching program were audiorecorded, transcribed, and coded on the basis of 3 relationship-building components. Once coded, thematic analysis was used to organize coded strategies into thematic categories and subcategories. Data were collected from October 10, 2014, to March 20, 2015. Data analysis took place from May 26, 2015, to July 20, 2016. Strategies and potentially counterproductive activities for building peer-coaching relationships in the surgical context to inform the future training of surgical coaches. Coaches used concrete strategies to align role and process expectations about the coaching process, to establish rapport, and to cultivate mutual trust with their coachees during introductory meetings. Potential coaching pitfalls are identified that could interfere with each of the 3 relationship-building components. Peer-nominated surgical coaches were provided with training on abstract concepts that underlie effective coaching practices in other fields. By identifying the strategies used by peer surgical coaches to operationalize these concepts, empirically based strategies to inform other surgical coaching programs are provided.

Protocol: a systematic review of studies developing and/or evaluating search strategies to identify prognosis studies.

PubMed

Corp, Nadia; Jordan, Joanne L; Hayden, Jill A; Irvin, Emma; Parker, Robin; Smith, Andrea; van der Windt, Danielle A

2017-04-20

Prognosis research is on the rise, its importance recognised because chronic health conditions and diseases are increasingly common and costly. Prognosis systematic reviews are needed to collate and synthesise these research findings, especially to help inform effective clinical decision-making and healthcare policy. A detailed, comprehensive search strategy is central to any systematic review. However, within prognosis research, this is challenging due to poor reporting and inconsistent use of available indexing terms in electronic databases. Whilst many published search filters exist for finding clinical trials, this is not the case for prognosis studies. This systematic review aims to identify and compare existing methodological filters developed and evaluated to identify prognosis studies of any of the three main types: overall prognosis, prognostic factors, and prognostic [risk prediction] models. Primary studies reporting the development and/or evaluation of methodological search filters to retrieve any type of prognosis study will be included in this systematic review. Multiple electronic bibliographic databases will be searched, grey literature will be sought from relevant organisations and websites, experts will be contacted, and citation tracking of key papers and reference list checking of all included papers will be undertaken. Titles will be screened by one person, and abstracts and full articles will be reviewed for inclusion independently by two reviewers. Data extraction and quality assessment will also be undertaken independently by two reviewers with disagreements resolved by discussion or by a third reviewer if necessary. Filters' characteristics and performance metrics reported in the included studies will be extracted and tabulated. To enable comparisons, filters will be grouped according to database, platform, type of prognosis study, and type of filter for which it was intended. This systematic review will identify all existing validated

Safety Strategy Use Among Women Seeking Temporary Protective Orders: The Relationship Between Violence Experienced, Strategy Effectiveness, and Risk Perception.

PubMed

Parker, Elizabeth M; Gielen, Andrea C; Castillo, Renan; Webster, Daniel

2015-01-01

This study examined safety strategy use in relation to intimate partner violence (IPV) victimization, perceived effectiveness of the strategies, and perception of danger from IPV among 197 abused women. More than 90% of the women used 1 or more strategies in the 6 months prior to their interview. Severe physical and sexual violence were significantly associated with an increased use of placating strategies. Perceived effectiveness of the strategies was high yet not associated with strategy use. Increased perception of danger from IPV was significantly associated with increased use of safety planning strategies. The findings suggest that safety planning should be tailored to fit women's specific contexts. Safety planning discussions should focus on strategies that reduce women's risk of continued violence and build on women's strengths.

Comparative clinical effectiveness of management strategies for sciatica: systematic review and network meta-analyses.

PubMed

Lewis, Ruth A; Williams, Nefyn H; Sutton, Alex J; Burton, Kim; Din, Nafees Ud; Matar, Hosam E; Hendry, Maggie; Phillips, Ceri J; Nafees, Sadia; Fitzsimmons, Deborah; Rickard, Ian; Wilkinson, Clare

2015-06-01

There are numerous treatment approaches for sciatica. Previous systematic reviews have not compared all these strategies together. To compare the clinical effectiveness of different treatment strategies for sciatica simultaneously. Systematic review and network meta-analysis. We searched 28 electronic databases and online trial registries, along with bibliographies of previous reviews for comparative studies evaluating any intervention to treat sciatica in adults, with outcome data on global effect or pain intensity. Network meta-analysis methods were used to simultaneously compare all treatment strategies and allow indirect comparisons of treatments between studies. The study was funded by the UK National Institute for Health Research Health Technology Assessment program; there are no potential conflict of interests. We identified 122 relevant studies; 90 were randomized controlled trials (RCTs) or quasi-RCTs. Interventions were grouped into 21 treatment strategies. Internal and external validity of included studies was very low. For overall recovery as the outcome, compared with inactive control or conventional care, there was a statistically significant improvement following disc surgery, epidural injections, nonopioid analgesia, manipulation, and acupuncture. Traction, percutaneous discectomy, and exercise therapy were significantly inferior to epidural injections or surgery. For pain as the outcome, epidural injections and biological agents were significantly better than inactive control, but similar findings for disc surgery were not statistically significant. Biological agents were significantly better for pain reduction than bed rest, nonopioids, and opioids. Opioids, education/advice alone, bed rest, and percutaneous discectomy were inferior to most other treatment strategies; although these findings represented large effects, they were statistically equivocal. For the first time, many different treatment strategies for sciatica have been compared in the

Identifying health facilities outside the enterprise: challenges and strategies for supporting health reform and meaningful use.

PubMed

Dixon, Brian E; Colvard, Cyril; Tierney, William M

2014-06-24

Objective: To support collation of data for disability determination, we sought to accurately identify facilities where care was delivered across multiple, independent hospitals and clinics. Methods: Data from various institutions' electronic health records were merged and delivered as continuity of care documents to the United States Social Security Administration (SSA). Results: Electronic records for nearly 8000 disability claimants were exchanged with SSA. Due to the lack of standard nomenclature for identifying the facilities in which patients received the care documented in the electronic records, SSA could not match the information received with information provided by disability claimants. Facility identifiers were generated arbitrarily by health care systems and therefore could not be mapped to the existing international standards. Discussion: We propose strategies for improving facility identification in electronic health records to support improved tracking of a patient's care between providers to better serve clinical care delivery, disability determination, health reform and meaningful use. Conclusion: Accurately identifying the facilities where health care is delivered to patients is important to a number of major health reform and improvement efforts underway in many nations. A standardized nomenclature for identifying health care facilities is needed to improve tracking of care and linking of electronic health records.

Effectiveness of alternative management strategies in meeting conservation objectives

Treesearch

Richards S. Holthausen; Carolyn Hull Sieg

2007-01-01

This chapter evaluates how well various management strategies meet a variety of conservation objectives, summarizes their effectiveness in meeting objectives for rare or little-known (RLK) species, and proposes ways to combine strategies to meet overall conservation objectives. We address two broad categories of management strategies. Species approaches result in...

Cost-Effectiveness Analysis of Different Testing Strategies that Use Antibody Levels to Detect Chronic Hepatitis C in Blood Donors.

PubMed

Granados-García, Víctor; Contreras, Ana M; García-Peña, Carmen; Salinas-Escudero, Guillermo; Thein, Hla-Hla; Flores, Yvonne N

2016-01-01

We conducted a cost-effectiveness analysis of seven hepatitis C virus (HCV) testing strategies in blood donors. Three of the seven strategies were based on HCV diagnosis and reporting guidelines in Mexico and four were from previous and current recommendations outlined by the CDC. The strategies that were evaluated determine antibody levels according to the signal-to-cut-off (S/CO) ratio and use reflex Immunoblot (IMB) or HCV RNA tests to confirm true positive (TP) cases of chronic HCV infection. Costs were calculated from the perspective of the Mexican Institute of Social Security (IMSS). A decision tree model was developed to estimate the expected number of true positive cases and costs for the base-case scenarios and for the sensitivity analyses. Base-case findings indicate an extended dominance of the CDC-USA2 and CDC-USA4 options by the IMSS Mexico3 and IMSS-Mexico1 alternatives. The probabilistic sensitivity analyses results suggest that for a willingness-to-pay (WTP) range of $0-9,000 USD the IMSS-Mexico1 strategy is the most cost-effective of all strategies ($5,000 USD per TP). The IMSS-Mexico3, IMSS-Mexico2, and CDC-USA3 strategies are also cost-effective strategies that cost between $7,800 and $8,800 USD per TP case detected. The CDC-USA1 strategy was very expensive and not cost-effective. HCV antibody testing strategies based on the classification of two or three levels of the S/CO are cost-effective procedures to identify patients who require reflex IMB or HCV RNA testing to confirm chronic HCV infection.

Effects of strategy on visual working memory capacity

PubMed Central

Bengson, Jesse J.; Luck, Steven J.

2015-01-01

Substantial evidence suggests that individual differences in estimates of working memory capacity reflect differences in how effectively people use their intrinsic storage capacity. This suggests that estimated capacity could be increased by instructions that encourage more effective encoding strategies. The present study tested this by giving different participants explicit strategy instructions in a change detection task. Compared to a condition in which participants were simply told to do their best, we found that estimated capacity was increased for participants who were instructed to remember the entire visual display, even at set sizes beyond their capacity. However, no increase in estimated capacity was found for a group that was told to focus on a subset of the items in supracapacity arrays. This finding confirms the hypothesis that encoding strategies may influence visual working memory performance, and it is contrary to the hypothesis that the optimal strategy is to filter out any items beyond the storage capacity. PMID:26139356

Effects of strategy on visual working memory capacity.

PubMed

Bengson, Jesse J; Luck, Steven J

2016-02-01

Substantial evidence suggests that individual differences in estimates of working memory capacity reflect differences in how effectively people use their intrinsic storage capacity. This suggests that estimated capacity could be increased by instructions that encourage more effective encoding strategies. The present study tested this by giving different participants explicit strategy instructions in a change detection task. Compared to a condition in which participants were simply told to do their best, we found that estimated capacity was increased for participants who were instructed to remember the entire visual display, even at set sizes beyond their capacity. However, no increase in estimated capacity was found for a group that was told to focus on a subset of the items in supracapacity arrays. This finding confirms the hypothesis that encoding strategies may influence visual working memory performance, and it is contrary to the hypothesis that the optimal strategy is to filter out any items beyond the storage capacity.

Maximizing cost-effectiveness by adjusting treatment strategy according to glaucoma severity

PubMed Central

Guedes, Ricardo Augusto Paletta; Guedes, Vanessa Maria Paletta; Gomes, Carlos Eduardo de Mello; Chaoubah, Alfredo

2016-01-01

Abstract Background: The aim of this study is to determine the most cost-effective strategy for the treatment of primary open-angle glaucoma (POAG) in Brazil, from the payer's perspective (Brazilian Public Health System) in the setting of the Glaucoma Referral Centers. Methods: Study design was a cost-effectiveness analysis of different treatment strategies for POAG. We developed 3 Markov models (one for each glaucoma stage: early, moderate and advanced), using a hypothetical cohort of POAG patients, from the perspective of the Brazilian Public Health System (SUS) and a horizon of the average life expectancy of the Brazilian population. Different strategies were tested according to disease severity. For early glaucoma, we compared observation, laser and medications. For moderate glaucoma, medications, laser and surgery. For advanced glaucoma, medications and surgery. Main outcome measures were ICER (incremental cost-effectiveness ratio), medical direct costs and QALY (quality-adjusted life year). Results: In early glaucoma, both laser and medical treatment were cost-effective (ICERs of initial laser and initial medical treatment over observation only, were R$ 2,811.39/QALY and R$ 3,450.47/QALY). Compared to observation strategy, the two alternatives have provided significant gains in quality of life. In moderate glaucoma population, medical treatment presented the highest costs among treatment strategies. Both laser and surgery were highly cost-effective in this group. For advanced glaucoma, both tested strategies were cost-effective. Starting age had a great impact on results in all studied groups. Initiating glaucoma therapy using laser or surgery were more cost-effective, the younger the patient. Conclusion: All tested treatment strategies for glaucoma provided real gains in quality of life and were cost-effective. However, according to the disease severity, not all strategies provided the same cost-effectiveness profile. Based on our findings, there should be a

Quasi-Experiment Study on Effectiveness Evaluation of Health Communication Strategies

PubMed Central

2016-01-01

This experimental study examined differences in doctor-patient relationships according to the health communication strategies during cases of medical malpractices occurred at primary medical institution. A total of 116 subjects aged in their 20s-50s was sampled. The first medical malpractice scenario chosen was the medical malpractice case most frequently registered at the Korean Medical Association Mutual Aid and the second scenario was associated with materials and devices as the cause of malpractice. Four types of crisis communication strategy messages were utilized, consisting of denial, denial + ingratiation, apology, and apology + ingratiation. Subjects were classified into four research groups by crisis communication strategy to measure levels of trust, control mutuality, commitment, and satisfaction, before and after the occurrence of medical malpractice and application of communication strategies. The findings of this study revealed that the apology strategy, compared with the denial strategy, showed a smaller difference before and after the application of communication strategies in all variables of trust (F = 8.080, F = 5.768), control mutuality (F = 8.824, F = 9.081), commitment (F = 9.815, F = 8.301), and satisfaction (F = 8.723, F = 5.638). Further, a significant interaction effect was shown between variables. The apology strategy, compared with the denial strategy, was effective in the improvement of doctor-patient relationships in both Scenarios I and II. For Scenario I, the apology strategy without ingratiation boosted commitment and satisfaction, but for Scenario II, utilizing the apology strategy with ingratiation boosted the effectiveness of trust and commitment. PMID:27365998

Quasi-Experiment Study on Effectiveness Evaluation of Health Communication Strategies.

PubMed

Song, Dae Jong; Choi, Jae Wook; Kim, Kyunghee; Kim, Min Soo; Moon, Jiwon Monica

2016-07-01

This experimental study examined differences in doctor-patient relationships according to the health communication strategies during cases of medical malpractices occurred at primary medical institution. A total of 116 subjects aged in their 20s-50s was sampled. The first medical malpractice scenario chosen was the medical malpractice case most frequently registered at the Korean Medical Association Mutual Aid and the second scenario was associated with materials and devices as the cause of malpractice. Four types of crisis communication strategy messages were utilized, consisting of denial, denial + ingratiation, apology, and apology + ingratiation. Subjects were classified into four research groups by crisis communication strategy to measure levels of trust, control mutuality, commitment, and satisfaction, before and after the occurrence of medical malpractice and application of communication strategies. The findings of this study revealed that the apology strategy, compared with the denial strategy, showed a smaller difference before and after the application of communication strategies in all variables of trust (F = 8.080, F = 5.768), control mutuality (F = 8.824, F = 9.081), commitment (F = 9.815, F = 8.301), and satisfaction (F = 8.723, F = 5.638). Further, a significant interaction effect was shown between variables. The apology strategy, compared with the denial strategy, was effective in the improvement of doctor-patient relationships in both Scenarios I and II. For Scenario I, the apology strategy without ingratiation boosted commitment and satisfaction, but for Scenario II, utilizing the apology strategy with ingratiation boosted the effectiveness of trust and commitment.

Multiple strategies of oxygen supply in Drosophila malignancies identify tracheogenesis as a novel cancer hallmark.

PubMed

Grifoni, Daniela; Sollazzo, Manuela; Fontana, Elisabetta; Froldi, Francesca; Pession, Annalisa

2015-03-12

Angiogenesis is the term used to describe all the alterations in blood vessel growth induced by a tumour mass following hypoxic stress. The occurrence of multiple strategies of vessel recruitment favours drug resistance, greatly complicating the treatment of certain tumours. In Drosophila, oxygen is conveyed to the internal organs by the tracheal system, a closed tubular network whose role in cancer growth is so far unexplored. We found that, as observed in human cancers, Drosophila malignant cells suffer from oxygen shortage, release pro-tracheogenic factors, co-opt nearby vessels and get incorporated into the tracheal walls. We also found that the parallelisms observed in cellular behaviours are supported by genetic and molecular conservation. Finally, we identified a molecular circuitry associated with the differentiation of cancer cells into tracheal cells. In summary, our findings identify tracheogenesis as a novel cancer hallmark in Drosophila, further expanding the power of the fly model in cancer research.

"Pedagogic Strategies": A Conceptual Framework for Effective Parent and Practitioner Strategies When Working with Children under Five

ERIC Educational Resources Information Center

Lawrence, Penny; Gallagher, Tracy

2015-01-01

This article traces the development of adult Pedagogic Strategies with children aged 0-5 years at the Pen Green Centre for Children and Their Families in England. Pedagogical Strategies are a conceptual framework of effective strategies both practitioners and parents "already" have to support children's learning. The methodology was…

Effects of Two Listening Strategies for Melodic Dictation

ERIC Educational Resources Information Center

Buonviri, Nathan O.

2017-01-01

The purpose of this research was to examine effects of two listening strategies on melodic dictation scores. Fifty-four undergraduate music majors completed short tonal melodic dictations in a within-subjects design with three conditions: (a) no specified strategy in the instructions, (b) required listening before writing, and (c) required writing…

Recruitment Strategies and Activities Used by Agriculture Teachers.

ERIC Educational Resources Information Center

Myers, Brian E.; Dyer, James E.; Breja, Lisa M.

2003-01-01

The most frequent student recruitment strategies reported by 275 secondary agriculture teachers were (in order of effectiveness) feeder schools, personal contacts, FFA, publications, strong curriculum, support groups, and special events. Specific activities for each strategy were identified. (Contains 34 references.) (SK)

Effective intervention strategies to improve health outcomes for cardiovascular disease patients with low health literacy skills: a systematic review.

PubMed

Lee, Tae Wha; Lee, Seon Heui; Kim, Hye Hyun; Kang, Soo Jin

2012-12-01

Systematic studies on the relationship between health literacy and health outcomes demonstrate that as health literacy declines, patients engage in fewer preventive health and self-care behaviors and have worse disease-related knowledge. The purpose of this study was to identify effective intervention strategies to improve health outcomes in patients with cardiovascular disease and low literacy skills. This study employs the following criteria recommended by Khan Kunz, Keijnen, and Antes (2003) for systematic review: framing question, identifying relevant literature, assessing quality of the literature, summarizing the evidence, and interpreting the finding. A total of 235 articles were reviewed by the research team, and 9 articles met inclusion criteria. Although nine studies were reviewed for their health outcomes, only six studies, which had a positive quality grade evaluation were used to recommend effective intervention strategies. Interventions were categorized into three groups: tailored counseling, self-monitoring, and periodic reminder. The main strategies used to improve health outcomes of low literacy patients included tailored counseling, improved provider-patient interactions, organizing information by patient preference, self-care algorithms, and self-directed learning. Specific strategies included written materials tailored to appropriate reading levels, materials using plain language, emphasizing key points with large font size, and using visual items such as icons or color codes. With evidence-driven strategies, health care professionals can use tailored interventions to provide better health education and counseling that meets patient needs and improves health outcomes. Copyright © 2012. Published by Elsevier B.V.

Asthma management simulation for children: translating theory, methods, and strategies to effect behavior change.

PubMed

Shegog, Ross; Bartholomew, L Kay; Gold, Robert S; Pierrel, Elaine; Parcel, Guy S; Sockrider, Marianna M; Czyzewski, Danita I; Fernandez, Maria E; Berlin, Nina J; Abramson, Stuart

2006-01-01

Translating behavioral theories, models, and strategies to guide the development and structure of computer-based health applications is well recognized, although a continued challenge for program developers. A stepped approach to translate behavioral theory in the design of simulations to teach chronic disease management to children is described. This includes the translation steps to: 1) define target behaviors and their determinants, 2) identify theoretical methods to optimize behavioral change, and 3) choose educational strategies to effectively apply these methods and combine these into a cohesive computer-based simulation for health education. Asthma is used to exemplify a chronic health management problem and a computer-based asthma management simulation (Watch, Discover, Think and Act) that has been evaluated and shown to effect asthma self-management in children is used to exemplify the application of theory to practice. Impact and outcome evaluation studies have indicated the effectiveness of these steps in providing increased rigor and accountability, suggesting their utility for educators and developers seeking to apply simulations to enhance self-management behaviors in patients.

Effects of strategy sequences and response-stimulus intervals on children's strategy selection and strategy execution: a study in computational estimation.

PubMed

Lemaire, Patrick; Brun, Fleur

2014-07-01

The present study investigates how children's better strategy selection and strategy execution on a given problem are influenced by which strategy was used on the immediately preceding problem and by the duration between their answer to the previous problem and current problem display. These goals are pursued in the context of an arithmetic problem solving task. Third and fifth graders were asked to select the better strategy to find estimates to two-digit addition problems like 36 + 78. On each problem, children could choose rounding-down (i.e., rounding both operands down to the closest smaller decades, like doing 40 + 60 to solve 42 + 67) or rounding-up strategies (i.e., rounding both operands up to the closest larger decades, like doing 50 + 70 to solve 42 + 67). Children were tested under a short RSI condition (i.e., the next problem was displayed 900 ms after participants' answer) or under a long RSI condition (i.e., the next problem was displayed 1,900 ms after participants' answer). Results showed that both strategy selection (e.g., children selected the better strategy more often under long RSI condition and after selecting the poorer strategy on the immediately preceding problem) and strategy execution (e.g., children executed strategy more efficiently under long RSI condition and were slower when switching strategy over two consecutive problems) were influenced by RSI and which strategy was used on the immediately preceding problem. Moreover, data showed age-related changes in effects of RSI and strategy sequence on mean percent better strategy selection and on strategy performance. The present findings have important theoretical and empirical implications for our understanding of general and specific processes involved in strategy selection, strategy execution, and strategic development.

The Effectiveness of Tutorial Strategies: An Experimental Evaluation.

ERIC Educational Resources Information Center

Swanson, Judy H.

The effectiveness of three tutorial strategies was evaluated by experimentally manipulating the strategies used in a 2 X 3 factorial design. Two tutors taught 48 college undergraduates a basic optics lesson about "how lenses work," using three instructional methods which varied the amount of tutor control. In the lecture condition, tutors assumed…

Cost-effectiveness of alternative colonoscopy surveillance strategies to mitigate metachronous colorectal cancer incidence.

PubMed

Erenay, Fatih Safa; Alagoz, Oguzhan; Banerjee, Ritesh; Said, Adnan; Cima, Robert R

2016-08-15

The incidence of metachronous colorectal cancer (MCRC) among colorectal cancer (CRC) survivors varies significantly, and the optimal colonoscopy surveillance practice for mitigating MCRC incidence is unknown. A cost-effectiveness analysis was used to compare the performances of the US Multi-Society Task Force guideline and all clinically reasonable colonoscopy surveillance strategies for 50- to 79-year-old posttreatment CRC patients with a computer simulation model. The US guideline [(1,3,5)] recommends the first colonoscopy 1 year after treatment, whereas the second and third colonoscopies are to be repeated at 3- and 5-year intervals. Some promising alternative cost-effective strategies were identified. In comparison with the US guideline, under various scenarios for a 20-year period, 1) reducing the surveillance interval of the guideline after the first colonoscopy by 1 year [(1,2,5)] would save up to 78 discounted life-years (LYs) and prevent 23 MCRCs per 1000 patients (incremental cost-effectiveness ratio [ICER] ≤ $23,270/LY), 2) reducing the intervals after the first and second negative colonoscopies by 1 year [(1,2,4)] would save/prevent up to 109 discounted LYs and 36 MCRCs (ICER ≤ $52,155/LY), and 3) reducing the surveillance intervals after the first and second negative colonoscopy by 1 and 2 years [(1,2,3)] would save/prevent up to 141 discounted LYs and 50 MCRCs (ICER ≤ $63,822/LY). These strategies would require up to 1100 additional colonoscopies per 1000 patients. Although the US guideline might not be cost-effective in comparison with a less intensive oncology guideline [(3,3,5); the ICER could be as high as $140,000/LY], the promising strategies would be cost-effective in comparison with such less intensive guidelines unless the cumulative MCRC incidence were very low. The US guideline might be improved by a slight increase in the surveillance intensity at the expense of moderately increased cost. More research is warranted to explore the

Effectiveness and Cost-Effectiveness of Expanded Antiviral Prophylaxis and Adjuvanted Vaccination Strategies for the Next Influenza Pandemic

PubMed Central

Khazeni, Nayer; Hutton, David W; Garber, Alan M; Owens, Douglas K

2011-01-01

Background The pandemic potential of the influenza A (H5N1) virus is among the greatest public health concerns of the 21st century. Objective To determine the effectiveness and cost-effectiveness of alternative pandemic mitigation and response strategies. Design Compartmental epidemic model in conjunction with a Markov model of disease progression. Data Sources Literature and expert opinion. Target Population Residents of a U.S. metropolitan city. Time Horizon Lifetime. Perspective Societal. Interventions One mitigation strategy used non-pharmaceutical interventions, vaccination, and antiviral pharmacotherapy in quantities similar to those available currently in the U.S. stockpile. The second and third strategies used expanded supplies of either antivirals (expanded antiviral prophylaxis strategy) or adjuvanted vaccine (expanded vaccination strategy) in addition to non-pharmaceutical interventions. Outcome Measures Infections and deaths averted, costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness. Results of Base Case Analysis The stockpiled strategy averted 44% of infections and deaths, gaining 258,342 QALYs at $8,907 per QALY gained relative to no intervention. Expanded antiviral prophylaxis delayed the pandemic, averting 48% of infections and deaths, and gaining 282,329 QALYs, with a less favorable cost-effectiveness ratio than adjuvanted vaccination. Adjuvanted vaccination was the most effective strategy and was cost-effective, averting 68% of infections and deaths, and gaining 404,030 QALYs at $10,844 per QALY gained relative to stockpiled strategy. Results of Sensitivity Analysis Over a wide range of assumptions, the incremental cost-effectiveness ratio of the expanded adjuvanted vaccination strategy was less than $50,000 per QALY gained. Limitations Large groups and frequent contacts may spread the virus more rapidly. The model is not designed to target interventions to specific groups. Conclusions Expanded adjuvanted vaccination

Cost-Effectiveness of Diagnostic Strategies for Suspected Scaphoid Fractures.

PubMed

Yin, Zhong-Gang; Zhang, Jian-Bing; Gong, Ke-Tong

2015-08-01

The aim of this study was to assess the cost effectiveness of multiple competing diagnostic strategies for suspected scaphoid fractures. With published data, the authors created a decision-tree model simulating the diagnosis of suspected scaphoid fractures. Clinical outcomes, costs, and cost effectiveness of immediate computed tomography (CT), day 3 magnetic resonance imaging (MRI), day 3 bone scan, week 2 radiographs alone, week 2 radiographs-CT, week 2 radiographs-MRI, week 2 radiographs-bone scan, and immediate MRI were evaluated. The primary clinical outcome was the detection of scaphoid fractures. The authors adopted societal perspective, including both the costs of healthcare and the cost of lost productivity. The incremental cost-effectiveness ratio (ICER), which expresses the incremental cost per incremental scaphoid fracture detected using a strategy, was calculated to compare these diagnostic strategies. Base case analysis, 1-way sensitivity analyses, and "worst case scenario" and "best case scenario" sensitivity analyses were performed. In the base case, the average cost per scaphoid fracture detected with immediate CT was $2553. The ICER of immediate MRI and day 3 MRI compared with immediate CT was $7483 and $32,000 per scaphoid fracture detected, respectively. The ICER of week 2 radiographs-MRI was around $170,000. Day 3 bone scan, week 2 radiographs alone, week 2 radiographs-CT, and week 2 radiographs-bone scan strategy were dominated or extendedly dominated by MRI strategies. The results were generally robust in multiple sensitivity analyses. Immediate CT and MRI were the most cost-effective strategies for diagnosing suspected scaphoid fractures. Economic and Decision Analyses Level II. See Instructions for Authors for a complete description of levels of evidence.

Effectiveness of international environmental regimes: Existing knowledge, cutting-edge themes, and research strategies

PubMed Central

Young, Oran R.

2011-01-01

International environmental regimes—especially those regimes articulated in multilateral environmental agreements—have been a subject of intense interest within the scientific community over the last three decades. However, there are substantial differences of opinion regarding the effectiveness of these governance systems or the degree to which they are successful in solving the problems leading to their creation. This article provides a critical review of the literature on this topic. It extracts and summarizes what is known about the effectiveness of environmental regimes in the form of a series of general and specific propositions. It identifies promising topics for consideration in the next phase of research in this field. Additionally, it comments on the research strategies available to pursue this line of analysis. The general conclusions are that international environmental regimes can and do make a difference, although often in conjunction with a number of other factors, and that a strategy of using a number of tools combined can help to improve understanding of the determinants of success. PMID:22143795

Effective Strategies for Enhancing Waste Management at University Campuses

ERIC Educational Resources Information Center

Ebrahimi, Kianoosh; North, Leslie A.

2017-01-01

Purpose: The purpose of this study is to identify and assess the waste management strategies that should be priorities for higher education institutions. The role of policy instruments (i.e. purchasing policies and recycling initiatives) in implementing sustainable zero-waste management programs at higher education institutions was investigated…

Identifying Strategies to Decrease Overtime, Absenteeism and Agency Use: Insights from Healthcare Leaders.

PubMed

Jeffs, Lianne; Grinspun, Doris; Closson, Tom; Mainville, Marie-Claude

2015-09-01

Working overtime, absenteeism and agency use can negatively impact working environments, the health of staff and patient outcomes, and increase healthcare costs. The purpose of this study was to explore how healthcare leaders in Ontario hospitals implement and sustain best practices that advance workforce stability within their organization. Qualitative study design using semi-structured interviews and thematic analysis. Participants included 23 healthcare leaders from 16 hospital sites. Two main themes emerged: (1) enacting proactive human resource practices and (2) having strong, caring and strategic leaders that create learning and supportive work environments. A number of sub-themes identified were reported through narratives stratified according to size (small/large) and performance (low/high) of each site. Insights gained from this study may offer healthcare leaders strategies to maximize the nursing workforce and minimize overtime, absenteeism and agency use to ensure safe, efficient and quality healthcare. Copyright © 2015 Longwoods Publishing.

The Effect of Language Learning Strategies on Proficiency, Attitudes and School Achievement

PubMed Central

Habók, Anita; Magyar, Andrea

2018-01-01

This study examines language learning strategy (LLS) use in connexion with foreign language attitude, proficiency and general school achievement among lower secondary students in Years 5 and 8 (n = 868) in Hungary. An adapted version of the Strategies Inventory for Language Learning questionnaire was used for data collection. The results showed that Hungarian students mainly engage in metacognitive strategies in both years. Differences between more and less proficient language learners’ strategy use have also been found. With regard to the effect of LLS on foreign language attitude, the foreign language mark and school achievement, path analysis indicated a good fit in both years. The metacognitive, social and memory strategies primarily influenced foreign language attitudes and marks in Year 5. The metacognitive strategies had a slight impact on school achievement as well as on foreign language marks. We demonstrated the dominant effect of metacognitive strategies and the low effect of memory strategies in Year 8. In addition, metacognitive strategies also influenced foreign language marks. The effect of foreign language marks on school achievement was also remarkable. There was a strong impact on the children’s attitudes through these variables. PMID:29379461

The Effect of Language Learning Strategies on Proficiency, Attitudes and School Achievement.

PubMed

Habók, Anita; Magyar, Andrea

2017-01-01

This study examines language learning strategy (LLS) use in connexion with foreign language attitude, proficiency and general school achievement among lower secondary students in Years 5 and 8 ( n = 868) in Hungary. An adapted version of the Strategies Inventory for Language Learning questionnaire was used for data collection. The results showed that Hungarian students mainly engage in metacognitive strategies in both years. Differences between more and less proficient language learners' strategy use have also been found. With regard to the effect of LLS on foreign language attitude, the foreign language mark and school achievement, path analysis indicated a good fit in both years. The metacognitive, social and memory strategies primarily influenced foreign language attitudes and marks in Year 5. The metacognitive strategies had a slight impact on school achievement as well as on foreign language marks. We demonstrated the dominant effect of metacognitive strategies and the low effect of memory strategies in Year 8. In addition, metacognitive strategies also influenced foreign language marks. The effect of foreign language marks on school achievement was also remarkable. There was a strong impact on the children's attitudes through these variables.

Adaptation and translation of mental health interventions in Middle Eastern Arab countries: a systematic review of barriers to and strategies for effective treatment implementation.

PubMed

Gearing, Robin E; Schwalbe, Craig S; MacKenzie, Michael J; Brewer, Kathryne B; Ibrahim, Rawan W; Olimat, Hmoud S; Al-Makhamreh, Sahar S; Mian, Irfan; Al-Krenawi, Alean

2013-11-01

All too often, efficacious psychosocial evidence-based interventions fail when adapted from one culture to another. International translation requires a deep understanding of the local culture, nuanced differences within a culture, established service practices, and knowledge of obstacles and promoters to treatment implementation. This research investigated the following objectives to better facilitate cultural adaptation and translation of psychosocial and mental health treatments in Arab countries: (1) identify barriers or obstacles; (2) identify promoting strategies; and (3) provide clinical and research recommendations. This systematic review of 22 psychosocial or mental health studies in Middle East Arab countries identified more barriers (68%) than promoters (32%) to effective translation and adaptation of empirically supported psychosocial interventions. Identified barriers include obstacles related to acceptability of the intervention within the cultural context, community and system difficulties, and problems with clinical engagement processes. Whereas identified promoter strategies centre on the importance of partnering and working within the local and cultural context, the need to engage with acceptable and traditional intervention characteristics, and the development of culturally appropriate treatment strategies and techniques. Although Arab cultures across the Middle East are unique, this article provides a series of core clinical and research recommendations to assist effective treatment adaptation and translation within Arab communities in the Middle East.

Dealing with Feeling: A Meta-Analysis of the Effectiveness of Strategies Derived from the Process Model of Emotion Regulation

ERIC Educational Resources Information Center

Webb, Thomas L.; Miles, Eleanor; Sheeran, Paschal

2012-01-01

The present meta-analysis investigated the effectiveness of strategies derived from the process model of emotion regulation in modifying emotional outcomes as indexed by experiential, behavioral, and physiological measures. A systematic search of the literature identified 306 experimental comparisons of different emotion regulation (ER)…

A gene-trap strategy identifies quiescence-induced genes in synchronized myoblasts.

PubMed

Sambasivan, Ramkumar; Pavlath, Grace K; Dhawan, Jyotsna

2008-03-01

Cellular quiescence is characterized not only by reduced mitotic and metabolic activity but also by altered gene expression. Growing evidence suggests that quiescence is not merely a basal state but is regulated by active mechanisms. To understand the molecular programme that governs reversible cell cycle exit, we focused on quiescence-related gene expression in a culture model of myogenic cell arrest and activation. Here we report the identification of quiescence-induced genes using a gene-trap strategy. Using a retroviral vector, we generated a library of gene traps in C2C12 myoblasts that were screened for arrest-induced insertions by live cell sorting (FACS-gal). Several independent gene- trap lines revealed arrest-dependent induction of betagal activity, confirming the efficacy of the FACS screen. The locus of integration was identified in 15 lines. In three lines,insertion occurred in genes previously implicated in the control of quiescence, i.e. EMSY - a BRCA2--interacting protein, p8/com1 - a p300HAT -- binding protein and MLL5 - a SET domain protein. Our results demonstrate that expression of chromatin modulatory genes is induced in G0, providing support to the notion that this reversibly arrested state is actively regulated.

Suppressor Effects of Coping Strategies on Resilience

ERIC Educational Resources Information Center

Yoon, Jae ho; Lee, Ji hae; Lee, Chae Yeon; Cho, Minhee; Lee, Sang Min

2014-01-01

The purpose of the current study is to demonstrate a significant suppressor effect among coping strategies on resilience. Two different samples were used to replicate the suppressor effect. Participants in the first example were 391 adolescents (middle school students) in Korea, and participants in the second example were 282 young adults…

Beyond "implementation strategies": classifying the full range of strategies used in implementation science and practice.

PubMed

Leeman, Jennifer; Birken, Sarah A; Powell, Byron J; Rohweder, Catherine; Shea, Christopher M

2017-11-03

Strategies are central to the National Institutes of Health's definition of implementation research as "the study of strategies to integrate evidence-based interventions into specific settings." Multiple scholars have proposed lists of the strategies used in implementation research and practice, which they increasingly are classifying under the single term "implementation strategies." We contend that classifying all strategies under a single term leads to confusion, impedes synthesis across studies, and limits advancement of the full range of strategies of importance to implementation. To address this concern, we offer a system for classifying implementation strategies that builds on Proctor and colleagues' (2013) reporting guidelines, which recommend that authors not only name and define their implementation strategies but also specify who enacted the strategy (i.e., the actor) and the level and determinants that were targeted (i.e., the action targets). We build on Wandersman and colleagues' Interactive Systems Framework to distinguish strategies based on whether they are enacted by actors functioning as part of a Delivery, Support, or Synthesis and Translation System. We build on Damschroder and colleague's Consolidated Framework for Implementation Research to distinguish the levels that strategies target (intervention, inner setting, outer setting, individual, and process). We then draw on numerous resources to identify determinants, which are conceptualized as modifiable factors that prevent or enable the adoption and implementation of evidence-based interventions. Identifying actors and targets resulted in five conceptually distinct classes of implementation strategies: dissemination, implementation process, integration, capacity-building, and scale-up. In our descriptions of each class, we identify the level of the Interactive System Framework at which the strategy is enacted (actors), level and determinants targeted (action targets), and outcomes used to

Children's Learning Strategies in Language Immersion Classrooms.

ERIC Educational Resources Information Center

Chamot, Anna Uhl; El-Dinary, Pamela Beard

This paper reports on an investigation of learning strategy applications in elementary foreign language immersion classrooms. The focus of the paper is on identifying strategies more and less effective learners use for classroom reading and writing tasks in the target language. Think-aloud data from third grade and fourth grade students were…

Effects of designed learning strategies to enhance biology students' understanding of the nature of science

NASA Astrophysics Data System (ADS)

Reeves, Carolyn T.

This research attempted to test the effectiveness of strategies designed for teaching the nature of science to Biology I students and to examine the effects of frequency of use of the strategies. Some strategies were designed to identify misconceptions about the nature of science; others were designed to correct misconceptions or provide correct concepts about the nature of science. This research commenced during the 3rd week of the 2001--2002 school year after obtaining IRB approval and permissions from school officials. The study ended after the 15th week. All participating students were given a pretest and a posttest of the Nature of Scientific Knowledge Scale Enhanced (NSKSE) test. Part I, 48 items, consisted of the NSKS test by Rubba & Anderson (1978). Part II, 10 items, consisted of a test constructed by the researcher. Part I contained questions about 6 tenets of the nature of science. Part II contained questions about how science works. The strategies were tested in two Biology I experimental classes, n = 41, and compared with two Biology I control classes, n = 34, by means of an analysis of covariance with the pretest scores used as the covariate. The overall mean posttest scores of the experimental and the control group were not found to be significantly different on either Part I, F(1,72) = 1.059, p = .307, or Part II, F(1,72) = 3.136, p = .081, of the test instrument. The number of times a strategy was used in each experimental classroom was determined. It was found that strategies were used almost twice as often in one classroom than in the other. A second set of ANCOVA analyses compared mean scores between Experimental Class A, Experimental Class B, and the control group. There was no significant difference between the groups on Part I, F(2,71) = .921, p = .403, but the difference between groups on Part II, F(2,71) = 5.769, p = .005, was significant. A post hoc Scheffe analysis showed that the class using strategies most often differed significantly

A strategy to identify opportunities for innovation in Romanian healthcare services.

PubMed

Coculescu, B I; Purcărea, V L; Coculescu, E C

2015-01-01

In principle, the development of medicine (including the Romanian health system) is primarily dependent on the level of funding and the efficiency with which this funding is used, the structure of the population and socio-economic development of the geographical area concerned, and not least, the attitudes and expectations of patients, which in turn translate into care taking policies system. Unlike the other services, health services are accessed by a large number of people, which results into high health. As an economic principle, the fewer resources are used to achieve the expected results, the more effective the supplier. However, the introduction of new medical technologies, many of them more reliable yet more expensive, required a reassessment of the way resources are used at the suppliers' level to produce the expected results, an evaluation based on cost-effectiveness per analysis (or per patient) criteria. Finally, medical services are the tools of the marketing strategy of any medical organizations without which the needs and motivations of the beneficiaries (patients) could not be satisfied. In essence, the entire marketing philosophy is based on the needs and wishes of the people and on concrete solutions to solve them.

A strategy to identify opportunities for innovation in Romanian healthcare services

PubMed Central

Coculescu, BI; Purcărea, VL; Coculescu, EC

2015-01-01

In principle, the development of medicine (including the Romanian health system) is primarily dependent on the level of funding and the efficiency with which this funding is used, the structure of the population and socio-economic development of the geographical area concerned, and not least, the attitudes and expectations of patients, which in turn translate into care taking policies system. Unlike the other services, health services are accessed by a large number of people, which results into high health. As an economic principle, the fewer resources are used to achieve the expected results, the more effective the supplier. However, the introduction of new medical technologies, many of them more reliable yet more expensive, required a reassessment of the way resources are used at the suppliers’ level to produce the expected results, an evaluation based on cost-effectiveness per analysis (or per patient) criteria. Finally, medical services are the tools of the marketing strategy of any medical organizations without which the needs and motivations of the beneficiaries (patients) could not be satisfied. In essence, the entire marketing philosophy is based on the needs and wishes of the people and on concrete solutions to solve them. PMID:26351536

A cost-effectiveness analysis of two different repositioning strategies for the prevention of pressure ulcers.

PubMed

Marsden, Grace; Jones, Katie; Neilson, Julie; Avital, Liz; Collier, Mark; Stansby, Gerard

2015-12-01

To assess the cost effectiveness of two repositioning strategies and inform the 2014 National Institute for Health and Care Excellence clinical guideline recommendations on pressure ulcer prevention. Pressure ulcers are distressing events, caused when skin and underlying tissues are placed under pressure sufficient to impair blood supply. They can have a substantial impact on quality of life and have significant resource implications. Repositioning is a key prevention strategy, but can be resource intensive, leading to variation in practice. This economic analysis was conducted to identify the most cost-effective repositioning strategy for the prevention of pressure ulcers. The economic analysis took the form of a cost-utility model. The clinical inputs to the model were taken from a systematic review of clinical data. The population in the model was older people in a nursing home. The economic model was developed with members of the guideline development group and included costs borne by the UK National Health Service. Outcomes were expressed as costs and quality adjusted life years. Despite being marginally more clinically effective, alternating 2 and 4 hourly repositioning is not a cost-effective use of UK National Health Service resources (compared with 4 hourly repositioning) for this high risk group of patients at a cost-effectiveness threshold of £20,000 per quality adjusted life years. These results were used to inform the clinical guideline recommendations for those who are at high risk of developing pressure ulcers. © 2015 John Wiley & Sons Ltd.

A study to identify winning strategies for the business community during the next pandemic.

PubMed

Spriggs, Martin

2013-01-01

This study examines the relationship between the healthcare system and the corporate sector to answer the following research question: how does the healthcare system best prepare small to medium-sized businesses for the next pandemic influenza? Data were collected and collated through a literature review, electronic survey and semi-structured follow-up telephone interviews. The participants were businesses with membership in the Alberta Chambers of Commerce, a provincial lobby group in Alberta, Canada. The findings indicate strategies that were effective in minimising impact to the business community during the H1N1 pandemic and suggest areas for the business community to improve in preparation for the next pandemic influenza. Recommendations focus on establishing new links for communication between the business community and the healthcare sector and improving strategies to increase the resilience of small to medium-sized businesses for the next pandemic influenza.

Children with suspected craniosynostosis: a cost-effectiveness analysis of diagnostic strategies.

PubMed

Medina, L Santiago; Richardson, Randy R; Crone, Kerry

2002-07-01

Our purpose was to evaluate the clinical and economic impact of three evaluation strategies in children at different risks of craniosynostosis. A decision-analytic and cost-effectiveness model was constructed to compare three evaluation in strategies in children with suspected synostosis: no imaging, radiography (if abnormal, followed by three-dimensional CT [3D CT]), and 3D CT. Three risk groups were analyzed on the basis of the prevalence (pretest probability) of disease: low (completly healthy children; prevalence, 34/100,000), intermediate (healthy children with head deformity; prevalence, 1/115), and high risk (children with syndromic craniofacial disorders [i.e., Crouzon's syndrome or Apert's syndrome]; prevalence, 9-10/10). Test performance (sensitivity and specificity) of the evaluation strategies was obtained from the literature. Costs (not charge) estimates were obtained from the hospital cost-accounting database and from the Medicaid fee schedule. In the low-risk group, the radiographic and 3D CT strategies resulted in a cost per quality-adjusted life year (QALY) gained of more than $560,000. In the intermediate-risk group, the radiographic strategy resulted in a cost per QALY gained of $54,600. Three-dimensional CT was more effective than the two other strategies but at a higher cost-hence, with a cost per QALY gained of $374,200. In the high-risk group, 3D CT was the most effective strategy with a cost per QALY gained of $33,800. Less experienced radiologists and poor-quality studies increased the evaluation cost per QALY gained for all of the risk groups because of decreased effectiveness. Radiologic screening of completely healthy children (low risk) for synostosis is not warranted because of the high cost per QALY gained of the radiographic and 3D CT strategies. In healthy children with head deformity (intermediate risk), the radiographic strategy had a reasonable cost per QALY gained. Three-dimensional CT was more effective but had a high cost per

[Cost-effectiveness analysis and diet quality index applied to the WHO Global Strategy].

PubMed

Machado, Flávia Mori Sarti; Simões, Arlete Naresse

2008-02-01

To test the use of cost-effectiveness analysis as a decision making tool in the production of meals for the inclusion of the recommendations published in the World Health Organization's Global Strategy. Five alternative options for breakfast menu were assessed previously to their adoption in a food service at a university in the state of Sao Paulo, Southeastern Brazil, in 2006. Costs of the different options were based on market prices of food items (direct cost). Health benefits were estimated based on adaptation of the Diet Quality Index (DQI). Cost-effectiveness ratios were estimated by dividing benefits by costs and incremental cost-effectiveness ratios were estimated as cost differential per unit of additional benefit. The meal choice was based on health benefit units associated to direct production cost as well as incremental effectiveness per unit of differential cost. The analysis showed the most simple option with the addition of a fruit (DQI = 64 / cost = R$ 1.58) as the best alternative. Higher effectiveness was seen in the options with a fruit portion (DQI1=64 / DQI3=58 / DQI5=72) compared to the others (DQI2=48 / DQI4=58). The estimate of cost-effectiveness ratio allowed to identifying the best breakfast option based on cost-effectiveness analysis and Diet Quality Index. These instruments allow easy application easiness and objective evaluation which are key to the process of inclusion of public or private institutions under the Global Strategy directives.

Cost-Effectiveness of Chagas Disease Vector Control Strategies in Northwestern Argentina

PubMed Central

Vazquez-Prokopec, Gonzalo M.; Spillmann, Cynthia; Zaidenberg, Mario; Kitron, Uriel; Gürtler, Ricardo E.

2009-01-01

Background Control and prevention of Chagas disease rely mostly on residual spraying of insecticides. In Argentina, vector control shifted from a vertical to a fully horizontal strategy based on community participation between 1992 and 2004. The effects of such strategy on Triatoma infestans, the main domestic vector, and on disease transmission have not been assessed. Methods and Findings Based on retrospective (1993–2004) records from the Argentinean Ministry of Health for the Moreno Department, Northwestern Argentina, we performed a cost-effectiveness (CE) analysis and compared the observed CE of the fully horizontal vector control strategy with the expected CE for a vertical or a mixed (i.e., vertical attack phase followed by horizontal surveillance) strategy. Total direct costs (in 2004 US$) of the horizontal and mixed strategies were, respectively, 3.3 and 1.7 times lower than the costs of the vertical strategy, due to reductions in personnel costs. The estimated CE ratios for the vertical, mixed and horizontal strategies were US$132, US$82 and US$45 per averted human case, respectively. When per diems were excluded from the costs (i.e., simulating the decentralization of control activities), the CE of vertical, mixed and horizontal strategies was reduced to US$60, US$42 and US$32 per averted case, respectively. Conclusions and Significance The mixed strategy would have averted between 1.6 and 4.0 times more human cases than the fully horizontal strategy, and would have been the most cost-effective option to interrupt parasite transmission in the Department. In rural and dispersed areas where waning vertical vector programs cannot accomplish full insecticide coverage, alternative strategies need to be developed. If properly implemented, community participation represents not only the most appealing but also the most cost-effective alternative to accomplish such objectives. PMID:19156190

Effective and cost-effective clinical trial recruitment strategies for postmenopausal women in a community-based, primary care setting.

PubMed

Butt, Debra A; Lock, Michael; Harvey, Bart J

2010-09-01

Little evidence exists to guide investigators on the effectiveness and cost-effectiveness of various recruitment strategies in primary care research. The purpose of this study is to describe the effectiveness and cost-effectiveness of eight clinical trial recruitment methods for postmenopausal women in a community-based setting. A retrospective analysis of the yield and cost of eight different recruitment methods: 1) family physician (FP) recruiters, 2) FP referrals, 3) community presentations, 4) community events, 5) newsletters, 6) direct mailings, 7) posters, and 8) newspaper advertisements that were used to recruit postmenopausal women to a randomized clinical trial (RCT) evaluating the effectiveness of gabapentin in treating hot flashes. We recruited 197 postmenopausal women from a total of 904 screened, with 291 of the remainder being ineligible and 416 declining to participate. Of the 904 women screened, 34 (3.8%) were from FP recruiters and 35 (3.9%) were from other FP referrals while 612 (67.7%) resulted from newspaper advertisements. Of the 197 women enrolled, 141 (72%) were from newspaper advertisements, with 26 (13%) following next from posters. Word of mouth was identified as an additional unanticipated study recruitment strategy. Metropolitan newspaper advertising at $112.73 (Canadian) per enrolled participant and posters at $119.98 were found to be cost-effective recruitment methods. Newspaper advertisements were the most successful method to recruit postmenopausal women into a community-based, primary care RCT. Copyright 2010 Elsevier Inc. All rights reserved.

The Effect of a Course Management System (CMS)-Supported Strategy Instruction on EFL Reading Comprehension and Strategy Use

ERIC Educational Resources Information Center

Tsai, Yea-Ru; Talley, Paul C.

2014-01-01

This paper reports on the effect of a Moodle-supported strategy instruction on both reading comprehension and strategy use among EFL (English as a Foreign Language) students. Specific reading strategy training was first integrated into a Moodle system, which included reading exercises on problem identification, monitoring comprehension,…

Occupational Stress and Mental Health Symptoms: Examining the Moderating Effect of Work Recovery Strategies in Firefighters.

PubMed

Sawhney, Gargi; Jennings, Kristen S; Britt, Thomas W; Sliter, Michael T

2017-06-12

The goal of this research was to examine the moderating effect of work recovery strategies on the relationship between occupational stress experienced by firefighters and mental health symptoms. Work recovery strategies were identified through semistructured interviews with 20 firefighters and a literature search on recovery strategies. A total of 7 work recovery strategies emerged using the 2 methods: work-related talks, stress-related talks, time with coworkers/supervisor, exercise, recreational activities, relaxation, and mastery experiences. Using a prospective study design with a 1-month time interval in a sample of 268 firefighters, experienced occupational stress at Time 1 was positively related to mental health symptoms at Time 2. In addition, with the exception of spending time with coworkers/supervisor, exercise and mastery experiences, recovery strategies at Time 1 were negatively related to mental health symptoms at Time 2. Lastly, all work recovery strategies, except stress-related talks and relaxation, moderated the relationship between experienced occupational stress at Time 1 and mental health symptoms at Time 2. Specifically, the positive relationship between experienced occupational stress and mental health symptoms was stronger when firefighters engaged in low, rather than high, work recovery strategies. Implications for research and practice are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Identifying Effective Spelling Interventions Using a Brief Experimental Analysis and Extended Analysis

ERIC Educational Resources Information Center

McCurdy, Merilee; Clure, Lynne F.; Bleck, Amanda A.; Schmitz, Stephanie L.

2016-01-01

Spelling is an important skill that is crucial to effective written communication. In this study, brief experimental analysis procedures were used to examine spelling instruction strategies (e.g., whole word correction; word study strategy; positive practice; and cover, copy, and compare) for four students. In addition, an extended analysis was…

The effectiveness of recruitment strategies on general practitioner’s survey response rates – a systematic review

PubMed Central

2014-01-01

Background Low survey response rates in general practice are common and lead to loss of power, selection bias, unexpected budgetary constraints and time delays in research projects. Methods Objective: To assess the effectiveness of recruitment strategies aimed at increasing survey response rates among GPs. Design: Systematic review. Search methods: MEDLINE (OVIDSP, 1948-2012), EMBASE (OVIDSP, 1980-2012), Evidence Based Medicine Reviews (OVIDSP, 2012) and references of included papers were searched. Major search terms included GPs, recruitment strategies, response rates, and randomised controlled trials (RCT). Selection criteria: Cluster RCTs, RCTs and factorial trial designs that evaluate recruitment strategies aimed at increasing GP survey response rates. Data collection and analysis: Abstracts identified by the search strategy were reviewed and relevant articles were retrieved. Each full-text publication was examined to determine whether it met the predetermined inclusion criteria. Data extraction and study quality was assessed by using predetermined checklists. Results Monetary and nonmonetary incentives were more effective than no incentive with monetary incentives having a slightly bigger effect than nonmonetary incentives. Large incentives were more effective than small incentives, as were upfront monetary incentives compared to promised monetary incentives. Postal surveys were more effective than telephone or email surveys. One study demonstrated that sequentially mixed mode (online survey followed by a paper survey with a reminder) was more effective than an online survey or the combination of an online and paper survey sent similtaneously in the first mail out. Pre-contact with a phonecall from a peer, personalised packages, sending mail on Friday, and using registered mail also increased response rates in single studies. Pre-contact by letter or postcard almost reached statistical signficance. Conclusions GP survey response rates may improve by using the

Developing a conservation strategy to maximize persistence of an endangered freshwater mussel species while considering management effectiveness and cost

USGS Publications Warehouse

Smith, David R.; McRae, Sarah E.; Augspurger, Tom; Ratcliffe, Judith A.; Nichols, Robert B.; Eads, Chris B.; Savidge, Tim; Bogan, Arthur E.

2015-01-01

We used a structured decision-making process to develop conservation strategies to increase persistence of Dwarf Wedgemussel (Alasmidonta heterodon) in North Carolina, USA, while accounting for uncertainty in management effectiveness and considering costs. Alternative conservation strategies were portfolios of management actions that differed by location of management actions on the landscape. Objectives of the conservation strategy were to maximize species persistence, maintain genetic diversity, maximize public support, and minimize management costs. We compared 4 conservation strategies: 1) the ‘status quo’ strategy represented current management, 2) the ‘protect the best’ strategy focused on protecting the best populations in the Tar River basin, 3) the ‘expand the distribution’ strategy focused on management of extant populations and establishment of new populations in the Neuse River basin, and 4) the ‘hybrid’ strategy combined elements of each strategy to balance conservation in the Tar and Neuse River basins. A population model informed requirements for population management, and experts projected performance of alternative strategies over a 20-y period. The optimal strategy depended on the relative value placed on competing objectives, which can vary among stakeholders. The protect the best and hybrid strategies were optimal across a wide range of relative values with 2 exceptions: 1) if minimizing management cost was of overriding concern, then status quo was optimal, or 2) if maximizing population persistence in the Neuse River basin was emphasized, then expand the distribution strategy was optimal. The optimal strategy was robust to uncertainty in management effectiveness. Overall, the structured decision process can help identify the most promising strategies for endangered species conservation that maximize conservation benefit given the constraint of limited funding.

Korean American Parents’ Perceptions of Effective Parenting Strategies in the United States

PubMed Central

Kim, Eunjung; Hong, Seunghye; Rockett, Camille Mariko

2016-01-01

This study aimed to explore the perceptions of Korean American parents on effective parenting strategies taught in a standardized U.S. parenting program. Participants in the study were interviewed using semi-structured open-ended questions, and audio taped interview data were transcribed and analyzed using content analysis. Themes that emerged were: effective parenting strategies, impact of learning effective parenting strategies on parents, and learning effective parenting strategies: impact on children. Findings indicated that Korean American parents felt the program was based on Western parenting strategies but they were effective. They also believed the program strategies would be useful in regulating their emotions, increasing their abilities to be patient and consistent with their children, and helping them explore issues from their child’s perspective, all of which they believed improved their parenting self-efficacy and intimacy with their children. Additionally, parents reported that their children acquired more self-confidence, better self-expression, increased obedience and decreased misbehaviors, and increased emotion regulation and problem solving as a result of their participation in the program. These findings could contribute to develop an effective, culturally and linguistically relevant parenting program for Korean American parents. PMID:27188016

The Effect of Strategy on Problem Solving: An FMRI Study

ERIC Educational Resources Information Center

Newman, Sharlene D.; Pruce, Benjamin; Rusia, Akash; Burns, Thomas, Jr.

2010-01-01

fMRI was used to examine the differential effect of two problem-solving strategies. Participants were trained to use both a pictorial/spatial and a symbolic/algebraic strategy to solve word problems. While these two strategies activated similar cortical regions, a number of differences were noted in the level of activation. These differences…

Identifying Instructional Strategies Used to Design Mobile Learning in a Corporate Setting

ERIC Educational Resources Information Center

Jackson-Butler, Uletta

2016-01-01

The purpose of this qualitative embedded multiple case study was to describe what instructional strategies corporate instructional designers were using to design mobile learning and to understand from their experiences which instructional strategies they believed enhance learning. Participants were five instructional designers who were actively…

Identifying and Prioritizing Implementation Barriers, Gaps, and Strategies Through the Nigeria Implementation Science Alliance: Getting to Zero in the Prevention of Mother-to-Child Transmission of HIV.

PubMed

Ezeanolue, Echezona E; Powell, Byron J; Patel, Dina; Olutola, Ayodotun; Obiefune, Michael; Dakum, Patrick; Okonkwo, Prosper; Gobir, Bola; Akinmurele, Timothy; Nwandu, Anthea; Torpey, Kwasi; Oyeledum, Bolanle; Aina, Muyiwa; Eyo, Andy; Oleribe, Obinna; Ibanga, Ikoedem; Oko, John; Anyaike, Chukwuma; Idoko, John; Aliyu, Muktar H; Sturke, Rachel; Watts, Heather; Siberry, George

2016-08-01

In 2013, Nigeria accounted for 15% of the 1.3 million pregnant women living with HIV in sub-Saharan Africa and 26% of new infections among children worldwide. Despite this, less than 20% of pregnant women in Nigeria received an HIV test during pregnancy, and only 23% of HIV-infected pregnant women received appropriate intervention following HIV diagnosis. This article reports findings from 2 structured group exercises conducted at the first Nigeria Implementation Science Alliance Conference to identify (1) barriers and research gaps related to prevention of mother-to-child transmission (PMTCT) and (2) potential strategies and interventions that could address PMTCT challenges. Two 1-hour structured group exercises were conducted with 10 groups of 14-15 individuals (n = 145), who were asked to brainstorm barriers and strategies and to rank their top 3 in each category. Data analysis eliminated duplicate responses and categorized each of the priorities along the HIV care continuum: HIV diagnosis, linkage to care, or retention in care. Participating stakeholders identified 20 unique barriers and research gaps related to PMTCT across the HIV continuum. Twenty-five unique interventions and implementation strategies were identified. Similar to the barriers and research gaps, these interventions and strategies were distributed across the HIV care continuum. The barriers and strategies identified in this study represent important pathways to progress addressing MTCT. The deliberate involvement of state and federal policy makers, program implementers, and researchers helps ensure that they are relevant and actionable.

Possible Effects of Strategy Instruction on L1 and L2 Reading.

ERIC Educational Resources Information Center

Salataci, Reyhan; Akyel, Ayse

2002-01-01

Investigates the reading strategies of Turkish English-as-a-Foreign-Language (EFL) students in Turkish and English and the possible effects of reading instruction on reading in Turkish and English. Addresses whether strategy instruction in EFL reading effects EFL reading strategies and reading comprehension in English , and whether strategy…

Cost-effectiveness of prevention strategies for American tegumentary leishmaniasis in Argentina.

PubMed

Orellano, Pablo Wenceslao; Vazquez, Nestor; Salomon, Oscar Daniel

2013-12-01

The aim of this study was to estimate the cost-effectiveness of reducing tegumentary leishmaniasis transmission using insecticide-impregnated clothing and curtains, and implementing training programs for early diagnosis. A societal perspective was adopted, with outcomes assessed in terms of costs per disability adjusted life years (DALY). Simulation was structured as a Markov model and costs were expressed in American dollars (US$). The incremental cost-effectiveness ratio of each strategy was calculated. One-way and multivariate sensitivity analyses were performed. The incremental cost-effectiveness ratio for early diagnosis strategy was estimated at US$ 156.46 per DALY averted, while that of prevention of transmission with insecticide-impregnated curtains and clothing was US$ 13,155.52 per DALY averted. Both strategies were more sensitive to the natural incidence of leishmaniasis, to the effectiveness of mucocutaneous leishmaniasis treatment and to the cost of each strategy. Prevention of vectorial transmission and early diagnosis have proved to be cost-effective measures.

Psoriasis in childhood: effective strategies to improve treatment adherence

PubMed Central

Shah, Kara N; Cortina, Sandra; Ernst, Michelle M; Kichler, Jessica C

2015-01-01

Psoriasis is a relatively common chronic inflammatory skin disease in children for which there is no cure. Most children have mild disease that can be managed with topical therapy as opposed to phototherapy or systemic therapy. Despite the mild presentation of psoriasis in most children, the disease can have a significant impact on quality of life due to the need for ongoing treatment, the frequently visible nature of the cutaneous manifestations, and the social stigma that is associated with psoriasis. Adherence to treatment, in particular topical therapy, is often poor in adults and compromises response to therapy and medical provider management strategies. Multiple factors that may contribute to nonadherence in adults with psoriasis have been identified, including lack of education on the disease and expectations for management, issues related to ease of use and acceptability of topical medications, and anxiety regarding possible medication side effects. There is currently no published data on adherence in the pediatric psoriasis population; however, poor adherence is often suspected when patients fail to respond to appropriate therapy. General strategies used to assess adherence in other pediatric disease populations can be applied to children with psoriasis, and interventions that reflect experience in other chronic dermatologic disorders such as atopic dermatitis may also be helpful for medical providers caring for children with psoriasis. PMID:29387581

The effectiveness of a learning strategies program for university students.

PubMed

Roces Montero, Cristina; Sierra Y Arizmendiarrieta, Beatriz

2017-11-01

University lecturers often complain about their students’ lack of learning strategies, but not many universities in Spain offer specific courses in this area. Studies on their effectiveness are also rare. This study presents the results of a Learning Strategies Course implemented at the School of Teacher Training and Education, University of Oviedo, Spain. A quasi-experimental design was used with an experi-mental (n = 60) and a control group (n = 57) of students on the Educational Psychology course. A Spanish adaptation of the Motivated Strategies for Learning Questionnaire (MSLQ): the CEAMR2 was used as a pre and post-test measure. Group A (EG) received training in learning strategies, while group B (CG) received no training. Post-test measures showed significant differences in five out of the ten learning strategies assessed: elaboration, organization, repetition, self-questioning and study space, and also an improvement in one out of the six motivational scales: control of learning beliefs. The results suggest that learning strategies courses with proven effectiveness should be offered to university students.

[Determination of cost-effective strategies in colorectal cancer screening].

PubMed

Dervaux, B; Eeckhoudt, L; Lebrun, T; Sailly, J C

1992-01-01

The object of the article is to implement particular methodologies in order to determine which strategies are cost-effective in the mass screening of colorectal cancer after a positive Hemoccult test. The first approach to be presented consists in proposing a method which enables all the admissible diagnostic strategies to be determined. The second approach enables a minimal cost function to be estimated using an adaptation of "Data Envelopment Analysis". This method proves to be particularly successful in cost-efficiency analysis, when the performance indicators are numerous and hard to aggregate. The results show that there are two cost-effective strategies after a positive Hemoccult test: coloscopy and sigmoidoscopy; they put into question the relevance of double contrast barium enema in the diagnosis of colo-rectal lesions.

Sampling strategies for estimating brook trout effective population size

Treesearch

Andrew R. Whiteley; Jason A. Coombs; Mark Hudy; Zachary Robinson; Keith H. Nislow; Benjamin H. Letcher

2012-01-01

The influence of sampling strategy on estimates of effective population size (Ne) from single-sample genetic methods has not been rigorously examined, though these methods are increasingly used. For headwater salmonids, spatially close kin association among age-0 individuals suggests that sampling strategy (number of individuals and location from...

Gene Manipulation Strategies to Identify Molecular Regulators of Axon Regeneration in the Central Nervous System

PubMed Central

Ribas, Vinicius T.; Costa, Marcos R.

2017-01-01

Limited axon regeneration in the injured adult mammalian central nervous system (CNS) usually results in irreversible functional deficits. Both the presence of extrinsic inhibitory molecules at the injury site and the intrinsically low capacity of adult neurons to grow axons are responsible for the diminished capacity of regeneration in the adult CNS. Conversely, in the embryonic CNS, neurons show a high regenerative capacity, mostly due to the expression of genes that positively control axon growth and downregulation of genes that inhibit axon growth. A better understanding of the role of these key genes controlling pro-regenerative mechanisms is pivotal to develop strategies to promote robust axon regeneration following adult CNS injury. Genetic manipulation techniques have been widely used to investigate the role of specific genes or a combination of different genes in axon regrowth. This review summarizes a myriad of studies that used genetic manipulations to promote axon growth in the injured CNS. We also review the roles of some of these genes during CNS development and suggest possible approaches to identify new candidate genes. Finally, we critically address the main advantages and pitfalls of gene-manipulation techniques, and discuss new strategies to promote robust axon regeneration in the mature CNS. PMID:28824380

Nice or effective? Social problem solving strategies in patients with major depressive disorder.

PubMed

Thoma, Patrizia; Schmidt, Tobias; Juckel, Georg; Norra, Christine; Suchan, Boris

2015-08-30

Our study addressed distinct aspects of social problem solving in 28 hospitalized patients with Major Depressive Disorder (MDD) and 28 matched healthy controls. Three scenario-based tests assessed the ability to infer the mental states of story characters in difficult interpersonal situations, the capacity to freely generate good strategies for dealing with such situations and the ability to identify the best solutions among less optimal alternatives. Also, standard tests assessing attention, memory, executive function and trait empathy were administered. Compared to controls, MDD patients showed impaired interpretation of other peoples' sarcastic remarks but not of the mental states underlying other peoples' actions. Furthermore, MDD patients generated fewer strategies that were socially sensitive and practically effective at the same time or at least only socially sensitive. Overall, while the free generation of adequate strategies for difficult social situations was impaired, recognition of optimal solutions among alternatives was spared in MDD patients. Higher generation scores were associated with higher trait empathy and cognitive flexibility scores. We suggest that this specific pattern of impairments ought to be considered in the development of therapies addressing impaired social skills in MDD. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

A strategy for evaluating pathway analysis methods.

PubMed

Yu, Chenggang; Woo, Hyung Jun; Yu, Xueping; Oyama, Tatsuya; Wallqvist, Anders; Reifman, Jaques

2017-10-13

Researchers have previously developed a multitude of methods designed to identify biological pathways associated with specific clinical or experimental conditions of interest, with the aim of facilitating biological interpretation of high-throughput data. Before practically applying such pathway analysis (PA) methods, we must first evaluate their performance and reliability, using datasets where the pathways perturbed by the conditions of interest have been well characterized in advance. However, such 'ground truths' (or gold standards) are often unavailable. Furthermore, previous evaluation strategies that have focused on defining 'true answers' are unable to systematically and objectively assess PA methods under a wide range of conditions. In this work, we propose a novel strategy for evaluating PA methods independently of any gold standard, either established or assumed. The strategy involves the use of two mutually complementary metrics, recall and discrimination. Recall measures the consistency of the perturbed pathways identified by applying a particular analysis method to an original large dataset and those identified by the same method to a sub-dataset of the original dataset. In contrast, discrimination measures specificity-the degree to which the perturbed pathways identified by a particular method to a dataset from one experiment differ from those identifying by the same method to a dataset from a different experiment. We used these metrics and 24 datasets to evaluate six widely used PA methods. The results highlighted the common challenge in reliably identifying significant pathways from small datasets. Importantly, we confirmed the effectiveness of our proposed dual-metric strategy by showing that previous comparative studies corroborate the performance evaluations of the six methods obtained by our strategy. Unlike any previously proposed strategy for evaluating the performance of PA methods, our dual-metric strategy does not rely on any ground truth

Clinical multi-omics strategies for the effective cancer management.

PubMed

Yoo, Byong Chul; Kim, Kyung-Hee; Woo, Sang Myung; Myung, Jae Kyung

2017-08-15

Cancer is a global health issue as a multi-factorial complex disease, and early detection and novel therapeutic strategies are required for more effective cancer management. With the development of systemic analytical -omics strategies, the therapeutic approach and study of the molecular mechanisms of carcinogenesis and cancer progression have moved from hypothesis-driven targeted investigations to data-driven untargeted investigations focusing on the integrated diagnosis, treatment, and prevention of cancer in individual patients. Predictive, preventive, and personalized medicine (PPPM) is a promising new approach to reduce the burden of cancer and facilitate more accurate prognosis, diagnosis, as well as effective treatment. Here we review the fundamentals of, and new developments in, -omics technologies, together with the key role of a variety of practical -omics strategies in PPPM for cancer treatment and diagnosis. In this review, a comprehensive and critical overview of the systematic strategy for predictive, preventive, and personalized medicine (PPPM) for cancer disease was described in a view of cancer prognostic prediction, diagnostics, and prevention as well as cancer therapy and drug responses. We have discussed multi-dimensional data obtained from various resources and integration of multisciplinary -omics strategies with computational method which could contribute the more effective PPPM for cancer. This review has provided the novel insights of the current applications of each and combined -omics technologies, which showed their powerful potential for the establishment of PPPM for cancer. Copyright © 2017 Elsevier B.V. All rights reserved.

IARC classes 1 and 2 carcinogens are successfully identified by an alternative strategy that detects DNA-reactivity and cell transformation ability of chemicals.

PubMed

Benigni, Romualdo; Bossa, Cecilia; Battistelli, Chiara Laura; Tcheremenskaia, Olga

2013-12-12

For decades, traditional toxicology has been the ultimate source of information on the carcinogenic potential of chemicals; however with increasing demand on regulation of chemicals and decreasing resources for testing, opportunities to accept "alternative" approaches have dramatically expanded. The need for tools able to identify carcinogens in shorter times and at a lower cost in terms of animal lives and money is still an open issue, and the present strategies and regulations for carcinogenicity pre-screening do not adequately protect human health. In previous papers, we have proposed an integrated in vitro/in silico strategy that detects DNA-reactivity and tissue disorganization/disruption by chemicals, and we have shown that the combination of Salmonella and Structural Alerts for the DNA-reactive carcinogens, and in vitro cell transformation assays for nongenotoxic carcinogens permits the identification of a very large proportion (up to 95%) of rodent carcinogens, while having a considerable specificity with the rodent noncarcinogens. In the present paper we expand the previous investigation and show that this alternative strategy identifies correctly IARC Classes 1 and 2 carcinogens. If implemented, this alternative strategy can contribute to improve the protection of human health while decreasing the use of animals. Copyright © 2013 Elsevier B.V. All rights reserved.

Cost-effectiveness of prenatal screening strategies for congenital heart disease.

PubMed

Pinto, N M; Nelson, R; Puchalski, M; Metz, T D; Smith, K J

2014-07-01

The economic implications of strategies to improve prenatal screening for congenital heart disease (CHD) in low-risk mothers have not been explored. The aim was to perform a cost-effectiveness analysis of different screening methods. We constructed a decision analytic model of CHD prenatal screening strategies (four-chamber screen (4C), 4C + outflow, nuchal translucency (NT) or fetal echocardiography) populated with probabilities from the literature. The model included whether initial screens were interpreted by a maternal-fetal medicine (MFM) specialist and different referral strategies if they were read by a non-MFM specialist. The primary outcome was the incremental cost per defect detected. Costs were obtained from Medicare National Fee estimates. A probabilistic sensitivity analysis was undertaken on model variables commensurate with their degree of uncertainty. In base-case analysis, 4C + outflow referred to an MFM specialist was the least costly strategy per defect detected. The 4C screen and the NT screen were dominated by other strategies (i.e. were more costly and less effective). Fetal echocardiography was the most effective, but most costly. On simulation of 10 000 low-risk pregnancies, 4C + outflow screen referred to an MFM specialist remained the least costly per defect detected. For an additional $580 per defect detected, referral to cardiology after a 4C + outflow was the most cost-effective for the majority of iterations, increasing CHD detection by 13 percentage points. The addition of examination of the outflow tracts to second-trimester ultrasound increases detection of CHD in the most cost-effective manner. Strategies to improve outflow-tract imaging and to refer with the most efficiency may be the best way to improve detection at a population level. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd.

Cost-effectiveness of strategies used in the evaluation of pregnancies complicated by elevated maternal serum alpha-fetoprotein levels.

PubMed

Nadel, A S; Norton, M E; Wilkins-Haug, L

1997-05-01

To perform a cost-effectiveness analysis of various protocols used in the diagnostic evaluation of pregnancies complicated by elevated levels of maternal serum alpha-fetoprotein (MSAFP). The variables incorporated in this model were the prevalence of relevant fetal anomalies; the sensitivity and specificity of MSAFP at 2.0 or 2.5 multiples of the median (MoM); and the sensitivity, specificity, cost, and safety of targeted ultrasound and amniocentesis. We expressed the cost-effectiveness of each strategy as the total cost of the diagnostic evaluation divided by the number of anomalous fetuses identified, yielding the cost per identified anomalous fetus. In a hypothetical cohort of 100,000 singleton pregnancies, a strategy of targeted ultrasound for MSAFP of at least 2.0 MoM detected 90 of 110 structurally abnormal fetuses, without iatrogenic fetal loss, at a cost of $5700 per anomalous fetus. A strategy of amniocentesis with karyo-type determination for MSAFP of at least 2.5 MoM detected 15 additional abnormal fetuses (87 structural abnormalities, ten autosomal aneuploidies, and eight sex chromosomal aneuploidies), with nine iatrogenic fetal losses, at an incremental cost of $46,100 per anomalous fetus. The increased cost and iatrogenic fetal loss rate may not justify the increased diagnostic yield of amniocentesis as compared with ultrasound in the evaluation of pregnancies complicated by elevated MSAFP.

Mold prevention strategies and possible health effects in the aftermath of hurricanes and major floods.

PubMed

Brandt, Mary; Brown, Clive; Burkhart, Joe; Burton, Nancy; Cox-Ganser, Jean; Damon, Scott; Falk, Henry; Fridkin, Scott; Garbe, Paul; McGeehin, Mike; Morgan, Juliette; Page, Elena; Rao, Carol; Redd, Stephen; Sinks, Tom; Trout, Douglas; Wallingford, Kenneth; Warnock, David; Weissman, David

2006-06-09

Extensive water damage after major hurricanes and floods increases the likelihood of mold contamination in buildings. This report provides information on how to limit exposure to mold and how to identify and prevent mold-related health effects. Where uncertainties in scientific knowledge exist, practical applications designed to be protective of a person's health are presented. Evidence is included about assessing exposure, clean-up and prevention, personal protective equipment, health effects, and public health strategies and recommendations. The recommendations assume that, in the aftermath of major hurricanes or floods, buildings wet for <48 hours will generally support visible and extensive mold growth and should be remediated, and excessive exposure to mold-contaminated materials can cause adverse health effects in susceptible persons regardless of the type of mold or the extent of contamination. For the majority of persons, undisturbed mold is not a substantial health hazard. Mold is a greater hazard for persons with conditions such as impaired host defenses or mold allergies. To prevent exposure that could result in adverse health effects from disturbed mold, persons should 1) avoid areas where mold contamination is obvious; 2) use environmental controls; 3) use personal protective equipment; and 4) keep hands, skin, and clothing clean and free from mold-contaminated dust. Clinical evaluation of suspected mold-related illness should follow conventional clinical guidelines. In addition, in the aftermath of extensive flooding, health-care providers should be watchful for unusual mold-related diseases. The development of a public health surveillance strategy among persons repopulating areas after extensive flooding is recommended to assess potential health effects and the effectiveness of prevention efforts. Such a surveillance program will help CDC and state and local public health officials refine the guidelines for exposure avoidance, personal protection

Getting men in the room: perceptions of effective strategies to initiate men's involvement in gender-based violence prevention in a global sample.

PubMed

Casey, Erin A; Leek, Cliff; Tolman, Richard M; Allen, Christopher T; Carlson, Juliana M

2017-09-01

As engaging men in gender-based violence prevention efforts becomes an increasingly institutionalised component of gender equity work globally, clarity is needed about the strategies that best initiate male-identified individuals' involvement in these efforts. The purpose of this study was to examine the perceived relevance and effectiveness of men's engagement strategies from the perspective of men around the world who have organised or attended gender-based violence prevention events. Participants responded to an online survey (available in English, French and Spanish) and rated the effectiveness of 15 discrete engagement strategies derived from earlier qualitative work. Participants also provided suggestions regarding strategies in open-ended comments. Listed strategies cut across the social ecological spectrum and represented both venues in which to reach men, and the content of violence prevention messaging. Results suggest that all strategies, on average, were perceived as effective across regions of the world, with strategies that tailor messaging to topics of particular concern to men (such as fatherhood and healthy relationships) rated most highly. Open-ended comments also surfaced tensions, particularly related to the role of a gender analysis in initial men's engagement efforts. Findings suggest the promise of cross-regional adaptation and information sharing regarding successful approaches to initiating men's anti-violence involvement.

The Effects of Physical Manipulatives on Children's Numerical Strategies

ERIC Educational Resources Information Center

Manches, Andrew; O'Malley, Claire

2016-01-01

This article focuses on how the representational properties of manipulatives affect the strategies children employ in problem solving. Two studies examined the effect of physical materials on 4-7-year-old children's problem solving strategies in a numerical (i.e., additive composition) task. The first study showed how children not only identified…

Three novel approaches to structural identifiability analysis in mixed-effects models.

PubMed

Janzén, David L I; Jirstrand, Mats; Chappell, Michael J; Evans, Neil D

2016-05-06

Structural identifiability is a concept that considers whether the structure of a model together with a set of input-output relations uniquely determines the model parameters. In the mathematical modelling of biological systems, structural identifiability is an important concept since biological interpretations are typically made from the parameter estimates. For a system defined by ordinary differential equations, several methods have been developed to analyse whether the model is structurally identifiable or otherwise. Another well-used modelling framework, which is particularly useful when the experimental data are sparsely sampled and the population variance is of interest, is mixed-effects modelling. However, established identifiability analysis techniques for ordinary differential equations are not directly applicable to such models. In this paper, we present and apply three different methods that can be used to study structural identifiability in mixed-effects models. The first method, called the repeated measurement approach, is based on applying a set of previously established statistical theorems. The second method, called the augmented system approach, is based on augmenting the mixed-effects model to an extended state-space form. The third method, called the Laplace transform mixed-effects extension, is based on considering the moment invariants of the systems transfer function as functions of random variables. To illustrate, compare and contrast the application of the three methods, they are applied to a set of mixed-effects models. Three structural identifiability analysis methods applicable to mixed-effects models have been presented in this paper. As method development of structural identifiability techniques for mixed-effects models has been given very little attention, despite mixed-effects models being widely used, the methods presented in this paper provides a way of handling structural identifiability in mixed-effects models previously not

The Effect of Using a Proposed Teaching Strategy Based on the Selective Thinking on Students' Acquisition Concepts in Mathematics

ERIC Educational Resources Information Center

Qudah, Ahmad Hassan

2016-01-01

This study aimed at identify the effect of using a proposed teaching strategy based on the selective thinking in acquire mathematical concepts by Classroom Teacher Students at Al- al- Bayt University, The sample of the study consisted of (74) students, equally distributed into a control group and an experimental group. The selective thinking…

ADHD in the Classroom: Effective Intervention Strategies

ERIC Educational Resources Information Center

DuPaul, George J.; Weyandt, Lisa L.; Janusis, Grace M.

2011-01-01

School-related difficulties are commonly associated with attention deficit hyperactivity disorder (ADHD). This article describes effective school-based intervention strategies including behavioral interventions, modifications to academic instruction, and home-school communication programs. One overlooked aspect of treatment of children with ADHD…

Testing the effectiveness of simplified search strategies for updating systematic reviews.

PubMed

Rice, Maureen; Ali, Muhammad Usman; Fitzpatrick-Lewis, Donna; Kenny, Meghan; Raina, Parminder; Sherifali, Diana

2017-08-01

The objective of the study was to test the overall effectiveness of a simplified search strategy (SSS) for updating systematic reviews. We identified nine systematic reviews undertaken by our research group for which both comprehensive and SSS updates were performed. Three relevant performance measures were estimated, that is, sensitivity, precision, and number needed to read (NNR). The update reference searches for all nine included systematic reviews identified a total of 55,099 citations that were screened resulting in final inclusion of 163 randomized controlled trials. As compared with reference search, the SSS resulted in 8,239 hits and had a median sensitivity of 83.3%, while precision and NNR were 4.5 times better. During analysis, we found that the SSS performed better for clinically focused topics, with a median sensitivity of 100% and precision and NNR 6 times better than for the reference searches. For broader topics, the sensitivity of the SSS was 80% while precision and NNR were 5.4 times better compared with reference search. SSS performed well for clinically focused topics and, with a median sensitivity of 100%, could be a viable alternative to a conventional comprehensive search strategy for updating this type of systematic reviews particularly considering the budget constraints and the volume of new literature being published. For broader topics, 80% sensitivity is likely to be considered too low for a systematic review update in most cases, although it might be acceptable if updating a scoping or rapid review. Copyright © 2017 Elsevier Inc. All rights reserved.

Identifying Links Between Sexual Violence and Youth Violence Perpetration: New Opportunities for Sexual Violence Prevention

PubMed Central

DeGue, Sarah; Massetti, Greta M.; Holt, Melissa K.; Tharp, Andra Teten; Valle, Linda Anne; Matjasko, Jennifer L.; Lippy, Caroline

2018-01-01

Objective One promising opportunity for advancing sexual violence (SV) research and identifying new avenues for prevention involves examining other forms of violence that may share risk factors with SV. Youth violence (YV) is ideal for consideration given evidence of overlap in SV and YV risk factors, a large set of established YV risk factors across the social ecology, and the number of evidence-based YV prevention strategies available. The current paper identifies shared and unique risk factors for SV and YV and highlights evidence-based YV prevention strategies that impact these shared risk factors. Conclusions Researchers and program developers should consider adapting and evaluating evidence-based YV prevention strategies to prevent SV. Modifying these programs to address SV’s unique risk factors may maximize their potential effectiveness. In addition, expanding SV research at the outer levels of the social ecology is critical to developing community-level prevention strategies. The YV literature suggests several potential risk factors at these levels in need of research for SV, including school connectedness, social disorganization, and availability of alcohol and drugs. Using the YV literature as a starting point for expanding SV research leverages prior investments in YV research, may help identify new SV prevention strategies at a limited cost, and moves the field more quickly toward implementation of cost-effective, multidomain violence prevention strategies in communities. PMID:29644117

Task-selective memory effects for successfully implemented encoding strategies.

PubMed

Leshikar, Eric D; Duarte, Audrey; Hertzog, Christopher

2012-01-01

Previous behavioral evidence suggests that instructed strategy use benefits associative memory formation in paired associate tasks. Two such effective encoding strategies--visual imagery and sentence generation--facilitate memory through the production of different types of mediators (e.g., mental images and sentences). Neuroimaging evidence suggests that regions of the brain support memory reflecting the mental operations engaged at the time of study. That work, however, has not taken into account self-reported encoding task success (i.e., whether participants successfully generated a mediator). It is unknown, therefore, whether task-selective memory effects specific to each strategy might be found when encoding strategies are successfully implemented. In this experiment, participants studied pairs of abstract nouns under either visual imagery or sentence generation encoding instructions. At the time of study, participants reported their success at generating a mediator. Outside of the scanner, participants further reported the quality of the generated mediator (e.g., images, sentences) for each word pair. We observed task-selective memory effects for visual imagery in the left middle occipital gyrus, the left precuneus, and the lingual gyrus. No such task-selective effects were observed for sentence generation. Intriguingly, activity at the time of study in the left precuneus was modulated by the self-reported quality (vividness) of the generated mental images with greater activity for trials given higher ratings of quality. These data suggest that regions of the brain support memory in accord with the encoding operations engaged at the time of study.

Reviewing the evidence on effectiveness and cost-effectiveness of HIV prevention strategies in Thailand.

PubMed

Pattanaphesaj, Juntana; Teerawattananon, Yot

2010-07-07

Following universal access to antiretroviral therapy in Thailand, evidence from National AIDS Spending Assessment indicates a decreasing proportion of expenditure on prevention interventions. To prompt policymakers to revitalize HIV prevention, this study identifies a comprehensive list of HIV/AIDs preventive interventions that are likely to be effective and cost-effective in Thailand. A systematic review of the national and international literature on HIV prevention strategies from 1997 to 2008 was undertaken. The outcomes used to consider the effectiveness of HIV prevention interventions were changes in HIV risk behaviour and HIV incidence. Economic evaluations that presented their results in terms of cost per HIV infection averted or cost per quality-adjusted life year (QALY) gained were also included. All studies were assessed against quality criteria. The findings demonstrated that school based-sex education plus life-skill programs, voluntary and routine HIV counselling and testing, male condoms, street outreach programs, needle and syringe programs, programs for the prevention of mother-to-child HIV transmission, male circumcision, screening blood products and donated organs for HIV, and increased alcohol tax were all effective in reducing HIV infection among target populations in a cost-effective manner. We found very limited local evidence regarding the effectiveness of HIV interventions amongst specific high risk populations. This underlines the urgent need to prioritise health research resources to assess the effectiveness and cost-effectiveness of HIV interventions aimed at reducing HIV infection among high risk groups in Thailand.

Reducing disaster risk in rural Arctic communities through effective communication strategies

NASA Astrophysics Data System (ADS)

Kontar, Y. Y.

2015-12-01

Communication is the process of exchanging and relaying vital information that has bearing on the effectiveness of all phases of emergency management: mitigation, preparedness, response, and recovery, making it one of the most important activities in disasters. Lack of communication between emergency managers, policy makers, and communities at risk may result in an inability to accurately identify disaster risk, and failure to determine priorities during a hazard event. Specific goals of communication change during the four phases of emergency management. Consequently, the communication strategy changes as well. Communication strategy also depends on a variety of attitudinal and motivational characteristics of the population at risk, as well as socioeconomic, cultural, and geographical features of the disaster-prone region. In May 2013, insufficient communication patterns between federal, state, tribal agencies, and affected communities significantly contributed to delays in the flood response and recovery in several rural villages along the Yukon River in central Alaska. This case study finds that long term dialogue is critical for managing disaster risk and increasing disaster resilience in rural Northern communities. It introduces new ideas and highlights best practices in disaster communication.

Using Visual Metaphors in Health Messages: A Strategy to Increase Effectiveness for Mental Illness Communication.

PubMed

Lazard, Allison J; Bamgbade, Benita A; Sontag, Jennah M; Brown, Carolyn

2016-12-01

Depression is highly prevalent among college students. Although treatment is often available on university campuses, many stigma-based barriers prevent students from seeking help. Communication strategies, such as the use of metaphors, are needed to reduce barriers. Specially, the use of visual metaphors, as a strategic message design tactic, may be an effective communication strategy to increase message appeal and engagement. Using a 2-phase approach, this study first identified common metaphors students use to conceptualize mental illness. Messages incorporating conceptual and visual metaphors were then designed and tested to determine their potential in reducing stigma. Participants (n = 256) were randomly assigned to 1 of 4 conditions in a between-subjects experiment: messages with visual and textual metaphors, messages with straightforward visuals and textual metaphors, text-based metaphor messages, or a control group. Overall, metaphorical messages are appealing, the use of visual metaphors leads to greater message engagement, and messages based on conceptual metaphors have the potential to reduce stigma. The use of conceptual and visual metaphors in campaign design is an effective strategy to communicate about a complex health topic, such as mental illness, and should be considered for use in campaigns to reduce barriers for help-seeking behavior.

The Effects of Program Embedded Learning Strategies, Using an Imagery Cue Strategy and an Attention Directing Strategy, to Improve Learning from Micro Computer Based Instruction (MCBI).

ERIC Educational Resources Information Center

Taylor, William; And Others

The effects of the Attention Directing Strategy and Imagery Cue Strategy as program embedded learning strategies for microcomputer-based instruction (MCBI) were examined in this study. Eight learning conditions with identical instructional content on the parts and operation of the human heart were designed: either self-paced or externally-paced,…

Effective behavioural strategies for reducing disgust in contamination-related OCD: A review.

PubMed

Ludvik, Dominika; Boschen, Mark J; Neumann, David L

2015-12-01

Disgust is an understudied but important emotion in various psychological disorders. Over the last decade, increasing evidence suggests that disgust is also present in various subtypes of obsessive-compulsive disorder (OCD), especially in contamination-related OCD (C-OCD). The treatment of choice for C-OCD is exposure with response prevention, originally designed to reduce fear-associated emotions thought to be acquired through Pavlovian conditioning (PC). However, disgust has been proposed to be acquired through evaluative conditioning (EC) and according to the referential model of this form of learning, there are functional differences between PC and EC that need to be considered in the treatment of disgust-related responses. Alternative strategies suggested by EC-based models include counterconditioning (contingent presentation of the CS with a US of opposite valence) and US revaluation (contingent presentation of the US with US of opposite valence). Drawing on the referential model, this paper reviews evidence for the effectiveness of each strategy to identify the most theoretically sound and empirically valid intervention to reduce disgust in C-OCD. Copyright © 2015 Elsevier Ltd. All rights reserved.

The effect of hospital control strategies on physician satisfaction and physician-hospital conflict.

PubMed Central

Burns, L R; Andersen, R M; Shortell, S M

1990-01-01

This article examines several strategies that hospitals use to control their medical staffs. Such strategies include placing physicians on salary, developing exclusive hospital affiliations with physicians, and involving physicians in decision-making bodies. Using regression techniques, we investigate which hospitals are more likely to utilize these strategies and whether such strategies are effective in promoting physician-hospital integration. Contrary to our expectations, corporate hospital structures (e.g., for-profit hospitals, membership in multihospital systems) generally do not employ these strategies more often and oftentimes employ them less. There is also little evidence that control strategies are effective levers for increasing physician satisfaction or decreasing physician-hospital conflict. We suggest that control strategies are useful for purposes other than promoting physician-hospital integration. Finally, hospital ownership appears to exert the biggest effect on physician satisfaction and conflict. PMID:2380074

Effective Strategies for Sustaining Professional Learning Communities

ERIC Educational Resources Information Center

Bennett, Patricia R.

2010-01-01

Professional Learning Communities (PLCs), in which educators work collaboratively to improve learning for students, need effective strategies to sustain them. PLCs promote continuous improvement in student learning and build academic success with increased teacher expertise. Grounded in organizational systems theory, participative leadership…

Societal costs in displaced transverse olecranon fractures: using decision analysis tools to find the most cost-effective strategy between tension band wiring and locked plating.

PubMed

Francis, Tittu; Washington, Travis; Srivastava, Karan; Moutzouros, Vasilios; Makhni, Eric C; Hakeos, William

2017-11-01

Tension band wiring (TBW) and locked plating are common treatment options for Mayo IIA olecranon fractures. Clinical trials have shown excellent functional outcomes with both techniques. Although TBW implants are significantly less expensive than a locked olecranon plate, TBW often requires an additional operation for implant removal. To choose the most cost-effective treatment strategy, surgeons must understand how implant costs and return to the operating room influence the most cost-effective strategy. This cost-effective analysis study explored the optimal treatment strategies by using decision analysis tools. An expected-value decision tree was constructed to estimate costs based on the 2 implant choices. Values for critical variables, such as implant removal rate, were obtained from the literature. A Monte Carlo simulation consisting of 100,000 trials was used to incorporate variability in medical costs and implant removal rates. Sensitivity analysis and strategy tables were used to show how different variables influence the most cost-effective strategy. TBW was the most cost-effective strategy, with a cost savings of approximately $1300. TBW was also the dominant strategy by being the most cost-effective solution in 63% of the Monte Carlo trials. Sensitivity analysis identified implant costs for plate fixation and surgical costs for implant removal as the most sensitive parameters influencing the cost-effective strategy. Strategy tables showed the most cost-effective solution as 2 parameters vary simultaneously. TBW is the most cost-effective strategy in treating Mayo IIA olecranon fractures despite a higher rate of return to the operating room. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Strategies for sustaining effective conservation partnerships

USGS Publications Warehouse

Alden, H.R.; Schroeder, R.L.

1998-01-01

Resource management partnerships among a wide variety of agencies and private groups are increasing in number across the country. The Colorado Rockies Regional Cooperative represents an early example of a grassroots effort of 14 partners to cooperate in the areas of research, education, and resource management. The cooperative conducted a survey of existing resource management partners and partnerships to determine what is necessary to establish and sustain effective partnerships. Survey findings, recent literature, and the experience of the Colorado Rockies Regional Cooperative suggest specific strategies for sustaining effective resource management partnerships.

Strategies, Protections and Mitigations for Electric Grid from Electromagnetic Pulse Effects

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

Foster, Rita Ann; Frickey, Steven Jay

2016-01-01

The mission of DOE’s Office of Electricity Delivery and Energy Reliability (OE) is to lead national efforts to modernize the electricity delivery system, enhance the security and reliability of America’s energy infrastructure and facilitate recovery from disruptions to the energy supply. One of the threats OE is concerned about is a high-altitude electro-magnetic pulse (HEMP) from a nuclear explosion and eletro-magnetic pulse (EMP) or E1 pulse can be generated by EMP weapons. DOE-OE provides federal leadership and technical guidance in addressing electric grid issues. The Idaho National Laboratory (INL) was chosen to conduct the EMP study for DOE-OE due tomore » its capabilities and experience in setting up EMP experiments on the electric grid and conducting vulnerability assessments and developing innovative technology to increase infrastructure resiliency. This report identifies known impacts to EMP threats, known mitigations and effectiveness of mitigations, potential cost of mitigation, areas for government and private partnerships in protecting the electric grid to EMP, and identifying gaps in our knowledge and protection strategies.« less

Keeping Our Students: Identifying Factors that Influence Student Withdrawal and Strategies to Enhance the Experience and Retention of First-Year Students

ERIC Educational Resources Information Center

Parmar, Deeba; Trotter, Eileen

2004-01-01

This article derives from local research at two UK universities as part of their institutional strategies to address retention and progression and enhance their students' experiences of higher education. In both Middlesex University and the University of Salford, research has been undertaken to identify factors which influence the retention and…

Recruitment strategies for an osteoporosis clinical trial: analysis of effectiveness.

PubMed

Heard, Allison; March, Rachel; Maguire, Patricia; Reilly, Penny; Helmore, Joy; Cameron, Sheryl; Frampton, Christopher; Nicholls, Gary; Gilchrist, Nigel

2012-09-01

To examine the effectiveness of a planned rapid recruitment strategy in an osteoporosis clinical trial. Multiple recruitment methods were explored, including media advertising, searching bone density scan and X-ray results in specialist and primary practice databases, community initiatives, and generation of research centre and study-specific pamphlets. Of 246 women screened, 41 consenting to the study, only 14 were randomised. Thus, 232 (94%) volunteers were screen failures, ineligible or declined to participate. With regard to the cost-effectiveness of all recruitment strategies, searching the research centre database was the most successful, with four women randomised at a cost of approximately NZ$302 per volunteer. Other strategies were less cost-effective. Obtaining a specific study cohort can be achieved by a comprehensive, targeted, rapid recruitment program. A research centre database search was the most successful and cost-effective recruitment modality in this small study. © 2012 Canterbury Geriatric Medical Research Trust. Australasian Journal on Ageing © 2012 ACOTA.

Evaluation Methods Basis of Strategy Development Effectiveness of the Enterprise

ERIC Educational Resources Information Center

Zotova, Anna S.; Kandrashina, Elena A.; Ivliev, Andrey D.; Charaeva, Marina V.

2016-01-01

The urgency to study the problem is caused by the necessity to make management decisions in terms of reducing goods life cycle, reducing profitability of production, increasing speed of technological progress. In this context, this article aims to identify and elaborate the tools for integrated diagnostic of strategy efficiency, taking into…

Career Education. Administrators and Counselors Implementation Model. Module III--Teacher Information and Orientation for Administrators. (3.1) Identify Change Strategy.

ERIC Educational Resources Information Center

Thompson, John A.; Chock, Mona K.O.

Part of a 13-volume series designed to be used as a group inservice or a self-learning system to train school administrators and counselors for their role in career education, this section of module 3 is designed to identify change strategies to help the principal motivate teachers to accept the concept of career education. (Module 3 is one of six…

POEM: Identifying Joint Additive Effects on Regulatory Circuits.

PubMed

Botzman, Maya; Nachshon, Aharon; Brodt, Avital; Gat-Viks, Irit

2016-01-01

Expression Quantitative Trait Locus (eQTL) mapping tackles the problem of identifying variation in DNA sequence that have an effect on the transcriptional regulatory network. Major computational efforts are aimed at characterizing the joint effects of several eQTLs acting in concert to govern the expression of the same genes. Yet, progress toward a comprehensive prediction of such joint effects is limited. For example, existing eQTL methods commonly discover interacting loci affecting the expression levels of a module of co-regulated genes. Such "modularization" approaches, however, are focused on epistatic relations and thus have limited utility for the case of additive (non-epistatic) effects. Here we present POEM (Pairwise effect On Expression Modules), a methodology for identifying pairwise eQTL effects on gene modules. POEM is specifically designed to achieve high performance in the case of additive joint effects. We applied POEM to transcription profiles measured in bone marrow-derived dendritic cells across a population of genotyped mice. Our study reveals widespread additive, trans-acting pairwise effects on gene modules, characterizes their organizational principles, and highlights high-order interconnections between modules within the immune signaling network. These analyses elucidate the central role of additive pairwise effect in regulatory circuits, and provide computational tools for future investigations into the interplay between eQTLs. The software described in this article is available at csgi.tau.ac.il/POEM/.

Effective Spelling Strategies for Students with Dyslexia in Hong Kong Secondary Schools

ERIC Educational Resources Information Center

Wai, Nicole; Chan, Ying; Zhang, Kaili Chen

2014-01-01

This study examines the effectiveness of five spelling strategies used to teach junior secondary school students with dyslexia. Participants were 30 secondary school teachers in Hong Kong. The teachers commented on five spelling strategies: the phonological strategy, an integration of phonological and orthographical strategies, the rule-based…

The effectiveness of policy and health education strategies for reducing adolescent smoking: a review of the evidence.

PubMed

Willemsen, M C; De Zwart, W M

1999-10-01

This paper identifies the most effective measures to prevent smoking among adolescents. A review was made of the international literature concerning a ban on tobacco advertising, restrictions on sales to youth, product regulation, price increase of cigarettes and educational strategies. It is concluded that isolated measures produce little effect. Most effect may be expected from a combination of a complete ban on tobacco advertising, increasing prices, restricting tobacco product sales to tobacconists, mass media education aimed at youth and intensifying school education. A less effective measure is limiting the age at which adolescents are allowed to buy cigarettes. Copyright 1999 The Association for Professionals in Services for Adolescents.

Cost-Effectiveness of HBV and HCV Screening Strategies – A Systematic Review of Existing Modelling Techniques

PubMed Central

Geue, Claudia; Wu, Olivia; Xin, Yiqiao; Heggie, Robert; Hutchinson, Sharon; Martin, Natasha K.; Fenwick, Elisabeth; Goldberg, David

2015-01-01

Introduction Studies evaluating the cost-effectiveness of screening for Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) are generally heterogeneous in terms of risk groups, settings, screening intervention, outcomes and the economic modelling framework. It is therefore difficult to compare cost-effectiveness results between studies. This systematic review aims to summarise and critically assess existing economic models for HBV and HCV in order to identify the main methodological differences in modelling approaches. Methods A structured search strategy was developed and a systematic review carried out. A critical assessment of the decision-analytic models was carried out according to the guidelines and framework developed for assessment of decision-analytic models in Health Technology Assessment of health care interventions. Results The overall approach to analysing the cost-effectiveness of screening strategies was found to be broadly consistent for HBV and HCV. However, modelling parameters and related structure differed between models, producing different results. More recent publications performed better against a performance matrix, evaluating model components and methodology. Conclusion When assessing screening strategies for HBV and HCV infection, the focus should be on more recent studies, which applied the latest treatment regimes, test methods and had better and more complete data on which to base their models. In addition to parameter selection and associated assumptions, careful consideration of dynamic versus static modelling is recommended. Future research may want to focus on these methodological issues. In addition, the ability to evaluate screening strategies for multiple infectious diseases, (HCV and HIV at the same time) might prove important for decision makers. PMID:26689908

The integrated rangeland fire management strategy actionable science plan

USGS Publications Warehouse

Aldridge, Cameron L.; Berg, Ken; Boyd, Chad S.; Boyte, Stephen P.; Bradford, John B.; Brunson, Ed; Cissel, John H.; Conway, Courtney J.; Chalfoun, Anna D.; Chambers, Jeanne C.; Clark, Patrick; Coates, Peter S.; Crist, Michele R.; Davis, Dawn M.; DeCrappeo, Nicole; Deibert, Patricia A.; Doherty, Kevin E.; Evers, Louisa B.; Finch, Deborah M.; Finn, Sean P.; Germino, Matthew J.; Glenn, Nancy F.; Gucker, Corey; Hall, John A.; Hanser, Steven E.; Havlina, Douglas W.; Heinrichs, Julie; Heller, Matt; Homer, Collin G.; Hunter, Molly E.; Jacobs, Ruth W.; Karl, Jason W.; Kearney, Richard; Kemp, Susan K; Kilkenny, Francis F.; Knick, Steven T.; Launchbaugh, Karen; Manier, Daniel J.; Mayer, Kenneth E.; Meyer, Susan E.; Monroe, Adrian; MontBlanc, Eugénie; Newingham, Beth A.; Pellant, Michael L.; Phillips, Susan L.; Pilliod, David S.; Ricca, Mark A.; Richardson, Bryce A.; Rose, Jeffrey A.; Shaw, Nancy; Sheley, Roger L.; Shinneman, Douglas J.; Wiechman , Lief A.; Wylie, Bruce K.

2016-01-01

The Integrated Rangeland Fire Management Strategy (hereafter Strategy, DOI 2015) outlined the need for coordinated, science-based adaptive management to achieve long-term protection, conservation, and restoration of the sagebrush (Artemisia spp.) ecosystem. A key component of this management approach is the identification of knowledge gaps that limit implementation of effective strategies to meet current management challenges. The tasks and actions identified in the Strategy address several broad topics related to management of the sagebrush ecosystem. This science plan is organized around these topics and specifically focuses on fire, invasive plant species and their effects on altering fire regimes, restoration, sagebrush and greater sage-grouse (Centrocercus urophasianus), and climate and weather.

Identifying Effectiveness Criteria for Internet Payment Systems.

ERIC Educational Resources Information Center

Shon, Tae-Hwan; Swatman, Paula M. C.

1998-01-01

Examines Internet payment systems (IPS): third-party, card, secure Web server, electronic token, financial electronic data interchange (EDI), and micropayment based. Reports the results of a Delphi survey of experts identifying and classifying IPS effectiveness criteria and classifying types of IPS providers. Includes the survey invitation letter…

Promoting Educator Effectiveness: The Effects of Two Key Strategies. NCEE 2018-4009

ERIC Educational Resources Information Center

Wayne, Andrew; Garet, Michael; Wellington, Alison; Chiang, Hanley

2018-01-01

Having a more effective teacher or principal can substantially improve students' academic outcomes. The Teacher Incentive Fund (TIF) program, established in 2006, provided competitive grants to help states and districts implement a multi-strategy approach to enhancing educator effectiveness. TIF grantees were required to measure educator…

Identifying strategies to assist final semester nursing students to develop numeracy skills: a mixed methods study.

PubMed

Ramjan, Lucie M; Stewart, Lyn; Salamonson, Yenna; Morris, Maureen M; Armstrong, Lyn; Sanchez, Paula; Flannery, Liz

2014-03-01

It remains a grave concern that many nursing students within tertiary institutions continue to experience difficulties with achieving medication calculation competency. In addition, universities have a moral responsibility to prepare proficient clinicians for graduate practice. This requires risk management strategies to reduce adverse medication errors post registration. To identify strategies and potential predictors that may assist nurse academics to tailor their drug calculation teaching and assessment methods. This project builds on previous experience and explores students' perceptions of newly implemented interventions designed to increase confidence and competence in medication calculation. This mixed method study surveyed students (n=405) enrolled in their final semester of study at a large, metropolitan university in Sydney, Australia. Tailored, contextualised interventions included online practice quizzes, simulated medication calculation scenarios developed for clinical practice classes, contextualised 'pen and paper' tests, visually enhanced didactic remediation and 'hands-on' contextualised workshops. Surveys were administered to students to determine their perceptions of interventions and to identify whether these interventions assisted with calculation competence. Test scores were analysed using SPSS v. 20 for correlations between students' perceptions and actual performance. Qualitative open-ended survey questions were analysed manually and thematically. The study reinforced that nursing students preferred a 'hands-on,' contextualised approach to learning that was 'authentic' and aligned with clinical practice. Our interventions assisted with supporting students' learning and improvement of calculation confidence. Qualitative data provided further insight into students' awareness of their calculation errors and preferred learning styles. Some of the strongest predictors for numeracy skill performance included (1) being an international student, (2

Effective Literacy Instructional Strategies in High Academic Growth Classrooms

ERIC Educational Resources Information Center

Jessup, Kathryn

2017-01-01

Instruction--the interaction that takes place between students, teachers, and content--is the foundation in which learning occurs. Effective literacy instruction considers the instructional strategies and foundational teaching components utilized by effective and highly effective teachers during literacy in classrooms of high academic growth. The…

Identifying Proactive Collaboration Strategies for Teacher Readiness for Marginalized Students

ERIC Educational Resources Information Center

Akin, Imani; Neumann, Crystal

2013-01-01

This research discusses the value of collaborating to develop strategies that enhance teacher readiness for the marginalized student and the use of qualitative data that can lead to student academic and social success. Education domains include the learning environment, technology, and building parent and community connections. This research…

Extending existing structural identifiability analysis methods to mixed-effects models.

PubMed

Janzén, David L I; Jirstrand, Mats; Chappell, Michael J; Evans, Neil D

2018-01-01

The concept of structural identifiability for state-space models is expanded to cover mixed-effects state-space models. Two methods applicable for the analytical study of the structural identifiability of mixed-effects models are presented. The two methods are based on previously established techniques for non-mixed-effects models; namely the Taylor series expansion and the input-output form approach. By generating an exhaustive summary, and by assuming an infinite number of subjects, functions of random variables can be derived which in turn determine the distribution of the system's observation function(s). By considering the uniqueness of the analytical statistical moments of the derived functions of the random variables, the structural identifiability of the corresponding mixed-effects model can be determined. The two methods are applied to a set of examples of mixed-effects models to illustrate how they work in practice. Copyright © 2017 Elsevier Inc. All rights reserved.

Towards a research strategy to support public health programs for behaviour change.

PubMed

Redman, S

1996-08-01

Major public health programs have had mixed results in improving health behaviours. In part, the failure to modify some key health behaviours is attributable to a lack of appropriate research on which to base behaviour-change programs. The research published by the Australian Journal of Public Health (now the Australian and New Zealand Journal of Public Health), as representative of Australian research, was analysed. The analysis indicated shortcomings in existing research as a basis for practitioners to build effective programs. While the Journal publishes a substantial amount of health-behaviour research, few studies used a randomised trial to assess the effects of interventions. Little research was designed to help practitioners to: identify the types of strategies that would reliably result in behaviour change; identify strategies to work with hard-to-reach groups like women from Aboriginal and non-English-speaking backgrounds; assess the costs and cost-effectiveness of different strategies; disseminate effective strategies at a state or national level. If improvements in public health are to occur, there is a need to develop and implement a strategy to ensure that research more effectively meets the needs of public health practitioners.

Effective strategies for recruiting of Asian cancer patients in internet research.

PubMed

Lim, Hyun Ju; Lin, Chia-Ju; Liu, Yi; Chee, Wonshik; Im, Eun-Ok

2006-01-01

This poster is aims to provide directions for effective strategies for recruiting Asian cancer patients in Internet study among Asian American cancer patients. In the study, we used four different strategies to recruit Asian cancer participants: (a) general and ethnic specific Internet cancer support groups; (b) Asian Internet communities/groups; (c) Asian physician clinics, Asian community and culture center; and (d) community consultants. The most effective recruitment strategy among them was the recruitment through community consultant. The findings support the importance of using key persons in ethnic minority communities to recruit ethnic minority participants.

Strategies in Forecasting Outcomes in Ethical Decision-making: Identifying and Analyzing the Causes of the Problem

PubMed Central

Beeler, Cheryl K.; Antes, Alison L.; Wang, Xiaoqian; Caughron, Jared J.; Thiel, Chase E.; Mumford, Michael D.

2010-01-01

This study examined the role of key causal analysis strategies in forecasting and ethical decision-making. Undergraduate participants took on the role of the key actor in several ethical problems and were asked to identify and analyze the causes, forecast potential outcomes, and make a decision about each problem. Time pressure and analytic mindset were manipulated while participants worked through these problems. The results indicated that forecast quality was associated with decision ethicality, and the identification of the critical causes of the problem was associated with both higher quality forecasts and higher ethicality of decisions. Neither time pressure nor analytic mindset impacted forecasts or ethicality of decisions. Theoretical and practical implications of these findings are discussed. PMID:20352056

Cost-Effectiveness Analysis of Six Strategies to Treat Recurrent Clostridium difficile Infection.

PubMed

Lapointe-Shaw, Lauren; Tran, Kim L; Coyte, Peter C; Hancock-Howard, Rebecca L; Powis, Jeff; Poutanen, Susan M; Hota, Susy

2016-01-01

To assess the cost-effectiveness of six treatment strategies for patients diagnosed with recurrent Clostridium difficile infection (CDI) in Canada: 1. oral metronidazole; 2. oral vancomycin; 3.oral fidaxomicin; 4. fecal transplantation by enema; 5. fecal transplantation by nasogastric tube; and 6. fecal transplantation by colonoscopy. Public insurer for all hospital and physician services. Ontario, Canada. A decision analytic model was used to model costs and lifetime health effects of each strategy for a typical patient experiencing up to three recurrences, over 18 weeks. Recurrence data and utilities were obtained from published sources. Cost data was obtained from published sources and hospitals in Toronto, Canada. The willingness-to-pay threshold was $50,000/QALY gained. Fecal transplantation by colonoscopy dominated all other strategies in the base case, as it was less costly and more effective than all alternatives. After accounting for uncertainty in all model parameters, there was an 87% probability that fecal transplantation by colonoscopy was the most beneficial strategy. If colonoscopy was not available, fecal transplantation by enema was cost-effective at $1,708 per QALY gained, compared to metronidazole. In addition, fecal transplantation by enema was the preferred strategy if the probability of recurrence following this strategy was below 8.7%. If fecal transplantation by any means was unavailable, fidaxomicin was cost-effective at an additional cost of $25,968 per QALY gained, compared to metronidazole. Fecal transplantation by colonoscopy (or enema, if colonoscopy is unavailable) is cost-effective for treating recurrent CDI in Canada. Where fecal transplantation is not available, fidaxomicin is also cost-effective.

Achieving Literacy Excellence through Identifying and Utilizing High Yield Strategies

ERIC Educational Resources Information Center

Hardison, Ashley

2017-01-01

The purpose of this study was to delve into the literacy instructional strategies of selected high-performing K-2 teachers in a Clark County, Nevada school district. The study assessed the efficacy of teachers using five core literacy components: phonemic awareness, phonics, vocabulary, fluency, and comprehension for student achievement. High…

Effects of Teaching Strategies in Annotated Bibliography Writing

ERIC Educational Resources Information Center

Tan-de Ramos, Jennifer

2015-01-01

The study examines the effect of teaching strategies to improved writing of students in the tertiary level. Specifically, three teaching approaches--the use of modelling, grammar-based, and information element-focused--were tested on their effect on the writing of annotated bibliography in three research classes at a university in Manila.…

Preventing Challenging Behaviors in Preschool: Effective Strategies for Classroom Teachers

ERIC Educational Resources Information Center

Coleman, Janelle C.; Crosby, Megan G.; Irwin, Heather K.; Dennis, Lindsay R.; Simpson, Cynthia G.; Rose, Chad A.

2013-01-01

This article provides practical strategies and techniques that early childhood educators can implement in their classrooms to effectively manage challenging behaviors. The specific strategies addressed fall under the following categories: (a) classroom management, (b) reinforcement, and (c) communication. Suggestions are made for how parents can…

Identifying potential environmental impacts of waste handling strategies in textile industry.

PubMed

Yacout, Dalia M M; Hassouna, M S

2016-08-01

Waste management is a successful instrument to minimize generated waste and improve environmental conditions. In spite of the large share of developing countries in the textile industry, limited information is available concerning the waste management strategies implemented for textiles on those countries and their environmental impacts. In the current study, two waste management approaches for hazardous solid waste treatment of acrylic fibers (landfill and incineration) were investigated. The main research questions were: What are the different impacts of each waste management strategy? Which waste management strategy is more ecofriendly? Life cycle assessment was employed in order to model the environmental impacts of each waste streaming approach separately then compare them together. Results revealed that incineration was the more ecofriendly approach. Highest impacts of both approaches were on ecotoxicity and carcinogenic potentials due to release of metals from pigment wastes. Landfill had an impact of 46.8 % on human health as compared to 28 % by incineration. Incineration impact on ecosystem quality was higher than landfill impact (68.4 and 51.3 %, respectively). As for resources category, incineration had a higher impact than landfill (3.5 and 2.0 %, respectively). Those impacts could be mitigated if state-of-the-art landfill or incinerator were used and could be reduced by applying waste to energy approaches for both management systems In conclusion, shifting waste treatment from landfill to incineration would decrease the overall environmental impacts and allow energy recovery. The potential of waste to energy approach by incineration with heat recovery could be considered in further studies. Future research is needed in order to assess the implementation of waste management systems and the preferable waste management strategies in the textile industry on developing countries.

Optimizing Telehealth Strategies for Subspecialty Care: Recommendations from Rural Pediatricians

PubMed Central

Demirci, Jill R.; Bogen, Debra L.; Mehrotra, Ateev; Miller, Elizabeth

2015-01-01

Abstract Background: Telehealth offers strategies to improve access to subspecialty care for children in rural communities. Rural pediatrician experiences and preferences regarding the use of these telehealth strategies for children's subspecialty care needs are not known. We elicited rural pediatrician experiences and preferences regarding different pediatric subspecialty telehealth strategies. Materials and Methods: Seventeen semistructured telephone interviews were conducted with rural pediatricians from 17 states within the United States. Interviewees were recruited by e-mails to a pediatric rural health listserv and to rural pediatricians identified through snowball sampling. Themes were identified through thematic analysis of interview transcripts. Institutional Review Board approval was obtained. Results: Rural pediatricians identified several telehealth strategies to improve access to subspecialty care, including physician access hotlines, remote electronic medical record access, electronic messaging systems, live video telemedicine, and telehealth triage systems. Rural pediatricians provided recommendations for optimizing the utility of each of these strategies based on their experiences with different systems. Rural pediatricians preferred specific telehealth strategies for specific clinical contexts, resulting in a proposed framework describing the complementary role of different telehealth strategies for pediatric subspecialty care. Finally, rural pediatricians identified additional benefits associated with the use of telehealth strategies and described a desire for telehealth systems that enhanced (rather than replaced) personal relationships between rural pediatricians and subspecialists. Conclusions: Rural pediatricians described complementary roles for different subspecialty care telehealth strategies. Additionally, rural pediatricians provided recommendations for optimizing individual telehealth strategies. Input from rural pediatricians will be

Importance of multi-modal approaches to effectively identify cataract cases from electronic health records.

PubMed

Peissig, Peggy L; Rasmussen, Luke V; Berg, Richard L; Linneman, James G; McCarty, Catherine A; Waudby, Carol; Chen, Lin; Denny, Joshua C; Wilke, Russell A; Pathak, Jyotishman; Carrell, David; Kho, Abel N; Starren, Justin B

2012-01-01

There is increasing interest in using electronic health records (EHRs) to identify subjects for genomic association studies, due in part to the availability of large amounts of clinical data and the expected cost efficiencies of subject identification. We describe the construction and validation of an EHR-based algorithm to identify subjects with age-related cataracts. We used a multi-modal strategy consisting of structured database querying, natural language processing on free-text documents, and optical character recognition on scanned clinical images to identify cataract subjects and related cataract attributes. Extensive validation on 3657 subjects compared the multi-modal results to manual chart review. The algorithm was also implemented at participating electronic MEdical Records and GEnomics (eMERGE) institutions. An EHR-based cataract phenotyping algorithm was successfully developed and validated, resulting in positive predictive values (PPVs) >95%. The multi-modal approach increased the identification of cataract subject attributes by a factor of three compared to single-mode approaches while maintaining high PPV. Components of the cataract algorithm were successfully deployed at three other institutions with similar accuracy. A multi-modal strategy incorporating optical character recognition and natural language processing may increase the number of cases identified while maintaining similar PPVs. Such algorithms, however, require that the needed information be embedded within clinical documents. We have demonstrated that algorithms to identify and characterize cataracts can be developed utilizing data collected via the EHR. These algorithms provide a high level of accuracy even when implemented across multiple EHRs and institutional boundaries.

Importance of multi-modal approaches to effectively identify cataract cases from electronic health records

PubMed Central

Rasmussen, Luke V; Berg, Richard L; Linneman, James G; McCarty, Catherine A; Waudby, Carol; Chen, Lin; Denny, Joshua C; Wilke, Russell A; Pathak, Jyotishman; Carrell, David; Kho, Abel N; Starren, Justin B

2012-01-01

Objective There is increasing interest in using electronic health records (EHRs) to identify subjects for genomic association studies, due in part to the availability of large amounts of clinical data and the expected cost efficiencies of subject identification. We describe the construction and validation of an EHR-based algorithm to identify subjects with age-related cataracts. Materials and methods We used a multi-modal strategy consisting of structured database querying, natural language processing on free-text documents, and optical character recognition on scanned clinical images to identify cataract subjects and related cataract attributes. Extensive validation on 3657 subjects compared the multi-modal results to manual chart review. The algorithm was also implemented at participating electronic MEdical Records and GEnomics (eMERGE) institutions. Results An EHR-based cataract phenotyping algorithm was successfully developed and validated, resulting in positive predictive values (PPVs) >95%. The multi-modal approach increased the identification of cataract subject attributes by a factor of three compared to single-mode approaches while maintaining high PPV. Components of the cataract algorithm were successfully deployed at three other institutions with similar accuracy. Discussion A multi-modal strategy incorporating optical character recognition and natural language processing may increase the number of cases identified while maintaining similar PPVs. Such algorithms, however, require that the needed information be embedded within clinical documents. Conclusion We have demonstrated that algorithms to identify and characterize cataracts can be developed utilizing data collected via the EHR. These algorithms provide a high level of accuracy even when implemented across multiple EHRs and institutional boundaries. PMID:22319176

Facebook or Twitter?: Effective recruitment strategies for family caregivers.

PubMed

Herbell, Kayla; Zauszniewski, Jaclene A

2018-06-01

This brief details recent recruitment insights from a large all-online study of family caregivers that aimed to develop a measure to assess how family caregivers manage daily stresses. Online recruitment strategies included the use of Twitter and Facebook. Overall, 800 individuals responded to the recruitment strategy; 230 completed all study procedures. The most effective online recruitment strategy for targeting family caregivers was Facebook, yielding 86% of the sample. Future researchers may find the use of social media recruitment methods appealing because they are inexpensive, simple, and efficient methods for obtaining National samples. Copyright © 2018 Elsevier Inc. All rights reserved.

The Effect of Teaching Search Strategies on Perceptual Performance.

PubMed

van der Gijp, Anouk; Vincken, Koen L; Boscardin, Christy; Webb, Emily M; Ten Cate, Olle Th J; Naeger, David M

2017-06-01

Radiology expertise is dependent on the use of efficient search strategies. The aim of this study is to investigate the effect of teaching search strategies on trainee's accuracy in detecting lung nodules at computed tomography. Two search strategies, "scanning" and "drilling," were tested with a randomized crossover design. Nineteen junior radiology residents were randomized into two groups. Both groups first completed a baseline lung nodule detection test allowing a free search strategy, followed by a test after scanning instruction and drilling instruction or vice versa. True positive (TP) and false positive (FP) scores and scroll behavior were registered. A mixed-design analysis of variance was applied to compare the three search conditions. Search strategy instruction had a significant effect on scroll behavior, F(1.3) = 54.2, P < 0.001; TP score, F(2) = 16.1, P < 0.001; and FP score, F(1.3) = 15.3, P < 0.001. Scanning instruction resulted in significantly lower TP scores than drilling instruction (M = 10.7, SD = 5.0 versus M = 16.3, SD = 5.3), t(18) = 4.78, P < 0.001; or free search (M = 15.3, SD = 4.6), t(18) = 4.44, P < 0.001. TP scores for drilling did not significantly differ from free search. FP scores for drilling (M = 7.3, SD = 5.6) were significantly lower than for free search (M = 12.5, SD = 7.8), t(18) = 4.86, P < 0.001. Teaching a drilling strategy is preferable to teaching a scanning strategy for finding lung nodules. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Vasa previa screening strategies: a decision and cost-effectiveness analysis.

PubMed

Sinkey, R G; Odibo, A O

2018-05-22

The aim of this study is to perform a decision and cost-effectiveness analysis comparing four screening strategies for the antenatal diagnosis of vasa previa among singleton pregnancies. A decision-analytic model was constructed comparing vasa previa screening strategies. Published probabilities and costs were applied to four transvaginal screening scenarios which occurred at the time of mid-trimester ultrasound: no screening, ultrasound-indicated screening, screening pregnancies conceived by in vitro fertilization (IVF), and universal screening. Ultrasound-indicated screening was defined as performing a transvaginal ultrasound at the time of routine anatomy ultrasound in response to one of the following sonographic findings associated with an increased risk of vasa previa: low-lying placenta, marginal or velamentous cord insertion, or bilobed or succenturiate lobed placenta. The primary outcome was cost per quality adjusted life years (QALY) in U.S. dollars. The analysis was from a healthcare system perspective with a willingness to pay (WTP) threshold of $100,000 per QALY selected. One-way and multivariate sensitivity analyses (Monte-Carlo simulation) were performed. This decision-analytic model demonstrated that screening pregnancies conceived by IVF was the most cost-effective strategy with an incremental cost effectiveness ratio (ICER) of $29,186.50 / QALY. Ultrasound-indicated screening was the second most cost-effective with an ICER of $56,096.77 / QALY. These data were robust to all one-way and multivariate sensitivity analyses performed. Within our baseline assumptions, transvaginal ultrasound screening for vasa previa appears to be most cost-effective when performed among IVF pregnancies. However, both IVF and ultrasound-indicated screening strategies fall within contemporary willingness-to-pay thresholds, suggesting that both strategies may be appropriate to apply in clinical practice. This article is protected by copyright. All rights reserved. This

Assessing urban potential flooding risk and identifying effective risk-reduction measures.

PubMed

Cherqui, Frédéric; Belmeziti, Ali; Granger, Damien; Sourdril, Antoine; Le Gauffre, Pascal

2015-05-01

Flood protection is one of the traditional functions of any drainage system, and it remains a major issue in many cities because of economic and health impact. Heavy rain flooding has been well studied and existing simulation software can be used to predict and improve level of protection. However, simulating minor flooding remains highly complex, due to the numerous possible causes related to operational deficiencies or negligent behaviour. According to the literature, causes of blockages vary widely from one case to another: it is impossible to provide utility managers with effective recommendations on how to improve the level of protection. It is therefore vital to analyse each context in order to define an appropriate strategy. Here we propose a method to represent and assess the flooding risk, using GIS and data gathered during operation and maintenance. Our method also identifies potential management responses. The approach proposed aims to provide decision makers with clear and comprehensible information. Our method has been successfully applied to the Urban Community of Bordeaux (France) on 4895 interventions related to flooding recorded during the 2009-2011 period. Results have shown the relative importance of different issues, such as human behaviour (grease, etc.) or operational deficiencies (roots, etc.), and lead to identify corrective and proactive. This study also confirms that blockages are not always directly due to the network itself and its deterioration. Many causes depend on environmental and operating conditions on the network and often require collaboration between municipal departments in charge of roads, green spaces, etc. Copyright © 2015 Elsevier B.V. All rights reserved.

Strategies for improved French-language health services

PubMed Central

Gauthier, Alain P.; Timony, Patrick E.; Serresse, Suzanne; Goodale, Natalie; Prpic, Jason

2015-01-01

Abstract Objective To identify strategies to improve the quality of health services for Francophone patients. Design A series of semistructured key informant interviews. Setting Northeastern Ontario. Participants A total of 18 physicians were interviewed. Ten physicians were interviewed in French, 7 physicians were women, and 10 physicians were located in urban communities. Methods Purposive and snowball sampling strategies were used to conduct a series of semistructured key informant interviews with family physicians practising in communities with a large Francophone population. Principles of grounded theory were applied, guided by a framework for patient-professional communication. Results were inductively derived following an iterative data collection–data analysis process and were analyzed using a detailed thematic approach. Main findings Respondents identified several strategies for providing high-quality French-language health services. Some were unique to non–French-speaking physicians (eg, using appropriate interpreter services), some were unique to French-speaking physicians (eg, using a flexible dialect), and some strategies were common to all physicians serving French populations (eg, hiring bilingual staff or having pamphlets and posters in both French and English). Conclusion Physicians interviewed for this study provided high-quality health care by attributing substantial importance to effective communication. While linguistic patient-to-physician concordance is ideal, it might not always be possible. Thus, conscious efforts to attenuate communication barriers are necessary, and several effective strategies exist. PMID:26505060

POEM: Identifying Joint Additive Effects on Regulatory Circuits

PubMed Central

Botzman, Maya; Nachshon, Aharon; Brodt, Avital; Gat-Viks, Irit

2016-01-01

Motivation: Expression Quantitative Trait Locus (eQTL) mapping tackles the problem of identifying variation in DNA sequence that have an effect on the transcriptional regulatory network. Major computational efforts are aimed at characterizing the joint effects of several eQTLs acting in concert to govern the expression of the same genes. Yet, progress toward a comprehensive prediction of such joint effects is limited. For example, existing eQTL methods commonly discover interacting loci affecting the expression levels of a module of co-regulated genes. Such “modularization” approaches, however, are focused on epistatic relations and thus have limited utility for the case of additive (non-epistatic) effects. Results: Here we present POEM (Pairwise effect On Expression Modules), a methodology for identifying pairwise eQTL effects on gene modules. POEM is specifically designed to achieve high performance in the case of additive joint effects. We applied POEM to transcription profiles measured in bone marrow-derived dendritic cells across a population of genotyped mice. Our study reveals widespread additive, trans-acting pairwise effects on gene modules, characterizes their organizational principles, and highlights high-order interconnections between modules within the immune signaling network. These analyses elucidate the central role of additive pairwise effect in regulatory circuits, and provide computational tools for future investigations into the interplay between eQTLs. Availability: The software described in this article is available at csgi.tau.ac.il/POEM/. PMID:27148351

Patient-derived models of acquired resistance can identify effective drug combinations for cancer.

PubMed

Crystal, Adam S; Shaw, Alice T; Sequist, Lecia V; Friboulet, Luc; Niederst, Matthew J; Lockerman, Elizabeth L; Frias, Rosa L; Gainor, Justin F; Amzallag, Arnaud; Greninger, Patricia; Lee, Dana; Kalsy, Anuj; Gomez-Caraballo, Maria; Elamine, Leila; Howe, Emily; Hur, Wooyoung; Lifshits, Eugene; Robinson, Hayley E; Katayama, Ryohei; Faber, Anthony C; Awad, Mark M; Ramaswamy, Sridhar; Mino-Kenudson, Mari; Iafrate, A John; Benes, Cyril H; Engelman, Jeffrey A

2014-12-19

Targeted cancer therapies have produced substantial clinical responses, but most tumors develop resistance to these drugs. Here, we describe a pharmacogenomic platform that facilitates rapid discovery of drug combinations that can overcome resistance. We established cell culture models derived from biopsy samples of lung cancer patients whose disease had progressed while on treatment with epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors and then subjected these cells to genetic analyses and a pharmacological screen. Multiple effective drug combinations were identified. For example, the combination of ALK and MAPK kinase (MEK) inhibitors was active in an ALK-positive resistant tumor that had developed a MAP2K1 activating mutation, and the combination of EGFR and fibroblast growth factor receptor (FGFR) inhibitors was active in an EGFR mutant resistant cancer with a mutation in FGFR3. Combined ALK and SRC (pp60c-src) inhibition was effective in several ALK-driven patient-derived models, a result not predicted by genetic analysis alone. With further refinements, this strategy could help direct therapeutic choices for individual patients. Copyright © 2014, American Association for the Advancement of Science.

Systematic review and cost-effectiveness evaluation of 'pill-in-the-pocket' strategy for paroxysmal atrial fibrillation compared to episodic in-hospital treatment or continuous antiarrhythmic drug therapy.

PubMed

Saborido, C Martin; Hockenhull, J; Bagust, A; Boland, A; Dickson, R; Todd, D

2010-06-01

Atrial fibrillation (AF) is a tachyarrhythmia characterised by uncoordinated atrial activation with consequent deterioration of impairment of atrial function and a rapid, irregular heartbeat. The annual incidence rate of paroxysmal AF (PAF) has been estimated at 1.0 per 1000 person-years (95% confidence interval 0.9 to 1.1), and reported prevalence rates show wide variations depending on age and country. Conventional treatment strategies for PAF focus on the suppression of paroxysms of AF and return to normal sinus rhythm. To summarise the results of the rapid reviews of the clinical effectiveness and cost-effectiveness literature describing the pill-in-the-pocket (PiP) approach for the treatment of patients with PAF; and to develop an economic model to assess the cost-effectiveness of PiP compared with in-hospital treatment (IHT) or continuous antiarrhythmic drugs (AADs) for the treatment of patients with PAF. Ovid MEDLINE and Ovid OLDMEDLINE 1950 to present with Daily Update were searched. The following electronic databases were searched for ongoing trials: Health Services Research Projects in Progress, ClinicalTrials.gov, metaRegister of Current Controlled Trials, BioMed Central, World Health Organization International Clinical Trials Registry Platform, ClinicalStudyResults.org and the National Library of Medicine Gateway. Inclusion criteria, which included patients suffering from PAF, were independently applied to all identified references by two reviewers (JH and CMS). Electronic searches were conducted to identify clinical effectiveness and cost-effectiveness evidence describing the use of a PiP strategy for the treatment of PAF, published since the release of the Royal College of Physicians' national guidelines on AF in June 2006. A Markov model was constructed to examine differences between three PAF strategies (PiP, AAD and IHT) in terms of cost per quality-adjusted life-year (QALY). A Markov model structure was chosen because it is assumed that PAF is a

Time management strategies for research productivity.

PubMed

Chase, Jo-Ana D; Topp, Robert; Smith, Carol E; Cohen, Marlene Z; Fahrenwald, Nancy; Zerwic, Julie J; Benefield, Lazelle E; Anderson, Cindy M; Conn, Vicki S

2013-02-01

Researchers function in a complex environment and carry multiple role responsibilities. This environment is prone to various distractions that can derail productivity and decrease efficiency. Effective time management allows researchers to maintain focus on their work, contributing to research productivity. Thus, improving time management skills is essential to developing and sustaining a successful program of research. This article presents time management strategies addressing behaviors surrounding time assessment, planning, and monitoring. Herein, the Western Journal of Nursing Research editorial board recommends strategies to enhance time management, including setting realistic goals, prioritizing, and optimizing planning. Involving a team, problem-solving barriers, and early management of potential distractions can facilitate maintaining focus on a research program. Continually evaluating the effectiveness of time management strategies allows researchers to identify areas of improvement and recognize progress.

Cost-effective strategies for rural community outreach, Hawaii, 2010-2011.

PubMed

Pellegrin, Karen L; Barbato, Anna; Holuby, R Scott; Ciarleglio, Anita E; Taniguchi, Ronald

2014-12-11

Three strategies designed to maximize attendance at educational sessions on chronic disease medication safety in older adults in rural areas were implemented sequentially and compared for cost-effectiveness: 1) existing community groups and events, 2) formal advertisement, and 3) employer-based outreach. Cost-effectiveness was measured by comparing overall cost per attendee recruited and number of attendees per event. The overall cost per attendee was substantially higher for the formal advertising strategy, which produced the lowest number of attendees per event. Leveraging existing community events and employers in rural areas was more cost-effective than formal advertisement for recruiting rural community members.

Sensemaking Strategies for Ethical Decision-making.

PubMed

Caughron, Jay J; Antes, Alison L; Stenmark, Cheryl K; Thiel, Chaise E; Wang, Xiaoqian; Mumford, Michael D

2011-01-01

The current study uses a sensemaking model and thinking strategies identified in earlier research to examine ethical decision-making. Using a sample of 163 undergraduates, a low fidelity simulation approach is used to study the effects personal involvement (in causing the problem and personal involvement in experiencing the outcomes of the problem) could have on the use of cognitive reasoning strategies that have been shown to promote ethical decision-making. A mediated model is presented which suggests that environmental factors influence reasoning strategies, reasoning strategies influence sensemaking, and sensemaking in turn influences ethical decision-making. Findings were mixed but generally supported the hypothesized model. Interestingly, framing the outcomes of ethically charged situations in terms of more global organizational outcomes rather than personal outcomes was found to promote the use of pro-ethical cognitive reasoning strategies.

"Shotgun" versus sequential testing. Cost-effectiveness of diagnostic strategies for vaginitis.

PubMed

Carr, Phyllis L; Rothberg, Michael B; Friedman, Robert H; Felsenstein, Donna; Pliskin, Joseph S

2005-09-01

Although vaginitis is a common outpatient problem, only 60% of patients can be diagnosed at the initial office visit of a primary care provider using the office procedures of pH testing, whiff tests, normal saline, and potassium hydroxide preps. To determine the most cost-effective diagnostic and treatment approach for the medical management of vaginitis. Decision and cost-effectiveness analyses. Healthy women with symptoms of vaginitis undiagnosed after an initial pelvic exam, wet mount preparations, pH, and the four criteria to diagnose bacterial vaginosis. General office practice. We evaluated 28 diagnostic strategies comprised of combinations of pH testing, vaginal cultures for yeast and Trichomonas vaginalis, Gram's stain for bacterial vaginosis, and DNA probes for Neisseria gonorrhoeae and Chlamydia. Data sources for the study were confined to English language literature. The outcome measures were symptom-days and costs. The least expensive strategy was to perform yeast culture, gonorrhoeae and Chlamydia probes at the initial visit, and Gram's stain and Trichomonas culture only when the vaginal pH exceeded 4.9 (330 dollars, 7.30 symptom days). Other strategies cost 8 dollars to 76 dollars more and increased duration of symptoms by up to 1.3 days. In probabilistic sensitivity analysis, this strategy was always the most effective strategy and was also least expensive 58% of the time. For patients with vaginitis symptoms undiagnosed by pelvic examination, wet mount preparations and related office tests, a comprehensive, pH-guided testing strategy at the initial office visit is less expensive and more effective than ordering tests sequentially.

Strategies for Teaching Developmental Mathematics Students at the College Level

ERIC Educational Resources Information Center

Swaincott Kautz, Natalie Lynn

2016-01-01

The purpose of this investigation was to identify strategies used by effective instructors of developmental mathematics, and to discover the perceptions developmental mathematics students have about these strategies. While there are research projects focusing solely on developmental mathematics achievement, this study fills a need by incorporating…

Identification of retention strategies for neurosurgeons in Iran: Results from expert panels.

PubMed

Rafiei, Sima; Abdollahzadeh, Sina; Hashemi, Fariba; Ranjbar, Mohammad

2017-04-04

Background: The key challenge is how to encourage and retain health professionals in their work location. There is a list of policy options for this purpose but applying an appropriate and effective set of strategies requires a country level research. Our study aimed to identify retention strategies for neurosurgeons and examine both the importance and feasibility of the identified strategies using expert panels' point of view. Methods: First of all, a literature review was conducted to identify retention strategies for physicians. Then to gain consensus on the strategies and determine their importance and feasibility an expert panel was organized and a modified Delphi process was used. Results: A total of 40 strategies were identified by the panel classified in seven categories of income and economic factors, professional/job factors, clinical infrastructure, personal/family factors, living condition and welfare, educational factors and career development, governmental regulations and management policies. Conclusion: Based on the study results, three areas of economic incentives, personal and professional factors got the greatest priority in health professional planning for retention purposes.

Effective Teaching-Learning Strategies for the Omaha System.

PubMed

Radhakrishnan, Kavita; Martin, Karen S; Johnson, Karen E; Garcia, Alexandra A

2016-02-01

Home healthcare clinicians can benefit from the use of interprofessional standardized terminologies to more efficiently document and assess patient problems, describe and present clinician interventions, and measure the outcomes of care. The Omaha System is a research-based, comprehensive standardized terminology that can enable users to describe and measure the impact of nursing and healthcare services on patient care and outcomes. In this article, we (1) describe effective strategies for teaching the Omaha System to home healthcare agency staff, and (2) illustrate those strategies' effectiveness by presenting an example from an Omaha System Basic Workshop conducted in 2015. The 12 participants included home healthcare nursing administrators and clinicians, software developers from several companies, nursing educators, and nursing researchers. The role-playing and unfolding case studies that we report here represent teaching strategies that can provide opportunities for home healthcare users to practice using the Omaha System. Quantitative evaluation consisted of comparing the participants' pretest and posttest scores on the survey. Qualitative evaluation involved analyzing participants' feedback and comments on a form distributed at the end of the workshop. Participants found the workshop beneficial in improving their understanding of the Omaha System and its application to their practice.

Cost-Effectiveness Analysis of Six Strategies to Treat Recurrent Clostridium difficile Infection

PubMed Central

Lapointe-Shaw, Lauren; Tran, Kim L.; Coyte, Peter C.; Hancock-Howard, Rebecca L.; Powis, Jeff; Poutanen, Susan M.; Hota, Susy

2016-01-01

Objective To assess the cost-effectiveness of six treatment strategies for patients diagnosed with recurrent Clostridium difficile infection (CDI) in Canada: 1. oral metronidazole; 2. oral vancomycin; 3.oral fidaxomicin; 4. fecal transplantation by enema; 5. fecal transplantation by nasogastric tube; and 6. fecal transplantation by colonoscopy. Perspective Public insurer for all hospital and physician services. Setting Ontario, Canada. Methods A decision analytic model was used to model costs and lifetime health effects of each strategy for a typical patient experiencing up to three recurrences, over 18 weeks. Recurrence data and utilities were obtained from published sources. Cost data was obtained from published sources and hospitals in Toronto, Canada. The willingness-to-pay threshold was $50,000/QALY gained. Results Fecal transplantation by colonoscopy dominated all other strategies in the base case, as it was less costly and more effective than all alternatives. After accounting for uncertainty in all model parameters, there was an 87% probability that fecal transplantation by colonoscopy was the most beneficial strategy. If colonoscopy was not available, fecal transplantation by enema was cost-effective at $1,708 per QALY gained, compared to metronidazole. In addition, fecal transplantation by enema was the preferred strategy if the probability of recurrence following this strategy was below 8.7%. If fecal transplantation by any means was unavailable, fidaxomicin was cost-effective at an additional cost of $25,968 per QALY gained, compared to metronidazole. Conclusion Fecal transplantation by colonoscopy (or enema, if colonoscopy is unavailable) is cost-effective for treating recurrent CDI in Canada. Where fecal transplantation is not available, fidaxomicin is also cost-effective. PMID:26901316

Effects of Reading Strategy Instruction on Attitude toward Strategies and Performance in Reading Texts of Different Difficulty Levels

ERIC Educational Resources Information Center

Shorkaee, Hossein Zabihi; Talebi, Seyed Hassan

2018-01-01

This study investigated the effects of Reading Strategy Instruction (RSI) on reading performance and attitude toward reading strategies while reading texts of different difficulty levels. Fifty-five university students studying Political and Basic Sciences took part in this study. After homogenizing the participants, 24 students were in the…

Aging and sequential modulations of poorer strategy effects: An EEG study in arithmetic problem solving.

PubMed

Hinault, Thomas; Lemaire, Patrick; Phillips, Natalie

2016-01-01

This study investigated age-related differences in electrophysiological signatures of sequential modulations of poorer strategy effects. Sequential modulations of poorer strategy effects refer to decreased poorer strategy effects (i.e., poorer performance when the cued strategy is not the best) on current problem following poorer strategy problems compared to after better strategy problems. Analyses on electrophysiological (EEG) data revealed important age-related changes in time, frequency, and coherence of brain activities underlying sequential modulations of poorer strategy effects. More specifically, sequential modulations of poorer strategy effects were associated with earlier and later time windows (i.e., between 200- and 550 ms and between 850- and 1250 ms). Event-related potentials (ERPs) also revealed an earlier onset in older adults, together with more anterior and less lateralized activations. Furthermore, sequential modulations of poorer strategy effects were associated with theta and alpha frequencies in young adults while these modulations were found in delta frequency and theta inter-hemispheric coherence in older adults, consistent with qualitatively distinct patterns of brain activity. These findings have important implications to further our understanding of age-related differences and similarities in sequential modulations of cognitive control processes during arithmetic strategy execution. Copyright © 2015 Elsevier B.V. All rights reserved.

A systems biology strategy to identify molecular mechanisms of action and protein indicators of traumatic brain injury.

PubMed

Yu, Chenggang; Boutté, Angela; Yu, Xueping; Dutta, Bhaskar; Feala, Jacob D; Schmid, Kara; Dave, Jitendra; Tawa, Gregory J; Wallqvist, Anders; Reifman, Jaques

2015-02-01

The multifactorial nature of traumatic brain injury (TBI), especially the complex secondary tissue injury involving intertwined networks of molecular pathways that mediate cellular behavior, has confounded attempts to elucidate the pathology underlying the progression of TBI. Here, systems biology strategies are exploited to identify novel molecular mechanisms and protein indicators of brain injury. To this end, we performed a meta-analysis of four distinct high-throughput gene expression studies involving different animal models of TBI. By using canonical pathways and a large human protein-interaction network as a scaffold, we separately overlaid the gene expression data from each study to identify molecular signatures that were conserved across the different studies. At 24 hr after injury, the significantly activated molecular signatures were nonspecific to TBI, whereas the significantly suppressed molecular signatures were specific to the nervous system. In particular, we identified a suppressed subnetwork consisting of 58 highly interacting, coregulated proteins associated with synaptic function. We selected three proteins from this subnetwork, postsynaptic density protein 95, nitric oxide synthase 1, and disrupted in schizophrenia 1, and hypothesized that their abundance would be significantly reduced after TBI. In a penetrating ballistic-like brain injury rat model of severe TBI, Western blot analysis confirmed our hypothesis. In addition, our analysis recovered 12 previously identified protein biomarkers of TBI. The results suggest that systems biology may provide an efficient, high-yield approach to generate testable hypotheses that can be experimentally validated to identify novel mechanisms of action and molecular indicators of TBI. © 2014 The Authors. Journal of Neuroscience Research Published by Wiley Periodicals, Inc.

Project INTERFACE: Identification of Effective Implementation Strategies for Integrating Microcomputer Instruction into Ongoing Educational Services for the Handicapped. Final Report, 1984-86.

ERIC Educational Resources Information Center

Shaw, Estelle; And Others

The monograph describes Project INTERFACE, a 2-year collaborative effort among the Board of Cooperative Educational Services (BOCES) of Nassau County (New York), Long Island University, and three local school districts. The project identified the "most effective" implementation strategies for integrating microcomputer instruction into…

Identifying Strategic Scientific Opportunities

Cancer.gov

As NCI's central scientific strategy office, CRS collaborates with the institute's divisions, offices, and centers to identify research opportunities to advance NCI's vision for the future of cancer research.

Effects of Levodopa on Postural Strategies in Parkinson's disease.

PubMed

Baston, Chiara; Mancini, Martina; Rocchi, Laura; Horak, Fay

2016-05-01

Altered postural control and balance are major disabling issues of Parkinson's disease (PD). Static and dynamic posturography have provided insight into PD's postural deficits; however, little is known about impairments in postural coordination. We hypothesized that subjects with PD would show more ankle strategy during quiet stance than healthy control subjects, who would include some hip strategy, and this stiffer postural strategy would increase with disease progression. We quantified postural strategy and sway dispersion with inertial sensors (one placed on the shank and one on the posterior trunk at L5 level) while subjects were standing still with their eyes open. A total of 70 subjects with PD, including a mild group (H&Y≤2, N=33) and a more severe group (H&Y≥3, N=37), were assessed while OFF and while ON levodopa medication. We also included a healthy control group (N=21). Results showed an overall preference of ankle strategy in all groups while maintaining balance. Postural strategy was significantly lower ON compared to OFF medication (indicating more hip strategy), but no effect of disease stage was found. Instead, sway dispersion was significantly larger in ON compared to OFF medication, and significantly larger in the more severe PD group compared to the mild. In addition, increased hip strategy during stance was associated with poorer self-perception of balance. Copyright © 2016 Elsevier B.V. All rights reserved.

[The effects of instruction about strategies for efficient calculation].

PubMed

Suzuki, Masayuki; Ichikawa, Shin'ichi

2016-06-01

Calculation problems such as "12x7÷3" can be solved rapidly and easily by using certain techniques; we call these problems "efficient calculation problems." However, it has been pointed out that many students do not always solve them efficiently. In the present study, we examined the effects of an intervention on 35 seventh grade students (23 males, 12 females). The students were instructed to use an overview strategy that stated, "Think carefully about the whole expression", and were then taught three sub-strategies. The results showed that students solved similar problems efficiently after the intervention and the effects were preserved for five months.

A science-based, watershed strategy to support effective remediation of abandoned mine lands

USGS Publications Warehouse

Buxton, Herbert T.; Nimick, David A.; Von Guerard, Paul; Church, Stan E.; Frazier, Ann G.; Gray, John R.; Lipin, Bruce R.; Marsh, Sherman P.; Woodward, Daniel F.; Kimball, Briant A.; Finger, Susan E.; Ischinger, Lee S.; Fordham, John C.; Power, Martha S.; Bunch, Christine M.; Jones, John W.

1997-01-01

A U.S. Geological Survey Abandoned Mine Lands Initiative will develop a strategy for gathering and communicating the scientific information needed to formulate effective and cost-efficient remediation of abandoned mine lands. A watershed approach will identify, characterize, and remediate contaminated sites that have the most profound effect on water and ecosystem quality within a watershed. The Initiative will be conducted during 1997 through 2001 in two pilot watersheds, the Upper Animas River watershed in Colorado and the Boulder River watershed in Montana. Initiative efforts are being coordinated with the U.S. Forest Service, Bureau of Land Management, National Park Service, and other stakeholders which are using the resulting scientific information to design and implement remediation activities. The Initiative has the following eight objective-oriented components: estimate background (pre-mining) conditions; define baseline (current) conditions; identify target sites (major contaminant sources); characterize target sites and processes affecting contaminant dispersal; characterize ecosystem health and controlling processes at target sites; develop remediation goals and monitoring network; provide an integrated, quality-assured and accessible data network; and document lessons learned for future applications of the watershed approach.

Opioid adjuvant strategy: improving opioid effectiveness.

PubMed

Bihel, Frédéric

2016-01-01

Opioid analgesics continue to be the mainstay of pharmacologic treatment of moderate to severe pain. Many patients, particularly those suffering from chronic pain, require chronic high-dose analgesic therapy. Achieving clinical efficacy and tolerability of such treatment regimens is hampered by the appearance of opioid-induced side effects such as tolerance, hyperalgesia and withdrawal syndrome. Among the therapeutic options to improve the opioid effectiveness, this current review focuses on strategies combining opioids to other drugs that can modulate opioid-mediated effects. We will discuss about experimental evidences reported for several potential opioid adjuvants, including N-methyl-D-aspartate receptor antagonists, 5-HT7 agonists, sigma-1 antagonists, I2-R ligands, cholecystokinin antagonists, neuropeptide FF-R antagonists and toll-like receptor 4 antagonists.

Whole-organism screening for gluconeogenesis identifies activators of fasting metabolism

PubMed Central

Gut, Philipp; Baeza-Raja, Bernat; Andersson, Olov; Hasenkamp, Laura; Hsiao, Joseph; Hesselson, Daniel; Akassoglou, Katerina; Verdin, Eric; Hirschey, Matthew D.; Stainier, Didier Y.R.

2012-01-01

Improving the control of energy homeostasis can lower cardiovascular risk in metabolically compromised individuals. To identify new regulators of whole-body energy control, we conducted a high-throughput screen in transgenic reporter zebrafish for small molecules that modulate the expression of the fasting-inducible gluconeogenic gene pck1. We show that this in vivo strategy identified several drugs that impact gluconeogenesis in humans, as well as metabolically uncharacterized compounds. Most notably, we find that the Translocator Protein (TSPO) ligands PK 11195 and Ro5-4864 are glucose lowering agents despite a strong inductive effect on pck1 expression. We show that these drugs are activators of a fasting-like energy state, and importantly that they protect high-fat diet induced obese mice from hepatosteatosis and glucose intolerance, two pathological manifestations of metabolic dysregulation. Thus, using a whole-organism screening strategy, this study has identified new small molecule activators of fasting metabolism. PMID:23201900

Exploring the effects of spatial autocorrelation when identifying key drivers of wildlife crop-raiding.

PubMed

Songhurst, Anna; Coulson, Tim

2014-03-01

Few universal trends in spatial patterns of wildlife crop-raiding have been found. Variations in wildlife ecology and movements, and human spatial use have been identified as causes of this apparent unpredictability. However, varying spatial patterns of spatial autocorrelation (SA) in human-wildlife conflict (HWC) data could also contribute. We explicitly explore the effects of SA on wildlife crop-raiding data in order to facilitate the design of future HWC studies. We conducted a comparative survey of raided and nonraided fields to determine key drivers of crop-raiding. Data were subsampled at different spatial scales to select independent raiding data points. The model derived from all data was fitted to subsample data sets. Model parameters from these models were compared to determine the effect of SA. Most methods used to account for SA in data attempt to correct for the change in P-values; yet, by subsampling data at broader spatial scales, we identified changes in regression estimates. We consequently advocate reporting both model parameters across a range of spatial scales to help biological interpretation. Patterns of SA vary spatially in our crop-raiding data. Spatial distribution of fields should therefore be considered when choosing the spatial scale for analyses of HWC studies. Robust key drivers of elephant crop-raiding included raiding history of a field and distance of field to a main elephant pathway. Understanding spatial patterns and determining reliable socio-ecological drivers of wildlife crop-raiding is paramount for designing mitigation and land-use planning strategies to reduce HWC. Spatial patterns of HWC are complex, determined by multiple factors acting at more than one scale; therefore, studies need to be designed with an understanding of the effects of SA. Our methods are accessible to a variety of practitioners to assess the effects of SA, thereby improving the reliability of conservation management actions.

Effects of age on navigation strategy.

PubMed

Rodgers, M Kirk; Sindone, Joseph A; Moffat, Scott D

2012-01-01

Age differences in navigation strategies have been demonstrated in animals, with aged animals more likely to prefer an egocentric (route) strategy and younger animals more likely to prefer an allocentric (place) strategy. Using a novel virtual Y-maze strategy assessment (vYSA), the present study demonstrated substantial age differences in strategy preference in humans. Older adults overwhelmingly preferred an egocentric strategy, while younger adults were equally distributed between egocentric and allocentric preference. A preference for allocentric strategy on the Y-maze strategy assessment was found to benefit performance on an independent assessment (virtual Morris water task) only in younger adults. These results establish baseline age differences in spatial strategies and suggest this may impact performance on other spatial navigation assessments. The results are interpreted within the framework of age differences in hippocampal structure and function. Copyright © 2012 Elsevier Inc. All rights reserved.

Employer retention strategies and their effect on nurses' job satisfaction and intent to stay.

PubMed

Ellenbecker, Carol Hall; Samia, Linda; Cushman, Margaret J; Porell, Frank W

2007-01-01

Faced with a nursing shortage and anticipated increase in demand, home care agencies are implementing retention strategies with little knowledge of their effectiveness. The purpose of this study is to describe the strategies implemented and their effect on nurse job satisfaction and intention to leave. Data were collected from a random sample of 123 New England agencies during in-person interviews. Most agencies reported implementing multiple recruitment and retention strategies. Regression results suggest that the effects of employer retention strategy on nurses' intent to stay are the indirect result of its effects on job satisfaction. The only retention intervention that made a statistically significant difference in job satisfaction was shared governance, and no retention strategy directly affected nurses' intention to stay in their jobs.

Cost-effectiveness analysis of mammography and clinical breast examination strategies

PubMed Central

Ahern, Charlotte Hsieh; Shen, Yu

2009-01-01

Purpose Breast cancer screening by mammography and clinical breast exam are commonly used for early tumor detection. Previous cost-effectiveness studies considered mammography alone or did not account for all relevant costs. In this study, we assessed the cost-effectiveness of screening schedules recommended by three major cancer organizations and compared them with alternative strategies. We considered costs of screening examinations, subsequent work-up, biopsy, and treatment interventions after diagnosis. Methods We used a microsimulation model to generate women’s life histories, and assessed screening and treatment impacts on survival. Using statistical models, we accounted for age-specific incidence, preclinical disease duration, and age-specific sensitivity and specificity for each screening modality. The outcomes of interest were quality-adjusted life years (QALYs) saved and total costs with a 3% annual discount rate. Incremental cost-effectiveness ratios were used to compare strategies. Sensitivity analyses were performed by varying some of the assumptions. Results Compared to guidelines from the National Cancer Institute and the U.S. Preventive Services Task Force, alternative strategies were more efficient. Mammography and clinical breast exam in alternating years from ages 40 to 79 was a cost-effective alternative compared to the guidelines, costing $35,500 per QALY saved compared with no screening. The American Cancer Society guideline was the most effective and the most expensive, costing over $680,000 for an added QALY compared to the above alternative. Conclusion Screening strategies with lower costs and benefits comparable to those currently recommended should be considered for implementation in practice and for future guidelines. PMID:19258473

The Design of Effective Case Study-Related Learning Strategies Training.

ERIC Educational Resources Information Center

Nuttall, Alice E.

The development of case study training materials for an experimental research strategy is described, and the effects of such training are discussed. The theoretical foundation for learning strategies training was a social-cognitive/expectancy value model of college learning and teaching. In a posttest-only 2-group design, 54 students in an…

Age Differences in the Effects of Experimenter-Instructed Versus Self-Generated Strategy Use

PubMed Central

Hertzog, Christopher; Price, Jodi; Dunlosky, John

2013-01-01

Background/Study Context Interactive imagery is superior to rote repetition as an encoding strategy for paired associate (PA) recall. Younger and older individuals often rate these strategies as equally effective before they gain experience using each strategy. The present study investigated how experimenter-supervised and participant-chosen strategy experience affected younger and older adults’ knowledge about the effectiveness of these two strategies. Methods Ninety-nine younger (M = 19.0 years, SD = 1.4) and 90 older adults (M = 70.4 years, SD = 5.2) participated in the experiment. In learning a first PA list participants were either instructed to use imagery or repetition to study specific items (supervised) or could choose their own strategies (unsupervised). All participants were unsupervised on a second PA list to evaluate whether strategy experience affected strategy knowledge, strategy use, and PA recall. Results Both instruction groups learned about the superiority of imagery use through task experience, downgrading repetition ratings and upgrading imagery ratings on the second list. However, older adults showed less knowledge updating than did younger adults. Previously supervised younger adults increased their imagery use, improving PA recall; older adults maintained a higher level of repetition use. Conclusions Older adults update knowledge of the differential effectiveness of the rote and imagery strategies, but to a lesser degree than younger adults. Older adults manifest an inertial tendency to continue using the repetition strategy even though they have learned that it is inferior to interactive imagery. PMID:22224949

Integrative kinome profiling identifies mTORC1/2 inhibition as treatment strategy in ovarian clear cell carcinoma.

PubMed

Caumanns, Joseph J; Berns, Katrien; Wisman, G Bea A; Fehrmann, Rudolf S N; Tomar, Tushar; Klip, Harry; Meersma, Gert Jan; Hijmans, E Marielle; Gennissen, Annemiek; Duiker, Evelien W; Weening, Desiree; Itamochi, Hiroaki; Kluin, Roelof Jc; Reyners, An K L; Birrer, Michael J; Salvesen, Helga B; Vergote, Ignace; Van Nieuwenhuysen, Els; Brenton, James D; Braicu, Elena I; Kupryjanczyk, Jolanta; Spiewankiewicz, Beata; Mittempergher, Lorenza; Bernards, Rene; van der Zee, Ate G J; de Jong, Steven

2018-04-23

Advanced stage ovarian clear cell carcinoma (OCCC) is unresponsive to conventional platinum-based chemotherapy. Frequent alterations in OCCC include deleterious mutations in the tumor suppressor ARID1A and activating mutations in the PI3K subunit PIK3CA. In this study, we aimed to identify currently unknown mutated kinases in OCCC patients and test druggability of downstream affected pathways in OCCC models. In a large set of OCCC patients (n=124), the human kinome (518 kinases) and additional cancer related genes were sequenced and copy number alterations were determined. Genetically characterized OCCC cell lines (n=17) and OCCC patient-derived xenografts (n=3) were used for drug testing of ERBB tyrosine kinase inhibitors erlotinib and lapatinib, the PARP inhibitor olaparib and the mTORC1/2 inhibitor AZD8055. We identified several putative driver mutations in kinases at low frequency that were not previously annotated in OCCC. Combining mutations and copy number alterations, 91% of all tumors are affected in the PI3K/AKT/mTOR pathway, the MAPK pathway or the ERBB family of receptor tyrosine kinases and 82% in the DNA repair pathway. Strong p-S6 staining in OCCC patients suggests high mTORC1/2 activity. We consistently found that the majority of OCCC cell lines are especially sensitive to mTORC1/2 inhibition by AZD8055 and not towards drugs targeting ERBB family of receptor tyrosine kinases or DNA repair signaling. We subsequently demonstrated the efficacy of mTORC1/2 inhibition in all our unique OCCC patient-derived xenograft models. These results propose mTORC1/2 inhibition as an effective treatment strategy in OCCC. Copyright ©2018, American Association for Cancer Research.

Contingency Space Analysis: An Alternative Method for Identifying Contingent Relations from Observational Data

PubMed Central

Martens, Brian K; DiGennaro, Florence D; Reed, Derek D; Szczech, Frances M; Rosenthal, Blair D

2008-01-01

Descriptive assessment methods have been used in applied settings to identify consequences for problem behavior, thereby aiding in the design of effective treatment programs. Consensus has not been reached, however, regarding the types of data or analytic strategies that are most useful for describing behavior–consequence relations. One promising approach involves the analysis of conditional probabilities from sequential recordings of behavior and events that follow its occurrence. In this paper we review several strategies for identifying contingent relations from conditional probabilities, and propose an alternative strategy known as a contingency space analysis (CSA). Step-by-step procedures for conducting and interpreting a CSA using sample data are presented, followed by discussion of the potential use of a CSA for conducting descriptive assessments, informing intervention design, and evaluating changes in reinforcement contingencies following treatment. PMID:18468280

Effects of Direct Instruction and Strategy Modeling on Upper-Primary Students’ Writing Development

PubMed Central

López, Paula; Torrance, Mark; Rijlaarsdam, Gert; Fidalgo, Raquel

2017-01-01

Strategy-focused instruction is one of the most effective approaches to improve writing skills. It aims to teach developing writers strategies that give them executive control over their writing processes. Programs under this kind of instruction tend to have multiple components that include direct instruction, modeling and scaffolded practice. This multi-component nature has two drawbacks: it makes implementation challenging due to the amount of time and training required to perform each stage, and it is difficult to determine the underlying mechanisms that contribute to its effectiveness. To unpack why strategy-focused instruction is effective, we explored the specific effects of two key components: direct teaching of writing strategies and modeling of strategy use. Six classes (133 students) of upper-primary education were randomly assigned to one of the two experimental conditions, in which students received instruction aimed at developing effective strategies for planning and drafting, or control group with no strategy instruction: Direct Instruction (N = 46), Modeling (N = 45), and Control (N = 42). Writing performance was assessed before the intervention and immediately after the intervention with two tasks, one collaborative and the other one individual to explore whether differential effects resulted from students writing alone or in pairs. Writing performance was assessed through reader-based and text-based measures of text quality. Results at post-test showed similar improvement in both intervention conditions, relatively to controls, in all measures and in both the collaborative and the individual task. No statistically significant differences were observed between experimental conditions. These findings suggest that both components, direct teaching and modeling, are equally effective in improving writing skills in upper primary students, and these effects are present even after a short training. PMID:28713299

Effect of educational components and strategies associated with insulin pump therapy: a systematic review.

PubMed

Jayasekara, Rasika Sirilal; Munn, Zachary; Lockwood, Craig

2011-12-01

The objectives of this review were to establish the effectiveness of approaches to the provision of education for adults with type 1 diabetes using or initiating insulin pump therapy (IPT), and identify the best available evidence on the association between intervals and duration of follow up and the stated outcome criteria. This review considered all studies and papers that involved adults (aged 16 years or over) with type 1 diabetes using IPT as their primary form of therapy who participated in education or training, with no restrictions placed on gender or comorbidities. All forms of education, including resources utilised during education were included in the review. The search strategy sought to find both published and unpublished studies and papers written in the English language. An initial limited search of MEDLINE and CINAHL databases was undertaken to identify optimal search terms. A second search using all identified key words and index terms was then undertaken based on key words specific to each database across all included databases from 1998 to February 2008. Thirdly, the reference lists of all identified reports and articles were searched for additional studies. Two independent reviewers assessed the methodological quality of retrieved papers using the corresponding checklist from the System for the Unified Management, Assessment and Review of Information (SUMARI) package. A total of 142 studies were identified as potentially relevant to the review question in the first and second steps of the literature search. Based on the title and abstract, 24 papers that were relevant to the review topic were retrieved for evaluation of methodological quality. Following this stage, 20 papers were excluded. Whilst searching the reference lists of the selected studies (n = 4), one paper met the inclusion criteria. Therefore, a total of five descriptive studies were included in the review. The included papers reported a variety of educational methods and

Newborns with suspected occult spinal dysraphism: a cost-effectiveness analysis of diagnostic strategies.

PubMed

Medina, L S; Crone, K; Kuntz, K M

2001-12-01

To assess the clinical and economic consequences of different diagnostic strategies in newborns with suspected occult spinal dysraphism. A decision-analytic model was constructed to project the cost and health outcomes of magnetic resonance imaging (MRI), ultrasound (US), plain radiographs, and no imaging in newborns with suspected occult spinal dysraphism. Morbidity and mortality rates of early versus late diagnosis of dysraphism and the sensitivity and specificity of MRI, US, and plain radiographs were obtained from the literature. Cost estimates were obtained from a hospital cost accounting database and from the Medicaid fee schedule. We found that the choice of imaging strategy depends on the underlying risk of occult spinal dysraphism. In low-risk children with intergluteal dimple or newborns of diabetic mothers (pretest probability: 0.3%-0.34%), US was the most effective strategy with an incremental cost-effectiveness ratio of $55 100 per quality-adjusted life year gained. For children with lumbosacral dimples, who have a higher pretest probability of 3.8%, US was less costly and more effective than the other 3 strategies considered. In intermediate-risk newborns with low anorectal malformation (pretest probability: 27%), US was more effective and less costly than radiographs and no imaging. However, MRI was more effective than US at an incremental cost-effectiveness of $1000 per quality-adjusted life year gained. In the high-risk group that included high anorectal malformation, cloacal malformation, and exstrophy (pretest probability: 44%-46%), MRI was actually cost-saving when compared with the other diagnostic strategies. For the intermediate-risk group, we found our analysis to be sensitive to the costs and diagnostic performances (sensitivity and specificity) of MRI and US. Lower MRI cost or greater MRI diagnostic performance improved the cost-effectiveness of the MRI strategy, whereas lower US cost or greater US diagnostic performance worsened the cost-effectiveness

Human capital strategy: talent management.

PubMed

Nagra, Michael

2011-01-01

Large organizations, including the US Army Medical Department and the Army Nurse Corps, are people-based organizations. Consequently, effective and efficient management of the human capital within these organizations is a strategic goal for the leadership. Over time, the Department of Defense has used many different systems and strategies to manage people throughout their service life-cycle. The current system in use is called Human Capital Management. In the near future, the Army's human capital will be managed based on skills, knowledge, and behaviors through various measurement tools. This article elaborates the human capital management strategy within the Army Nurse Corps, which identifies, develops, and implements key talent management strategies under the umbrella of the Corps' human capital goals. The talent management strategy solutions are aligned under the Nurse Corps business strategy captured by the 2008 Army Nurse Corps Campaign Plan, and are implemented within the context of the culture and core values of the organization.

Understanding MBA Consumer Needs and the Development of Marketing Strategy

ERIC Educational Resources Information Center

Dailey, Lynn; Anderson, Murphy; Ingenito, Cristina; Duffy, David; Krimm, Paul; Thomson, Scott

2006-01-01

The need to develop marketing strategies in higher education is evident. In order to develop effective strategies, marketers must understand the basic needs that their product fulfills. Exploratory research was utilized to identify and better understand the needs that motivate consumers to pursue an MBA degree. This paper emphasizes the importance…

Engineering nanoparticle strategies for effective cancer immunotherapy.

PubMed

Yoon, Hong Yeol; Selvan, Subramanian Tamil; Yang, Yoosoo; Kim, Min Ju; Yi, Dong Kee; Kwon, Ick Chan; Kim, Kwangmeyung

2018-03-21

Cancer immunotherapy has been emerging in recent years, due to the inherent nature of the immune system. Although recent successes of immunotherapeutics in clinical application have attracted development of a novel immunotherapeutics, the off-target side effect and low immunogenicity of them remain challenges for the effective cancer immunotherapy. Theranostic nanoparticle system may one of key technology to address these issues by offering targeted delivery of various types of immunotherapeutics, resulting in significant improvements in the tumor immunotherapy. However, appropriate design or engineering of nanoparticles will be needed to improve delivery efficiency of antigen, adjuvant and therapeutics, resulting in eliciting antitumor immunity. Here, we review the current state of the art of cancer immunotherapeutic strategies, mainly based on nanoparticles (NPs). This includes NP-based antigen/adjuvant delivery vehicles to draining lymph nodes, and tumor antigen-specific T-lymphocytes for cancer immunotherapy. Several NP-based examples are shown for immune checkpoint modulation and immunogenic cell death. These overall studies demonstrate the great potential of NPs in cancer immunotherapy. Finally, engineering NP strategies will provide great opportunities to improve therapeutic effects as well as optimization of treatment processes, allowing to meet the individual needs in the cancer immunotherapy. Copyright © 2018 Elsevier Ltd. All rights reserved.

Sensemaking Strategies for Ethical Decision-making

PubMed Central

Caughron, Jay J.; Antes, Alison L.; Stenmark, Cheryl K.; Thiel, Chaise E.; Wang, Xiaoqian; Mumford, Michael D.

2015-01-01

The current study uses a sensemaking model and thinking strategies identified in earlier research to examine ethical decision-making. Using a sample of 163 undergraduates, a low fidelity simulation approach is used to study the effects personal involvement (in causing the problem and personal involvement in experiencing the outcomes of the problem) could have on the use of cognitive reasoning strategies that have been shown to promote ethical decision-making. A mediated model is presented which suggests that environmental factors influence reasoning strategies, reasoning strategies influence sensemaking, and sensemaking in turn influences ethical decision-making. Findings were mixed but generally supported the hypothesized model. Interestingly, framing the outcomes of ethically charged situations in terms of more global organizational outcomes rather than personal outcomes was found to promote the use of pro-ethical cognitive reasoning strategies. PMID:26257505

Identifying transposon insertions and their effects from RNA-sequencing data.

PubMed

de Ruiter, Julian R; Kas, Sjors M; Schut, Eva; Adams, David J; Koudijs, Marco J; Wessels, Lodewyk F A; Jonkers, Jos

2017-07-07

Insertional mutagenesis using engineered transposons is a potent forward genetic screening technique used to identify cancer genes in mouse model systems. In the analysis of these screens, transposon insertion sites are typically identified by targeted DNA-sequencing and subsequently assigned to predicted target genes using heuristics. As such, these approaches provide no direct evidence that insertions actually affect their predicted targets or how transcripts of these genes are affected. To address this, we developed IM-Fusion, an approach that identifies insertion sites from gene-transposon fusions in standard single- and paired-end RNA-sequencing data. We demonstrate IM-Fusion on two separate transposon screens of 123 mammary tumors and 20 B-cell acute lymphoblastic leukemias, respectively. We show that IM-Fusion accurately identifies transposon insertions and their true target genes. Furthermore, by combining the identified insertion sites with expression quantification, we show that we can determine the effect of a transposon insertion on its target gene(s) and prioritize insertions that have a significant effect on expression. We expect that IM-Fusion will significantly enhance the accuracy of cancer gene discovery in forward genetic screens and provide initial insight into the biological effects of insertions on candidate cancer genes. © The Author(s) 2017. Published by Oxford University Press on behalf of Nucleic Acids Research.

The Effect of Reciprocal Teaching Intervention Strategy on Reading Comprehension Skills of 5th Grade Elementary School Students with Reading Disabilities

ERIC Educational Resources Information Center

Gomaa, Omema Mostafa Kamel

2015-01-01

This study investigated the effect of using reciprocal teaching intervention strategy on improving reading comprehension of reading disabled students in primary five. A total of 66 students identified with RD participated. The sample was divided into two groups; experimental (n = 33 boys) and control (n = 33 boys). ANCOVA and T test were employed…

Stop! Look & Lesson: A Guide to Identifying and Correcting Common Mathematical Errors Strategies.

ERIC Educational Resources Information Center

Palmer, Don; And Others

This book provides a comprehensive collection of 66 teaching strategies and ideas to help overcome problems with number, each linked to a specific kind of error described in the related manual. Most of these strategies are classroom-ready and easily implemented. Some are notes for the teacher to read and then plan activities accordingly, and many…

A comparison of alternative strategies for cost-effective water quality management in lakes.

PubMed

Kramer, Daniel Boyd; Polasky, Stephen; Starfield, Anthony; Palik, Brian; Westphal, Lynne; Snyder, Stephanie; Jakes, Pamela; Hudson, Rachel; Gustafson, Eric

2006-09-01

Roughly 45% of the assessed lakes in the United States are impaired for one or more reasons. Eutrophication due to excess phosphorus loading is common in many impaired lakes. Various strategies are available to lake residents for addressing declining lake water quality, including septic system upgrades and establishing riparian buffers. This study examines 25 lakes to determine whether septic upgrades or riparian buffers are a more cost-effective strategy to meet a phosphorus reduction target. We find that riparian buffers are the more cost-effective strategy in every case but one. Large transaction costs associated with the negotiation and monitoring of riparian buffers, however, may be prohibiting lake residents from implementing the most cost-effective strategy.

A Comparison of Alternative Strategies for Cost-Effective Water Quality Management in Lakes

NASA Astrophysics Data System (ADS)

Kramer, Daniel Boyd; Polasky, Stephen; Starfield, Anthony; Palik, Brian; Westphal, Lynne; Snyder, Stephanie; Jakes, Pamela; Hudson, Rachel; Gustafson, Eric

2006-09-01

Roughly 45% of the assessed lakes in the United States are impaired for one or more reasons. Eutrophication due to excess phosphorus loading is common in many impaired lakes. Various strategies are available to lake residents for addressing declining lake water quality, including septic system upgrades and establishing riparian buffers. This study examines 25 lakes to determine whether septic upgrades or riparian buffers are a more cost-effective strategy to meet a phosphorus reduction target. We find that riparian buffers are the more cost-effective strategy in every case but one. Large transaction costs associated with the negotiation and monitoring of riparian buffers, however, may be prohibiting lake residents from implementing the most cost-effective strategy.

Why Study Geoscience? Identifying Effective Recruitment and Retention Strategies for an Undergraduate Earth & Environmental Sciences Program

NASA Astrophysics Data System (ADS)

Vajoczki, S.; Eyles, C. H.; Stewart, J.; Dasilva, L.

2005-12-01

McMaster University is a `research intensive' university with 17,000+ full time undergraduate students. The School of Geography and Earth Sciences (SGES) is located within the Faculty of Science, offers B.Sc., B.A., M.Sc., M.A. and PhD degree programs and teaches more than 70 undergraduate courses on an annual basis. The Honours B.Sc program in Earth and Environmental Sciences (EES) graduates approximately 25 students per year. Students enroll in undergraduate SGES programs in their second year, after completion of an introductory first year in the Faculty of Science in which they take compulsory science courses including math, physics, chemistry, and biology. First year students, as well as those in upper years, may also elect to take one or more of three introductory courses offered by SGES (Earth & the Environment, The Living Environment, Atmosphere & Hydrosphere) to complete their science requirements. Most students entering the Faculty of Science know little about geoscience as it does not form an important part of the Ontario secondary school curriculum. Hence, recruitment into the EES program is primarily via the first year courses. In order to establish reasons why students elected to take the introductory courses offered by SGES, and their reasons for considering subsequent entry to the B.Sc program, a survey of students taking one of the courses was conducted in the fall of 2003. Results from the survey indicate that students enroll in the course, and subsequently the EES program, for a variety of reasons including: general interest in how the planet works, concern for the environment, interesting title of the course and reputation of the instructor. Student concern over lack of potential jobs is cited as the main reason for not pursuing a degree in geoscience. This survey has helped to direct the multifaceted recruitment strategies used by SGES to continue to develop its undergraduate program through delivery of high quality first year courses

Strategies for Sustained Weight Management: Perspectives From African American Patients With Type 2 Diabetes.

PubMed

Fitzpatrick, Stephanie L; Hill-Briggs, Felicia

2017-06-01

Purpose The purpose of this study was to identify effective strategies for sustained weight management used by African American patients with obesity and type 2 diabetes. Methods In this study, nominal group technique was used to identify effective strategies for weight management used by 12 African Americans with overweight/obesity and type 2 diabetes who successfully lost or maintained their weight after completing DECIDE (Decision-making Education for Choices In Diabetes Everyday), a 9-module, literacy-adapted diabetes and cardiovascular disease (CVD) education and problem-solving training program. Results Participants generated a list of 101 strategies that covered 4 domains: nutrition, physical activity, cognitive-behavioral strategies, and other. Self-monitoring and relying on social support were the top 2 strategies for weight maintenance. Conclusion Future obesity studies should consider including friends/family as well as electronic tools to facilitate self-monitoring and regular practice of behavioral strategies for long-term success.

Identifying strategies to improve access to credible and relevant information for public health professionals: a qualitative study

PubMed Central

LaPelle, Nancy R; Luckmann, Roger; Simpson, E Hatheway; Martin, Elaine R

2006-01-01

Background Movement towards evidence-based practices in many fields suggests that public health (PH) challenges may be better addressed if credible information about health risks and effective PH practices is readily available. However, research has shown that many PH information needs are unmet. In addition to reviewing relevant literature, this study performed a comprehensive review of existing information resources and collected data from two representative PH groups, focusing on identifying current practices, expressed information needs, and ideal systems for information access. Methods Nineteen individual interviews were conducted among employees of two domains in a state health department – communicable disease control and community health promotion. Subsequent focus groups gathered additional data on preferences for methods of information access and delivery as well as information format and content. Qualitative methods were used to identify themes in the interview and focus group transcripts. Results Informants expressed similar needs for improved information access including single portal access with a good search engine; automatic notification regarding newly available information; access to best practice information in many areas of interest that extend beyond biomedical subject matter; improved access to grey literature as well as to more systematic reviews, summaries, and full-text articles; better methods for indexing, filtering, and searching for information; and effective ways to archive information accessed. Informants expressed a preference for improving systems with which they were already familiar such as PubMed and listservs rather than introducing new systems of information organization and delivery. A hypothetical ideal model for information organization and delivery was developed based on informants' stated information needs and preferred means of delivery. Features of the model were endorsed by the subjects who reviewed it. Conclusion

Alternative strategies to reduce maternal mortality in India: a cost-effectiveness analysis.

PubMed

Goldie, Sue J; Sweet, Steve; Carvalho, Natalie; Natchu, Uma Chandra Mouli; Hu, Delphine

2010-04-20

Approximately one-quarter of all pregnancy- and delivery-related maternal deaths worldwide occur in India. Taking into account the costs, feasibility, and operational complexity of alternative interventions, we estimate the clinical and population-level benefits associated with strategies to improve the safety of pregnancy and childbirth in India. Country- and region-specific data were synthesized using a computer-based model that simulates the natural history of pregnancy (both planned and unintended) and pregnancy- and childbirth-associated complications in individual women; and considers delivery location, attendant, and facility level. Model outcomes included clinical events, population measures, costs, and cost-effectiveness ratios. Separate models were adapted to urban and rural India using survey-based data (e.g., unmet need for birth spacing/limiting, facility births, skilled birth attendants). Model validation compared projected maternal indicators with empiric data. Strategies consisted of improving coverage of effective interventions that could be provided individually or packaged as integrated services, could reduce the incidence of a complication or its case fatality rate, and could include improved logistics such as reliable transport to an appropriate referral facility as well as recognition of referral need and quality of care. Increasing family planning was the most effective individual intervention to reduce pregnancy-related mortality. If over the next 5 y the unmet need for spacing and limiting births was met, more than 150,000 maternal deaths would be prevented; more than US$1 billion saved; and at least one of every two abortion-related deaths averted. Still, reductions in maternal mortality reached a threshold ( approximately 23%-35%) without including strategies that ensured reliable access to intrapartum and emergency obstetrical care (EmOC). An integrated and stepwise approach was identified that would ultimately prevent four of five

Alternative Strategies to Reduce Maternal Mortality in India: A Cost-Effectiveness Analysis

PubMed Central

Goldie, Sue J.; Sweet, Steve; Carvalho, Natalie; Natchu, Uma Chandra Mouli; Hu, Delphine

2010-01-01

Background Approximately one-quarter of all pregnancy- and delivery-related maternal deaths worldwide occur in India. Taking into account the costs, feasibility, and operational complexity of alternative interventions, we estimate the clinical and population-level benefits associated with strategies to improve the safety of pregnancy and childbirth in India. Methods and Findings Country- and region-specific data were synthesized using a computer-based model that simulates the natural history of pregnancy (both planned and unintended) and pregnancy- and childbirth-associated complications in individual women; and considers delivery location, attendant, and facility level. Model outcomes included clinical events, population measures, costs, and cost-effectiveness ratios. Separate models were adapted to urban and rural India using survey-based data (e.g., unmet need for birth spacing/limiting, facility births, skilled birth attendants). Model validation compared projected maternal indicators with empiric data. Strategies consisted of improving coverage of effective interventions that could be provided individually or packaged as integrated services, could reduce the incidence of a complication or its case fatality rate, and could include improved logistics such as reliable transport to an appropriate referral facility as well as recognition of referral need and quality of care. Increasing family planning was the most effective individual intervention to reduce pregnancy-related mortality. If over the next 5 y the unmet need for spacing and limiting births was met, more than 150,000 maternal deaths would be prevented; more than US$1 billion saved; and at least one of every two abortion-related deaths averted. Still, reductions in maternal mortality reached a threshold (∼23%–35%) without including strategies that ensured reliable access to intrapartum and emergency obstetrical care (EmOC). An integrated and stepwise approach was identified that would ultimately

Strategies for Effectively Documenting Sexual Orientation and Gender Identity in Electronic Health Record.

PubMed

Frangella, Julia; Otero, Carlos; Luna, Daniel

2018-01-01

In this communication we identify strategies for effectively documenting Sexual Orientation and Gender Identity in Electronic Health Records. For this review a multidisciplinary group composed by three physicians, a nurse, an engineer and a lawyer analyzed the evidence in bibliography related to the topic and summarized the results. After analyzing the information, we summarized and classified them into three major topics: To request, to store and to display and access to the information. How to standardize those data and where data specifically will be populated in EHRs have not been answered yet. The target of all of these efforts should be: to be sensitive with the needs of the patient and to ensure high quality of care.

Evaluating the effectiveness of a training program that builds teachers’ capability to identify and appropriately refer middle and high school students with mental health problems in Brazil: an exploratory study

PubMed Central

2014-01-01

Background In Brazil, like many countries, there has been a failure to identify mental health problems (MHP) in young people and refer them to appropriate care and support. The school environment provides an ideal setting to do this. Therefore, effective programs need to be developed to train teachers to identify and appropriately refer children with possible MHP. We aimed to evaluate teachers’ ability to identify and appropriately refer students with possible MHP, and the effectiveness of a psychoeducational strategy to build teachers’ capability in this area. Methods To meet the first objective, we conducted a case-control study using a student sample. To meet the second, we employed longitudinal design with repeated measures before and after introducing the psychoeducational strategy using a teacher sample. In the case control study, the Youth Self-Report was used to investigate internalizing and externalizing problems. Before training, teachers selected 26 students who they thought were likely to have MHP. Twenty-six non-selected students acted as controls and were matched by gender, age and grade. The underlying principle was that if teachers could identify abnormal behaviors among their actual students, those with some MHP would likely be among the case group and those without among the control group. In the longitudinal study, 32 teachers were asked to evaluate six vignettes that highlighted behaviors indicating a high risk for psychosis, depression, conduct disorder, hyperactivity, mania, and normal adolescent behavior. We calculated the rates of correct answers for identifying the existence of some MHP and the need for referral before and after training; teachers were not asked to identify the individual conditions. Results Teachers were already able to identify the most symptomatic students, who had both internalizing and externalizing problems, as possibly having MHP, but teachers had difficulty in identifying students with internalizing problems

Evaluating the effectiveness of a training program that builds teachers' capability to identify and appropriately refer middle and high school students with mental health problems in Brazil: an exploratory study.

PubMed

Vieira, Marlene A; Gadelha, Ary A; Moriyama, Taís S; Bressan, Rodrigo A; Bordin, Isabel A

2014-02-28

In Brazil, like many countries, there has been a failure to identify mental health problems (MHP) in young people and refer them to appropriate care and support. The school environment provides an ideal setting to do this. Therefore, effective programs need to be developed to train teachers to identify and appropriately refer children with possible MHP. We aimed to evaluate teachers' ability to identify and appropriately refer students with possible MHP, and the effectiveness of a psychoeducational strategy to build teachers' capability in this area. To meet the first objective, we conducted a case-control study using a student sample. To meet the second, we employed longitudinal design with repeated measures before and after introducing the psychoeducational strategy using a teacher sample. In the case control study, the Youth Self-Report was used to investigate internalizing and externalizing problems. Before training, teachers selected 26 students who they thought were likely to have MHP. Twenty-six non-selected students acted as controls and were matched by gender, age and grade. The underlying principle was that if teachers could identify abnormal behaviors among their actual students, those with some MHP would likely be among the case group and those without among the control group. In the longitudinal study, 32 teachers were asked to evaluate six vignettes that highlighted behaviors indicating a high risk for psychosis, depression, conduct disorder, hyperactivity, mania, and normal adolescent behavior. We calculated the rates of correct answers for identifying the existence of some MHP and the need for referral before and after training; teachers were not asked to identify the individual conditions. Teachers were already able to identify the most symptomatic students, who had both internalizing and externalizing problems, as possibly having MHP, but teachers had difficulty in identifying students with internalizing problems alone. At least 50.0% of teachers

Expertise in ill-defined problem-solving domains as effective strategy use.

PubMed

Schunn, Christian D; McGregor, Mark U; Saner, Lelyn D

2005-12-01

Expertise consists of many different cognitive structures. Lemaire and Siegler (1995) have proposed a four-layered account of expertise from a strategies perspective: Experts have better strategies, tend to use strategies that are better overall more often, are better able to select the circumstances to which a strategy best applies, and are better able to execute a given strategy. Originally, this account came from work in simple, well-defined domains. We explored this account in the complex, ill-defined domain of platoon leadership. In Experiment 1A, we elicited free-text responses to leadership scenarios from novices, intermediates, and experts, finding expertise effects for strategy base rates and choice, but not for strategy existence or the number of strategies used. In Experiment 1B, we used a new group of experts to gather ratings of the execution accuracy of the responses in Experiment 1A and found expertise differences in the ability to execute the same strategies. We propose several elaborations to the original four-layered strategies account of expertise on the basis of these results.

Effects of cooperative learning strategy on undergraduate kinesiology students' learning styles.

PubMed

Meeuwsen, Harry J; King, George A; Pederson, Rockie

2005-10-01

A growing body of research supports cooperative learning as an effective teaching strategy. A specific cooperative learning strategy, Team-based Learning, was applied to a convenience sample of four undergraduate sophomore-level motor behavior courses over four semesters from Fall 2002 to Spring 2004 to examine whether this strategy would affect students' learning styles. The data from the Grasha-Reichmann Student Learning Style Scales indicated that this teaching strategy was associated with a significant decrease in the negative Avoidant and Dependent learning styles and an improvement in the positive Participant learning style.

Introduction strategies raise key questions.

PubMed

Finger, W R; Keller, S

1995-09-01

Key issues that must be considered before a new contraceptive is introduced center on the need for a trained provider to begin or terminate the method, its side effects, duration of use, method's ability to meet users' needs and preferences, and extra training or staff requirements. Logistics and economic issues to consider are identifying a dependable way of effectively supplying commodities, planning extra services needed for the method, and cost of providing the method. Each contraceptive method presents a different side effect pattern and burdens the service delivery setting differently. The strategy developed to introduce or expand the 3-month injectable Depo-Provera (DMPA) can be used for any method. It includes a needs assessment and addresses regulatory issues, service delivery policies and procedures, information and training, evaluation, and other concerns. Viet Nam's needs assessment showed that Norplant should not be introduced until the service delivery system becomes stronger. Any needs assessment for expansion of contraceptive services should cover sexually transmitted disease/HIV issues. A World Health Organization strategy helps officials identify the best method mix for local situations. Introductory strategies must aim to improve the quality of family planning programs and expand choices. Many begin by examining existing data and conducting interviews with policymakers, users, providers, and women's health advocates. Introductory programs for Norplant focus on provider training, adequate counseling and informed consent for users, and ready access to removal. They need a well-prepared service delivery infrastructure. The first phase of the DMPA introductory strategy for the Philippines comprised a social marketing campaign and DMPA introduction at public clinics in 10 pilot areas with strong service delivery. Successful AIDS prevention programs show that people tend to use barrier methods when they are available. USAID is currently studying

Effectiveness and cost-effectiveness of different immunization strategies against whooping cough to reduce child morbidity and mortality.

PubMed