An exploratory study about meaningful work in acute care nursing.

PubMed

Pavlish, Carol; Hunt, Roberta

2012-01-01

To develop deeper understandings about nurses' perceptions of meaningful work and the contextual factors that impact finding meaning in work. Much has been written about nurses' job satisfaction and the impact on quality of health care. However, scant qualitative evidence exists regarding nurses' perceptions of meaningful work and how factors in the work environment influence their perceptions. The literature reveals links among work satisfaction, retention, quality of care, and meaningfulness in work. Using a narrative design, researchers interviewed 13 public health nurses and 13 acute care nurses. Categorical-content analysis with Atlas.ti data management software was conducted separately for each group of nurses. This article reports results for acute care nurses. Twenty-four stories of meaningful moments were analyzed and categorized. Three primary themes of meaningful work emerged: connections, contributions, and recognition. Participants described learning-focused environment, teamwork, constructive management, and time with patients as facilitators of meaningfulness and task-focused environment, stressful relationships, and divisive management as barriers. Meaningful nursing roles were advocate, catalyst and guide, and caring presence. Nurse administrators are the key to improving quality of care by nurturing opportunities for nurses to find meaning and satisfaction in their work. Study findings provide nurse leaders with new avenues for improving work environments and job satisfaction to potentially enhance healthcare outcomes. © 2012 Wiley Periodicals, Inc.

Determining the longitudinal validity and meaningful differences in HRQL of the PedsQL™ Sickle Cell Disease Module.

PubMed

Panepinto, Julie A; Paul Scott, J; Badaki-Makun, Oluwakemi; Darbari, Deepika S; Chumpitazi, Corrie E; Airewele, Gladstone E; Ellison, Angela M; Smith-Whitley, Kim; Mahajan, Prashant; Sarnaik, Sharada A; Charles Casper, T; Cook, Larry J; Leonard, Julie; Hulbert, Monica L; Powell, Elizabeth C; Liem, Robert I; Hickey, Robert; Krishnamurti, Lakshmanan; Hillery, Cheryl A; Brousseau, David C

2017-06-12

Detecting change in health status over time and ascertaining meaningful changes are critical elements when using health-related quality of life (HRQL) instruments to measure patient-centered outcomes. The PedsQL™ Sickle Cell Disease module, a disease specific HRQL instrument, has previously been shown to be valid and reliable. Our objectives were to determine the longitudinal validity of the PedsQL™ Sickle Cell Disease module and the change in HRQL that is meaningful to patients. An ancillary study was conducted utilizing a multi-center prospective trial design. Children ages 4-21 years with sickle cell disease admitted to the hospital for an acute painful vaso-oclusive crisis were eligible. Children completed HRQL assessments at three time points (in the Emergency Department, one week post-discharge, and at return to baseline (One to three months post-discharge). The primary outcome was change in HRQL score. Both distribution (effect size, standard error of measurement (SEM)) and anchor (global change assessment) based methods were used to determine the longitudinal validity and meaningful change in HRQL. Changes in HRQL meaningful to patients were identified by anchoring the change scores to the patient's perception of global improvement in pain. Moderate effect sizes (0.20-0.80) were determined for all domains except the Communication I and Cognitive Fatigue domains. The value of 1 SEM varied from 3.8-14.6 across all domains. Over 50% of patients improved by at least 1 SEM in Total HRQL score. A HRQL change score of 7-10 in the pain domains represented minimal perceived improvement in HRQL and a HRQL change score of 18 or greater represented moderate to large improvement. The PedsQL™ Sickle Cell Disease Module is responsive to changes in HRQL in patients experiencing acute painful vaso-occlusive crises. The study data establish longitudinal validity and meaningful change parameters for the PedsQL™ Sickle Cell Disease Module. ClinicalTrials.gov (study

Health Information Technology: Meaningful Use and Next Steps to Improving Electronic Facilitation of Medication Adherence.

PubMed

Bosworth, Hayden B; Zullig, Leah L; Mendys, Phil; Ho, Michael; Trygstad, Troy; Granger, Christopher; Oakes, Megan M; Granger, Bradi B

2016-03-15

The use of health information technology (HIT) may improve medication adherence, but challenges for implementation remain. The aim of this paper is to review the current state of HIT as it relates to medication adherence programs, acknowledge the potential barriers in light of current legislation, and provide recommendations to improve ongoing medication adherence strategies through the use of HIT. We describe four potential HIT barriers that may impact interoperability and subsequent medication adherence. Legislation in the United States has incentivized the use of HIT to facilitate and enhance medication adherence. The Health Information Technology for Economic and Clinical Health (HITECH) was recently adopted and establishes federal standards for the so-called "meaningful use" of certified electronic health record (EHR) technology that can directly impact medication adherence. The four persistent HIT barriers to medication adherence include (1) underdevelopment of data reciprocity across clinical, community, and home settings, limiting the capture of data necessary for clinical care; (2) inconsistent data definitions and lack of harmonization of patient-focused data standards, making existing data difficult to use for patient-centered outcomes research; (3) inability to effectively use the national drug code information from the various electronic health record and claims datasets for adherence purposes; and (4) lack of data capture for medication management interventions, such as medication management therapy (MTM) in the EHR. Potential recommendations to address these issues are discussed. To make meaningful, high quality data accessible, and subsequently improve medication adherence, these challenges will need to be addressed to fully reach the potential of HIT in impacting one of our largest public health issues.

Developing an instrument to measure emotional behaviour abilities of meaningful learning through the Delphi technique.

PubMed

Cadorin, Lucia; Bagnasco, Annamaria; Tolotti, Angela; Pagnucci, Nicola; Sasso, Loredana

2017-09-01

To identify items for a new instrument that measures emotional behaviour abilities of meaningful learning, according to Fink's Taxonomy. Meaningful learning is an active process that promotes a wider and deeper understanding of concepts. It is the result of an interaction between new and previous knowledge and produces a long-term change of knowledge and skills. To measure meaningful learning capability, it is very important in the education of health professionals to identify problems or special learning needs. For this reason, it is necessary to create valid instruments. A Delphi Study technique was implemented in four phases by means of e-mail. The study was conducted from April-September 2015. An expert panel consisting of ten researchers with experience in Fink's Taxonomy was established to identify the items of the instrument. Data were analysed for conceptual description and item characteristics and attributes were rated. Expert consensus was sought in each of these phases. An 87·5% consensus cut-off was established. After four rounds, consensus was obtained for validation of the content of the instrument 'Assessment of Meaningful learning Behavioural and Emotional Abilities'. This instrument consists of 56 items evaluated on a 6-point Likert-type scale. Foundational Knowledge, Application, Integration, Human Dimension, Caring and Learning How to Learn were the six major categories explored. This content validated tool can help educators (teachers, trainers and tutors) to identify and improve the strategies to support students' learning capability, which could increase their awareness of and/or responsibility in the learning process. © 2017 John Wiley & Sons Ltd.

Examining emergency department communication through a staff-based participatory research method: identifying barriers and solutions to meaningful change.

PubMed

Cameron, Kenzie A; Engel, Kirsten G; McCarthy, Danielle M; Buckley, Barbara A; Mercer Kollar, Laura Min; Donlan, Sarah M; Pang, Peter S; Makoul, Gregory; Tanabe, Paula; Gisondi, Michael A; Adams, James G

2010-12-01

We test an initiative with the staff-based participatory research (SBPR) method to elicit communication barriers and engage staff in identifying strategies to improve communication within our emergency department (ED). ED staff at an urban hospital with 85,000 ED visits per year participated in a 3.5-hour multidisciplinary workshop. The workshop was offered 6 times and involved: (1) large group discussion to review the importance of communication within the ED and discuss findings from a recent survey of patient perceptions of ED-team communication; (2) small group discussions eliciting staff perceptions of communication barriers and best practices/strategies to address these challenges; and (3) large group discussions sharing and refining emergent themes and suggested strategies. Three coders analyzed summaries from group discussions by using latent content and constant comparative analysis to identify focal themes. A total of 127 staff members, including attending physicians, residents, nurses, ED assistants, and secretaries, participated in the workshop (overall participation rate 59.6%; range 46.7% to 73.3% by staff type). Coders identified a framework of 4 themes describing barriers and proposed interventions: (1) greeting and initial interaction, (2) setting realistic expectations, (3) team communication and respect, and (4) information provision and delivery. The majority of participants (81.4%) reported that their participation would cause them to make changes in their clinical practice. Involving staff in discussing barriers and facilitators to communication within the ED can result in a meaningful process of empowerment, as well as the identification of feasible strategies and solutions at both the individual and system levels. Copyright © 2010 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

Developing a system to track meaningful outcome measures in head and neck cancer treatment.

PubMed

Walters, Ronald S; Albright, Heidi W; Weber, Randal S; Feeley, Thomas W; Hanna, Ehab Y; Cantor, Scott B; Lewis, Carol M; Burke, Thomas W

2014-02-01

The health care industry, including consumers, providers, and payers of health care, recognize the importance of developing meaningful, patient-centered measures. This article describes our experience using an existing electronic medical record largely based on free text formats without structured documentation, in conjunction with tumor registry abstraction techniques, to obtain and analyze data for use in clinical improvement and public reporting. We performed a retrospective analysis of 2467 previously untreated patients treated with curative intent who presented with laryngeal, pharyngeal, or oral cavity cancer in order to develop a system to monitor and report meaningful outcome metrics of head and neck cancer treatment. Patients treated between 1995 and 2006 were analyzed for the primary outcomes of survival at 1 and 2 years, the ability to speak at 1 year posttreatment, and the ability to swallow at 1 year posttreatment. We encountered significant limitations in clinical documentation because of the lack of standardization of meaningful measures, as well limitations with data abstraction using a retrospective approach to reporting measures. Almost 5000 person-hours were required for data abstraction, quality review, and reporting, at a cost of approximately $134,000. Our multidisciplinary teams document extensive patient information; however, data is not stored in easily accessible formats for measurement, comparison, and reporting. We recommend identifying measures meaningful to patients, providers, and payers to be documented throughout the patients' entire treatment cycle, and significant investment in the improvements to electronic medical records and tumor registry reporting in order to provide meaningful quality measures for the future. Copyright © 2013 Wiley Periodicals, Inc.

The EXCITE Trial: Predicting a Clinically Meaningful Motor Activity Log Outcome

PubMed Central

Park, Si-Woon; Wolf, Steven L.; Blanton, Sarah; Winstein, Carolee; Nichols-Larsen, Deborah S.

2013-01-01

Background and Objective This study determined which baseline clinical measurements best predicted a predefined clinically meaningful outcome on the Motor Activity Log (MAL) and developed a predictive multivariate model to determine outcome after 2 weeks of constraint-induced movement therapy (CIMT) and 12 months later using the database from participants in the Extremity Constraint Induced Therapy Evaluation (EXCITE) Trial. Methods A clinically meaningful CIMT outcome was defined as achieving higher than 3 on the MAL Quality of Movement (QOM) scale. Predictive variables included baseline MAL, Wolf Motor Function Test (WMFT), the sensory and motor portion of the Fugl-Meyer Assessment (FMA), spasticity, visual perception, age, gender, type of stroke, concordance, and time after stroke. Significant predictors identified by univariate analysis were used to develop the multivariate model. Predictive equations were generated and odds ratios for predictors were calculated from the multivariate model. Results Pretreatment motor function measured by MAL QOM, WMFT, and FMA were significantly associated with outcome immediately after CIMT. Pretreatment MAL QOM, WMFT, proprioception, and age were significantly associated with outcome after 12 months. Each unit of higher pretreatment MAL QOM score and each unit of faster pretreatment WMFT log mean time improved the probability of achieving a clinically meaningful outcome by 7 and 3 times at posttreatment, and 5 and 2 times after 12 months, respectively. Patients with impaired proprioception had a 20% probability of achieving a clinically meaningful outcome compared with those with intact proprioception. Conclusions Baseline clinical measures of motor and sensory function can be used to predict a clinically meaningful outcome after CIMT. PMID:18780883

The EXCITE Trial: Predicting a clinically meaningful motor activity log outcome.

PubMed

Park, Si-Woon; Wolf, Steven L; Blanton, Sarah; Winstein, Carolee; Nichols-Larsen, Deborah S

2008-01-01

This study determined which baseline clinical measurements best predicted a predefined clinically meaningful outcome on the Motor Activity Log (MAL) and developed a predictive multivariate model to determine outcome after 2 weeks of constraint-induced movement therapy (CIMT) and 12 months later using the database from participants in the Extremity Constraint Induced Therapy Evaluation (EXCITE) Trial. A clinically meaningful CIMT outcome was defined as achieving higher than 3 on the MAL Quality of Movement (QOM) scale. Predictive variables included baseline MAL, Wolf Motor Function Test (WMFT), the sensory and motor portion of the Fugl-Meyer Assessment (FMA), spasticity, visual perception, age, gender, type of stroke, concordance, and time after stroke. Significant predictors identified by univariate analysis were used to develop the multivariate model. Predictive equations were generated and odds ratios for predictors were calculated from the multivariate model. Pretreatment motor function measured by MAL QOM, WMFT, and FMA were significantly associated with outcome immediately after CIMT. Pretreatment MAL QOM, WMFT, proprioception, and age were significantly associated with outcome after 12 months. Each unit of higher pretreatment MAL QOM score and each unit of faster pretreatment WMFT log mean time improved the probability of achieving a clinically meaningful outcome by 7 and 3 times at posttreatment, and 5 and 2 times after 12 months, respectively. Patients with impaired proprioception had a 20% probability of achieving a clinically meaningful outcome compared with those with intact proprioception. Baseline clinical measures of motor and sensory function can be used to predict a clinically meaningful outcome after CIMT.

Increased trunk extension endurance is associated with meaningful improvement in balance among older adults with mobility problems.

PubMed

Suri, Pradeep; Kiely, Dan K; Leveille, Suzanne G; Frontera, Walter R; Bean, Jonathan F

2011-07-01

To determine whether trunk extension endurance changes with training are associated with clinically meaningful improvements in balance among mobility-limited older adults. Longitudinal data from a randomized controlled trial. Outpatient rehabilitation research center. Community-dwelling older adults (N=64; mean age, 75.9y) with mobility limitations as defined by a score of 4 to 10 on the Short Physical Performance Battery. Sixteen weeks of progressive resistance training. Outcomes were the Berg Balance Scale (BBS) and the Unipedal Stance Time (UST). Predictors included leg strength, leg power, trunk extension endurance, and the product of heart rate and blood pressure (RPP) at the final stage of an exercise tolerance test. We performed an analysis of data from participants who completed 16 weeks of training by using binary outcomes defined by a clinically meaningful change (CMC) from baseline to completion of the intervention (BBS=4 units; UST=5s). The association of predictor variables with balance outcomes was examined separately and together in multivariate adjusted logistic regression models. Trunk extension endurance in seconds (1.04 [1.00-1.09]) was independently associated with CMC on the BBS. Trunk extension endurance (1.02 [1.00-1.03]) was independently associated with CMC on the UST. Other physical attributes were not associated with meaningful change in balance. Improvements in trunk extension endurance were independently associated with CMCs in balance in older adults. Leg strength, leg power, and RPP were not associated with CMC in balance. Poor trunk extension endurance may be a rehabilitative impairment worthy of further study as a modifiable factor linked to balance among older adults. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

An algorithm for encryption of secret images into meaningful images

NASA Astrophysics Data System (ADS)

Kanso, A.; Ghebleh, M.

2017-03-01

Image encryption algorithms typically transform a plain image into a noise-like cipher image, whose appearance is an indication of encrypted content. Bao and Zhou [Image encryption: Generating visually meaningful encrypted images, Information Sciences 324, 2015] propose encrypting the plain image into a visually meaningful cover image. This improves security by masking existence of encrypted content. Following their approach, we propose a lossless visually meaningful image encryption scheme which improves Bao and Zhou's algorithm by making the encrypted content, i.e. distortions to the cover image, more difficult to detect. Empirical results are presented to show high quality of the resulting images and high security of the proposed algorithm. Competence of the proposed scheme is further demonstrated by means of comparison with Bao and Zhou's scheme.

Patient-level clinically meaningful improvements in activities of daily living and pain after total hip arthroplasty: data from a large US institutional registry.

PubMed

Singh, Jasvinder A; Lewallen, David G

2013-06-01

To characterize patient-level clinically meaningful improvements in pain and limitation of key activities of daily living (ADLs) after primary or revision total hip arthroplasty (THA). We analysed prospectively collected data from the Mayo Clinic Total Joint Registry to study clinically meaningful improvements in index hip pain severity and limitation in seven key ADLs (walking, climbing stairs, putting on shoes/socks, picking up objects, getting in/out of car, rising from a chair and sitting), from preoperative to 2- and 5-year post-THA. The primary THA cohort consisted of 6168 responders preoperatively, 5707 at 2 years and 3289 at 5 years postoperatively. The revision THA cohort consisted of 2063 responders preoperatively, 2682 at 2 years and 1627 at 5 years postoperatively. In the primary THA cohort, clinically meaningful pain reduction to mild or no hip pain at 2 years was reported by 94% with moderate and 91% with severe preoperative pain; respective proportions were 91% and 89% at 5-year follow-up. For revision THA, respective proportions were 84% and 77% at 2 years and 80% and 78% at 5 years. In the primary THA cohort, up to 4% with moderate and 17% with severe preoperative ADL limitation reported severe limitation in the respective activity 2 years post-primary THA; at 5 years, the respective proportions were up to 7% and 20%. Respective proportions for revision THA were up to 10% and 26% at 2 years and 13% and 30% at 5 years. These comprehensive data for patient-level clinically meaningful improvements in pain and seven key ADLs can help patients set realistic goals for improvement after THA.

Pre-operative Thresholds for Achieving Meaningful Clinical Improvement after Arthroscopic Treatment of Femoroacetabular Impingement

PubMed Central

Nwachukwu, Benedict U.; Fields, Kara G.; Nawabi, Danyal H.; Kelly, Bryan T.; Ranawat, Anil S.

2016-01-01

sagittal CEA was the only variable maintaining significance (p = 0.032). Conclusion: We used a large prospective hip arthroscopy database to identify pre-operative patient outcome score thresholds predictive of meaningful post-operative outcome improvement after arthroscopic FAI treatment. This is the largest reported hip arthroscopy cohort to define MCID and the first to do so for iHOT-33. The HOS-ADL may have the best predictive ability for achieving MCID after hip arthroscopy. Patients with relatively high pre-operative ADL, quality of life and functional status appear to have a high chance for achieveing MCID up to our defined thresholds. Hip dysplasia is an important outcome modifier. The findings of this study may be useful for managing preoperative expectation for patients undergoing arthroscopic FAI surgery.

Predictors of meaningful improvement in quality of life after temporal lobe epilepsy surgery: A prospective study.

PubMed

Pauli, Carla; Schwarzbold, Marcelo Liborio; Diaz, Alexandre Paim; de Oliveira Thais, Maria Emilia Rodrigues; Kondageski, Charles; Linhares, Marcelo Neves; Guarnieri, Ricardo; de Lemos Zingano, Bianca; Ben, Juliana; Nunes, Jean Costa; Markowitsch, Hans Joachim; Wolf, Peter; Wiebe, Samuel; Lin, Katia; Walz, Roger

2017-05-01

To investigate prospectively the independent predictors of a minimum clinically important change (MCIC) in quality of life (QOL) after anterior temporal lobectomy (ATL) for drug-resistant mesial temporal lobe epilepsy related to hippocampal sclerosis (MTLE-HS) in Brazilian patients. Multiple binary logistic regression analysis was performed to identify the clinical, demographic, radiologic, and electrophysiologic variables independently associated with MCIC in the Quality of Life in Epilepsy-31 Inventory (QOLIE-31) overall score 1 year after ATL in 77 consecutive patients with unilateral MTLE-HS. The overall QOLIE-31 score and all its subscale scores increased significantly (p < 0.0001) 1 year after ATL. In the final logistic regression model, absence of presurgical diagnosis of depression (adjusted odds ratio [OR] 4.4, 95% confidence interval [CI] 1.1-16.1, p = 0.02) and a complete postoperative seizure control (adjusted OR 4.1, 95% CI 1.2-14.5, p = 0.03) were independently associated with improvement equal to or greater than the MCIC in QOL after ATL. The overall model accuracy for MCIC improvement in the QOL was 85.6%, with a 95.2% of sensitivity and 46.7% of specificity. These results in Brazilian patients reinforce the external validation of previous findings in Canadian patients showing that presurgical depression and complete seizure control after surgery are independent predictors for meaningful improvement in QOL after ATL, and have implications for the surgical management of MTLE patients. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

Identifying a Clinically Meaningful Threshold for Change in Uveitic Macular Edema Evaluated by Optical Coherence Tomography

PubMed Central

Sugar, Elizabeth A.; Jabs, Douglas A.; Altaweel, Michael M.; Lightman, Sue; Acharya, Nisha; Vitale, Albert T.; Thorne, Jennifer E.

2011-01-01

Purpose To identify a clinically meaningful threshold for change in retinal thickness measured by optical coherence tomography (OCT) for patients with uveitic macular edema, using correlation with change in visual acuity. Design Cross-sectional and longitudinal study. Methods 128 eyes (101 individuals) with macular edema enrolled in the Multicenter Uveitis Steroid Treatment (MUST) trial. At enrollment and after six months of follow-up, retinal thickness was measured at the central subfield with time domain OCT and visual acuity was measured with logarithmic (ETDRS) visual acuity charts. Participants were classified as having macular edema if the retinal thickness was ≥260μm. Results A threshold for change in retinal center subfield thickness of 20% balanced the percentage of false positives and negatives for predicting greater than 10-letter change in visual acuity with sensitivity of 77% and a specificity of 75%. The results were similar for greater than 5 or 15 or greater letter changes. Those with a 20% or greater reduction in retinal thickness had a mean 11.0 letter improvement (95% CI: 7.7 to 14.3) as compared to a -0.4 letter change (95% CI: -4.1 to 3.3) in visual acuity for those without a 20% reduction (p < 0.01). Conclusions In addition to being above the level of measurement uncertainty, a 20% change in retinal thickness in patients with macular edema appears to be optimal for clinically important changes in visual acuity and may be considered as an outcome for clinical trials of treatments for uveitic macular edema. PMID:21861971

Meaningful use and good catches: More appropriate metrics for checklist effectiveness.

PubMed

Putnam, Luke R; Anderson, Kathryn T; Diffley, Michael B; Hildebrandt, Aubrey A; Caldwell, Kelly M; Minzenmayer, Andrew N; Covey, Sarah E; Kawaguchi, Akemi L; Lally, Kevin P; Tsao, KuoJen

2016-12-01

The benefit of utilizing surgical safety checklists has been recently questioned. We evaluated our checklist performance after implementing a program that includes checklist-related good catches. Multifaceted interventions aimed at the preincision checklist and 5 prospective audits were conducted from 2011-2015. We documented adherence to the checklist (verbalization of each checkpoint), fidelity (meaningful performance of each checkpoint), and good catches (events with the potential to cause the patient harm but that were prevented from occurring). Good catches were divided into quality improvement-based categories (processes, medication, safety, communication, and equipment). A total of 1,346 checklist performances were observed (range, 144-373/yr). Adherence to the preincision checklist improved from 30% to 95% (P < .001), while adherence to the preinduction and debriefing checklists decreased (71% to 56%, P = .002) and remained unchanged (76%), respectively. Preincision fidelity decreased from 86% to 76% (P = .012). Good catches were identified during 16% of preincision checklist performances; process issues were most common (32%) followed by issues of medication administration (30%) and safety (22%). Implementation of a systematic checklist program resulted in significant and sustainable improvement in performance. Meaningful use and associated good catches may be more appropriate metric than actual patient harm for measuring checklist effectiveness. Although not previously described, checklist-related good catches represent an unknown benefit of checklists. Copyright © 2016 Elsevier Inc. All rights reserved.

Making Fractions Meaningful

ERIC Educational Resources Information Center

McCormick, Kelly K.

2015-01-01

To be able to support meaningful mathematical experiences, preservice elementary school teachers (PSTs) must learn mathematics in deep and meaningful ways (Ma 1999). They need to experience investigating and making sense of the mathematics they will be called on to teach. To expand their own--often limited--views of what it means to teach and…

Meaningful work and mental health: job satisfaction as a moderator.

PubMed

Allan, Blake A; Dexter, Chelsea; Kinsey, Rebecca; Parker, Shelby

2018-02-01

Depression, anxiety and stress are common problems for modern workers. Although having meaningful work, or work that is significant, facilitates personal growth, and contributes to the greater good, has been linked to better mental health, people's work might also need to be satisfying or enjoyable to improve outcomes. The purpose of the present study was to examine meaningful work's relation to mental health (i.e. depression, anxiety and stress) and investigate job satisfaction as a moderator of this relation. The study hypotheses were tested with a large, diverse sample recruited from an online source. Partially supporting hypotheses, when controlling for job satisfaction, meaningful work negatively correlated with depression but did not have a significant relation with anxiety and stress. Similarly, job satisfaction negatively predicted depression and stress. Furthermore, the relations between meaningful work and both anxiety and stress were moderated by job satisfaction. Specifically, only people perceiving their work as meaningful and satisfying reported less anxiety and stress. Although continued research is needed, employers and employees may have to target both the meaningfulness and job satisfaction to address the issues of stress and anxiety among working adults.

Identifying a clinically meaningful threshold for change in uveitic macular edema evaluated by optical coherence tomography.

PubMed

Sugar, Elizabeth A; Jabs, Douglas A; Altaweel, Michael M; Lightman, Sue; Acharya, Nisha; Vitale, Albert T; Thorne, Jennifer E

2011-12-01

To identify a clinically meaningful threshold for change in retinal thickness measured by optical coherence tomography for patients with uveitic macular edema using correlation with change in visual acuity. Cross-sectional and longitudinal study. One hundred twenty-eight eyes (101 individuals) with macular edema enrolled in the Multicenter Uveitis Steroid Treatment (MUST) trial. At enrollment and after 6 months of follow-up, retinal thickness was measured at the central subfield with time-domain optical coherence tomography and visual acuity was measured with logarithmic (Early Treatment Diabetic Retinopathy Study) visual acuity charts. Participants were classified as having macular edema if the retinal thickness was 260 μm or more. A threshold for change in retinal center subfield thickness of 20% balanced the percentage of false positives and false negatives for predicting more than a 10-letter change in visual acuity with a sensitivity of 77% and a specificity of 75%. The results were similar for more than 5-letter changes and for 15-letter or more changes. Those with a 20% or more reduction in retinal thickness had a mean 11.0-letter improvement (95% confidence interval, 7.7 to 14.3) as compared with a -0.4-letter change (95% confidence interval, -4.1 to 3.3) in visual acuity for those without a 20% reduction (P < .01). In addition to being above the level of measurement uncertainty, a 20% change in retinal thickness in patients with macular edema seems to be optimal for clinically important changes in visual acuity and may be considered as an outcome for clinical trials of treatments for uveitic macular edema. Copyright © 2011 Elsevier Inc. All rights reserved.

Meaningful use care coordination criteria: Perceived barriers and benefits among primary care providers.

PubMed

Cohen, Genna R; Adler-Milstein, Julia

2016-04-01

Stage 2 and proposed Stage 3 meaningful use criteria ask providers to support patient care coordination by electronically generating, exchanging, and reconciling key information during patient care transitions. A stratified random sample of primary care practices in Michigan (n = 328) that had already met Stage 1 meaningful use criteria was surveyed, in order to identify the anticipated barriers to meeting these criteria as well as the expected impact on patient care coordination from doing so. The top three barriers, as identified by >65% of the primary care providers surveyed, were difficulty sending and receiving patient information electronically, a lack of provider and practice staff time, and the complex workflow changes required. Despite these barriers, primary care providers expressed strong agreement that meeting the proposed Stage 3 care coordination criteria would improve their patients' treatment and ensure they know about their patients' visits to other providers. The survey results suggest the need to enhance policy approaches and organizational strategies to address the key barriers identified by providers and practices in order to realize important care coordination benefits. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Students' Meaningful Learning Orientation and Their Meaningful Understandings of Meiosis and Genetics.

ERIC Educational Resources Information Center

Cavallo, Ann Liberatore

This 1-week study explored the extent to which high school students (n=140) acquired meaningful understanding of selected biological topics (meiosis and the Punnett square method) and the relationship between these topics. This study: (1) examined "mental modeling" as a technique for measuring students' meaningful understanding of the…

Rising to the Challenge: Meaningful Assessment of Student Learning

ERIC Educational Resources Information Center

Association of Public and Land-grant Universities, 2010

2010-01-01

"Rising to the Challenge: Meaningful Assessment of Student Learning" was envisioned in response to a 2007 request for proposals from the U.S. Department of Education's Fund for Improvement of Post Secondary Education (FIPSE). FIPSE called for national, consortial contributions to improving the knowledge and abilities to assess student…

Operating Room Delays: Meaningful Use in Electronic Health Record.

PubMed

Van Winkle, Rachelle A; Champagne, Mary T; Gilman-Mays, Meri; Aucoin, Julia

2016-06-01

Perioperative areas are the most costly to operate and account for more than 40% of expenses. The high costs prompted one organization to analyze surgical delays through a retrospective review of their new electronic health record. Electronic health records have made it easier to access and aggregate clinical data; 2123 operating room cases were analyzed. Implementing a new electronic health record system is complex; inaccurate data and poor implementation can introduce new problems. Validating the electronic health record development processes determines the ease of use and the user interface, specifically related to user compliance with the intent of the electronic health record development. The revalidation process after implementation determines if the intent of the design was fulfilled and data can be meaningfully used. In this organization, the data fields completed through automation provided quantifiable, meaningful data. However, data fields completed by staff that required subjective decision making resulted in incomplete data nearly 24% of the time. The ease of use was further complicated by 490 permutations (combinations of delay types and reasons) that were built into the electronic health record. Operating room delay themes emerged notwithstanding the significant complexity of the electronic health record build; however, improved accuracy could improve meaningful data collection and a more accurate root cause analysis of operating room delays. Accurate and meaningful use of data affords a more reliable approach in quality, safety, and cost-effective initiatives.

Sweeping the Floor or Putting a Man on the Moon: How to Define and Measure Meaningful Work.

PubMed

Both-Nwabuwe, Jitske M C; Dijkstra, Maria T M; Beersma, Bianca

2017-01-01

Meaningful work is integral to well-being and a flourishing life. The construct of "meaningful work" is, however, consistently affected by conceptual ambiguity. Although there is substantial support for arguments to maintain the status of conceptual ambiguity, we make a case for the benefits of having consensus on a definition and scale of meaningful work in the context of paid work. The objective of this article, therefore, was twofold. Firstly, we wanted to develop a more integrative definition of meaningful work. Secondly, we wanted to establish a corresponding operationalization. We reviewed the literature on the existing definitions of meaningful work and the scales designed to measure it. We found 14 definitions of meaningful work. Based on these definitions, we identified four categories of definitions, which led us to propose an integrative and comprehensive definition of meaningful work. We identified two validated scales that were partly aligned with the proposed definition. Based on our review, we conclude that scholars in this field should coalesce rather than diverge their efforts to conceptualize and measure meaningful work.

Sweeping the Floor or Putting a Man on the Moon: How to Define and Measure Meaningful Work

PubMed Central

Both-Nwabuwe, Jitske M. C.; Dijkstra, Maria T. M.; Beersma, Bianca

2017-01-01

Meaningful work is integral to well-being and a flourishing life. The construct of “meaningful work” is, however, consistently affected by conceptual ambiguity. Although there is substantial support for arguments to maintain the status of conceptual ambiguity, we make a case for the benefits of having consensus on a definition and scale of meaningful work in the context of paid work. The objective of this article, therefore, was twofold. Firstly, we wanted to develop a more integrative definition of meaningful work. Secondly, we wanted to establish a corresponding operationalization. We reviewed the literature on the existing definitions of meaningful work and the scales designed to measure it. We found 14 definitions of meaningful work. Based on these definitions, we identified four categories of definitions, which led us to propose an integrative and comprehensive definition of meaningful work. We identified two validated scales that were partly aligned with the proposed definition. Based on our review, we conclude that scholars in this field should coalesce rather than diverge their efforts to conceptualize and measure meaningful work. PMID:29033867

The journey of primary care practices to meaningful use: a Colorado Beacon Consortium study.

PubMed

Fernald, Douglas H; Wearner, Robyn; Dickinson, W Perry

2013-01-01

The Health Information Technology for Economic and Clinical Health Act of 2009 provides for incentive payments through Medicare and Medicaid for clinicians who implement electronic health records (EHRs) and use this technology meaningfully to improve patient care. There are few comprehensive descriptions of how primary care practices achieve the meaningful use of clinical data, including the formal stage 1 meaningful use requirements. Evaluation of the Colorado Beacon Consortium project included iterative qualitative analysis of practice narratives, provider and staff interviews, and separate focus groups with quality improvement (QI) advisors and staff from the regional health information exchange (HIE). Most practices described significant realignment of practice priorities and aims, which often required substantial education and training of physicians and staff. Re-engineering office processes, data collection protocols, EHRs, staff roles, and practice culture comprised the primary effort and commitment to attest to stage 1 meaningful use and subsequent meaningful use of clinical data. While realizing important benefits, practices bore a significant burden in learning the true capabilities of their EHRs with little effective support from vendors. Attestation was an important initial milestone in the process, but practices faced substantial ongoing work to use their data meaningfully for patient care and QI. Key resources were instrumental to these practices: local technical EHR expertise; collaborative learning mechanisms; and regular contact and support from QI advisors. Meeting the stage 1 requirements for incentives under Medicare and Medicaid meaningful use criteria is the first waypoint in a longer journey by primary care practices to the meaningful use of electronic data to continuously improve the care and health of their patients. The intensive re-engineering effort for stage 1 yielded practice changes consistent with larger practice aims and goals

Students' Perceptions of Meaningfulness in First Year Experience Courses: A Case Study

ERIC Educational Resources Information Center

Evans, Nancy J.

2012-01-01

This qualitative case study, framed by a constructivist perspective, addresses a deficit in the literature and the knowledge base of a first year experience (FYE) academic program at a large, urban university regarding freshmen perceptions of meaningfulness in their courses. Existing studies identify concepts related to meaningfulness, but do not…

Meaningful Experiences in Physical Education and Youth Sport: A Review of the Literature

ERIC Educational Resources Information Center

Beni, Stephanie; Fletcher, Tim; Ní Chróinín, Déirdre

2017-01-01

The purpose of this research is to review the literature about young people's meaningful experiences in physical education and youth sport. We reviewed 50 empirical peer-reviewed articles published in English since 1987. Five themes were identified as central influences to young people's meaningful experiences in physical education and sport:…

Meaningful coping with chronic pain: Exploring the interplay between goal violation, meaningful coping strategies and life satisfaction in chronic pain patients.

PubMed

Dezutter, Jessie; Dewitte, Laura; Thauvoye, Evalyne; Vanhooren, Siebrecht

2017-02-01

Trying to cope with chronic pain is a highly demanding and challenging task and pain patients often need to reformulate goals or aspirations due to their pain condition. This goal violation is often related with experienced distress and requires coping processes in order to decrease the distress and stimulate a healthy adaptation. Some scholars, however, argued that in so-called unsolvable or irreparable stressors such as chronic pain, conventional coping strategies like problem-focused coping might not be the most adaptive option. In these situations, meaningful coping strategies attempting to transform the meaning of the stressful experience would be more accurate. In this study, we aim to test if goal violation triggers meaningful coping strategies over time and whether engagement in these meaningful coping strategies result in improved life satisfaction, as an indicator of adaptation. A longitudinal three wave study in a sample of paint patients (n = 125) tests whether goal violation triggers positive reappraisal and downward comparison, two possible meaningful coping strategies. The study furthermore tests if engagement in these strategies results in a better adaptation to the pain condition, reflected in higher life satisfaction. Results partially supported our hypotheses by pointing to the benevolent role of downward comparison on life satisfaction via decreased goal violation of pain patients. Our findings however did also show that positive reappraisal predicted lower life satisfaction via increased levels of appraised goal violation which questions the role of positive reappraisal as a genuine meaningful coping strategy. Implications and limitations are discussed. © 2016 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

What Makes Learning Meaningful?

ERIC Educational Resources Information Center

Wilson, Arthur L.; Burket, Lee

This document examines the work of Dewey, Kolb, Jarvis, Mezirow, Freire, Rogers, and Houle to find out what these experiential learning theorists have to say about the role experience plays in making learning meaningful. The first section addresses each writer's work for specific ideas of how experience is related to making learning meaningful,…

The Effect of Patient Portals on Quality Outcomes and Its Implications to Meaningful Use: A Systematic Review

PubMed Central

2015-01-01

Background The Health Information Technology for Economic and Clinical Health (HITECH) Act imposes pressure on health care organizations to qualify for “Meaningful Use”. It is assumed that portals should increase patient participation in medical decisions, but whether or not the use of portals improves outcomes remains to be seen. Objective The purpose of this systemic review is to outline and summarize study results on the effect of patient portals on quality, or chronic-condition outcomes as defined by the Agency for Healthcare Research and Quality, and its implications to Meaningful Use since the beginning of 2011. This review updates and builds on the work by Ammenwerth, Schnell-Inderst, and Hoerbst. Methods We performed a systematic literature search in PubMed, CINAHL, and Google Scholar. We identified any data-driven study, quantitative or qualitative, that examined a relationship between patient portals, or patient portal features, and outcomes. We also wanted to relate the findings back to Meaningful Use criteria. Over 4000 articles were screened, and 27 were analyzed and summarized for this systematic review. Results We identified 26 studies and 1 review, and we summarized their findings and applicability to our research question. Very few studies associated use of the patient portal, or its features, to improved outcomes; 37% (10/27) of papers reported improvements in medication adherence, disease awareness, self-management of disease, a decrease of office visits, an increase in preventative medicine, and an increase in extended office visits, at the patient’s request for additional information. The results also show an increase in quality in terms of patient satisfaction and customer retention, but there are weak results on medical outcomes. Conclusions The results of this review demonstrate that more health care organizations today offer features of a patient portal than in the review published in 2011. Articles reviewed rarely analyzed a full

The effect of patient portals on quality outcomes and its implications to meaningful use: a systematic review.

PubMed

Kruse, Clemens Scott; Bolton, Katy; Freriks, Greg

2015-02-10

The Health Information Technology for Economic and Clinical Health (HITECH) Act imposes pressure on health care organizations to qualify for "Meaningful Use". It is assumed that portals should increase patient participation in medical decisions, but whether or not the use of portals improves outcomes remains to be seen. The purpose of this systemic review is to outline and summarize study results on the effect of patient portals on quality, or chronic-condition outcomes as defined by the Agency for Healthcare Research and Quality, and its implications to Meaningful Use since the beginning of 2011. This review updates and builds on the work by Ammenwerth, Schnell-Inderst, and Hoerbst. We performed a systematic literature search in PubMed, CINAHL, and Google Scholar. We identified any data-driven study, quantitative or qualitative, that examined a relationship between patient portals, or patient portal features, and outcomes. We also wanted to relate the findings back to Meaningful Use criteria. Over 4000 articles were screened, and 27 were analyzed and summarized for this systematic review. We identified 26 studies and 1 review, and we summarized their findings and applicability to our research question. Very few studies associated use of the patient portal, or its features, to improved outcomes; 37% (10/27) of papers reported improvements in medication adherence, disease awareness, self-management of disease, a decrease of office visits, an increase in preventative medicine, and an increase in extended office visits, at the patient's request for additional information. The results also show an increase in quality in terms of patient satisfaction and customer retention, but there are weak results on medical outcomes. The results of this review demonstrate that more health care organizations today offer features of a patient portal than in the review published in 2011. Articles reviewed rarely analyzed a full patient portal but instead analyzed features of a portal

"Meaningful use" of EHR in dental school clinics: how to benefit from the U.S. HITECH Act's financial and quality improvement incentives.

PubMed

Kalenderian, Elsbeth; Walji, Muhammad; Ramoni, Rachel B

2013-04-01

Through the 2009 HITECH (Health Information Technology for Economic and Clinical Health) Act, the U.S. government committed $27 billion to incentivize the adoption and "meaningful use" of certified electronic health records (EHRs) by providers, including dentists. Given their patient profiles, dental school clinics are in a position to benefit from this time-delimited commitment to support the adoption and use of certified EHR technology under the Medicaid-based incentive. The benefits are not merely financial: rather, the meaningful use objectives and clinical quality measures can drive quality improvement initiatives within dental practices and help develop a community of medical and dental professionals focused on quality. This article describes how dentists can qualify as eligible providers and the set of activities that must be undertaken and attested to in order to obtain this incentive. Two case studies describe the approaches that can be used to meet the Medicaid threshold necessary to be eligible for the incentive. Dentists can and have successfully applied for meaningful use incentive payments. Given the diverse set of patients who are treated at dental schools, these dental practices are among those most likely to benefit from the incentive programs.

Identifying Continuous Quality Improvement Priorities in Maternal, Infant, and Early Childhood Home Visiting.

PubMed

Preskitt, Julie; Fifolt, Matthew; Ginter, Peter M; Rucks, Andrew; Wingate, Martha S

2016-01-01

The purpose of this article was to describe a methodology to identify continuous quality improvement (CQI) priorities for one state's Maternal, Infant, and Early Childhood Home Visiting program from among the 40 required constructs associated with 6 program benchmarks. The authors discuss how the methodology provided consensus on system CQI quality measure priorities and describe variation among the 3 service delivery models used within the state. Q-sort methodology was used by home visiting (HV) service delivery providers (home visitors) to prioritize HV quality measures for the overall state HV system as well as their service delivery model. There was general consensus overall and among the service delivery models on CQI quality measure priorities, although some variation was observed. Measures associated with Maternal, Infant, and Early Childhood Home Visiting benchmark 1, Improved Maternal and Newborn Health, and benchmark 3, Improvement in School Readiness and Achievement, were the highest ranked. The Q-sort exercise allowed home visitors an opportunity to examine priorities within their service delivery model as well as for the overall First Teacher HV system. Participants engaged in meaningful discussions regarding how and why they selected specific quality measures and developed a greater awareness and understanding of a systems approach to HV within the state. The Q-sort methodology presented in this article can easily be replicated by other states to identify CQI priorities at the local and state levels and can be used effectively in states that use a single HV service delivery model or those that implement multiple evidence-based models for HV service delivery.

An empirically based conceptual framework for fostering meaningful patient engagement in research.

PubMed

Hamilton, Clayon B; Hoens, Alison M; Backman, Catherine L; McKinnon, Annette M; McQuitty, Shanon; English, Kelly; Li, Linda C

2018-02-01

Patient engagement in research (PEIR) is promoted to improve the relevance and quality of health research, but has little conceptualization derived from empirical data. To address this issue, we sought to develop an empirically based conceptual framework for meaningful PEIR founded on a patient perspective. We conducted a qualitative secondary analysis of in-depth interviews with 18 patient research partners from a research centre-affiliated patient advisory board. Data analysis involved three phases: identifying the themes, developing a framework and confirming the framework. We coded and organized the data, and abstracted, illustrated, described and explored the emergent themes using thematic analysis. Directed content analysis was conducted to derive concepts from 18 publications related to PEIR to supplement, confirm or refute, and extend the emergent conceptual framework. The framework was reviewed by four patient research partners on our research team. Participants' experiences of working with researchers were generally positive. Eight themes emerged: procedural requirements, convenience, contributions, support, team interaction, research environment, feel valued and benefits. These themes were interconnected and formed a conceptual framework to explain the phenomenon of meaningful PEIR from a patient perspective. This framework, the PEIR Framework, was endorsed by the patient research partners on our team. The PEIR Framework provides guidance on aspects of PEIR to address for meaningful PEIR. It could be particularly useful when patient-researcher partnerships are led by researchers with little experience of engaging patients in research. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Evaluating meaningful learning using concept mapping in dental hygiene education: a pilot study.

PubMed

Canasi, Dina M; Amyot, Cynthia; Tira, Daniel

2014-02-01

Concept mapping, as a teaching strategy, has been shown to promote critical thinking and problem solving in educational settings. Dental clinicians must distinguish between critical and irrelevant characteristics in the delivery of care, thus necessitating reasoning skills to do so. One of the aims of the American Dental Education Association Commission on Change and Innovation (ADEA-CCI) is to identify deficiencies in curriculum which were meant to improve critical thinking and problem solving skills necessary in clinical practice. The purpose of this study was to compare 2 teaching strategies, traditional lecture and lecture supported by concept mapping exercises within collaborative working groups, to determine if there is a beneficial effect on meaningful learning. For this pilot study, the study population consisted of students from 2 geographically separated associate level dental hygiene programs in the southeastern U.S. A quasi-experimental control group pre- and post-test design was used. The degree of meaningful learning achieved by both programs was assessed by comparing pre- and post-test results. Both programs experienced a significant degree of meaningful learning from pre- to post-test. However, there was no statistically significant difference between the programs on the post-test. These results were in direct contrast to research in other disciplines on concept mapping and its effect on promoting meaningful learning. Further investigation into the study's outcome was obtained through a follow-up focus group. In spite of careful attention to methodology in the development of this research project, the focus group illuminated methodological failings that potentially impacted the outcome of the study. Recommendations are underscored for future conduct of educational research of this kind.

Sensitivity of Claims-Based Algorithms to Ascertain Smoking Status More Than Doubled with Meaningful Use.

PubMed

Huo, Jinhai; Yang, Ming; Tina Shih, Ya-Chen

2018-03-01

The "meaningful use of certified electronic health record" policy requires eligible professionals to record smoking status for more than 50% of all individuals aged 13 years or older in 2011 to 2012. To explore whether the coding to document smoking behavior has increased over time and to assess the accuracy of smoking-related diagnosis and procedure codes in identifying previous and current smokers. We conducted an observational study with 5,423,880 enrollees from the year 2009 to 2014 in the Truven Health Analytics database. Temporal trends of smoking coding, sensitivity, specificity, positive predictive value, and negative predictive value were measured. The rate of coding of smoking behavior improved significantly by the end of the study period. The proportion of patients in the claims data recorded as current smokers increased 2.3-fold and the proportion of patients recorded as previous smokers increased 4-fold during the 6-year period. The sensitivity of each International Classification of Diseases, Ninth Revision, Clinical Modification code was generally less than 10%. The diagnosis code of tobacco use disorder (305.1X) was the most sensitive code (9.3%) for identifying smokers. The specificities of these codes and the Current Procedural Terminology codes were all more than 98%. A large improvement in the coding of current and previous smoking behavior has occurred since the inception of the meaningful use policy. Nevertheless, the use of diagnosis and procedure codes to identify smoking behavior in administrative data is still unreliable. This suggests that quality improvements toward medical coding on smoking behavior are needed to enhance the capability of claims data for smoking-related outcomes research. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Meaningful activities for improving the wellbeing of people with dementia: beyond mere pleasure to meeting fundamental psychological needs.

PubMed

Nyman, Samuel R; Szymczynska, Paulina

2016-03-01

Dementia is being increasingly recognised as a major public health issue for our ageing populations. A critical aspect of supporting people with dementia is facilitating their participation in meaningful activities. However, research to date has not drawn on theories of ageing from developmental psychology that would help undergird the importance of such meaningful activity. For the first time, we connect existing activity provision for people with dementia with developmental psychology theories of ageing. We reviewed the literature in two stages: first, we narratively searched the literature to demonstrate the relevance of psychological theories of ageing for provision of meaningful activities for people with dementia, and in particular focused on stage-based theories of adult development (Carl Jung and Erik Erikson), gerotranscendence (Tornstam), selective optimisation with compensation (Baltes and Baltes), and optimisation in primary and secondary control (Heckhausen and Schulz). Second, we systematically searched PubMed and PsycINFO for studies with people with dementia that made use of the aforementioned theories. The narrative review highlights that activity provision for people with dementia goes beyond mere pleasure to meeting fundamental psychological needs. More specifically, that life review therapy and life story work address the need for life review; spiritual/religious activities address the need for death preparation; intergenerational activities address the need for intergenerational relationships; re-acquaintance with previously conducted leisure activities addresses the need for a sense of control and to achieve life goals; and pursuit of new leisure activities addresses the need to be creative. The systematic searches identified two studies that demonstrated the utility of applying Erikson's theory of psychosocial development to dementia care. We argue for the importance of activity provision for people with dementia to help promote wellbeing

Identifying priorities for quality improvement at an emergency Department in Ghana.

PubMed

DeWulf, Annelies; Otchi, Elom H; Soghoian, Sari

2017-08-30

Healthcare quality improvement (QI) is a global priority, and understanding the perspectives of frontline healthcare workers can help guide sustainable and meaningful change. We report a qualitative investigation of emergency department (ED) staff priorities for QI at a tertiary care hospital in Ghana. The aims of the study were to educate staff about the World Health Organization's (WHO) definition of quality in healthcare, and to identify an initial focus for building a departmental QI program. Semi-structured interviews were conducted with ED staff using open-ended questions to probe their understanding and valuation of the six dimensions of quality defined by the WHO. Participants were then asked to rank the dimensions in order of importance for QI. Qualitative responses were thematically analyzed, and ordinal rank-order was determined for quantitative data regarding QI priorities. Twenty (20) members of staff of different cadres participated, including ED physicians, nurses, orderlies, a security officer, and an accountant. A majority of participants (61%) ranked access to emergency healthcare as high priority for QI. Two recurrent themes - financial accessibility and hospital bed availability - accounted for the majority of discussions, each linked to all the dimensions of healthcare quality. ED staff related all of the WHO quality dimensions to their work, and prioritized access to emergency care as the most important area for improvement. Participants expressed a high degree of motivation to improve healthcare quality, and the study helped with the development of a departmental QI program focused on the broad topic of access to ED services.

Reaping the benefits of meaningful work: The mediating versus moderating role of work engagement.

PubMed

Johnson, Matthew J; Jiang, Lixin

2017-08-01

This study examined whether meaningful work may improve one's quality of life outside of the workplace (i.e., work-to-life enrichment). More importantly, we proposed and tested competing hypotheses regarding the role of work engagement in the relationship between meaningful work and work-to-life enrichment. Specifically, we investigated whether work engagement served as a mediator of this relationship, as suggested by the job demands-resources model, or instead a moderator, as suggested by conservation of resources theory. Two-wave survey data were collected from 194 respondents recruited via Amazon Mechanical Turk. Analyses showed that meaningful work was positively related to work-to-life enrichment over time (i.e., 3 months later). Additionally, work engagement mediated but did not moderate the relationship between meaningful work at Time 1 and work-to-life enrichment at Time 2. We suggest that organizations foster a sense of meaningfulness in employees to facilitate engagement and in turn enrich employees' lives beyond the workplace. Therefore, not only organizations, but individuals as well may reap the benefits of meaningful work. Copyright © 2016 John Wiley & Sons, Ltd.

Accepting Lower Salaries for Meaningful Work

PubMed Central

Hu, Jing; Hirsh, Jacob B.

2017-01-01

A growing literature indicates that people are increasingly motivated to experience a sense of meaning in their work lives. Little is known, however, about how perceptions of work meaningfulness influence job choice decisions. Although much of the research on job choice has focused on the importance of financial compensation, the subjective meanings attached to a job should also play a role. The current set of studies explored the hypothesis that people are willing to accept lower salaries for more meaningful work. In Study 1, participants reported lower minimum acceptable salaries when comparing jobs that they considered to be personally meaningful with those that they considered to be meaningless. In Study 2, an experimental enhancement of a job’s apparent meaningfulness lowered the minimum acceptable salary that participants required for the position. In two large-scale cross-national samples of full-time employees in 2005 and 2015, Study 3 found that participants who experienced more meaningful work lives were more likely to turn down higher-paying job offers elsewhere. The strength of this effect also increased significantly over this time period. Study 4 replicated these findings in an online sample, such that participants who reported having more meaningful work were less willing to leave their current jobs and organizations for higher paying opportunities. These patterns of results remained significant when controlling for demographic factors and differences in job characteristics. PMID:29085310

Self-Determination and Meaningful Work: Exploring Socioeconomic Constraints

PubMed Central

Allan, Blake A.

2016-01-01

This study examined a model of meaningful work among a diverse sample of working adults. From the perspectives of Self-Determination Theory and the Psychology of Working Framework, we tested a structural model with social class and work volition predicting SDT motivation variables, which in turn predicted meaningful work. Partially supporting hypotheses, work volition was positively related to internal regulation and negatively related to amotivation, whereas social class was positively related to external regulation and amotivation. In turn, internal regulation was positively related to meaningful work, whereas external regulation and amotivation were negatively related to meaningful work. Indirect effects from work volition to meaningful work via internal regulation and amotivation were significant, and indirect effects from social class to meaningful work via external regulation and amotivation were significant. This study highlights the important relations between SDT motivation variables and meaningful work, especially the large positive relation between internal regulation and meaningful work. However, results also reveal that work volition and social class may play critical roles in predicting internal regulation, external regulation, and amotivation. PMID:26869970

Self-Determination and Meaningful Work: Exploring Socioeconomic Constraints.

PubMed

Allan, Blake A; Autin, Kelsey L; Duffy, Ryan D

2016-01-01

This study examined a model of meaningful work among a diverse sample of working adults. From the perspectives of Self-Determination Theory and the Psychology of Working Framework, we tested a structural model with social class and work volition predicting SDT motivation variables, which in turn predicted meaningful work. Partially supporting hypotheses, work volition was positively related to internal regulation and negatively related to amotivation, whereas social class was positively related to external regulation and amotivation. In turn, internal regulation was positively related to meaningful work, whereas external regulation and amotivation were negatively related to meaningful work. Indirect effects from work volition to meaningful work via internal regulation and amotivation were significant, and indirect effects from social class to meaningful work via external regulation and amotivation were significant. This study highlights the important relations between SDT motivation variables and meaningful work, especially the large positive relation between internal regulation and meaningful work. However, results also reveal that work volition and social class may play critical roles in predicting internal regulation, external regulation, and amotivation.

Making Science Meaningful for Young People with Diverse Needs

ERIC Educational Resources Information Center

Stead, Di

2015-01-01

In the autumn term of 2011, it was identified that a programme of support for developing science in the curriculum was required at a newly opened special school, Beacon Reach, in Lancashire, which caters to children with autism spectrum disorders. Staff wanted to provide a relevant and meaningful curriculum, accessible even to young people who…

Hyperinsulinemic Normoglycemia does not meaningfully improve Myocardial Performance during Cardiac Surgery: A Randomized Trial

PubMed Central

Duncan, Andra E.; Kashy, Babak Kateby; Sarwar, Sheryar; Singh, Akhil; Stenina-Adognravi, Olga; Christoffersen, Steffen; Alfirevic, Andrej; Sale, Shiva; Yang, Dongsheng; Thomas, James D.; Gillinov, Marc; Sessler, Daniel I.

2015-01-01

Background Glucose-insulin-potassium (GIK) administration during cardiac surgery inconsistently improves myocardial function, perhaps because hyperglycemia negates the beneficial effects of GIK. The hyperinsulinemic normoglycemic clamp (HNC) technique may better enhance the myocardial benefits of GIK. We extended previous GIK investigations by: 1) targeting normoglycemia while administering a glucose-insulin-potassium infusion (HNC); 2) using improved echocardiographic measures of myocardial deformation, specifically myocardial longitudinal strain and strain rate; and, 3) assessing activation of glucose metabolic pathways. Methods 100 patients having aortic valve replacement for aortic stenosis were randomly assigned to HNC (high-dose insulin with concomitant glucose infusion titrated to normoglycemia) versus standard therapy (insulin treatment if glucose >150 mg/dL). Our primary outcomes were left ventricular longitudinal strain and strain rate, assessed using speckle-tracking echocardiography. Right atrial tissue was analyzed for activation of glycolysis/pyruvate oxidation and alternative metabolic pathways. Results Time-weighted mean glucose concentrations were lower with HNC (127±19 mg/dL) than standard care (177±41 mg/dL; P<0.001). Echocardiographic data were adequate in 72 patients for strain analysis and 67 patients for strain rate analysis. HNC did not improve myocardial strain, with an HNC minus standard therapy difference of −1.2 (97.5%CI: −2.9, 0.5)%; P=0.11. Strain rate was significantly better, but by a clinically unimportant amount: −0.16 (−0.30, −0.03) sec−1, P = 0.007. There was no evidence of increased glycolytic, pyruvate oxidation, or hexosamine biosynthetic pathway activation in right atrial samples (n = 20, HNC; 22, standard therapy). Conclusions Administration of glucose and insulin while targeting normoglycemia during aortic valve replacement did not meaningfully improve myocardial function. PMID:26200180

Concept Mapping Using Cmap Tools to Enhance Meaningful Learning

NASA Astrophysics Data System (ADS)

Cañas, Alberto J.; Novak, Joseph D.

Concept maps are graphical tools that have been used in all facets of education and training for organizing and representing knowledge. When learners build concept maps, meaningful learning is facilitated. Computer-based concept mapping software such as CmapTools have further extended the use of concept mapping and greatly enhanced the potential of the tool, facilitating the implementation of a concept map-centered learning environment. In this chapter, we briefly present concept mapping and its theoretical foundation, and illustrate how it can lead to an improved learning environment when it is combined with CmapTools and the Internet. We present the nationwide “Proyecto Conéctate al Conocimiento” in Panama as an example of how concept mapping, together with technology, can be adopted by hundreds of schools as a means to enhance meaningful learning.

Instruments for measuring meaningful learning in healthcare students: a systematic psychometric review.

PubMed

Cadorin, Lucia; Bagnasco, Annamaria; Tolotti, Angela; Pagnucci, Nicola; Sasso, Loredana

2016-09-01

To identify, evaluate and describe the psychometric properties of instruments that measure learning outcomes in healthcare students. Meaningful learning is an active process that enables a wider and deeper understanding of concepts. It is the result of an interaction between new and prior knowledge and produces a long-standing change in knowledge and skills. In the field of education, validated and reliable instruments for assessing meaningful learning are needed. A psychometric systematic review. MEDLINE CINAHL, SCOPUS, ERIC, Cochrane Library, Psychology & Behavioural Sciences Collection Database from 1990-December 2013. Using pre-determined inclusion criteria, three reviewers independently identified studies for full-text review. Then they extracted data for quality appraisal and graded instrument validity using the Consensus-based Standards for the selection of the health status Measurement INstruments checklist and the Psychometric Grading Framework. Of the 57 studies identified for full-text review, 16 met the inclusion criteria and 13 different instruments were assessed. Following quality assessment, only one instrument was considered of good quality but it measured meaningful learning only in part; the others were either fair or poor. The Psychometric Grading Framework indicated that one instrument was weak, while the others were very weak. No instrument displayed adequate validity. The systematic review produced a synthesis of the psychometric properties of tools that measure learning outcomes in students of healthcare disciplines. Measuring learning outcomes is very important when educating health professionals. The identified tools may constitute a starting point for the development of other assessment tools. © 2016 John Wiley & Sons Ltd.

Meaningfulness of service and marital satisfaction in Army couples.

PubMed

Bergmann, Jeffrey S; Renshaw, Keith D; Allen, Elizabeth S; Markman, Howard J; Stanley, Scott M

2014-10-01

The vast numbers of military service members who have been deployed since 2001 highlights the need to better understand relationships of military couples. A unique consideration in military couples is the concept of meaningfulness of service, or the value service members and their partners place on military service in spite of the sacrifices it requires. In a sample of 606 Army couples, the authors used path analysis to examine how male service members' and female spouses' perceived meaningfulness of service added to the prediction of marital satisfaction in both members of the couple, when accounting for service members' PTSD symptoms. Spouses' perceived meaningfulness of service was linked with higher marital satisfaction in spouses, regardless of service member's perceived meaningfulness of service. Service members' perceived meaningfulness of service was also associated with increased marital satisfaction in service members, but only when their spouses also perceived higher meaningfulness. There were no significant interactions between service members' PTSD and either partner's perceived meaningfulness. Implications for enhanced attention to spousal perceptions of meaningfulness of service are discussed. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Meaningfulness of Service and Marital Satisfaction in Army Couples

PubMed Central

Bergmann, Jeffrey S.; Renshaw, Keith D.; Allen, Elizabeth S.; Markman, Howard J.; Stanley, Scott M.

2015-01-01

The vast numbers of military service members who have been deployed since 2001 highlights the need to better understand relationships of military couples. A unique consideration in military couples is the concept of meaningfulness of service, or the value service members and their partners place on military service in spite of the sacrifices it requires. In a sample of 606 Army couples, we used path analysis to examine how male service members’ and female spouses’ perceived meaningfulness of service added to the prediction of marital satisfaction in both members of the couple, when accounting for service members’ PTSD symptoms. Spouses’ perceived meaningfulness of service was linked with higher marital satisfaction in spouses, regardless of service member’s perceived meaningfulness of service. Service members’ perceived meaningfulness of service was also associated with increased marital satisfaction in service members, but only when their spouses also perceived higher meaningfulness. There were no significant interactions between service members’ PTSD and either partner’s perceived meaningfulness. Implications for enhanced attention to spousal perceptions of meaningfulness of service are discussed. PMID:25046347

Hemispheric Differences in Processing Dichotic Meaningful and Non-Meaningful Words

ERIC Educational Resources Information Center

Yasin, Ifat

2007-01-01

Classic dichotic-listening paradigms reveal a right-ear advantage (REA) for speech sounds as compared to non-speech sounds. This REA is assumed to be associated with a left-hemisphere dominance for meaningful speech processing. This study objectively probed the relationship between ear advantage and hemispheric dominance in a dichotic-listening…

What constitutes meaningful engagement for patients and families as partners on research teams?

PubMed

Black, Agnes; Strain, Kimberly; Wallsworth, Christine; Charlton, Sara-Grey; Chang, Wilma; McNamee, Kate; Hamilton, Clayon

2018-01-01

Objective There is growing emphasis on health care organizations to ensure that lay people are meaningfully engaged as partners on research teams. Our aim was to explore the perspectives of patients, family members and informal caregivers who have been involved on health care research teams in Canada and elicit their recommendations for meaningful engagement. Methods We conducted a qualitative study guided by thematic analysis of transcripts of focus groups and interviews of 19 experienced patient research partners in Canada. Results We identified four main themes: research environment, expectations, support and value, which highlight participants' combined perspectives on important factors to ensure their engagement in research is meaningful. Conclusions Our findings add to the evolving evidence base on the perspectives of lay people involved in health care research and their recommendations for research leaders on meaningful engagement. Our study suggests that research leaders should provide a welcoming research environment, outline appropriate expectations for patient research partners on research teams, support patient research partners' engagement in projects and recognize the value patient research partners bring to health research.

Role of Social Knowledge Networking technology in facilitating meaningful use of Electronic Health Record medication reconciliation.

PubMed

Rangachari, Pavani

2016-06-01

Despite the federal policy impetus towards EHR Medication Reconciliation, hospital adherence has lagged for one chief reason; low physician engagement, which in turn emanates from lack of consensus in regard to which physician is responsible for managing a patient's medication list, and the importance of medication reconciliation as a tool for improving patient safety and quality of care. The Technology-in-Practice (TIP) framework stresses the role of human action in enacting structures of technology use or "technologies-in-practice." Applying the TIP framework to the EHR Medication Reconciliation context, helps frame the problem as one of low physician engagement in performing EHR Medication Reconciliation, translating to limited-use-EHR-in-practice. Concurrently, the problem suggests a hierarchical network structure, reflecting limited communication among hospital administrators and clinical providers on the importance of EHR Medication Reconciliation in improving patient safety. Integrating the TIP literature with the more recent knowledge-in-Practice (KIP) literature suggests that EHR-in-practice could be transformed from "limited use" to "meaningful use" through the use of Social Knowledge Networking (SKN) Technology to create new social network structures, and enable engagement, learning, and practice change. Correspondingly, the objectives of this paper are to: 1) Conduct a narrative review of the literature on "technology use," to understand how technologies-in-practice may be transformed from limited use to meaningful use; 2) Conduct a narrative review of the literature on "organizational change implementation," to understand how changes in technology use could be successfully implemented and sustained in a healthcare organizational context; and 3) Apply lessons learned from the narrative literature reviews to identify strategies for the meaningful use and successful implementation of EHR Medication Reconciliation technology.

Enhancing the Meaningfulness of Work for Astronauts on Long Duration Space Exploration Missions.

PubMed

Britt, Thomas W; Sytine, Anton; Brady, Ashley; Wilkes, Russ; Pittman, Rebecca; Jennings, Kristen; Goguen, Kandice

2017-08-01

Numerous authors have identified the stressors likely to be encountered on long duration space exploration missions (e.g., to Mars), including the possibility of significant crises, separation from family, boredom/monotony, and interpersonal conflict. Although many authors have noted that meaningful work may be beneficial for astronauts on these missions, none have detailed the sources of meaningful work for astronauts and how these sources may differ between astronauts. The present article identifies how engagement in meaningful work during long duration missions may mitigate the adverse effects of demands and increase the potential for benefits resulting from the missions. Semistructured interviews were conducted with nine NASA personnel, including astronauts, flight directors, and flight surgeons. Questions addressed sources of meaning for astronauts, characteristics of tasks that enhance vs. detract from meaning, and recommendations for enhancing meaning. Personnel mentioned contributing to humanity and the next generation, contributing to the mission, and exploration as the most meaningful aspects of their work. Characteristics of tasks that enhanced meaning included using a variety of skills, feeling personal control over their schedule, autonomy in the execution of tasks, and understanding the importance of the experiments conducted on the mission. Top recommendations to sustain meaning were insuring social needs were met through such activities as the strategic use of social media, giving astronauts autonomy as well as structure, and conducting training during transit. Implications are addressed for tailoring meaning-based interventions for astronauts participating on long duration missions and assessing the effectiveness of these interventions.Britt TW, Sytine A, Brady A, Wilkes R, Pittman R, Jennings K, Goguen K. Enhancing the meaningfulness of work for astronauts on long duration space exploration missions. Aerosp Med Hum Perform. 2017; 88(8):779-783.

Types of Meaningfulness of Life and Values of Future Teachers

ERIC Educational Resources Information Center

Salikhova, Nailia R.

2016-01-01

The leading role of meaning of life in regulation of human's activity of all types provides the relevance of the research. The goal of the paper is to identify and describe types of meaningfulness of life in future teachers, and to reveal the specificity of values hierarchy indicative of each type. The leading approach applied in the research was…

Setting Meaningful Criterion-Reference Cut Scores as an Effective Professional Development

ERIC Educational Resources Information Center

Munyofu, Paul

2010-01-01

The state of Pennsylvania, like many organizations interested in performance improvement, routinely engages in professional development activities. Educators in this hands-on activity engaged in setting meaningful criterion-referenced cut scores for career and technical education assessments using two methods. The main purposes of this study were…

Accurate and Inaccurate Conceptions about Osmosis That Accompanied Meaningful Problem Solving.

ERIC Educational Resources Information Center

Zuckerman, June Trop

This study focused on the knowledge of six outstanding science students who solved an osmosis problem meaningfully. That is, they used appropriate and substantially accurate conceptual knowledge to generate an answer. Three generated a correct answer; three, an incorrect answer. This paper identifies both the accurate and inaccurate conceptions…

Predicting Manual Therapy Treatment Success in Patients With Chronic Ankle Instability: Improving Self-Reported Function.

PubMed

Wikstrom, Erik A; McKeon, Patrick O

2017-04-01

  Therapeutic modalities that stimulate sensory receptors around the foot-ankle complex improve chronic ankle instability (CAI)-associated impairments. However, not all patients have equal responses to these modalities. Identifying predictors of treatment success could improve clinician efficiency when treating patients with CAI.   To conduct a response analysis on existing data to identify predictors of improved self-reported function in patients with CAI.   Secondary analysis of a randomized controlled clinical trial.   Sports medicine research laboratories.   Fifty-nine patients with CAI, which was defined in accordance with the International Ankle Consortium recommendations.   Participants were randomized into 3 treatment groups (plantar massage [PM], ankle-joint mobilization [AJM], or calf stretching [CS]) that received six 5-minute treatments over 2 weeks.   Treatment success, defined as a patient exceeding the minimally clinically important difference of the Foot and Ankle Ability Measure-Sport (FAAM-S).   Patients with ≤5 recurrent sprains and ≤82.73% on the Foot and Ankle Ability Measure had a 98% probability of having a meaningful FAAM-S improvement after AJM. As well, ≥5 balance errors demonstrated 98% probability of meaningful FAAM-S improvements from AJM. Patients <22 years old and with ≤9.9 cm of dorsiflexion had a 99% probability of a meaningful FAAM-S improvement after PM. Also, those who made ≥2 single-limb-stance errors had a 98% probability of a meaningful FAAM-S improvement from PM. Patients with ≤53.1% on the FAAM-S had an 83% probability of a meaningful FAAM-S improvement after CS.   Each sensory-targeted ankle-rehabilitation strategy resulted in a unique combination of predictors of success for patients with CAI. Specific indicators of success with AJM were deficits in self-reported function, single-limb balance, and <5 previous sprains. Age, weight-bearing-dorsiflexion restrictions, and single-limb balance

Sustaining "meaningful use" of health information technology in low-resource practices.

PubMed

Green, Lee A; Potworowski, Georges; Day, Anya; May-Gentile, Rachelle; Vibbert, Danielle; Maki, Bruce; Kiesel, Leslie

2015-01-01

The implementation of electronic health records (EHRs) has been extensively studied, but their maintenance once implemented has not. The Regional Extension Center (REC) program provides implementation assistance to priority practices-those with limited financial, technical, and organizational resources-but the assistance is time limited. Our objective was to identify potential barriers to maintenance of meaningful use of EHRs in priority primary care practices using a qualitative observational study for federally qualified health centers (FQHCs) and priority practices in Michigan. We conducted cognitive task analysis (CTA) interviews and direct observations of health information technology implementation in FQHCs. In addition, we conducted semistructured interviews with implementation specialists serving priority practices to detect emergent themes relevant to maintenance. Maintaining EHR technology will require ongoing expert technical support indefinitely beyond implementation to address upgrades and security needs. Maintaining meaningful use for quality improvement will require ongoing support for leadership and change management. Priority practices not associated with larger systems lack access to the necessary technical expertise, financial resources, and leverage with vendors to continue alone. Rural priority practices are particularly challenged, because expertise is often not available locally. Priority practices, especially in rural areas, are at high risk for falling on the wrong side of a "digital divide" as payers and regulators enact increasing expectations for EHR use and information management. For those without affiliation to maintain the necessary expert staff, ongoing support will be needed for those practices to remain viable. © 2015 Annals of Family Medicine, Inc.

Meaningful Peer Review in Radiology: A Review of Current Practices and Potential Future Directions.

PubMed

Moriarity, Andrew K; Hawkins, C Matthew; Geis, J Raymond; Dreyer, Keith J; Kamer, Aaron P; Khandheria, Paras; Morey, Jose; Whitfill, James; Wiggins, Richard H; Itri, Jason N

2016-12-01

The current practice of peer review within radiology is well developed and widely implemented compared with other medical specialties. However, there are many factors that limit current peer review practices from reducing diagnostic errors and improving patient care. The development of "meaningful peer review" requires a transition away from compliance toward quality improvement, whereby the information and insights gained facilitate education and drive systematic improvements that reduce the frequency and impact of diagnostic error. The next generation of peer review requires significant improvements in IT functionality and integration, enabling features such as anonymization, adjudication by multiple specialists, categorization and analysis of errors, tracking, feedback, and easy export into teaching files and other media that require strong partnerships with vendors. In this article, the authors assess various peer review practices, with focused discussion on current limitations and future needs for meaningful peer review in radiology. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Stimulus Set Meaningfulness and Neurophysiological Differentiation: A Functional Magnetic Resonance Imaging Study

PubMed Central

Boly, Melanie; Sasai, Shuntaro; Gosseries, Olivia; Oizumi, Masafumi; Casali, Adenauer; Massimini, Marcello; Tononi, Giulio

2015-01-01

A meaningful set of stimuli, such as a sequence of frames from a movie, triggers a set of different experiences. By contrast, a meaningless set of stimuli, such as a sequence of ‘TV noise’ frames, triggers always the same experience—of seeing ‘TV noise’—even though the stimuli themselves are as different from each other as the movie frames. We reasoned that the differentiation of cortical responses underlying the subject’s experiences, as measured by Lempel-Ziv complexity (incompressibility) of functional MRI images, should reflect the overall meaningfulness of a set of stimuli for the subject, rather than differences among the stimuli. We tested this hypothesis by quantifying the differentiation of brain activity patterns in response to a movie sequence, to the same movie scrambled in time, and to ‘TV noise’, where the pixels from each movie frame were scrambled in space. While overall cortical activation was strong and widespread in all conditions, the differentiation (Lempel-Ziv complexity) of brain activation patterns was correlated with the meaningfulness of the stimulus set, being highest in the movie condition, intermediate in the scrambled movie condition, and minimal for ‘TV noise’. Stimulus set meaningfulness was also associated with higher information integration among cortical regions. These results suggest that the differentiation of neural responses can be used to assess the meaningfulness of a given set of stimuli for a given subject, without the need to identify the features and categories that are relevant to the subject, nor the precise location of selective neural responses. PMID:25970444

Computer Algebra, Virtual Learning Environment and Meaningful Learning: Is It Possible?

ERIC Educational Resources Information Center

Abar, Celina A. A. P.; Barbosa, Lisbete Madsen

2011-01-01

A major challenge faced by teachers nowadays relates to the usage of proper educational technology to achieve a true and meaningful learning experience involving time for reflection. Teachers constantly seek new ways to improve instruction, but in virtual learning environments they often find themselves in a new role, interacting in a dynamic…

Making meaningful improvements to direct care worker training through informed policy: Understanding how care setting structure and culture matter.

PubMed

Kemeny, M Elizabeth; Mabry, J Beth

2017-01-01

Well-intentioned policy governing the training of direct care workers (DCWs) who serve older persons, in practice, may become merely a compliance issue for organizations rather than a meaningful way to improve quality of care. This study investigates the relationships between best practices in DCW training and the structure and culture of long term support service (LTSS) organizations. Using a mixed-methods approach to analyzing data from 328 licensed LTSS organizations in Pennsylvania, the findings suggest that public policy should address methods of training, not just content, and consider organizational variations in size, training evaluation practices, DCW integration, and DCW input into care planning. Effective training also incorporates support for organizations and supervisors as key aspects of DCWs' learning and working environment.

The Retention of Meaningful Understanding of Meiosis and Genetics.

ERIC Educational Resources Information Center

Cavallo, Ann Liberatore

This study investigated the retention of meaningful understanding of the biological topics of meiosis, the Punnett square method and the relations between these two topics. This study also explored the predictive influence of students' general tendency to learn meaningfully or by rote (meaningful learning orientation), prior knowledge of meiosis,…

Meaningfulness in work - experiences among employed individuals with persistent mental illness.

PubMed

Leufstadius, Christel; Eklund, Mona; Erlandsson, Lena-Karin

2009-01-01

The aim of the present study was to investigate how people with persistent mental illness, with various types of work and employment conditions, experience and describe the meaningfulness of work. The study had a qualitative approach and twelve informants living in the community were purposefully selected and interviewed according to overarching themes. The interviews were analysed using qualitative content analysis, and all of the authors were involved in the analysis process. The findings resulted in four main themes: 1) work per se has certain characteristics, 2) participation in different contexts gives a feeling of normality, acceptance, belonging and fulfilment of norms and values, 3) work affords structure, energy and a balanced daily life, and 4) work increases well-being and strengthens one's identity. A tentative model is described concerning perceived meaningfulness in work among individuals with persistent mental illness, in which the first three aspects of meaning are a prerequisite for meaning in terms of increased well-being and strengthened identity. Furthermore, it seems important that work has to bring the just right challenge to the individual in order for him or her to perceive the identified aspects of meaningfulness.

Thematic Unit Planning in Social Studies: Make It Focused and Meaningful

ERIC Educational Resources Information Center

Horton, Todd A.; Barnett, Jennifer A.

2008-01-01

Unit planning is perhaps the most difficult of the teacher duties to execute well. This paper offers suggestions for improving focus and increasing the meaningfulness of thematic unit content for students. Stressing the concept of a Big Understanding, it outlines 6 sequential steps in the creation of units which, when applied, not only establish a…

Making a Natural Product Chemistry Course Meaningful with a Mini Project Laboratory

ERIC Educational Resources Information Center

Hakim, Aliefman; Liliasari; Kadarohman, Asep; Syah, Yana Maolana

2016-01-01

This paper discusses laboratory activities that can improve the meaningfulness of natural product chemistry course. These laboratory activities can be useful for students from many different disciplines including chemistry, pharmacy, and medicine. Students at the third-year undergraduate level of chemistry education undertake the project to…

Relationships between students' meaningful learning orientation and their understanding of genetics topics

NASA Astrophysics Data System (ADS)

Cavallo, Ann M. Liberatore; Schafer, Larry E.

This study explored factors predicting the extent to which high school students (N = 140) acquired meaningful understanding of the biological topics of meiosis, the Punnett-square method, and the relationships between these topics. This study (a) examined mental modeling as a technique for measuring students' meaningful understanding of the topics, (b) measured students' predisposed, generalized tendency to learn meaningfully (meaningful learning orientation), (c) determined the extent to which students' meaningful learning orientation predicted meaningful understanding beyond that predicted by aptitude and achievement motivation, (d) experimentally tested two instructional treatments (relationships presented to students, relationships generated by students), (e) explored the relationships of meaningful learning orientation, prior knowledge, instructional treatment, and all interactions of these variables in predicting meaningful understanding. The results of correlations and multiple regressions indicated that meaningful learning orientation contributed to students' attainment of meaningful understanding independent of aptitude and achievement motivation. Meaningful learning orientation and prior knowledge interacted in unique ways for each topic to predict students' attainment of meaningful understanding. Instructional treatment had relatively little relationship to students' acquisition of meaningful understanding, except for learners midrange between meaningful and rote. These findings imply that a meaningful learning approach among students may be important, perhaps as much or more than aptitude and achievement motivation, for their acquisition of interrelated, meaningful understandings of science.

Anesthesiology leadership rounding: identifying opportunities for improvement.

PubMed

Gravenstein, Dietrich; Ford, Susan; Enneking, F Kayser

2012-01-01

Rounding that includes participation of individuals with authority to implement changes has been advocated as important to the transformation of an institution into a high-quality and safe organization. We describe a Department of Anesthesiology's experience with leadership rounding. The Department Chair or other senior faculty designate, a quality coordinator, up to four residents, the ward charge nurse, and patient nurses participated in rounds at bedsides. During a 23-month period, 14 significant opportunities to improve care were identified. Nurses identified 5 of these opportunities, primary team physicians 2, the rounding team 4, and patients or their family members another 3. The anesthesiology service had sole or shared responsibility for 10 improvements. A variety of organizations track specific measures across all phases of the patient experience to gauge quality of care. Chart auditing tools for detecting threats to safety are often used. These measures and tools missed opportunities for improvement that were discovered only through rounding. We conclude that the introduction of leadership rounding by an anesthesiology service can identify opportunities for improving quality that are not captured by conventional efforts.

Measuring Meaningful Work: The Work and Meaning Inventory (WAMI)

ERIC Educational Resources Information Center

Steger, Michael F.; Dik, Bryan J.; Duffy, Ryan D.

2012-01-01

Many people desire work that is meaningful. However, research in this area has attracted diverse ideas about meaningful work (MW), accompanied by an equally disparate collection of ways of assessing MW. To further advance study in this area, the authors propose a multidimensional model of work as a subjectively meaningful experience consisting of…

Hospital Characteristics are Associated With Readiness to Attain Stage 2 Meaningful Use of Electronic Health Records.

PubMed

Kim, Jungyeon; Ohsfeldt, Robert L; Gamm, Larry D; Radcliff, Tiffany A; Jiang, Luohua

2017-06-01

To examine the difference between rural and urban hospitals as to their overall level of readiness for stage 2 meaningful use of electronic health records (EHRs) and to identify other key factors that affect their readiness for stage 2 meaningful use. A conceptual framework based on the theory of organizational readiness for change was used in a cross-sectional multivariate analysis using 2,083 samples drawn from the HIMSS Analytics survey conducted with US hospitals in 2013. Rural hospitals were less likely to be ready for stage 2 meaningful use compared to urban hospitals in the United States (OR = 0.49) in our final model. Hospitals' past experience with an information exchange initiative, staff size in the information system department, and the Chief Information Officer (CIO)'s responsibility for health information management were identified as the most critical organizational contextual factors that were associated with hospitals' readiness for stage 2. Rural hospitals lag behind urban hospitals in EHR adoption, which will hinder the interoperability of EHRs among providers across the nation. The identification of critical factors that relate to the adoption of EHR systems provides insights into possible organizational change efforts that can help hospitals to succeed in attaining meaningful use requirements. Rural hospitals have increasingly limited resources, which have resulted in a struggle for these facilities to attain meaningful use. Given increasing closures among rural hospitals, it is all the more important that EHR development focus on advancing rural hospital quality of care and linkages with patients and other organizations supporting the care of their patients. © 2016 National Rural Health Association.

Livestock Helminths in a Changing Climate: Approaches and Restrictions to Meaningful Predictions

PubMed Central

Fox, Naomi J.; Marion, Glenn; Davidson, Ross S.; White, Piran C. L.; Hutchings, Michael R.

2012-01-01

Simple Summary Parasitic helminths represent one of the most pervasive challenges to livestock, and their intensity and distribution will be influenced by climate change. There is a need for long-term predictions to identify potential risks and highlight opportunities for control. We explore the approaches to modelling future helminth risk to livestock under climate change. One of the limitations to model creation is the lack of purpose driven data collection. We also conclude that models need to include a broad view of the livestock system to generate meaningful predictions. Abstract Climate change is a driving force for livestock parasite risk. This is especially true for helminths including the nematodes Haemonchus contortus, Teladorsagia circumcincta, Nematodirus battus, and the trematode Fasciola hepatica, since survival and development of free-living stages is chiefly affected by temperature and moisture. The paucity of long term predictions of helminth risk under climate change has driven us to explore optimal modelling approaches and identify current bottlenecks to generating meaningful predictions. We classify approaches as correlative or mechanistic, exploring their strengths and limitations. Climate is one aspect of a complex system and, at the farm level, husbandry has a dominant influence on helminth transmission. Continuing environmental change will necessitate the adoption of mitigation and adaptation strategies in husbandry. Long term predictive models need to have the architecture to incorporate these changes. Ultimately, an optimal modelling approach is likely to combine mechanistic processes and physiological thresholds with correlative bioclimatic modelling, incorporating changes in livestock husbandry and disease control. Irrespective of approach, the principal limitation to parasite predictions is the availability of active surveillance data and empirical data on physiological responses to climate variables. By combining improved empirical

Is This a Meaningful Learning Experience? Interactive Critical Self-Inquiry as Investigation

ERIC Educational Resources Information Center

Allard, Andrea C.; Gallant, Andrea

2012-01-01

What conditions enable educators to engage in meaningful learning experiences with peers and beginning practitioners? This article documents a self-study on our actions-in-practice in a peer mentoring project. The investigation involved an iterative process to improve our knowledge as teacher educators, reflective practitioners, and researchers.…

Patients' and Caregivers' Attributes in a Meaningful Care Encounter: Similarities and Notable Differences

PubMed Central

Snellman, Ingrid; Gustafsson, Christine; Gustafsson, Lena-Karin

2012-01-01

In today's healthcare system, there is an imbalance between what patients expect of caregivers' care and their perception of the care they get. How is it possible to reduce this imbalance? The aim of this paper was to describe attributes associated with meaningful encounters in the Swedish healthcare system based on patients' and caregivers' written narratives and to note the differences and similarities between the attributes identified by the two groups. This paper is a qualitative descriptive study. The analysis was guided by qualitative content analyses. Based on patients' narratives, attributes associated with a meaningful encounter fell into four categories: the kind-hearted caregiver, the thoughtful caregiver, the mutually oriented caregiver, and the helpful caregiver. Based on caregivers' narratives, the attributes were categorized as being humane, caring through physical contact, caring by nurturing communication, joy and laughter in care, and a sense of mutuality. The results show that there are both similarities and differences in patients' and caregivers' opinions about the attributes of a meaningful encounter. Knowing more about the attributes associated with meaningful encounters makes it possible for caregivers to individualize care for patients and makes it easier to help and support patients in what they most need support with. PMID:22701802

Sustaining “Meaningful Use” of Health Information Technology in Low-Resource Practices

PubMed Central

Green, Lee A.; Potworowski, Georges; Day, Anya; May-Gentile, Rachelle; Vibbert, Danielle; Maki, Bruce; Kiesel, Leslie

2015-01-01

PURPOSE The implementation of electronic health records (EHRs) has been extensively studied, but their maintenance once implemented has not. The Regional Extension Center (REC) program provides implementation assistance to priority practices—those with limited financial, technical, and organizational resources—but the assistance is time limited. Our objective was to identify potential barriers to maintenance of meaningful use of EHRs in priority primary care practices using a qualitative observational study for federally qualified health centers (FQHCs) and priority practices in Michigan. METHODS We conducted cognitive task analysis (CTA) interviews and direct observations of health information technology implementation in FQHCs. In addition, we conducted semistructured interviews with implementation specialists serving priority practices to detect emergent themes relevant to maintenance. RESULTS Maintaining EHR technology will require ongoing expert technical support indefinitely beyond implementation to address upgrades and security needs. Maintaining meaningful use for quality improvement will require ongoing support for leadership and change management. Priority practices not associated with larger systems lack access to the necessary technical expertise, financial resources, and leverage with vendors to continue alone. Rural priority practices are particularly challenged, because expertise is often not available locally. CONCLUSIONS Priority practices, especially in rural areas, are at high risk for falling on the wrong side of a “digital divide” as payers and regulators enact increasing expectations for EHR use and information management. For those without affiliation to maintain the necessary expert staff, ongoing support will be needed for those practices to remain viable. PMID:25583887

A Journey through Meaningful Use at a Large Academic Medical Center: Lessons of Leadership, Administration, and Technical Implementation

PubMed Central

Unger, Melissa D.; Aldrich, Alison M.; Hefner, Jennifer L.; Rizer, Milisa K.

2014-01-01

Successfully reporting meaningful use of electronic health records to the Centers for Medicare and Medicaid Services can be a challenging process, particularly for healthcare organizations with large numbers of eligible professionals. This case report describes a successful meaningful use attestation process undertaken at a major academic medical center. It identifies best practices in the areas of leadership, administration, communication, ongoing support, and technological implementation. PMID:25593572

A journey through meaningful use at a large academic medical center: lessons of leadership, administration, and technical implementation.

PubMed

Unger, Melissa D; Aldrich, Alison M; Hefner, Jennifer L; Rizer, Milisa K

2014-01-01

Successfully reporting meaningful use of electronic health records to the Centers for Medicare and Medicaid Services can be a challenging process, particularly for healthcare organizations with large numbers of eligible professionals. This case report describes a successful meaningful use attestation process undertaken at a major academic medical center. It identifies best practices in the areas of leadership, administration, communication, ongoing support, and technological implementation.

Disorientating, fun or meaningful? Disadvantaged families' experiences of a science museum visit

NASA Astrophysics Data System (ADS)

Archer, Louise; Dawson, Emily; Seakins, Amy; Wong, Billy

2016-12-01

It is widely agreed that there is a need to increase and widen science participation. Informal science learning environments (ISLEs), such as science museums, may provide valuable spaces within which to engage visitors—yet the visitor profile of science museums remains narrow. This paper seeks to understand the experiences of socially disadvantaged families within such spaces. Using a Bourdieusian analytic lens, we analyse qualitative data from a small study conducted with ten parents and ten children from an urban school who visited a large science museum. Data includes pre- and post-interviews, audio recordings and visit fieldnotes. We characterised families' experiences as falling into three discourses, as `disorientating', `fun' or `meaningful' visits. Analysis identifies how the families' experiences, and the likelihood of deriving science learning from the visit, were shaped through interactions of habitus and capital. Implications for improving equity and inclusion within ISLEs are discussed.

From Mindless to Meaningful

ERIC Educational Resources Information Center

Billings, Laura; Roberts, Terry

2014-01-01

Despite teachers' best intentions, traditional whole-class discussions sometimes end up sounding like the monotonous drone of Charlie Brown's teacher. But with careful planning, teachers can structure discussions that encourage meaningful student interaction and collaborative thinking, write Laura Billings and Terry Roberts of the…

An operational definition of a statistically meaningful trend.

PubMed

Bryhn, Andreas C; Dimberg, Peter H

2011-04-28

Linear trend analysis of time series is standard procedure in many scientific disciplines. If the number of data is large, a trend may be statistically significant even if data are scattered far from the trend line. This study introduces and tests a quality criterion for time trends referred to as statistical meaningfulness, which is a stricter quality criterion for trends than high statistical significance. The time series is divided into intervals and interval mean values are calculated. Thereafter, r(2) and p values are calculated from regressions concerning time and interval mean values. If r(2) ≥ 0.65 at p ≤ 0.05 in any of these regressions, then the trend is regarded as statistically meaningful. Out of ten investigated time series from different scientific disciplines, five displayed statistically meaningful trends. A Microsoft Excel application (add-in) was developed which can perform statistical meaningfulness tests and which may increase the operationality of the test. The presented method for distinguishing statistically meaningful trends should be reasonably uncomplicated for researchers with basic statistics skills and may thus be useful for determining which trends are worth analysing further, for instance with respect to causal factors. The method can also be used for determining which segments of a time trend may be particularly worthwhile to focus on.

Life is pretty meaningful.

PubMed

Heintzelman, Samantha J; King, Laura A

2014-09-01

The human experience of meaning in life is widely viewed as a cornerstone of well-being and a central human motivation. Self-reports of meaning in life relate to a host of important functional outcomes. Psychologists have portrayed meaning in life as simultaneously chronically lacking in human life as well as playing an important role in survival. Examining the growing literature on meaning in life, we address the question "How meaningful is life, in general?" We review possible answers from various psychological sources, some of which anticipate that meaning in life should be low and others that it should be high. Summaries of epidemiological data and research using two self-report measures of meaning in life suggest that life is pretty meaningful. Diverse samples rate themselves significantly above the midpoint on self-reports of meaning in life. We suggest that if meaning in life plays a role in adaptation, it must be commonplace, as our analysis suggests. (c) 2014 APA, all rights reserved.

Integrating Concept Mapping into Information Systems Education for Meaningful Learning and Assessment

ERIC Educational Resources Information Center

Wei, Wei; Yue, Kwok-Bun

2017-01-01

Concept map (CM) is a theoretically sound yet easy to learn tool and can be effectively used to represent knowledge. Even though many disciplines have adopted CM as a teaching and learning tool to improve learning effectiveness, its application in IS curriculum is sparse. Meaningful learning happens when one iteratively integrates new concepts and…

42 CFR 495.210 - Meaningful EHR user attestation.

Code of Federal Regulations, 2014 CFR

2014-10-01

... INCENTIVE PROGRAM Requirements Specific to Medicare Advantage (MA) Organizations § 495.210 Meaningful EHR user attestation. (a) Qualifying MA organizations are required to attest, in a form and manner specified by CMS, that each qualifying MA EP and qualifying MA-affiliated eligible hospitals is a meaningful...

42 CFR 495.210 - Meaningful EHR user attestation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... INCENTIVE PROGRAM Requirements Specific to Medicare Advantage (MA) Organizations § 495.210 Meaningful EHR user attestation. (a) Qualifying MA organizations are required to attest, in a form and manner specified by CMS, that each qualifying MA EP and qualifying MA-affiliated eligible hospitals is a meaningful...

42 CFR 495.210 - Meaningful EHR user attestation.

Code of Federal Regulations, 2013 CFR

2013-10-01

... INCENTIVE PROGRAM Requirements Specific to Medicare Advantage (MA) Organizations § 495.210 Meaningful EHR user attestation. (a) Qualifying MA organizations are required to attest, in a form and manner specified by CMS, that each qualifying MA EP and qualifying MA-affiliated eligible hospitals is a meaningful...

42 CFR 495.210 - Meaningful EHR user attestation.

Code of Federal Regulations, 2011 CFR

2011-10-01

... INCENTIVE PROGRAM Requirements Specific to Medicare Advantage (MA) Organizations § 495.210 Meaningful EHR user attestation. (a) Qualifying MA organizations are required to attest, in a form and manner specified by CMS, that each qualifying MA EP and qualifying MA-affiliated eligible hospitals is a meaningful...

42 CFR 495.210 - Meaningful EHR user attestation.

Code of Federal Regulations, 2012 CFR

2012-10-01

... INCENTIVE PROGRAM Requirements Specific to Medicare Advantage (MA) Organizations § 495.210 Meaningful EHR user attestation. (a) Qualifying MA organizations are required to attest, in a form and manner specified by CMS, that each qualifying MA EP and qualifying MA-affiliated eligible hospitals is a meaningful...

Meaningful and Purposeful Practice

ERIC Educational Resources Information Center

Clementi, Donna

2014-01-01

This article describes a graphic, designed by Clementi and Terrill, the authors of "Keys to Planning for Learning" (2013), visually representing the components that contribute to meaningful and purposeful practice in learning a world language, practice that leads to greater proficiency. The entire graphic is centered around the letter…

Developing Meaningfulness at Work through Emotional Intelligence Training

ERIC Educational Resources Information Center

Thory, Kathryn

2016-01-01

To date, there remains a significant gap in the human resource development (HRD) literature in understanding how training and development contributes to meaningful work. In addition, little is known about how individuals proactively make their work more meaningful. This article shows how emotional intelligence (EI) training promotes learning about…

Meaningful Responses to Literature

ERIC Educational Resources Information Center

Kovarik, Madeline

2006-01-01

If students were as engaged in reading as they are in video games, television, and sports, the world would be rife with proficient readers. Using a variety of instructional strategies, teachers can make the reading experience more meaningful, increase comprehension, and build proficiency. Mastering cognitive skills can change student reading from…

Helping others increases meaningful work: Evidence from three experiments.

PubMed

Allan, Blake A; Duffy, Ryan D; Collisson, Brian

2018-03-01

The aim of the current research was to examine whether manipulating task significance increased the meaningfulness of work among students (Study 1), an online sample of working adults (Study 2), and public university employees (Study 3). In Study 1, students completed a typing task for the benefit of themselves, a charity, or someone they knew would directly benefit from their work. People who worked to benefit someone else, rather than themselves, reported greater task meaningfulness. In Study 2, a representative, online sample of employees reflected on a time when they worked to benefit themselves or someone else at work. Results revealed that people who reflected on working to benefit someone else, rather than themselves, reported greater work meaningfulness. In Study 3, public university employees participated in a community intervention by working as they normally would, finding new ways to help people each day, or finding several new ways to help others on a single day. People who helped others many times in a single day experienced greater gains in work meaningfulness over time. Across 3 experimental studies, we found that people who perceived their work as helping others experienced more meaningfulness in their work. This highlights the potential mechanisms practitioners, employers, and other parties can use to increase the meaningfulness of work, which has implications for workers' well-being and productivity. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Hospital budget increase for information technology during phase 1 meaningful use.

PubMed

Neumeier, Harold; Berner, Eta S; Burke, Darrell E; Azuero, Andres

2015-01-01

Federal policies have a significant effect on how businesses spend money. The 2009 HITECH (Health Information Technology for Economic and Clinical Health Act) authorized incentive payments through Medicare and Medicaid to clinicians and hospitals when they use certified electronic health records privately and securely to achieve specified improvements in care delivery. Federal incentive payments were offered in 2011 for hospitals that had satisfied "meaningful use" criteria. A longitudinal study of nonfederal hospital information technology (IT) budgets (N = 493) during the years 2009 to 2011 found increases in the percentage of hospital annual operating budgets allocated to IT in the years leading up to these federal incentives. This increase was most pronounced among hospitals receiving high proportions of their reimbursements from Medicaid, followed by hospitals receiving high proportions of their reimbursements from Medicare, possibly indicating a budget shift during this period to more IT spending to achieve meaningful-use policy guidelines.

Measuring meaningful learning in the undergraduate chemistry laboratory

NASA Astrophysics Data System (ADS)

Galloway, Kelli R.

The undergraduate chemistry laboratory has been an essential component in chemistry education for over a century. The literature includes reports on investigations of singular aspects laboratory learning and attempts to measure the efficacy of reformed laboratory curriculum as well as faculty goals for laboratory learning which found common goals among instructors for students to learn laboratory skills, techniques, experimental design, and to develop critical thinking skills. These findings are important for improving teaching and learning in the undergraduate chemistry laboratory, but research is needed to connect the faculty goals to student perceptions. This study was designed to explore students' ideas about learning in the undergraduate chemistry laboratory. Novak's Theory of Meaningful Learning was used as a guide for the data collection and analysis choices for this research. Novak's theory states that in order for meaningful learning to occur the cognitive, affective, and psychomotor domains must be integrated. The psychomotor domain is inherent in the chemistry laboratory, but the extent to which the cognitive and affective domains are integrated is unknown. For meaningful learning to occur in the laboratory, students must actively integrate both the cognitive domain and the affective domains into the "doing" of their laboratory work. The Meaningful Learning in the Laboratory Instrument (MLLI) was designed to measure students' cognitive and affective expectations and experiences within the context of conducting experiments in the undergraduate chemistry laboratory. Evidence for the validity and reliability of the data generated by the MLLI were collected from multiple quantitative studies: a one semester study at one university, a one semester study at 15 colleges and universities across the United States, and a longitudinal study where the MLLI was administered 6 times during two years of general and organic chemistry laboratory courses. Results from

Training And Supervision Did Not Meaningfully Improve Quality Of Care For Pregnant Women Or Sick Children In Sub-Saharan Africa.

PubMed

Leslie, Hannah H; Gage, Anna; Nsona, Humphreys; Hirschhorn, Lisa R; Kruk, Margaret E

2016-09-01

In-service training courses and supportive supervision of health workers are among the most common interventions to improve the quality of health care in low- and middle-income countries. Despite extensive investment from donors, evaluations of the long-term effect of these two interventions are scarce. We used nationally representative surveys of health systems in seven countries in sub-Saharan Africa to examine the association of in-service training and supervision with provider quality in antenatal and sick child care. The results of our analysis showed that observed quality of care was poor, with fewer than half of evidence-based actions completed by health workers, on average. In-service training and supervision were associated with quality of sick child care; they were associated with quality of antenatal care only when provided jointly. All associations were modest-at most, improvements related to interventions were equivalent to 2 additional provider actions out of the 18-40 actions expected per visit. In-service training and supportive supervision as delivered were not sufficient to meaningfully improve the quality of care in these countries. Greater attention to the quality of health professional education and national health system performance will be required to provide the standard of health care that patients deserve. Project HOPE—The People-to-People Health Foundation, Inc.

Feasibility, appropriateness, meaningfulness and effectiveness of patient participation at bedside shift reporting: mixed-method research protocol.

PubMed

Malfait, Simon; Eeckloo, Kristof; Lust, Elisa; Van Biesen, Wim; Van Hecke, Ann

2017-02-01

To evaluate the feasibility, appropriateness, meaningfulness and effectiveness of bedside shift reporting in a minimum of five interventions and five control wards. Hospitals continually improve their quality of care. Next to improvements in clinical performance, more patient participation is stimulated through different methods. Methods to enhance patient participation such as bedside shift reporting lack rigorously performed research to determine their feasibility, appropriateness, meaningfulness and effectiveness. Small-scale research and a previous pilot study indicate that bedside shift reporting improves patient participation, nurse-nurse communication and nurse-patient communication. The development, implementation and evaluation of bedside shift report are based on the Medical Research Council framework for complex interventions in health care. A matched, controlled, mixed-method, longitudinal study design will be used. The Feasibility-Appropriateness-Meaningfulness-Effectiveness framework will be applied for the quantitative and qualitative evaluation of bedside shift report. A tailored intervention and implementation process for bedside shift report will be developed using diagnostic interviews, co-design and acceptability testing. The intervention will be evaluated before implementation and three times after implementation. Individual and focus group interviews will be performed. Questionnaires, observations and analysis of the medical records and administrative databases will be completed. This study was funded in October 2015. Research Ethics Committee approval was granted in March 2016. There is a pressing need for rigorous research into the effects of interventions for improving patient participation. This study addresses the significance of bedside shift report as an intervention to improve quality of care, communication and patient participation within a large-scale, matched, controlled research design. © 2016 John Wiley & Sons Ltd.

Birth, meaningful viability and abortion.

PubMed

Jensen, David

2015-06-01

What role does birth play in the debate about elective abortion? Does the wrongness of infanticide imply the wrongness of late-term abortion? In this paper, I argue that the same or similar factors that make birth morally significant with regard to abortion make meaningful viability morally significant due to the relatively arbitrary time of birth. I do this by considering the positions of Mary Anne Warren and José Luis Bermúdez who argue that birth is significant enough that the wrongness of infanticide does not imply the wrongness of late-term abortion. On the basis of the relatively arbitrary timing of birth, I argue that meaningful viability is the point at which elective abortion is prima facie morally wrong. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Focusing on Active, Meaningful Learning. IDEA Paper No. 34.

ERIC Educational Resources Information Center

Stalheim-Smith, Ann

This paper discusses active and meaningful learning and the application of this instructional approach to the college classroom, focusing on techniques used in the author's biology classes. Active and meaningful learning places emphasis on students actually doing things and thinking about what they are doing, relating new information to…

Medicaid Stage 1 Meaningful Use EHR Incentive Payments Are Associated With Higher Quality but Not Improvements in Quality.

PubMed

Grinspan, Zachary M; Bao, Yuhua; Edwards, Alison; Johnson, Phyllis; Kaushal, Rainu; Kern, Lisa M

This was a retrospective cohort study of ambulatory care quality by physicians who received payment for Medicaid Stage 1 Meaningful Use (MU) in 2012 using New York State Medicaid Claims (2010-2013). Eight quality measures were used to compare performance of physicians who received payments to Adopt, Implement, or Use (AIU) an electronic health record in 2011 but not for MU in 2012 (AIU-only group) and physicians who cared for Medicaid patients but received no payments (no-incentive group), using propensity score-weighted difference-in-difference logistic regression analyses, clustering by physician. In all, 13 697 physicians and 913 476 patients were studied. In 2010, the MU group scored higher than both groups (vs AIU-only in 3 of 8 measures, 0.8-1.3 adjusted percentage points; vs no-incentive, 2 of 8 measures, 0.9-2.0 adjusted percentage points). The difference-in-difference analysis found no additional improvements in quality over time relative to either control group. Longer follow-up is needed to determine the effects of Stage 2 MU.

Meaningful Use of Health Information Technology by Rural Hospitals

ERIC Educational Resources Information Center

McCullough, Jeffrey; Casey, Michelle; Moscovice, Ira; Burlew, Michele

2011-01-01

Purpose: This study examines the current status of meaningful use of health information technology (IT) in Critical Access Hospitals (CAHs), other rural, and urban US hospitals, and it discusses the potential role of Medicare payment incentives and disincentives in encouraging CAHs and other rural hospitals to achieve meaningful use. Methods: Data…

Meaningful Movement for Children: Stay True to Their Natures

ERIC Educational Resources Information Center

Baumgarten, Sam

2006-01-01

This article discusses the meaningful movement for children. In this article, the author discusses "roots" in the "physical education garden" which, when thoroughly examined, reveal tried and true insights about children and their natures. By revisiting these natures or characteristics, one will have a clearer picture of what is meaningful to…

Guidelines to encourage the adoption and meaningful use of health information technologies in the South African healthcare landscape.

PubMed

Mostert-Phipps, Nicky; Pottas, Dalenca; Korpela, Mikko

2013-01-01

There are various benefits associated with the adoption and meaningful use of health information technologies (HITs) in the healthcare sector. Despite these benefits, the South African healthcare sector has been slow to adopt HITs such as electronic record systems. The purpose of this research project was to formulate guidelines to encourage the adoption and meaningful use of HITs in the South African healthcare landscape. A three-round Delphi study was conducted to identify factors that should be addressed to encourage the adoption and meaningful use of HITs in the South African healthcare landscape. The Delphi panel included 21 participants that were considered to be suitably knowledgeable regarding the area under consideration. Consensus was reached on 42 factors that were rated as having a direct to significant impact on the adoption and meaningful use of HITs in the South African context. These factors were further analysed to formulate 20 guidelines that indicate that there are a wide range of factors that would have to be addressed involving a multitude of stakeholders.

The Potato Chip Really Does Look Like Elvis! Neural Hallmarks of Conceptual Processing Associated with Finding Novel Shapes Subjectively Meaningful

PubMed Central

Federmeier, Kara D.; Paller, Ken A.

2012-01-01

Clouds and inkblots often compellingly resemble something else—faces, animals, or other identifiable objects. Here, we investigated illusions of meaning produced by novel visual shapes. Individuals found some shapes meaningful and others meaningless, with considerable variability among individuals in these subjective categorizations. Repetition for shapes endorsed as meaningful produced conceptual priming in a priming test along with concurrent activity reductions in cortical regions associated with conceptual processing of real objects. Subjectively meaningless shapes elicited robust activity in the same brain areas, but activity was not influenced by repetition. Thus, all shapes were conceptually evaluated, but stable conceptual representations supported neural priming for meaningful shapes only. During a recognition memory test, performance was associated with increased frontoparietal activity, regardless of meaningfulness. In contrast, neural conceptual priming effects for meaningful shapes occurred during both priming and recognition testing. These different patterns of brain activation as a function of stimulus repetition, type of memory test, and subjective meaningfulness underscore the distinctive neural bases of conceptual fluency versus episodic memory retrieval. Finding meaning in ambiguous stimuli appears to depend on conceptual evaluation and cortical processing events similar to those typically observed for known objects. To the brain, the vaguely Elvis-like potato chip truly can provide a substitute for the King himself. PMID:22079921

Meaningful participation for children in the Dutch child protection system: A critical analysis of relevant provisions in policy documents.

PubMed

Bouma, Helen; López López, Mónica; Knorth, Erik J; Grietens, Hans

2018-05-01

Policymakers are increasingly focusing on the participation of children in the child protection system (CPS). However, research shows that actual practice still needs to be improved. Embedding children's participation in legislation and policy documents is one important prerequisite for achieving meaningful participation in child protection practice. In this study, the participation of children in the Dutch CPS under the new Youth Act 2015 is critically analyzed. National legislation and policy documents were studied using a model of "meaningful participation" based on article 12 of the UNCRC. Results show that the idea of children's participation is deeply embedded in the current Dutch CPS. However, Dutch policy documents do not fully cover the three dimensions of what is considered to be meaningful participation for children: informing, hearing, and involving. Furthermore, children's participation differs among the organizations included in the child protection chain. A clear overall policy concerning the participation of children in the Dutch CPS is lacking. The conclusions of this critical analysis of policy documents and the framework of meaningful participation presented may provide a basis for the embedding of meaningful participation for children in child protection systems of other countries. Copyright © 2018 Elsevier Ltd. All rights reserved.

Effect of Meaningful Recognition on Critical Care Nurses' Compassion Fatigue.

PubMed

Kelly, Lesly A; Lefton, Cindy

2017-11-01

As caregivers in high-pressure environments, critical care nurses are at risk for burnout and secondary trauma-components of compassion fatigue. Recent findings have increased understanding of the phenomena, specifically that satisfaction and meaningful recognition may play a role in reducing burnout and raising compassion satisfaction; however, no large multisite studies of compassion fatigue have been conducted. To examine the effect of meaningful recognition and other predictors on compassion fatigue in a multicenter national sample of critical care nurses. A quantitative, descriptive online survey was completed by 726 intensive care unit nurses in 14 hospitals with an established meaningful recognition program and 410 nurses in 10 hospitals without such a program. Site coordinators at each hospital coordinated distribution of the survey to nurses to assess multiple predictors against outcomes, measured by the Professional Quality of Life Scale. Cross-validation and linear regression modeling were conducted to determine significant predictors of burnout, secondary traumatic stress, and compassion satisfaction. Similar levels of burnout, secondary traumatic stress, compassion satisfaction, overall satisfaction, and intent to leave were reported by nurses in hospitals with and without meaningful recognition programs. Meaningful recognition was a significant predictor of decreased burnout and increased compassion satisfaction. Additionally, job satisfaction and job enjoyment were highly predictive of decreased burnout, decreased secondary traumatic stress, and increased compassion satisfaction. In addition to acknowledging and valuing nurses' contributions to care, meaningful recognition could reduce burnout and boost compassion satisfaction. ©2017 American Association of Critical-Care Nurses.

Merit-Based Incentive Payment System: Meaningful Changes in the Final Rule Brings Cautious Optimism.

PubMed

Manchikanti, Laxmaiah; Helm Ii, Standiford; Calodney, Aaron K; Hirsch, Joshua A

2017-01-01

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) eliminated the flawed Sustainable Growth Rate (SGR) act formula - a longstanding crucial issue of concern for health care providers and Medicare beneficiaries. MACRA also included a quality improvement program entitled, "The Merit-Based Incentive Payment System, or MIPS." The proposed rule of MIPS sought to streamline existing federal quality efforts and therefore linked 4 distinct programs into one. Three existing programs, meaningful use (MU), Physician Quality Reporting System (PQRS), value-based payment (VBP) system were merged with the addition of Clinical Improvement Activity category. The proposed rule also changed the name of MU to Advancing Care Information, or ACI. ACI contributes to 25% of composite score of the four programs, PQRS contributes 50% of the composite score, while VBP system, which deals with resource use or cost, contributes to 10% of the composite score. The newest category, Improvement Activities or IA, contributes 15% to the composite score. The proposed rule also created what it called a design incentive that drives movement to delivery system reform principles with the inclusion of Advanced Alternative Payment Models (APMs).Following the release of the proposed rule, the medical community, as well as Congress, provided substantial input to Centers for Medicare and Medicaid Services (CMS),expressing their concern. American Society of Interventional Pain Physicians (ASIPP) focused on 3 important aspects: delay the implementation, provide a 3-month performance period, and provide ability to submit meaningful quality measures in a timely and economic manner. The final rule accepted many of the comments from various organizations, including several of those specifically emphasized by ASIPP, with acceptance of 3-month reporting period, as well as the ability to submit non-MIPS measures to improve real quality and make the system meaningful. CMS also provided a mechanism for

Aging, culture, and memory for socially meaningful item-context associations: an East-West cross-cultural comparison study.

PubMed

Yang, Lixia; Li, Juan; Spaniol, Julia; Hasher, Lynn; Wilkinson, Andrea J; Yu, Jing; Niu, Yanan

2013-01-01

Research suggests that people in Eastern interdependent cultures process information more holistically and attend more to contextual information than do people in Western independent cultures. The current study examined the effects of culture and age on memory for socially meaningful item-context associations in 71 Canadians of Western European descent (35 young and 36 older) and 72 native Chinese citizens (36 young and 36 older). All participants completed two blocks of context memory tasks. During encoding, participants rated pictures of familiar objects. In one block, objects were rated either for their meaningfulness in the independent living context or their typicality in daily life. In the other block, objects were rated for their meaningfulness in the context of fostering relationships with others or for their typicality in daily life. The encoding in each block was followed by a recognition test in which participants identified pictures and their associated contexts. The results showed that Chinese outperformed Canadians in context memory, though both culture groups showed similar age-related deficits in item and context memory. The results suggest that Chinese are at an advantage in memory for socially meaningful item-context associations, an advantage that continues from young adulthood into old age.

Eight Steps to Meaningful Grading

ERIC Educational Resources Information Center

Deddeh, Heather; Main, Erin; Fulkerson, Sharon Ratzlaff

2010-01-01

A group of teachers at Clifford Smart Middle School in Michigan's Walled Lake Consolidated School District have broken free from traditional grading in order to embrace a more meaningful grading practice. Using standards-based grading practices, they believe their grading now accurately communicates to students and parents the student's mastery…

Doing the Project and Learning the Content: Designing Project-Based Science Curricula for Meaningful Understanding

ERIC Educational Resources Information Center

Kanter, David E.

2010-01-01

Project-based science curricula can improve students' usable or meaningful understanding of the science content underlying a project. However, such curricula designed around "performances" wherein students design or make something do not always do this. We researched ways to design performance project-based science curricula (pPBSc) to better…

Meaningful use of health information technology by rural hospitals.

PubMed

McCullough, Jeffrey; Casey, Michelle; Moscovice, Ira; Burlew, Michele

2011-01-01

This study examines the current status of meaningful use of health information technology (IT) in Critical Access Hospitals (CAHs), other rural, and urban US hospitals, and it discusses the potential role of Medicare payment incentives and disincentives in encouraging CAHs and other rural hospitals to achieve meaningful use. Data from the American Hospital Association (AHA) Annual Survey IT Supplement were analyzed, using t tests and probit regressions to assess whether implementation rates in CAHs and other rural hospitals are significantly different from rates in urban hospitals. Of the many measures we examined, only 4 have been met by a majority of rural hospitals: electronic recording of patient demographics and electronic access to lab reports, radiology reports, and radiology images. Meaningful use is even less prevalent among CAHs. We also find that rural hospitals lag behind urban institutions in nearly every measure of meaningful use. These differences are particularly large and significant for CAHs. The meaningful use incentive system creates many challenges for CAHs. First, investments are evaluated and subsidies determined after adoption. Thus, CAHs must accept financial risk when adopting health IT; this may be particularly important for large expenditures. Second, the subsidies may be low for relatively small expenditures. Third, since the subsidies are based on observable costs, CAHs will receive no support for their intangible costs (eg, workflow disruption). A variety of policies may be used to address these problems of financial risk, uncertain returns in a rural setting, and limited resources. © 2011 National Rural Health Association.

A Meaningful High School Diploma

ERIC Educational Resources Information Center

Siegel, Shepherd

2009-01-01

Creating a meaningful high school diploma will expose students to the full range of adult options which will enable them to shape their high school education in a way that connects to their current interests and stimulates the growth of new ones. Fully connecting all students to these four worlds of knowledge will equip them to build one…

Poignancy: Mixed Emotional Experience in the Face of Meaningful Endings

PubMed Central

Ersner-Hershfield, Hal; Mikels, Joseph A.; Sullivan, Sarah J.; Carstensen, Laura L.

2009-01-01

The experience of mixed emotions increases with age. Socioemotional selectivity theory suggests that mixed emotions are associated with shifting time horizons. Theoretically, perceived constraints on future time increase appreciation for life, which, in turn, elicits positive emotions such as happiness. Yet, the very same temporal constraints heighten awareness that these positive experiences come to an end, thus yielding mixed emotional states. In 2 studies, the authors examined the link between the awareness of anticipated endings and mixed emotional experience. In Study 1, participants repeatedly imagined being in a meaningful location. Participants in the experimental condition imagined being in the meaningful location for the final time. Only participants who imagined “last times” at meaningful locations experienced more mixed emotions. In Study 2, college seniors reported their emotions on graduation day. Mixed emotions were higher when participants were reminded of the ending that they were experiencing. Findings suggest that poignancy is an emotional experience associated with meaningful endings. PMID:18179325

Using Shared Leadership to Achieve School Improvement Goals: A Qualitative Study of One High School's Journey

ERIC Educational Resources Information Center

Putman, Leigh Ann

2012-01-01

This qualitative phenomenological study examined the impact of shared leadership committees on school improvement efforts. The research identified which leadership factors lead to successful shared leadership committees and which supports and structures were needed for the committees to be meaningful in regards to school improvement. Certified…

Interchange. Program Improvement Products Identified through Networking.

ERIC Educational Resources Information Center

Ohio State Univ., Columbus. National Center for Research in Vocational Education.

This catalog lists exemplary field-based program improvement products identified by the Dissemination and Utilization Products and Services Program (D&U) at the National Center for Research in Vocational Education. It is designed to increase awareness of these products among vocational educators and to provide information about them that…

Aging, Culture, and Memory for Socially Meaningful Item-Context Associations: An East-West Cross-Cultural Comparison Study

PubMed Central

Yang, Lixia; Li, Juan; Spaniol, Julia; Hasher, Lynn; Wilkinson, Andrea J.; Yu, Jing; Niu, Yanan

2013-01-01

Research suggests that people in Eastern interdependent cultures process information more holistically and attend more to contextual information than do people in Western independent cultures. The current study examined the effects of culture and age on memory for socially meaningful item-context associations in 71 Canadians of Western European descent (35 young and 36 older) and 72 native Chinese citizens (36 young and 36 older). All participants completed two blocks of context memory tasks. During encoding, participants rated pictures of familiar objects. In one block, objects were rated either for their meaningfulness in the independent living context or their typicality in daily life. In the other block, objects were rated for their meaningfulness in the context of fostering relationships with others or for their typicality in daily life. The encoding in each block was followed by a recognition test in which participants identified pictures and their associated contexts. The results showed that Chinese outperformed Canadians in context memory, though both culture groups showed similar age-related deficits in item and context memory. The results suggest that Chinese are at an advantage in memory for socially meaningful item-context associations, an advantage that continues from young adulthood into old age. PMID:23593288

Generation Me or Meaning? Exploring Meaningful Work in College Students and Career Counselors

ERIC Educational Resources Information Center

Allan, Blake A.; Owens, Rhea L.; Duffy, Ryan D.

2017-01-01

Assessing the value of meaningful work among undergraduate students is important for guiding career counseling, especially because today's students are often stereotyped as entitled and uninterested in prosocial or meaningful work. Additionally, understanding the value of meaningful work from the perspectives of career counselors would clarify if…

The Meaningful Activity Participation Assessment: a measure of engagement in personally valued activities.

PubMed

Eakman, Aaron M; Carlson, Mike E; Clark, Florence A

2010-01-01

The Meaningful Activity Participation Assessment (MAPA), a recently developed 28-item tool designed to measure the meaningfulness of activity, was tested in a sample of 154 older adults. The MAPA evidenced a sufficient level of internal consistency and test-retest reliability and correlated as theoretically predicted with the Life Satisfaction Index-Z, the Satisfaction with Life Scale, the Engagement in Meaningful Activities Survey, the Purpose in Life Test, the Center for Epidemiologic Studies Depression Inventory and the Rand SF-36v2 Health Survey subscales. Zero-order correlations consistently demonstrated meaningful relationships between the MAPA and scales of psychosocial well-being and health-related quality of life. Results from multiple regression analyses further substantiated these findings, as greater meaningful activity participation was associated with better psychological well-being and health-related quality of life. The MAPA appears to be a reliable and valid measure of meaningful activity, incorporating both subjective and objective indicators of activity engagement.

THE MEANINGFUL ACTIVITY PARTICIPATION ASSESSMENT: A MEASURE OF ENGAGEMENT IN PERSONALLY VALUED ACTIVITIES*

PubMed Central

EAKMAN, AARON M.; CARLSON, MIKE E.; CLARK, FLORENCE A.

2011-01-01

The Meaningful Activity Participation Assessment (MAPA), a recently developed 28-item tool designed to measure the meaningfulness of activity, was tested in a sample of 154 older adults. The MAPA evidenced a sufficient level of internal consistency and test-retest reliability and correlated as theoretically predicted with the Life Satisfaction Index-Z, the Satisfaction with Life Scale, the Engagement in Meaningful Activities Survey, the Purpose in Life Test, the Center for Epidemiologic Studies Depression Inventory and the Rand SF-36v2 Health Survey subscales. Zero-order correlations consistently demonstrated meaningful relationships between the MAPA and scales of psychosocial well-being and health-related quality of life. Results from multiple regression analyses further substantiated these findings, as greater meaningful activity participation was associated with better psychological well-being and health-related quality of life. The MAPA appears to be a reliable and valid measure of meaningful activity, incorporating both subjective and objective indicators of activity engagement. PMID:20649161

Dignity and respect: facilitating meaningful occupation for SeSotho elders.

PubMed

Du Toit, Sanetta H J; Böning, Wilmarié; Van Der Merwe, Tania Rauch

2014-03-01

Frail and vulnerable adults are divested of meaningful encounters when modernization and urbanization force them to embrace an unconventional residential care environment as a home. The aim of this article is to report on a study of SeSotho elders living in residential care to illustrate how more meaningful and culturally relevant experiences could be facilitated for them. A content analysis was done of the individual opinions of 15 collaborators as a secondary scrutiny of information obtained during a nominal group process. MAJOR FINDINGS. Findings revealed that elders were prone to experience loneliness, helplessness, and boredom due to situations dominated by occupational injustice. Co-occupations, training of staff, and environmental adaptations that allow a sense of interdependence could contribute in facilitating occupational justice for elders from a traditional South African indigenous background living in residential care. Human dignity and respect are upheld within residential care when elders have access to purposeful and meaningful activities of their choice that are culturally appropriate. Occupational therapists should advocate for doing, belonging, and becoming by facilitating meaningful occupational participation that is culturally relevant for their clients.

Making Social Studies Meaningful to Elementary Students.

ERIC Educational Resources Information Center

Klein, Susan

1982-01-01

Describes a unit on Ancient Greece designed to make social studies meaningful to fourth and fifth graders. Individual projects and group activities helped students learn about ancient Greek culture. (AM)

Why Do You Work with Struggling Students? Teacher Perceptions of Meaningful Work in Trauma-Impacted Classrooms

ERIC Educational Resources Information Center

Brunzell, Tom; Stokes, Helen; Waters, Lea

2018-01-01

This study contributed new findings to the construct of meaningful work (MW) and negative impacts on MW. In other professional samples, finding meaning in work has been shown to be an effective buffer when facing workplace adversity. However, prior investigation has neither identified nor explored the specific sources and mechanisms of meaningful…

Audio-Visual and Meaningful Semantic Context Enhancements in Older and Younger Adults.

PubMed

Smayda, Kirsten E; Van Engen, Kristin J; Maddox, W Todd; Chandrasekaran, Bharath

2016-01-01

Speech perception is critical to everyday life. Oftentimes noise can degrade a speech signal; however, because of the cues available to the listener, such as visual and semantic cues, noise rarely prevents conversations from continuing. The interaction of visual and semantic cues in aiding speech perception has been studied in young adults, but the extent to which these two cues interact for older adults has not been studied. To investigate the effect of visual and semantic cues on speech perception in older and younger adults, we recruited forty-five young adults (ages 18-35) and thirty-three older adults (ages 60-90) to participate in a speech perception task. Participants were presented with semantically meaningful and anomalous sentences in audio-only and audio-visual conditions. We hypothesized that young adults would outperform older adults across SNRs, modalities, and semantic contexts. In addition, we hypothesized that both young and older adults would receive a greater benefit from a semantically meaningful context in the audio-visual relative to audio-only modality. We predicted that young adults would receive greater visual benefit in semantically meaningful contexts relative to anomalous contexts. However, we predicted that older adults could receive a greater visual benefit in either semantically meaningful or anomalous contexts. Results suggested that in the most supportive context, that is, semantically meaningful sentences presented in the audiovisual modality, older adults performed similarly to young adults. In addition, both groups received the same amount of visual and meaningful benefit. Lastly, across groups, a semantically meaningful context provided more benefit in the audio-visual modality relative to the audio-only modality, and the presence of visual cues provided more benefit in semantically meaningful contexts relative to anomalous contexts. These results suggest that older adults can perceive speech as well as younger adults when both

Audio-Visual and Meaningful Semantic Context Enhancements in Older and Younger Adults

PubMed Central

Smayda, Kirsten E.; Van Engen, Kristin J.; Maddox, W. Todd; Chandrasekaran, Bharath

2016-01-01

Speech perception is critical to everyday life. Oftentimes noise can degrade a speech signal; however, because of the cues available to the listener, such as visual and semantic cues, noise rarely prevents conversations from continuing. The interaction of visual and semantic cues in aiding speech perception has been studied in young adults, but the extent to which these two cues interact for older adults has not been studied. To investigate the effect of visual and semantic cues on speech perception in older and younger adults, we recruited forty-five young adults (ages 18–35) and thirty-three older adults (ages 60–90) to participate in a speech perception task. Participants were presented with semantically meaningful and anomalous sentences in audio-only and audio-visual conditions. We hypothesized that young adults would outperform older adults across SNRs, modalities, and semantic contexts. In addition, we hypothesized that both young and older adults would receive a greater benefit from a semantically meaningful context in the audio-visual relative to audio-only modality. We predicted that young adults would receive greater visual benefit in semantically meaningful contexts relative to anomalous contexts. However, we predicted that older adults could receive a greater visual benefit in either semantically meaningful or anomalous contexts. Results suggested that in the most supportive context, that is, semantically meaningful sentences presented in the audiovisual modality, older adults performed similarly to young adults. In addition, both groups received the same amount of visual and meaningful benefit. Lastly, across groups, a semantically meaningful context provided more benefit in the audio-visual modality relative to the audio-only modality, and the presence of visual cues provided more benefit in semantically meaningful contexts relative to anomalous contexts. These results suggest that older adults can perceive speech as well as younger adults when

Training order and structural location of meaningful stimuli: effects on equivalence class formation.

PubMed

Nartey, Richard K; Arntzen, Erik; Fields, Lanny

2015-12-01

In the present study, equivalence class formation was influenced by the temporal point of inclusion of a meaningful stimulus when baseline relations were serially or sequentially trained, and much less so by the location of the meaningful stimulus in the nodal structure of the class. In Experiment 1, participants attempted to form three 3-node, 5-member classes (A→B→C→D→E) under the simultaneous protocol. After serially training the baseline relations AB, BC, CD, and DE, in that order, the emergence of all emergent relations was tested concurrently. In the A-as-PIC condition, A was meaningful stimulus and B to E were meaningless stimulus, and 60 % of the participants formed classes. In addition, classes were formed by 40 %, 70 %, 40 %, and 20 % of the participants in the B-as-PIC, C-as-PIC, D-as-PIC, and E-as-PIC groups, respectively. Thus, the likelihood of class formation could have been influenced by the location of a meaningful stimulus in the class structure and/or by its order of introduction during training. In Experiment 2, we controlled for any effect of order of introduction by the concurrent training of all of the baseline relations. Regardless of the location of the meaningful stimulus, 0-20 % of participants formed classes. Thus, the temporal order of introducing a meaningful stimulus was the primary modulator of the class-enhancing property of meaningful stimuli, and not the location of the meaningful stimulus in the class structure.

An integrative approach to inferring biologically meaningful gene modules.

PubMed

Cho, Ji-Hoon; Wang, Kai; Galas, David J

2011-07-26

The ability to construct biologically meaningful gene networks and modules is critical for contemporary systems biology. Though recent studies have demonstrated the power of using gene modules to shed light on the functioning of complex biological systems, most modules in these networks have shown little association with meaningful biological function. We have devised a method which directly incorporates gene ontology (GO) annotation in construction of gene modules in order to gain better functional association. We have devised a method, Semantic Similarity-Integrated approach for Modularization (SSIM) that integrates various gene-gene pairwise similarity values, including information obtained from gene expression, protein-protein interactions and GO annotations, in the construction of modules using affinity propagation clustering. We demonstrated the performance of the proposed method using data from two complex biological responses: 1. the osmotic shock response in Saccharomyces cerevisiae, and 2. the prion-induced pathogenic mouse model. In comparison with two previously reported algorithms, modules identified by SSIM showed significantly stronger association with biological functions. The incorporation of semantic similarity based on GO annotation with gene expression and protein-protein interaction data can greatly enhance the functional relevance of inferred gene modules. In addition, the SSIM approach can also reveal the hierarchical structure of gene modules to gain a broader functional view of the biological system. Hence, the proposed method can facilitate comprehensive and in-depth analysis of high throughput experimental data at the gene network level.

An integrative approach to inferring biologically meaningful gene modules

PubMed Central

2011-01-01

Background The ability to construct biologically meaningful gene networks and modules is critical for contemporary systems biology. Though recent studies have demonstrated the power of using gene modules to shed light on the functioning of complex biological systems, most modules in these networks have shown little association with meaningful biological function. We have devised a method which directly incorporates gene ontology (GO) annotation in construction of gene modules in order to gain better functional association. Results We have devised a method, Semantic Similarity-Integrated approach for Modularization (SSIM) that integrates various gene-gene pairwise similarity values, including information obtained from gene expression, protein-protein interactions and GO annotations, in the construction of modules using affinity propagation clustering. We demonstrated the performance of the proposed method using data from two complex biological responses: 1. the osmotic shock response in Saccharomyces cerevisiae, and 2. the prion-induced pathogenic mouse model. In comparison with two previously reported algorithms, modules identified by SSIM showed significantly stronger association with biological functions. Conclusions The incorporation of semantic similarity based on GO annotation with gene expression and protein-protein interaction data can greatly enhance the functional relevance of inferred gene modules. In addition, the SSIM approach can also reveal the hierarchical structure of gene modules to gain a broader functional view of the biological system. Hence, the proposed method can facilitate comprehensive and in-depth analysis of high throughput experimental data at the gene network level. PMID:21791051

Evidence-Based Approach to Fiber Supplements and Clinically Meaningful Health Benefits, Part 1

PubMed Central

McRorie, Johnson W.

2015-01-01

Dietary fiber that is intrinsic and intact in fiber-rich foods (eg, fruits, vegetables, legumes, whole grains) is widely recognized to have beneficial effects on health when consumed at recommended levels (25 g/d for adult women, 38 g/d for adult men). Most (90%) of the US population does not consume this level of dietary fiber, averaging only 15 g/d. In an attempt to bridge this “fiber gap,” many consumers are turning to fiber supplements, which are typically isolated from a single source. Fiber supplements cannot be presumed to provide the health benefits that are associated with dietary fiber from whole foods. Of the fiber supplements on the market today, only a minority possess the physical characteristics that underlie the mechanisms driving clinically meaningful health benefits. The first part (current issue) of this 2-part series will focus on the 4 main characteristics of fiber supplements that drive clinical efficacy (solubility, degree/rate of fermentation, viscosity, and gel formation), the 4 clinically meaningful designations that identify which health benefits are associated with specific fibers, and the gel-dependent mechanisms in the small bowel that drive specific health benefits (eg, cholesterol lowering, improved glycemic control). The second part (next issue) of this 2-part series will focus on the effects of fiber supplements in the large bowel, including the 2 mechanisms by which fiber prevents/relieves constipation (insoluble mechanical irritant and soluble gel-dependent water-holding capacity), the gel-dependent mechanism for attenuating diarrhea and normalizing stool form in irritable bowel syndrome, and the combined large bowel/small bowel fiber effects for weight loss/maintenance. The second part will also discuss how processing for marketed products can attenuate efficacy, why fiber supplements can cause gastrointestinal symptoms, and how to avoid symptoms for better long-term compliance. PMID:25972618

Evidence-Based Approach to Fiber Supplements and Clinically Meaningful Health Benefits, Part 2

PubMed Central

McRorie, Johnson W.

2015-01-01

Dietary fiber that is intrinsic and intact in fiber-rich foods (eg, fruits, vegetables, legumes, whole grains) is widely recognized to have beneficial effects on health when consumed at recommended levels (25 g/d for adult women, 38 g/d for adult men). Most (90%) of the US population does not consume this level of dietary fiber, averaging only 15 g/d. In an attempt to bridge this “fiber gap,” many consumers are turning to fiber supplements, which are typically isolated from a single source. Fiber supplements cannot be presumed to provide the health benefits that are associated with dietary fiber from whole foods. Of the fiber supplements on the market today, only a minority possess the physical characteristics that underlie the mechanisms driving clinically meaningful health benefits. In this 2-part series, the first part (previous issue) described the 4 main characteristics of fiber supplements that drive clinical efficacy (solubility, degree/rate of fermentation, viscosity, and gel formation), the 4 clinically meaningful designations that identify which health benefits are associated with specific fibers, and the gel-dependent mechanisms in the small bowel that drive specific health benefits (eg, cholesterol lowering, improved glycemic control). The second part (current issue) of this 2-part series will focus on the effects of fiber supplements in the large bowel, including the 2 mechanisms by which fiber prevents/relieves constipation (insoluble mechanical irritant and soluble gel-dependent water-holding capacity), the gel-dependent mechanism for attenuating diarrhea and normalizing stool form in irritable bowel syndrome, and the combined large bowel/small bowel fiber effects for weight loss/maintenance. The second part will also discuss how processing for marketed products can attenuate efficacy, why fiber supplements can cause gastrointestinal symptoms, and how to avoid symptoms for better long-term compliance. PMID:25972619

Meaningful Learning in the Cooperative Classroom

ERIC Educational Resources Information Center

Sharan, Yael

2015-01-01

Meaningful learning is based on more than what teachers transmit; it promotes the construction of knowledge out of learners' experience, feelings and exchanges with other learners. This educational view is based on the constructivist approach to learning and the co-operative learning approach. Researchers and practitioners in various…

Identifying priorities for improving rear seat occupant protection.

DOT National Transportation Integrated Search

2009-03-01

This project helped to identify priorities for improving the safety of rear seat occupants through a literature review and NASS-CDS injury analysis. The literature review covers injury patterns of rear seat occupants, new safety technologies intended...

Effectiveness of functional electrical stimulation on walking speed, functional walking category, and clinically meaningful changes for people with multiple sclerosis.

PubMed

Street, Tamsyn; Taylor, Paul; Swain, Ian

2015-04-01

To determine the effectiveness of functional electrical stimulation (FES) on drop foot in patients with multiple sclerosis (MS), using data from standard clinical practice. Case series with a consecutive sample of FES users collected between 2008 and 2013. Specialist FES center at a district general hospital. Patients with MS who have drop foot (N=187) (117 women, 70 men; mean age, 55y [range, 27-80y]; mean duration since diagnosis, 11.7y [range, 1-56y]). A total of 166 patients were still using FES after 20 weeks, with 153 patients completing the follow-up measures. FES of the common peroneal nerve (178 unilateral, 9 bilateral FES users). Clinically meaningful changes (ie, >.05m/s and >0.1m/s) and functional walking category derived from 10-m walking speed. An increase in walking speed was found to be highly significant (P<.001), both initially where a minimum clinically meaningful change was observed (.07m/s) and after 20 weeks with a substantial clinically meaningful change (.11m/s). After 20 weeks, treatment responders displayed a 27% average improvement in their walking speed. No significant training effect was found. Overall functional walking category was maintained or improved in 95% of treatment responders. FES of the dorsiflexors is a well-accepted intervention that enables clinically meaningful changes in walking speed, leading to a preserved or an increased functional walking category. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Features of asthma which provide meaningful insights for understanding the disease heterogeneity.

PubMed

Deliu, M; Yavuz, T S; Sperrin, M; Belgrave, D; Sahiner, U M; Sackesen, C; Kalayci, O; Custovic, A

2018-01-01

Data-driven methods such as hierarchical clustering (HC) and principal component analysis (PCA) have been used to identify asthma subtypes, with inconsistent results. To develop a framework for the discovery of stable and clinically meaningful asthma subtypes. We performed HC in a rich data set from 613 asthmatic children, using 45 clinical variables (Model 1), and after PCA dimensionality reduction (Model 2). Clinical experts then identified a set of asthma features/domains which informed clusters in the two analyses. In Model 3, we reclustered the data using these features to ascertain whether this improved the discovery process. Cluster stability was poor in Models 1 and 2. Clinical experts highlighted four asthma features/domains which differentiated the clusters in two models: age of onset, allergic sensitization, severity, and recent exacerbations. In Model 3 (HC using these four features), cluster stability improved substantially. The cluster assignment changed, providing more clinically interpretable results. In a 5-cluster model, we labelled the clusters as: "Difficult asthma" (n = 132); "Early-onset mild atopic" (n = 210); "Early-onset mild non-atopic: (n = 153); "Late-onset" (n = 105); and "Exacerbation-prone asthma" (n = 13). Multinomial regression demonstrated that lung function was significantly diminished among children with "Difficult asthma"; blood eosinophilia was a significant feature of "Difficult," "Early-onset mild atopic," and "Late-onset asthma." Children with moderate-to-severe asthma were present in each cluster. An integrative approach of blending the data with clinical expert domain knowledge identified four features, which may be informative for ascertaining asthma endotypes. These findings suggest that variables which are key determinants of asthma presence, severity, or control may not be the most informative for determining asthma subtypes. Our results indicate that exacerbation-prone asthma may be a separate asthma

Growth Of New York Physician Participation In Meaningful Use Of Electronic Health Records Was Variable, 2011-12.

PubMed

Jung, Hye-Young; Unruh, Mark A; Kaushal, Rainu; Vest, Joshua R

2015-06-01

The federal government has invested $30 billion to promote the adoption and use of electronic health records (EHRs) through the Medicare and Medicaid EHR Incentive Programs. However, the associations between the characteristics of physicians, practices, and markets and the patterns of provider participation in ongoing federal meaningful-use incentive programs over time have been largely unexplored. In this article we describe the participation of New York physicians during the first two years of the meaningful-use initiative. We examined longitudinal patterns to identify characteristics associated with nonparticipation, late adoption of EHRs, noncontinuous participation, and switching programs. We found that 8.1 percent of 26,368 New York physicians participated in the Medicare incentive program in 2011, and 6.1 percent participated in the Medicaid program. Physician participation in the programs grew to 23.9 percent and 8.5 percent, respectively, in 2012. Many physicians in the Medicaid incentive program in 2011 did not participate in either program in 2012. Prior EHR use, access to financial resources, and organizational capacity were physician characteristics associated with early and consistent participation in the meaningful-use initiative. Annual participation requirements, coupled with different options to meet meaningful-use criteria under the incentive programs, create disparate groups of physicians, which illustrates the need to monitor participants for continued participation. Project HOPE—The People-to-People Health Foundation, Inc.

What students are saying about science: Student perspectives of meaningful, effective and ineffective learning experiences in science class

NASA Astrophysics Data System (ADS)

Brown, Thomas John

Statement of the problem. Research studies have rarely incorporated the subjective experience of students as they are engaged in learning. When the students' position is viewed at all in a research study, it is usually viewed from the perspective of the adult educators' interests and ways of seeing. As a result, the most conspicuously absent feature from the research literature is the first person voice of the student. In regards to science education specifically, few studies have focused on the students' perspective of their experience in science. Therefore, the purpose of this study was to describe and understand student perspectives of meaningful, effective, and ineffective learning experiences in science class. The following served as guiding questions: (1) What do students describe as meaningful and effective learning experiences in science class? (2) What do students describe as obstacles to their effective learning in science class? Methods. An interpretive research methodology was chosen for this study. The nine participants that took part in the study were grouped as self-directed, teacher-guided, and teacher-dependent learners. A variety of data gathering techniques were used including field notes, participant observations, interviews and focus groups. Throughout the study, inductive analysis was employed as a process for making sense out of the data. More specifically, the constant comparative method was used to categorize the data and facilitate the search for meaningful patterns. The analysis included a thick description of the students' experience of science in the first person voice of the student. The results of this study indicate that teachers play the fundamental role in the establishment of an effective learning environment and that students' consider their improved understanding to be a key to their meaningful learning. In addition, the students' improved understanding requires that teachers are actively involved in their progress and are

Meaningful Engagement to Enhance Diversity: Broadened Impact Actualized

NASA Astrophysics Data System (ADS)

Whitney, V. W.; Pyrtle, A. J.

2008-12-01

The MS PHD'S Professional Development Program was established by and for UR/US populations to facilitate increased and sustained participation within the Earth system science community. MS PHD'S is jointly funded by NSF and NASA. Fourteen (14) minority Earth system scientists served as Program mentors and one- hundred fifteen (115) minority and non-minority scientists served as Meeting Mentors to student participants. Representatives from fifty-six (56) agencies and institutions provided support and exposure to MS PHD'S student participants. Two hundred fifty-eight (258) highly qualified UR/US students completed on-line applications to participate in the MS PHD'S Professional Development Program. Because of funding limitations, slightly fewer than 50% of the applicants were selected to participate. One-hundred twenty-six (126) undergraduate and graduate students from 26 states and Puerto Rico participated in the MS PHD'S program. Sixty-eight (68) MS PHD'S student participants self-identified as African American; thirty-four (34) as Puerto Rican; nine (9) as Hispanic/Mexican American, ten (10) as Native American and one (1) each as African, Asian, Pacific Islander, Hispanic and Multi-Ethnic. During the five year span of MS PHD'S programming, sixteen (16) student participants completed BS degrees, twelve (12) completed MS degrees and ten (10) completed the Doctoral degrees. How did MS PHD'S establish meaningful engagement to enhance diversity within the Earth system science community? This case study reveals replicable processes and constructs to enhance the quality of meaningful collaboration and engagement. In addition, the study addresses frequently asked questions (FAQ's) on outreach, recruitment, engagement, retention and success of students from underrepresented populations within diversity-focused programs.

Identify the Best Evidence for School and Student Improvement

ERIC Educational Resources Information Center

Thessin, Rebecca A.

2016-01-01

Empowering teachers to use data effectively as part of a process of instructional improvement calls for schools and districts to engage in systematic collection and analysis of evidence as part of an ongoing school improvement cycle. In research and practice, the author has identified four steps school leaders--supported by central office--must…

Meaningful use: a roadmap for the advancement of health information exchange

PubMed Central

2013-01-01

Frankel and colleagues have compared Israel and the U.S.’s experiences with health information exchange (HIE). They highlight the importance of institutional factors in fostering HIE development, notably the influence of local structures, experience and incentives. Historically, information infrastructure in the U.S. has been limited due to lack of standards, fragmented institutions and competition. The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 authorized billions of dollars for the adoption and “Meaningful Use” of electronic health records. HITECH programs and Meaningful Use incentives target the advancement of HIE through 1) building blocks, 2) local support and 3) payment incentives. Meaningful Use requirements create a roadmap to broader electronic exchange of health information among providers and with patients. Ultimately, successful HIE in the U.S. will depend on whether Meaningful Use can address institutional needs within local markets. This is a commentary on http://www.ijhpr.org/content/2/1/722 PMID:23880399

New method for finding multiple meaningful trajectories

NASA Astrophysics Data System (ADS)

Bao, Zhonghao; Flachs, Gerald M.; Jordan, Jay B.

1995-07-01

Mathematical foundations and algorithms for efficiently finding multiple meaningful trajectories (FMMT) in a sequence of digital images are presented. A meaningful trajectory is motion created by a sentient being or by a device under the control of a sentient being. It is smooth and predictable over short time intervals. A meaningful trajectory can suddenly appear or disappear in sequence images. The development of the FMMT is based on these assumptions. A finite state machine in the FMMT is used to model the trajectories under the conditions of occlusions and false targets. Each possible trajectory is associated with an initial state of a finite state machine. When two frames of data are available, a linear predictor is used to predict the locations of all possible trajectories. All trajectories within a certain error bound are moved to a monitoring trajectory state. When trajectories attain three consecutive good predictions, they are moved to a valid trajectory state and considered to be locked into a tracking mode. If an object is occluded while in the valid trajectory state, the predicted position is used to continue to track; however, the confidence in the trajectory is lowered. If the trajectory confidence falls below a lower limit, the trajectory is terminated. Results are presented that illustrate the FMMT applied to track multiple munitions fired from a missile in a sequence of images. Accurate trajectories are determined even in poor images where the probabilities of miss and false alarm are very high.

[Job demands, meaningful work, and turnover intention among nurses].

PubMed

Cortese, C G; Gatti, Paola; Ghislieri, Chiara

2014-01-01

The shortage of nurses is a worldwide issue. Since turnover intention (TI) is considered one of the major determinants of turnover behaviour, it is essential to look deeper into the way it operates. This study uses the job demands-resources model to investigate the TI of nurses, on the one hand looking at the relationship that some demands (workload, emotional dissonance and abusive supervision) have on TI and on the other, investigating the role of a specific resource (meaningful work - MW) in terms of its effect on TI and as a potential moderator of the relationship between each demand and TI. The research project was carried out in a large hospital in Northern Italy by administering a self-report questionnaire to all nurses; 630 questionnaires were distributed, 423 (67.14%) of which were completed. The statistical analyses were performed with PASW 18. The results highlight a positive relationship between demands and TI and a negative relationship between meaningful work and TI. Moreover, a significant moderating effect of meaningful work on the relationship between emotional dissonance and TI also emerged. No significant moderating effects were found for the relationship between the other two demands and TI. This research allowed us to verify the importance of constructs such as abusive supervision and meaningful work that have not yet been extensively studied, within the context of nursing staff in Italy; it also offered a range of suggestions for organizational developments and for further investigations in this field.

Professionalizing action research--a meaningful strategy for modernizing services?

PubMed

Hall, Julie E

2006-04-01

This paper outlines how a specific action research approach can be used to secure practice development in services which have found sustained change difficult. For the purpose of this paper discussion focuses upon using professionalizing action research (a form of action research) to secure transformation in acute inpatient mental health services. This speciality has experienced long-term difficultly in meaningful practice change. Not limited to this context parallels can be made with other health and social care services requiring significant modernization. The aim is to critically discuss the use of professionalizing action research as an approach to sustainable change. clarifies whether this method is a suitable vehicle for change, which is ideally suited to services which have a poor record of practice development. A review of action research and practice development literature forms the basis of this paper. The literature is sourced through bulletin boards, electronic databases and the British Library Classification Scheme. Keywords searched are action research, team learning, managing change and practice development. Following definition; the components of professionalizing action research are analysed using the themes of educative base, problem focus, improvement and involvement. The educative base of professionalizing action research is collaborative reflective practice which is used to initiate meaningful change, rooted in everyday practice. The benefit of this is that change actions are based in real-time situations. The problem focus component of professionalizing action research is used to emphasize the views of service users and carers. This is positive in terms of the patient and public involvement agenda although this theme does emphasize limitations of the approach. The final components are involvement and improvement, these are debated as pluralistic notions and the implications of this are acknowledged. Reviewing the literature and theoretical

Meaningful Use of School Health Data

ERIC Educational Resources Information Center

Johnson, Kathleen Hoy; Bergren, Martha Dewey

2011-01-01

Meaningful use (MU) of Electronic Health Records (EHRs) is an important development in the safety and security of health care delivery in the United States. Advancement in the use of EHRs occurred with the passage of the American Recovery and Reinvestment Act of 2009, which provides incentives for providers to support adoption and use of EHRs.…

Identifying regional opportunities for accelerated timber managemnet

Treesearch

David A. Gansner; Joseph E. Barnard; Samuel F. Gingrich; Samuel F. Gingrich

1973-01-01

Describes a procedure for identifying regional opportunities for accelerated timber management and demonstrates its application. Results provide a basis for rational choices among alternative management strategies and permit meaningful micro- and macro-evaluations of treatment response.

Meaningful Dialogue in Digitally Mediated Learning for In-Service Teacher Development

ERIC Educational Resources Information Center

Cramp, Andy

2015-01-01

This paper considers the role and development of meaningful dialogue in digitally mediated learning (DML) in UK higher education for teachers. It argues that more research is vital in the field of meaningful dialogue if we are to avoid the risk that pedagogic values in DML become increasingly driven by market forces toward "data vending"…

Using Learning Environments to Create Meaningful Work for Co-Op Students

ERIC Educational Resources Information Center

Nevison, Colleen; Drewery, David; Pretti, Judene; Cormier, Lauren

2017-01-01

For students in cooperative education (co-op) programs, meaningful work is a critical aspect of participation and a key component of program success. However, studies have not explored how meaningful work can be created for co-op students. The purpose of this study was to evaluate the relationship between co-op students' perceptions of a learning…

Business intelligence effort get a boost. The meaningful use framework highlights the value of data warehouses and BI tools.

PubMed

Raths, David

2011-01-01

As patient care organizations nationwide prepare to report on meaningful use quality measures, those with enterprise data warehouses may find they have a head start. The more advanced among them are establishing workgroups to create dashboards to analyze progress and identify gaps that need addressing.

Rural primary care practices and meaningful use of electronic health records: the role of Regional Extension Centers.

PubMed

Casey, Michelle M; Moscovice, Ira; McCullough, Jeffrey

2014-01-01

To examine the role of Regional Extension Centers (RECs) in helping rural physician practices adopt electronic health records (EHRs) and achieve meaningful use. Using data from the Office of the National Coordinator for Health Information Technology, we conducted a county-level regression analysis using ordinary least squares to better understand rural-urban differences in REC participation, EHR implementation, and meaningful use, controlling for counties' economic conditions. We prepared case studies of 2 RECs that are serving a large number of rural practices, based on interviews with key individuals at the RECs, their partner organizations, and rural primary care practices that received assistance from the RECs. RECs are largely achieving their objective of targeting providers in communities that face barriers to EHRs. REC participants are disproportionately rural and more likely to come from high poverty and low employment communities. The case study RECs had long-standing relationships with rural providers, as well as extensive staff expertise in quality improvement and EHR implementation, and employed a variety of strategies to successfully assist rural providers. Rural providers report that REC assistance was invaluable in helping them implement EHRs and achieve meaningful use status. Modifying the criteria for Medicare and Medicaid EHR incentives could help additional rural providers pay for EHRs. REC federal funding is scheduled to end in 2014, but practices that have not yet adopted EHRs may need significant, ongoing assistance to receive meaningful use. © 2013 National Rural Health Association.

A meaningful daily life in nursing homes - a place of shelter and a space of freedom: a participatory appreciative action reflection study

PubMed Central

2014-01-01

Background Shortcomings in elderly care have been reported in many parts of the world, including Sweden. However, national guidelines for elderly care have been introduced in Sweden, which contain core values and local guarantees of dignity. These highlight the need for dignity and well-being, and organising the older person’s daily life so that they perceive it as meaningful. Therefore, the aim of the present study was to describe older persons’ experience and knowledge about obstacles, opportunities and solutions to developing a meaningful daily life for those living in nursing homes. Methods This study combined the Participatory Appreciative Action Reflection (PAAR) and hermeneutic approaches. Twenty-five older persons participated and persons with dementia or cognitive impairments were included. Repeated interviews were carried out as reflective conversations, leaving 50 interviews in total, wherein the older persons provided their analyses and reflections on a meaningful daily life. Finally, an analysis of the data was completed based on a life-world hermeneutic approach. Results We identified five tentative interpretations that describe obstacles, opportunities and solutions for a meaningful daily life. Themes 2 and 4 outline obstacles for a meaningful daily life, and Themes 1, 3 and 5 describe opportunities and solutions for a meaningful daily life: (1) Having space to be yourself; (2) No space to be yourself; (3) Belonging and security; (4) A feeling of insecurity; and (5) Longing for something to happen. In the main interpretation, we found that the five tentative interpretations are related to Tuan’s concepts of space and place, where place can be described as security and stableness, and space as freedom and openness. Conclusions The reciprocal relationship is a solution for a meaningful daily life and occurs in the interaction between staff and older persons in nursing homes. It is the balance of power, and constitutes a place of shelter and a

Annotating spatio-temporal datasets for meaningful analysis in the Web

NASA Astrophysics Data System (ADS)

Stasch, Christoph; Pebesma, Edzer; Scheider, Simon

2014-05-01

More and more environmental datasets that vary in space and time are available in the Web. This comes along with an advantage of using the data for other purposes than originally foreseen, but also with the danger that users may apply inappropriate analysis procedures due to lack of important assumptions made during the data collection process. In order to guide towards a meaningful (statistical) analysis of spatio-temporal datasets available in the Web, we have developed a Higher-Order-Logic formalism that captures some relevant assumptions in our previous work [1]. It allows to proof on meaningful spatial prediction and aggregation in a semi-automated fashion. In this poster presentation, we will present a concept for annotating spatio-temporal datasets available in the Web with concepts defined in our formalism. Therefore, we have defined a subset of the formalism as a Web Ontology Language (OWL) pattern. It allows capturing the distinction between the different spatio-temporal variable types, i.e. point patterns, fields, lattices and trajectories, that in turn determine whether a particular dataset can be interpolated or aggregated in a meaningful way using a certain procedure. The actual annotations that link spatio-temporal datasets with the concepts in the ontology pattern are provided as Linked Data. In order to allow data producers to add the annotations to their datasets, we have implemented a Web portal that uses a triple store at the backend to store the annotations and to make them available in the Linked Data cloud. Furthermore, we have implemented functions in the statistical environment R to retrieve the RDF annotations and, based on these annotations, to support a stronger typing of spatio-temporal datatypes guiding towards a meaningful analysis in R. [1] Stasch, C., Scheider, S., Pebesma, E., Kuhn, W. (2014): "Meaningful spatial prediction and aggregation", Environmental Modelling & Software, 51, 149-165.

Validation of Groundwater Models: Meaningful or Meaningless?

NASA Astrophysics Data System (ADS)

Konikow, L. F.

2003-12-01

Although numerical simulation models are valuable tools for analyzing groundwater systems, their predictive accuracy is limited. People who apply groundwater flow or solute-transport models, as well as those who make decisions based on model results, naturally want assurance that a model is "valid." To many people, model validation implies some authentication of the truth or accuracy of the model. History matching is often presented as the basis for model validation. Although such model calibration is a necessary modeling step, it is simply insufficient for model validation. Because of parameter uncertainty and solution non-uniqueness, declarations of validation (or verification) of a model are not meaningful. Post-audits represent a useful means to assess the predictive accuracy of a site-specific model, but they require the existence of long-term monitoring data. Model testing may yield invalidation, but that is an opportunity to learn and to improve the conceptual and numerical models. Examples of post-audits and of the application of a solute-transport model to a radioactive waste disposal site illustrate deficiencies in model calibration, prediction, and validation.

Meaningful use's benefits and burdens for US family physicians.

PubMed

Holman, G Talley; Waldren, Steven E; Beasley, John W; Cohen, Deborah J; Dardick, Lawrence D; Fox, Chester H; Marquard, Jenna; Mullins, Ryan; North, Charles Q; Rafalski, Matt; Rivera, A Joy; Wetterneck, Tosha B

2018-06-01

The federal meaningful use (MU) program was aimed at improving adoption and use of electronic health records, but practicing physicians have criticized it. This study was aimed at quantifying the benefits (ie, usefulness) and burdens (ie, workload) of the MU program for practicing family physicians. An interdisciplinary national panel of experts (physicians and engineers) identified the work associated with MU criteria during patient encounters. They conducted a national survey to assess each criterion's level of patient benefit and compliance burden. In 2015, 480 US family physicians responded to the survey. Their demographics were comparable to US norms. Eighteen of 31 MU criteria were perceived as useful for more than half of patient encounters, with 13 of those being useful for more than two-thirds. Thirteen criteria were useful for less than half of patient encounters. Four useful criteria were reported as having a high compliance burden. There was high variability in physicians' perceived benefits and burdens of MU criteria. MU Stage 1 criteria, which are more related to basic/routine care, were perceived as beneficial by most physicians. Stage 2 criteria, which are more related to complex and population care, were perceived as less beneficial and more burdensome to comply with. MU was discontinued, but the merit-based incentive payment system within the Medicare Access and CHIP Reauthorization Act of 2015 adopted its criteria. For many physicians, MU created a significant practice burden without clear benefits to patient care. This study suggests that policymakers should not assess MU in aggregate, but as individual criteria for open discussion.

Is the diagnostic threshold for bulimia nervosa clinically meaningful?

PubMed

Chapa, Danielle A N; Bohrer, Brittany K; Forbush, Kelsie T

2018-01-01

The DSM-5 differentiates full- and sub-threshold bulimia nervosa (BN) according to average weekly frequencies of binge eating and inappropriate compensatory behaviors. This study was the first to evaluate the modified frequency criterion for BN published in the DSM-5. The purpose of this study was to test whether community-recruited adults (N=125; 83.2% women) with current full-threshold (n=77) or sub-threshold BN (n=48) differed in comorbid psychopathology and eating disorder (ED) illness duration, symptom severity, and clinical impairment. Participants completed the Clinical Impairment Assessment and participated in semi-structured clinical interviews of ED- and non-ED psychopathology. Differences between the sub- and full-threshold BN groups were assessed using MANOVA and Chi-square analyses. ED illness duration, age-of-onset, body mass index (BMI), alcohol and drug misuse, and the presence of current and lifetime mood or anxiety disorders did not differ between participants with sub- and full-threshold BN. Participants with full-threshold BN had higher levels of clinical impairment and weight concern than those with sub-threshold BN. However, minimal clinically important difference analyses suggested that statistically significant differences between participants with sub- and full-threshold BN on clinical impairment and weight concern were not clinically significant. In conclusion, sub-threshold BN did not differ from full-threshold BN in clinically meaningful ways. Future studies are needed to identify an improved frequency criterion for BN that better distinguishes individuals in ways that will more validly inform prognosis and effective treatment planning for BN. Copyright © 2017 Elsevier Ltd. All rights reserved.

Understanding identifiability as a crucial step in uncertainty assessment

NASA Astrophysics Data System (ADS)

Jakeman, A. J.; Guillaume, J. H. A.; Hill, M. C.; Seo, L.

2016-12-01

The topic of identifiability analysis offers concepts and approaches to identify why unique model parameter values cannot be identified, and can suggest possible responses that either increase uniqueness or help to understand the effect of non-uniqueness on predictions. Identifiability analysis typically involves evaluation of the model equations and the parameter estimation process. Non-identifiability can have a number of undesirable effects. In terms of model parameters these effects include: parameters not being estimated uniquely even with ideal data; wildly different values being returned for different initialisations of a parameter optimisation algorithm; and parameters not being physically meaningful in a model attempting to represent a process. This presentation illustrates some of the drastic consequences of ignoring model identifiability analysis. It argues for a more cogent framework and use of identifiability analysis as a way of understanding model limitations and systematically learning about sources of uncertainty and their importance. The presentation specifically distinguishes between five sources of parameter non-uniqueness (and hence uncertainty) within the modelling process, pragmatically capturing key distinctions within existing identifiability literature. It enumerates many of the various approaches discussed in the literature. Admittedly, improving identifiability is often non-trivial. It requires thorough understanding of the cause of non-identifiability, and the time, knowledge and resources to collect or select new data, modify model structures or objective functions, or improve conditioning. But ignoring these problems is not a viable solution. Even simple approaches such as fixing parameter values or naively using a different model structure may have significant impacts on results which are too often overlooked because identifiability analysis is neglected.

Livestock Helminths in a Changing Climate: Approaches and Restrictions to Meaningful Predictions.

PubMed

Fox, Naomi J; Marion, Glenn; Davidson, Ross S; White, Piran C L; Hutchings, Michael R

2012-03-06

Climate change is a driving force for livestock parasite risk. This is especially true for helminths including the nematodes Haemonchus contortus, Teladorsagia circumcincta, Nematodirus battus, and the trematode Fasciola hepatica, since survival and development of free-living stages is chiefly affected by temperature and moisture. The paucity of long term predictions of helminth risk under climate change has driven us to explore optimal modelling approaches and identify current bottlenecks to generating meaningful predictions. We classify approaches as correlative or mechanistic, exploring their strengths and limitations. Climate is one aspect of a complex system and, at the farm level, husbandry has a dominant influence on helminth transmission. Continuing environmental change will necessitate the adoption of mitigation and adaptation strategies in husbandry. Long term predictive models need to have the architecture to incorporate these changes. Ultimately, an optimal modelling approach is likely to combine mechanistic processes and physiological thresholds with correlative bioclimatic modelling, incorporating changes in livestock husbandry and disease control. Irrespective of approach, the principal limitation to parasite predictions is the availability of active surveillance data and empirical data on physiological responses to climate variables. By combining improved empirical data and refined models with a broad view of the livestock system, robust projections of helminth risk can be developed.

Impacts of EHR Certification and Meaningful Use Implementation on an Integrated Delivery Network.

PubMed

Bowes, Watson A

2014-01-01

Three years ago Intermountain Healthcare made the decision to participate in the Medicare and Medicaid Electronic Heath Record (EHR) Incentive Program which required that hospitals and providers use a certified EHR in a meaningful way. At that time, the barriers to enhance our home grown system, and change clinician workflows were numerous and large. This paper describes the time and effort required to enhance our legacy systems in order to pass certification, including filling 47 gaps in (EHR) functionality. We also describe the processes and resources that resulted in successful changes to many clinical workflows required by clinicians to meet meaningful use requirements. In 2011 we set meaningful use targets of 75% of employed physicians and 75% of our hospitals to meet Stage 1 of meaningful use by 2013. By the end of 2013, 87% of 696 employed eligible professionals and 100% of 22 Intermountain hospitals had successfully attested for Stage 1. This paper describes documented and perceived costs to Intermountain including time, effort, resources, postponement of other projects, as well as documented and perceived benefits of attainment of meaningful use.

Cache-Cache Comparison for Supporting Meaningful Learning

ERIC Educational Resources Information Center

Wang, Jingyun; Fujino, Seiji

2015-01-01

The paper presents a meaningful discovery learning environment called "cache-cache comparison" for a personalized learning support system. The processing of seeking hidden relations or concepts in "cache-cache comparison" is intended to encourage learners to actively locate new knowledge in their knowledge framework and check…

Meaningful change and responsiveness in common physical performance measures in older adults.

PubMed

Perera, Subashan; Mody, Samir H; Woodman, Richard C; Studenski, Stephanie A

2006-05-01

To estimate the magnitude of small meaningful and substantial individual change in physical performance measures and evaluate their responsiveness. Secondary data analyses using distribution- and anchor-based methods to determine meaningful change. Secondary analysis of data from an observational study and clinical trials of community-dwelling older people and subacute stroke survivors. Older adults with mobility disabilities in a strength training trial (n=100), subacute stroke survivors in an intervention trial (n=100), and a prospective cohort of community-dwelling older people (n=492). Gait speed, Short Physical Performance Battery (SPPB), 6-minute-walk distance (6MWD), and self-reported mobility. Most small meaningful change estimates ranged from 0.04 to 0.06 m/s for gait speed, 0.27 to 0.55 points for SPPB, and 19 to 22 m for 6MWD. Most substantial change estimates ranged from 0.08 to 0.14 m/s for gait speed, 0.99 to 1.34 points for SPPB, and 47 to 49 m for 6MWD. Based on responsiveness indices, per-group sample sizes for clinical trials ranged from 13 to 42 for substantial change and 71 to 161 for small meaningful change. Best initial estimates of small meaningful change are near 0.05 m/s for gait speed, 0.5 points for SPPB, and 20 m for 6MWD and of substantial change are near 0.10 m/s for gait speed, 1.0 point for SPPB, and 50 m for 6MWD. For clinical use, substantial change in these measures and small change in gait speed and 6MWD, but not SPPB, are detectable. For research use, these measures yield feasible sample sizes for detecting meaningful change.

Values: The Natural Result of Meaningful Relationships.

ERIC Educational Resources Information Center

Beedy, Jeff; Gordon, John

1997-01-01

The New Hampton School (New Hampshire) uses the holistic Total Human Development Model with both students and faculty to instill principles focused on relationships as central to teaching and learning; respect and responsibility; sense of community; whole person development within the community; compassion and service; and the meaningful,…

Refusing analgesics: using continuous improvement to improve pain management on a surgical ward.

PubMed

Carr, Eloise C J

2002-11-01

Despite advances in pain control many patients experience moderate to severe pain whilst in hospital. Contributory factors include inadequate assessment and documentation of pain, as well as patient and professional misconceptions. A 28-bedded surgical ward in a District General Hospital in the South of England was the setting for the project. A small preliminary audit of pain on this ward indicated that some patients experienced postoperative pain, which was not effectively controlled. A 'continuous improvement' framework was used to increase understanding of the problem and identify an aim for the project, which was to reduce the number of patients refusing analgesics when offered by nurses. An audit to ascertain how many patients refused analgesia revealed that, of 133 patients offered, 93 (70%) refused. Using the 'Model for Improvement' (Langley et al., 1996) a number of changes were introduced, including a patient information sheet, regular documented pain assessment and an innovative staff education programme. To evaluate if the changes in practice had been successful, further audit data were collected from 167 patients. Sixty-three (44%) accepted analgesics, indicating a significant decrease in the number refusing (P = 0.005). This small project demonstrated that continuous improvement methodology can improve the management of pain and quality of care for patients. Such an approach brings practitioner and patient into meaningful understanding and offers solutions which are realistic, achievable and sustainable over time. Despite finite resources and increased pressure on staff it is possible to motivate people when they feel they have ownership and change is meaningful. Continuous improvement methods offer an exciting, feasible, patient-centred approach to improving care.

Defining a clinically meaningful effect for the design and interpretation of randomized controlled trials.

PubMed

Keefe, Richard S E; Kraemer, Helena C; Epstein, Robert S; Frank, Ellen; Haynes, Ginger; Laughren, Thomas P; McNulty, James; Reed, Shelby D; Sanchez, Juan; Leon, Andrew C

2013-05-01

This article captures the proceedings of a meeting aimed at defining clinically meaningful effects for use in randomized controlled trials for psychopharmacological agents. Experts from a variety of disciplines defined clinically meaningful effects from their perspectives along with viewpoints about how to design and interpret randomized controlled trials. The article offers relevant, practical, and sometimes anecdotal information about clinically meaningful effects and how to interpret them. The concept for this session was the work of co-chairs Richard Keefe and the late Andy Leon. Faculty included Richard Keefe, PhD; James McNulty, AbScB; Robert S. Epstein, MD, MS; Shelby D. Reed, PhD; Juan Sanchez, MD; Ginger Haynes, PhD; Andrew C. Leon, PhD; Helena Chmura Kraemer, PhD; Ellen Frank, PhD, and Kenneth L. Davis, MD. The term clinically meaningful effect is an important aspect of designing and interpreting randomized controlled trials but can be particularly difficult in the setting of psychopharmacology where effect size may be modest, particularly over the short term, because of a strong response to placebo. Payers, regulators, patients, and clinicians have different concerns about clinically meaningful effects and may describe these terms differently. The use of moderators in success rate differences may help better delineate clinically meaningful effects. There is no clear consensus on a single definition for clinically meaningful differences in randomized controlled trials, and investigators must be sensitive to specific concerns of stakeholders in psychopharmacology in order to design and execute appropriate clinical trials.

On Meaningful Measurement: Concepts, Technology and Examples.

ERIC Educational Resources Information Center

Cheung, K. C.

This paper discusses how concepts and procedural skills in problem-solving tasks, as well as affects and emotions, can be subjected to meaningful measurement (MM), based on a multisource model of learning and a constructivist information-processing theory of knowing. MM refers to the quantitative measurement of conceptual and procedural knowledge…

Homeless Veterans: Management Improvements Could Help VA Better Identify Supportive Housing Projects

DTIC Science & Technology

2016-12-01

HOMELESS VETERANS Management Improvements Could Help VA Better Identify Supportive-Housing Projects Report to...VETERANS Management Improvements Could Help VA Better Identify Supportive-Housing Projects What GAO Found As of September 2016, for veterans who...disabled veterans. These supportive-housing EULs receive project -based HUD-VASH vouchers, which provide housing subsidies, on-site case management

Aligning institutional priorities: engaging house staff in a quality improvement and safety initiative to fulfill Clinical Learning Environment Review objectives and electronic medical record Meaningful Use requirements.

PubMed

Flanagan, Meghan R; Foster, Carolyn C; Schleyer, Anneliese; Peterson, Gene N; Mandell, Samuel P; Rudd, Kristina E; Joyner, Byron D; Payne, Thomas H

2016-02-01

House staff quality improvement projects are often not aligned with training institution priorities. House staff are the primary users of inpatient problem lists in academic medical centers, and list maintenance has significant patient safety and financial implications. Improvement of the problem list is an important objective for hospitals with electronic health records under the Meaningful Use program. House staff surveys were used to create an electronic problem list manager (PLM) tool enabling efficient problem list updating. Number of new problems added and house staff perceptions of the problem list were compared before and after PLM intervention. The PLM was used by 654 house staff after release. Surveys demonstrated increased problem list updating (P = .002; response rate 47%). Mean new problems added per day increased from 64 pre-PLM to 125 post-PLM (P < .001). This innovative project serves as a model for successful engagement of house staff in institutional quality and safety initiatives with tangible institutional benefits. Copyright © 2016 Elsevier Inc. All rights reserved.

Defining a Clinically Meaningful Effect for the Design and Interpretation of Randomized Controlled Trials

PubMed Central

Kraemer, Helena C.; Epstein, Robert S.; Frank, Ellen; Haynes, Ginger; Laughren, Thomas P.; Mcnulty, James; Reed, Shelby D.; Sanchez, Juan; Leon, Andrew C.

2013-01-01

Objective: This article captures the proceedings of a meeting aimed at defining clinically meaningful effects for use in randomized controlled trials for psychopharmacological agents. Design: Experts from a variety of disciplines defined clinically meaningful effects from their perspectives along with viewpoints about how to design and interpret randomized controlled trials. Setting: The article offers relevant, practical, and sometimes anecdotal information about clinically meaningful effects and how to interpret them. Participants: The concept for this session was the work of co-chairs Richard Keefe and the late Andy Leon. Faculty included Richard Keefe, PhD; James McNulty, AbScB; Robert S. Epstein, MD, MS; Shelby D. Reed, PhD; Juan Sanchez, MD; Ginger Haynes, PhD; Andrew C. Leon, PhD; Helena Chmura Kraemer, PhD; Ellen Frank, PhD, and Kenneth L. Davis, MD. Results: The term clinically meaningful effect is an important aspect of designing and interpreting randomized controlled trials but can be particularly difficult in the setting of psychopharmacology where effect size may be modest, particularly over the short term, because of a strong response to placebo. Payers, regulators, patients, and clinicians have different concerns about clinically meaningful effects and may describe these terms differently. The use of moderators in success rate differences may help better delineate clinically meaningful effects. Conclusion: There is no clear consensus on a single definition for clinically meaningful differences in randomized controlled trials, and investigators must be sensitive to specific concerns of stakeholders in psychopharmacology in order to design and execute appropriate clinical trials. PMID:23882433

Assessing Assessment: In Pursuit of Meaningful Learning

ERIC Educational Resources Information Center

Rootman-le Grange, Ilse; Blackie, Margaret A. L.

2018-01-01

The challenge of supporting the development of meaningful learning is prevalent in chemistry education research. One of the core activities used in the learning process is assessments. The aim of this paper is to illustrate how the semantics dimension of Legitimation Code Theory can be a helpful tool to critique the quality of assessments and…

Whakawhanaungatanga: the importance of culturally meaningful connections to improve uptake of pulmonary rehabilitation by Māori with COPD - a qualitative study.

PubMed

Levack, William Mm; Jones, Bernadette; Grainger, Rebecca; Boland, Pauline; Brown, Melanie; Ingham, Tristram R

2016-01-01

Pulmonary rehabilitation is known to improve function and quality of life for people with chronic obstructive pulmonary disease (COPD). However, little research has been conducted on the influence of culture on experiences of pulmonary rehabilitation. This study examined factors influencing uptake of pulmonary rehabilitation by Māori with COPD in New Zealand. Grounded theory nested within kaupapa Māori methodology. Transcripts were analyzed from interviews and focus groups with 15 Māori and ten New Zealand non-Māori invited to attend pulmonary rehabilitation for COPD. Māori participants had either attended a mainstream hospital-based program, a community-based program designed "by Māori, for Māori", or had experienced both. Several factors influencing uptake of pulmonary rehabilitation were common to all participants regardless of ethnicity: 1) participants' past experiences (eg, of exercise; of health care systems), 2) attitudes and expectations, 3) access issues (eg, time, transport, and conflicting responsibilities), and 4) initial program experiences. These factors were moderated by the involvement of family and peers, interactions with health professionals, the way information on programs was presented, and by new illness events. For Māori, however, several additional factors were also identified relating to cultural experiences of pulmonary rehabilitation. In particular, Māori participants placed high value on whakawhanaungatanga: the making of culturally meaningful connections with others. Culturally appropriate communication and relationship building was deemed so important by some Māori participants that when it was absent, they felt strongly discouraged to attend pulmonary rehabilitation. Only the more holistic services offered a program in which they felt culturally safe and to which they were willing to return for ongoing rehabilitation. Lack of attention to cultural factors in the delivery of pulmonary rehabilitation may be a barrier to its

Implementing a Social Knowledge Networking (SKN) system to enable meaningful use of an EHR medication reconciliation system

PubMed Central

Rangachari, Pavani

2018-01-01

Background Despite the regulatory impetus toward meaningful use of electronic health record (EHR) Medication Reconciliation (MedRec) to prevent medication errors during care transitions, hospital adherence has lagged for one chief reason: low physician engagement, stemming from lack of consensus about which physician is responsible for managing a patient’s medication list. In October 2016, Augusta University received a 2-year grant from the Agency for Healthcare Research and Quality to implement a Social Knowledge Networking (SKN) system for enabling its health system (AU Health) to progress from “limited use” of EHR MedRec technology to “meaningful use.” The hypothesis is that SKN would bring together a diverse group of practitioners, to facilitate tacit knowledge exchange on issues related to EHR MedRec, which in turn is expected to increase practitioners’ engagement in addressing those issues and enable meaningful use of EHR. The specific aims are to examine: 1) user-engagement in the SKN system, and 2) associations between “SKN use” and “meaningful use” of EHR. Methods The 2-year project uses an exploratory mixed-method design and consists of three phases: 1) development; 2) SKN implementation; and 3) analysis. Phase 1, completed in May 2017, sought to identify a comprehensive set of issues related to EHR MedRec from practitioners directly involved in the MedRec process. This process facilitated development of a “Reporting Tool” on issues related to EHR MedRec, which, along with an existing “SKN/Discussion Tool,” was integrated into the EHR at AU Health. Phase 2 (launched in June 2017) involves implementing the EHR-integrated SKN system over a 52-week period in inpatient and outpatient medicine units. Discussion The prospective implementation design is expected to generate context-sensitive strategies for meaningful use and successful implementation of EHR MedRec and thereby make substantial contributions to the patient safety and

Implementing a Social Knowledge Networking (SKN) system to enable meaningful use of an EHR medication reconciliation system.

PubMed

Rangachari, Pavani

2018-01-01

Despite the regulatory impetus toward meaningful use of electronic health record (EHR) Medication Reconciliation (MedRec) to prevent medication errors during care transitions, hospital adherence has lagged for one chief reason: low physician engagement, stemming from lack of consensus about which physician is responsible for managing a patient's medication list. In October 2016, Augusta University received a 2-year grant from the Agency for Healthcare Research and Quality to implement a Social Knowledge Networking (SKN) system for enabling its health system (AU Health) to progress from "limited use" of EHR MedRec technology to "meaningful use." The hypothesis is that SKN would bring together a diverse group of practitioners, to facilitate tacit knowledge exchange on issues related to EHR MedRec, which in turn is expected to increase practitioners' engagement in addressing those issues and enable meaningful use of EHR. The specific aims are to examine: 1) user-engagement in the SKN system, and 2) associations between "SKN use" and "meaningful use" of EHR. The 2-year project uses an exploratory mixed-method design and consists of three phases: 1) development; 2) SKN implementation; and 3) analysis. Phase 1, completed in May 2017, sought to identify a comprehensive set of issues related to EHR MedRec from practitioners directly involved in the MedRec process. This process facilitated development of a "Reporting Tool" on issues related to EHR MedRec, which, along with an existing "SKN/Discussion Tool," was integrated into the EHR at AU Health. Phase 2 (launched in June 2017) involves implementing the EHR-integrated SKN system over a 52-week period in inpatient and outpatient medicine units. The prospective implementation design is expected to generate context-sensitive strategies for meaningful use and successful implementation of EHR MedRec and thereby make substantial contributions to the patient safety and risk management literature. From a health care policy

Significant Work Is About Self-Realization and Broader Purpose: Defining the Key Dimensions of Meaningful Work.

PubMed

Martela, Frank; Pessi, Anne B

2018-01-01

Research on meaningful work has proliferated in recent years, with an increasing understanding of the centrality of meaningfulness for work-related motivation, commitment, and well-being. However, ambiguity around the main construct, "meaningful work," has hindered this progress as various researchers have used partly overlapping, partly differing conceptualizations. To bring clarity to this issue, we examine a broad range of various definitions of meaningful work and come to argue that meaningfulness in the broadest sense is about work significance as an overall evaluation of work as regards whether it is intrinsically valuable and worth doing. Furthermore, we argue that there are two key sub-dimensions to this work significance: Broader purpose as work serving some greater good or prosocial goals (the intrinsic value of work beyond the person in question). And self-realization as a sense of autonomy, authenticity and self-expression at work (the intrinsic value of work for the person in question). Previous definitions of meaningful work feature typically one or two of these elements-significance, broader purpose, self-realization -, but in the future it would be beneficial to clearly acknowledge all three elements in both definitions and operationalizations of meaningful work.

Significant Work Is About Self-Realization and Broader Purpose: Defining the Key Dimensions of Meaningful Work

PubMed Central

Martela, Frank; Pessi, Anne B.

2018-01-01

Research on meaningful work has proliferated in recent years, with an increasing understanding of the centrality of meaningfulness for work-related motivation, commitment, and well-being. However, ambiguity around the main construct, “meaningful work,” has hindered this progress as various researchers have used partly overlapping, partly differing conceptualizations. To bring clarity to this issue, we examine a broad range of various definitions of meaningful work and come to argue that meaningfulness in the broadest sense is about work significance as an overall evaluation of work as regards whether it is intrinsically valuable and worth doing. Furthermore, we argue that there are two key sub-dimensions to this work significance: Broader purpose as work serving some greater good or prosocial goals (the intrinsic value of work beyond the person in question). And self-realization as a sense of autonomy, authenticity and self-expression at work (the intrinsic value of work for the person in question). Previous definitions of meaningful work feature typically one or two of these elements—significance, broader purpose, self-realization –, but in the future it would be beneficial to clearly acknowledge all three elements in both definitions and operationalizations of meaningful work. PMID:29632502

Community-based medical education: is success a result of meaningful personal learning experiences?

PubMed

Kelly, Len; Walters, Lucie; Rosenthal, David

2014-01-01

Community-based medical education (CBME) is the delivery of medical education in a specific social context. Learners become a part of social and medical communities where their learning occurs. Longitudinal integrated clerkships (LICs) are year-long community-based placements where the curriculum and clinical experience is typically delivered by primary care physicians. These programs have proven to be robust learning environments, where learners develop strong communication skills and excellent clinical reasoning. To date, no learning model has been offered to describe CBME. The characteristics of CBME are explored by the authors who suggest that the social and professional context provided in small communities enhances medical education. The authors postulate that meaningfulness is engendered by the authentic context, which develops over time. These relationships with preceptors, patients and the community provide meaningfulness, which in turn enhances learning. The authors develop a novel learning model. They propose that the context-rich environment of CBME allows for meaningful relationships and experiences for students and that such meaningfulness enhances learning.

Meaningful Use of Electronic Health Records by Outpatient Physicians and Readmissions of Medicare Fee-for-Service Beneficiaries.

PubMed

Unruh, Mark A; Jung, Hye-Young; Vest, Joshua R; Casalino, Lawrence P; Kaushal, Rainu

2017-05-01

Nearly one-fifth of hospitalized Medicare fee-for-service beneficiaries are readmitted within 30 days. Participation in the Meaningful Use initiative among outpatient physicians may reduce readmissions. To evaluate the impact of outpatient physicians' participation in Meaningful Use on readmissions. The study population included 90,774 Medicare fee-for-service beneficiaries from New York State (2010-2012). We compared changes in the adjusted odds of readmission for patients of physicians who participated in Meaningful Use-stage 1, before and after attestation as meaningful users, with concurrent patients of matched control physicians who used paper records or electronic health records without Meaningful Use participation. Three secondary analyses were conducted: (1) limited to patients with 3+ Elixhauser comorbidities; (2) limited to patients with conditions used by Medicare to penalize hospitals with high readmission rates (acute myocardial infarction, congestive heart failure, and pneumonia); and (3) using only patients of physicians with electronic health records who were not meaningful users as the controls. Thirty-day readmission. Patients of Meaningful Use physicians had 6% lower odds of readmission compared with patients of physicians who were not meaningful users, but the estimate was not statistically significant (odds ratio: 0.94, 95% confidence interval, 0.88-1.01). Estimated odds ratios from secondary analyses were broadly consistent with our primary analysis. Physician participation in Meaningful Use was not associated with reduced readmissions. Additional studies are warranted to see if readmissions decline in future stages of Meaningful Use where more emphasis is placed on health information exchange and outcomes.

Building Employer Capacity to Support Meaningful Employment for Persons with Developmental Disabilities: A Grounded Theory Study of Employment Support Perspectives

ERIC Educational Resources Information Center

Rashid, Marghalara; Hodgetts, Sandra; Nicholas, David

2017-01-01

To explore strategies to build employer capacity to support people with DD in meaningful employment from perspective of employment support workers. A grounded theory study was conducted with 34 employment support individuals. A theoretical sampling approach was used to identify and recruit participants from multiple sites in Ontario and Alberta.…

A Continuum of Learning: From Rote Memorization to Meaningful Learning in Organic Chemistry

ERIC Educational Resources Information Center

Grove, Nathaniel P.; Bretz, Stacey Lowery

2012-01-01

The Assimilation Theory of Ausubel and Novak has typically been used in the research literature to describe two extremes to learning chemistry: meaningful learning "versus" rote memorization. It is unlikely, however, that such discrete categories of learning exist. Rote and meaningful learning, rather, are endpoints along a continuum of…

Meaningful Gamification in an Industrial/Organizational Psychology Course

ERIC Educational Resources Information Center

Stansbury, Jessica A.; Earnest, David R.

2017-01-01

Motivation and game research continue to demonstrate that the implementation of game design characteristics in the classroom can be engaging and intrinsically motivating. The present study assessed the extent to which an industrial organizational psychology course designed learning environment created with meaningful gamification elements can…

Water Habitat Study: Prediction Makes It More Meaningful.

ERIC Educational Resources Information Center

Glasgow, Dennis R.

1982-01-01

Suggests a teaching strategy for water habitat studies to help students make a meaningful connection between physiochemical data (dissolved oxygen content, pH, and water temperature) and biological specimens they collect. Involves constructing a poster and using it to make predictions. Provides sample poster. (DC)

The effect of meaningfulness and integrative processing in expressive writing on positive and negative affect and life satisfaction.

PubMed

Schutte, Nicola S; Searle, Trudy; Meade, Stephen; Dark, Neill A

2012-01-01

Meaningfulness and integrative processing of expressive writing may influence the effect of expressive writing. Participants completed measures of positive affect, negative affect and life satisfaction before and after an expressive writing intervention. Participants were randomly assigned to one of four expressive writing instruction conditions, which combined higher and lower levels of meaning and integrative processing instructions. Meaningfulness and integrative processing instructions had significant effects in increasing positive affect and there was a significant interaction between meaningfulness instructions and integrative processing instructions; participants in the high meaningfulness and high integrative processing instruction condition showed the greatest increase in positive affect. Meaningfulness had a significant effect in decreasing negative affect. The intervention did not influence life satisfaction. Both meaningfulness and integrative processing instructions led to more self-reported personal meaningfulness of the writing and more cognitive, emotional, behavioural and situational changes. More self-reported meaningfulness of the writing and more cognitive, emotional, behavioural and situational changes made as a result of the writing were in turn associated with greater increases in positive affect. The results of the study affirm the importance of meaningfulness and processing in expressive writing and potentially provide information regarding how to increase the effectiveness of expressive writing.

The Meaningful Activity Participation Assessment: A Measure of Engagement in Personally Valued Activities

ERIC Educational Resources Information Center

Eakman, Aaron M.; Carlson, Mike E.; Clark, Florence A.

2010-01-01

The Meaningful Activity Participation Assessment (MAPA), a recently developed 28-item tool designed to measure the meaningfulness of activity, was tested in a sample of 154 older adults. The MAPA evidenced a sufficient level of internal consistency and test-retest reliability and correlated as theoretically predicted with the Life Satisfaction…

Identifying critical steps towards improved access to innovation in cancer care: a European CanCer Organisation position paper.

PubMed

Aapro, Matti; Astier, Alain; Audisio, Riccardo; Banks, Ian; Bedossa, Pierre; Brain, Etienne; Cameron, David; Casali, Paolo; Chiti, Arturo; De Mattos-Arruda, Leticia; Kelly, Daniel; Lacombe, Denis; Nilsson, Per J; Piccart, Martine; Poortmans, Philip; Riklund, Katrine; Saeter, Gunnar; Schrappe, Martin; Soffietti, Riccardo; Travado, Luzia; van Poppel, Hein; Wait, Suzanne; Naredi, Peter

2017-09-01

In recent decades cancer care has seen improvements in the speed and accuracy of diagnostic procedures; the effectiveness of surgery, radiation therapy and medical treatments; the power of information technology; and the development of multidisciplinary, specialist-led approaches to care. Such innovations are essential if we are to continue improving the lives of cancer patients across Europe despite financial pressures on our healthcare systems. Investment in innovation must be balanced with the need to ensure the sustainability of healthcare budgets, and all health professionals have a responsibility to help achieve this balance. It requires scrutiny of the way care is delivered; we must be ready to discontinue practices or interventions that are inefficient, and prioritise innovations that may deliver the best outcomes possible for patients within the limits of available resources. Decisions on innovations should take into account their long-term impact on patient outcomes and costs, not just their immediate costs. Adopting a culture of innovation requires a multidisciplinary team approach, with the patient at the centre and an integral part of the team. It must take a whole-system and whole-patient perspective on cancer care and be guided by high-quality real-world data, including outcomes relevant to the patient and actual costs of care; this accurately reflects the impact of any innovation in clinical practice. The European CanCer Organisation is committed to working with its member societies, patient organisations and the cancer community at large to find sustainable ways to identify and integrate the most meaningful innovations into all aspects of cancer care. Copyright © 2017. Published by Elsevier Ltd.

Business intelligence: using insight to improve the value and performance of your practice.

PubMed

Coan, Tim

2007-01-01

Using information to improve the value of your practice can be a great way to create leverage and improve the performance of your practice. Business intelligence (BI) is the result of a complete system that produces meaningful insights by providing the information necessary to make business decisions. Changes made from these insights improve both the performance and value of your practice. It is important to identify the key elements required of a good BI system and the areas within a practice that can directly benefit from an effective BI system.

Effectiveness of meaningful occupation interventions for people living with dementia in residential aged care: a systematic review.

PubMed

Travers, Catherine; Brooks, Deborah; Hines, Sonia; O'Reilly, Maria; McMaster, Mitchell; He, Wei; MacAndrew, Margaret; Fielding, Elaine; Karlsson, Lina; Beattie, Elizabeth

2016-12-01

The ability to participate in valued activities, whether for work, leisure or family, is an important aspect of personal identity. In dementia, progressive memory loss means that abilities developed over a lifetime begin to be lost as well, contributing to the loss of self and identity. Some studies have reported that activities or interventions tailored to be meaningful to the person with dementia (defined as any activity important to the individual) are more effective in addressing behavioral and psychological symptoms of dementia (BPSD) and improving quality of life (QoL) than those that are not so tailored. However, the effectiveness of individualizing interventions or activities for this population is not known. In response to consumer feedback by the Consumer Dementia Research Network that this question ought to be addressed, this review was undertaken, the aim of which was to determine the effectiveness of meaningful occupation interventions for people living with dementia in residential aged care facilities (RACFs). People living with dementia in RACFs (nursing homes).Any intervention that was individualized to be meaningful to the participant, versus any active control condition or usual care.Experimental and observational studies. Quality of life, BPSD (such as agitation, aggression, depression, wandering and apathy), mood, function, cognition and sleep. The search strategy aimed to identify both published and unpublished studies, with the following 12 databases extensively searched: PubMed, CINAHL, PsycINFO, ISI Web of Science, OTSeeker, Embase, Cochrane CENTRAL, clinicaltrials.gov, Mednar, OpenSIGLE, New York Academy of Medicine Library Gray Literature Report, ProQuest Dissertations and Theses. The search strategy was limited to papers published in English between 2004 and January 31, 2015. All studies were assessed independently by two reviewers for relevance, eligibility and methodological quality. Data from included papers were extracted using a

Increasing Meaningful Assistive Technology Use in the Classrooms

ERIC Educational Resources Information Center

Connor, Cynthia; Beard, Lawrence A.

2015-01-01

Although personal technology is consistently used by students and teachers, meaningful use of technology for instruction may not be feasible without providing teachers specific training and support. One university is providing workshops, feedback through coursework, and hands-on training to teacher candidates and local area teachers. In addition,…

E-Learning Content Design Standards Based on Interactive Digital Concepts Maps in the Light of Meaningful and Constructivist Learning Theory

ERIC Educational Resources Information Center

Afify, Mohammed Kamal

2018-01-01

The present study aims to identify standards of interactive digital concepts maps design and their measurement indicators as a tool to develop, organize and administer e-learning content in the light of Meaningful Learning Theory and Constructivist Learning Theory. To achieve the objective of the research, the author prepared a list of E-learning…

Creating a meaningful infection control program: one home healthcare agency's lessons.

PubMed

Poff, Renee McCoy; Browning, Sarah Via

2014-03-01

Creating a meaningful infection control program in the home care setting proved to be challenging for agency leaders of one hospital-based home healthcare agency. Challenges arose when agency leaders provided infection control (IC) data to the hospital's IC Committee. The IC Section Chief asked for national benchmark comparisons to align home healthcare reporting to that of the hospital level. At that point, it was evident that the home healthcare IC program lacked definition and structure. The purpose of this article is to share how one agency built a meaningful IC program.

Connecting the Dots: The Decline in Meaningful Learning

ERIC Educational Resources Information Center

Stewart, Kenneth; Kilmartin, Christopher

2014-01-01

The authors describe cross-decades changes in the achievement attitudes and behaviors of average U. S. undergraduates that parallel the declines in meaningful learning reported by Arum and colleagues. Comparisons of pre-1987 and 2004-8 students on seven achievement-predictive measures revealed that (a) average 2004-8 undergraduates scored…

Development of procedures for identifying high-crash locations and prioritizing safety improvements

DOT National Transportation Integrated Search

2003-06-01

The objectives of this study were to review and analyze the current procedures for identifying high-crash locations and evaluating and prioritizing roadway safety improvements at high-crash locations, and to recommend improved methods. Several tasks ...

Development of procedures for identifying high-crash locations and prioritizing safety improvements.

DOT National Transportation Integrated Search

2003-06-01

The objectives of this study were to review and analyze the current procedures for identifying high-crash locations and evaluating and prioritizing roadway safety improvements at high-crash locations, and to recommend improved methods. Several tasks ...

Effects of perceptual load and socially meaningful stimuli on crossmodal selective attention in Autism Spectrum Disorder and neurotypical samples.

PubMed

Tyndall, Ian; Ragless, Liam; O'Hora, Denis

2018-04-01

The present study examined whether increasing visual perceptual load differentially affected both Socially Meaningful and Non-socially Meaningful auditory stimulus awareness in neurotypical (NT, n = 59) adults and Autism Spectrum Disorder (ASD, n = 57) adults. On a target trial, an unexpected critical auditory stimulus (CAS), either a Non-socially Meaningful ('beep' sound) or Socially Meaningful ('hi') stimulus, was played concurrently with the presentation of the visual task. Under conditions of low visual perceptual load both NT and ASD samples reliably noticed the CAS at similar rates (77-81%), whether the CAS was Socially Meaningful or Non-socially Meaningful. However, during high visual perceptual load NT and ASD participants reliably noticed the meaningful CAS (NT = 71%, ASD = 67%), but NT participants were unlikely to notice the Non-meaningful CAS (20%), whereas ASD participants reliably noticed it (80%), suggesting an inability to engage selective attention to ignore non-salient irrelevant distractor stimuli in ASD. Copyright © 2018 Elsevier Inc. All rights reserved.

Identifying strategies to improve the effectiveness of booster seat laws

DOT National Transportation Integrated Search

2008-05-01

The objective of this project was to identify strategies to improve the effectiveness of booster seat laws. The project explored the possible factors that relate to the use and nonuse of booster seats, and examined the attitudes of law enforcement of...

A business case for HIT adoption: effects of "meaningful use" EHR financial incentives on clinic revenue.

PubMed

Behkami, Nima A; Dorr, David A; Morrice, Stuart

2010-01-01

The goal of this study is to describe a framework that allows decision makers to efficiently evaluate factors that affect Electronic Health Record (EHR) adoption and test suitable interventions; specifically financial incentives. The United States healthcare delivery system is experiencing a transformation to improve population health. There is strong agreement that "meaningful use" of Health Information Technology (HIT) is a major enabler in this effort. However it's also understood that the high cost of implementing an EHR is an obstacle for adoption. To help understand these complexities we developed a simulation model designed to capture the dynamic nature of policy interventions that affect the adoption of EHR. We found that "Effective" use of HIT approaches break-even-point and larger clinic revenue many times faster that "average" or "poor" use of HIT. This study uses a systems perspective to the evaluate EHR adoption process through the "meaningful use" redesign as proposed in the American Reinvestment and Recovery Act 2009 in the United States healthcare industry by utilizing the System Dynamics methodology and Scenario Analysis.

Video-Sharing Website Writing as Identity Performance: Heuristic Inquiry into Experiencing Personally Meaningful Music

ERIC Educational Resources Information Center

Nicholes, Justin

2016-01-01

Enacting heuristic phenomenological inquiry, this article explores the experience of watching a video of a live show of what was personally meaningful music for the researcher. In this study, personally meaningful music, defined as music integral to adolescent identity construction, was sung by and conveyed through the online "discoursal…

A prospective longitudinal study testing relationships between meaningful activities, basic psychological needs fulfillment, and meaning in life.

PubMed

Eakman, Aaron M

2014-01-01

The current study used a prospective longitudinal design to determine whether change in meaningful activity over an 11-month period could help explain change in meaning in life in a sample of 174 undergraduate and graduate students. The Engagement in Meaningful Activities Survey, Basic Psychological Needs Scales (i.e., autonomy, competence, relatedness), and the Meaning in Life Questionnaire were used as indicators of the constructs of meaningful activity, basic psychological needs fulfillment, and meaning and purpose in life. The findings were in support of the study hypotheses and indicated that change in meaningful activity explained both change in basic psychological needs fulfillment (i.e., autonomy, competence, relatedness) and change in meaning in life. Further, this study reports findings consistent with results from cross-sectional studies in support of the hypothesis that change in meaningful activity may influence change in meaning in life through two pathways: a direct path of influence from meaningful activity to meaning in life and an indirect path through change in basic psychological needs fulfillment. The current study contributes to a growing literature implicating subjective evaluations of day-to-day action (or meaningful activity) as a fruitful means for exploring relationships between occupation and well-being. Copyright 2014, SLACK Incorporated.

Hospital IT adoption strategies associated with implementation success: implications for achieving meaningful use.

PubMed

Ford, Eric W; Menachemi, Nir; Huerta, Timothy R; Yu, Feliciano

2010-01-01

Health systems are facing significant pressure to either implement health information technology (HIT) systems that have "certified" electronic health record applications and that fulfill the federal government's definition of "meaningful use" or risk substantial financial penalties in the near future. To this end, hospitals have adopted one of three strategies, described as "best of breed," "best of suite," and "single vendor," to meet organizational and regulatory demands. The single-vendor strategy is used by the simple majority of U.S. hospitals, but is it the most effective mode for achieving full implementation? Moreover, what are the implications of adopting this strategy for achieving meaningful use? The simple answer to the first question is that the hospitals using the hybrid best of suite strategy had fully implemented HIT systems in significantly greater proportions than did hospitals employing either of the other strategies. Nonprofit and system-affiliated hospitals were more likely to have fully implemented their HIT systems. In addition, increased health maintenance organization market penetration rates were positively correlated with complete implementation rates. These results have ongoing implications for achieving meaningful use in the near term. The federal government's rewards and incentives program related to the meaningful use of HIT in hospitals has created an organizational imperative to implement such systems. For hospitals that have not begun systemwide implementation, pursuing a best of suite strategy may provide the greatest chance for achieving all or some of the meaningful use targets in the near term or at least avoiding future penalties scheduled to begin in 2015.

Idiopathic Pulmonary Fibrosis: Clinically Meaningful Primary Endpoints in Phase 3 Clinical Trials

PubMed Central

Collard, Harold R.; Anstrom, Kevin J.; Flaherty, Kevin R.; Fleming, Thomas R.; King, Talmadge E.; Martinez, Fernando J.; Brown, Kevin K.

2012-01-01

Definitive evidence of clinical efficacy in a Phase 3 trial is best shown by a beneficial impact on a clinically meaningful endpoint—that is, an endpoint that directly measures how a patient feels (symptoms), functions (the ability to perform activities in daily life), or survives. In idiopathic pulmonary fibrosis (IPF), we believe the endpoints that best meet these criteria are all-cause mortality and all-cause nonelective hospitalization. There are no validated measures of symptoms or broader constructs such as health status or funtional status in IPF. A surrogate endpoint is defined as an indirect measure that is intended to substitute for a clinically meaningful endpoint. Surrogate endpoints can be appropriate outcome measures if validated. However, validation requires substantial evidence that the effect of an intervention on a clinically meaningful endpoint is reliably predicted by the effect of an intervention on the surrogate endpoint. For patients with IPF, there are currently no validated surrogate endpoints. PMID:22505745

Motives for meaningful involvement in rural AIDS service organizations

PubMed Central

Paterson, Barbara L.; Ross, Steven; Gaudet, Ted

2013-01-01

The research described herein was a three-year exploratory descriptive study to examine how meaningful involvement (MIPA) is conceptualized and experienced in rural regions of the Maritime provinces of Canada. The focus of this paper is one aspect of the research; i.e., what motivates the clients of AIDS Service Organizations (ASOs) in rural Canada to become meaningfully involved? We interviewed 34 people who were past or current clients of ASOs in Maritime Canada and who self-reported as engaging in at-risk behaviors for HIV or living with HIV. The interviews explored participants' perspectives about their motives for becoming meaningfully involved in an ASO. Three themes regarding motives for MIPA were revealed: (1) meeting personal needs; (2) making a difference to others; and (3) recognizing a fit between their skills, goals, needs and the opportunities and experiences within the ASO and with other ASO clients. Participants generally cited more than one motive. This research study contributed to the field of knowledge about the motives for MIPA in which it reveals (1) that MIPA was conceptualized by the rural ASO clients as whatever participation provided them personal meaning (i.e., by fulfilling a personal need, by making a difference, and by recognizing a fit) and (2) the important role that ASO staff and volunteers have in fostering and sustaining MIPA. The study also highlighted a trajectory of involvements that support the need for ASOs to entertain a wide range of roles that are assumed as MIPA. PMID:24111835

“Meaningful use” of electronic health records and its relevance to laboratories and pathologists

PubMed Central

Henricks, Walter H.

2011-01-01

Electronic health records (EHRs) have emerged as a major topic in health care and are central to the federal government’s strategy for transforming healthcare delivery in the United States. Recent federal actions that aim to promote the use of EHRs promise to have significant implications for laboratories and for pathology practices. Under the HITECH (Health Information Technology Economic and Clinical Health) Act, an EHR incentive program has been established through which individual physicians and hospitals can qualify to receive incentive payments if they achieve “meaningful use” of “certified” EHR technology. The rule also establishes payment penalties in future years for eligible providers who have not met the requirements for meaningful use of EHRs. Meaningful use must be achieved using EHR technology that has been certified in accordance with functional and technical criteria that are set forth a regulation that parallels the meaningful use criteria in the incentive program. These actions and regulations are important to laboratories and pathologists for a number of reasons. Several of the criteria and requirements in the meaningful use rules and EHR certification criteria relate directly or indirectly to laboratory testing and laboratory information management, and future stage requirements are expected to impact the laboratory as well. Furthermore, as EHR uptake expands, there will be greater expectations for electronic interchange of laboratory information and laboratory information system (LIS)-EHR interfaces. Laboratories will need to be aware of the technical, operational, and business challenges that they may face as expectations for LIS-EHR increase. This paper reviews the important recent federal efforts aimed at accelerating EHR use, including the incentive program for EHR meaningful use, provider eligibility, and EHR certification criteria, from a perspective of their relevance for laboratories and pathology practices. PMID:21383931

Individual olfactory perception reveals meaningful nonolfactory genetic information

PubMed Central

Secundo, Lavi; Snitz, Kobi; Weissler, Kineret; Pinchover, Liron; Shoenfeld, Yehuda; Loewenthal, Ron; Agmon-Levin, Nancy; Frumin, Idan; Bar-Zvi, Dana; Shushan, Sagit; Sobel, Noam

2015-01-01

Each person expresses a potentially unique subset of ∼400 different olfactory receptor subtypes. Given that the receptors we express partially determine the odors we smell, it follows that each person may have a unique nose; to capture this, we devised a sensitive test of olfactory perception we termed the “olfactory fingerprint.” Olfactory fingerprints relied on matrices of perceived odorant similarity derived from descriptors applied to the odorants. We initially fingerprinted 89 individuals using 28 odors and 54 descriptors. We found that each person had a unique olfactory fingerprint (P < 10−10), which was odor specific but descriptor independent. We could identify individuals from this pool using randomly selected sets of 7 odors and 11 descriptors alone. Extrapolating from this data, we determined that using 34 odors and 35 descriptors we could individually identify each of the 7 billion people on earth. Olfactory perception, however, fluctuates over time, calling into question our proposed perceptual readout of presumably stable genetic makeup. To test whether fingerprints remain informative despite this temporal fluctuation, building on the linkage between olfactory receptors and HLA, we hypothesized that olfactory perception may relate to HLA. We obtained olfactory fingerprints and HLA typing for 130 individuals, and found that olfactory fingerprint matching using only four odorants was significantly related to HLA matching (P < 10−4), such that olfactory fingerprints can save 32% of HLA tests in a population screen (P < 10−6). In conclusion, a precise measure of olfactory perception reveals meaningful nonolfactory genetic information. PMID:26100865

Effect of Community-Based Occupational Therapy on Health-Related Quality of Life and Engagement in Meaningful Activities of Women with Breast Cancer.

PubMed

Petruseviciene, Daiva; Surmaitiene, Deive; Baltaduoniene, Daiva; Lendraitiene, Egle

2018-01-01

level of insomnia ( p < 0.05). Based on the results of our study, we recommend applying occupational therapy in the field of community healthcare in order to maintain or improve breast cancer patients' health-related quality of life and suggest involving women into meaningful activities during community-based occupational therapy after clarifying which activities are important to them.

Heard and valued: the development of a model to meaningfully engage marginalized populations in health services planning.

PubMed

Snow, M Elizabeth; Tweedie, Katherine; Pederson, Ann

2018-03-15

Recently, patient engagement has been identified as a promising strategy for supporting healthcare planning. However, the context and structure of universalistic, "one-size-fits-all" approaches often used for patient engagement may not enable diverse patients to participate in decision-making about programs intended to meet their needs. Specifically, standard patient engagement approaches are gender-blind and might not facilitate the engagement of those marginalized by, for example, substance use, low income, experiences of violence, homelessness, and/or mental health challenges-highly gendered health and social experiences. The project's purpose was to develop a heuristic model to assist planners to engage patients who are not traditionally included in healthcare planning. Using a qualitative research approach, we reviewed literature and conducted interviews with patients and healthcare planners regarding engaging marginalized populations in health services planning. From these inputs, we created a model and planning manual to assist healthcare planners to engage marginalized patients in health services planning, which we piloted in two clinical programs undergoing health services design. The findings from the pilots were used to refine the model. The analysis of the interviews and literature identified power and gender as barriers to participation, and generated suggestions to support diverse populations both to attend patient engagement events and to participate meaningfully. Engaging marginalized populations cannot be reduced to a single defined process, but instead needs to be understood as an iterative process of fitting engagement methods to a particular situation. Underlying this process are principles for meaningfully engaging marginalized people in healthcare planning. A one-size-fits-all approach to patient engagement is not appropriate given patients' diverse barriers to meaningful participation in healthcare planning. Instead, planners need a

Meaningful Work and Secondary School Teachers' Intention to Leave

ERIC Educational Resources Information Center

Janik, M.; Rothmann, S.

2015-01-01

The study investigates the relations between secondary school teachers' work-role fit, job enrichment, supervisor relationships, co-worker relationships, psychological meaningfulness of work and intention to leave. A cross-sectional survey was used. The participants were 502 secondary school teachers in Namibia. The following measuring instruments…

42 CFR 495.6 - Meaningful use objectives and measures for EPs, eligible hospitals, and CAHs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM General Provisions § 495.6 Meaningful use objectives and... their first payment year. For Medicaid EPs who adopt, implement, or upgrade certified EHR technology in... certified EHR technology in their first payment year, the meaningful use objectives and associated measures...

Development of an Assessment Tool to Measure Students' Meaningful Learning in the Undergraduate Chemistry Laboratory

ERIC Educational Resources Information Center

Galloway, Kelli R.; Bretz, Stacey Lowery

2015-01-01

Research on learning in the undergraduate chemistry laboratory necessitates an understanding of students' perspectives of learning. Novak's Theory of Meaningful Learning states that the cognitive (thinking), affective (feeling), and psychomotor (doing) domains must be integrated for meaningful learning to occur. The psychomotor domain is the…

Identifiability of PBPK Models with Applications to Dimethylarsinic Acid Exposure

EPA Science Inventory

Any statistical model should be identifiable in order for estimates and tests using it to be meaningful. We consider statistical analysis of physiologically-based pharmacokinetic (PBPK) models in which parameters cannot be estimated precisely from available data, and discuss diff...

Engaging clinical nurses in quality and performance improvement activities.

PubMed

Albanese, Madeline P; Evans, Dietra A; Schantz, Cathy A; Bowen, Margaret; Disbot, Maureen; Moffa, Joseph S; Piesieski, Patricia; Polomano, Rosemary C

2010-01-01

Nursing performance measures are an integral part of quality initiatives in acute care; however, organizations face numerous challenges in developing infrastructures to support quality improvement processes and timely dissemination of outcomes data. At the Hospital of the University of Pennsylvania, a Magnet-designated organization, extensive work has been conducted to incorporate nursing-related outcomes in the organization's quality plan and to integrate roles for clinical nurses into the Department of Nursing and organization's core performance-based programs. Content and strategies that promote active involvement of nurses and prepare them to be competent and confident stakeholders in quality initiatives are presented. Engaging clinical nurses in the work of quality and performance improvement is essential to achieving excellence in clinical care. It is important to have structures and processes in place to bring meaningful data to the bedside; however, it is equally important to incorporate outcomes into practice. When nurses are educated about performance and quality measures, are engaged in identifying outcomes and collecting meaningful data, are active participants in disseminating quality reports, and are able to recognize the value of these activities, data become one with practice.

Using social knowledge networking technology to enable meaningful use of electronic health record technology in hospitals and health systems.

PubMed

Rangachari, Pavani

2014-12-01

Despite the federal policy momentum towards "meaningful use" of Electronic Health Records, the healthcare organizational literature remains replete with reports of unintended adverse consequences of implementing Electronic Health Records, including: increased work for clinicians, unfavorable workflow changes, and unexpected changes in communication patterns & practices. In addition to being costly and unsafe, these unintended adverse consequences may pose a formidable barrier to "meaningful use" of Electronic Health Records. Correspondingly, it is essential for hospital administrators to understand and detect the causes of unintended adverse consequences, to ensure successful implementation of Electronic Health Records. The longstanding Technology-in-Practice framework emphasizes the role of human agency in enacting structures of technology use or "technologies-in-practice." Given a set of unintended adverse consequences from health information technology implementation, this framework could help trace them back to specific actions (types of technology-in-practice) and institutional conditions (social structures). On the other hand, the more recent Knowledge-in-Practice framework helps understand how information and communication technologies ( e.g. , social knowledge networking systems) could be implemented alongside existing technology systems, to create new social structures, generate new knowledge-in-practice, and transform technology-in-practice. Therefore, integrating the two literature streams could serve the dual purpose of understanding and overcoming unintended adverse consequences of Electronic Health Record implementation. This paper seeks to: (1) review the theoretical literatures on technology use & implementation, and identify a framework for understanding & overcoming unintended adverse consequences of implementing Electronic Health Records; (2) outline a broad project proposal to test the applicability of the framework in enabling "meaningful use

42 CFR 495.6 - Meaningful use objectives and measures for EPs, eligible hospitals, and CAHs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM General Provisions § 495.6 Meaningful use objectives and... year. For Medicaid EPs who adopt, implement, or upgrade certified EHR technology in their first payment... technology in their first payment year, the meaningful use objectives and associated measures of the Stage 1...

42 CFR 495.6 - Meaningful use objectives and measures for EPs, eligible hospitals, and CAHs.

Code of Federal Regulations, 2012 CFR

2012-10-01

... HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM General Provisions § 495.6 Meaningful use objectives and... year. For Medicaid EPs who adopt, implement, or upgrade certified EHR technology in their first payment... technology in their first payment year, the meaningful use objectives and associated measures of the Stage 1...

42 CFR 495.6 - Meaningful use objectives and measures for EPs, eligible hospitals, and CAHs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM General Provisions § 495.6 Meaningful use objectives and... year. For Medicaid EPs who adopt, implement, or upgrade certified EHR technology in their first payment... technology in their first payment year, the meaningful use objectives and associated measures of the Stage 1...

Initial Development of the Meaningful Learning with Technology Scale (MeLTS) for High-School Students

ERIC Educational Resources Information Center

Lee, Chwee Beng

2018-01-01

With the rapid developments in emerging technologies and the emphasis on technologies in learning environments, the connection between technologies and meaningful learning has strengthened. Developing an understanding of the components of meaningful learning with technology is pivotal, as this may enable educators to make more informed decisions…

Pedagogical Principles of Learning to Teach Meaningful Physical Education

ERIC Educational Resources Information Center

Ní Chróinín, Déirdre; Fletcher, Tim; O'Sullivan, Mary

2018-01-01

Background: Concerns that current forms of physical education teacher education (PETE) are not adequately providing teachers with the tools necessary for working with the realities and challenges of teaching physical education in contemporary schools has led some scholars to advocate for an approach that prioritises meaningfulness in physical…

Categorizing Drugs and Drug-Taking: A More Meaningful Approach.

ERIC Educational Resources Information Center

Gold, Robert S.; Duncan, David F.

This document reviews various definitions of the nature and classification of drugs. Difficulties with existing categorizations which use such bases as clinical utility, molecular structure, effects on the central nervous system, legality, and hazard potential are disucssed. A more meaningful categorization based on the availability and sources of…

Relationship of procedural numbers with meaningful procedural autonomy in general surgery residents.

PubMed

Stride, Herbert P; George, Brian C; Williams, Reed G; Bohnen, Jordan D; Eaton, Megan J; Schuller, Mary C; Zhao, Lihui; Yang, Amy; Meyerson, Shari L; Scully, Rebecca; Dunnington, Gary L; Torbeck, Laura; Mullen, John T; Mandell, Samuel P; Choti, Michael; Foley, Eugene; Are, Chandrakanth; Auyang, Edward; Chipman, Jeffrey; Choi, Jennifer; Meier, Andreas; Smink, Douglas; Terhune, Kyla P; Wise, Paul; DaRosa, Debra; Soper, Nathaniel; Zwischenberger, Jay B; Lillemoe, Keith; Fryer, Jonathan P

2018-03-01

Concerns exist regarding the competency of general surgery graduates with performing core general surgery procedures. Current competence assessment incorporates minimal procedural numbers requirements. Based on the Zwisch scale we evaluated the level of autonomy achieved by categorical PGY1-5 general surgery residents at 14 U.S. general surgery resident training programs between September 1, 2015 and December 31, 2016. With 5 of the most commonly performed core general surgery procedures, we correlated the level of autonomy achieved by each resident with the number of procedures they had performed before the evaluation period, with the intent of identifying specific target numbers that would correlate with the achievement of meaningful autonomy for each procedure with most residents. Whereas a definitive target number was identified for laparoscopic appendectomy (i.e. 25), for the other 4 procedures studied (i.e. laparoscopic cholecystectomy, 52; open inguinal hernia repair, 42; ventral hernia repair, 35; and partial colectomy, 60), target numbers identified were less definitive and/or were higher than many residents will experience during their surgical residency training. We conclude that procedural target numbers are generally not effective in predicting procedural competence and should not be used as the basis for determining residents' readiness for independent practice. Copyright © 2017. Published by Elsevier Inc.

Toward a Clinically Meaningful Taxonomy of Violent Offenders: The Role of Anger and Thinking Styles.

PubMed

Low, Kyra; Day, Andrew

2015-05-22

Violent offender rehabilitation programs aim to reduce the risk of re-offending in known offenders by addressing a range of different treatments needs, often with core intervention targets of improving anger regulation and altering antisocial beliefs and thinking styles. Such programs have proven efficacy in reducing recidivism for some, but not all, violent offenders, and little is known about the effects of these programs on different offender types. This study investigates whether subtypes of violent offenders can be meaningfully identified and considers how this influences short-term treatment outcomes. Cluster analysis identified three distinctive violent offender groups within a sample of 305 male offenders who had been assessed for participation in a violent offender rehabilitation program. An "unregulated" group had high levels of anger experience and expression and low levels of anger control, and held beliefs that were strongly supportive of a criminal lifestyle. A "regulated" group demonstrated levels of anger and beliefs supporting criminal activity that were not in a range that warranted treatment. Finally, an "overregulated" group was assessed as the group at highest risk of violent re-offending and had low levels of anger experience and expression and an absence of beliefs supporting criminal activity. The unregulated group appeared to gain the most benefit from treatment, although it had the highest levels of criminal thinking and problematic anger. These findings nonetheless offer support for the hypothesis that violent offender treatment programs may be optimally effective when targeted at particular types of offenders. © The Author(s) 2015.

Enhancing meaningful learning and self-efficacy through collaboration between dental hygienist and physiotherapist students - a scholarship project.

PubMed

Johannsen, A; Bolander-Laksov, K; Bjurshammar, N; Nordgren, B; Fridén, C; Hagströmer, M

2012-11-01

Within the field of Dental Hygiene (DH) and Physiotherapy (PT), students are taught to use an evidence-based approach. Educators need to consider the nature of evidence-based practice from the perspective of content knowledge and learning strategies. Such effort to seek best available evidence and to apply a systematic and scholarly approach to teaching and learning is called scholarship of teaching and learning. To evaluate the application of the scholarship model including an evidence-based approach to enhance meaningful learning and self-efficacy among DH and PT students. Based on the research on student learning, three central theories were identified (constructivism, meaningful learning and self-efficacy). These were applied in our context to support learner engagement and the application of prior knowledge in a new situation. The DH students performed an oral health examination on the PT students, and the PT students performed an individual health test on the DH students; both groups used motivational interviewing. Documentation of student's learning experience was carried out through seminars and questionnaires. The students were overall satisfied with the learning experience. Most appreciated are that it reflected a 'real' professional situation and that it also reinforced important learning from their seminars. The scholarship model made the teachers aware of the importance of evidence-based teaching. Furthermore, the indicators for meaningful learning and increased self-efficacy were high, and the students became more engaged by practising in a real situation, more aware of other health professions and reflected about tacit knowledge. © 2012 John Wiley & Sons A/S.

Authentic Leadership and Altruism: The Mediating Role of Meaningfulness

ERIC Educational Resources Information Center

Sagnak, Mesut; Kuruöz, Mehmet

2017-01-01

The purpose of this study was to investigate the mediating effects of meaningfulness on the relationship between authentic leadership and altruistic behavior. The participants consisted of 356 teachers randomly selected from 14 primary and secondary schools in Nigde. Three different instruments were used in this study. The scales were translated…

The use of a responder analysis to identify clinically meaningful differences in chronic urticaria patients following placebo- controlled treatment with rupatadine 10 and 20 mg.

PubMed

Giménez-Arnau, A; Izquierdo, I; Maurer, M

2009-09-01

According to the EAACI/GA(2)LEN/EDF guidelines for urticaria management, modern non-sedating H1-antihistamines are the first-line symptomatic treatment for chronic urticaria. Two previous randomized clinical trials demonstrated rupatadine efficacy and safety in chronic urticaria treatment. However, a responder analysis to identify clinically meaningful differences in patients with chronic urticaria has not yet been performed. This analysis includes the pooled data from two randomized, double-blind, placebo-controlled, multicentre studies in which chronic urticaria patients were treated with rupatadine at different doses. Responder rates were defined as the percentage of patients after 4 weeks of treatment who exhibited a reduction of symptoms by at least 50% or 75% as compared to baseline. The variables analysed were as follows: Mean Pruritus Score (MPS), Mean Number of Wheals (MNW), and Mean Urticaria Activity Score (UAS). A total of 538 patients were included. This responder analysis, using different response levels, shows that the efficacy of rupatadine 10 mg and 20 mg is significantly better as compared to placebo in the treatment of chronic urticaria patients. Notably, treatment with rupatadine 20 mg daily resulted in a higher percentage of patients with response of 75% symptom reduction or better than rupatadine 10 mg. Our results support the use of higher than standard doses of non sedating antihistamines in chronic urticaria. We strongly recommend performing and reporting responder analyses for established and new drugs used by patients with chronic urticaria.

Meaningful Words and Non-Words Repetitive Articulatory Rate (Oral Diadochokinesis) in Persian Speaking Children.

PubMed

Zamani, Peyman; Rezai, Hossein; Garmatani, Neda Tahmasebi

2017-08-01

Repetitive articulatory rate or Oral Diadochokinesis (oral-DDK) shows a guideline for appraisal and diagnosis of subjects with oral-motor disorder. Traditionally, meaningless words repetition has been utilized in this task and preschool children have challenges with them. Therefore, we aimed to determine some meaningful words in order to test oral-DDK in Persian speaking preschool children. Participants were 142 normally developing children, (age range 4-6 years), who were asked to produce /motæka, golabi/ as two meaningful Persian words and /pa-ta-ka/ as non-word in conventional oral-DDK task. We compared the time taken for 10-times fast repetitions of two meaningful Persian words and the tri-syllabic nonsense word /pa-ta-ka/. Praat software was used to calculate the average time that subjects took to produce the target items. In 4-5 year old children, [Formula: see text] of time taken for 10-times repetitions of /pa-ta-ka, motæka, golabi/ were [Formula: see text], and [Formula: see text] seconds respectively, and in 5-6 year old children were [Formula: see text], and [Formula: see text] seconds respectively. Findings showed that the main effect of type of words on oral diadochokinesis was significant ([Formula: see text]). Children repeated meaningful words /motæka, golabi/ faster than the non-word /pa-ta-ka/. Sex and age factors had no effect on time taken for repetition of oral-DDK test. It is suggested that Speech Therapists can use meaningful words to facilitate oral-DDK test for children.

Comprehension for What? Preparing Students for Their Meaningful Future

ERIC Educational Resources Information Center

Conley, Mark W.; Wise, Antoinette

2011-01-01

Researchers, policymakers, and educators face a daunting task these days concerning literacy education for the here and now and literacy for the future. Even though one clings to the romantic notion that education provides the building blocks in a straight line to a meaningful future, the reality is that mixed goals and instructional messages…

Ukrainian Teacher Candidates Develop Dispositions of Socially Meaningful Activity

ERIC Educational Resources Information Center

Koshmanova, Tetyana; Ravchyna, Tetyana

2010-01-01

This study addresses how the method of peer mediation can be utilized by teacher educators in developing students' attitudes to care for those who are in need, how to actively participate in socially meaningful activity without any expectation of reward, and how to contribute to the democratic development of a post-conflict country via active…

The use of arithmetic average method in identifying critical success criteria for Homestay Programmes

NASA Astrophysics Data System (ADS)

Daud, Shahidah Md; Ramli, Razamin; Kasim, Maznah Mat; Kayat, Kalsom; Razak, Rafidah Abd

2015-12-01

Malaysian Homestay is very unique. It is classified as Community Based Tourism (CBT). Homestay Programme which is a community events where a tourist stays together with a host family for a period of time and enjoying cultural exchange besides having new experiences. Homestay programme has booming the tourism industry since there is over 100 Homestay Programme currently being registered with the Ministry of Culture and Tourism Malaysia. However, only few Homestay Programme enjoying the benefits of success Homestay Programme. Hence, this article seeks to identify the critical success factors for a Homestay Programme in Malaysia. An Arithmetic Average method is utilized to further evaluate the identified success factors in a more meaningful way. The findings will help Homestay Programme function as a community development tool that manages tourism resources. Thus, help the community in improving local economy and creating job opportunities.

Engaging Axiology: Enabling MeaningfulTransdisciplinary Collaboration in Adapted Physical Activity.

PubMed

Peers, Danielle

2018-07-01

In this article, I explore the concept of axiology in the context of adapted physical activity research and analyze its connection to the more commonly discussed paradigmatic assumptions of epistemology and ontology. Following methodological scholars, I argue for an acknowledgment of the pivotal role that axiology already plays in adapted physical activity research and for the potential interdisciplinary and transdisciplinary opportunities that could be enabled by engaging with axiology in more explicit ways. I discuss a number of potential axiological gaps between the field of adapted physical activity and disability communities, arguing that such differences may undermine attempts at doing meaningful transdisciplinary research with such communities. I offer strategies for bridging these axiological gaps, encouraging us to work together in axiologically reflexive ways in order to increase meaningful opportunities for more people with disabilities to be engaged in the movement-based activities and communities of their choice.

The right to appropriate and meaningful education for children with ASD.

PubMed

Marshall, David; Goodall, Craig

2015-10-01

This paper will explore from a 'child's rights perspective' the 'right' of children with autistic spectrum disorder (ASD) to appropriate and meaningful education. Human 'rights' principles within international law will be evaluated in relation to how they have been interpreted and applied in relation to achieving this 'right'. The International Convention of the Rights of the Child (United Nations in Convention on the rights of the child, office of the high commissioner, United Nations, Geneva, 1989) and the convention on the rights of the person with disability (United Nations in Convention on the rights of person's with disabilities and optional protocol, office of the high commissioner, United Nations, Geneva, 2006) amongst others will be utilised to argue the case for 'inclusive' educational opportunities to be a 'right' of every child on the autistic spectrum. The efficacy of mainstream inclusion is explored, identifying the position that a 'one size fits all' model of education is not appropriate for all children with ASD.

Service Learning in Undergraduate Nursing Education: Strategies to Facilitate Meaningful Reflection.

PubMed

Schmidt, Nola A; Brown, Janet M

2016-01-01

Service learning is recognized as a valuable pedagogy involving experiential learning, reflection, and reciprocal learning. Students develop critical thinking and social awareness by using the crucial activity of reflecting upon their experiential learning with community partners. The purpose of this paper is to demystify the process of reflection by identifying best practices to enhance reflection and offering suggestions for grading. By understanding "the what" and "the how" of reflection, educators can implement service learning experiences designed to include the essential component of reflection. Strategies for facilitating meaningful reflection are described including descriptions of what students should reflect upon and how to initiate reflection through writing, reading, doing, and telling. Grading rubrics are suggested to facilitate evaluation of student reflection. When properly implemented, service learning encourages students to be good citizens of the world. By using best practices associated with reflection, students can be challenged to think critically about the world and how their service can achieve community goals. Copyright © 2016. Published by Elsevier Inc.

Identifying patients with hypertension: a case for auditing electronic health record data.

PubMed

Baus, Adam; Hendryx, Michael; Pollard, Cecil

2012-01-01

Problems in the structure, consistency, and completeness of electronic health record data are barriers to outcomes research, quality improvement, and practice redesign. This nonexperimental retrospective study examines the utility of importing de-identified electronic health record data into an external system to identify patients with and at risk for essential hypertension. We find a statistically significant increase in cases based on combined use of diagnostic and free-text coding (mean = 1,256.1, 95% CI 1,232.3-1,279.7) compared to diagnostic coding alone (mean = 1,174.5, 95% CI 1,150.5-1,198.3). While it is not surprising that significantly more patients are identified when broadening search criteria, the implications are critical for quality of care, the movement toward the National Committee for Quality Assurance's Patient-Centered Medical Home program, and meaningful use of electronic health records. Further, we find a statistically significant increase in potential cases based on the last two or more blood pressure readings greater than or equal to 140/90 mm Hg (mean = 1,353.9, 95% CI 1,329.9-1,377.9).

The Teacher as an Agent of Meaningful Educational Change

ERIC Educational Resources Information Center

Vandeyar, Saloshna

2017-01-01

This paper peers through the window to look at how a teacher brings about meaningful educational change in a diverse classroom. Utilizing three sets of arguments from the field of educational change, I traced educational change within a teacher during the course of an academic year. Data capture comprised a mix of semi-structured interviews and…

Effectiveness and meaningful use of paediatric surgical safety checklists and their implementation strategies: a systematic review with narrative synthesis

PubMed Central

Lagoo, Janaka; Lopushinsky, Steven R; Haynes, Alex B; Bain, Paul; Flageole, Helene; Skarsgard, Erik D; Brindle, Mary E

2017-01-01

Objective To examine the effectiveness and meaningful use of paediatric surgical safety checklists (SSCs) and their implementation strategies through a systematic review with narrative synthesis. Summary background data Since the launch of the WHO SSC, checklists have been integrated into surgical systems worldwide. Information is sparse on how SSCs have been integrated into the paediatric surgical environment. Methods A broad search strategy was created using Pubmed, Embase, CINAHL, Cochrane Central, Web of Science, Science Citation Index and Conference Proceedings Citation Index. Abstracts and full texts were screened independently, in duplicate for inclusion. Extracted study characteristic and outcomes generated themes explored through subgroup analyses and idea webbing. Results 1826 of 1921 studies were excluded after title and abstract review (kappa 0.77) and 47 after full-text review (kappa 0.86). 20 studies were of sufficient quality for narrative synthesis. Clinical outcomes were not affected by SSC introduction in studies without implementation strategies. A comprehensive SSC implementation strategy in developing countries demonstrated improved outcomes in high-risk surgeries. Narrative synthesis suggests that meaningful compliance is inconsistently measured and rarely achieved. Strategies involving feedback improved compliance. Stakeholder-developed implementation strategies, including team-based education, achieved greater acceptance. Three studies suggest that parental involvement in the SSC is valued by parents, nurses and physicians and may improve patient safety. Conclusions A SSC implementation strategy focused on paediatric patients and their families can achieve high acceptability and good compliance. SSCs’ role in improving measures of paediatric surgical outcome is not well established, but they may be effective when used within a comprehensive implementation strategy especially for high-risk patients in low-resource settings. PMID:29042377

A meaningful MESS (Medical Education Scholarship Support).

PubMed

Whicker, Shari A; Engle, Deborah L; Chudgar, Saumil; DeMeo, Stephen; Bean, Sarah M; Narayan, Aditee P; Grochowski, Colleen O'Connor; Nagler, Alisa

2016-01-01

Graduate medical education faculty bear the responsibility of demonstrating active research and scholarship; however, faculty who choose education-focused careers may face unique obstacles related to the lack of promotion tracks, funding, career options, and research opportunities. Our objective was to address education research and scholarship barriers by providing a collaborative peer-mentoring environment and improve the production of research and scholarly outputs. We describe a Medical Education Scholarship Support (MESS) group created in 2013. MESS is an interprofessional, multidisciplinary peer-mentoring education research community that now spans multiple institutions. This group meets monthly to address education research and scholarship challenges. Through this process, we develop new knowledge, research, and scholarly products, in addition to meaningful collaborations. MESS originated with eight founding members, all of whom still actively participate. MESS has proven to be a sustainable unfunded local community of practice, encouraging faculty to pursue health professions education (HPE) careers and fostering scholarship. We have met our original objectives that involved maintaining 100% participant retention; developing increased knowledge in at least seven content areas; and contributing to the development of 13 peer-reviewed publications, eight professional presentations, one Masters of Education project, and one educational curriculum. The number of individuals engaged in HPE research continues to rise. The MESS model could be adapted for use at other institutions, thereby reducing barriers HPE researchers face, providing an effective framework for trainees interested in education-focused careers, and having a broader impact on the education research landscape.

Meaningful Learning and Summative Assessment in Geography Education: An Analysis in Secondary Education in the Netherlands

ERIC Educational Resources Information Center

Bijsterbosch, Erik; van der Schee, Joop; Kuiper, Wilmad

2017-01-01

Enhancing meaningful learning is an important aim in geography education. Also, assessment should reflect this aim. Both formative and summative assessments contribute to meaningful learning when more complex knowledge and cognitive processes are assessed. The internal school-based geography examinations of the final exam in pre-vocational…

Meaningful learning: The essential factor for conceptual change in limited or inappropriate propositional hierarchies leading to empowerment of learners

NASA Astrophysics Data System (ADS)

Novak, Joseph D.

2002-07-01

The construction and reconstruction of meanings by learners requires that they actively seek to integrate new knowledge with knowledge already in their cognitive structure. Ausubel's assimilation theory of cognitive learning has been shown to be effective in guiding research and instructional design to facilitate meaningful learning (Ausubel, The psychology of meaningful verbal learning, New York: Grune and Stratton, 1963; Educational psychology: A cognitive view, New York: Holt, Rinehart and Winston, 1968; The acquisition and retention of knowledge, Dordrecht: Kluwer, 2000). Gowin's Vee heuristic has been employed effectively to aid teachers and students in understanding the constructed nature of knowledge (Gowin, Educating, Ithaca, NY: Cornell University Press, 1981). Situated learning occurs when learning is by rote or at a lower level of meaningful learning. Concept mapping has been used effectively to aid meaningful learning with resulting modification of student's knowledge structures. When these knowledge structures are limited or faulty in some way, they may be referred to as Limited or Inappropriate Propositional Hierarchies (LIPH's). Conceptual change, or more accurately conceptual reconstrution, requires meaningful learning to modify LIPH's. Collaborative group learning facilitates meaningful learning and new knowledge construction. World-wide economic changes are forcing major changes in business and industry placing a premium on the power and value of knowledge and new knowledge production. These changes require changes in school and university education that centers on the nature and power of meaningful learning. New computer tools are available to facilitate teaching activities targeted at modifying LIPH's, and aiding meaningful learning in general.

Improved Newborn Hearing Screening Follow-up Results in More Infants Identified

PubMed Central

Alam, Suhana; Gaffney, Marcus; Eichwald, John

2015-01-01

Longitudinal research suggests that efforts at the national, state, and local levels are leading to improved follow-up and data reporting. Data now support the assumption that the number of deaf or hard-of-hearing infants identified through newborn hearing screening increases with a reduction in the number of infants lost to follow-up. Documenting the receipt of services has made a noticeable impact on reducing lost to follow-up rates and early identification of infants with hearing loss; however, continued improvement and monitoring of services are still needed. PMID:23803975

Improved newborn hearing screening follow-up results in more infants identified.

PubMed

Alam, Suhana; Gaffney, Marcus; Eichwald, John

2014-01-01

Longitudinal research suggests that efforts at the national, state, and local levels are leading to improved follow-up and data reporting. Data now support the assumption that the number of deaf or hard-of-hearing infants identified through newborn hearing screening increases with a reduction in the number of infants lost to follow-up. Documenting the receipt of services has made a noticeable impact on reducing lost to follow-up rates and early identification of infants with hearing loss; however, continued improvement and monitoring of services are still needed.

The Role of Meaningful Dialogue in Early Childhood Education Leadership

ERIC Educational Resources Information Center

Deakins, Eric

2007-01-01

Action research was used to study the effectiveness of Learning Organisation and Adaptive Enterprise theories for promoting organisation-wide learning and creating a more effective early childhood education organisation. This article describes the leadership steps taken to achieve shared vision via meaningful dialogue between board, management and…

Student Engagement and Teacher Guidance in Meaningful Mathematics: Enduring Principles

ERIC Educational Resources Information Center

Freeman, Gregory D.; Lucius, Lisa B.

2008-01-01

In mathematics, developing a conceptual understanding and observing properly modeled methods rarely lead to successful student performance. The student must participate. As with bike riding, participation with monitoring and guidance makes initial efforts meaningful and beneficial. In this article, the authors share a bike riding experience and…

Engaging the Public to Identify Opportunities to Improve Critical Care: A Qualitative Analysis of an Open Community Forum.

PubMed

Potestio, Melissa L; Boyd, Jamie M; Bagshaw, Sean M; Heyland, Daren; Oxland, Peter; Doig, Christopher J; Zygun, Dave; Stelfox, Henry T

2015-01-01

To engage the public to understand how to improve the care of critically ill patients. A qualitative content analysis of an open community forum (Café Scientifique). Public venue in Calgary, Alberta, Canada. Members of the general public including patients, families of patients, health care providers, and members of the community at large. A panel of researchers, decision-makers, and a family member led a Café Scientifique, an informal dialogue between the populace and experts, over three-hours to engage the public to understand how to improve the care of critically ill patients. Conventional qualitative content analysis was used to analyze the data. The inductive analysis occurred in three phases: coding, categorizing, and developing themes. Thirty-eight members of the public (former ICU patients, family members of patients, providers, community members) attended. Participants focused the discussion and provided concrete suggestions for improvement around communication (family as surrogate voice, timing of conversations, decision tools) and provider well-being and engagement, as opposed to medical interventions in critical care. Café participants believe patient and family centered care is important to ensure high-quality care in the ICU. A Café Scientifique is a valuable forum to engage the public to contribute to priority setting areas for research in critical care, as well as a platform to share lived experience. Research stakeholders including health care organizations, governments, and funding organizations should provide more opportunities for the public to engage in meaningful conversations about how to best improve healthcare.

Age differences in memory for meaningful and arbitrary associations: A memory retrieval account.

PubMed

Amer, Tarek; Giovanello, Kelly S; Grady, Cheryl L; Hasher, Lynn

2018-02-01

Older adults typically show poor associative memory performance relative to younger adults. This age-related effect, however, is mediated by the meaningfulness of the materials used, such that age differences are minimized with the use of information that is consistent with prior knowledge. While this effect has been interpreted as facilitative learning through schematic support, the role of memory retrieval on this effect has yet to be explored. Using an associative memory paradigm that varied the extent of controlled retrieval for previously studied meaningful or arbitrary associations, older and younger adults in the present study retrieved realistic and unrealistic grocery item prices in a speeded, or in a slow, more control-based retrieval condition. There were no age differences in memory for realistic (meaningful) prices in either condition; however, younger adults showed better memory than older adults for unrealistic prices in the controlled retrieval condition only. These results suggest that age differences in memory for arbitrary associations can, at least partly, be accounted for by age reductions in strategic, controlled retrieval. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Arbitrary conditional discriminative functions of meaningful stimuli and enhanced equivalence class formation.

PubMed

Nedelcu, Roxana I; Fields, Lanny; Arntzen, Erik

2015-03-01

Equivalence class formation by college students was influenced through the prior acquisition of conditional discriminative functions by one of the abstract stimuli (C) in the to-be-formed classes. Participants in the GR-0, GR-1, and GR-5 groups attempted to form classes under the simultaneous protocol, after mastering 0, 1, or 5 conditional relations between C and other abstract stimuli (V, W, X, Y, Z) that were not included in the to-be-formed classes (ABCDE). Participants in the GR-many group attempted to form classes that contained four abstract stimuli and one meaningful picture as the C stimulus. In the GR-0, GR-1, GR-5, and GR-many groups, classes were formed by 17, 25, 58, and 67% of participants, respectively. Thus, likelihood of class formation was enhanced by the prior formation of five C-based conditional relations (the GR-5 vs. GR-0 condition), or the inclusion of a meaningful stimulus as a class member (the GR-many vs. GR-0 condition). The GR-5 and GR-many conditions produced very similar yields, indicating that class formation was enhanced to a similar degree by including a meaningful stimulus or an abstract stimulus that had become a member of five conditional relations prior to equivalence class formation. Finally, the low and high yields produced by the GR-1 and GR-5 conditions showed that the class enhancement effect of the GR-5 condition was due to the number of conditional relations established during preliminary training and not to the sheer amount of reinforcement provided while learning these conditional relations. Class enhancement produced by meaningful stimuli, then, can be attributed to their acquired conditional discriminative functions as well as their discriminative, connotative, and denotative properties. © Society for the Experimental Analysis of Behavior.

Do Contemporary Randomized Controlled Trials Meet ESMO Thresholds for Meaningful Clinical Benefit?

PubMed

Del Paggio, J C; Azariah, B; Sullivan, R; Hopman, W M; James, F V; Roshni, S; Tannock, I F; Booth, C M

2017-01-01

The European Society for Medical Oncology (ESMO) recently released a magnitude of clinical benefit scale (ESMO-MCBS) for systemic therapies for solid cancers. Here, we evaluate contemporary randomized controlled trials (RCTs) against the proposed ESMO thresholds for meaningful clinical benefit. RCTs evaluating systemic therapy for breast cancer, nonsmall cell lung cancer (NSCLC), colorectal cancer (CRC), and pancreatic cancer published 2011-2015 were reviewed. Data were abstracted regarding trial characteristics and outcomes, and these were applied to the ESMO-MCBS. We also determined whether RCTs were designed to detect an effect that would meet clinical benefit as defined by the ESMO-MCBS. About 277 eligible RCTs were included (40% breast, 31% NSCLC, 22% CRC, 6% pancreas). Median sample size was 532 and 83% were funded by industry. Among all 277 RCTs, the experimental therapy was statistically superior to the control arm in 138 (50%) trials: results of only 31% (43/138) of these trials met the ESMO-MCBS clinical benefit threshold. RCTs with curative intent were more likely to meet clinically meaningful thresholds than those with palliative intent [61% (19/31) versus 22% (24/107), P < 0.001]. Among the 226 RCTs for which the ESMO-MCBS could be applied, 31% (70/226) were designed to detect an effect size that could meet ESMO-MCBS thresholds. Less than one-third of contemporary RCTs with statistically significant results meet ESMO thresholds for meaningful clinical benefit, and this represents only 15% of all published trials. Investigators, funding agencies, regulatory agencies, and industry should adopt more stringent thresholds for meaningful benefit in the design of future RCTs. © The Author 2016. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Theoretical Frameworks to Guide School Improvement

ERIC Educational Resources Information Center

Evans, Lisa; Thornton, Bill; Usinger, Janet

2012-01-01

A firm grounding in change theory can provide educational leaders with an opportunity to orchestrate meaningful organizational improvements. This article provides an opportunity for practicing leaders to review four major theories of organizational change--continuous improvement, two approaches to organizational learning, and appreciative inquiry.…

The effects of Roundhouse diagram construction and use on meaningful science learning in the middle school classroom

NASA Astrophysics Data System (ADS)

Ward, Robin Eichel

This research explored the effects of Roundhouse diagram construction and use on meaningful learning of science concepts in a 6th-grade science classroom. This investigation examined the transformation of students' science concepts as they became more proficient in constructing Roundhouse diagrams, what problems students encountered while constructing Roundhouse diagrams, and how choices of iconic images affected their progress in meaningfully learning science concepts as they constructed a series of Roundhouse diagrams. The process of constructing a Roundhouse diagram involved recognizing the learner's relevant existing concepts, evaluating the central concepts for a science lesson and breaking them down into their component parts, reconstructing the learner's conceptual framework by reducing the amount of detail efficiently, reviewing the reconstruction process, and linking each key concept to an iconic image. The researcher collected and analyzed qualitative and quantitative data to determine the effectiveness of the Roundhouse diagram. Data included field notes, observations, students' responses to Roundhouse diagram worksheets, students' perceptions from evaluation sheets, students' mastery of technique sheets, tapes and transcripts of students' interviews, student-constructed Roundhouse diagrams, and documentation of science grades both pre- and post-Roundhouse diagramming. This multiple case study focused on six students although the whole class was used for statistical purposes. Stratified purposeful sampling was used to facilitate comparisons as well as week-by-week comparisons of students' science grades and Roundhouse diagram scores to gain additional insight into the effectiveness of the Roundhouse diagramming method. Through participation in constructing a series of Roundhouse diagrams, middle school students gained a greater understanding of science concepts. Roundhouse diagram scores improved over time during the 10-week Roundhouse diagramming

Age Differences in the Neuroelectric Adaptation to Meaningful Sounds

PubMed Central

Leung, Ada W. S.; He, Yu; Grady, Cheryl L.; Alain, Claude

2013-01-01

Much of what we know regarding the effect of stimulus repetition on neuroelectric adaptation comes from studies using artificially produced pure tones or harmonic complex sounds. Little is known about the neural processes associated with the representation of everyday sounds and how these may be affected by aging. In this study, we used real life, meaningful sounds presented at various azimuth positions and found that auditory evoked responses peaking at about 100 and 180 ms after sound onset decreased in amplitude with stimulus repetition. This neural adaptation was greater in young than in older adults and was more pronounced when the same sound was repeated at the same location. Moreover, the P2 waves showed differential patterns of domain-specific adaptation when location and identity was repeated among young adults. Background noise decreased ERP amplitudes and modulated the magnitude of repetition effects on both the N1 and P2 amplitude, and the effects were comparable in young and older adults. These findings reveal an age-related difference in the neural processes associated with adaptation to meaningful sounds, which may relate to older adults’ difficulty in ignoring task-irrelevant stimuli. PMID:23935900

Patient Hospital Experience Improved Modestly, But No Evidence Medicare Incentives Promoted Meaningful Gains.

PubMed

Papanicolas, Irene; Figueroa, José F; Orav, E John; Jha, Ashish K

2017-01-01

The Centers for Medicare and Medicaid Services (CMS) has played a leading role in efforts to improve patients' experiences with hospital care. Yet little is known about how much patient experience has changed over the past decade, and even less is known about the impact of CMS's most recent strategy: tying payments to performance under the Value-Based Purchasing (VBP) program. We examined trends in multiple measures of patient satisfaction in the period 2008-14. We found that patient experience has improved modestly at US hospitals-both those participating in the VBP program and others-with the majority of improvement concentrated in the period before the program was implemented. While certain subsets of hospitals improved more than others, we found no evidence that the program has had a beneficial effect. As policy makers continue to promote value-based payment as a way to improve patient experience, it will be critical to ensure that payment is structured in ways that actually drive improvement. Project HOPE—The People-to-People Health Foundation, Inc.

‘Killing Me Softly With His/Her Song’: How Leaders Dismantle Followers’ Sense of Work Meaningfulness

PubMed Central

Kipfelsberger, Petra; Kark, Ronit

2018-01-01

Leaders influence followers’ meaning and play a key role in shaping their employees’ experience of work meaningfulness. While the dominant perspective in theory and in empirical work focuses on the positive influence of leaders on followers’ work meaningfulness, our conceptual model explores conditions in which leaders may harm followers’ sense of meaning. We introduce six types of conditions: leaders’ personality traits, leaders’ behaviors, the relationship between leader and follower, followers’ attributions, followers’ characteristics, and job design under which leaders’ meaning making efforts might harm or ‘kill’ followers’ sense of work meaningfulness. Accordingly, we explore how these conditions may interact with leaders’ meaning making efforts to lower levels of followers’ sense of meaning, and in turn, lead to negative personal outcomes (cynicism, lower well-being, and disengagement), as well as negative organizational outcomes (corrosive organizational energy, higher turnover rates, and lower organizational productivity). By doing so, our research extends the current literature, enabling a more comprehensive understanding of leaders’ influence on followers’ work meaningfulness, while considering the dark side of meaning making. PMID:29867638

Anand Niketan Ashram, Rangpur, India: An Education for Meaningful Participation.

ERIC Educational Resources Information Center

Desai, Prakash O.; Haggerson, Nelson L.

1987-01-01

Describes a visit to the Anand Niketan Ashram in the interior of the State of Gujarat India, an internationally known school with a model education for meaningful citizen participation. Explores the program's philosophy activities and describes how the authors came together to have this experience and write this article. (BSR)

Meaningful community involvement in protected area issues: a dialogue session

Treesearch

Laurie Yung

2000-01-01

The current effort to rethink public involvement in decision-making processes for federal lands is gaining momentum. Advocates of alternative decision-making processes seek to involve communities in more meaningful ways than traditional NEPA-style public participation. These new processes take the form of citizen monitoring, partnerships, and most often, collaboration...

An investigation of meaningful understanding and effectiveness of the implementation of Piagetian and Ausubelian theories in physics instruction

NASA Astrophysics Data System (ADS)

Williams, Karen Ann

One section of college students (N = 25) enrolled in an algebra-based physics course was selected for a Piagetian-based learning cycle (LC) treatment while a second section (N = 25) studied in an Ausubelian-based meaningful verbal reception learning treatment (MVRL). This study examined the students' overall (concept + problem solving + mental model) meaningful understanding of force, density/Archimedes Principle, and heat. Also examined were students' meaningful understanding as measured by conceptual questions, problems, and mental models. In addition, students' learning orientations were examined. There were no significant posttest differences between the LC and MVRL groups for students' meaningful understanding or learning orientation. Piagetian and Ausubelian theories explain meaningful understanding for each treatment. Students from each treatment increased their meaningful understanding. However, neither group altered their learning orientation. The results of meaningful understanding as measured by conceptual questions, problem solving, and mental models were mixed. Differences were attributed to the weaknesses and strengths of each treatment. This research also examined four variables (treatment, reasoning ability, learning orientation, and prior knowledge) to find which best predicted students' overall meaningful understanding of physics concepts. None of these variables were significant predictors at the.05 level. However, when the same variables were used to predict students' specific understanding (i.e. concept, problem solving, or mental model understanding), the results were mixed. For forces and density/Archimedes Principle, prior knowledge and reasoning ability significantly predicted students' conceptual understanding. For heat, however, reasoning ability was the only significant predictor of concept understanding. Reasoning ability and treatment were significant predictors of students' problem solving for heat and forces. For density

Getting the foundations right for the measurement of medication safety: the need for a meaningful conceptual frame.

PubMed

Ng, Jerome; Scahill, Shane; Harrison, Jeff

2017-03-24

A number of initiatives aimed at improving medication safety in and across New Zealand public hospitals have been introduced over recent years. Clinicians, policymakers and patients now want to know whether patients are safer today from medicine use than they have been in the past. The challenge has been determining exactly what should be measured. In this viewpoint, we critically examine the suitability of adverse drug events (ADE) as a primary metric for assessing the progress of medication safety improvement. We provide an overview of contemporary dialogue on medication safety measurement and highlight the emergent challenges. Finally, we reflect on how New Zealand has approached medication safety measurement so far and argue the need for a multi-stakeholder informed conceptual framework with a view to further enhancing meaningful assessment of medication safety.

Improving accuracy for identifying related PubMed queries by an integrated approach.

PubMed

Lu, Zhiyong; Wilbur, W John

2009-10-01

PubMed is the most widely used tool for searching biomedical literature online. As with many other online search tools, a user often types a series of multiple related queries before retrieving satisfactory results to fulfill a single information need. Meanwhile, it is also a common phenomenon to see a user type queries on unrelated topics in a single session. In order to study PubMed users' search strategies, it is necessary to be able to automatically separate unrelated queries and group together related queries. Here, we report a novel approach combining both lexical and contextual analyses for segmenting PubMed query sessions and identifying related queries and compare its performance with the previous approach based solely on concept mapping. We experimented with our integrated approach on sample data consisting of 1539 pairs of consecutive user queries in 351 user sessions. The prediction results of 1396 pairs agreed with the gold-standard annotations, achieving an overall accuracy of 90.7%. This demonstrates that our approach is significantly better than the previously published method. By applying this approach to a one day query log of PubMed, we found that a significant proportion of information needs involved more than one PubMed query, and that most of the consecutive queries for the same information need are lexically related. Finally, the proposed PubMed distance is shown to be an accurate and meaningful measure for determining the contextual similarity between biological terms. The integrated approach can play a critical role in handling real-world PubMed query log data as is demonstrated in our experiments.

Creating Meaningful Inquiry in Inclusive Classrooms: Practitioners' Stories of Research

ERIC Educational Resources Information Center

Jones, Phyllis, Ed.; Whitehurst, Teresa, Ed.; Egerton, Jo, Ed.

2012-01-01

In recent years, the concept of teachers as researchers in both special and mainstream school settings has become part of our everyday language. Whilst many educational practitioners will see the need for research within their setting, many may not be familiar with the technical elements they believe are required. "Creating Meaningful Inquiry in…

Knowing Where You're Going: Planning for Meaningful Course Closure

ERIC Educational Resources Information Center

Burgess-Van Aken, Barbara

2017-01-01

A literature review on approaches to a final course session reveals a dearth of attention to the issue. Options for last-day activities fall into three categories: professor-centered, activity-focused, and student-driven. Using the criterion that meaningful course closure calls for last-day activities that engage students in reflection not only…

The Effects of Learning Styles and Meaningful Learning on the Learning Achievement of Gamification Health Education Curriculum

ERIC Educational Resources Information Center

Fan, Kuo-Kuang; Xiao, Peng-wei; Su, Chung-Ho

2015-01-01

This study aims to discuss the correlations among learning styles, meaningful learning, and learning achievement. Directed at the rather difficult to comprehend human blood circulation unit in the biology materials for junior high school students, a Mobile Meaningful Blood Circulation Learning System, called MMBCLS gamification learning, was…

The effects of meaningful irrelevant speech and road traffic noise on teachers' attention, episodic and semantic memory.

PubMed

Enmarker, Ingela

2004-11-01

The aim of the present experiment was to examine the effects of meaningful irrelevant speech and road traffic noise on attention, episodic and semantic memory, and also to examine whether the noise effects were age-dependent. A total of 96 male and female teachers in the age range of 35-45 and 55-65 years were randomly assigned to a silent or the two noise conditions. Noise effects found in episodic memory were limited to a meaningful text, where cued recall contrary to expectations was equally impaired by the two types of noise. However, meaningful irrelevant speech also deteriorated recognition of the text, whereas road traffic noise caused no decrement. Retrieval from two word fluency tests in semantic memory showed strong effects of noise exposure, one affected by meaningful irrelevant speech and the other by road traffic noise. The results implied that both acoustic variation and the semantic interference could be of importance for noise impairments. The expected age-dependent noise effects did not show up.

Post discharge issues identified by a call-back program: identifying improvement opportunities.

PubMed

Ojeda, Patricia I; Kara, Areeba

2017-12-01

The period following discharge from the hospital is one of heightened vulnerability. Discharge instructions serve as a guide during this transition. Yet, clinicians receive little feedback on the quality of this document that ties into the patients' experience. We reviewed the issues voiced by discharged patients via a call-back program and compared them to the discharge instructions they had received. At our institution, patients receive an automated call forty-eight hours following discharge inquiring about progress. If indicated by the response to the call, they are directed to a nurse who assists with problem solving. We reviewed the nursing documentation of these encounters for a period of nine months. The issues voiced were grouped into five categories: communication, medications, durable medical equipment/therapies, follow up and new or ongoing symptoms. The discharge instructions given to each patient were reviewed. We retrieved data on the number of discharges from each specialty from the hospital over the same period. A total of 592 patients voiced 685 issues. The numbers of patients discharged from medical or surgical services identified as having issues via the call-back line paralleled the proportions discharged from medical and surgical services from the hospital during the same period. Nearly a quarter of the issues discussed had been addressed in the discharge instructions. The most common category of issues was related to communication deficits including missing or incomplete information which made it difficult for the patient to enact or understand the plan of care. Medication prescription related issues were the next most common. Resource barriers and questions surrounding medications were often unaddressed. Post discharge issues affect patients discharged from all services equally. Data from call back programs may provide actionable targets for improvement, identify the inpatient team's 'blind spots' and be used to provide feedback to clinicians.

Assessing clinically meaningful treatment effects in controlled trials: chronic migraine as an example.

PubMed

Dodick, David W; Turkel, Catherine C; DeGryse, Ronald E; Diener, Hans-Christoph; Lipton, Richard B; Aurora, Sheena K; Nolan, Marissa E; Silberstein, Stephen D

2015-02-01

In addition to headache, persons with chronic migraine (CM) experience multiple symptoms, both ictal and interictal, that may contribute to their suffering. Translating clinical trial results into practice requires assessment of the results' clinical meaningfulness. When examining treatment benefit in this disabled patient population, multiple headache-symptom measures should be considered to fully reflect clinical relevance. Currently, only onabotulinumtoxinA is approved specifically for headache prophylaxis in adults with CM. Topiramate is the only other therapeutic agent with double-blind, placebo-controlled evidence in this population. Herein we evaluate the clinical meaningfulness of onabotulinumtoxinA and topiramate as headache prophylaxis in CM by comparing primary endpoints from the placebo-controlled, double-blind phase of the Phase 3 REsearch Evaluating Migraine Prophylaxis Therapy (PREEMPT) clinical program and the topiramate clinical trial (frequency of headache days [primary endpoint in PREEMPT; secondary in topiramate trial] and migraine/migrainous days [primary in topiramate trial, or "migraine/probable-migraine days"; secondary in PREEMPT]). Additionally, outcome measures such as responder rates, health-related quality of life, discontinuation rates, safety, and tolerability profiles are important clinical considerations. The clinical data indicate that statistically significant, clinically relevant treatment benefits exist for both onabotulinumtoxinA and topiramate. These data support these treatments as meaningful headache prophylaxis in adults with CM. CM is a chronic pain condition. We sought to determine the clinical relevance of recent trials in this disabled population. Clinical data indicate that statistically significant, clinically relevant treatment benefits exist for both onabotulinumtoxinA and topiramate, and support use of these treatments as meaningful headache prophylaxis in CM. Copyright © 2015 American Pain Society. Published

Effects of a meaningful, a discriminative, and a meaningless stimulus on equivalence class formation.

PubMed

Fields, Lanny; Arntzen, Erik; Nartey, Richard K; Eilifsen, Christoffer

2012-03-01

Thirty college students attempted to form three 3-node 5-member equivalence classes under the simultaneous protocol. After concurrent training of AB, BC, CD, and DE relations, all probes used to assess the emergence of symmetrical, transitive, and equivalence relations were presented for two test blocks. When the A-E stimuli were all abstract shapes, none of 10 participants formed classes. When the A, B, D, and E stimuli were abstract shapes and the C stimuli were meaningful pictures, 8 of 10 participants formed classes. This high yield may reflect the expansion of existing classes that consist of the associates of the meaningful stimuli, rather than the formation of the ABCDE classes, per se. When the A-E stimuli were abstract shapes and the C stimuli became S(D)s prior to class formation, 5 out of 10 participants formed classes. Thus, the discriminative functions served by the meaningful stimuli can account for some of the enhancement of class formation produced by the inclusion of a meaningful stimulus as a class member. A sorting task, which provided a secondary measure of class formation, indicated the formation of all three classes when the emergent relations probes indicated the same outcome. In contrast, the sorting test indicated "partial" class formation when the emergent relations test indicated no class formation. Finally, the effects of nodal distance on the relatedness of stimuli in the equivalence classes were not influenced by the functions served by the C stimuli in the equivalence classes.

Job enrichment: creating meaningful career development opportunities for nurses.

PubMed

Duffield, Christine; Baldwin, Richard; Roche, Michael; Wise, Sarah

2014-09-01

This paper presents an evaluation of a career development policy in South Australia which increased the number of senior staff nurse positions and provided senior registered nurses with time away from clinical duties to undertake agreed projects. We use Kanter's model of structural power and commitment theory to understand the dimensions of this policy. Development strategies for experienced staff who wish to remain at the bedside are needed, especially in smaller health services with limited opportunities for horizontal or vertical mobility. Face-to-face semistructured interviews were conducted with 54 senior staff nurses who participated in the career structure arrangements. The policy enhanced the structure of opportunity in three ways: by increasing the number of senior staff nurse positions, the ladder steps were improved; undertaking strategic projects developed new skills; and the job enrichment approach facilitated time out from the immediate pressures of ward work and challenged nurses in a different way. Through job enrichment, South Australia has found a novel way of providing meaningful career development opportunities for experienced nurses. Methods of job enrichment need to be considered as part of career development policy, especially where movement between clinical facilities is limited and staff wish to remain at the bedside. © 2013 John Wiley & Sons Ltd.

Eco-Efficient Process Improvement at the Early Development Stage: Identifying Environmental and Economic Process Hotspots for Synergetic Improvement Potential.

PubMed

Piccinno, Fabiano; Hischier, Roland; Seeger, Stefan; Som, Claudia

2018-05-15

We present here a new eco-efficiency process-improvement method to highlight combined environmental and costs hotspots of the production process of new material at a very early development stage. Production-specific and scaled-up results for life cycle assessment (LCA) and production costs are combined in a new analysis to identify synergetic improvement potentials and trade-offs, setting goals for the eco-design of new processes. The identified hotspots and bottlenecks will help users to focus on the relevant steps for improvements from an eco-efficiency perspective and potentially reduce their associated environmental impacts and production costs. Our method is illustrated with a case study of nanocellulose. The results indicate that the production route should start with carrot pomace, use heat and solvent recovery, and deactivate the enzymes with bleach instead of heat. To further improve the process, the results show that focus should be laid on the carrier polymer, sodium alginate, and the production of the GripX coating. Overall, the method shows that the underlying LCA scale-up framework is valuable for purposes beyond conventional LCA studies and is applicable at a very early stage to provide researchers with a better understanding of their production process.

Using patients’ experiences to identify priorities for quality improvement in breast cancer care: patient narratives, surveys or both?

PubMed Central

2012-01-01

Background Patients’ experiences have become central to assessing the performance of healthcare systems worldwide and are increasingly being used to inform quality improvement processes. This paper explores the relative value of surveys and detailed patient narratives in identifying priorities for improving breast cancer services as part of a quality improvement process. Methods One dataset was collected using a narrative interview approach, (n = 13) and the other using a postal survey (n = 82). Datasets were analyzed separately and then compared to determine whether similar priorities for improving patient experiences were identified. Results There were both similarities and differences in the improvement priorities arising from each approach. Day surgery was specifically identified as a priority in the narrative dataset but included in the survey recommendations only as part of a broader priority around improving inpatient experience. Both datasets identified appointment systems, patients spending enough time with staff, information about treatment and side effects and more information at the end of treatment as priorities. The specific priorities identified by the narrative interviews commonly related to ‘relational’ aspects of patient experience. Those identified by the survey typically related to more ‘functional’ aspects and were not always sufficiently detailed to identify specific improvement actions. Conclusions Our analysis suggests that whilst local survey data may act as a screening tool to identify potential problems within the breast cancer service, they do not always provide sufficient detail of what to do to improve that service. These findings may have wider applicability in other services. We recommend using an initial preliminary survey, with better use of survey open comments, followed by an in-depth qualitative analysis to help deliver improvements to relational and functional aspects of patient experience. PMID:22913525

Early interventions involving parents to improve neurodevelopmental outcomes of premature infants: a meta-analysis.

PubMed

Vanderveen, J A; Bassler, D; Robertson, C M T; Kirpalani, H

2009-05-01

To determine in a systematic review, whether interventions for infant development that involve parents, improve neurodevelopment at 12 months corrected age or older. Randomized trials were identified where an infant intervention was aimed to improve development and involved parents of preterms; and long-term neurodevelopment using standardized tests at 12 months (or longer) was reported. Identified studies (n=25) used a variety of interventions including parent education, infant stimulation, home visits or individualized developmental care. Meta-analysis at 12 months (N=2198 infants) found significantly higher mental (N=2198) and physical (N=1319) performance scores favoring the intervention group. At 24 months, the mental (N=1490) performance scores were improved, but physical (N=1025) performance scores were not statistically significant. The improvement in neurodevelopmental outcome was not sustained at 36 months (N=961) and 5 years (N=1017). Positive clinically meaningful effects (>5 points) are seen to an age of 36 months, but are no longer present at 5 years.

Concept mapping to promote meaningful learning, help relate theory to practice and improve learning self-efficacy in Asian mental health nursing students: A mixed-methods pilot study.

PubMed

Bressington, Daniel T; Wong, Wai-Kit; Lam, Kar Kei Claire; Chien, Wai Tong

2018-01-01

Student nurses are provided with a great deal of knowledge within university, but they can find it difficult to relate theory to nursing practice. This study aimed to test the appropriateness and feasibility of assessing Novak's concept mapping as an educational strategy to strengthen the theory-practice link, encourage meaningful learning and enhance learning self-efficacy in nursing students. This pilot study utilised a mixed-methods quasi-experimental design. The study was conducted in a University school of Nursing in Hong Kong. A total of 40 third-year pre-registration Asian mental health nursing students completed the study; 12 in the concept mapping (CM) group and 28 in the usual teaching methods (UTM) group. The impact of concept mapping was evaluated thorough analysis of quantitative changes in students' learning self-efficacy, analysis of the structure and contents of the concept maps (CM group), a quantitative measure of students' opinions about their reflective learning activities and content analysis of qualitative data from reflective written accounts (CM group). There were no significant differences in self-reported learning self-efficacy between the two groups (p=0.38). The concept mapping helped students identify their current level of understanding, but the increased awareness may cause an initial drop in learning self-efficacy. The results highlight that most CM students were able to demonstrate meaningful learning and perceived that concept mapping was a useful reflective learning strategy to help them to link theory and practice. The results provide preliminary evidence that the concept mapping approach can be useful to help mental health nursing students visualise their learning progress and encourage the integration of theoretical knowledge with clinical knowledge. Combining concept mapping data with quantitative measures and qualitative reflective journal data appears to be a useful way of assessing and understanding the effectiveness of

Finding pathways to more equitable and meaningful public-scientist partnerships

Treesearch

Daniela Soleri; Jonathan W. Long; Monica D. Ramirez-Andreotta; Ruth Eitemiller; Rajul Pandyaǁ

2016-01-01

For many, citizen science is exciting because of the possibility for more diverse, equitable partnerships in scientific research with outcomes considered meaningful and useful by all, including public participants. This was the focus of a symposium we organized at the 2015 conference of the Citizen Science Association. Here we synthesize points made by symposium...

Children's associative learning: automatic and deliberate encoding of meaningful associations.

PubMed

Guttentag, R

1995-01-01

Three experiments were conducted examining 10- and 11-year-old children's deliberate and automatic encoding of meaningful associative relationships on a paired-associate learning task. Subjects in Experiment 1 were presented pairs of related and unrelated words under deliberate memorization and item-specific incidental-learning conditions. Cued-recall performance was superior with related relative to unrelated pairs under both instructional conditions, suggesting that the encoding of an association between items occurred automatically with meaningfully related words. In Experiment 2, it was found that execution of a verbal elaboration strategy required more time with unrelated than with related pairs, suggesting greater ease of elaboration strategy execution with related materials. Experiment 3 monitored strategy use online using a think-aloud procedure. Cued-recall performance was superior with related pairs when subjects used rehearsal. In contrast, elaboration produced equivalent levels of recall with both types of items, but subjects executed the strategy successfully more often with related than with unrelated pairs. These findings are discussed in terms of the role of automatic processes and the effort demands of strategy execution in children's strategy use.

Engaging the Public to Identify Opportunities to Improve Critical Care: A Qualitative Analysis of an Open Community Forum

PubMed Central

Potestio, Melissa L.; Boyd, Jamie M.; Bagshaw, Sean M.; Heyland, Daren; Oxland, Peter; Doig, Christopher J.; Zygun, Dave; Stelfox, Henry T.

2015-01-01

Objective To engage the public to understand how to improve the care of critically ill patients. Design A qualitative content analysis of an open community forum (Café Scientifique). Setting Public venue in Calgary, Alberta, Canada. Participants Members of the general public including patients, families of patients, health care providers, and members of the community at large. Methods A panel of researchers, decision-makers, and a family member led a Café Scientifique, an informal dialogue between the populace and experts, over three-hours to engage the public to understand how to improve the care of critically ill patients. Conventional qualitative content analysis was used to analyze the data. The inductive analysis occurred in three phases: coding, categorizing, and developing themes. Results Thirty-eight members of the public (former ICU patients, family members of patients, providers, community members) attended. Participants focused the discussion and provided concrete suggestions for improvement around communication (family as surrogate voice, timing of conversations, decision tools) and provider well-being and engagement, as opposed to medical interventions in critical care. Conclusions Café participants believe patient and family centered care is important to ensure high-quality care in the ICU. A Café Scientifique is a valuable forum to engage the public to contribute to priority setting areas for research in critical care, as well as a platform to share lived experience. Research stakeholders including health care organizations, governments, and funding organizations should provide more opportunities for the public to engage in meaningful conversations about how to best improve healthcare. PMID:26580406

A novel summary report of colonoscopy: timeline visualization providing meaningful colonoscopy video information.

PubMed

Cho, Minwoo; Kim, Jee Hyun; Kong, Hyoun Joong; Hong, Kyoung Sup; Kim, Sungwan

2018-05-01

The colonoscopy adenoma detection rate depends largely on physician experience and skill, and overlooked colorectal adenomas could develop into cancer. This study assessed a system that detects polyps and summarizes meaningful information from colonoscopy videos. One hundred thirteen consecutive patients had colonoscopy videos prospectively recorded at the Seoul National University Hospital. Informative video frames were extracted using a MATLAB support vector machine (SVM) model and classified as bleeding, polypectomy, tool, residue, thin wrinkle, folded wrinkle, or common. Thin wrinkle, folded wrinkle, and common frames were reanalyzed using SVM for polyp detection. The SVM model was applied hierarchically for effective classification and optimization of the SVM. The mean classification accuracy according to type was over 93%; sensitivity was over 87%. The mean sensitivity for polyp detection was 82.1%, and the positive predicted value (PPV) was 39.3%. Polyps detected using the system were larger (6.3 ± 6.4 vs. 4.9 ± 2.5 mm; P = 0.003) with a more pedunculated morphology (Yamada type III, 10.2 vs. 0%; P < 0.001; Yamada type IV, 2.8 vs. 0%; P < 0.001) than polyps missed by the system. There were no statistically significant differences in polyp distribution or histology between the groups. Informative frames and suspected polyps were presented on a timeline. This summary was evaluated using the system usability scale questionnaire; 89.3% of participants expressed positive opinions. We developed and verified a system to extract meaningful information from colonoscopy videos. Although further improvement and validation of the system is needed, the proposed system is useful for physicians and patients.

Educating fellows in practice-based learning and improvement and systems-based practice: The value of quality improvement in clinical practice.

PubMed

Carey, William A; Colby, Christopher E

2013-02-01

In 1999, the Accreditation Council for Graduate Medical Education identified 6 general competencies in which all residents must receive training. In the decade since these requirements went into effect, practice-based learning and improvement (PBLI) and systems-based practice (SBP) have proven to be the most challenging competencies to teach and assess. Because PBLI and SBP both are related to quality improvement (QI) principles and processes, we developed a QI-based curriculum to teach these competencies to our fellows. This experiential curriculum engaged our fellows in our neonatal intensive care unit's (NICU's) structured QI process. After identifying specific patient outcomes in need of improvement, our fellows applied validated QI methods to develop evidence-based treatment protocols for our neonatal intensive care unit. These projects led to immediate and meaningful improvements in patient care and also afforded our fellows various means by which to demonstrate their competence in PBLI and SBP. Our use of portfolios enabled us to document our fellows' performance in these competencies quite easily and comprehensively. Given the clinical and educational structures common to most intensive care unit-based training programs, we believe that a QI-based curriculum such as ours could be adapted by others to teach and assess PBLI and SBP. Copyright © 2013 Elsevier Inc. All rights reserved.

Meaningful call combinations and compositional processing in the southern pied babbler.

PubMed

Engesser, Sabrina; Ridley, Amanda R; Townsend, Simon W

2016-05-24

Language's expressive power is largely attributable to its compositionality: meaningful words are combined into larger/higher-order structures with derived meaning. Despite its importance, little is known regarding the evolutionary origins and emergence of this syntactic ability. Although previous research has shown a rudimentary capability to combine meaningful calls in primates, because of a scarcity of comparative data, it is unclear to what extent analog forms might also exist outside of primates. Here, we address this ambiguity and provide evidence for rudimentary compositionality in the discrete vocal system of a social passerine, the pied babbler (Turdoides bicolor). Natural observations and predator presentations revealed that babblers produce acoustically distinct alert calls in response to close, low-urgency threats and recruitment calls when recruiting group members during locomotion. On encountering terrestrial predators, both vocalizations are combined into a "mobbing sequence," potentially to recruit group members in a dangerous situation. To investigate whether babblers process the sequence in a compositional way, we conducted systematic experiments, playing back the individual calls in isolation as well as naturally occurring and artificial sequences. Babblers reacted most strongly to mobbing sequence playbacks, showing a greater attentiveness and a quicker approach to the loudspeaker, compared with individual calls or control sequences. We conclude that the sequence constitutes a compositional structure, communicating information on both the context and the requested action. Our work supports previous research suggesting combinatoriality as a viable mechanism to increase communicative output and indicates that the ability to combine and process meaningful vocal structures, a basic syntax, may be more widespread than previously thought.

Meaningfulness of Sex Differences in Selected Interest-Values Test Scores.

ERIC Educational Resources Information Center

Plant, Walter T.; Southern, Mara L.

This research paper examines the meaningfulness of sex differences in the Allport, Vernon and Lindzey (AVL) Study of Values Scale and in selected scales of the Strong-Campbell Interest Inventory (SCII), using somewhat diverse groups of men and women. By comparing men's and women's scores on the two measures, it was found that little accuracy in…

The Legacy Project Intervention to Enhance Meaningful Family Interactions: Case Examples

PubMed Central

ALLEN, REBECCA S.

2009-01-01

Manualized reminiscence and life review therapies are supported as an evidence-based, effective treatment for depression among older adults, but this therapeutic approach is usually individually administered and has rarely been applied in palliative care settings. We combined mutual reminiscence and life review with engagement in meaningful activity and examined the efficacy of this family-based dyadic intervention to decrease caregiving stress and increase family communication. Seventeen individuals living with chronic, life-limiting illnesses in the community and their family caregivers received three home visits with a master’s-level interventionist. During these sessions and through structured homework activities, the interventionist actively worked with the family to construct a personal Legacy Project, usually a scrapbook with photos, a cookbook, or audiotaped stories that celebrated the life of the ill individual. All participants in the intervention group initiated a Legacy Project and reported that Legacy activities improved family communication. Participation in Legacy creation also resulted in increased positive emotional experiences in patient and caregiver groups. These results are illustrated through careful examination of three case studies. PMID:20046967

Identifying Patients with Hypertension: A Case for Auditing Electronic Health Record Data

PubMed Central

Baus, Adam; Hendryx, Michael; Pollard, Cecil

2012-01-01

Problems in the structure, consistency, and completeness of electronic health record data are barriers to outcomes research, quality improvement, and practice redesign. This nonexperimental retrospective study examines the utility of importing de-identified electronic health record data into an external system to identify patients with and at risk for essential hypertension. We find a statistically significant increase in cases based on combined use of diagnostic and free-text coding (mean = 1,256.1, 95% CI 1,232.3–1,279.7) compared to diagnostic coding alone (mean = 1,174.5, 95% CI 1,150.5—1,198.3). While it is not surprising that significantly more patients are identified when broadening search criteria, the implications are critical for quality of care, the movement toward the National Committee for Quality Assurance's Patient-Centered Medical Home program, and meaningful use of electronic health records. Further, we find a statistically significant increase in potential cases based on the last two or more blood pressure readings greater than or equal to 140/90 mm Hg (mean = 1,353.9, 95% CI 1,329.9—1,377.9). PMID:22737097

California safety-net hospitals likely to be penalized by ACA value, readmission, and meaningful-use programs.

PubMed

Gilman, Matlin; Adams, E Kathleen; Hockenberry, Jason M; Wilson, Ira B; Milstein, Arnold S; Becker, Edmund R

2014-08-01

The Affordable Care Act includes provisions to increase the value obtained from health care spending. A growing concern among health policy experts is that new Medicare policies designed to improve the quality and efficiency of hospital care, such as value-based purchasing (VBP), the Hospital Readmissions Reduction Program (HRRP), and electronic health record (EHR) meaningful-use criteria, will disproportionately affect safety-net hospitals, which are already facing reduced disproportionate-share hospital (DSH) payments under both Medicare and Medicaid. We examined hospitals in California to determine whether safety-net institutions were more likely than others to incur penalties under these programs. To assess quality, we also examined whether mortality outcomes were different at these hospitals. Our study found that compared to non-safety-net hospitals, safety-net institutions had lower thirty-day risk-adjusted mortality rates in the period 2009-11 for acute myocardial infarction, heart failure, and pneumonia and marginally lower adjusted Medicare costs. Nonetheless, safety-net hospitals were more likely than others to be penalized under the VBP program and the HRRP and more likely not to meet EHR meaningful-use criteria. The combined effects of Medicare value-based payment policies on the financial viability of safety-net hospitals need to be considered along with DSH payment cuts as national policy makers further incorporate performance measures into the overall payment system. Project HOPE—The People-to-People Health Foundation, Inc.

The Right to Appropriate and Meaningful Education for Children with ASD

ERIC Educational Resources Information Center

Marshall, David; Goodall, Craig

2015-01-01

This paper will explore from a "child's rights perspective" the "right" of children with autistic spectrum disorder (ASD) to appropriate and meaningful education. Human "rights" principles within international law will be evaluated in relation to how they have been interpreted and applied in relation to achieving this…

Effects of a Meaningful, a Discriminative, and a Meaningless Stimulus on Equivalence Class Formation

PubMed Central

Fields, Lanny; Arntzen, Erik; Nartey, Richard K; Eilifsen, Christoffer

2012-01-01

Thirty college students attempted to form three 3-node 5-member equivalence classes under the simultaneous protocol. After concurrent training of AB, BC, CD, and DE relations, all probes used to assess the emergence of symmetrical, transitive, and equivalence relations were presented for two test blocks. When the A–E stimuli were all abstract shapes, none of 10 participants formed classes. When the A, B, D, and E stimuli were abstract shapes and the C stimuli were meaningful pictures, 8 of 10 participants formed classes. This high yield may reflect the expansion of existing classes that consist of the associates of the meaningful stimuli, rather than the formation of the ABCDE classes, per se. When the A–E stimuli were abstract shapes and the C stimuli became SDs prior to class formation, 5 out of 10 participants formed classes. Thus, the discriminative functions served by the meaningful stimuli can account for some of the enhancement of class formation produced by the inclusion of a meaningful stimulus as a class member. A sorting task, which provided a secondary measure of class formation, indicated the formation of all three classes when the emergent relations probes indicated the same outcome. In contrast, the sorting test indicated “partial” class formation when the emergent relations test indicated no class formation. Finally, the effects of nodal distance on the relatedness of stimuli in the equivalence classes were not influenced by the functions served by the C stimuli in the equivalence classes. PMID:22389524

The co-creation of meaningful action: bridging enaction and interactional sociology.

PubMed

De Jaegher, Hanne; Peräkylä, Anssi; Stevanovic, Melisa

2016-05-05

What makes possible the co-creation of meaningful action? In this paper, we go in search of an answer to this question by combining insights from interactional sociology and enaction. Both research schools investigate social interactions as such, and conceptualize their organization in terms of autonomy. We ask what it could mean for an interaction to be autonomous, and discuss the structures and processes that contribute to and are maintained in the so-called interaction order. We also discuss the role played by individual vulnerability as well as the vulnerability of social interaction processes in the co-creation of meaningful action. Finally, we outline some implications of this interdisciplinary fraternization for the empirical study of social understanding, in particular in social neuroscience and psychology, pointing out the need for studies based on dynamic systems approaches on origins and references of coordination, and experimental designs to help understand human co-presence. © 2016 The Authors.

The co-creation of meaningful action: bridging enaction and interactional sociology

PubMed Central

Peräkylä, Anssi; Stevanovic, Melisa

2016-01-01

What makes possible the co-creation of meaningful action? In this paper, we go in search of an answer to this question by combining insights from interactional sociology and enaction. Both research schools investigate social interactions as such, and conceptualize their organization in terms of autonomy. We ask what it could mean for an interaction to be autonomous, and discuss the structures and processes that contribute to and are maintained in the so-called interaction order. We also discuss the role played by individual vulnerability as well as the vulnerability of social interaction processes in the co-creation of meaningful action. Finally, we outline some implications of this interdisciplinary fraternization for the empirical study of social understanding, in particular in social neuroscience and psychology, pointing out the need for studies based on dynamic systems approaches on origins and references of coordination, and experimental designs to help understand human co-presence. PMID:27069055

Microfluidic screening and whole-genome sequencing identifies mutations associated with improved protein secretion by yeast.

PubMed

Huang, Mingtao; Bai, Yunpeng; Sjostrom, Staffan L; Hallström, Björn M; Liu, Zihe; Petranovic, Dina; Uhlén, Mathias; Joensson, Haakan N; Andersson-Svahn, Helene; Nielsen, Jens

2015-08-25

There is an increasing demand for biotech-based production of recombinant proteins for use as pharmaceuticals in the food and feed industry and in industrial applications. Yeast Saccharomyces cerevisiae is among preferred cell factories for recombinant protein production, and there is increasing interest in improving its protein secretion capacity. Due to the complexity of the secretory machinery in eukaryotic cells, it is difficult to apply rational engineering for construction of improved strains. Here we used high-throughput microfluidics for the screening of yeast libraries, generated by UV mutagenesis. Several screening and sorting rounds resulted in the selection of eight yeast clones with significantly improved secretion of recombinant α-amylase. Efficient secretion was genetically stable in the selected clones. We performed whole-genome sequencing of the eight clones and identified 330 mutations in total. Gene ontology analysis of mutated genes revealed many biological processes, including some that have not been identified before in the context of protein secretion. Mutated genes identified in this study can be potentially used for reverse metabolic engineering, with the objective to construct efficient cell factories for protein secretion. The combined use of microfluidics screening and whole-genome sequencing to map the mutations associated with the improved phenotype can easily be adapted for other products and cell types to identify novel engineering targets, and this approach could broadly facilitate design of novel cell factories.

Improving care transitions through meaningful use stage 2: continuity of care document.

PubMed

Murphy, Lyn Stankiewicz; Wilson, Marisa L; Newhouse, Robin P

2013-02-01

In this department, Drs Murphy, Wilson, and Newhouse highlight hot topics in nursing outcomes, research, and evidence-based practice relevant to the nurse administrator. The goal is to discuss the practical implications for nurse leaders in diverse healthcare settings. Content includes evidence-based projects and decision making, locating measurement tools for quality improvement and safety projects, using outcome measures to evaluate quality, practice implications of administrative research, and exemplars of projects that demon strate innovative approaches to organizational problems. In this article, the authors describe the elements of continuity of care documentation, how sharing information can improve the quality and safety of care transitions and the implications for nurse executives.

Improving the reliability of automated non-destructive inspection

NASA Astrophysics Data System (ADS)

Brierley, N.; Tippetts, T.; Cawley, P.

2014-02-01

In automated NDE a region of an inspected component is often interrogated several times, be it within a single data channel, across multiple channels or over the course of repeated inspections. The systematic combination of these diverse readings is recognized to provide a means to improve the reliability of the inspection, for example by enabling noise suppression. Specifically, such data fusion makes it possible to declare regions of the component defect-free to a very high probability whilst readily identifying indications. Registration, aligning input datasets to a common coordinate system, is a critical pre-computation before meaningful data fusion takes place. A novel scheme based on a multiobjective optimization is described. The developed data fusion framework, that is able to identify and rate possible indications in the dataset probabilistically, based on local data statistics, is outlined. The process is demonstrated on large data sets from the industrial ultrasonic testing of aerospace turbine disks, with major improvements in the probability of detection and probability of false call being obtained.

Improving accuracy for identifying related PubMed queries by an integrated approach

PubMed Central

Lu, Zhiyong; Wilbur, W. John

2009-01-01

PubMed is the most widely used tool for searching biomedical literature online. As with many other online search tools, a user often types a series of multiple related queries before retrieving satisfactory results to fulfill a single information need. Meanwhile, it is also a common phenomenon to see a user type queries on unrelated topics in a single session. In order to study PubMed users’ search strategies, it is necessary to be able to automatically separate unrelated queries and group together related queries. Here, we report a novel approach combining both lexical and contextual analyses for segmenting PubMed query sessions and identifying related queries and compare its performance with the previous approach based solely on concept mapping. We experimented with our integrated approach on sample data consisting of 1,539 pairs of consecutive user queries in 351 user sessions. The prediction results of 1,396 pairs agreed with the gold-standard annotations, achieving an overall accuracy of 90.7%. This demonstrates that our approach is significantly better than the previously published method. By applying this approach to a one day query log of PubMed, we found that a significant proportion of information needs involved more than one PubMed query, and that most of the consecutive queries for the same information need are lexically related. Finally, the proposed PubMed distance is shown to be an accurate and meaningful measure for determining the contextual similarity between biological terms. The integrated approach can play a critical role in handling real-world PubMed query log data as is demonstrated in our experiments. PMID:19162232

What Do Medical Students Perceive as Meaningful in the Psychiatry Clerkship Learning Environment? A Content Analysis of Critical Incident Narratives.

PubMed

Gathright, Molly M; Thrush, Carol; Guise, J Benjamin; Krain, Lewis; Clardy, James

2016-04-01

In order to better understand the professional development of medical students during their psychiatry clerkship, this study identifies common themes and characteristics of students' critical incident narratives which are designed to capture a recount of clerkship experiences they perceived as meaningful. A total of 205 narratives submitted by psychiatry clerkship students in 2010-2011 were subjected to a thematic analysis using a methodological approach and adaptation of categories derived from prior similar research. Descriptive content analysis was also carried out to assess the valence of the narrative content, characters involved, and whether there was evidence that the experience changed students' perspectives in some way. Narratives contained a variety of positive (19%) and negative content (24%) and many contained a hybrid of both (57%). The most common theme (29%) concerned issues of respect and disrespect in patient, clinical, and coworker interactions. In general, the majority (68%) of students' meaningful experience narratives reflected a change in their perspective (e.g., I learned that...). Narratives containing positive and hybrid content were associated with a change in students' perspective (χ(2) = 10.61, df = 2, p < 0.005). Medical students are keenly aware of the learning environment. Positive and hybrid critical incident narratives were associated with a stated change in their beliefs, attitudes, or behaviors due to the experience. Understanding the events that are meaningful to students can also provide rich feedback to medical educators regarding the ways in which students perceive clinical learning environments and how to best foster their professional development.

Meaningful call combinations and compositional processing in the southern pied babbler

PubMed Central

Engesser, Sabrina; Ridley, Amanda R.; Townsend, Simon W.

2016-01-01

Language’s expressive power is largely attributable to its compositionality: meaningful words are combined into larger/higher-order structures with derived meaning. Despite its importance, little is known regarding the evolutionary origins and emergence of this syntactic ability. Although previous research has shown a rudimentary capability to combine meaningful calls in primates, because of a scarcity of comparative data, it is unclear to what extent analog forms might also exist outside of primates. Here, we address this ambiguity and provide evidence for rudimentary compositionality in the discrete vocal system of a social passerine, the pied babbler (Turdoides bicolor). Natural observations and predator presentations revealed that babblers produce acoustically distinct alert calls in response to close, low-urgency threats and recruitment calls when recruiting group members during locomotion. On encountering terrestrial predators, both vocalizations are combined into a “mobbing sequence,” potentially to recruit group members in a dangerous situation. To investigate whether babblers process the sequence in a compositional way, we conducted systematic experiments, playing back the individual calls in isolation as well as naturally occurring and artificial sequences. Babblers reacted most strongly to mobbing sequence playbacks, showing a greater attentiveness and a quicker approach to the loudspeaker, compared with individual calls or control sequences. We conclude that the sequence constitutes a compositional structure, communicating information on both the context and the requested action. Our work supports previous research suggesting combinatoriality as a viable mechanism to increase communicative output and indicates that the ability to combine and process meaningful vocal structures, a basic syntax, may be more widespread than previously thought. PMID:27155011

A qualitative study of perceptions of meaningful change in spinal muscular atrophy.

PubMed

McGraw, Sarah; Qian, Ying; Henne, Jeff; Jarecki, Jill; Hobby, Kenneth; Yeh, Wei-Shi

2017-04-04

This qualitative study examined how individuals with Spinal Muscular Atrophy (SMA), their caregivers, and clinicians defined meaningful change, primarily in the Type II and non-ambulant type III patient populations, associated with treatment of this condition. In addition, we explored participants' views about two measures of motor function routinely used in clinical trials for these SMA subtypes, namely the expanded version of the Hammersmith Functional Motor Scale (HFMSE) and the Upper Limb Module (ULM). The 123 participants (21 with SMA, 64 parents, and 11 clinicians), recruited through SMA advocacy organizations, participated in one of 16 focus groups or 37 interviews. The sessions were audio-recorded, and verbatim transcripts were analyzed using a grounded theory approach. For the participants, meaningful change was relative to functional ability, and small changes in motor function could have an important impact on quality of life. Because patients and families feared progressive loss of functional ability, the participants saw maintenance of abilities as a meaningful outcome. They believed that measures of motor function covered important items, but worried that the HFMSE and ULM might not be sensitive enough to capture small changes. In addition, they felt that outcome measures should assess other important features of life with SMA, including the ability to perform daily activities, respiratory function, swallowing, fatigue, and endurance. Given the heterogeneity of SMA, it is important to expand the assessment of treatment effects to a broader range of outcomes using measures sensitive enough to detect small changes.

Improving cell mixture deconvolution by identifying optimal DNA methylation libraries (IDOL).

PubMed

Koestler, Devin C; Jones, Meaghan J; Usset, Joseph; Christensen, Brock C; Butler, Rondi A; Kobor, Michael S; Wiencke, John K; Kelsey, Karl T

2016-03-08

Confounding due to cellular heterogeneity represents one of the foremost challenges currently facing Epigenome-Wide Association Studies (EWAS). Statistical methods leveraging the tissue-specificity of DNA methylation for deconvoluting the cellular mixture of heterogenous biospecimens offer a promising solution, however the performance of such methods depends entirely on the library of methylation markers being used for deconvolution. Here, we introduce a novel algorithm for Identifying Optimal Libraries (IDOL) that dynamically scans a candidate set of cell-specific methylation markers to find libraries that optimize the accuracy of cell fraction estimates obtained from cell mixture deconvolution. Application of IDOL to training set consisting of samples with both whole-blood DNA methylation data (Illumina HumanMethylation450 BeadArray (HM450)) and flow cytometry measurements of cell composition revealed an optimized library comprised of 300 CpG sites. When compared existing libraries, the library identified by IDOL demonstrated significantly better overall discrimination of the entire immune cell landscape (p = 0.038), and resulted in improved discrimination of 14 out of the 15 pairs of leukocyte subtypes. Estimates of cell composition across the samples in the training set using the IDOL library were highly correlated with their respective flow cytometry measurements, with all cell-specific R (2)>0.99 and root mean square errors (RMSEs) ranging from [0.97 % to 1.33 %] across leukocyte subtypes. Independent validation of the optimized IDOL library using two additional HM450 data sets showed similarly strong prediction performance, with all cell-specific R (2)>0.90 and R M S E<4.00 %. In simulation studies, adjustments for cell composition using the IDOL library resulted in uniformly lower false positive rates compared to competing libraries, while also demonstrating an improved capacity to explain epigenome-wide variation in DNA methylation within two large

Making Each Other’s Daily Life: Nurse Assistants’ Experiences and Knowledge on Developing a Meaningful Daily Life in Nursing Homes

PubMed Central

James, Inger; Fredriksson, Carin; Wahlström, Catrin; Kihlgren, Annica; Blomberg, Karin

2014-01-01

Background: In a larger action research project, guidelines were generated for how a meaningful daily life could be developed for older persons. In this study, we focused on the nurse assistants’ (NAs) perspectives, as their knowledge is essential for a well-functioning team and quality of care. The aim was to learn from NAs’ experiences and knowledge about how to develop a meaningful daily life for older persons in nursing homes and the meaning NAs ascribe to their work. Methods: The project is based on Participatory and Appreciative Action and Reflection. Data were generated through interviews, participating observations and informal conversations with 27 NAs working in nursing homes in Sweden, and a thematic analysis was used. Result: NAs developed a meaningful daily life by sensing and finding the “right” way of being (Theme 1). They sense and read the older person in order to judge how the person was feeling (Theme 2). They adapt to the older person (Theme 3) and share their daily life (Theme 4). NAs use emotional involvement to develop a meaningful daily life for the older person and meaning in their own work (Theme 5), ultimately making each other’s daily lives meaningful. Conclusion: It was obvious that NAs based the development of a meaningful daily life on different forms of knowledge: the oreticaland practical knowledge, and practical wisdom, all of which are intertwined. These results could be used within the team to constitute a meaningful daily life for older persons in nursing homes. PMID:25246997

Kent County Health Department: Using an Agency Strategic Plan to Drive Improvement.

PubMed

Saari, Chelsey K

The Kent County Health Department (KCHD) was accredited by the Public Health Accreditation Board (PHAB) in September 2014. Although Michigan has had a state-level accreditation process for local health departments since the late 1990s, the PHAB accreditation process presented a unique opportunity for KCHD to build on successes achieved through state accreditation and enhance performance in all areas of KCHD programs, services, and operations. PHAB's standards, measures, and peer-review process provided a standardized and structured way to identify meaningful opportunities for improvement and to plan and implement strategies for enhanced performance and established a platform for being recognized nationally as a high-performing local health department. The current case report highlights the way in which KCHD has developed and implemented its strategic plan to guide efforts aimed at addressing gaps identified through the accreditation process and to drive overall improvement within our agency.

Identifying clinically important difference on the Epworth Sleepiness Scale: results from a narcolepsy clinical trial of JZP-110.

PubMed

Scrima, Lawrence; Emsellem, Helene A; Becker, Philip M; Ruoff, Chad; Lankford, Alan; Bream, Gary; Khayrallah, Moise; Lu, Yuan; Black, Jed

2017-10-01

While scores ≤10 on the Epworth Sleepiness Scale (ESS) are within the normal range, the reduction in elevated ESS score that is clinically meaningful in patients with narcolepsy has not been established. This post hoc analysis of a clinical trial of patients with narcolepsy evaluated correlations between Patient Global Impression of Change (PGI-C) and ESS. Data of adult patients with narcolepsy from a double-blind, 12-week placebo-controlled study of JZP-110, a wake-promoting agent, were used in this analysis. Descriptive statistics and receiver operating characteristic (ROC) analysis compared PGI-C (anchor measure) to percent change from baseline in ESS to establish the responder criterion from patients taking either placebo or JZP-110 (treatments). At week 12, patients (n = 10) who reported being "very much improved" on the PGI-C had a mean 76.7% reduction in ESS score, and patients (n = 33) who reported being "much improved" on the PGI-C had a mean 49.1% reduction in ESS score. ROC analysis showed that patients who improved were almost exclusively from JZP-110 treatment group, with an area-under-the-curve of 0.9, and revealed that a 25% reduction in ESS (sensitivity, 81.4%; specificity, 80.9%) may be an appropriate threshold for defining a meaningful patient response to JZP-110 and placebo. A ≥25% reduction in patients' subjective ESS score may be useful as a threshold to identify patients with narcolepsy who respond to JZP-110 treatment. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Towards a More Meaningful Involvement of Librarians in Academic Program Reviews

ERIC Educational Resources Information Center

Bowker, Lynne

2018-01-01

Purpose: Using a descriptive case study approach, this paper aims to validate academic librarians' perceptions that they are marginalized by faculty during academic program reviews, and recommends ways for the two groups to collaborate more effectively to make program reviews more meaningful. Design/methodology/approach: The paper describes a case…

Sustained Partnerships: The Establishment and Development of Meaningful Student-Faculty Relationships

ERIC Educational Resources Information Center

Urso, David J.

2012-01-01

This phenomenological study was designed to explore the one-on-one connections between successful students and the faculty members with whom a meaningful relationship was fostered. The specific focus was on the establishment, development, and reciprocity within the context of the relationships. By comparing the students' experiences to their…

Transforming City Schools through Art: Approaches to Meaningful K-12 Learning

ERIC Educational Resources Information Center

Hutzel, Karen; Bastos, Flavia M. C.; Cozier, Kimberly J.

2012-01-01

This anthology places art at the center of meaningful urban education reform. Providing a fresh perspective on urban education, the contributors describe a positive, asset-based community development model designed to tap into the teaching/learning potential already available in urban cities. Rather than focusing on a lack of resources, this…

Can you prove it? There is no magic bullet for reporting capabilities to meet meaningful use guidelines.

PubMed

Lawrence, Daphne

2010-04-01

In order to qualify for meaningful use in 2011, hospitals will only need to use attestation. Hospitals will have to submit data to CMS electronically in 2012. Not all the data elements needed to prove meaningful use are routinely captured. Standardization is a stumbling block to reporting. For medium to large hospitals using a vendor to set up the reporting is an option.

Conceptualizing death in a worldview consistent, meaningful way and its effects on worldview defense.

PubMed

Rogers, Ross

2011-02-01

Research within terror management theory (TMT) has shown that when mortality is made salient, people subsequently engage in worldview defense: an increase in derogation of an individual who does not share their worldview along with an increase in veneration of an individual who does. Research has also shown that high levels of self-esteem (either dispositionally possessed or artificially enhanced) or legitimization of one's meaning supplying system (worldview) can attenuate the increase in worldview defense typically seen after mortality salience. Extending these findings, this research examined the hypothesis that motivating participants to consider their mortality in a manner that was personally meaningful and thus consistent with their particular worldview would also serve to assuage the need for worldview defense. The research reported below supported this reasoning. Specifically, participants with a Christian religious background who were given the typical mortality salience prime produced more positive evaluations of a Christian target and more negative evaluations of a Jewish target. However, participants with a Christian religious background who were presented with a meaningful mortality salience induction produced evaluations of the Christian and Jewish targets that did not differ. The implications of conceptualizing death meaningfully are discussed.

Digital Storytelling: A Meaningful Technology-Integrated Approach for Engaged Student Learning

ERIC Educational Resources Information Center

Sadik, Alaa

2008-01-01

Although research emphasizes the importance of integrating technology into the curriculum, the use of technology can only be effective if teachers themselves possess the expertise to use technology in a meaningful way in the classroom. The aim of this study was to assist Egyptian teachers in developing teaching and learning through the application…

Creating an Effective and Meaningful Learning Environment for High-Ability Learners!

ERIC Educational Resources Information Center

Davis, Joy Lawson

2013-01-01

An effective and meaningful classroom for high-ability students is one in which teaching and learning is focused on meeting students' intellectual, academic, and psychosocial needs using specific strategies to impact their learning today as they prepare for tomorrow. As parents become more engaged with teachers, it also is important for them…

Neural dissociations between meaningful and mere inconsistency in impression updating

PubMed Central

Todorov, Alexander

2016-01-01

Recent neuroimaging work has identified a network of regions that work in concert to update impressions of other people, particularly in response to inconsistent behavior. However, the specific functional contributions of these regions to the updating process remain unclear. Using fMRI, we tested whether increases in activity triggered by inconsistent behavior reflect changes in the stored representations of other people in response to behavioral inconsistency, or merely a response to the inconsistency itself. Participants encountered a series of individuals whose behavior either changed in an attributionally meaningful fashion or was merely inconsistent with the immediately preceding behavior. We observed that left ventrolateral prefrontal cortex (vlPFC) and left inferior frontal gyrus (IFG) were preferentially recruited in response to unexpected, immoral behavior, whereas a separate set of regions (including dorsal anterior cingulate cortex, posterior cingulate cortex and temporoparietal junction/inferior parietal lobule) was preferentially recruited in response to more mundane inconsistencies in behavior. These results shed light on the distributed systems supporting impression updating. Specifically, while many regions supporting updating may primarily respond to moment-to-moment changes in behavior, a subset of regions (e.g. vlPFC and IFG) may contribute to updating person representations in response to trait-relevant changes in behavior. PMID:27217118

Sentence Processing as a Function of Syntax, Short Term Memory Capacity, the Meaningfulness of the Stimulus and Age

ERIC Educational Resources Information Center

Gamlin, Peter J.

1971-01-01

Examines the effects of short term memory (STM) capacity, meaningfulness of stimuli, and age upon listeners' structuring of sentences. Results show that the interaction between STM capacity and meaningfulness (1) approached significance when data were collapsed over both age levels, and (2) was significant for one age level. Tables and references.…

Effect of comorbid tics on a clinically meaningful response to 8-week open-label trial of fluoxetine in obsessive compulsive disorder.

PubMed

Husted, David S; Shapira, Nathan A; Murphy, Tanya K; Mann, Giselle D; Ward, Herbert E; Goodman, Wayne K

2007-01-01

Currently, there are limited published data evaluating the effects of tics on serotonin reuptake inhibitor (SRI) monotherapy responses in treating obsessive-compulsive disorder (OCD). One retrospective case-controlled analysis of OCD patients treated with SRI monotherapy showed lesser improvement in OCD symptoms in patients with tics than those without. However, more recently there were preliminary reports of OCD subjects treated with SRI monotherapy which did not demonstrate poorer response in subjects with tics or Tourette's Syndrome (TS). The specific aim of this study was to investigate whether the presence of comorbid chronic tics affected "clinically meaningful improvement" [McDougle, C.J., Goodman, W.K., Leckman, J.F., Barr, L.C., Heninger, G.R., Price, L.H., 1993. The efficacy of fluvoxamine in obsessive-compulsive disorder: effects of comorbid chronic tic disorder. Journal of Clinical Psychopharmacology 13, 354-358] of OCD in an 8-week open-label trial of fluoxetine monotherapy. Seventy-four adult subjects (13 patients with comorbid chronic tics and 61 patients without tics) with a primary DSM-IV OCD diagnosis were treated with up to 40mg fluoxetine for 8 weeks and had at least one post-baseline evaluation. The results indicate that there was a significant response by time in both fluoxetine-with-tic subjects and fluoxetine-without-tic subjects. Additionally, there were 3 (23.0%) OCD subjects with tics who had clinically meaningful improvement versus 16 (26.2%) OCD subjects without tics that demonstrated similar levels of improvement. These findings indicate that OCD patients with or without chronic tic disorders did not have a differential response to an 8-week open-label trial of fluoxetine. Limitations include the relatively low number of tic subjects and the open-label nature of the study. Additional data are needed on how comorbid tics may affect SRI treatment response in OCD.

Kaiser Permanente's performance improvement system, Part 4: Creating a learning organization.

PubMed

Schilling, Lisa; Dearing, James W; Staley, Paul; Harvey, Patti; Fahey, Linda; Kuruppu, Francesca

2011-12-01

In 2006, recognizing variations in performance in quality, safety, service, and efficiency, Kaiser Permanente leaders initiated the development of a performance improvement (PI) system. Kaiser Permanente has implemented a strategy for creating the systemic capacity for continuous improvement that characterizes a learning organization. Six "building blocks" were identified to enable Kaiser Permanente to make the transition to becoming a learning organization: real-time sharing of meaningful performance data; formal training in problem-solving methodology; workforce engagement and informal knowledge sharing; leadership structures, beliefs, and behaviors; internal and external benchmarking; and technical knowledge sharing. Putting each building block into place required multiple complex strategies combining top-down and bottom-up approaches. Although the strategies have largely been successful, challenges remain. The demand for real-time meaningful performance data can conflict with prioritized changes to health information systems. It is an ongoing challenge to teach PI, change management, innovation, and project management to all managers and staff without consuming too much training time. Challenges with workforce engagement include low initial use of tools intended to disseminate information through virtual social networking. Uptake of knowledge-sharing technologies is still primarily by innovators and early adopters. Leaders adopt new behaviors at varying speeds and have a range of abilities to foster an environment that is psychologically safe and stimulates inquiry. A learning organization has the capability to improve, and it develops structures and processes that facilitate the acquisition and sharing of knowledge.

An evaluation of meaningful learning in a high school chemistry course

NASA Astrophysics Data System (ADS)

Bross, April J.

This study utilized an action research methodology to examine students' understandings of science knowledge, and meaningful learning using the SLD (Science Lecture Demonstration) and laboratory instructional method in a high school chemistry classroom. This method was a modification of the Science Lecture Demonstration Method as developed by Majerich and Schmuckler (2004, in press), the modification due to the addition of a laboratory component. The participants in this study represented a convenience sample which included one class of twenty-two, middle to high socio-economic status students (Mean family income over $75,000/year in 2005 U.S. dollars) in an honors chemistry course at a public high school in the state of New Jersey. These participants included nine girls and thirteen boys. The results of this study indicated what the students' understandings of science knowledge were, how the understandings differed among students, and to what extent those understandings were indicative of meaningful learning. These results were obtained by careful analysis of student generated concept maps, narratives from demonstration quizzes, laboratory reports, and test questions, as well as a teacher/researcher reflection upon the classroom experience. A simple taxonomy for analyzing students' understandings of science knowledge was developed, based upon the work of Majerich (2004). Findings indicated that the students' understanding of science knowledge, as well as the extent of meaningful learning that occurs in the chemistry classroom may be influenced by the roles of: explicit directions, pre-existing knowledge from elementary and middle school science classes, using examples vs. non-examples, macroscopic vs. microscopic views of nature, time for reflection, and everyday vs. scientific language. Results obtained from high school student responses confirmed Novak's observation of elementary students' lack of differentiation between the terms vapor and gas (Novak, 1998).

Telling the Story of MindRising: Minecraft, Mindfulness and Meaningful Learning

ERIC Educational Resources Information Center

Butler, Deirdre; Brown, Mark; Críosta, Gar Mac

2016-01-01

This paper describes a unique project known as MindRising Games. It reports how the innovative use of Minecraft™ combined with the principles of mindfulness and meaningful learning contributed to rich digital story telling. MindRising Games was a competition, which was part of the 100-year commemoration of the Easter Rising, designed to celebrate…

Effects of Meaningfulness and Context on Information Processing in Third-Graders.

ERIC Educational Resources Information Center

Montgomery, Theresa; Richman, Shanna

The effects of meaningfulness of the stimulus materials and the presence or absence of contextual cues on problem-solving behavior were investigated. Third-graders (N=80) were randomly assigned to one of four conditions and their performance in a series of discrimination problems was observed. Subjects in Conditions I and II responded to stimuli…

Pedagogical Background for Technology Education--Meaningful Learning in Theory and Practice

ERIC Educational Resources Information Center

Autio, Ossi

2009-01-01

One important theme in technology education is the growing need to develop the type of pedagogies that encourage pupils in authentic and meaningful learning experiences. Often, the teaching strategies of technology education are only a matter of teaching the handling of materials and tools, and the production of mere objects does not consider how…

Meaningful Statistics in Professional Practices as a Bridge between Mathematics and Science: An Evaluation of a Design Research Project

ERIC Educational Resources Information Center

Dierdorp, Adri; Bakker, Arthur; van Maanen, Jan A.; Eijkelhof, Harrie M. C.

2014-01-01

Background: Creating coherence between school subjects mathematics and science and making these school subjects meaningful are still topical challenges. This study investigates how students make meaningful connections between mathematics, statistics, science and applications when they engage in a specially developed unit that is based on…

Towards capturing meaningful outcomes for people with dementia in psychosocial intervention research: A pan-European consultation.

PubMed

Øksnebjerg, Laila; Diaz-Ponce, Ana; Gove, Dianne; Moniz-Cook, Esme; Mountain, Gail; Chattat, Rabih; Woods, Bob

2018-06-19

People with dementia are often marginalized and excluded from influence, also in relation to dementia research. There is, however, a growing requirement for inclusion through Patient and Public Involvement (PPI), but there is still limited knowledge on how researchers can fully benefit from the involvement of people with dementia in the development and testing of psychosocial interventions. This paper describes the results of a pan-European consultation with people with dementia, synthesizing their views on outcomes of psychosocial interventions. To involve people with dementia in establishing what are meaningful outcomes when participating in psychosocial interventions. Consultations took place at four divergent sites across Europe, involving twenty-five people with dementia from nine European countries. The methods used for the consultation were developed through an iterative process involving people with dementia. Data from the consultation were analysed from a thematic analysis approach. The results suggested that people with dementia wish to participate in interventions that enhance their well-being, confidence, health, social participation and human rights. This highlights a need for improvements in psychosocial research to capture these outcomes. Involving people with dementia in discussions of psychosocial interventions has enhanced our understanding about meaningful outcome measures in research and methods of data collection. This study suggests that new outcome measures in psychosocial research are needed where concepts of positive psychology and social health can guide innovation and outcome measurement. © 2018 The Authors. Health Expectations published by John Wiley & Sons Ltd.

Identifying Turbulent Structures through Topological Segmentation

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

Bremer, Peer-Timo; Gruber, Andrea; Bennett, Janine C.

2016-01-01

A new method of extracting vortical structures from a turbulent flow is proposed whereby topological segmentation of an indicator function scalar field is used to identify the regions of influence of the individual vortices. This addresses a long-standing challenge in vector field topological analysis: indicator functions commonly used produce a scalar field based on the local velocity vector field; reconstructing regions of influence for a particular structure requires selecting a threshold to define vortex extent. In practice, the same threshold is rarely meaningful throughout a given flow. By also considering the topology of the indicator field function, the characteristics ofmore » vortex strength and extent can be separated and the ambiguity in the choice of the threshold reduced. The proposed approach is able to identify several types of vortices observed in a jet in cross-flow configuration simultaneously where no single threshold value for a selection of common indicator functions appears able to identify all of these vortex types.« less

Biotechnologies as a Context for Enhancing Junior High-School Students' Ability to Ask Meaningful Questions about Abstract Biological Processes.

ERIC Educational Resources Information Center

Olsher, G.; Dreyfus, A.

1999-01-01

Suggests a new approach to teaching about biochemical cellular processes by stimulating student interest in those biochemical processes that allowed for the outcomes of modern biotechnologies. Discusses the development of students' ability to ask meaningful questions about intra-cellular processes, and the resulting meaningful learning of relevant…

The RISE Framework: Using Learning Analytics to Automatically Identify Open Educational Resources for Continuous Improvement

ERIC Educational Resources Information Center

Bodily, Robert; Nyland, Rob; Wiley, David

2017-01-01

The RISE (Resource Inspection, Selection, and Enhancement) Framework is a framework supporting the continuous improvement of open educational resources (OER). The framework is an automated process that identifies learning resources that should be evaluated and either eliminated or improved. This is particularly useful in OER contexts where the…

Perspective: The missing link in academic career planning and development: pursuit of meaningful and aligned work.

PubMed

Lieff, Susan J

2009-10-01

Retention of faculty in academic medicine is a growing challenge. It has been suggested that inattention to the humanistic values of the faculty is contributing to this problem. Professional development should consider faculty members' search for meaning, purpose, and professional fulfillment and should support the development of an ability to reflect on these issues. Ensuring the alignment of academic physicians' inner direction with their outer context is critical to professional fulfillment and effectiveness. Personal reflection on the synergy of one's strengths, passions, and values can help faculty members define meaningful work so as to enable clearer career decision making. The premise of this article is that an awareness of and the pursuit of meaningful work and its alignment with the academic context are important considerations in the professional fulfillment and retention of academic faculty. A conceptual framework for understanding meaningful work and alignment and ways in which that framework can be applied and taught in development programs are presented and discussed.

Real-World Massage Therapy Produces Meaningful Effectiveness Signal for Primary Care Patients with Chronic Low Back Pain: Results of a Repeated Measures Cohort Study.

PubMed

Elder, William G; Munk, Niki; Love, Margaret M; Bruckner, Geza G; Stewart, Kathryn E; Pearce, Kevin

2017-07-01

While efficacy of massage and other nonpharmacological treatments for chronic low back pain is established, stakeholders have called for pragmatic studies of effectiveness in "real-world" primary health care. The Kentucky Pain Research and Outcomes Study evaluated massage impact on pain, disability, and health-related quality of life for primary care patients with chronic low back pain. We report effectiveness and feasibility results, and make comparisons with established minimal clinically important differences. Primary care providers referred eligible patients for 10 massage sessions with community practicing licensed massage therapists. Oswestry Disability Index and SF-36v2 measures obtained at baseline and postintervention at 12 and 24 weeks were analyzed with mixed linear models and Tukey's tests. Additional analyses examined clinically significant improvement and predictive patient characteristics. Of 104 enrolled patients, 85 and 76 completed 12 and 24 weeks of data collection, respectively. Group means improved at 12 weeks for all outcomes and at 24 weeks for SF-36v2's Physical Component Summary and Bodily Pain Domain. Of those with clinically improved disability at 12 weeks, 75% were still clinically improved at 24 weeks ( P  < 0.01). For SF-36v2 Physical and Mental Component Summaries, 55.4% and 43.4%, respectively, showed clinically meaningful improvement at 12 weeks, 46.1% and 30.3% at 24 weeks. For Bodily Pain Domain, 49.4% were clinically improved at 12 weeks, 40% at 24 weeks. Adults older than age 49 years had better pain and disability outcomes than younger adults. Results provide a meaningful signal of massage effect for primary care patients with chronic low back pain and call for further research in practice settings using pragmatic designs with control groups. © 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Meaningful Gamification and Students' Motivation: A Strategy for Scaffolding Reading Material

ERIC Educational Resources Information Center

Ling, Lynette Tan Yuen

2018-01-01

Gamification is an innovative pedagogical strategy where digital games are used in an educational setting and as an aid to learning. Recent publications on gamification in the classroom investigate the concept of "meaningful gamification," where, in line with Ryan and Deci's self-determination theory, competency, autonomy, and…

UMI-tools: modeling sequencing errors in Unique Molecular Identifiers to improve quantification accuracy

PubMed Central

2017-01-01

Unique Molecular Identifiers (UMIs) are random oligonucleotide barcodes that are increasingly used in high-throughput sequencing experiments. Through a UMI, identical copies arising from distinct molecules can be distinguished from those arising through PCR amplification of the same molecule. However, bioinformatic methods to leverage the information from UMIs have yet to be formalized. In particular, sequencing errors in the UMI sequence are often ignored or else resolved in an ad hoc manner. We show that errors in the UMI sequence are common and introduce network-based methods to account for these errors when identifying PCR duplicates. Using these methods, we demonstrate improved quantification accuracy both under simulated conditions and real iCLIP and single-cell RNA-seq data sets. Reproducibility between iCLIP replicates and single-cell RNA-seq clustering are both improved using our proposed network-based method, demonstrating the value of properly accounting for errors in UMIs. These methods are implemented in the open source UMI-tools software package. PMID:28100584

Self-Regulated Learning Procedure for University Students: The "Meaningful Text-Reading" Strategy

ERIC Educational Resources Information Center

Roman Sanchez, Jose Maria

2004-01-01

Introduction: Experimental validation of a self-regulated learning procedure for university students, i.e. the "meaningful text-reading" strategy, is reported in this paper. The strategy's theoretical framework is the "ACRA Model" of learning strategies. The strategy consists of a flexible, recurring sequence of five mental operations of written…

An Investigation of the Factors Motivating Meaningful Learning of Statistics by Graduate Systems Management Students at AFIT.

DTIC Science & Technology

1987-09-01

DAC-RiB 271 AN INVESTIGATION OF THE FACTORS MOTIVATING MEANINGFUL v’ LEARNING OF STATIST (U) AIR FORCE INST OF TECH WRIGHT-PATTERSON RFB OH SCHOOL OF...Furthermore, the views expressed in the document are those of the author and do not necessarily reflect the views of the School of Systems and...MEANINGFUL LEARNING OF STATISTICS BY GRADUATE SYSTEMS MANAGEMENT STUDENTS AT AFIT THESIS Presented to the Faculty of the School of Systems and Logistics

Improving risk-stratification of Diabetes complications using temporal data mining.

PubMed

Sacchi, Lucia; Dagliati, Arianna; Segagni, Daniele; Leporati, Paola; Chiovato, Luca; Bellazzi, Riccardo

2015-01-01

To understand which factor trigger worsened disease control is a crucial step in Type 2 Diabetes (T2D) patient management. The MOSAIC project, funded by the European Commission under the FP7 program, has been designed to integrate heterogeneous data sources and provide decision support in chronic T2D management through patients' continuous stratification. In this work we show how temporal data mining can be fruitfully exploited to improve risk stratification. In particular, we exploit administrative data on drug purchases to divide patients in meaningful groups. The detection of drug consumption patterns allows stratifying the population on the basis of subjects' purchasing attitude. Merging these findings with clinical values indicates the relevance of the applied methods while showing significant differences in the identified groups. This extensive approach emphasized the exploitation of administrative data to identify patterns able to explain clinical conditions.

Beyond Needs Analysis: Soft Systems Methodology for Meaningful Collaboration in EAP Course Design

ERIC Educational Resources Information Center

Tajino, Akira; James, Robert; Kijima, Kyoichi

2005-01-01

Designing an EAP course requires collaboration among various concerned stakeholders, including students, subject teachers, institutional administrators and EAP teachers themselves. While needs analysis is often considered fundamental to EAP, alternative research methodologies may be required to facilitate meaningful collaboration between these…

Evaluating SPP/APR Improvement Activities

ERIC Educational Resources Information Center

National Early Childhood Technical Assistance Center (NECTAC), 2009

2009-01-01

This document is intended to assist State Education Agency (SEA) and Lead Agency (LA) staff and technical assistance providers in designing a meaningful evaluation for the State Performance Plan (SPP)/Annual Performance Report (APR) improvement activities. It provides: (1) information about the relevance of evaluation in the context of improvement…

Meaningful Engagement in Scientific Practices: How Classroom Communities Develop Authentic Epistemologies for Science

NASA Astrophysics Data System (ADS)

Krist, Christina Rae

Recent reforms in science education, based on decades of learning research, emphasize engaging students in science and engineering practices as the means to develop and refine disciplinary ideas. These reforms advocate an epistemic shift in how school science is done: from students learning about science ideas to students figuring out core science ideas. This shift is challenging to implement: how do we bring the goals and practices of a discipline into classroom communities in meaningful ways that go beyond simply following rote scientific procedures? In this dissertation, I investigate how classroom communities learn to engage meaningfully in scientific practices, characterizing their engagement as a process of epistemic learning. I take a situated perspective that defines learning as shifts in how members engage in communities of practice. I examine students' epistemic learning as a function of their participation in a classroom community of scientific practice along two dimensions: what they do, or the practical epistemic heuristics they use to guide how they build knowledge; and who they are, or how ownership and authorship of ideas is negotiated and affectively marked through interaction. I focus on a cohort of students as they move from 6th to 8 th grade. I analyze three science units, one from each grade level, to look at the epistemic heuristics implicit in student and teacher talk and how the use of those heuristics shifts over time. In addition, I examine one anomalous 8th grade class to look at how students and the teacher position themselves and each other with respect to the ideas in their classroom and how that positioning supports epistemic learning. Taken together, these analyses demonstrate how students' engagement in scientific practices evolves in terms of what they do and who they are in relation to the knowledge and ideas in their classroom over time. I propose a model for epistemic learning that articulates how classroom communities develop

Identifying Teacher Needs for Promoting Education through Science as a Paradigm Shift in Science Education

ERIC Educational Resources Information Center

Holbrook, J.; Rannikmae, M.; Valdmann, A.

2014-01-01

This paper identifies an "education through science" philosophy for school science teaching at the secondary level and determines its interrelationship with approaches to student acquisition of key educational competences and the identification of teacher needs to promote meaningful learning during science lessons. Based on the…

Write Another Poem about Marigold: Meaningful Writing as a Process of Change.

ERIC Educational Resources Information Center

Teichmann, Sandra Gail

1995-01-01

Considers a process approach toward the goal of meaningful writing which may aid in positive personal change. Outlines recent criticism of contemporary poetry; argues against tradition and practice of craft in writing poetry. Proposes a means of writing centered on a method of inquiry involving elements of self-involvement, curiosity, and risk to…

Student Projects that Make a Meaningful and Lasting Contribution to Course Content

ERIC Educational Resources Information Center

Schmidt, Shelly J.

2013-01-01

The objective of this teaching tip is to share with others an idea of how to transform student projects from a dead-end process to a value-added end product, value-added end products that make a meaningful and lasting contribution to course content for use by future students. (Contains 2 tables.)

Does (Non-)Meaningful Sensori-Motor Engagement Promote Learning with Animated Physical Systems?

ERIC Educational Resources Information Center

Pouw, Wim T. J. L.; Eielts, Charly; Gog, Tamara; Zwaan, Rolf A.; Paas, Fred

2016-01-01

Previous research indicates that sensori-motor experience with physical systems can have a positive effect on learning. However, it is not clear whether this effect is caused by mere bodily engagement or the intrinsically meaningful information that such interaction affords in performing the learning task. We investigated (N = 74), through the use…

Meaningful Products: Making the Whole Greater Than the Sum of the Parts

ERIC Educational Resources Information Center

Jansen, Barbara A.

2005-01-01

A library media specialist believes students should go beyond the facts and other information they find in sources. They can stretch their intellect and engage them in the learning process. The students can produce more meaningful and significant results by combining information found in sources, their original idea and transferable skills in the…

The Concept Maps as a Didactic Resource Tool of Meaningful Learning in Astronomy Themes

NASA Astrophysics Data System (ADS)

Silveira, Felipa Pacífico Ribeiro de Assis; Mendonça, Conceição Aparecida Soares

2015-07-01

This article presents the results of an investigation that sought to understand the performance of the conceptual map (MC) as a teaching resource facilitator of meaningful learning of scientific concepts on astronomical themes, developed with elementary school students. The methodology employed to obtain and process the data was based on a quantitative and qualitative approach. On the quantitative level we designed a quasi-experimental research with a control group that did not use the MC and an experimental group that used the MC, both being evaluated in the beginning and end of the process. In this case, the performance of both groups is displayed in a descriptive and analytical study. In the qualitative approach, the MCs were interpreted using the structuring and assigned meanings shared by the student during his/her presentation. The results demonstrated through the improvement of qualifications that the MC made a difference in conceptual learning and in certain skills revealed by learning indicators.

Meaningful Learning in the Teaching of Culture: The Project Based Learning Approach

ERIC Educational Resources Information Center

Kean, Ang Chooi; Kwe, Ngu Moi

2014-01-01

This paper reports on a collaborative effort taken by a team of three teacher educators in using the Project Based Learning (PBL) approach in the teaching of Japanese culture with the aim to investigate the presence of actual "meaningful learning" among 15 students of a 12-Week Preparatory Japanese Language course under a teacher…

Getting to Teacher Ownership: How Schools Are Creating Meaningful Change. Executive Summary

ERIC Educational Resources Information Center

Saunders, Marisa; Alcantara, Vianna; Cervantes, Laura; Del Razo, Jaime; Lopez, Ruth; Perez, Wendy

2017-01-01

This executive summary presents highlights from a study exploring the concept of teacher ownership and how it can bring about the deep and meaningful changes that schools need and that all students deserve. Based on teacher surveys and interviews in twenty-one schools in Los Angeles that are implementing major reforms, the study suggests that…

The Power of Dialogue and Meaningful Connectedness: Conversations between Two Female Scholars

ERIC Educational Resources Information Center

Nganga, Christine W.; Beck, Makini

2017-01-01

In this paper, the authors examine the power of dialogue and meaningful connectedness from their perspectives as female scholars of color. They draw from the feminist co-mentoring literature, which encourages equal balance of power among participants where each person takes on the role of teacher and learner, or mentor and mentee, since both have…

Identifying Meaningful Behaviors for Social Competence: A Contextual Approach.

ERIC Educational Resources Information Center

Warnes, Emily D.; Sheridan, Susan M.; Geske, Jenenne; Warnes, William A.

An exploratory study was conducted which assessed behaviors that characterize social competence in the 2nd and 5th grades. A contextual approach was used to gather information from 2nd and 5th grade children and their parents and teachers regarding the behaviors they perceived to be important for getting along well with peers. Data were gathered…

Older Adults Co-Creating Meaningful Individualized Social Activities Online for Healthy Ageing.

PubMed

Blusi, Madeleine; Nilsson, Ingeborg; Lindgren, Helena

2018-01-01

Social isolation and loneliness among older people is a growing problem with negative effects on physical and mental health. In co-creation with older adults individualized social activities were designed where older adults through computer mediated communication were able to participate in social activities without leaving their homes. Four types of activities were designed; outdoor activity, music event, visiting a friend and leisure activity. A participatory action research design was applied, where end users together with scientists from two research fields developed, tested and evaluated online participation in the activities. Usability and safety of the systems were major concerns among older adults. The evaluation pointed out that level of simplicity, usability and audio-video quality determined the level of satisfaction with the human interaction during the activity, thereby affecting the meaningfulness of the activity. The research presented in this paper constitutes the first step in a long-term research process aiming at developing a digital coaching system that gives older adults personalized support for increasing participation in meaningful social activities.

Identifying Effective and Sustainable Measures for Community-Based Environmental Monitoring

NASA Astrophysics Data System (ADS)

McKay, Ariana J.; Johnson, Chris J.

2017-09-01

Resource development projects typically result in monitoring programs that fail to fully consider the values and participation of surrounding communities. Also, monitoring protocols for single environmental values can be insufficient for addressing the cumulative impacts of resource development. Community-based environmental monitoring (CBEM) has emerged as a way to meaningfully include local citizens in the decision-making process and assessment of the development of natural resources. Our research explored how to develop effective and sustainable CBEM. Interviews were conducted with staff from 15 CBEM programs established across Canada to identify criteria of what constitutes effective CBEM. Results demonstrate that CBEM offers an effective, locally adapted, and culturally applicable approach to facilitate community participation in natural resource management and to track environmental change. Benefits of CBEM include: locally relevant monitoring protocols, inclusion of cumulative impacts, better informed decision-making, and increased awareness and collaboration amongst community, governments, and proponents. Challenges associated with CBEM are cost, capacity, longevity, distribution of results, and establishing credibility. This research validates the use of CBEM for improving resource management.

Using risk-adjustment models to identify high-cost risks.

PubMed

Meenan, Richard T; Goodman, Michael J; Fishman, Paul A; Hornbrook, Mark C; O'Keeffe-Rosetti, Maureen C; Bachman, Donald J

2003-11-01

We examine the ability of various publicly available risk models to identify high-cost individuals and enrollee groups using multi-HMO administrative data. Five risk-adjustment models (the Global Risk-Adjustment Model [GRAM], Diagnostic Cost Groups [DCGs], Adjusted Clinical Groups [ACGs], RxRisk, and Prior-expense) were estimated on a multi-HMO administrative data set of 1.5 million individual-level observations for 1995-1996. Models produced distributions of individual-level annual expense forecasts for comparison to actual values. Prespecified "high-cost" thresholds were set within each distribution. The area under the receiver operating characteristic curve (AUC) for "high-cost" prevalences of 1% and 0.5% was calculated, as was the proportion of "high-cost" dollars correctly identified. Results are based on a separate 106,000-observation validation dataset. For "high-cost" prevalence targets of 1% and 0.5%, ACGs, DCGs, GRAM, and Prior-expense are very comparable in overall discrimination (AUCs, 0.83-0.86). Given a 0.5% prevalence target and a 0.5% prediction threshold, DCGs, GRAM, and Prior-expense captured $963,000 (approximately 3%) more "high-cost" sample dollars than other models. DCGs captured the most "high-cost" dollars among enrollees with asthma, diabetes, and depression; predictive performance among demographic groups (Medicaid members, members over 64, and children under 13) varied across models. Risk models can efficiently identify enrollees who are likely to generate future high costs and who could benefit from case management. The dollar value of improved prediction performance of the most accurate risk models should be meaningful to decision-makers and encourage their broader use for identifying high costs.

Engaging in Work Even When It Is Meaningless: Positive Affective Disposition and Meaningful Work Interact in Relation to Work Engagement

ERIC Educational Resources Information Center

Steger, Michael F.; Littman-Ovadia, Hadassah; Miller, Michal; Menger, Lauren; Rothmann, Sebastiaan

2013-01-01

The central aim of the present study was to assess the predictive value of affective disposition and meaningful work on employee engagement. Specifically, it was proposed that meaningful work moderates the relationship between affective disposition and engagement. Questionnaires were completed by 252 white-collar employees, working in a variety of…

Nuclear waste transportation: case studies of identifying stakeholder risk information needs.

PubMed Central

Drew, Christina H; Grace, Deirdre A; Silbernagel, Susan M; Hemmings, Erin S; Smith, Alan; Griffith, William C; Takaro, Timothy K; Faustman, Elaine M

2003-01-01

The U.S. Department of Energy (DOE) is responsible for the cleanup of our nation's nuclear legacy, involving complex decisions about how and where to dispose of nuclear waste and how to transport it to its ultimate disposal site. It is widely recognized that a broad range of stakeholders and tribes should be involved in this kind of decision. All too frequently, however, stakeholders and tribes are only invited to participate by commenting on processes and activities that are near completion; they are not included in the problem formulation stages. Moreover, it is often assumed that high levels of complexity and uncertainty prevent meaningful participation by these groups. Considering the types of information that stakeholders and tribes need to be able to participate in the full life cycle of decision making is critical for improving participation and transparency of decision making. Toward this objective, the Consortium for Risk Evaluation with Stakeholder Participation (CRESP) participated in three public processes relating to nuclear waste transportation and disposal in 1997-1998. First, CRESP organized focus groups to identify concerns about nuclear waste transportation. Second, CRESP conducted exit surveys at regional public workshops held by DOE to get input from stakeholders on intersite waste transfer issues. Third, CRESP developed visual tools to synthesize technical information and allow stakeholders and tribes with varying levels of knowledge about nuclear waste to participate in meaningful discussion. In this article we share the results of the CRESP findings, discuss common themes arising from these interactions, and comment on special considerations needed to facilitate stakeholder and tribal participation in similar decision-making processes. PMID:12611653

Urban environment and children's active lifestyle: softGIS revealing children's behavioral patterns and meaningful places.

PubMed

Kyttä, A Marketta; Broberg, Anna K; Kahila, Maarit H

2012-01-01

To determine the relationship between (1) urban structure characteristics, (2) children's environmental experiences and active behavioral patterns, and (3) perceived health and body mass index (BMI). Cross-sectional study. City of Turku, western coast of Finland, 175,000 inhabitants. Average residential density of the studied settings was 17 housing units per hectare, proportion of green structure 43%, and proportion of population under 15 years old 17%. One thousand eight hundred thirty seven fifth (10-12 years old) and seventh (13-15 years old) graders from 54 schools in Turku. Self-reported behavioral patterns (activity of school travel mode, territorial range, mobility licenses, and distance to meaningful places) and environmental experiences (localized meaningful places, likability index, environmental fears) were gathered on the basis of locality with an Internet-based softGIS method. Self-reported BMI, perceived health, and daily symptoms were also queried. Geographic information system-based measures of urban structure (residential density, proportion of green structure, proportion of children), calculated within a 500-m buffer of each respondent's home, were used as independent variables. Mainly logistic regression analysis. After controlling for gender, age, and neighborhood socioeconomic status (proportion of academically educated), residential density was significantly associated with active travel mode to school and short distances to the meaningful places of children. The proportions of green structure and children had an association with nonactive transport, long distance to meaningful places, and small territorial range. We also found significant associations between active school travel mode and reduced risk of being overweight when controlled for gender and age but not when the proportion of academically educated was also controlled. The negative association between likability index and daily symptoms and positive association with perceived health

Special Collections and the New Web: Using LibGuides to Provide Meaningful Access

ERIC Educational Resources Information Center

Lewis, Barbara; Griffin, Melanie

2011-01-01

Librarians have long struggled to find user-friendly mediums to provide meaningful information to patrons using bibliographies, pathfinders, and subject guides with varying degrees of success. Content management systems, such as Springshare's LibGuides, have recently been developed to facilitate the creation of online subject guides. Special…

Reader Response in Secondary Settings: Increasing Comprehension through Meaningful Interactions with Literary Texts

ERIC Educational Resources Information Center

Woodruff, Amanda H.; Griffin, Robert A.

2017-01-01

A fresh look at the reader response theory to enhance student comprehension through meaningful interactions with literature, this paper explores the instructional implications of a reader response approach in secondary classrooms and examines its role in fostering students' critical reading and thinking skills. The approach promotes transaction…

Stakeholder Engagement to Identify Priorities for Improving the Quality and Value of Critical Care.

PubMed

Stelfox, Henry T; Niven, Daniel J; Clement, Fiona M; Bagshaw, Sean M; Cook, Deborah J; McKenzie, Emily; Potestio, Melissa L; Doig, Christopher J; O'Neill, Barbara; Zygun, David

2015-01-01

Large amounts of scientific evidence are generated, but not implemented into patient care (the 'knowledge-to-care' gap). We identified and prioritized knowledge-to-care gaps in critical care as opportunities to improve the quality and value of healthcare. We used a multi-method community-based participatory research approach to engage a Network of all adult (n = 14) and pediatric (n = 2) medical-surgical intensive care units (ICUs) in a fully integrated geographically defined healthcare system serving 4 million residents. Participants included Network oversight committee members (n = 38) and frontline providers (n = 1,790). Network committee members used a modified RAND/University of California Appropriateness Methodology, to serially propose, rate (validated 9 point scale) and revise potential knowledge-to-care gaps as priorities for improvement. The priorities were sent to frontline providers for evaluation. Results were relayed back to all frontline providers for feedback. Initially, 68 knowledge-to-care gaps were proposed, rated and revised by the committee (n = 32 participants) over 3 rounds of review and resulted in 13 proposed priorities for improvement. Then, 1,103 providers (62% response rate) evaluated the priorities, and rated 9 as 'necessary' (median score 7-9). Several factors were associated with rating priorities as necessary in multivariable logistic regression, related to the provider (experience, teaching status of ICU) and topic (strength of supporting evidence, potential to benefit the patient, potential to improve patient/family experience, potential to decrease costs). A community-based participatory research approach engaged a diverse group of stakeholders to identify 9 priorities for improving the quality and value of critical care. The approach was time and cost efficient and could serve as a model to prioritize areas for research quality improvement across other settings.

Building Employer Capacity to Support Meaningful Employment for Persons with Developmental Disabilities: A Grounded Theory Study of Employment Support Perspectives.

PubMed

Rashid, Marghalara; Hodgetts, Sandra; Nicholas, David

2017-11-01

To explore strategies to build employer capacity to support people with DD in meaningful employment from perspective of employment support workers. A grounded theory study was conducted with 34 employment support individuals. A theoretical sampling approach was used to identify and recruit participants from multiple sites in Ontario and Alberta. Three main themes, with seven sub-themes, emerged: (1) experiences of supporting employment finding for people with DD, (2) institutional influences on employee experiences, and (3) attitudes, assumptions and stigma. Several recommendations related to building employer capacity were offered. Our findings provide insight on specific elements and strategies that can support building employer capacity for persons with DD.

Readiness for Meaningful Use of Health Information Technology and Patient Centered Medical Home Recognition Survey Results

PubMed Central

Shin, Peter; Sharac, Jessica

2013-01-01

Objective Determine the factors that impact HIT use and MU readiness for community health centers (CHCs). Background The HITECH Act allocates funds to Medicaid and Medicare providers to encourage the adoption of electronic health records (EHR), in an effort to improve health care quality and patient outcomes, and to reduce health care costs. Methods We surveyed CHCs on their Readiness for Meaningful Use (MU) of Health Information Technology (HIT) and Patient Centered Medical Home (PCMH) Recognition, then we combined responses with 2009 Uniform Data System data to determine which factors impact use of HIT and MU readiness. Results Nearly 70% of CHCs had full or partial EHR adoption at the time of survey. Results are presented for centers with EHR adoption, by the length of time that their EHR systems have been in operation. PMID:24834365

Exploring Novel Tools for Assessing High School Students' Meaningful Understanding of Organic Reactions

ERIC Educational Resources Information Center

Vachliotis, Theodoros; Salta, Katerina; Vasiliou, Petroula; Tzougraki, Chryssa

2011-01-01

Systemic assessment questions (SAQs) are novel assessment tools used in the context of the Systemic Approach to Teaching and Learning (SATL) model. The purpose of this model is to enhance students' meaningful understanding of scientific concepts by use of constructivist concept mapping procedures, which emphasize the development of systems…

Parent Perceptions of Time Spent Meaningfully by Young Adults with Pervasive Support Needs

ERIC Educational Resources Information Center

Rossetti, Zachary; Lehr, Donna; Lederer, Leslie; Pelerin, Dana; Huang, Shuoxi

2015-01-01

This article describes a qualitative study that examined how 23 young adults with pervasive support needs and limited functional communication spent their time and how their parents (n = 23) and direct support professionals (DSPs; n = 2) defined meaningfulness in relation to the young adults' experiences. Data were collected through…

Identifying positive deviants in healthcare quality and safety: a mixed methods study.

PubMed

O'Hara, Jane K; Grasic, Katja; Gutacker, Nils; Street, Andrew; Foy, Robbie; Thompson, Carl; Wright, John; Lawton, Rebecca

2018-01-01

Objective Solutions to quality and safety problems exist within healthcare organisations, but to maximise the learning from these positive deviants, we first need to identify them. This study explores using routinely collected, publicly available data in England to identify positively deviant services in one region of the country. Design A mixed methods study undertaken July 2014 to February 2015, employing expert discussion, consensus and statistical modelling to identify indicators of quality and safety, establish a set of criteria to inform decisions about which indicators were robust and useful measures, and whether these could be used to identify positive deviants. Setting Yorkshire and Humber, England. Participants None - analysis based on routinely collected, administrative English hospital data. Main outcome measures We identified 49 indicators of quality and safety from acute care settings across eight data sources. Twenty-six indicators did not allow comparison of quality at the sub-hospital level. Of the 23 remaining indicators, 12 met all criteria and were possible candidates for identifying positive deviants. Results Four indicators (readmission and patient reported outcomes for hip and knee surgery) offered indicators of the same service. These were selected by an expert group as the basis for statistical modelling, which supported identification of one service in Yorkshire and Humber showing a 50% positive deviation from the national average. Conclusion Relatively few indicators of quality and safety relate to a service level, making meaningful comparisons and local improvement based on the measures difficult. It was possible, however, to identify a set of indicators that provided robust measurement of the quality and safety of services providing hip and knee surgery.

Building and Sustaining Hope. A Response to "Meaningful Hope for Teachers in a Time of High Anxiety and Low Morale"

ERIC Educational Resources Information Center

Hytten, Kathy

2011-01-01

In this essay, I respond to Carrie Nolan and Sarah M. Stitzlein's article "Meaningful Hope for Teachers in a Time of High Anxiety and Low Morale" and support their argument for meaningful hope grounded in pragmatist philosophy. I agree that while hope is routinely called for in the educational literature, it is often done so in superficial and…

Some hospitals are falling behind in meeting 'meaningful use' criteria and could be vulnerable to penalties in 2015.

PubMed

DesRoches, Catherine M; Worzala, Chantal; Bates, Scott

2013-08-01

With nearly $30 billion in incentives available, it is critical to know to what extent US hospitals have been able to respond to those incentives by adopting electronic health record (EHR) systems that meet Medicare's criteria for their "meaningful use." Medicare has provided aggregate incentive payment data, but still missing is an understanding of how these payments are distributed across hospital types and years. Our analysis of Medicare data found a substantial increase in the percentage of hospitals receiving EHR incentive payments between 2011 (17.4 percent) and 2012 (36.8 percent). However, this increase was not uniform across all hospitals, and the overall proportion of hospitals receiving a payment for meaningful use was low. Critical-access, smaller, and publicly owned or nonprofit hospitals appeared to be at particular risk for failing to meet Medicare's meaningful-use criteria, and the overall proportion of hospitals receiving a payment for meaningful use was low. Starting in 2015, hospitals that fail to meet the criteria will be subject to financial penalties. To address the needs of institutions in danger of incurring these penalties, policy makers could implement targeted grant programs and provide additional information technology workforce support. In addition, the capacity of EHR system vendors should be carefully monitored to ensure that these institutions have access to the technology they need.

Meaningful lives: elders in treatment for depression.

PubMed

Ragan, Meredith; Kane, Catherine F

2010-12-01

Depression among elderly persons is common. Major depression is disabling, highly prevalent, and adversely affects daily function and quality of life. Although studies have demonstrated that interpersonal psychotherapy (IPT) and medication can relieve the symptoms of depression, many elders do not seek treatment. Of those elders who do participate in treatment experience, 20% to 50% do not experience partial or full relief from depressive symptoms. Improvements in treatment strategies are needed to better serve this population. In this study, 20 elders in treatment for depression with IPT and medication were interviewed to better understand their day-to-day lives. These interviews provided insights and perspectives to inform clinical practice and improve treatment strategies. The major themes identified were independence, spirituality, family, depression, medical comorbidities, and motivation. Potential treatment strategies were derived from these themes. Copyright © 2010 Elsevier Inc. All rights reserved.

Shwirl: Meaningful coloring of spectral cube data with volume rendering

NASA Astrophysics Data System (ADS)

Vohl, Dany

2017-04-01

Shwirl visualizes spectral data cubes with meaningful coloring methods. The program has been developed to investigate transfer functions, which combines volumetric elements (or voxels) to set the color, and graphics shaders, functions used to compute several properties of the final image such as color, depth, and/or transparency, as enablers for scientific visualization of astronomical data. The program uses Astropy (ascl:1304.002) to handle FITS files and World Coordinate System, Qt (and PyQt) for the user interface, and VisPy, an object-oriented Python visualization library binding onto OpenGL.

Implementing meaningful, educative curricula, and assessments in complex school environments.

PubMed

Ennis, Catherine D

This commentary uses the lens of curricular implementation to consider issues and opportunities afforded by the papers in this special edition. While it is interesting to envision innovative approaches to physical education, actually implementing changes in the complex institutional school environment is exceptionally challenging. These authors have done an excellent job presenting viable solutions and fore grounding challenges. Yet, without a concerted effort to invite teachers to engage with us in this process, our implementation initiatives may not enhance the meaningful and educative process that these scholars envision for physical education.

Implementing meaningful, educative curricula, and assessments in complex school environments

PubMed Central

Ennis, Catherine D.

2015-01-01

This commentary uses the lens of curricular implementation to consider issues and opportunities afforded by the papers in this special edition. While it is interesting to envision innovative approaches to physical education, actually implementing changes in the complex institutional school environment is exceptionally challenging. These authors have done an excellent job presenting viable solutions and fore grounding challenges. Yet, without a concerted effort to invite teachers to engage with us in this process, our implementation initiatives may not enhance the meaningful and educative process that these scholars envision for physical education. PMID:25960685

Meaningful task-specific training (MTST) for stroke rehabilitation: a randomized controlled trial.

PubMed

Arya, Kamal Narayan; Verma, Rajesh; Garg, R K; Sharma, V P; Agarwal, Monika; Aggarwal, G G

2012-01-01

The upper extremity motor deficit is one of the functional challenges in post stroke patients. The objective of the present study was to evaluate the effectiveness of the meaningful task-specific training (MTST) on the upper extremity motor recovery during the subacute phase after a stroke. This was a randomized, controlled, double-blinded trial in the neurology department of a university hospital and occupational therapy unit of a rehabilitation institute. A convenience sample of 103 people, 4 to 24 weeks (mean, 12.15 weeks) after the stroke, was randomized into 2 groups (MTST, 51; standard training group, 52). Subjects in the Brunnstrom stage of arm recovery of 2 to 5 were included in the study. Ninety-five participants completed the 8-week follow-up. Participants were assigned to receive either the MTST or dose-matched standard training program based on the Brunnstrom stage and Bobath neurodevelopmental technique, 4 to 5 days a week for 4 weeks. Fugl-Meyer assessment (FMA), Action Research Arm Test (ARAT), Graded Wolf Motor Function Test (GWMFT), and Motor Activity Log (MAL) were outcome measures The MTST group showed a positive improvement in the mean scores on the outcome measures at post and follow-up assessments in comparison to the control group. Further, statistically significant differences were observed in changes between the groups at post and follow-up assessment for FMA, ARAT, GWMFT, and MAL. The MTST produced statistically significant and clinically relevant improvements in the upper extremity motor recovery of the patients who had a subacute stroke.

Meaningful Use of Data in Care Coordination by the Advanced Practice Registered Nurse: The TeleFamilies Project

PubMed Central

Looman, Wendy S.; Erickson, Mary M.; Garwick, Ann W.; Cady, Rhonda G.; Kelly, Anne; Pettey, Carrie; Finkelstein, Stanley M.

2012-01-01

Meaningful use of electronic health records to coordinate care requires skillful synthesis and integration of subjective and objective data by practitioners to provide context for information. This is particularly relevant in the coordination of care for children with complex special health care needs. The purpose of this paper is to present a conceptual framework and example of meaningful use within an innovative telenursing intervention to coordinate care for children with complex special health care needs. The TeleFamilies intervention engages an advanced practice nurse in a full-time care coordinator role within an existing hospital-based medical home for children with complex special health care needs. Care coordination is facilitated by the synthesis and integration of internal and external data using an enhanced electronic health record and telehealth encounters via telephone and videoconferencing between the advanced practice nurse and the family at home. The advanced practice nurse’s ability to maintain an updated plan of care that is shared across providers and systems and build a relationship over time with the patient and family supports meaningful use of these data. PMID:22948406

The hepatitis C cascade of care: identifying priorities to improve clinical outcomes.

PubMed

Linas, Benjamin P; Barter, Devra M; Leff, Jared A; Assoumou, Sabrina A; Salomon, Joshua A; Weinstein, Milton C; Kim, Arthur Y; Schackman, Bruce R

2014-01-01

As highly effective hepatitis C virus (HCV) therapies emerge, data are needed to inform the development of interventions to improve HCV treatment rates. We used simulation modeling to estimate the impact of loss to follow-up on HCV treatment outcomes and to identify intervention strategies likely to provide good value for the resources invested in them. We used a Monte Carlo state-transition model to simulate a hypothetical cohort of chronically HCV-infected individuals recently screened positive for serum HCV antibody. We simulated four hypothetical intervention strategies (linkage to care; treatment initiation; integrated case management; peer navigator) to improve HCV treatment rates, varying efficacies and costs, and identified strategies that would most likely result in the best value for the resources required for implementation. Sustained virologic responses (SVRs), life expectancy, quality-adjusted life expectancy (QALE), costs from health system and program implementation perspectives, and incremental cost-effectiveness ratios (ICERs). We estimate that imperfect follow-up reduces the real-world effectiveness of HCV therapies by approximately 75%. In the base case, a modestly effective hypothetical peer navigator program maximized the number of SVRs and QALE, with an ICER compared to the next best intervention of $48,700/quality-adjusted life year. Hypothetical interventions that simultaneously addressed multiple points along the cascade provided better outcomes and more value for money than less costly interventions targeting single steps. The 5-year program cost of the hypothetical peer navigator intervention was $14.5 million per 10,000 newly diagnosed individuals. We estimate that imperfect follow-up during the HCV cascade of care greatly reduces the real-world effectiveness of HCV therapy. Our mathematical model shows that modestly effective interventions to improve follow-up would likely be cost-effective. Priority should be given to developing and

25 CFR 170.501 - What happens when the review process identifies areas for improvement?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false What happens when the review process identifies areas for improvement? 170.501 Section 170.501 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN RESERVATION ROADS PROGRAM Planning, Design, and Construction of Indian Reservation Roads...

Does Constructivist Approach Applicable through Concept Maps to Achieve Meaningful Learning in Science?

ERIC Educational Resources Information Center

Jena, Ananta Kumar

2012-01-01

This study deals with the application of constructivist approach through individual and cooperative modes of spider and hierarchical concept maps to achieve meaningful learning on science concepts (e.g. acids, bases & salts, physical and chemical changes). The main research questions were: Q (1): is there any difference in individual and…

Sources of Meaningfulness in the Workplace: A Study in the US Hospitality Sector

ERIC Educational Resources Information Center

Dimitrov, Danielle

2012-01-01

Purpose: The purpose of this paper is to explore the sources of meaningfulness at the workplace, according to the perceptions of hospitality employees from different national cultures in one US-based hotel, based on Dimitrov's empirical study about the features of the humane organization. Design/methodology/approach: This was an exploratory…

Measuring Meaningful Learning in the Undergraduate Chemistry Laboratory: A National, Cross-Sectional Study

ERIC Educational Resources Information Center

Galloway, Kelli R.; Bretz, Stacey Lowery

2015-01-01

Research on laboratory learning points to the need to better understand what and how students learn in the undergraduate chemistry laboratory. The Meaningful Learning in the Laboratory Instrument (MLLI) was administered to general and organic chemistry students from 15 colleges and universities across the United States in order to measure the…

Representing and Practising Meaningful Differences in a Well-Structured but Complex Art Curriculum

ERIC Educational Resources Information Center

Cunliffe, Leslie

2010-01-01

This paper conceptualizes the secondary art curriculum as a well-structured but complex knowledge-domain, with the aim of emphasizing meaningful differences in the way creative grammar operates in the following gatherings of art practices: Pre-historic and non-European cultures; Ancient and European cultures before c. 1800; Romantic and Modern…

Towards a mathematical theory of meaningful communication

NASA Astrophysics Data System (ADS)

Corominas-Murtra, Bernat; Fortuny, Jordi; Solé, Ricard V.

2014-04-01

Meaning has been left outside most theoretical approaches to information in biology. Functional responses based on an appropriate interpretation of signals have been replaced by a probabilistic description of correlations between emitted and received symbols. This assumption leads to potential paradoxes, such as the presence of a maximum information associated to a channel that creates completely wrong interpretations of the signals. Game-theoretic models of language evolution and other studies considering embodied communicating agents show that the correct (meaningful) match resulting from agent-agent exchanges is always achieved and natural systems obviously solve the problem correctly. Inspired by the concept of duality of the communicative sign stated by the swiss linguist Ferdinand de Saussure, here we present a complete description of the minimal system necessary to measure the amount of information that is consistently decoded. Several consequences of our developments are investigated, such as the uselessness of a certain amount of information properly transmitted for communication among autonomous agents.

Achieving meaningful use: a health system perspective.

PubMed

Bero, Cynthia L; Lee, Thomas H

2010-12-01

In 2002, Partners HealthCare (Partners) launched a strategy to accelerate the use of ambulatory electronic medical records across its network of 6000 physicians. Through focus on quality software products, creation of a system of financial incentives, and active engagement of health system leadership, Partners reached high levels of physician adoption by late 2006. Partners eventually introduced a mandate that made ambulatory electronic medical record use a requirement for all of its physicians. During this multi-year initiative, Partners also focused on the effective use of electronic medical records and introduced a series of tactics designed to optimize the use of these systems. With introduction of the meaningful-use concepts in the Health Information Technology for Economic and Clinical Health (HITECH) Act, Partners will transition its efforts toward this important national priority. Partners' experience offers some unique insights into the process of electronic medical record adoption across a large, diverse health system.

Establishing a portfolio of quality-improvement projects in pediatric surgery through advanced improvement leadership systems.

PubMed

Gerrein, Betsy T; Williams, Christina E; Von Allmen, Daniel

2013-01-01

Formal quality-improvement (QI) projects require that participants are educated in QI methods to provide them with the capability to carry out successful, meaningful work. However, orchestrating a portfolio of projects that addresses the strategic mission of the institution requires an extension of basic QI training to provide the division or business unit with the capacity to successfully develop and manage the portfolio. Advanced Improvement Leadership Systems is a program to help units create a meaningful portfolio. This program, used by the Division of Pediatric General and Thoracic Surgery at Cincinnati Children's Hospital Medical Center, helped establish a portfolio of targeted QI projects designed to achieve outstanding outcomes at competitive costs in multiple clinical areas aligned with the institution's strategic goals (improve disease-based outcomes, patient safety, flow, and patient and family experience). These objectives are addressed in an institutional strategic plan built around 5 core areas: Safety, Productivity, Care Coordination and Outcomes, Patient and Family Experience, and Value. By combining the portfolio of QI projects with improvements in the divisional infrastructure, effective improvement efforts were realized throughout the division. In the 9 months following the program, divisional capability resulted in a 16.5% increase (5.7% to 22.2%) of formally trained staff working on 10 QI teams. Concurrently, a leadership team, designed to coordinate projects, remove barriers, and provide technical support, provided the capacity to pursue this ongoing effort. The Advanced Improvement Leadership Systems program increased the Division's efficiency and effectiveness in pursing the QI mission that is integral at our hospital.

Establishing a Portfolio of Quality-Improvement Projects in Pediatric Surgery through Advanced Improvement Leadership Systems

PubMed Central

Gerrein, Betsy T; Williams, Christina E; von Allmen, Daniel

2013-01-01

Formal quality-improvement (QI) projects require that participants are educated in QI methods to provide them with the capability to carry out successful, meaningful work. However, orchestrating a portfolio of projects that addresses the strategic mission of the institution requires an extension of basic QI training to provide the division or business unit with the capacity to successfully develop and manage the portfolio. Advanced Improvement Leadership Systems is a program to help units create a meaningful portfolio. This program, used by the Division of Pediatric General and Thoracic Surgery at Cincinnati Children’s Hospital Medical Center, helped establish a portfolio of targeted QI projects designed to achieve outstanding outcomes at competitive costs in multiple clinical areas aligned with the institution’s strategic goals (improve disease-based outcomes, patient safety, flow, and patient and family experience). These objectives are addressed in an institutional strategic plan built around 5 core areas: Safety, Productivity, Care Coordination and Outcomes, Patient and Family Experience, and Value. By combining the portfolio of QI projects with improvements in the divisional infrastructure, effective improvement efforts were realized throughout the division. In the 9 months following the program, divisional capability resulted in a 16.5% increase (5.7% to 22.2%) of formally trained staff working on 10 QI teams. Concurrently, a leadership team, designed to coordinate projects, remove barriers, and provide technical support, provided the capacity to pursue this ongoing effort. The Advanced Improvement Leadership Systems program increased the Division’s efficiency and effectiveness in pursing the QI mission that is integral at our hospital. PMID:24361020

Spectral embedding finds meaningful (relevant) structure in image and microarray data

PubMed Central

Higgs, Brandon W; Weller, Jennifer; Solka, Jeffrey L

2006-01-01

Background Accurate methods for extraction of meaningful patterns in high dimensional data have become increasingly important with the recent generation of data types containing measurements across thousands of variables. Principal components analysis (PCA) is a linear dimensionality reduction (DR) method that is unsupervised in that it relies only on the data; projections are calculated in Euclidean or a similar linear space and do not use tuning parameters for optimizing the fit to the data. However, relationships within sets of nonlinear data types, such as biological networks or images, are frequently mis-rendered into a low dimensional space by linear methods. Nonlinear methods, in contrast, attempt to model important aspects of the underlying data structure, often requiring parameter(s) fitting to the data type of interest. In many cases, the optimal parameter values vary when different classification algorithms are applied on the same rendered subspace, making the results of such methods highly dependent upon the type of classifier implemented. Results We present the results of applying the spectral method of Lafon, a nonlinear DR method based on the weighted graph Laplacian, that minimizes the requirements for such parameter optimization for two biological data types. We demonstrate that it is successful in determining implicit ordering of brain slice image data and in classifying separate species in microarray data, as compared to two conventional linear methods and three nonlinear methods (one of which is an alternative spectral method). This spectral implementation is shown to provide more meaningful information, by preserving important relationships, than the methods of DR presented for comparison. Tuning parameter fitting is simple and is a general, rather than data type or experiment specific approach, for the two datasets analyzed here. Tuning parameter optimization is minimized in the DR step to each subsequent classification method, enabling the

Improving Teaching, One Conversation at a Time

ERIC Educational Resources Information Center

Arneson, Shelly

2015-01-01

Both speaking and listening are essential to effective communication. Unfortunately, meaningful two-way exchanges are largely absent from conversations about improving professional practice. Instead, many teachers say that they feel the observation and evaluation process is something that is done "to" them--at the post-observation…

Meaningful Understanding and Systems Thinking in Organic Chemistry: Validating Measurement and Exploring Relationships

ERIC Educational Resources Information Center

Vachliotis, Theodoros; Salta, Katerina; Tzougraki, Chryssa

2014-01-01

The purpose of this study was dual: First, to develop and validate assessment schemes for assessing 11th grade students' meaningful understanding of organic chemistry concepts, as well as their systems thinking skills in the domain. Second, to explore the relationship between the two constructs of interest based on students' performance…

Moving beyond the Barriers: Supporting Meaningful Teacher Collaboration to Improve Secondary School Mathematics

ERIC Educational Resources Information Center

Jao, Limin; McDougall, Doug

2016-01-01

The Collaborative Teacher Inquiry Project was a professional development initiative that sought to improve the teaching and learning of Grade 9 Applied mathematics by encouraging teachers to work collaboratively. The project brought together Grade 9 Applied mathematics teachers from 11 schools across four neighboring public school boards in the…

The Volunteering-in-Place (VIP) Program: Providing meaningful volunteer activity to residents in assisted living with mild cognitive impairment.

PubMed

Klinedinst, N Jennifer; Resnick, Barbara

2016-01-01

The Volunteering-in-Place (VIP) Program was developed to provide individualized meaningful volunteer activities matched to interests and capabilities for older adults with MCI in assisted living. The purposes of this single-site pre-test/post-test pilot study were to (1) establish feasibility of the VIP Program based on treatment fidelity (design, treatment, delivery, enactment); and (2) evaluate preliminary efficacy via improvement in psychological health (depressive symptoms, usefulness, purpose, resilience, and life satisfaction) and decreased sedentary activity (survey and Fitbit) at 3 and 6 months. Ten residents participated. The majority was white, female and educated, and on average 88 years old. The VIP Program was feasible and most participants continued to volunteer at 6 months. There were non-significant improvements in depressive symptoms, usefulness, purpose, resilience and recreational physical activity. The results of this study provide support for the feasibility of the VIP Program. Further study is necessary to examine efficacy. Copyright © 2016 Elsevier Inc. All rights reserved.

The Meaningful Roles Intervention: An Evolutionary Approach to Reducing Bullying and Increasing Prosocial Behavior.

PubMed

Ellis, Bruce J; Volk, Anthony A; Gonzalez, Jose-Michael; Embry, Dennis D

2016-12-01

Bullying is a problem that affects adolescents worldwide. Efforts to prevent bullying have been moderately successful at best, or iatrogenic at worst. We offer an explanation for this limited success by employing an evolutionary-psychological perspective to analyze antibullying interventions. We argue that bullying is a goal-directed behavior that is sensitive to benefits as well as costs, and that interventions must address these benefits. This perspective led us to develop a novel antibullying intervention, Meaningful Roles, which offers bullies prosocial alternatives-meaningful roles and responsibilities implemented through a school jobs program and reinforced through peer-to-peer praise notes-that effectively meet the same status goals as bullying behavior. We describe this new intervention and how its theoretical evolutionary roots may be applicable to other intervention programs. © 2015 The Authors. Journal of Research on Adolescence © 2015 Society for Research on Adolescence.

In search for genetic determinants of clinically meaningful differential cardiovascular event reduction by pravastatin in the PHArmacogenetic study of Statins in the Elderly at risk (PHASE)/PROSPER study.

PubMed

Postmus, Iris; Johnson, Paul C D; Trompet, Stella; de Craen, Anton J M; Slagboom, P Eline; Devlin, James J; Shiffman, Dov; Sacks, Frank M; Kearney, Patricia M; Stott, David J; Buckley, Brendan M; Sattar, Naveed; Ford, Ian; Westendorp, Rudi G J; Jukema, J Wouter

2014-07-01

Statin therapy is widely used in the prevention and treatment of cardiovascular events and is associated with significant risk reductions. However, there is considerable variation in response to statin therapy both in terms of LDL cholesterol reduction and clinical outcomes. It has been hypothesized that genetic variation contributes importantly to this individual drug response. We investigated the interaction between genetic variants and pravastatin or placebo therapy on the incidence of cardiovascular events by performing a genome-wide association study in the participants of the PROspective Study of Pravastatin in the Elderly at Risk for vascular disease--PHArmacogenetic study of Statins in the Elderly at risk (PROSPER/PHASE) study (n = 5244). We did not observe genome-wide significant associations with a clinically meaningful differential cardiovascular event reduction by pravastatin therapy. In addition, SNPs with p-values lower than 1 × 10(-4) were assessed for replication in a case-only analysis within two randomized placebo controlled pravastatin trials, CARE (n = 711) and WOSCOPS (n = 522). rs7102569, on chromosome 11 near the ODZ4 gene, was replicated in the CARE study (p = 0.008), however the direction of effect was opposite. This SNP was not associated in WOSCOPS. In addition, none of the SNPs replicated significantly after correcting for multiple testing. We could not identify genetic variation that was significantly associated at genome-wide level with a clinically meaningful differential event reduction by pravastatin treatment in a large prospective study. We therefore assume that in daily practice the use of genetic characteristics to personalize pravastatin treatment to improve prevention of cardiovascular disease will be limited. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Making space for belonging: critical reflections on the implementation of personalised adult social care under the veil of meaningful inclusion.

PubMed

Power, Andrew

2013-07-01

This paper critically reflects on the way in which recent adult social care reform has been evolving beneath the alleged policy goal of prioritising the cultivation of meaningful inclusion and 'belonging' in the community. With this goal, there has been a focus away from 'services' for persons with intellectual disabilities, to supporting natural connections within the community. This paper draws on a grounded theory study of the perspectives of those responsible for overseeing community living arrangements for persons with disabilities, drawing on interviews and focus groups with service providers and relevant government officials. It examines the socio-spatial implications of the gradual shift towards 'belonging' as a disability policy goal, as it has evolved in two discrete settings - British Columbia, Canada and Ireland. The findings identify the complexities involved in facilitating active community connection for persons with intellectual disabilities and reveal important cautionary lessons for other jurisdictions where community living policy has arguably been moving away from communal services towards self-managed supports in 'real' communities through personal budgets in an effort to remove barriers to participation. The paper thus critically reflects on the rapid pursuit for transformation in personalised adult social care in government policy, arguing that the process of fostering meaningful community inclusion will and should take time. Copyright © 2013 Elsevier Ltd. All rights reserved.

Actual evapotranspiration and deficit: Biologically meaningful correlates of vegetation distribution across spatial scales

USGS Publications Warehouse

Stephenson, N.L.

1998-01-01

Correlative approaches to understanding the climatic controls of vegetation distribution have exhibited at least two important weaknesses: they have been conceptually divorced across spatial scales, and their climatic parameters have not necessarily represented aspects of climate of broad physiological importance to plants. Using examples from the literature and from the Sierra Nevada of California, I argue that two water balance parameters-actual evapotranspiration (AET) and deficit (D)-are biologically meaningful, are well correlated with the distribution of vegetation types, and exhibit these qualities over several orders of magnitude of spatial scale (continental to local). I reach four additional conclusions. (1) Some pairs of climatic parameters presently in use are functionally similar to AET and D; however, AET and D may be easier to interpret biologically. (2) Several well-known climatic parameters are biologically less meaningful or less important than AET and D, and consequently are poorer correlates of the distribution of vegetation types. Of particular interest, AET is a much better correlate of the distributions of coniferous and deciduous forests than minimum temperature. (3) The effects of evaporative demand and water availability on a site's water balance are intrinsically different. For example, the 'dry' experienced by plants on sunward slopes (high evaporative demand) is not comparable to the 'dry' experienced by plants on soils with low water-holding capacities (low water availability), and these differences are reflected in vegetation patterns. (4) Many traditional topographic moisture scalars-those that additively combine measures related to evaporative demand and water availability are not necessarily meaningful for describing site conditions as sensed by plants; the same holds for measured soil moisture. However, using AET and D in place of moisture scalars and measured soil moisture can solve these problems.

Callings, Work Role Fit, Psychological Meaningfulness and Work Engagement among Teachers in Zambia

ERIC Educational Resources Information Center

Rothmann, Sebastiaan; Hamukang'andu, Lukondo

2013-01-01

Our aim in this study was to investigate the relationships among a calling orientation, work role fit, psychological meaningfulness and work engagement of teachers in Zambia. A quantitative approach was followed and a cross-sectional survey was used. The sample (n = 150) included 75 basic and 75 secondary school teachers in the Choma district of…

Meaningful Informed Consent with Young Children: Looking Forward through an Interactive Narrative Approach

ERIC Educational Resources Information Center

Mayne, Fiona; Howitt, Christine; Rennie, Léonie

2016-01-01

Ideas about ethical research with young children are evolving at a rapid rate. Not only can young children participate in the informed consent process, but researchers now also recognize that the process must be meaningful for them. As part of a larger study, this article reviews children's rights and informed consent literature as the foundation…

Meaningful Learning from Practice: Web-Based Video in Professional Preparation Programmes in University

ERIC Educational Resources Information Center

Admiraal, Wilfried

2014-01-01

Web-based video is one of the technologies which can support meaningful learning from practice--in addition to practical benefits such as accessibility of practices, flexibility in updating information, and incorporating video into multimedia resources. A multiple case study was set up on the use of a web-based video learning environment in two…

A Mixed-Methods Study of the Recovery Concept, "A Meaningful Day," in Community Mental Health Services for Individuals with Serious Mental Illnesses.

PubMed

Myers, Neely A L; Smith, Kelly; Pope, Alicia; Alolayan, Yazeed; Broussard, Beth; Haynes, Nora; Compton, Michael T

2016-10-01

The recovery concept encompasses overcoming or managing one's illness, being physically and emotionally healthy, and finding meaningful purpose through work, school, or volunteering, which connects one to others in mutually fulfilling ways. Using a mixed-methods approach, we studied the emphasis on "a meaningful day" in the new Opening Doors to Recovery (ODR) program in southeast Georgia. Among 100 participants, we measured the meaningful day construct using three quantitative items at baseline (hospital discharge) and at 4-, 8-, and 12-month follow-up, finding statistically significant linear trends over time for all three measures. Complementary qualitative interviews with 30 individuals (ODR participants, family members, and ODR's Community Navigation Specialists and program leaders) revealed themes pertaining to companionship, productivity, achieving stability, and autonomy, as well as the concern about insufficient resources. The concept of "a meaningful day" can be a focus of clinical attention and measured as a person-centered outcome for clients served by recovery-oriented community mental health services.

Engaging police to identify challenging school crossings and potential improvements.

PubMed

Bull, Catherine B; Von Hagen, Leigh Ann; Lubin, Andrea; Shivaraman, Gayathri; Chibbaro, Daniel

2018-04-26

This paper discusses the value of police officers as vital sources of information regarding pedestrian safety in their communities by presenting results from a survey of traffic safety police officers. The survey requested information on school crossings that the officers considered most challenging for pedestrians. Officers specified the intersections or mid-block locations with school crossings, and answered questions about elements of the locations, such as what makes the locations challenging, and what might be done to improve conditions at these locations. A key finding from the survey is the police officers' identification of challenging intersections or other crossing locations by criteria other than the occurrence of crashes, including reported pedestrian-vehicle near-miss incidents. A broad literature review of pedestrian safety studies provides context for the use of near-miss data in discussions of improvements to pedestrian crossings. Although not typically considered a primary resource for pedestrian safety information, police officers are most often very familiar with their communities, work in locations where pedestrian and motor vehicle traffic can be experienced and observed, and receive information from their staff and members of the public who use pedestrian crossings. The survey findings demonstrate that police officer insights and near-miss data may serve as important supplementary sources of information in the effort to identify locations in need of interventions before crash occurrence. Copyright © 2018 Elsevier Ltd. All rights reserved.

Development of methodologies and procedures for identifying STS users and uses

NASA Technical Reports Server (NTRS)

Archer, J. L.; Beauchamp, N. A.; Macmichael, D. C.

1974-01-01

A study was conducted to identify new uses and users of the new Space Transporation System (STS) within the domestic government sector. The study develops a series of analytical techniques and well-defined functions structured as an integrated planning process to assure efficient and meaningful use of the STS. The purpose of the study is to provide NASA with the following functions: (1) to realize efficient and economic use of the STS and other NASA capabilities, (2) to identify new users and uses of the STS, (3) to contribute to organized planning activities for both current and future programs, and (4) to air in analyzing uses of NASA's overall capabilities.

Persistent Identifiers for Improved Accessibility for Linked Data Querying

NASA Astrophysics Data System (ADS)

Shepherd, A.; Chandler, C. L.; Arko, R. A.; Fils, D.; Jones, M. B.; Krisnadhi, A.; Mecum, B.

2016-12-01

The adoption of linked open data principles within the geosciences has increased the amount of accessible information available on the Web. However, this data is difficult to consume for those who are unfamiliar with Semantic Web technologies such as Web Ontology Language (OWL), Resource Description Framework (RDF) and SPARQL - the RDF query language. Consumers would need to understand the structure of the data and how to efficiently query it. Furthermore, understanding how to query doesn't solve problems of poor precision and recall in search results. For consumers unfamiliar with the data, full-text searches are most accessible, but not ideal as they arrest the advantages of data disambiguation and co-reference resolution efforts. Conversely, URI searches across linked data can deliver improved search results, but knowledge of these exact URIs may remain difficult to obtain. The increased adoption of Persistent Identifiers (PIDs) can lead to improved linked data querying by a wide variety of consumers. Because PIDs resolve to a single entity, they are an excellent data point for disambiguating content. At the same time, PIDs are more accessible and prominent than a single data provider's linked data URI. When present in linked open datasets, PIDs provide balance between the technical and social hurdles of linked data querying as evidenced by the NSF EarthCube GeoLink project. The GeoLink project, funded by NSF's EarthCube initiative, have brought together data repositories include content from field expeditions, laboratory analyses, journal publications, conference presentations, theses/reports, and funding awards that span scientific studies from marine geology to marine ecosystems and biogeochemistry to paleoclimatology.

Identifiability of PBPK Models with Applications to ...

EPA Pesticide Factsheets

Any statistical model should be identifiable in order for estimates and tests using it to be meaningful. We consider statistical analysis of physiologically-based pharmacokinetic (PBPK) models in which parameters cannot be estimated precisely from available data, and discuss different types of identifiability that occur in PBPK models and give reasons why they occur. We particularly focus on how the mathematical structure of a PBPK model and lack of appropriate data can lead to statistical models in which it is impossible to estimate at least some parameters precisely. Methods are reviewed which can determine whether a purely linear PBPK model is globally identifiable. We propose a theorem which determines when identifiability at a set of finite and specific values of the mathematical PBPK model (global discrete identifiability) implies identifiability of the statistical model. However, we are unable to establish conditions that imply global discrete identifiability, and conclude that the only safe approach to analysis of PBPK models involves Bayesian analysis with truncated priors. Finally, computational issues regarding posterior simulations of PBPK models are discussed. The methodology is very general and can be applied to numerous PBPK models which can be expressed as linear time-invariant systems. A real data set of a PBPK model for exposure to dimethyl arsinic acid (DMA(V)) is presented to illustrate the proposed methodology. We consider statistical analy

Belief system, meaningfulness, and psychopathology associated with suicidality among Chinese college students: a cross-sectional survey.

PubMed

Zhao, Jiubo; Yang, Xueling; Xiao, Rong; Zhang, Xiaoyuan; Aguilera, Diane; Zhao, Jingbo

2012-08-17

Research suggests that Chinese religious believers are more likely to commit suicide than those identifying as non-religious among rural young adults, contrary to findings in Western countries. However, one cannot conclude that religiosity is associated with elevated suicide risk without examining the effect of political and religious beliefs in a generally atheist country like China where political belief plays a dominant role in the belief system of young adults. The present study investigated the effects of political and religious belief on suicidality with meaningfulness and psychopathology as potential mediators in a large representative sample of Chinese college students. A cross-sectional survey was conducted among 1390 first-year college students randomly sampled from 10 colleges and universities in mainland China. A total of 1168 respondents (84.0%) provided complete data on all variables. Lifetime prevalence of suicidal ideation, plan, and attempt were 45.1%, 6.8%, and 1.9% respectively, with one-year suicidal ideation showing at 19.3%. Female gender was associated with elevated risk of suicidality. Political belief but not religious belief was associated with decreased suicide risk. A significant interactive effect of political belief and religious belief was found, indicating that for political believers, being religious was associated with decreased suicide risk; for non-political believers, being religious was associated with increased suicide risk. Multi-group structural equation modeling showed that meaningfulness completely mediated and psychopathology partially mediated the effect of belief system on suicidality. Gender differences were found in pathways of political belief by religious beliefs to suicidality and political belief to psychopathology. The coefficients were significant for males but not for females. In less religious societies, political belief may serve as a means of integration as does religious affiliation in religious societies

Reactive and proactive aggression as meaningful distinctions at the variable and person level in primary school-aged children.

PubMed

Carroll, Annemaree; McCarthy, Molly; Houghton, Stephen; Sanders O'Connor, Emma; Zadow, Corinne

2018-04-24

Reactive and proactive aggression is a dichotomous classification of aggression in adults and children. This distinction has been supported by a number of variable-based and factor analytic studies. Due to high inter-correlations, however, the reactive-proactive aggression distinction may not be entirely useful for understanding how group or individual aggressive behavior varies in children and adolescents. Drawing on a sample of primary school-aged children (N = 242) aged 7-12 years, this study sought to determine whether reactive and proactive aggression could be distinguished at the variable-level and the person-level in children. Exploratory Factor Analysis of data from an aggression instrument measuring both functions and forms of aggression, found a two-factor construct of aggression constituted by a reactive and proactive aggression factor. A person-based analysis was then conducted after classifying children according to the presence of reactive and/or proactive aggression. Discriminant function analysis was used to discern whether classifications on the basis of aggression function produced meaningful distinctions in terms of antisocial traits and emotional valence and intensity measures. Two functions were identified which distinguished children with different combinations of reactive and proactive aggression. Reactive-only aggressive children were defined primarily by high levels of impulsivity, while proactive-only children were defined primarily by higher levels of antisocial traits. Children high in both types of aggression exhibited both the presence of antisocial traits and impulsivity. Contrary to recent findings, this suggests that differences in aggression functions remain meaningful at the person level in children. Implications for interventions are discussed. © 2018 Wiley Periodicals, Inc.

Mutually Beneficial Foreign Language Learning: Creating Meaningful Interactions through Video-Synchronous Computer-Mediated Communication

ERIC Educational Resources Information Center

Kato, Fumie; Spring, Ryan; Mori, Chikako

2016-01-01

Providing learners of a foreign language with meaningful opportunities for interactions, specifically with native speakers, is especially challenging for instructors. One way to overcome this obstacle is through video-synchronous computer-mediated communication tools such as Skype software. This study reports quantitative and qualitative data from…

University Students' English Language Improvements through a Content-Based Course

ERIC Educational Resources Information Center

Gómez Flórez, Erica; Jiménez Díaz, Jhon Jaime; Lopera, Sergio Alonso

2011-01-01

Content-Based Instruction (CBI) may result in improved proficiency in language skills due to the meaningful combination of subject matter and foreign language as a means of communication. This paper shows how university students improved their level of English by means of a content methodology as they attended a course called Topics in Molecular…

Where language meets meaningful action: a combined behavior and lesion analysis of aphasia and apraxia.

PubMed

Weiss, Peter H; Ubben, Simon D; Kaesberg, Stephanie; Kalbe, Elke; Kessler, Josef; Liebig, Thomas; Fink, Gereon R

2016-01-01

It is debated how language and praxis are co-represented in the left hemisphere (LH). As voxel-based lesion-symptom mapping in LH stroke patients with aphasia and/or apraxia may contribute to this debate, we here investigated the relationship between language and praxis deficits at the behavioral and lesion levels in 50 sub-acute stroke patients. We hypothesized that language and (meaningful) action are linked via semantic processing in Broca's region. Behaviorally, half of the patients suffered from co-morbid aphasia and apraxia. While 24% (n = 12) of all patients exhibited aphasia without apraxia, apraxia without aphasia was rare (n = 2, 4%). Left inferior frontal, insular, inferior parietal, and superior temporal lesions were specifically associated with deficits in naming, reading, writing, or auditory comprehension. In contrast, lesions affecting the left inferior frontal gyrus, premotor cortex, and the central region as well as the inferior parietal lobe were associated with apraxic deficits (i.e., pantomime, imitation of meaningful and meaningless gestures). Thus, contrary to the predictions of the embodied cognition theory, lesions to sensorimotor and premotor areas were associated with the severity of praxis but not language deficits. Lesions of Brodmann area (BA) 44 led to combined apraxic and aphasic deficits. Data suggest that BA 44 acts as an interface between language and (meaningful) action thereby supporting parcellation schemes (based on connectivity and receptor mapping) which revealed a BA 44 sub-area involved in semantic processing.

Identifying spatially similar gene expression patterns in early stage fruit fly embryo images: binary feature versus invariant moment digital representations

PubMed Central

Gurunathan, Rajalakshmi; Van Emden, Bernard; Panchanathan, Sethuraman; Kumar, Sudhir

2004-01-01

Background Modern developmental biology relies heavily on the analysis of embryonic gene expression patterns. Investigators manually inspect hundreds or thousands of expression patterns to identify those that are spatially similar and to ultimately infer potential gene interactions. However, the rapid accumulation of gene expression pattern data over the last two decades, facilitated by high-throughput techniques, has produced a need for the development of efficient approaches for direct comparison of images, rather than their textual descriptions, to identify spatially similar expression patterns. Results The effectiveness of the Binary Feature Vector (BFV) and Invariant Moment Vector (IMV) based digital representations of the gene expression patterns in finding biologically meaningful patterns was compared for a small (226 images) and a large (1819 images) dataset. For each dataset, an ordered list of images, with respect to a query image, was generated to identify overlapping and similar gene expression patterns, in a manner comparable to what a developmental biologist might do. The results showed that the BFV representation consistently outperforms the IMV representation in finding biologically meaningful matches when spatial overlap of the gene expression pattern and the genes involved are considered. Furthermore, we explored the value of conducting image-content based searches in a dataset where individual expression components (or domains) of multi-domain expression patterns were also included separately. We found that this technique improves performance of both IMV and BFV based searches. Conclusions We conclude that the BFV representation consistently produces a more extensive and better list of biologically useful patterns than the IMV representation. The high quality of results obtained scales well as the search database becomes larger, which encourages efforts to build automated image query and retrieval systems for spatial gene expression patterns

Achieving meaningful mathematics literacy for students with learning disabilities. Cognition and Technology Group at Vanderbilt.

PubMed

Goldman, S R; Hasselbring, T S

1997-01-01

In this article we consider issues relevant to the future of mathematics instruction and achievement for students with learning disabilities. The starting point for envisioning the future is the changing standards for mathematics learning and basic mathematical literacy. We argue that the shift from behaviorist learning theories to constructivist and social constructivist theories (see Rivera, this series) provides an opportunity to develop and implement a hybrid model of mathematics instruction. The hybrid model we propose embeds, or situates, important skill learning in meaningful contexts. We discuss some examples of instructional approaches to complex mathematical problem solving that make use of meaningful contexts. Evaluation data on these approaches have yielded positive and encouraging results for students with learning disabilities as well as general education students. Finally, we discuss various ways in which technology is important for realizing hybrid instructional models in mathematics.

Parent Involvement in Meaningful Post-School Experiences for Young Adults With IDD and Pervasive Support Needs.

PubMed

Rossetti, Zachary; Lehr, Donna; Pelerin, Dana; Huang, Shuoxi; Lederer, Leslie

2016-08-01

Despite initiatives supporting young adults with intellectual and developmental disabilities (IDD) to engage in post-secondary education and integrated employment, those with more intensive support needs are not as easily involved in these post-school experiences. In an effort to learn from positive examples, we examined parent involvement in meaningful post-school experiences by eight young adults with IDD and pervasive support needs. Secondary analysis of data from a prior interview study yielded this smaller sample of eight young adults with meaningful post-school experiences. Their parents were actively involved as fierce advocates and creative problem solvers. The active involvement of parents included: a) attitudinal facilitators, b) advocacy efforts and perceptions, and c) strategic actions. Implications for future research and practice are described.

Category-contingent face adaptation for novel colour categories: Contingent effects are seen only after social or meaningful labelling.

PubMed

Little, Anthony C; DeBruine, Lisa M; Jones, Benedict C

2011-01-01

A face appears normal when it approximates the average of a population. Consequently, exposure to faces biases perceptions of subsequently viewed faces such that faces similar to those recently seen are perceived as more normal. Simultaneously inducing such aftereffects in opposite directions for two groups of faces indicates somewhat discrete representations for those groups. Here we examine how labelling influences the perception of category in faces differing in colour. We show category-contingent aftereffects following exposure to faces differing in eye spacing (wide versus narrow) for blue versus red faces when such groups are consistently labelled with socially meaningful labels (Extravert versus Introvert; Soldier versus Builder). Category-contingent aftereffects were not seen using identical methodology when labels were not meaningful or were absent. These data suggest that human representations of faces can be rapidly tuned to code for meaningful social categories and that such tuning requires both a label and an associated visual difference. Results highlight the flexibility of the cognitive visual system to discriminate categories even in adulthood. Copyright © 2010 Elsevier B.V. All rights reserved.

Using NSSE to Assess and Improve Undergraduate Education: Lessons from the Field

ERIC Educational Resources Information Center

National Survey of Student Engagement, 2009

2009-01-01

Assessment is a worthwhile undertaking when meaningful data are generated, evidence-based improvement initiatives are thoroughly considered and discussed, and results are ultimately used to improve educational effectiveness. National Survey of Student Engagement (NSSE) results are oriented toward such practical use. Each year, more campuses use…

Using Design-Based Research to Develop Meaningful Online Discussions in Undergraduate Field Experience Courses

ERIC Educational Resources Information Center

Johnson, Carol; Hill, Laurie; Lock, Jennifer; Altowairiki, Noha; Ostrowski, Chris; da Rosa dos Santos, Luciano; Liu, Yang

2017-01-01

From a design perspective, the intentionality of students to engage in surface or deep learning is often experienced through prescribed activities and learning tasks. Educators understand that meaningful learning can be furthered through the structural and organizational design of the online environment that motivates the student towards task…

The Hepatitis C Cascade of Care: Identifying Priorities to Improve Clinical Outcomes

PubMed Central

Linas, Benjamin P.; Barter, Devra M.; Leff, Jared A.; Assoumou, Sabrina A.; Salomon, Joshua A.; Weinstein, Milton C.; Kim, Arthur Y.; Schackman, Bruce R.

2014-01-01

Background As highly effective hepatitis C virus (HCV) therapies emerge, data are needed to inform the development of interventions to improve HCV treatment rates. We used simulation modeling to estimate the impact of loss to follow-up on HCV treatment outcomes and to identify intervention strategies likely to provide good value for the resources invested in them. Methods We used a Monte Carlo state-transition model to simulate a hypothetical cohort of chronically HCV-infected individuals recently screened positive for serum HCV antibody. We simulated four hypothetical intervention strategies (linkage to care; treatment initiation; integrated case management; peer navigator) to improve HCV treatment rates, varying efficacies and costs, and identified strategies that would most likely result in the best value for the resources required for implementation. Main measures Sustained virologic responses (SVRs), life expectancy, quality-adjusted life expectancy (QALE), costs from health system and program implementation perspectives, and incremental cost-effectiveness ratios (ICERs). Results We estimate that imperfect follow-up reduces the real-world effectiveness of HCV therapies by approximately 75%. In the base case, a modestly effective hypothetical peer navigator program maximized the number of SVRs and QALE, with an ICER compared to the next best intervention of $48,700/quality-adjusted life year. Hypothetical interventions that simultaneously addressed multiple points along the cascade provided better outcomes and more value for money than less costly interventions targeting single steps. The 5-year program cost of the hypothetical peer navigator intervention was $14.5 million per 10,000 newly diagnosed individuals. Conclusions We estimate that imperfect follow-up during the HCV cascade of care greatly reduces the real-world effectiveness of HCV therapy. Our mathematical model shows that modestly effective interventions to improve follow-up would likely be cost

Are there meaningful individual differences in temporal inconsistency in self-reported personality?

PubMed

Soubelet, Andrea; Salthouse, Timothy A; Oishi, Shigehiro

2014-11-01

The current project had three goals. The first was to examine whether it is meaningful to refer to across-time variability in self-reported personality as an individual differences characteristic. The second was to investigate whether negative affect was associated with variability in self-reported personality, while controlling for mean levels, and correcting for measurement errors. The third goal was to examine whether variability in self-reported personality would be larger among young adults than among older adults, and whether the relation of variability with negative affect would be stronger at older ages than at younger ages. Two moderately large samples of participants completed the International Item Pool Personality questionnaire assessing the Big Five personality dimensions either twice or thrice, in addition to several measures of negative affect. Results were consistent with the hypothesis that within-person variability in self-reported personality is a meaningful individual difference characteristic. Some people exhibited greater across-time variability than others after removing measurement error, and people who showed temporal instability in one trait also exhibited temporal instability across the other four traits. However, temporal variability was not related to negative affect, and there was no evidence that either temporal variability or its association with negative affect varied with age.

Outside track advances. Think smaller and rural hospitals are hopelessly behind in satisfying the meaningful-use criteria under ARRA-HITECH? Don't be so sure.

PubMed

Hagland, Mark

2010-04-01

Smaller and rural hospitals face particular challenges in terms of matching the needed financial and human resources to the task of achieving meaningful use. Nonetheless, some smaller and rural hospitals have made surprising progress towards meeting the 2011 meaningful use criteria. Data reporting requirements under meaningful use will be particularly challenging for this type of hospital; engaging clinicians, especially physicians, in coming together to meet the challenges early on, will be critical to success.

Improving Vocabulary Acquisition through Direct and Indirect Teaching.

ERIC Educational Resources Information Center

Glowacki, Deborah; Lanucha, Cheryl; Pietrus, Debra

Students who lag behind in vocabulary commonly experience academic failure. A student's vocabulary knowledge directly impacts reading comprehension. To improve comprehension, students need exposure to a variety of literature and opportunities for meaningful practice of vocabulary they encounter daily. Vocabulary is developed through a variety of…

Child Support; Need to Improve Efforts to Identify Fathers and Obtain Support Orders.

DTIC Science & Technology

1987-04-01

34 Reduces the stigma of illegitimacy and helps give the child a sense of identity. • Increases the child’s opportunity to develop a close parental...A179 979 CHILD SUPPORT; NEED TO IMPROVE EFFORTS TO IDENTIFY 1/1 FATHERS AND OBTAIN SUPPORT ORDERS(U) GENERAL ACCOUNTING OFFICE WASHINGTON DC HUNAN...April 30, 1987 The Honorable Otis R. Bowen, M.D. The Secretary of Health and Human Services Dear Mr. Secretary: This report discusses child support

Critical differences between elective and emergency surgery: identifying domains for quality improvement in emergency general surgery.

PubMed

Columbus, Alexandra B; Morris, Megan A; Lilley, Elizabeth J; Harlow, Alyssa F; Haider, Adil H; Salim, Ali; Havens, Joaquim M

2018-04-01

The objective of our study was to characterize providers' impressions of factors contributing to disproportionate rates of morbidity and mortality in emergency general surgery to identify targets for care quality improvement. Emergency general surgery is characterized by a high-cost burden and disproportionate morbidity and mortality. Factors contributing to these observed disparities are not comprehensively understood and targets for quality improvement have not been formally developed. Using a grounded theory approach, emergency general surgery providers were recruited through purposive-criterion-based sampling to participate in semi-structured interviews and focus groups. Participants were asked to identify contributors to emergency general surgery outcomes, to define effective care for EGS patients, and to describe operating room team structure. Interviews were performed to thematic saturation. Transcripts were iteratively coded and analyzed within and across cases to identify emergent themes. Member checking was performed to establish credibility of the findings. A total of 40 participants from 5 academic hospitals participated in either individual interviews (n = 25 [9 anesthesia, 12 surgery, 4 nursing]) or focus groups (n = 2 [15 nursing]). Emergency general surgery was characterized by an exceptionally high level of variability, which can be subcategorized as patient-variability (acute physiology and comorbidities) and system-variability (operating room resources and workforce). Multidisciplinary communication is identified as a modifier to variability in emergency general surgery; however, nursing is often left out of early communication exchanges. Critical variability in emergency general surgery may impact outcomes. Patient-variability and system-variability, with focus on multidisciplinary communication, represent potential domains for quality improvement in this field. Copyright © 2017 Elsevier Inc. All rights reserved.

Meaningful Words and Non-Words Repetitive Articulatory Rate (Oral Diadochokinesis) in Persian Speaking Children

ERIC Educational Resources Information Center

Zamani, Peyman; Rezai, Hossein; Garmatani, Neda Tahmasebi

2017-01-01

Repetitive articulatory rate or Oral Diadochokinesis (oral-DDK) shows a guideline for appraisal and diagnosis of subjects with oral-motor disorder. Traditionally, meaningless words repetition has been utilized in this task and preschool children have challenges with them. Therefore, we aimed to determine some meaningful words in order to test…

Designing and Integrating Reusable Learning Objects for Meaningful Learning: Cases from a Graduate Programme

ERIC Educational Resources Information Center

Koh, Joyce Hwee Ling

2017-01-01

E-learning quality depends on sound pedagogical integration between the content resources and lesson activities within an e-learning system. This study proposes that a meaningful learning with technology framework can be used to guide the design and integration of content resources with e-learning activities in ways that promote learning…

Nominal group technique: a brainstorming tool for identifying areas to improve pain management in hospitalized patients.

PubMed

Peña, Adolfo; Estrada, Carlos A; Soniat, Debbie; Taylor, Benjamin; Burton, Michael

2012-01-01

Pain management in hospitalized patients remains a priority area for improvement; effective strategies for consensus development are needed to prioritize interventions. To identify challenges, barriers, and perspectives of healthcare providers in managing pain among hospitalized patients. Qualitative and quantitative group consensus using a brainstorming technique for quality improvement-the nominal group technique (NGT). One medical, 1 medical-surgical, and 1 surgical hospital unit at a large academic medical center. Nurses, resident physicians, patient care technicians, and unit clerks. Responses and ranking to the NGT question: "What causes uncontrolled pain in your unit?" Twenty-seven health workers generated a total of 94 ideas. The ideas perceived contributing to a suboptimal pain control were grouped as system factors (timeliness, n = 18 ideas; communication, n = 11; pain assessment, n = 8), human factors (knowledge and experience, n = 16; provider bias, n = 8; patient factors, n = 19), and interface of system and human factors (standardization, n = 14). Knowledge, timeliness, provider bias, and patient factors were the top ranked themes. Knowledge and timeliness are considered main priorities to improve pain control. NGT is an efficient tool for identifying general and context-specific priority areas for quality improvement; teams of healthcare providers should consider using NGT to address their own challenges and barriers. Copyright © 2011 Society of Hospital Medicine.

Identifying effective pathways in a successful continuous quality improvement programme: the GEDAPS study.

PubMed

Bodicoat, Danielle H; Mundet, Xavier; Gray, Laura J; Cos, Xavier; Davies, Melanie J; Khunti, Kamlesh; Cano, Juan-Franciso

2014-12-01

Continuous quality improvement programmes often target several aspects of care, some of which may be more effective meaning that resources could be focussed on these. The objective was to identify the effective and ineffective aspects of a successful continuous quality improvement programme for individuals with type 2 diabetes in primary care. Data were from a series of cross-sectional studies (GEDAPS) in primary care, Catalonia, Spain, in 55 centres (2239 participants) in 1993, and 92 centres (5819 participants) in 2002. A structural equation modelling approach was used. The intervention was associated with improved microvascular outcomes through microalbuminuria and funduscopy screening, which had a direct effect on microvascular outcomes, and through attending 2-4 nurse visits and having ≥1 blood pressure measurement, which acted through reducing systolic blood pressure. The intervention was associated with improved macrovascular outcomes through blood pressure measurement and attending 2-4 nurse visits (through systolic blood pressure) and having ≥3 education topics, ≥1 HbA1c measurement and adequate medication (through HbA1c). Cholesterol measurement, weight measurement and foot examination did not contribute towards the effectiveness of the intervention. The pathways through which a continuous quality improvement programme appeared to act to reduce microvascular and macrovascular complications were driven by reductions in systolic blood pressure and HbA1c, which were attained through changes in nurse and education visits, measurement and medication. This suggests that these factors are potential areas on which future quality improvement programmes should focus. © 2014 John Wiley & Sons, Ltd.

Hospital Characteristics Related to the Intention to Apply for Meaningful Use Incentive Payments

PubMed Central

Diana, Mark L; Kazley, Abby Swanson; Ford, Eric W; Menachemi, Nir

2012-01-01

The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 provides incentives for hospitals to fully adopt and use electronic health records (EHRs). We used data from the 2009 American Hospital Association (AHA) Annual Survey Information Technology Supplement and the Centers for Medicare and Medicaid Services (CMS) 2008 Hospital Cost Reports to examine how various hospital characteristics are associated with the intention to pursue meaningful use incentives. Overall, 86 percent of hospitals indicated an intent to pursue HITECH incentives. However, hospitals that already have an EHR system, are larger, and are located in urban areas are more likely to indicate an intention to pursue incentives. Despite a high interest in HITECH incentives, certain hospital characteristics, including current EHR use, increase the proclivity for some hospitals to pursue meaningful use. Given these differences, there is the potential for the HITECH Act to inadvertently increase the digital divide between hospitals with certain characteristics and their counterparts without those characteristics. Policy makers should consider ways to alleviate barriers, especially for nonusers of EHRs, to realize the maximum benefits of the HITECH Act. PMID:22737100

Creating Meaningful Change in Education: A Cascading Logic Model. Scaling-Up Brief. Number 6

ERIC Educational Resources Information Center

Blase, Karen; Fixsen, Dean; Jackson, Kathleen Ryan

2015-01-01

Creating meaningful change in a state's education system from the capitol to the classroom is complex and challenging work. Over the past several decades, considerable research, policy, and funding have focused on the use of evidence-based programs (EBP) in schools. However, these practices only are effective when fully and effectively implemented…

Inclusion of Sexual Orientation and Gender Identity in Stage 3 Meaningful Use Guidelines: A Huge Step Forward for LGBT Health.

PubMed

Cahill, Sean R; Baker, Kellan; Deutsch, Madeline B; Keatley, Joanne; Makadon, Harvey J

2016-04-01

Final rules issued by the Centers for Medicare and Medicaid Services and the Office of the National Coordinator for Health Information Technology in October 2015 require electronic health record software certified for Meaningful Use to include sexual orientation and gender identity (SO/GI) fields. This is a critical step toward making SO/GI data collection a standard practice in clinical settings. Sexual orientation identity-whether one identifies as gay, lesbian, or bisexual-correlates with behavioral health burden, and it is important to collect these data. Providers should also collect sex assigned at birth data as well as current gender identity data. Training of clinical staff in collection and use of SO/GI data, education of LGBT patients, and SO/GI nondiscrimination policies are critical for successful implementation.

Measuring Meaningful Learning in the Undergraduate General Chemistry and Organic Chemistry Laboratories: A Longitudinal Study

ERIC Educational Resources Information Center

Galloway, Kelli R.; Bretz, Stacey Lowery

2015-01-01

Understanding how students learn in the undergraduate chemistry teaching laboratory is an essential component to developing evidence-based laboratory curricula. The Meaningful Learning in the Laboratory Instrument (MLLI) was developed to measure students' cognitive and affective expectations and experiences for learning in the chemistry…

Estimating a Meaningful Point of Change: A Comparison of Exploratory Techniques Based on Nonparametric Regression

ERIC Educational Resources Information Center

Klotsche, Jens; Gloster, Andrew T.

2012-01-01

Longitudinal studies are increasingly common in psychological research. Characterized by repeated measurements, longitudinal designs aim to observe phenomena that change over time. One important question involves identification of the exact point in time when the observed phenomena begin to meaningfully change above and beyond baseline…

Regional reference variation provides ecologically meaningful protection criteria for northern world heritage site.

PubMed

Bowman, Michelle; Spencer, Paula; Dubé, Monique; West, David

2010-01-01

Unprecedented rates of resource development and climate change at northern latitudes coupled with a lack of baseline information limits our ability to set ecologically meaningful criteria needed to protect these inherently sensitive ecosystems. We surveyed water and sediment chemistry, community composition of benthic algae and invertebrates and fish, and condition of a sentinel fish species, slimy sculpin (Cottus cognatus), in 2 rivers adjacent to metal mines and in 20 reference rivers in the headwaters of a World Heritage Site, the South Nahanni River Basin, NWT, Canada. The normal range (i.e., mean ± 2 standard deviations) of biological conditions in regional reference sites (grouped by community type) were used to set ecologically meaningful effect sizes. These effect sizes were used in noncentral hypotheses tests to assess the ecological condition of potentially impaired sites. Significant impairments at sites influenced by current and historical mining activity were indicative of mild enrichment (e.g., increased benthic abundance and sculpin condition) and bioaccumulation of metals (e.g., increased concentrations of Cu and Fe in muscle tissue of sculpin). Comparisons between our regional reference study and a concurrent upstream–downstream study showed that the sensitivity of biological endpoints was typically related to the impairment criteria used and not to the type of study design. Concentrations of metals such as Al, Cu, and Fe in river water at reference sites were above federal and regional guidelines, suggesting that these guidelines are not appropriate for the metal-rich headwaters of the South Nahanni River. The ephemerellid mayflies Drunella spinifera and Ephemerella maculata were present in 4 of our study sites; their occurrence had not previously been documented in the Yukon or Northwest Territories. Our results confirmed that the lack of baseline information on the physiochemical and biological composition of northern rivers is hampering

Beyond tokenistic participation: using representational artefacts to enable meaningful public participation in health service design.

PubMed

Morrison, Cecily; Dearden, Andy

2013-10-01

A number of recent policies promote public participation in health service design. Yet, a growing literature has articulated a gap between policy aims and actual practice resulting in public participation becoming tokenistic. Drawing on theory from participatory design, we argue that choosing appropriate artefacts to act as representations can structure discussions between public participants and health professionals in ways that both groups find meaningful and valid. Through a case study of a service improvement project in outpatient services for older people, we describe three representational artefacts: emotion maps, stories, and tracing paper, and explain how they helped to mediate interactions between public participants and health professionals. We suggest that using such representational artefacts can provide an alternative approach to participation that stands in contrast to the current focus on the professionalisation of public participants. We conclude that including participatory designers in projects, to chose or design appropriate representational artefacts, can help to address the policy-practice gap of including public participants in health service design. Copyright © 2013 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Role of Educational Games Improves Meaningful Learning

ERIC Educational Resources Information Center

Nachimuthu, K.; Vijayakumari, G.

2011-01-01

A game is a set of activities involving one or more players. It has goals, constraints, payoffs, and consequences. A game is rule-guided and artificial in some respects. (Richard Wilson, 2010). According to Garris et al. (2002), define educational game play as "voluntary, nonproductive, and separate from the real world"; and they found…

The Effect of Case Teaching on Meaningful and Retentive Learning When Studying Genetic Engineering

ERIC Educational Resources Information Center

Güccük, Ahmet; Köksal, Mustafa Serdar

2017-01-01

The purpose of this study is to investigate the effects of case teaching on how students learn about genetic engineering, in terms of meaningful learning and retention of learning. The study was designed as quasi-experimental research including 63 8th graders (28 boys and 35 girls). To collect data, genetic engineering achievement tests were…

Conducting a SWOT Analysis for Program Improvement

ERIC Educational Resources Information Center

Orr, Betsy

2013-01-01

A SWOT (strengths, weaknesses, opportunities, and threats) analysis of a teacher education program, or any program, can be the driving force for implementing change. A SWOT analysis is used to assist faculty in initiating meaningful change in a program and to use the data for program improvement. This tool is useful in any undergraduate or degree…

42 CFR 495.6 - Meaningful use objectives and measures for EPs, eligible hospitals, and CAHs.

Code of Federal Regulations, 2014 CFR

2014-10-01

... HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM General Provisions § 495.6 Meaningful use objectives and... their first payment year. For Medicaid EPs who adopt, implement, or upgrade certified EHR technology in... first payment year. (4) Flexible options for using certified EHR technology in 2014. For an EHR...

Security, Dignity, Caring Relationships, and Meaningful Work: Needs Motivating Participation in a Job-Training Program

ERIC Educational Resources Information Center

Ayers, David F.; Miller-Dyce, Cherrel; Carlone, David

2008-01-01

Researchers asked 17 participants in a job-training program to describe their personal struggles following an economic restructuring. Examined through a critical theoretical lens, findings indicate that the learners enrolled in the program to reclaim security, dignity, meaningful work, and caring relationships. Program planners at community…

The Effect of Mechanical and Meaningful Production of Output on Learning English Relative Clauses

ERIC Educational Resources Information Center

Abadikhah, Shirin

2012-01-01

The present study examined the effectiveness of mechanical and meaningful production of output on the learning of English relative clauses by Iranian EFL learners. The study involved two groups of learners (N = 36) who completed a pre-test, three activities and a post-test over an 8-week period. The collaborative dialogue of the participants was…

Myasthenia Gravis Impairment Index: Responsiveness, meaningful change, and relative efficiency.

PubMed

Barnett, Carolina; Bril, Vera; Kapral, Moira; Kulkarni, Abhaya V; Davis, Aileen M

2017-12-05

To study responsiveness and meaningful change of the Myasthenia Gravis Impairment Index (MGII) and its relative efficiency compared to other measures. We enrolled 95 patients receiving prednisone, IV immunoglobulin (IVIg), or plasma exchange (PLEX) and 54 controls. Patients were assessed with the MGII and other measures-including the Quantitative Myasthenia Gravis Score, Myasthenia Gravis Composite, and Myasthenia Gravis Activities of Daily Living-at baseline and 3-4 weeks after treatment. Statistical markers of responsiveness included between-groups and within-group differences, and we estimated the relative efficiency of the MGII compared to other measures. Patient-meaningful change was assessed with an anchor-based method, using the patient's impression of change. We determined the minimal detectable change (MDC) and the minimal important difference (MID) at the group and individual level. Treated patients had a higher change in MGII scores than controls (analysis of covariance p < 0.001). The ocular domain changed more with prednisone than with IVIg/PLEX (effect size 0.67 and 0.13, analysis of covariance p = 0.001). The generalized domain changed more with IVIg/PLEX than with prednisone (effect size 0.50 and 0.22, analysis of covariance p = 0.07). For the total MGII score, the individual MDC95 was 9.1 and the MID was 5.5 for individuals and 8.1 for groups. Relative efficiency ratios were >1 favoring the MGII. The MGII demonstrated responsiveness to prednisone, IVIg, and PLEX in patients with myasthenia. There is a differential response in ocular and generalized symptoms to type of therapy. The MGII has higher relative efficiency than comparison measures and is viable for use in clinical trials. Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

Residential energy consumption and conservation programs: A systematic approach to identify inefficient households, provide meaningful feedback, and prioritize homes for conservation intervention

NASA Astrophysics Data System (ADS)

Macsleyne, Amelia Chadbourne Carus

There are three main objectives for residential energy conservation policies: to reduce the use of fossil fuels, reduce greenhouse gas emissions, and reduce the energy costs seen by the consumer (U.S. Department of Energy: Strategic Objectives, 2006). A prominent difficulty currently facing conservation policy makers and program managers is how to identify and communicate with households that would be good candidates for conservation intervention, in such a way that affects a change in consumption patterns and is cost-effective. This research addresses this issue by separating the problem into three components: how to identify houses that are significantly more inefficient than comparable households; how to find the maximum financially-feasible investment in energy efficiency for a household in order to reduce annual energy costs and/or improve indoor comfort; and how to prioritize low-income households for a subsidized weatherization program. Each component of the problem is presented as a paper prepared for publication. Household consumption related to physical house efficiency, thermostat settings, and daily appliance usage is studied in the first and second paper by analyzing natural gas utility meter readings associated with over 10,000 households from 2001-2006. A rich description of a house's architectural characteristics and household demographics is attained by integrating publicly available databases based on the house address. This combination of information allows for the largest number of individual households studied at this level of detail to date. The third paper uses conservation program data from two natural gas utilities that administer and sponsor the program; over 1,000 weatherized households are included in this sample. This research focuses on natural gas-related household conservation. However, the same principles and methods could be applied for electricity-related conservation programs. We find positive policy implications from each of

Public reporting needed to improve the health of Tennesseans.

PubMed

Bailey, James E; Gibson, Deborah

2005-11-01

Tennessee providers are recognizing an urgent need for a new and improved model of healthcare, characterized by transparent accountability to consumers. Meaningful health system improvements will require broad public disclosure of healthcare performance data at the hospital, clinic and community levels using nationally recognized standards. All Tennessee communities need a routine community health report card, to help their citizens to work together toward their most important health goals.

Cognitive-behavioural therapy does not meaningfully reduce depression in most people with epilepsy: a systematic review of clinically reliable improvement.

PubMed

Noble, Adam J; Reilly, James; Temple, James; Fisher, Peter L

2018-05-07

Psychological treatment is recommended for depression and anxiety in those with epilepsy. This review used standardised criteria to evaluate, for the first time, the clinical relevance of any symptom change these treatments afford patients. Databases were searched until March 2017 for relevant trials in adults. Trial quality was assessed and trial authors asked for individual participants' pre-treatment and post-treatment distress data. Jacobson's methodology determined the proportion in the different trial arms demonstrating reliable symptom change on primary and secondary outcome measures and its direction. Search yielded 580 unique articles; only eight eligible trials were identified. Individual participant data for five trials-which included 398 (85%) of the 470 participants randomised by the trials-were received. The treatments evaluated lasted ~7 hours and all incorporated cognitive-behavioural therapy (CBT). Depression was the primary outcome in all; anxiety a secondary outcome in one. On average, post-treatment assessments occurred 12 weeks following randomisation; 2 weeks after treatment had finished. There were some limitations in how trials were conducted, but overall trial quality was 'good'. Pooled risk difference indicated likelihood of reliable improvement in depression symptoms was significantly higher for those randomised to CBT. The extent of gain was though low-the depressive symptoms of most participants (66.9%) receiving CBT were 'unchanged' and 2.7% 'reliably deteriorated'. Only 30.4% made a 'reliable improvement. This compares with 10.2% of participants in the control arms who 'reliably improved' without intervention. The effect of the treatments on secondary outcome measures, including anxiety, was also low. Existing CBT treatments appear to have limited benefit for depression symptoms in epilepsy. Almost 70% of people with epilepsy do not reliably improve following CBT. Only a limited number of trials have though been conducted in this

Identifying Feasible Physical Activity Programs for Long-Term Care Homes in the Ontario Context

PubMed Central

Shakeel, Saad; Newhouse, Ian; Malik, Ali; Heckman, George

2015-01-01

Background Structured exercise programs for frail institutionalized seniors have shown improvement in physical, functional, and psychological health of this population. However, the ‘feasibility’ of implementation of such programs in real settings is seldom discussed. The purpose of this systematic review was to gauge feasibility of exercise and falls prevention programs from the perspective of long-term care homes in Ontario, given the recent changes in funding for publically funded physiotherapy services. Method Six electronic databases were searched by two independent researchers for randomized controlled trials that targeted long-term care residents and included exercise as an independent component of the intervention. Results A total of 39 studies were included in this review. A majority of these interventions were led by physiotherapist(s), carried out three times per week for 30–45 minutes per session. However, a few group-based interventions that were led by long-term care staff, volunteers, or trained non-exercise specialists were identified that also required minimal equipment. Conclusion This systematic review has identified ‘feasible’ physical activity and falls prevention programs that required minimal investment in staff and equipment, and demonstrated positive outcomes. Implementation of such programs represents cost-effective means of providing long-term care residents with meaningful gains in physical, psychological, and social health. PMID:26180563

Ineffectiveness of commercial weight-loss programs for achieving modest but meaningful weight loss: Systematic review and meta-analysis.

PubMed

McEvedy, Samantha M; Sullivan-Mort, Gillian; McLean, Siân A; Pascoe, Michaela C; Paxton, Susan J

2017-10-01

This study collates existing evidence regarding weight loss among overweight but otherwise healthy adults who use commercial weight-loss programs. Systematic search of 3 databases identified 11 randomized controlled trials and 14 observational studies of commercial meal-replacement, calorie-counting, or pre-packaged meal programs which met inclusion criteria. In meta-analysis using intention-to-treat data, 57 percent of individuals who commenced a commercial weight program lost less than 5 percent of their initial body weight. One in two (49%) studies reported attrition ≥30 percent. A second meta-analysis found that 37 percent of program completers lost less than 5 percent of initial body weight. We conclude that commercial weight-loss programs frequently fail to produce modest but clinically meaningful weight loss with high rates of attrition suggesting that many consumers find dietary changes required by these programs unsustainable.

An integrated uncertainty analysis and data assimilation approach for improved streamflow predictions

NASA Astrophysics Data System (ADS)

Hogue, T. S.; He, M.; Franz, K. J.; Margulis, S. A.; Vrugt, J. A.

2010-12-01

The current study presents an integrated uncertainty analysis and data assimilation approach to improve streamflow predictions while simultaneously providing meaningful estimates of the associated uncertainty. Study models include the National Weather Service (NWS) operational snow model (SNOW17) and rainfall-runoff model (SAC-SMA). The proposed approach uses the recently developed DiffeRential Evolution Adaptive Metropolis (DREAM) to simultaneously estimate uncertainties in model parameters, forcing, and observations. An ensemble Kalman filter (EnKF) is configured with the DREAM-identified uncertainty structure and applied to assimilating snow water equivalent data into the SNOW17 model for improved snowmelt simulations. Snowmelt estimates then serves as an input to the SAC-SMA model to provide streamflow predictions at the basin outlet. The robustness and usefulness of the approach is evaluated for a snow-dominated watershed in the northern Sierra Mountains. This presentation describes the implementation of DREAM and EnKF into the coupled SNOW17 and SAC-SMA models and summarizes study results and findings.

Using Cluster Analysis to Characterize Meaningful Learning in a First-Year University Chemistry Laboratory Course

ERIC Educational Resources Information Center

Galloway, Kelli R.; Bretz, Stacey Lowery

2015-01-01

The Meaningful Learning in the Laboratory Instrument (MLLI) was designed to measure students' cognitive and affective learning in the university chemistry laboratory. The MLLI was administered at the beginning and the end of the first semester to first-year university chemistry students to measure their expectations and experiences for learning in…

The Search for Meaningful E-Learning at Canadian Universities: A Multi-Institutional Research Study

ERIC Educational Resources Information Center

Salyers, Vincent; Carter, Lorraine; Carter, Alanna; Myers, Sue; Barrett, Penelope

2014-01-01

While e-learning is now characterized by a past and trends within that past, there continues to be uncertainty about how e-learning is defined and conceptualized, whether or not we like e-learning, and whether or not it is as meaningful to us as face to face learning. The purpose of this study was to document the e-learning perceptions of students…

Changes in the quality of care during progress from stage 1 to stage 2 of Meaningful Use.

PubMed

Levine, David M; Healey, Michael J; Wright, Adam; Bates, David W; Linder, Jeffrey A; Samal, Lipika

2017-03-01

The Centers for Medicare and Medicaid Services (CMS) canceled Meaningful Use (MU), replacing it with Advancing Care Information, which preserves many MU elements. Therefore, transitioning from MU stage 1 to MU stage 2 has important implications for the new policy, yet the quality of care provided by physicians transitioning from MU1 to MU2 is unknown. Retrospective longitudinal evaluation of the quality of care delivered by outpatient physicians at an academic medical center in the transition between MU1 and MU2. Between MU1 and MU2, 4 measures improved: hypertension control (35% vs 40%), influenza immunization (63% vs 68%), tobacco use assessment/counseling (86% vs 96%), and diabetes control (93% vs 96%; P all <.01). One worsened: senior weight screening/follow-up (54% vs 49%; P  < .01). Two were unchanged: chlamydia screening and adult weight screening/follow-up. In this single-site study, when clinicians progressed from MU1 to MU2, 4 quality measures improved, 2 were unchanged, and 1 worsened. Analysis of national data should guide policy decisions about the content of MU's successor. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Using an International Clinical Registry of Regional Anesthesia to Identify Targets for Quality Improvement

PubMed Central

Sites, Brian D.; Barrington, Michael J.; Davis, Matthew

2014-01-01

Background Despite the widespread use of regional anesthesia, limited information on clinical performance exists. Institutions, therefore, have little knowledge of how they are performing in regards to both safety and effectiveness. In this study, we demonstrate how a medical institution (or physician/physician group) may use data from a multi-center clinical registry of regional anesthesia to inform quality improvement strategies. Methods We analyzed data from the International Registry of Regional Anesthesia that includes prospective data on peripheral regional anesthesia procedures from 19 centers located around the world. Using data from the clinical registry, we present summary statistics of the overall safety and effectiveness of regional anesthesia. Furthermore, we demonstrate, using a variety of performance measures, how these data can be used by hospitals to identify areas for quality improvement. To do so, we compare the performance of one member institution (a United States medical center in New Hampshire) to that of the other 18 member institutions of the clinical registry. Results The clinical registry contained information on 23,271 blocks that were performed between June 1, 2011, and May 1, 2014, on 16,725 patients. The overall success rate was 96.7%, immediate complication rate was 2.2%, and the all-cause 60-day rate of neurological sequelae was 8.3 (95% CI, 7.2–9.7) per 10,000. Registry wide major hospital events included 7 wrong site blocks, 3 seizures, 1 complete heart block, 1 retroperitoneal hematoma, and 3 pneumothoraces. For our reference medical center, we identified areas meriting quality improvement. Specifically, after accounting for differences in the age, sex, and health status of patient populations, the reference medical center appeared to rely more heavily on opioids for post procedure management, had higher patient pain scores, and experienced delayed discharge when compared with other member institutions. Conclusions To our

Belief system, meaningfulness, and psychopathology associated with suicidality among Chinese college students: a cross-sectional survey

PubMed Central

2012-01-01

Background Research suggests that Chinese religious believers are more likely to commit suicide than those identifying as non-religious among rural young adults, contrary to findings in Western countries. However, one cannot conclude that religiosity is associated with elevated suicide risk without examining the effect of political and religious beliefs in a generally atheist country like China where political belief plays a dominant role in the belief system of young adults. The present study investigated the effects of political and religious belief on suicidality with meaningfulness and psychopathology as potential mediators in a large representative sample of Chinese college students. Methods A cross-sectional survey was conducted among 1390 first-year college students randomly sampled from 10 colleges and universities in mainland China. Results A total of 1168 respondents (84.0%) provided complete data on all variables. Lifetime prevalence of suicidal ideation, plan, and attempt were 45.1%, 6.8%, and 1.9% respectively, with one-year suicidal ideation showing at 19.3%. Female gender was associated with elevated risk of suicidality. Political belief but not religious belief was associated with decreased suicide risk. A significant interactive effect of political belief and religious belief was found, indicating that for political believers, being religious was associated with decreased suicide risk; for non-political believers, being religious was associated with increased suicide risk. Multi-group structural equation modeling showed that meaningfulness completely mediated and psychopathology partially mediated the effect of belief system on suicidality. Gender differences were found in pathways of political belief by religious beliefs to suicidality and political belief to psychopathology. The coefficients were significant for males but not for females. Conclusions In less religious societies, political belief may serve as a means of integration as does

Identifying key areas of ecosystem services potential to improve ecological management in Chongqing City, southwest China.

PubMed

Xiao, Yang; Xiao, Qiang

2018-03-29

Because natural ecosystems and ecosystem services (ES) are both critical to the well-being of humankind, it is important to understand their relationships and congruence for conservation planning. Spatial conservation planning is required to set focused preservation priorities and to assess future ecological implications. This study uses the combined measures of ES models and ES potential to estimate and analyze all four groups of ecosystem services to generate opportunities to maximize ecosystem services. Subsequently, we identify the key areas of conservation priorities as future forestation and conservation hotspot zones to improve the ecological management in Chongqing City, located in the upper reaches of the Three Gorges Reservoir Area, China. Results show that ecosystem services potential is extremely obvious. Compared to ecosystem services from 2000, we determined that soil conservation could be increased by 59.11%, carbon sequestration by 129.51%, water flow regulation by 83.42%, and water purification by 84.42%. According to our prioritization results, approximately 48% of area converted to forests exhibited high improvements in all ecosystem services (categorized as hotspot-1, hotspot-2, and hotspot-3). The hotspots identified in this study can be used as an excellent surrogate for evaluation ecological engineering benefits and can be effectively applied in improving ecological management planning.

Qualitative Insights from a Canadian Multi-Institutional Research Study: In Search of Meaningful E-Learning

ERIC Educational Resources Information Center

Carter, Lorraine M.; Salyers, Vince; Myers, Sue; Hipfner, Carol; Hoffart, Caroline; MacLean, Christa; White, Kathy; Matus, Theresa; Forssman, Vivian; Barrett, Penelope

2014-01-01

This paper reports the qualitative findings of a mixed methods research study conducted at three Canadian post-secondary institutions. Called the Meaningful E-learning or MEL project, the study was an exploration of the teaching and learning experiences of faculty and students as well as their perceptions of the benefits and challenges of…

Opportunity for Adult Bonding/Meaningful Neighborhood Roles and Life-Satisfaction among USA Middle School Students

ERIC Educational Resources Information Center

Paxton, Raheem J.; Valois, Robert F.; Huebner, E. Scott; Drane, J. Wasner

2006-01-01

This study investigated the relationship between adolescent life- satisfaction and bonding to adults/developing meaningful roles in the neighborhood within a pilot study of slightly modified version of the CDC Middle School Youth Risk Behavior Survey (MSYRBS) in a southern state in the USA. Overall, 43% of students reported that they were…

Supervision that Improves Teaching: Strategies and Techniques. Second Edition

ERIC Educational Resources Information Center

Sullivan, Susan; Glanz, Jeffrey

2004-01-01

In this exciting, new edition of "Supervision That Improves Teaching," the authors have taken their reflective clinical supervision process to a new level, with the planning conference now the heart of the supervision cycle. Sullivan and Glanz have addressed the dilemmas of preserving meaningful supervision in an era of high-stakes…

Discriminative functions and over-training as class-enhancing determinants of meaningful stimuli.

PubMed

Travis, Robert W; Fields, Lanny; Arntzen, Erik

2014-07-01

Likelihood of equivalence class formation (yield) was influenced by pre-class formation of simultaneous and successive discriminations, their mastery criteria, and overtraining of the successive discriminations. Each undergraduate in seven groups attempted to form two 3-node, 5-member equivalence classes (ABCDE). In the pictorial (PIC) group, meaningless nonsense syllables were used as the A, B, D, and E stimuli and meaningful pictures as the C stimuli. Nonsense syllables only were used in the other groups. The abstract (ABS) or 0-0-0 group involved no pre-class training. In the 84-0-0, 84-5-0 and 84-20-0 groups, simultaneous discriminations were trained among C stimuli to a mastery criterion of 84 trials, followed by successive discriminations trained to mastery criteria of 0, 5, and 20 trials, respectively. In the 84-20-0, 84-20-100, and 84-20-500 groups, simultaneous and successive discriminations were trained as noted, followed by overtraining with 0, 100, 500 successive-discrimination trials, respectively. The ABS group produced a 6% yield with the 84-0-0, 84-5-0, and 84-20-0 groups producing further modest increments. Overtraining produced a linear increase in yield, reaching 85% after 500 overtraining trials, a yield matching that produced by classes containing pictures as C stimuli (PIC). Thus, acquired discriminative functions and the overtraining of at least one function can account for class enhancement by meaningful stimuli. © Society for the Experimental Analysis of Behavior.

Linking job-relevant personality traits, transformational leadership, and job performance via perceived meaningfulness at work: A moderated mediation model.

PubMed

Frieder, Rachel E; Wang, Gang; Oh, In-Sue

2018-03-01

By integrating the fundamental principles of the theory of purposeful work behavior (TPWB; Barrick, Mount, & Li, 2013) with cognitive-affective personality system (CAPS) theory (Mischel, 1977; Mischel & Shoda, 1995), we examine how and when salespeople's job-relevant personality traits relate to their performance. We argue that individuals with personality traits that fit outdoor sales jobs (i.e., conscientious, extraversion, openness to experience) will perceive their work as more meaningful and as a result achieve heightened performance. Moreover, drawing from TPWB and CAPS theory, we expect that as an important element of the social context, transformational leadership moderates the indirect effect of salespeople's job-relevant personality traits on their job performance via enhanced perceptions of meaningfulness at work. Results based on data from 496 outdoor salespeople and their 218 supervisors and regional managers provide support for the hypotheses pertaining to conscientiousness and openness, but not extraversion. Specifically, the conditional indirect effects of conscientiousness or openness on performance through perceived meaningfulness are more positive under low, rather than high, levels of transformational leadership. Implications for research and practice are discussed along with study limitations and future research directions. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Improvements in the Protein Identifier Cross-Reference service.

PubMed

Wein, Samuel P; Côté, Richard G; Dumousseau, Marine; Reisinger, Florian; Hermjakob, Henning; Vizcaíno, Juan A

2012-07-01

The Protein Identifier Cross-Reference (PICR) service is a tool that allows users to map protein identifiers, protein sequences and gene identifiers across over 100 different source databases. PICR takes input through an interactive website as well as Representational State Transfer (REST) and Simple Object Access Protocol (SOAP) services. It returns the results as HTML pages, XLS and CSV files. It has been in production since 2007 and has been recently enhanced to add new functionality and increase the number of databases it covers. Protein subsequences can be Basic Local Alignment Search Tool (BLAST) against the UniProt Knowledgebase (UniProtKB) to provide an entry point to the standard PICR mapping algorithm. In addition, gene identifiers from UniProtKB and Ensembl can now be submitted as input or mapped to as output from PICR. We have also implemented a 'best-guess' mapping algorithm for UniProt. In this article, we describe the usefulness of PICR, how these changes have been implemented, and the corresponding additions to the web services. Finally, we explain that the number of source databases covered by PICR has increased from the initial 73 to the current 102. New resources include several new species-specific Ensembl databases as well as the Ensembl Genome ones. PICR can be accessed at http://www.ebi.ac.uk/Tools/picr/.

Identifying treatment responders and predictors of improvement after cognitive-behavioral therapy for juvenile fibromyalgia.

PubMed

Sil, Soumitri; Arnold, Lesley M; Lynch-Jordan, Anne; Ting, Tracy V; Peugh, James; Cunningham, Natoshia; Powers, Scott W; Lovell, Daniel J; Hashkes, Philip J; Passo, Murray; Schikler, Kenneth N; Kashikar-Zuck, Susmita

2014-07-01

The primary objective of this study was to estimate a clinically significant and quantifiable change in functional disability to identify treatment responders in a clinical trial of cognitive-behavioral therapy (CBT) for youth with juvenile fibromyalgia (JFM). The second objective was to examine whether baseline functional disability (Functional Disability Inventory), pain intensity, depressive symptoms (Children's Depression Inventory), coping self-efficacy (Pain Coping Questionnaire), and parental pain history predicted treatment response in disability at 6-month follow-up. Participants were 100 adolescents (11-18 years of age) with JFM enrolled in a recently published clinical trial comparing CBT to a fibromyalgia education (FE) intervention. Patients were identified as achieving a clinically significant change in disability (i.e., were considered treatment responders) if they achieved both a reliable magnitude of change (estimated as a > or = 7.8-point reduction on the FDI) using the Reliable Change Index, and a reduction in FDI disability grade based on established clinical reference points. Using this rigorous standard, 40% of patients who received CBT (20 of 50) were identified as treatment responders, compared to 28% who received FE (14 of 50). For CBT, patients with greater initial disability and higher coping efficacy were significantly more likely to achieve a clinically significant improvement in functioning. Pain intensity, depressive symptoms, and parent pain history did not significantly predict treatment response. Estimating clinically significant change for outcome measures in behavioral trials sets a high bar but is a potentially valuable approach to improve the quality of clinical trials, to enhance interpretability of treatment effects, and to challenge researchers to develop more potent and tailored interventions. Copyright © 2014 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Identifying indigenous peoples for health research in a global context: a review of perspectives and challenges.

PubMed

Bartlett, Judith G; Madariaga-Vignudo, Lucia; O'Neil, John D; Kuhnlein, Harriet V

2007-09-01

Identifying Indigenous Peoples globally is complex and contested despite there being an estimated 370 million living in 70 countries. The specific context and use of locally relevant and clear definitions or characterizations of Indigenous Peoples is important for recognizing unique health risks Indigenous Peoples face, for understanding local Indigenous health aspirations and for reflecting on the need for culturally disaggregated data to plan meaningful research and health improvement programs. This paper explores perspectives on defining Indigenous Peoples and reflects on challenges in identifying Indigenous Peoples. Literature reviews and Internet searches were conducted, and some key experts were consulted. Pragmatic and political definitions by international institutions, including the United Nations, are presented as well as characterizations of Indigenous Peoples by governments and academic researchers. Assertions that Indigenous Peoples have about definitions of indigeneity are often related to maintenance of cultural integrity and sustainability of lifestyles. Described here are existing definitions and interests served by defining (or leaving undefined) such definitions, why there is no unified definition and implications of "too restrictive" a definition. Selected indigenous identities and dynamics are presented for North America, the Arctic, Australia and New Zealand, Latin America and the Caribbean, Asia and Africa. While health researchers need to understand the Indigenous Peoples with whom they work, ultimately, indigenous groups themselves best define how they wish to be viewed and identified for research purposes.

Meaningful experiences in science education: Engaging the space researcher in a cultural transformation to greater science literacy

NASA Astrophysics Data System (ADS)

Morrow, Cherilynn A.

1993-11-01

The visceral appeal of space science and exploration is a very powerful emotional connection to a very large and diverse collection of people, most of whom have little or no perspective about what it means to do science and engineering. Therein lies the potential of space for a substantially enhanced positive impact on culture through education. This essay suggests that through engaging more of the space research and development community in enabling unique and 'meaningful educational experiences' for educators and students at the pre-collegiate levels, space science and exploration can amplify its positive feedback on society and act as an important medium for cultural transformation to greater science literacy. I discuss the impact of space achievements on people and define what is meant by a 'meaningful educational experience,' all of which points to the need for educators and students to be closer to the practice of real science. I offer descriptions of two nascent science education programs associated with NASA which have the needed characteristics for providing meaningful experiences that can cultivate greater science literacy. Expansion of these efforts and others like it will be needed to have the desired impact on culture, but I suggest that the potential for the needed resources is there in the scientific research communities. A society in which more people appreciate and understand science and science methods would be especially conducive to human progress in space and on Earth.

Visual attention to meaningful stimuli by 1- to 3-year olds: implications for the measurement of memory.

PubMed

Hayne, Harlene; Jaeger, Katja; Sonne, Trine; Gross, Julien

2016-11-01

The visual recognition memory (VRM) paradigm has been widely used to measure memory during infancy and early childhood; it has also been used to study memory in human and nonhuman adults. Typically, participants are familiarized with stimuli that have no special significance to them. Under these conditions, greater attention to the novel stimulus during the test (i.e., novelty preference) is used as the primary index of memory. Here, we took a novel approach to the VRM paradigm and tested 1-, 2-, and 3-year olds using photos of meaningful stimuli that were drawn from the participants' own environment (e.g., photos of their mother, father, siblings, house). We also compared their performance to that of participants of the same age who were tested in an explicit pointing version of the VRM task. Two- and 3-year olds exhibited a strong familiarity preference for some, but not all, of the meaningful stimuli; 1-year olds did not. At no age did participants exhibit the kind of novelty preference that is commonly used to define memory in the VRM task. Furthermore, when compared to pointing, looking measures provided a rough approximation of recognition memory, but in some instances, the looking measure underestimated retention. The use of meaningful stimuli raise important questions about the way in which visual attention is interpreted in the VRM paradigm, and may provide new opportunities to measure memory during infancy and early childhood. © 2016 Wiley Periodicals, Inc.

Meaningful experiences in science education: Engaging the space researcher in a cultural transformation to greater science literacy

NASA Technical Reports Server (NTRS)

Morrow, Cherilynn A.

1993-01-01

The visceral appeal of space science and exploration is a very powerful emotional connection to a very large and diverse collection of people, most of whom have little or no perspective about what it means to do science and engineering. Therein lies the potential of space for a substantially enhanced positive impact on culture through education. This essay suggests that through engaging more of the space research and development community in enabling unique and 'meaningful educational experiences' for educators and students at the pre-collegiate levels, space science and exploration can amplify its positive feedback on society and act as an important medium for cultural transformation to greater science literacy. I discuss the impact of space achievements on people and define what is meant by a 'meaningful educational experience,' all of which points to the need for educators and students to be closer to the practice of real science. I offer descriptions of two nascent science education programs associated with NASA which have the needed characteristics for providing meaningful experiences that can cultivate greater science literacy. Expansion of these efforts and others like it will be needed to have the desired impact on culture, but I suggest that the potential for the needed resources is there in the scientific research communities. A society in which more people appreciate and understand science and science methods would be especially conducive to human progress in space and on Earth.

School nurse evaluations: making the process meaningful and motivational.

PubMed

McDaniel, Kathryn H; Overman, Muriel; Guttu, Martha; Engelke, Martha Keehner

2013-02-01

The professional standards of school nursing practice provide a framework to help school nurses focus on their unique mission of promoting health and academic achievement for all students. Without the standards, the nurse's role can become task oriented and limited in scope. By using an evaluation tool that reflects the standards, nurses not only become aware and begin to understand the standards; they also become directly accountable for meeting them. In addition, developing an evaluation process based on the standards of school nurse practice increases the visibility of school nurses and helps school administrators understand the role of the school nurse. This article describes how one school district integrated the scope and standards of school nursing into the job description and performance evaluation of the nurse. The process which is used to complete the evaluation in a manner that is meaningful and motivational to the school nurse is described.

Event Segmentation Improves Event Memory up to One Month Later

ERIC Educational Resources Information Center

Flores, Shaney; Bailey, Heather R.; Eisenberg, Michelle L.; Zacks, Jeffrey M.

2017-01-01

When people observe everyday activity, they spontaneously parse it into discrete meaningful events. Individuals who segment activity in a more normative fashion show better subsequent memory for the events. If segmenting events effectively leads to better memory, does asking people to attend to segmentation improve subsequent memory? To answer…

Using Medicare Data to Identify Individuals Who Are Electricity Dependent to Improve Disaster Preparedness and Response

PubMed Central

DeSalvo, Karen; Finne, Kristen; Worrall, Chris; Bogdanov, Alina; Dinkler, Ayame; Babcock, Sarah; Kelman, Jeffrey

2014-01-01

During a disaster or prolonged power outage, individuals who use electricity-dependent medical equipment are often unable to operate it and seek care in acute care settings or local shelters. Public health officials often report that they do not have proactive and systematic ways to rapidly identify and assist these individuals. In June 2013, we piloted a first-in-the-nation emergency preparedness drill in which we used Medicare claims data to identify individuals with electricity-dependent durable medical equipment during a disaster and securely disclosed it to a local health department. We found that Medicare claims data were 93% accurate in identifying individuals using a home oxygen concentrator or ventilator. The drill findings suggest that claims data can be useful in improving preparedness and response for electricity-dependent populations. PMID:24832404

Using Medicare data to identify individuals who are electricity dependent to improve disaster preparedness and response.

PubMed

DeSalvo, Karen; Lurie, Nicole; Finne, Kristen; Worrall, Chris; Bogdanov, Alina; Dinkler, Ayame; Babcock, Sarah; Kelman, Jeffrey

2014-07-01

During a disaster or prolonged power outage, individuals who use electricity-dependent medical equipment are often unable to operate it and seek care in acute care settings or local shelters. Public health officials often report that they do not have proactive and systematic ways to rapidly identify and assist these individuals. In June 2013, we piloted a first-in-the-nation emergency preparedness drill in which we used Medicare claims data to identify individuals with electricity-dependent durable medical equipment during a disaster and securely disclosed it to a local health department. We found that Medicare claims data were 93% accurate in identifying individuals using a home oxygen concentrator or ventilator. The drill findings suggest that claims data can be useful in improving preparedness and response for electricity-dependent populations.

Novel subgroups of attention-deficit/hyperactivity disorder identified by topological data analysis and their functional network modular organizations

PubMed Central

Kyeong, Sunghyon; Kim, Jae-Jin; Kim, Eunjoo

2017-01-01

Attention-deficit/hyperactivity disorder (ADHD) is a clinically heterogeneous condition and identification of clinically meaningful subgroups would open up a new window for personalized medicine. Thus, we aimed to identify new clinical phenotypes in children and adolescents with ADHD and to investigate whether neuroimaging findings validate the identified phenotypes. Neuroimaging and clinical data from 67 children with ADHD and 62 typically developing controls (TDCs) from the ADHD-200 database were selected. Clinical measures of ADHD symptoms and intelligence quotient (IQ) were used as input features into a topological data analysis (TDA) to identify ADHD subgroups within our sample. As external validators, graph theoretical measures obtained from the functional connectome were compared to address the biological meaningfulness of the identified subtypes. The TDA identified two unique subgroups of ADHD, labelled as mild symptom ADHD (mADHD) and severe symptom ADHD (sADHD). The output topology shape was repeatedly observed in the independent validation dataset. The graph theoretical analysis showed a decrease in the degree centrality and PageRank in the bilateral posterior cingulate cortex in the sADHD group compared with the TDC group. The mADHD group showed similar patterns of intra- and inter-module connectivity to the sADHD group. Relative to the TDC group, the inter-module connectivity between the default mode network and executive control network were significantly increased in the sADHD group but not in the mADHD group. Taken together, our results show that the data-driven TDA is potentially useful in identifying objective and biologically relevant disease phenotypes in children and adolescents with ADHD. PMID:28829775

Enhanced equivalence class formation by the delay and relational functions of meaningful stimuli.

PubMed

Arntzen, Erik; Nartey, Richard K; Fields, Lanny

2015-05-01

Undergraduates in six groups of 10 attempted to form three 3-node 5-member equivalence classes (A → B → C → D → E) under the simultaneous protocol. In five of six groups, all stimuli were abstract shapes; in the PIC group, C stimuli were pictures with the remainder being abstract shapes. Before class formation, participants in the Identity-S and Identity-D groups were given preliminary training to form identity conditional discriminations with the C stimuli using simultaneous and 6 s delayed matching-to-sample procedures, respectively. In the Arbitrary-S and Arbitrary-D groups, before class formation, arbitrary conditional discriminations were formed between C and X stimuli using simultaneous and 6 s delayed matching-to-sample procedures, respectively. With no preliminary training, classes in the PIC and ABS groups were formed by 80% and 0% of participants, respectively. After preliminary training, class formation (yield) increased with delay, regardless of relational type. For each of the two delays, yield was slightly greater after forming arbitrary- instead of identity-relations. Yield was greatest, however, when a class contained a meaningful stimulus (PIC). During failed class formation, probes produced experimenter-defined relations, participant-defined relations, and unsystematic responding; delay, but not the relation type in preliminary training influenced relational and indeterminate responding. These results suggest how meaningful stimuli enhance equivalence class formation. © Society for the Experimental Analysis of Behavior.

Students as Collaborators in Creating Meaningful Learning Experiences in Technology-Enhanced Classrooms: An Engaged Scholarship Approach

ERIC Educational Resources Information Center

Nel, Liezel

2017-01-01

In dealing with numerous challenges, higher education instructors need to adapt their pedagogical practices to present students with meaningful, engaged learning experiences that are likely to promote student success and adequately prepare students for the world we live in. As part of this pedagogical transformation instructors also need to…

Identifying Eating Occasion-Based Opportunities to Improve the Overall Diets of Australian Adolescents

PubMed Central

Fayet-Moore, Flavia; McConnell, Andrew; Kim, Jean; Mathias, Kevin C.

2017-01-01

Adolescents in Australia have a poor dietary intake, leading to large numbers of them being at risk for inadequate intake of micronutrients, and excessive intake of less healthful dietary components. This study examined dietary intakes at multiple eating occasions to identify opportunities for more targeted recommendations and strategies to improve dietary intakes among adolescents. Data from the first 24-h recall of 14–18 years old in the 2011–2012 National Nutrition and Physical Activity Survey were analysed (n = 772). Participant-defined eating occasions were classified as breakfast, lunch, dinner or other eating occasions combined. The mean percent contribution to the total day intake of top shortfall nutrients (calcium, magnesium, vitamin A, iron), discretionary calories, saturated fat, free sugars and sodium, as well as nutrient density, the foods consumed and the percent of consumers at each eating occasion, were calculated. Breakfast had the lowest prevalence of consumers (81%), contributed the least to total daily energy (14.6%) and almost a quarter of daily calcium and iron. Other eating occasions combined contributed 47.5% of free sugars and were top contributors of daily calcium (34.6%) and magnesium (31.7%). Discretionary foods contributed 32.4% of the energy at lunch, and the sodium content at lunch was 415 mg/1000 kJ. Key opportunities identified for adolescents were to increase breakfast consumption, given the high nutrient densities of breakfasts consumed; improve overall lunch quality, particularly the sodium content; promote the intake of milk, fruit and a variety of vegetables at both lunch and dinner; maintain healthful choices at in-between meal eating occasions while focusing on decreasing the intake of discretionary foods. PMID:28613261

Sacrifice: an ethical dimension of caring that makes suffering meaningful.

PubMed

Helin, Kaija; Lindström, Unni A

2003-07-01

This article is intended to raise the question of whether sacrifice can be regarded stituting a deep ethical structure in the relationship between patient and carer. The significance of sacrifice in a patient-carer relationship cannot, however, be fully understood from the standpoint of the consistently utilitarian ethic that characterizes today's ethical discourse. Deontological ethics, with its universal principles, also does not provide a suitable point of departure. Ethical recommendations and codices are important and serve as general sources of knowledge when making decisions, but they should be supplemented by an ethic that takes into consideration contextual and situational factors that make every encounter between patient and carer unique. Caring science research literature presents, on the whole, general agreement on the importance of responsibility and devotian with regard to sense of duty, warmth and genuine engagement in caring. That sacrifice may also constitute an important ethical element in the patient-carer relationship is, however, a contradictory and little considered theme. Caring literature that deals with sacrifice/self-sacrifice indicates contradictory import. It is nevertheless interesting to notice that both the negative and the positive aspects bring out importance of the concept for the professional character of caring. The tradition of ideas in medieval Christian mysticism with reference to Lévinas' ethic of responsibility offers a deeper perspective in which the meaningfulness of sacrifice in the caring relationship can be sought. The theme of sacrifice is not of interest merely as a carer's ethical outlook, but sacrifice can also be understood as a potential process of transformation health. The instinctive or conscious experience of sacrifice on the part of the individual patient can, on a symbolic level, be regarded as analogous to the cultic or religious sacrifice aiming at atonement. Sacrifice appears to the patient as an act of

Identifying Natural Alignments Between Ambulatory Surgery Centers and Local Health Systems: Building Broader Communities of Surgical Care.

PubMed

Funk, Russell J; Owen-Smith, Jason; Landon, Bruce E; Birkmeyer, John D; Hollingsworth, John M

2017-02-01

To develop and compare methods for identifying natural alignments between ambulatory surgery centers (ASCs) and hospitals that anchor local health systems. Using all-payer data from Florida's State Ambulatory Surgery and Inpatient Databases (2005-2009), we developed 3 methods for identifying alignments between ASCS and hospitals. The first, a geographic proximity approach, used spatial data to assign an ASC to its nearest hospital neighbor. The second, a predominant affiliation approach, assigned an ASC to the hospital with which it shared a plurality of surgeons. The third, a network community approach, linked an ASC with a larger group of hospitals held together by naturally occurring physician networks. We compared each method in terms of its ability to capture meaningful and stable affiliations and its administrative simplicity. Although the proximity approach was simplest to implement and produced the most durable alignments, ASC surgeon's loyalty to the assigned hospital was low with this method. The predominant affiliation and network community approaches performed better and nearly equivalently on these metrics, capturing more meaningful affiliations between ASCs and hospitals. However, the latter's alignments were least durable, and it was complex to administer. We describe 3 methods for identifying natural alignments between ASCs and hospitals, each with strengths and weaknesses. These methods will help health system managers identify ASCs with which to partner. Moreover, health services researchers and policy analysts can use them to study broader communities of surgical care.

Co-creating meaningful structures within long-term psychotherapy group culture.

PubMed

Gayle, Robin G

2009-07-01

Meaningful group structures are co-created within the long-term outpatient psychotherapy group through a hermeneutical interaction between structure and immediate experience of structure by individuals embedded in personal and collective contexts. Co-created meanings expand original group- and self-understandings and further evolve structures that are stable yet do not exist independently of the narratives and affects of the members who interact with them. Group structures do not reduce, expand, or dissolve but change in connection to the experiences and meaning attributions within the group. This intersubjective process mediates the emphasis within group theory on leader responsibility for culture building that risks overpromoting certain psychotherapeutic cultural intentions over others. Three examples of intersubjective hermeneutical interaction within long-term psychotherapy groups lend insight into global, cultural, and societal groups.

Fidelity Assessment to Improve Teacher Instruction and School Decision Making

ERIC Educational Resources Information Center

McKenna, John William; Parenti, Melissa

2017-01-01

Teachers must provide high-quality instruction based on evidence-based practices to provide students meaningful opportunities to learn and to improve school outcomes. Although teachers have access to a variety of resources on evidence-based practices, poor implementation may limit the effectiveness of teacher practices, as indicated by low levels…

Concept Development and Meaningful Learning among Electrical Engineering Students Engaged in a Problem-Based Laboratory Experience

ERIC Educational Resources Information Center

Bledsoe, Karen E.; Flick, Lawrence

2012-01-01

This phenomenographic study documented changes in student-held electrical concepts the development of meaningful learning among students with both low and high prior knowledge within a problem-based learning (PBL) undergraduate electrical engineering course. This paper reports on four subjects: two with high prior knowledge and two with low prior…

The measurement of water scarcity: Defining a meaningful indicator.

PubMed

Damkjaer, Simon; Taylor, Richard

2017-09-01

Metrics of water scarcity and stress have evolved over the last three decades from simple threshold indicators to holistic measures characterising human environments and freshwater sustainability. Metrics commonly estimate renewable freshwater resources using mean annual river runoff, which masks hydrological variability, and quantify subjectively socio-economic conditions characterising adaptive capacity. There is a marked absence of research evaluating whether these metrics of water scarcity are meaningful. We argue that measurement of water scarcity (1) be redefined physically in terms of the freshwater storage required to address imbalances in intra- and inter-annual fluxes of freshwater supply and demand; (2) abandons subjective quantifications of human environments and (3) be used to inform participatory decision-making processes that explore a wide range of options for addressing freshwater storage requirements beyond dams that include use of renewable groundwater, soil water and trading in virtual water. Further, we outline a conceptual framework redefining water scarcity in terms of freshwater storage.

Failure to engage the public in issues related to inland fishes and fisheries: strategies for building public and political will to promote meaningful conservation.

PubMed

Cooke, S J; Lapointe, N W R; Martins, E G; Thiem, J D; Raby, G D; Taylor, M K; Beard, T D; Cowx, I G

2013-10-01

Generating awareness of environmental conservation issues among the public is essential if there is an expectation of them to alter their behaviour, facilitate informed decisions and engage governments or regulatory authorities to take action. There are, however, exceedingly few public engagement success stories related to inland fishes and fisheries policy and resource allocation decisions. Inland aquatic resources and their associated fisheries provide employment, recreation, culture and, in developing regions, a considerable proportion of human nutrition and food security. Freshwater fishes are incredibly diverse but are among the most endangered organisms globally. Many threats to inland fisheries are driven largely by externalities to inland fisheries. The purpose of this paper is to draw attention to the role and plight of inland fishes and fisheries, and the need to generate the public and political will necessary to promote meaningful conservation. With this paper, the extent to which the scientific and environmental management communities have failed to engage the public in issues related to inland fishes and fisheries is characterized. Next, the barriers or factors that serve as the basis for the problem with public engagement are identified. The paper concludes by identifying strategies, including those focused on environmental education initiatives, for building the public and political will necessary to promote meaningful conservation of inland fishes and fisheries in developed and developing countries. Scientists, environmental managers, non-governmental organizations, politicians, regulatory authorities and the media all have important roles to play in overcoming challenges to inland fisheries. Failure to engage the public in freshwater conservation and management issues will impede efforts to stem the loss of freshwater habitats, fisheries and aquatic biodiversity. Thankfully, there are opportunities to learn from success stories related to other

Public health surveillance and meaningful use regulations: a crisis of opportunity.

PubMed

Lenert, Leslie; Sundwall, David N

2012-03-01

The Health Information Technology for Economic and Clinical Health Act is intended to enhance reimbursement of health care providers for meaningful use of electronic health records systems. This presents both opportunities and challenges for public health departments. To earn incentive payments, clinical providers must exchange specified types of data with the public health system, such as immunization and syndromic surveillance data and notifiable disease reporting. However, a crisis looms because public health's information technology systems largely lack the capabilities to accept the types of data proposed for exchange. Cloud computing may be a solution for public health information systems. Through shared computing resources, public health departments could reap the benefits of electronic reporting within federal funding constraints.

Face Time: Meaningful Public Engagement Through Interactive, In-Person Outreach Efforts

NASA Astrophysics Data System (ADS)

Bartel, B. A.; Agopian, M.

2017-12-01

Science festivals, classrooms, community groups, and farmers markets provide rich opportunities for scientists to interact with the non-expert public. These venues offer scientists not only the opportunity to explain their science to the public, but to actually converse about the science, to put a human face with the scientific enterprise, and to learn about the values and knowledge levels of people within our communities. This interaction allows us to connect with a curious and sometimes skeptical public, correct misinformation, inspire the next generation (and the next generation's parents), and speak directly with voters about the relevance of science to our daily lives. While other channels of communication may reach a broader audience, these in-person, often one-on-one interactions make for meaningful, memorable, and potentially impactful experiences for scientists and non-experts alike. Skills used to engage the public in these planned events are the same skills we need to engage in any productive conversation. Communications training addressing effective conversations with non-experts can help scientists communicate more effectively not only by helping us hone our messaging, but also by recognizing our assumptions, biases, and our tendency to explain more than listen, even when our will is good. We have provided communications training based on the NSF-funded Portal to the Public (PoP) framework to students, post-docs, and educators. Feedback indicates these communications workshops improve participants' teaching abilities, confidence in engaging with the public, and even ability to articulate research to fellow scientists. In this presentation, we will share best practices for engaging non-experts based on PoP, as well as drawing from our experience in outreach at events, in classrooms, and in museums.

Improving the accuracy of total quality management instruments.

PubMed

Bechtel, G A; Wood, D

1996-03-01

Total quality management (TQM) instruments are essential tools in defining concepts identified in an Ishikawa or ¿cause-and-effect¿ diagram. Collecting meaningful and accurate data using TQM instruments is imperative if productivity and quality of care are to be enhanced. This article provides managers with techniques and guidelines that will enhance the reliability and validity of TQM instruments, thereby promoting organization efficiency and customer satisfaction.

Optimizing the User Experience: Identifying Opportunities to Improve Use of an Inpatient Portal.

PubMed

Walker, Daniel M; Menser, Terri; Yen, Po-Yin; McAlearney, Ann Scheck

2018-01-01

Patient portals specifically designed for the inpatient setting have significant potential to improve patient care. However, little is known about how the users of this technology, the patients, may interact with the inpatient portals. As a result, hospitals have limited ability to design approaches that support patient use of the portal. This study aims to evaluate the user experience associated with an inpatient portal. We used a Think-Aloud protocol to study user interactions with a commercially available inpatient portal-MyChart Bedside (MCB). Study participants included 19 English-speaking adults over the age of 18 years. In one-on-one sessions, participants narrated their experience using the MCB application and completing eight specific tasks. Recordings were transcribed and coded into three dimensions of the user experience: physical, cognitive, and sociobehavioral. Our analysis of the physical experience highlighted the navigational errors and technical challenges associated with the use of MCB. We also found that issues associated with the cognitive experience included comprehension problems that spurred anxiety and uncertainty. Analysis of the sociobehavioral experience suggested that users have different learning styles and preferences for learning including self-guided, handouts, and in-person training. Inpatient portals may be an effective tool to improve the patient experience in the hospital. Moreover, making this technology available to inpatients may help to foster ongoing use of technology across the care continuum. However, deriving the benefits from the technology requires appropriate support. We identified multiple opportunities for hospital management to intervene. In particular, teaching patients to use the application by making a variety of instructional materials available could help to reduce several identified barriers to use. Additionally, hospitals should be prepared to manage patient anxiety and increased questioning arising from the

The Daily Readiness Huddle: a process to rapidly identify issues and foster improvement through problem-solving accountability.

PubMed

Donnelly, Lane F; Cherian, Shirley S; Chua, Kimberly B; Thankachan, Sam; Millecker, Laura A; Koroll, Alex G; Bisset, George S

2017-01-01

Because of the increasing complexities of providing imaging for pediatric health care services, a more reliable process to manage the daily delivery of care is necessary. Objective We describe our Daily Readiness Huddle and the effects of the process on problem identification and improvement. Our Daily Readiness Huddle has four elements: metrics review, clinical volume review, daily readiness assessment, and problem accountability. It is attended by radiologists, directors, managers, front-line staff with concerns, representatives from support services (information technology [IT] and biomedical engineering [biomed]), and representatives who join the meeting in a virtual format from off-site locations. Data are visually displayed on erasable whiteboards. The daily readiness assessment uses queues to determine whether anyone has concerns or outlier data in regard to S-MESA (Safety, Methods, Equipment, Supplies or Associates). Through this assessment, problems are identified and categorized as quick hits (will be resolved in 24-48 h, not requiring project management) and complex issues. Complex issues are assigned an owner, quality coach and report-back date. Additionally, projects are defined as improvements that are often strategic, are anticipated to take more than 60 days, and do not necessarily arise out of identified issues during the Daily Readiness Huddle. We tracked and calculated the mean, median and range of days to resolution and completion for complex issues and for projects during the first full year of implementing this process. During the first 12 months, 91 complex issues were identified and resolved, 11 projects were in progress and 33 completed, with 23 other projects active or in planning. Time to resolution of complex issues (in days) was mean 37.5, median 34.0, and range 1-105. For projects, time to completion (in days) was mean 86.0, median 84.0, and range 5-280. The Daily Readiness Huddle process has given us a framework to rapidly identify

Elective surgical case cancellation in the Veterans Health Administration system: identifying areas for improvement.

PubMed

Argo, Joshua L; Vick, Catherine C; Graham, Laura A; Itani, Kamal M F; Bishop, Michael J; Hawn, Mary T

2009-11-01

This study evaluated elective surgical case cancellation (CC) rates, reasons for these cancellations, and identified areas for improvement within the Veterans Health Administration (VA) system. CC data for 2006 were collected from the scheduling software for 123 VA facilities. Surveys were distributed to 40 facilities (10 highest and 10 lowest CC rates for high- and low-volume facilities). CC reasons were standardized and piloted at 5 facilities. Of 329,784 cases scheduled by 9 surgical specialties, 40,988 (12.4%) were cancelled. CC reasons (9,528) were placed into 6 broad categories: patient (35%), work-up/medical condition change (28%), facility (20%), surgeon (8%), anesthesia (1%), and miscellaneous (8%). Survey results show areas for improvement at the facility level and a standardized list of 28 CC reasons was comprehensive. Interventions that decrease cancellations caused by patient factors, inadequate work-up, and facility factors are needed to reduce overall elective surgical case cancellations.

Perioperative self-reflection among surgical residents.

PubMed

Peshkepija, Andi N; Basson, Marc D; Davis, Alan T; Ali, Muhammad; Haan, Pam S; Gupta, Rama N; Hardaway, John C; Nebeker, Cody A; McLeod, Michael K; Osmer, Robert L; Anderson, Cheryl I

2017-09-01

We studied prevalence and predictors of meaningful self-reflection among surgical residents and with prompting/structured interventions, sought to improve/sustain resident skills. Residents from six programs recorded 1032 narrative self-reflective comments (120 residents), using a web-based platform. If residents identified something learned or to be improved, self-reflection was deemed meaningful. Independent variables PGY level, resident/surgeon gender, study site/Phase1: July2014-August2015 vs. Phase2: September2015-September2016) were analyzed. Meaningful self-reflection was documented in 40.6% (419/1032) of entries. PGY5's meaningfully self-reflected less than PGY1-4's, 26.1% vs. 49.6% (p = 0.002). In multivariate analysis, resident narratives during Phase 2 were 4.7 times more likely to engage in meaningful self-reflection compared to Phase1 entries (p < 0.001). Iterative changes during Phase2 showed a 236% increase in meaningful self-reflection, compared to Phase1. Surgical residents uncommonly practice meaningful self-reflection, even when prompted, and PGY5/chief residents reflect less than more junior residents. Substantial/sustained improvements in resident self-reflection can occur with both training and interventions. Copyright © 2017 Elsevier Inc. All rights reserved.

Dissociating Neural Correlates of Meaningful Emblems from Meaningless Gestures in Deaf Signers and Hearing Non-Signers

PubMed Central

Husain, Fatima T.; Patkin, Debra J.; Kim, Jieun; Braun, Allen R.; Horwitz, Barry

2012-01-01

Emblems are meaningful, culturally-specific hand gestures that are analogous to words. In this fMRI study, we contrasted the processing of emblematic gestures with meaningless gestures by pre-lingually Deaf and hearing participants. Deaf participants, who used American Sign Language, activated bilateral auditory processing and associative areas in the temporal cortex to a greater extent than the hearing participants while processing both types of gestures relative to rest. The hearing non-signers activated a diverse set of regions, including those implicated in the mirror neuron system, such as premotor cortex (BA 6) and inferior parietal lobule (BA 40) for the same contrast. Further, when contrasting the processing of meaningful to meaningless gestures (both relative to rest), the Deaf participants, but not the hearing, showed greater response in the left angular and supramarginal gyri, regions that play important roles in linguistic processing. These results suggest that whereas the signers interpreted emblems to be comparable to words, the non-signers treated emblems as similar to pictorial descriptions of the world and engaged the mirror neuron system. PMID:22968047

Acting Out: Enabling Meaningful Participation Among People With Long-Term Mental Health Problems in a Music and Theater Workshop.

PubMed

Ørjasæter, Kristin Berre; Ness, Ottar

2017-09-01

In this article, we explore what enables meaningful participation in a music and theater workshop from a first person's perspective of people with mental health problems. The study uses a hermeneutical-phenomenological approach. Data were collected from qualitative in-depth interviews with 12 participants in a music and theater workshop located in a Norwegian mental health hospital. Data were analyzed through thematic analysis. Two overarching themes were identified: (a) room for dignity and (b) a creative arena. This study indicates that to enable participation for people with long-term mental health problems, it is important to facilitate activities that are flexible, person centered, and resource oriented, in which participants have the possibility to participate regardless of symptoms, functional ability, or whether they are hospitalized. In addition, having professionals who believe in creative growth and offer an illness-free zone that belongs to the participants in a hospital setting is of great importance.

Using health technology assessment to identify gaps in evidence and inform study design for comparative effectiveness research.

PubMed

Tunis, Sean R; Turkelson, Charles

2012-12-01

Health technology assessment (HTA) is primarily used as a tool to ensure that clinical and policy decisions are made with the benefit of a systematic analysis of all completed research. This article describes the progress and potential for HTA reports to improve the quality and relevance of future research and to better serve the information needs of patients, clinicians, payers, and other decision makers. We conducted a review of the current published literature and working papers describing past, ongoing, and future initiatives that rely on HTA reports to identify gaps in evidence and improve the design of future research. Although still in a developmental stage, significant progress is under way to improve methods for using HTA reports for the systematic identification of research gaps, prioritization of future research, and improvement of study designs. Several well-defined frameworks have been developed to assist those who produce HTA to become more effective in these additional domains of work. A recurring element of this work is the importance of meaningfully involving stakeholders in the process of defining future research needs and designing studies to address them. Patients, clinicians, and payers are important audiences for completed research and are now recognized as serving an important role in determining what future research is needed. There are substantial opportunities to improve the quality, relevance, and efficiency of clinical research. Recent efforts are beginning to demonstrate the potential to build on the work invested in developing HTA reports to provide a roadmap toward these objectives.

Patient Centred Systems: Techno-Anthropological reflections on the challenges of 'meaningfully engaging' patients within health informatics research.

PubMed

Wong, Ming-Chao; Almond, Helen; Cummings, Elizabeth; Roehrer, Erin; Showell, Chris; Turner, Paul

2015-01-01

This chapter explores how Techno-Anthropology can contribute to more explicitly professional and ethically responsible reflections on the socio-technical practices involved in meaningfully engaging patients in health informatics research. The chapter draws on insights from health informatics research projects focused on chronic disease and self-management conducted in Tasmania during the last 10 years. Through these projects the paper explores three topics of relevance to 'meaningful engagement' with patients: (i) Patient Self-Management and Chronic Disease (ii) Patients as Users in Health Informatics research, and, (iii) Evaluations of outcomes in Health and Health Informatics Interventions. Techno-Anthropological reflections are then discussed through the concepts of liminality, polyphony and power. This chapter argues that beyond its contribution to methodology, an important role for Techno-Anthropology in patient centred health informatics research may be its capacity to support new ways of conceptualising and critically reflecting on the construction and mediation of patients' needs, values and perspectives.

Introduction of a Journal Excerpt Activity Improves Undergraduate Students' Performance in Statistics

ERIC Educational Resources Information Center

Rabin, Laura A.; Nutter-Upham, Katherine E.

2010-01-01

We describe an active learning exercise intended to improve undergraduate students' understanding of statistics by grounding complex concepts within a meaningful, applied context. Students in a journal excerpt activity class read brief excerpts of statistical reporting from published research articles, answered factual and interpretive questions,…

Achieving the Meaningful Use Standard: A Model for Implementing Change Within Medical Practices.

PubMed

Fryefield, David C; Staggs, Stuart; Herman, William; Stickler, Alan; Ahmad, Asif; Patt, Debra A; Beveridge, Roy A

2014-03-01

Change management in medical practices is often an uphill battle. Lack of agreement on standards, ineffective leadership, inertia, inconsistent access to data, and inability to clearly define and communicate the benefits of change represent significant barriers to success. In 2009, the Health Information Technology for Economic and Clinical Health (HITECH) Act created the meaningful use (MU) incentive program administered through the Centers for Medicare and Medicaid Services (CMS). To earn financial incentive payments, eligible physicians adopt certified electronic health record (EHR) technology and use it to meet specified objectives. In response, leadership of the US Oncology Network launched an MU initiative designed to create a comprehensive system of tools, education, performance feedback, and support that would facilitate successful achievement of the MU standards. The EHR used by the majority of network physicians was modified according to the MU specifications, and EHR certification was obtained. Baseline compliance data were measured for each of the MU standards and for each of the eligible physicians. Physician and staff workflow processes necessary for consistent data input and compliance were outlined for each standard. Each practice identified one or more staff members who would act as MU leads. Training modules were developed for the MU leads as well as for physicians, mid-level providers, nurses, medical assistants, and office staff. An MU measurement tool was created, designed to target areas for MU process improvement and automate reporting. Data were updated and verified weekly to provide timely feedback to practices, including individual physician detail and links to individual patient records. A total of 943 practitioners within the US Oncology Network met eligibility criteria for the MU program. At baseline, compliance with each MU standard ranged from 0% (clinical summaries) to 100% (computerized order entry). In many cases, data were simply

Public Health Surveillance and Meaningful Use Regulations: A Crisis of Opportunity

PubMed Central

Sundwall, David N.

2012-01-01

The Health Information Technology for Economic and Clinical Health Act is intended to enhance reimbursement of health care providers for meaningful use of electronic health records systems. This presents both opportunities and challenges for public health departments. To earn incentive payments, clinical providers must exchange specified types of data with the public health system, such as immunization and syndromic surveillance data and notifiable disease reporting. However, a crisis looms because public health’s information technology systems largely lack the capabilities to accept the types of data proposed for exchange. Cloud computing may be a solution for public health information systems. Through shared computing resources, public health departments could reap the benefits of electronic reporting within federal funding constraints. PMID:22390523

Identifying specific beliefs to target to improve restaurant employees' intentions for performing three important food safety behaviors.

PubMed

Pilling, Valerie K; Brannon, Laura A; Shanklin, Carol W; Howells, Amber D; Roberts, Kevin R

2008-06-01

Current national food safety training programs appear ineffective at improving food safety practices in foodservice operations, given the substantial number of Americans affected by foodborne illnesses after eating in restaurants each year. The Theory of Planned Behavior (TpB) was used to identify important beliefs that may be targeted to improve foodservice employees' intentions for three food safety behaviors that have the most substantial affect on public health: hand washing, using thermometers, and proper handling of food contact surfaces. In a cross-sectional design, foodservice employees (n=190) across three midwestern states completed a survey assessing TpB components and knowledge for the three food safety behaviors. Multiple regression analyses were performed on the TpB components for each behavior. Independent-samples t tests identified TpB beliefs that discriminated between participants who absolutely intend to perform the behaviors and those with lower intention. Employees' attitudes were the one consistent predictor of intentions for performing all three behaviors. However, a unique combination of important predictors existed for each separate behavior. Interventions for improving employees' behavioral intentions for food safety should focus on TpB components that predict intentions for each behavior and should bring all employees' beliefs in line with those of the employees who already intend to perform the food safety behaviors. Registered dietitians; dietetic technicians, registered; and foodservice managers can use these results to enhance training sessions and motivational programs to improve employees' food safety behaviors. Results also assist these professionals in recognizing their responsibility for enforcing and providing adequate resources for proper food safety behaviors.

Meaningful Learning with Mobile Devices: Pre-Service Class Teachers' Experiences of Mobile Learning in the Outdoors

ERIC Educational Resources Information Center

Kärki, Tomi; Keinänen, Heli; Tuominen, Anu; Hoikkala, Marianna; Matikainen, Eila; Maijala, Hanna

2018-01-01

The authors consider the use of mobile learning environment ActionTrack in teacher education. Pre-service class teachers' (N = 277) experiences of the mobile learning environment were measured with a 7-point Likert-scale questionnaire based on seven attributes of meaningful learning. Students' ratings for different attributes were analysed…

The Role of Post-Visit Action Resources in Facilitating Meaningful Free-Choice Learning after a Zoo Visit

ERIC Educational Resources Information Center

Bueddefeld, Jill N. H.; Van Winkle, Christine M.

2018-01-01

Places like zoos, where free-choice learning is encouraged, are important for conveying climate change and sustainability issues to the public. Free-choice learning that targets environmentally focused sustainable behavior changes must be meaningful in order to encourage actual behavior change post-visit. However, visitors often fail to translate…

Social-Cognition and the Broad Autism Phenotype: Identifying Genetically Meaningful Phenotypes

ERIC Educational Resources Information Center

Losh, Molly; Piven, Joseph

2007-01-01

Background: Strong evidence from twin and family studies suggests that the genetic liability to autism may be expressed through personality and language characteristics qualitatively similar, but more subtly expressed than those defining the full syndrome. This study examined behavioral features of this "broad autism phenotype" (BAP) in relation…

Predicting loss of employment over three years in multiple sclerosis: clinically meaningful cognitive decline.

PubMed

Morrow, Sarah A; Drake, Allison; Zivadinov, Robert; Munschauer, Frederick; Weinstock-Guttman, Bianca; Benedict, Ralph H B

2010-10-01

Cognitive dysfunction is common in multiple sclerosis (MS), yet the magnitude of change on objective neuropsychological (NP) tests that is clinically meaningful is unclear. We endeavored to determine NP markers of the transition from employment to work disability in MS, as indicated by degree of decline on individual tests. Participants were 97 employed MS patients followed over 41.3 ± 17.6 months with a NP battery covering six domains of cognitive function. Deterioration at follow-up was designated as documented and paid disability benefits (conservative definition) or a reduction in hours/work responsibilities (liberal definition). Using the conservative definition, 28.9% reported deteriorated employment status and for the liberal definition, 45.4%. The Symbol Digit Modalities Test (SDMT) and California Verbal Learning Test, Total Learning (CVLT2-TL) measures distinguished employed and disabled patients at follow-up. Controlling for demographic and MS characteristics, the odds ratio of a deterioration based on a change of 2.0 on the CVLT2-TL was 3.7 (95% CI 1.2-11.4 and SDMT by 4.0 was 4.2 (95% CI 1.2-14.8), accounting for 86.7% of the area under the ROC curve. We conclude that decline on NP testing over time is predictive of deterioration in vocational status, establishing a magnitude of decline on NP tests that is clinically meaningful.

The Relationship Between Magnet Designation, Electronic Health Record Adoption, and Medicare Meaningful Use Payments.

PubMed

Lippincott, Christine; Foronda, Cynthia; Zdanowicz, Martin; McCabe, Brian E; Ambrosia, Todd

2017-08-01

The objective of this study was to examine the relationship between nursing excellence and electronic health record adoption. Of 6582 US hospitals, 4939 were eligible for the Medicare Electronic Health Record Incentive Program, and 6419 were eligible for evaluation on the HIMSS Analytics Electronic Medical Record Adoption Model. Of 399 Magnet hospitals, 330 were eligible for the Medicare Electronic Health Record Incentive Program, and 393 were eligible for evaluation in the HIMSS Analytics Electronic Medical Record Adoption Model. Meaningful use attestation was defined as receipt of a Medicare Electronic Health Record Incentive Program payment. The adoption electronic health record was defined as Level 6 and/or 7 on the HIMSS Analytics Electronic Medical Record Adoption Model. Logistic regression showed that Magnet-designated hospitals were more likely attest to Meaningful Use than non-Magnet hospitals (odds ratio = 3.58, P < .001) and were more likely to adopt electronic health records than non-Magnet hospitals (Level 6 only: odds ratio = 3.68, P < .001; Level 6 or 7: odds ratio = 4.02, P < .001). This study suggested a positive relationship between Magnet status and electronic health record use, which involves earning financial incentives for successful adoption. Continued investigation is needed to examine the relationships between the quality of nursing care, electronic health record usage, financial implications, and patient outcomes.

Emotions experienced at event recall and the self: Implications for the regulation of self-esteem, self-continuity and meaningfulness.

PubMed

Ritchie, Timothy D; Sedikides, Constantine; Skowronski, John J

2016-01-01

The intensity of positive affect elicited by recall of positive events exceeds the intensity of negative affect elicited by recall of negative events (fading affect bias, or FAB). The research described in the present article examined the relation between the FAB and three regulatory goals of the self: esteem, continuity and meaningfulness. The extent to which an event contributed to esteem (Study 1), continuity (Study 2) or meaningfulness (Study 3) was related to positive affect at event recall provoked by positive memories and to negative affect at event recall provoked by negative memories. The relation between affect experienced at recall and the three regulatory goals was bidirectional. The results showcase how individuals use recall for self-regulatory purposes and how they implement self-regulatory goals for positive affect.

Pilot Study: Improving Patient Outcomes with Healing Touch.

PubMed

Hendricks, Kimberly; Wallace, Kelley F

2017-01-01

Healing Touch therapies use a practitioner's intentional placement of hands to influence the patient's energy fields to promote self-healing. In the changing climate of health care, in which the patient experience increasingly drives reimbursements, it is vital to find unique and meaningful ways beyond traditional medical therapies to ensure positive patient experiences. To that end, our peritoneal dialysis clinic staff adopted Jean Watson's theoretical framework, by which patients are treated as whole unique individuals with a "multidimensional system of energy, with a consciousness that can be affected by another to promote well-being." In a rapidly growing urban clinic of more than 100 patients, our nurses identified the need to provide more ways to improve patient care.Staff were educated on ways to set positive intentions for patient contacts and to incorporate patient narratives into contact. Optional daily prayer was initiated, and patients were invited to attend a new support group for peritoneal dialysis patients and their families. In addition, a preliminary pilot provided Healing Touch treatments to interested patients. That pilot was associated with improvement in 4 of 5 measured categories. Fatigue and pain decreased by 46% and 68% respectively. Stress and anxiety fell by 49%, and a large drop of 84% in depression was observed. Nausea was unchanged.

Incorporating Meaningful Gamification in a Blended Learning Research Methods Class: Examining Student Learning, Engagement, and Affective Outcomes

ERIC Educational Resources Information Center

Tan, Meng; Hew, Khe Foon

2016-01-01

In this study, we investigated how the use of meaningful gamification affects student learning, engagement, and affective outcomes in a short, 3-day blended learning research methods class using a combination of experimental and qualitative research methods. Twenty-two postgraduates were randomly split into two groups taught by the same…

Understanding the factors that influence the adoption and meaningful use of social media by physicians to share medical information.

PubMed

McGowan, Brian S; Wasko, Molly; Vartabedian, Bryan Steven; Miller, Robert S; Freiherr, Desirae D; Abdolrasulnia, Maziar

2012-09-24

Within the medical community there is persistent debate as to whether the information available through social media is trustworthy and valid, and whether physicians are ready to adopt these technologies and ultimately embrace them as a format for professional development and lifelong learning. To identify how physicians are using social media to share and exchange medical information with other physicians, and to identify the factors that influence physicians' use of social media as a component of their lifelong learning and continuing professional development. We developed a survey instrument based on the Technology Acceptance Model, hypothesizing that technology usage is best predicted by a physician's attitudes toward the technology, perceptions about the technology's usefulness and ease of use, and individual factors such as personal innovativeness. The survey was distributed via email to a random sample of 1695 practicing oncologists and primary care physicians in the United States in March 2011. Responses from 485 physicians were analyzed (response rate 28.61%). Overall, 117 of 485 (24.1%) of respondents used social media daily or many times daily to scan or explore medical information, whereas 69 of 485 (14.2%) contributed new information via social media on a daily basis. On a weekly basis or more, 296 of 485 (61.0%) scanned and 223 of 485 (46.0%) contributed. In terms of attitudes toward the use of social media, 279 of 485 respondents (57.5%) perceived social media to be beneficial, engaging, and a good way to get current, high-quality information. In terms of usefulness, 281 of 485 (57.9%) of respondents stated that social media enabled them to care for patients more effectively, and 291 of 485 (60.0%) stated it improved the quality of patient care they delivered. The main factors influencing a physician's usage of social media to share medical knowledge with other physicians were perceived ease of use and usefulness. Respondents who had positive

Medicare incentive payments for meaningful use of electronic health records: accounting and reporting developments.

PubMed

2012-02-01

The Healthcare Financial Management Association through its Principles and Practices (P&P) Board publishes issue analyses to provide short-term practical assistance on emerging issues in healthcare financial management. In a new issue analysis excerpted in this article, HFMA's P&P Board provides some clarity to the healthcare industry on certain accounting and reporting issues resulting from incentive payments under the Medicare program for the meaningful use of electronic health record (EHR) technology. Consultation on these matters with independent auditors is highly recommended.

Identifying thresholds for relationships between impacts of rationing of nursing care and nurse- and patient-reported outcomes in Swiss hospitals: a correlational study.

PubMed

Schubert, Maria; Clarke, Sean P; Glass, Tracy R; Schaffert-Witvliet, Bianca; De Geest, Sabina

2009-07-01

In the Rationing of Nursing Care in Switzerland Study, implicit rationing of care was the only factor consistently significantly associated with all six studied patient outcomes. These results highlight the importance of rationing as a new system factor regarding patient safety and quality of care. Since at least some rationing of care appears inevitable, it is important to identify the thresholds of its influences in order to minimize its negative effects on patient outcomes. To describe the levels of implicit rationing of nursing care in a sample of Swiss acute care hospitals and to identify clinically meaningful thresholds of rationing. Descriptive cross-sectional multi-center study. Five Swiss-German and three Swiss-French acute care hospitals. 1338 nurses and 779 patients. Implicit rationing of nursing care was measured using the newly developed Basel Extent of Rationing of Nursing Care (BERNCA) instrument. Other variables were measured using survey items from the International Hospital Outcomes Study battery. Data were summarized using appropriate descriptive measures, and logistic regression models were used to define a clinically meaningful rationing threshold level. For the studied patient outcomes, identified rationing threshold levels varied from 0.5 (i.e., between 0 ('never') and 1 ('rarely') to 2 ('sometimes')). Three of the identified patient outcomes (nosocomial infections, pressure ulcers, and patient satisfaction) were particularly sensitive to rationing, showing negative consequences anywhere it was consistently reported (i.e., average BERNCA scores of 0.5 or above). In other cases, increases in negative outcomes were first observed from the level of 1 (average ratings of rarely). Rationing scores generated using the BERNCA instrument provide a clinically meaningful method for tracking the correlates of low resources or difficulties in resource allocation on patient outcomes. Thresholds identified here provide parameters for administrators to

Sparse Bayesian Learning for Identifying Imaging Biomarkers in AD Prediction

PubMed Central

Shen, Li; Qi, Yuan; Kim, Sungeun; Nho, Kwangsik; Wan, Jing; Risacher, Shannon L.; Saykin, Andrew J.

2010-01-01

We apply sparse Bayesian learning methods, automatic relevance determination (ARD) and predictive ARD (PARD), to Alzheimer’s disease (AD) classification to make accurate prediction and identify critical imaging markers relevant to AD at the same time. ARD is one of the most successful Bayesian feature selection methods. PARD is a powerful Bayesian feature selection method, and provides sparse models that is easy to interpret. PARD selects the model with the best estimate of the predictive performance instead of choosing the one with the largest marginal model likelihood. Comparative study with support vector machine (SVM) shows that ARD/PARD in general outperform SVM in terms of prediction accuracy. Additional comparison with surface-based general linear model (GLM) analysis shows that regions with strongest signals are identified by both GLM and ARD/PARD. While GLM P-map returns significant regions all over the cortex, ARD/PARD provide a small number of relevant and meaningful imaging markers with predictive power, including both cortical and subcortical measures. PMID:20879451

Local contextual processing of abstract and meaningful real-life images in professional athletes.

PubMed

Fogelson, Noa; Fernandez-Del-Olmo, Miguel; Acero, Rafael Martín

2012-05-01

We investigated the effect of abstract versus real-life meaningful images from sports on local contextual processing in two groups of professional athletes. Local context was defined as the occurrence of a short predictive series of stimuli occurring before delivery of a target event. EEG was recorded in 10 professional basketball players and 9 professional athletes of individual sports during three sessions. In each session, a different set of visual stimuli were presented: triangles facing left, up, right, or down; four images of a basketball player throwing a ball; four images of a baseball player pitching a baseball. Stimuli consisted of 15 % targets and 85 % of equal numbers of three types of standards. Recording blocks consisted of targets preceded by randomized sequences of standards and by sequences including a predictive sequence signaling the occurrence of a subsequent target event. Subjects pressed a button in response to targets. In all three sessions, reaction times and peak P3b latencies were shorter for predicted targets compared with random targets, the last most informative stimulus of the predictive sequence induced a robust P3b, and N2 amplitude was larger for random targets compared with predicted targets. P3b and N2 peak amplitudes were larger in the professional basketball group in comparison with professional athletes of individual sports, across the three sessions. The findings of this study suggest that local contextual information is processed similarly for abstract and for meaningful images and that professional basketball players seem to allocate more attentional resources in the processing of these visual stimuli.

Temporally contiguous pencast instruction promotes meaningful learning for dental and dental hygiene students in physiology.

PubMed

Roesch, Darren M

2014-01-01

Smartpens allow for the creation of computerized "pencasts" that combine voice narration with handwritten notes and illustrations. The purpose of this study was to test the effects of voluntary participation in extracurricular instruction with a pencast on student learning. Dental and dental hygiene students were given instruction in a complex physiological topic using lecture and static slides. An Internet link to a pencast that covered the complex topic in a more temporally contiguous fashion was also provided for voluntary review. The students were given a multiple-choice exam that consisted of retention and transfer test questions. Sixty-nine percent of the students who did not watch the pencast and 89 percent of the students who watched the pencast answered the retention test question correctly (p=0.08). Fifty-four percent of the students who did not watch the pencast and 90 percent of the students who watched the pencast answered the transfer test question correctly (p=0.005). This finding indicates that students who watched the pencast performed better on a transfer test, a measurement of meaningful learning, than students who received only the narrated instruction with static images. This supports the hypothesis that temporally contiguous instruction promotes more meaningful learning than lecture accompanied only by static slide images.

The Richness of Task-Evoked Hemodynamic Responses Defines a Pseudohierarchy of Functionally Meaningful Brain Networks

PubMed Central

Orban, Pierre; Doyon, Julien; Petrides, Michael; Mennes, Maarten; Hoge, Richard; Bellec, Pierre

2015-01-01

Functional magnetic resonance imaging can measure distributed and subtle variations in brain responses associated with task performance. However, it is unclear whether the rich variety of responses observed across the brain is functionally meaningful and consistent across individuals. Here, we used a multivariate clustering approach that grouped brain regions into clusters based on the similarity of their task-evoked temporal responses at the individual level, and then established the spatial consistency of these individual clusters at the group level. We observed a stable pseudohierarchy of task-evoked networks in the context of a delayed sequential motor task, where the fractionation of networks was driven by a gradient of involvement in motor sequence preparation versus execution. In line with theories about higher-level cognitive functioning, this gradient evolved in a rostro-caudal manner in the frontal lobe. In addition, parcellations in the cerebellum and basal ganglia matched with known anatomical territories and fiber pathways with the cerebral cortex. These findings demonstrate that subtle variations in brain responses associated with task performance are systematic enough across subjects to define a pseudohierarchy of task-evoked networks. Such networks capture meaningful functional features of brain organization as shaped by a given cognitive context. PMID:24729172

Meaningful use in the safety net: a rapid ethnography of patient portal implementation at five community health centers in California.

PubMed

Ackerman, Sara L; Sarkar, Urmimala; Tieu, Lina; Handley, Margaret A; Schillinger, Dean; Hahn, Kenneth; Hoskote, Mekhala; Gourley, Gato; Lyles, Courtney

2017-09-01

US health care institutions are implementing secure websites (patient portals) to achieve federal Meaningful Use (MU) certification. We sought to understand efforts to implement portals in "safety net" health care systems that provide services for low-income populations. Our rapid ethnography involved visits at 4 California safety net health systems and in-depth interviews at a fifth. Visits included interviews with clinicians and executives ( n  = 12), informal focus groups with front-line staff ( n  = 35), observations of patient portal sign-up procedures and clinic work, review of marketing materials and portal use data, and a brief survey ( n  = 45). Our findings demonstrate that the health systems devoted considerable effort to enlisting staff support for portal adoption and integrating portal-related work into clinic routines. Although all health systems had achieved, or were close to achieving, MU benchmarks, patients faced numerous barriers to portal use and our participants were uncertain how to achieve and sustain "meaningful use" as defined by and for their patients. Health systems' efforts to achieve MU certification united clinic staff under a shared ethos of improved quality of care. However, MU's assumptions about patients' demand for electronic access to health information and ability to make use of it directed clinics' attention to enrollment and message routing rather than to the relevance and usability of a tool that is minimally adaptable to the safety net context. We found a mismatch between MU-based metrics of patient engagement and the priorities and needs of safety net patient populations. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Failure of Ivermectin per Rectum to Achieve Clinically Meaningful Serum Levels in Two Cases of Strongyloides Hyperinfection

PubMed Central

Bogoch, Isaac I.; Khan, Kamran; Abrams, Howard; Nott, Caroline; Leung, Elizabeth; Fleckenstein, Lawrence; Keystone, Jay S.

2015-01-01

Two cases of Strongyloides hyperinfection are presented. Ivermectin was initially administered orally and per rectum pending the availability of subcutaneous (SC) preparations. In neither case did rectal suppositories of ivermectin achieve clinically meaningful serum values. Clinicians should use SC preparations of ivermectin as early as possible in Strongyloides hyperinfection and dissemination. PMID:25918215

Leadership to Support Student Voice: The Role of School Leaders in Supporting Meaningful Student Government and Voice

ERIC Educational Resources Information Center

Pautsch, Catherine A.

2010-01-01

Student voice is defined as meaningful opportunities that allow students to take an active role in the decision-making that influences their lives. While there is a growing body of literature linking student voice to increased student engagement, achievement, civic engagement and successful school reform, the role of the principal in supporting…

Making Meaningful Decisions about Time, Workload and Pedagogy in the Digital Age: The Course Resource Appraisal Model

ERIC Educational Resources Information Center

Kennedy, Eileen; Laurillard, Diana; Horan, Bernard; Charlton, Patricia

2015-01-01

This article reports on a design-based research project to create a modelling tool to analyse the costs and learning benefits involved in different modes of study. The Course Resource Appraisal Model (CRAM) provides accurate cost-benefit information so that institutions are able to make more meaningful decisions about which kind of…

A systematic literature search to identify performance measure outcomes used in clinical studies of racehorses.

PubMed

Wylie, C E; Newton, J R

2018-05-01

Racing performance is often used as a measurable outcome variable in research studies investigating clinical diagnoses or interventions. However, the use of many different performance measures largely precludes conduct of meaningful comparative studies and, to date, those being used have not been collated. To systematically review the veterinary scientific literature for the use of racing performance as a measurable outcome variable in clinical studies of racehorses, collate and identify those most popular, and identify their advantages and disadvantages. Systematic literature search. The search criteria "((racing AND performance) AND (horses OR equidae))" were adapted for both MEDLINE and CAB Abstracts databases. Data were collected in standardised recording forms for binary, categorical and quantitative measures, and the use of performance indices. In total, 217 studies that described racing performance were identified, contributing 117 different performance measures. No one performance measure was used in all studies, despite 90.3% using more than one variable. Data regarding race starts and earnings were used most commonly, with 88.0% and 54.4% of studies including at least one measure of starts and earnings, respectively. Seventeen variables were used 10 times or more, with the top five comprising: 'return to racing', 'number of starts', 'days to first start', 'earnings per period of time' and 'earnings per start'. The search strategies may not have identified all relevant papers, introducing bias to the review. Performance indices have been developed to improve assessment of interventions; however, they are not widely adopted in the scientific literature. Use of the two most commonly identified measures, whether the horse returned to racing and number of starts over a defined period of time, would best facilitate future systematic reviews and meta-analyses in advance of the development of a gold-standard measure of race performance outcome. © 2017 EVJ Ltd.

Cost-effectiveness of achieving clinical improvement with a dissonance-based eating disorder prevention program.

PubMed

Akers, Laura; Rohde, Paul; Stice, Eric; Butryn, Meghan L; Shaw, Heather

2017-01-01

Using data from an effectiveness trial delivered by college clinicians, we examined the cost-effectiveness of the dissonance-based Body Project program for reducing eating disorder symptoms in women with body dissatisfaction. The outcome of interest was individual-level change; 14.9% of Body Project participants attained clinically meaningful improvement vs. 6.7% of controls. Delivering the intervention costs approximately $70 (2012 U.S. dollars) per person. Incremental cost-effectiveness was $838 for each additional at-risk person reducing eating disorder symptomology to a clinically meaningful degree. These analyses demonstrate the economic value of the Body Project for college-age women with symptoms below the eating disorder diagnosis threshold.

High-throughput screening identifies microRNAs that target Nox2 and improve function after acute myocardial infarction.

PubMed

Yang, Junyu; Brown, Milton E; Zhang, Hanshuo; Martinez, Mario; Zhao, Zhihua; Bhutani, Srishti; Yin, Shenyi; Trac, David; Xi, Jianzhong Jeff; Davis, Michael E

2017-05-01

Myocardial infarction (MI) is the most common cause of heart failure. Excessive production of ROS plays a key role in the pathogenesis of cardiac remodeling after MI. NADPH with NADPH oxidase (Nox)2 as the catalytic subunit is a major source of superoxide production, and expression is significantly increased in the infarcted myocardium, especially by infiltrating macrophages. While microRNAs (miRNAs) are potent regulators of gene expression and play an important role in heart disease, there still lacks efficient ways to identify miRNAs that target important pathological genes for treating MI. Thus, the overall objective was to establish a miRNA screening and delivery system for improving heart function after MI using Nox2 as a critical target. With the use of the miRNA-target screening system composed of a self-assembled cell microarray (SAMcell), three miRNAs, miR-106b, miR-148b, and miR-204, were identified that could regulate Nox2 expression and its downstream products in both human and mouse macrophages. Each of these miRNAs were encapsulated into polyketal (PK3) nanoparticles that could effectively deliver miRNAs into macrophages. Both in vitro and in vivo studies in mice confirmed that PK3-miRNAs particles could inhibit Nox2 expression and activity and significantly improve infarct size and acute cardiac function after MI. In conclusion, our results show that miR-106b, miR-148b, and miR-204 were able to improve heart function after myocardial infarction in mice by targeting Nox2 and possibly altering inflammatory cytokine production. This screening system and delivery method could have broader implications for miRNA-mediated therapeutics for cardiovascular and other diseases. NEW & NOTEWORTHY NADPH oxidase (Nox)2 is a promising target for treating cardiovascular disease, but there are no specific inhibitors. Finding endogenous signals that can target Nox2 and other inflammatory molecules is of great interest. In this study, we used high-throughput screening

Development of Learning Models Based on Problem Solving and Meaningful Learning Standards by Expert Validity for Animal Development Course

NASA Astrophysics Data System (ADS)

Lufri, L.; Fitri, R.; Yogica, R.

2018-04-01

The purpose of this study is to produce a learning model based on problem solving and meaningful learning standards by expert assessment or validation for the course of Animal Development. This research is a development research that produce the product in the form of learning model, which consist of sub product, namely: the syntax of learning model and student worksheets. All of these products are standardized through expert validation. The research data is the level of validity of all sub products obtained using questionnaire, filled by validators from various field of expertise (field of study, learning strategy, Bahasa). Data were analysed using descriptive statistics. The result of the research shows that the problem solving and meaningful learning model has been produced. Sub products declared appropriate by expert include the syntax of learning model and student worksheet.