Sample records for multisite case study

  1. A Mixed Methods Sampling Methodology for a Multisite Case Study

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  2. How Institutional and University Counselor Policies Effectively Respond to Victims of Cyber Violent Acts: A Multisite Case Study

    ERIC Educational Resources Information Center

    Richards, Gretchen M.

    2012-01-01

    This multisite case study examined how institutional and university counselor policies effectively respond to cyber violent acts. Stake's (2006) multisite case study methodology was used to identify seven themes from current literature. Two sites with four participants were selected. The participants included two counseling directors and the…

  3. The Role of Involvement and Use in Multisite Evaluations

    ERIC Educational Resources Information Center

    Lawrenz, Frances; King, Jean A.; Ooms, Ann

    2011-01-01

    A cross-case analysis of four National Science Foundation (NSF) case studies identified both unique details and common themes related to promoting the use and influence of multisite evaluations. The analysis provided evidence of diverse evaluation use by stakeholders and suggested that people taking part in the multisite evaluations perceived…

  4. The Peculiar Institution?: A Multisite Case Study of Athletic Department Cultures at Small Christian Institutions

    ERIC Educational Resources Information Center

    Ramseyer, Paul Robert

    2017-01-01

    This multisite case study explored the perceptions of athletic department members of the important factors of organizational cultures in athletic departments at small Christian institutions in the Midwestern United States. The study comprised of site visits to three small Christian institutions in the Midwestern United States. At each site, six…

  5. A Qualitative Multi-Site Case Study: Examining Principals' Leadership Styles and School Performance

    ERIC Educational Resources Information Center

    Preyear, Loukisha

    2015-01-01

    The purpose of this qualitative multi-site case study was to explore the impact of principals' leadership styles on student academic achievement in a high-poverty low-performing school district in Louisiana. A total of 17 participants, principals and teachers, from this school district were used in this study. Data source triangulation of…

  6. A comparison of single- and multi-site calibration and validation: a case study of SWAT in the Miyun Reservoir watershed, China

    NASA Astrophysics Data System (ADS)

    Bai, Jianwen; Shen, Zhenyao; Yan, Tiezhu

    2017-09-01

    An essential task in evaluating global water resource and pollution problems is to obtain the optimum set of parameters in hydrological models through calibration and validation. For a large-scale watershed, single-site calibration and validation may ignore spatial heterogeneity and may not meet the needs of the entire watershed. The goal of this study is to apply a multi-site calibration and validation of the Soil andWater Assessment Tool (SWAT), using the observed flow data at three monitoring sites within the Baihe watershed of the Miyun Reservoir watershed, China. Our results indicate that the multi-site calibration parameter values are more reasonable than those obtained from single-site calibrations. These results are mainly due to significant differences in the topographic factors over the large-scale area, human activities and climate variability. The multi-site method involves the division of the large watershed into smaller watersheds, and applying the calibrated parameters of the multi-site calibration to the entire watershed. It was anticipated that this case study could provide experience of multi-site calibration in a large-scale basin, and provide a good foundation for the simulation of other pollutants in followup work in the Miyun Reservoir watershed and other similar large areas.

  7. Culture and Influence in Multisite Evaluation

    ERIC Educational Resources Information Center

    Kirkhart, Karen E.

    2011-01-01

    Understanding the influence of multisite evaluation requires careful consideration of cultural context. The author illustrates dimensions of influence and culture with excerpts from four National Science Foundation evaluation case studies and summarizes what influence teaches everyone about culture and what culture teaches everyone about…

  8. Mixed mechanisms of multi-site phosphorylation

    PubMed Central

    Suwanmajo, Thapanar; Krishnan, J.

    2015-01-01

    Multi-site phosphorylation is ubiquitous in cell biology and has been widely studied experimentally and theoretically. The underlying chemical modification mechanisms are typically assumed to be distributive or processive. In this paper, we study the behaviour of mixed mechanisms that can arise either because phosphorylation and dephosphorylation involve different mechanisms or because phosphorylation and/or dephosphorylation can occur through a combination of mechanisms. We examine a hierarchy of models to assess chemical information processing through different mixed mechanisms, using simulations, bifurcation analysis and analytical work. We demonstrate how mixed mechanisms can show important and unintuitive differences from pure distributive and processive mechanisms, in some cases resulting in monostable behaviour with simple dose–response behaviour, while in other cases generating new behaviour-like oscillations. Our results also suggest patterns of information processing that are relevant as the number of modification sites increases. Overall, our work creates a framework to examine information processing arising from complexities of multi-site modification mechanisms and their impact on signal transduction. PMID:25972433

  9. The role of economics in the QUERI program: QUERI Series

    PubMed Central

    Smith, Mark W; Barnett, Paul G

    2008-01-01

    Background The United States (U.S.) Department of Veterans Affairs (VA) Quality Enhancement Research Initiative (QUERI) has implemented economic analyses in single-site and multi-site clinical trials. To date, no one has reviewed whether the QUERI Centers are taking an optimal approach to doing so. Consistent with the continuous learning culture of the QUERI Program, this paper provides such a reflection. Methods We present a case study of QUERI as an example of how economic considerations can and should be integrated into implementation research within both single and multi-site studies. We review theoretical and applied cost research in implementation studies outside and within VA. We also present a critique of the use of economic research within the QUERI program. Results Economic evaluation is a key element of implementation research. QUERI has contributed many developments in the field of implementation but has only recently begun multi-site implementation trials across multiple regions within the national VA healthcare system. These trials are unusual in their emphasis on developing detailed costs of implementation, as well as in the use of business case analyses (budget impact analyses). Conclusion Economics appears to play an important role in QUERI implementation studies, only after implementation has reached the stage of multi-site trials. Economic analysis could better inform the choice of which clinical best practices to implement and the choice of implementation interventions to employ. QUERI economics also would benefit from research on costing methods and development of widely accepted international standards for implementation economics. PMID:18430199

  10. The role of economics in the QUERI program: QUERI Series.

    PubMed

    Smith, Mark W; Barnett, Paul G

    2008-04-22

    The United States (U.S.) Department of Veterans Affairs (VA) Quality Enhancement Research Initiative (QUERI) has implemented economic analyses in single-site and multi-site clinical trials. To date, no one has reviewed whether the QUERI Centers are taking an optimal approach to doing so. Consistent with the continuous learning culture of the QUERI Program, this paper provides such a reflection. We present a case study of QUERI as an example of how economic considerations can and should be integrated into implementation research within both single and multi-site studies. We review theoretical and applied cost research in implementation studies outside and within VA. We also present a critique of the use of economic research within the QUERI program. Economic evaluation is a key element of implementation research. QUERI has contributed many developments in the field of implementation but has only recently begun multi-site implementation trials across multiple regions within the national VA healthcare system. These trials are unusual in their emphasis on developing detailed costs of implementation, as well as in the use of business case analyses (budget impact analyses). Economics appears to play an important role in QUERI implementation studies, only after implementation has reached the stage of multi-site trials. Economic analysis could better inform the choice of which clinical best practices to implement and the choice of implementation interventions to employ. QUERI economics also would benefit from research on costing methods and development of widely accepted international standards for implementation economics.

  11. Declining Student Enrollment: A Case Study Exploring How Three Suburban School Districts Crafted Coherence

    ERIC Educational Resources Information Center

    Dimmitt, Eric J.

    2012-01-01

    This qualitative multi-site case study's purpose was to prove that the crafting coherence process was evident when three suburban Midwestern school districts implemented schools' goals while experiencing reductions in instructional programming, staffing, and facilities resources along with school closings due to significant declining student…

  12. Implementing Transfer and Articulation: A Case Study of Community Colleges and State Universities

    ERIC Educational Resources Information Center

    Senie, Kathryn C.

    2016-01-01

    This study examined the cultural aspects of a transfer articulation policy between public community colleges and state universities enacted by a newly consolidated state governing board for higher education in a northeastern state. A qualitative multisite case study design explored how key stakeholders, faculty, administrators and staff viewed the…

  13. A general Bayesian framework for calibrating and evaluating stochastic models of annual multi-site hydrological data

    NASA Astrophysics Data System (ADS)

    Frost, Andrew J.; Thyer, Mark A.; Srikanthan, R.; Kuczera, George

    2007-07-01

    SummaryMulti-site simulation of hydrological data are required for drought risk assessment of large multi-reservoir water supply systems. In this paper, a general Bayesian framework is presented for the calibration and evaluation of multi-site hydrological data at annual timescales. Models included within this framework are the hidden Markov model (HMM) and the widely used lag-1 autoregressive (AR(1)) model. These models are extended by the inclusion of a Box-Cox transformation and a spatial correlation function in a multi-site setting. Parameter uncertainty is evaluated using Markov chain Monte Carlo techniques. Models are evaluated by their ability to reproduce a range of important extreme statistics and compared using Bayesian model selection techniques which evaluate model probabilities. The case study, using multi-site annual rainfall data situated within catchments which contribute to Sydney's main water supply, provided the following results: Firstly, in terms of model probabilities and diagnostics, the inclusion of the Box-Cox transformation was preferred. Secondly the AR(1) and HMM performed similarly, while some other proposed AR(1)/HMM models with regionally pooled parameters had greater posterior probability than these two models. The practical significance of parameter and model uncertainty was illustrated using a case study involving drought security analysis for urban water supply. It was shown that ignoring parameter uncertainty resulted in a significant overestimate of reservoir yield and an underestimation of system vulnerability to severe drought.

  14. Progress in centralised ethics review processes: Implications for multi-site health evaluations.

    PubMed

    Prosser, Brenton; Davey, Rachel; Gibson, Diane

    2015-04-01

    Increasingly, public sector programmes respond to complex social problems that intersect specific fields and individual disciplines. Such responses result in multi-site initiatives that can span nations, jurisdictions, sectors and organisations. The rigorous evaluation of public sector programmes is now a baseline expectation. For evaluations of large and complex multi-site programme initiatives, the processes of ethics review can present a significant challenge. However in recent years, there have been new developments in centralised ethics review processes in many nations. This paper provides the case study of an evaluation of a national, inter-jurisdictional, cross-sector, aged care health initiative and its encounters with Australian centralised ethics review processes. Specifically, the paper considers progress against the key themes of a previous five-year, five nation study (Fitzgerald and Phillips, 2006), which found that centralised ethics review processes would save time, money and effort, as well as contribute to more equitable workloads for researchers and evaluators. The paper concludes with insights for those charged with refining centralised ethics review processes, as well as recommendations for future evaluators of complex multi-site programme initiatives. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Factors Influencing Teachers' Technology Self-Efficacy: A Case Study

    ERIC Educational Resources Information Center

    Farah, Amy Caroline

    2012-01-01

    Factors influencing teachers' levels of technology self-efficacy were examined through a qualitative multi-site, multi-subject case study research design. An initial survey was administered to all full-time, certified teachers at three school sites in order to gauge teachers' current level of technology self-efficacy. From that…

  16. On multi-site damage identification using single-site training data

    NASA Astrophysics Data System (ADS)

    Barthorpe, R. J.; Manson, G.; Worden, K.

    2017-11-01

    This paper proposes a methodology for developing multi-site damage location systems for engineering structures that can be trained using single-site damaged state data only. The methodology involves training a sequence of binary classifiers based upon single-site damage data and combining the developed classifiers into a robust multi-class damage locator. In this way, the multi-site damage identification problem may be decomposed into a sequence of binary decisions. In this paper Support Vector Classifiers are adopted as the means of making these binary decisions. The proposed methodology represents an advancement on the state of the art in the field of multi-site damage identification which require either: (1) full damaged state data from single- and multi-site damage cases or (2) the development of a physics-based model to make multi-site model predictions. The potential benefit of the proposed methodology is that a significantly reduced number of recorded damage states may be required in order to train a multi-site damage locator without recourse to physics-based model predictions. In this paper it is first demonstrated that Support Vector Classification represents an appropriate approach to the multi-site damage location problem, with methods for combining binary classifiers discussed. Next, the proposed methodology is demonstrated and evaluated through application to a real engineering structure - a Piper Tomahawk trainer aircraft wing - with its performance compared to classifiers trained using the full damaged-state dataset.

  17. The Heart of School Improvement: A Multi-Site Case Study of Leadership for Teacher Learning in Vietnam

    ERIC Educational Resources Information Center

    Tran, Ngoc H.; Hallinger, Philip; Truong, Thang

    2018-01-01

    This study addressed the research question: How do Vietnamese principals lead the professional learning of teachers? The research was comprised of a multiple-site case study of leadership and teacher learning in four Vietnamese schools. Qualitative data analysis aimed at identifying modal practices adopted by these Vietnamese principals to lead…

  18. Examining the Decisional Ethic of Textbook Adoption in Christian Schools: A Collective Case Study

    ERIC Educational Resources Information Center

    Phillips, Cecil John

    2016-01-01

    The purpose of this collective case study is to examine the decisional ethic Christian school administrators employ when evaluating textbooks for adoption in Christian schools. The study affirms the truism that Christian schools ought to be decidedly Christian and focuses upon textbook adoption practices in Christian schools. A multisite,…

  19. Adult Health Learning and Transformation: A Case Study of a Canadian Community-Based Program

    ERIC Educational Resources Information Center

    Coady, Maureen

    2013-01-01

    This article describes a case study of adult learning in a Canadian multisite Community Cardiovascular Hearts in Motion program. The researcher highlights the informal learning of 40 adult participants in this 12-week community-based cardiac rehabilitation/education program in five rural Nova Scotia communities. The effects of this learning and…

  20. Parental Involvement in Active Transport to School Initiatives: A Multi-Site Case Study

    ERIC Educational Resources Information Center

    Eyler, Amy; Baldwin, Julie; Carnoske, Cheryl; Nickelson, Jan; Troped, Philip; Steinman, Lesley; Pluto, Delores; Litt, Jill; Evenson, Kelly; Terpstra, Jennifer; Brownson, Ross; Schmid, Thomas

    2008-01-01

    Background: Increasing physical activity in youth is a recommended approach to curbing the childhood obesity epidemic. One way to help increase children's daily activity is to promote active transportation to and from school (ATS). Purpose: The purpose of this case study was to explore parental perception of, and participation in, ATS initiatives.…

  1. Standards of Competence: A Multi-Site Case Study of School Reform. Project: Effects of Testing Reforms and Standards.

    ERIC Educational Resources Information Center

    Ellwein, Mary Catherine; Glass, Gene V.

    A qualitative case study involving five educational institutions assessed the use of competency testing as a prerequisite for high school graduation, criterion for admission into college, criterion for teacher certification, and statewide assessment tool. Focus was on persons and processes involved in setting educational standards associated with…

  2. The Relationship between Pedagogical Beliefs and Teacher Efficacy: A Case Study of Chinese Foreign Language Teachers in Texas

    ERIC Educational Resources Information Center

    Liu, I-Chun

    2012-01-01

    This study investigated an emerging language learning culture by examining the relationship between teachers' pedagogical beliefs and perceived efficacy in two cities in southern Texas. Drawing on Bandura's (1994) theory of self-efficacy and Ashton and Webb's (1986) notions about teacher efficacy, a multi-sited case study was conducted to explore…

  3. A Multiple Case Study: The Effect of Professional Development on Teachers' Perceived Ability to Foster Resilience

    ERIC Educational Resources Information Center

    Klinger, Mary A.

    2012-01-01

    The purpose of this mixed methods study was to determine the effect of professional development on teachers' perceptions of their ability to foster resilience. Secondary questions investigated the effects of school level and socioeconomic status. An exploratory multi-site case study was designed to compare the perceptions of educators from…

  4. A multisite validation of whole slide imaging for primary diagnosis using standardized data collection and analysis.

    PubMed

    Wack, Katy; Drogowski, Laura; Treloar, Murray; Evans, Andrew; Ho, Jonhan; Parwani, Anil; Montalto, Michael C

    2016-01-01

    Text-based reporting and manual arbitration for whole slide imaging (WSI) validation studies are labor intensive and do not allow for consistent, scalable, and repeatable data collection or analysis. The objective of this study was to establish a method of data capture and analysis using standardized codified checklists and predetermined synoptic discordance tables and to use these methods in a pilot multisite validation study. Fifteen case report form checklists were generated from the College of American Pathology cancer protocols. Prior to data collection, all hypothetical pairwise comparisons were generated, and a level of harm was determined for each possible discordance. Four sites with four pathologists each generated 264 independent reads of 33 cases. Preestablished discordance tables were applied to determine site by site and pooled accuracy, intrareader/intramodality, and interreader intramodality error rates. Over 10,000 hypothetical pairwise comparisons were evaluated and assigned harm in discordance tables. The average difference in error rates between WSI and glass, as compared to ground truth, was 0.75% with a lower bound of 3.23% (95% confidence interval). Major discordances occurred on challenging cases, regardless of modality. The average inter-reader agreement across sites for glass was 76.5% (weighted kappa of 0.68) and for digital it was 79.1% (weighted kappa of 0.72). These results demonstrate the feasibility and utility of employing standardized synoptic checklists and predetermined discordance tables to gather consistent, comprehensive diagnostic data for WSI validation studies. This method of data capture and analysis can be applied in large-scale multisite WSI validations.

  5. Conducting a Multisite Education Research Project: Strategies to Overcome the Barriers to Achieve the Benefits.

    PubMed

    Beischel, Kelly P; Hart, Julie; Turkelson, Sandra L

    2016-01-01

    Multisite education research projects have many benefits as well as perceived barriers. In this article, we share our experiences with a multisite education research project and the barriers we overcame to reap the benefits. The outcome of our research resulted in increased rigor, role-modeling professional collaboration, and promotion of future multisite education studies. The strategies presented in this article will help alleviate perceived barriers and ameliorate the process of conducting multisite education research studies.

  6. An Examination of Physical Education Data Sources and Collection Procedures during a Federally Funded Grant

    ERIC Educational Resources Information Center

    Dauenhauer, Brian D.; Keating, Xiaofen D.; Lambdin, Dolly

    2018-01-01

    Purpose: This study aimed to conduct an in-depth investigation into physical education data sources and collection procedures in a district that was awarded a Physical Education Program (PEP) grant. Method: A qualitative, multi-site case study was conducted in which a single school district was the overarching case and eight schools served as…

  7. Bias and Bias Correction in Multi-Site Instrumental Variables Analysis of Heterogeneous Mediator Effects

    ERIC Educational Resources Information Center

    Reardon, Sean F.; Unlu, Faith; Zhu, Pei; Bloom, Howard

    2013-01-01

    We explore the use of instrumental variables (IV) analysis with a multi-site randomized trial to estimate the effect of a mediating variable on an outcome in cases where it can be assumed that the observed mediator is the only mechanism linking treatment assignment to outcomes, as assumption known in the instrumental variables literature as the…

  8. Bias and Bias Correction in Multisite Instrumental Variables Analysis of Heterogeneous Mediator Effects

    ERIC Educational Resources Information Center

    Reardon, Sean F.; Unlu, Fatih; Zhu, Pei; Bloom, Howard S.

    2014-01-01

    We explore the use of instrumental variables (IV) analysis with a multisite randomized trial to estimate the effect of a mediating variable on an outcome in cases where it can be assumed that the observed mediator is the only mechanism linking treatment assignment to outcomes, an assumption known in the IV literature as the exclusion restriction.…

  9. PS2-06: Best Practices for Advancing Multi-site Chart Abstraction Research

    PubMed Central

    Blick, Noelle; Cole, Deanna; King, Colleen; Riordan, Rick; Von Worley, Ann; Yarbro, Patty

    2012-01-01

    Background/Aims Multi-site chart abstraction studies are becoming increasingly common within the HMORN. Differences in systems among HMORN sites can pose significant obstacles to the success of these studies. It is therefore crucial to standardize abstraction activities by following best practices for multi-site chart abstraction, as consistency of processes across sites will increase efficiencies and enhance data quality. Methods Over the past few months the authors have been meeting to identify obstacles to multi-site chart abstraction and to address ways in which multi-site chart abstraction processes can be systemized and standardized. The aim of this workgroup is to create a best practice guide for multi-site chart abstraction studies. Focus areas include: abstractor training, format for chart abstraction (database, paper, etc), data quality, redaction, mechanism for transferring data, site specific access to medical records, IRB/HIPAA concerns, and budgetary issues. Results The results of the workgroup’s efforts (the best practice guide) will be presented by a panel of experts at the 2012 HMORN conference. The presentation format will also focus on discussion among attendees to elicit further input and to identify areas that need to be further addressed. Subsequently, the best practice guide will be posted on the HMORN website. Discussion The best practice guide for multi-site chart abstraction studies will establish sound guidelines and serve as an aid to researchers embarking on multi-site chart abstraction studies. Efficiencies and data quality will be further enhanced with standardized multi-site chart abstraction practices.

  10. Significant Learning Experiences and Ignatian Pedagogy: A Case Study of Curricula, Academic Practices, and Graduate Outcomes in Jesuit Universities' Honors Programs

    ERIC Educational Resources Information Center

    Pampel, Robert

    2017-01-01

    This qualitative, multisite case study used Dee Fink's taxonomy of significant learning as a lens through which to examine the curricular structure, academic practices, and graduate outcomes for honors programs at Jesuit colleges and universities in the United States. Special attention was given to the distinctive quality of Ignatian pedagogy and…

  11. Understanding Learning Transfer in Employment Preparation Programmes for Adults with Low Skills

    ERIC Educational Resources Information Center

    Taylor, Maurice C.; Ayala, Gabriel E.; Pinsent-Johnson, Christine

    2009-01-01

    This Canadian study investigated how the transfer of learning occurred in an employment preparation programme for adults with low literacy skills using a multi-site case study research design. Four different programmes involving trainees, instructors and workplace supervisors participated in the investigation. Results indicated that the transfer…

  12. Workplace Learning: The Roles of Knowledge Accessibility and Management

    ERIC Educational Resources Information Center

    Li, Jessica; Brake, Gary; Champion, Angeline; Fuller, Tony; Gabel, Sandy; Hatcher-Busch, Lori

    2009-01-01

    Purpose: The purpose of this paper is to examine how knowledge management systems have been used by the studied organizations to improve knowledge accessibility and knowledge sharing in order to increase workplace learning. Design/methodology/approach: The study relies on a qualitative multisite case study method. Data were obtained from five…

  13. Laterality defects in the national birth defects prevention study 1998-2007 birth prevalence and descriptive epidemiology

    USDA-ARS?s Scientific Manuscript database

    Little is known epidemiologically about laterality defects. Using data from the National Birth Defects Prevention Study (NBDPS), a large multi-site case-control study of birth defects, we analyzed prevalence and selected characteristics in children born with laterality defects born from 1998 to 2007...

  14. Gaming Geography: Educational Games and Literacy Development in the Grade 4 Classroom

    ERIC Educational Resources Information Center

    Lotherington, Heather; Ronda, Natalia Sinitskaya

    2009-01-01

    This paper outlines a case study conducted in two public schools in the greater Toronto area as a complementary component of a multisite experimental study exploring educational game development as a learning activity for motivating and engaging students in curriculum-related literacy activities (Owston et al., 2007). Researchers studied children…

  15. Their Work, Identity, and Entry to the Profession

    ERIC Educational Resources Information Center

    Washington, Youlanda C.; Miller, Stephen K.; Fiene, Jeanne R.

    2007-01-01

    This qualitative multi-site case study examines Kentucky's female superintendents: their professional work, identity, and entry to the role. Data sources were extensive interviews from twelve districts--superintendents, central office administrators, and school board members, plus questionnaires and district documents. Results revealed a web-like…

  16. Social Studies Pedagogy for Latino/a Newcomer Youth: Toward a Theory of Culturally and Linguistically Relevant Citizenship Education

    ERIC Educational Resources Information Center

    Jaffee, Ashley Taylor

    2016-01-01

    This study examines how teachers in 4 urban newcomer high schools conceptualized and implemented social studies education for Latino/a newcomer youth through an emerging framework of culturally and linguistically relevant citizenship education. Through a multi-site, collective case study design, the perspectives and decision making of social…

  17. Community Building as an Instructional Goal in Japanese Adult Basic Education

    ERIC Educational Resources Information Center

    Jacobson, Erik

    2009-01-01

    This paper presents the results of a multisite case study of adult basic education in Japan. A key finding of the study is that as part of community building within classrooms, students, teachers, and administrators prioritize human relations and expressions of empathy rather than academic skill development. In contrast to Japanese educational…

  18. Pedagogy for Latino/a Newcomer Students: A Study of Four Secondary Social Studies Teachers in New York City Urban Newcomer Schools

    ERIC Educational Resources Information Center

    Taylor, Ashley M.

    2013-01-01

    This dissertation study examined how teachers in four newcomer schools conceptualized and implemented social studies education for newcomer Latino/a youth. I designed this multi-site, collective case study to examine the perspectives and decision making of four social studies teachers' enacted pedagogy for Latino/a newcomer students. I…

  19. Impactful Student Learning Outcomes of One-to-One Student Laptop Programs in Low Socioeconomic Schools

    ERIC Educational Resources Information Center

    Harris, Matthew Joseph

    2010-01-01

    At present, a majority of one-to-one student laptop programs exist in schools that serve affluent communities, which denies low socioeconomic students the learning benefits of ubiquitous access to technology. Using a "Studying Up-Studying Down" paradigm, this multi-site case study collected mixed method data from program participants at five…

  20. Governing Universities. Changing the Culture?

    ERIC Educational Resources Information Center

    Bargh, Catherine; Scott, Peter; Smith, David

    This book reports on a British research project involving a questionnaire survey of 494 university governors and a multi-site case study analysis to examine how different types of higher education institutions (especially "old" and "new" universities and colleges) converge and/or diverge in their governance styles. Chapter 1…

  1. Teachers' Clinical Experiences and Attitudes toward Technology Inclusion

    ERIC Educational Resources Information Center

    Paganelli, Andrea Lynch

    2010-01-01

    The purpose of this qualitative multisite case study is to examine participants' attitudes toward technology, types of technology available for participant use, and the extent to which technology is used by preservice and mentor teachers during clinical experiences. Research supports the benefit of improved attitudes toward technology integration…

  2. Leadership Strategies in Implementation of High-School Standards-Based Grading Systems

    ERIC Educational Resources Information Center

    Pritzl, Jerome

    2016-01-01

    This multi-site case study examined leadership strategies used during successful implementation of standards-based grading systems in three Wisconsin high schools. It found that leaders' reported commitment, patience, and persistence showed evidence of sustainable, high-functioning systems. It drew two main conclusions: first, school leaders need…

  3. Confronting "Difficult Knowledge": Critical Aesthetics and War in the Classroom

    ERIC Educational Resources Information Center

    Heybach Vivirito, Jessica A.

    2012-01-01

    This qualitative multi-site case study explores critical aesthetic experiences in teacher education classrooms, and advocates for the inclusion of theoretical and practical knowledge of "difficult knowledge," visual culture, and critical aesthetics in the classroom. Social reality consists of a perpetual stream of tragic and horrific…

  4. Perceptions of Absenteeism and Diminished Engagement among Instructors and Nonlicensed Students in Medical Assistant Programs

    ERIC Educational Resources Information Center

    Miller, Russell

    2012-01-01

    Adult nonlicensed students can experience diminished engagement and increased absenteeism while attempting to complete medical assistant programs. The purpose of this qualitative, multisite narrative case study was to explore the perceptions, meanings, and interpretations of instructors and students. The theoretical foundation focused on the…

  5. Educational Inequalities and Ukrainian Orphans' Future Pathways: Social Reproduction or Transformation through the Hidden Curriculum?

    ERIC Educational Resources Information Center

    Korzh, Alla

    2013-01-01

    This qualitative multi-site case study, situated in the context of Ukraine's post-Soviet political economy, examined how orphanage educators' expectations and beliefs about orphans' academic abilities and potential, curriculum, peer relationships, and education policy shaped orphans' post-secondary education decisions and trajectories. Examination…

  6. Colorblind Mentoring? Exploring White Faculty Mentoring of Students of Color

    ERIC Educational Resources Information Center

    McCoy, Dorian L.; Winkle-Wagner, Rachelle; Luedke, Courtney L.

    2015-01-01

    In this critical multisite case study we examined the concept of colorblind mentoring. Using Bonilla-Silva's Colorblind Racism Frames, we sought to understand White faculty members' perspectives on their mentoring of Students of Color. The findings revealed that White faculty members often engage with students from a "colorblind…

  7. Principals and Teachers Leading Together.

    ERIC Educational Resources Information Center

    Ryan, Sherrill A.

    This report has two main purposes: to examine the perceived impact of teacher leadership, and to explore the conditions in schools that support or constrain teacher leadership. It discusses peer-nominated, nonadministrative leaders; leadership practices; and sources of power. The report is based on a multisite case study of three schools, serving…

  8. Multiperiod planning tool for multisite pig production systems.

    PubMed

    Nadal-Roig, E; Plà, L M

    2014-09-01

    This paper presents a multiperiod planning tool for multisite pig production systems based on Linear Programming (LP). The aim of the model is to help pig managers of multisite systems in making short-term decisions (mainly related to pig transfers between farms and batch management in fattening units) and mid-term or long-term decisions (according to company targets and expansion strategy). The model skeleton follows the structure of a three-site system that can be adapted to any multisite system present in the modern pig industry. There are three basic phases, namely, piglet production, rearing pigs, and fattening. Each phase involves a different set of farms; therefore, transportation between farms and delivering of pigs to the abattoir are under consideration. The model maximizes the total gross margin calculated from the income of sales to the abattoir and the production costs over the time horizon considered. Production cost depends on each type of farm involved in the process. Parameters like number of farms per phase and distance, farm capacity, reproduction management policies, feeding and veterinary expenses, and transportation costs are taken into account. The model also provides a schedule of transfers between farms in terms of animals to be transported and number of trucks involved. The use of the model is illustrated with a case study based on a real instance of a company located in Catalonia (Spain).

  9. A Study of Rural High School Principals' Perceptions as Social Justice Leaders

    ERIC Educational Resources Information Center

    Albritton, Shelly; Huffman, Stephanie; McClellan, Rhonda

    2017-01-01

    This multisite case study explores how rural principals in high poverty schools in a Southern state that had identified themselves as social justice leaders perceived student diversity, specifically LGBTQ students, and how they sustained a socially-just school climate for all students. Using a qualitative approach lent itself to understanding the…

  10. Fostering a Developmentally Responsive Middle-to-High School Transition: The Role of Transition Supports

    ERIC Educational Resources Information Center

    Ellerbrock, Cheryl R.; Denmon, Jennifer; Owens, Ruchelle; Lindstrom, Krista

    2015-01-01

    This yearlong qualitative multisite case study investigated ways middle and high school transition supports foster a developmentally responsive transition for students. A total of 23 participants engaged in this study, including 4 students, 4 middle school teachers, 13 high school teachers, 1 middle school principal, and 1 high school principal.…

  11. Food Defense Practices of School Districts in Northern U.S. States

    ERIC Educational Resources Information Center

    Klitzke, Carol J.

    2013-01-01

    This study assessed implementation of food defense practices in public schools in Montana, Wyoming, South Dakota, North Dakota, Iowa, Minnesota, and Wisconsin. The first phase involved a qualitative multi-site case study: one-day visits were made to five school districts in the states of Iowa, South Dakota, Minnesota, and Wisconsin. A principal,…

  12. Decision Rules Used in Academic Program Closure: Where the Rubber Meets the Road.

    ERIC Educational Resources Information Center

    Eckel, Peter D.

    This study examines, from an organizational perspective, decision rules guiding program discontinuance, testing the framework of decision rule rationality versus action rationality. A multi-site case study method was used; interviews were conducted with 11-16 individuals at each of four research I or II universities that had discontinued at least…

  13. Policies Related to Active Transport to and from School: A Multisite Case Study

    ERIC Educational Resources Information Center

    Eyler, Amy A.; Brownson, Ross C.; Doescher, Mark P.; Evenson, Kelly R.; Fesperman, Carrie E.; Litt, Jill S.; Pluto, Delores; Steinman, Lesley E.; Terpstra, Jennifer L.; Troped, Philip J.; Schmid, Thomas L.

    2008-01-01

    Active transportation to and from school (ATS) is a viable strategy to help increase physical activity among youth. ATS can be challenging because initiatives require transdisciplinary collaboration, are influenced by the built environment and are affected by numerous policies. The purpose of this study is to identify policies and factors that…

  14. The Implementation of Enrollment Management at Two Public Universities Experiencing Demographic and Funding Challenges

    ERIC Educational Resources Information Center

    Lee, Stephen

    2010-01-01

    The purpose of this study was to evaluate the implementation of enrollment management at two public universities. The theoretical framework was conceptual and centered on the effectiveness of the implementation process as a pivotal factor in the development of a comprehensive enrollment management operation. This multi-site case study included 14…

  15. Utility in a Fallible Tool: A Multi-Site Case Study of Automated Writing Evaluation

    ERIC Educational Resources Information Center

    Grimes, Douglas; Warschauer, Mark

    2010-01-01

    Automated writing evaluation (AWE) software uses artificial intelligence (AI) to score student essays and support revision. We studied how an AWE program called MY Access![R] was used in eight middle schools in Southern California over a three-year period. Although many teachers and students considered automated scoring unreliable, and teachers'…

  16. Implementing a Statewide Mandated Career Pathways/Programs of Study School Reform Model: Select Findings from a Multisite Case Study

    ERIC Educational Resources Information Center

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

    2012-01-01

    "A Longitudinal Study of the South Carolina Personal Pathways to Success Initiative" (see Hammond, Drew, et al., 2011) follows the implementation of a statewide mandated career-focused school reform policy in one U.S. state. The research focuses on eight diverse high schools in the state, personnel at those schools, and approximately…

  17. Using Standardized Diagnostic Instruments to Classify Children with Autism in the Study to Explore Early Development

    ERIC Educational Resources Information Center

    Wiggins, Lisa D.; Reynolds, Ann; Rice, Catherine E.; Moody, Eric J.; Bernal, Pilar; Blaskey, Lisa; Rosenberg, Steven A.; Lee, Li-Ching; Levy, Susan E.

    2015-01-01

    The Study to Explore Early Development (SEED) is a multi-site case-control study designed to explore the relationship between autism spectrum disorder (ASD) phenotypes and etiologies. The goals of this paper are to (1) describe the SEED algorithm that uses the Autism Diagnostic Interview-Revised (ADI-R) and Autism Diagnostic Observation Schedule…

  18. Interorganizational Special Education Programming in Rural Areas: Technical Report on the Multisite Naturalistic Field Study. Volumes I through IV.

    ERIC Educational Resources Information Center

    Skrtic, Thomas M.; And Others

    The report discusses a field study of the implementation of major requirements of P.L. 94-142, the Education For All Handicapped Children Act, by rural districts, and presents detailed case studies of five districts' responses. The first volume introduces the naturalistic model of inquiry, noting its philosophical underpinnings and basic…

  19. Validity Evidence and Scoring Guidelines for Standardized Patient Encounters and Patient Notes From a Multisite Study of Clinical Performance Examinations in Seven Medical Schools.

    PubMed

    Park, Yoon Soo; Hyderi, Abbas; Heine, Nancy; May, Win; Nevins, Andrew; Lee, Ming; Bordage, Georges; Yudkowsky, Rachel

    2017-11-01

    To examine validity evidence of local graduation competency examination scores from seven medical schools using shared cases and to provide rater training protocols and guidelines for scoring patient notes (PNs). Between May and August 2016, clinical cases were developed, shared, and administered across seven medical schools (990 students participated). Raters were calibrated using training protocols, and guidelines were developed collaboratively across sites to standardize scoring. Data included scores from standardized patient encounters for history taking, physical examination, and PNs. Descriptive statistics were used to examine scores from the different assessment components. Generalizability studies (G-studies) using variance components were conducted to estimate reliability for composite scores. Validity evidence was collected for response process (rater perception), internal structure (variance components, reliability), relations to other variables (interassessment correlations), and consequences (composite score). Student performance varied by case and task. In the PNs, justification of differential diagnosis was the most discriminating task. G-studies showed that schools accounted for less than 1% of total variance; however, for the PNs, there were differences in scores for varying cases and tasks across schools, indicating a school effect. Composite score reliability was maximized when the PN was weighted between 30% and 40%. Raters preferred using case-specific scoring guidelines with clear point-scoring systems. This multisite study presents validity evidence for PN scores based on scoring rubric and case-specific scoring guidelines that offer rigor and feedback for learners. Variability in PN scores across participating sites may signal different approaches to teaching clinical reasoning among medical schools.

  20. Towards a Neurobehavioral Profile of Fetal Alcohol Spectrum Disorders

    PubMed Central

    Mattson, Sarah N.; Roesch, Scott C.; Fagerlund, Åse; Autti-Rämö, Ilona; Jones, Kenneth Lyons; May, Philip A.; Adnams, Colleen M.; Konovalova, Valentina; Riley, Edward P.

    2010-01-01

    Background A primary goal of recent research is the development of neurobehavioral profiles that specifically define fetal alcohol spectrum disorders (FASD), which may assist differential diagnosis or improve treatment. In the current study we define a preliminary profile using neuropsychological data from a multisite study. Methods Data were collected using a broad neurobehavioral protocol from two sites of a multisite study of FASD. Subjects were children with heavy prenatal alcohol exposure and unexposed controls. The alcohol-exposed group included children with and with out fetal alcohol syndrome (FAS). From 547 neuropsychological, 22 variables were selected for analysis based on their ability to distinguish children with heavy prenatal alcohol exposure from nonexposed controls. These data were analyzed using latent profile analysis (LPA). Results The results indicated that a 2-class model best fit the data. The resulting profile was successful at distinguishing subjects with FAS from nonexposed controls without FAS with 92% overall accuracy; 87.8% of FAS cases and 95.7% of controls were correctly classified. The same analysis was repeated with children with heavy prenatal alcohol exposure but without FAS and non-exposed controls with similar results. The overall accuracy was 84.7%; 68.4% of alcohol-exposed cases and 95% of controls were correctly classified. In both analyses, the profile based on neuropsychological variables was more successful at distinguishing the groups than was IQ alone. Conclusions We used data from two sites of a multisite study and a broad neuropsychological test battery to determine a profile that could be used to accurately identify children affected by prenatal alcohol exposure. Results indicated that measures of executive function and spatial processing are especially sensitive to prenatal alcohol exposure. PMID:20569243

  1. Nonlinear instabilities of multi-site breathers in Klein-Gordon lattices

    DOE PAGES

    Cuevas-Maraver, Jesus; Kevrekidis, Panayotis G.; Pelinovsky, Dmitry E.

    2016-08-01

    Here, we explore the possibility of multi-site breather states in a nonlinear Klein–Gordon lattice to become nonlinearly unstable, even if they are found to be spectrally stable. The mechanism for this nonlinear instability is through the resonance with the wave continuum of a multiple of an internal mode eigenfrequency in the linearization of excited breather states. For the nonlinear instability, the internal mode must have its Krein signature opposite to that of the wave continuum. This mechanism is not only theoretically proposed, but also numerically corroborated through two concrete examples of the Klein–Gordon lattice with a soft (Morse) and amore » hard (Φ 4) potential. Compared to the case of the nonlinear Schrödinger lattice, the Krein signature of the internal mode relative to that of the wave continuum may change depending on the period of the multi-site breather state. For the periods for which the Krein signatures of the internal mode and the wave continuum coincide, multi-site breather states are observed to be nonlinearly stable.« less

  2. Distribution of Bell-inequality violation versus multiparty-quantum-correlation measures

    NASA Astrophysics Data System (ADS)

    Sharma, Kunal; Das, Tamoghna; Sen (de), Aditi; Sen, Ujjwal

    Violation of a Bell inequality guarantees the existence of quantum correlations in a shared quantum state. A pure bipartite quantum state, having nonvanishing quantum correlation, always violates a Bell inequality. Such correspondence is absent for multipartite pure quantum states in the case of multipartite correlation function Bell inequalities with two settings at each site. We establish a connection between the monogamy of Bell-inequality violation and multiparty quantum correlations for shared multisite quantum states. We believe that the relation is generic, as it is true for a number of different multisite measures that are defined from radically different perspectives. Precisely, we quantify the multisite-quantum-correlation content in the states by generalized geometric measure, a genuine multisite entanglement measure, as well as three monogamybased multiparty-quantum-correlation measures, viz., 3-tangle, quantum-discord score, and quantum-work-deficit score. We find that generalized Greenberger-Horne-Zeilinger states and another single-parameter family of states, which we refer to as the special Greenberger-Horne-Zeilinger states, have the status of extremal states in such relations.

  3. Distribution of Bell-inequality violation versus multiparty-quantum-correlation measures

    NASA Astrophysics Data System (ADS)

    Sharma, Kunal; Das, Tamoghna; SenDe, Aditi; Sen, Ujjwal

    2016-06-01

    Violation of a Bell inequality guarantees the existence of quantum correlations in a shared quantum state. A pure bipartite quantum state, having nonvanishing quantum correlation, always violates a Bell inequality. Such correspondence is absent for multipartite pure quantum states in the case of multipartite correlation function Bell inequalities with two settings at each site. We establish a connection between the monogamy of Bell-inequality violation and multiparty quantum correlations for shared multisite quantum states. We believe that the relation is generic, as it is true for a number of different multisite measures that are defined from radically different perspectives. Precisely, we quantify the multisite-quantum-correlation content in the states by generalized geometric measure, a genuine multisite entanglement measure, as well as three monogamy-based multiparty-quantum-correlation measures, viz., 3-tangle, quantum-discord score, and quantum-work-deficit score. We find that generalized Greenberger-Horne-Zeilinger states and another single-parameter family of states, which we refer to as the special Greenberger-Horne-Zeilinger states, have the status of extremal states in such relations.

  4. Entering the (Postgraduate) Field: Underrepresented Students' Acquisition of Cultural and Social Capital in Graduate School Preparation Programs

    ERIC Educational Resources Information Center

    Winkle-Wagner, Rachelle; McCoy, Dorian L.

    2016-01-01

    Examining the role of humanities graduate preparation programs in facilitating underrepresented undergraduate students' socialization to the field (social context) of graduate education, this critical multisite case study finds that these programs are crucial to bidirectional anticipatory socialization for graduate education, where one gains new…

  5. Campus Sustainability in Chinese Higher Education Institutions: Focuses, Motivations and Challenges

    ERIC Educational Resources Information Center

    Lo, Kevin

    2015-01-01

    Purpose: The purpose of this paper is to examine the focuses, motivations and challenges of achieving campus sustainability in Chinese higher education institutions (HEIs). Design/methodology/approach: A multisite case study was conducted in Changchun City, Jilin, where eight HEIs of various types were examined. Structured interviews with school…

  6. Understanding a Successful Implementation of Organizational Social Media: A Multi-Site Case Study

    ERIC Educational Resources Information Center

    Lahman, Caroline D.

    2017-01-01

    The purpose of this dissertation was to examine the successful implementation of social media strategies in multiple organizations. Examining the factors an organization used to implement social media can provide the understanding of the benefits and risks associated with this technology. Some businesses are considered successful using social…

  7. Coping Strategies Title I Teachers Use to Manage Burnout and Stress: A Multisite Case Study

    ERIC Educational Resources Information Center

    Jeter, Lisa

    2013-01-01

    Teacher burnout contributes to poor psychological and physical health, absenteeism, early retirement, and leads to inadequate teacher performance with adverse outcomes in student learning and achievement. Effective coping skills have been proposed as possible protectors from the effects of burnout; therefore, examining teachers' coping resources…

  8. Organizational Development in Transition: The Schooling Perspective.

    ERIC Educational Resources Information Center

    Snyder, Karolyn J.; And Others

    This paper presents the initial findings of a comprehensive 28-school multi-site case study, which sought to identify patterns in schools that are changing bureaucratic work patterns to those found in quality-management systems. The schools are located in Florida, Virginia, Minnesota, and Louisiana; all are led by principals who are trainers in…

  9. Bridging the Divide: Developing a Scholarly Habitus for Aspiring Graduate Students through Summer Bridge Programs Participation

    ERIC Educational Resources Information Center

    McCoy, Dorian L.; Winkle-Wagner, Rachelle

    2015-01-01

    This multisite case study explored the role of summer institutes in preparing Students of Color for doctoral programs. Bourdieu's social reproduction theory, particularly the concept of habitus, was employed as a theoretical framework to investigate how the participants further developed habitus (their dispositions, identities, and perspectives)…

  10. Fostering Department Chair Instructional Leadership Capacity: Laying the Groundwork for Distributed Instructional Leadership

    ERIC Educational Resources Information Center

    Klar, Hans W.

    2012-01-01

    In this article, I provide findings from a multisite case study of three urban high schools. In each of the schools, principals endeavoured to foster the capabilities of their department chairs to enhance school-wide instructional capacity and increase student achievement. Data were gathered from interviews, participant observations and document…

  11. Developmentally Responsive Teacher Practices across the Middle-to-High-School Transition

    ERIC Educational Resources Information Center

    Ellerbrock, Cheryl R.; Abbas, Bridget; DiCicco, Michael

    2014-01-01

    In this year-long qualitative multi-site case study, researchers identified how eighth and ninth-grade teacher practices may support students' basic and developmental needs across the middle-to-high-school transition. Data were collected throughout 2009, including individual interviews, focus group interviews, observations, and artifact data of 23…

  12. Encouraged or Weeded Out: Perspectives of Students of Color in the STEM Disciplines on Faculty Interactions

    ERIC Educational Resources Information Center

    McCoy, Dorian L.; Luedke, Courtney L.; Winkle-Wagner, Rachelle

    2017-01-01

    For this multisite qualitative case study, framed in Bourdieu's social reproduction theory, we examined mentoring experiences among Students of Color majoring in science, technology, engineering and mathematics (STEM) disciplines at both a predominantly White institution and a historically Black institution. Findings revealed that faculty served…

  13. Reduced Financial Resources and the Strategic Position of Community Colleges: How an "Embedded Community College" Can Neutralize External Pressures

    ERIC Educational Resources Information Center

    Namuo, Clyne G. H.

    2013-01-01

    This multi-site case study is really the story of three same-state community colleges (Bridge and Buffer Community College, Grants and Reserves Community College, and Crystal Ball Community College) two years after they suffered a potentially catastrophic 50% reduction in state allocations. This study examined their responses to those reductions…

  14. Reduced hypothalamic-pituitary-adrenal axis activity in chronic multi-site musculoskeletal pain: partly masked by depressive and anxiety disorders.

    PubMed

    Generaal, Ellen; Vogelzangs, Nicole; Macfarlane, Gary J; Geenen, Rinie; Smit, Johannes H; Penninx, Brenda W J H; Dekker, Joost

    2014-07-09

    Studies on hypothalamic-pituitary-adrenal axis (HPA-axis) function amongst patients with chronic pain show equivocal results and well-controlled cohort studies are rare in this field. The goal of our study was to examine whether HPA-axis dysfunction is associated with the presence and the severity of chronic multi-site musculoskeletal pain. Data are from the Netherlands Study of Depression and Anxiety including 1125 subjects with and without lifetime depressive and anxiety disorders. The Chronic Pain Grade questionnaire was used to determine the presence and severity of chronic multi-site musculoskeletal pain. Subjects were categorized into a chronic multi-site musculoskeletal pain group (n = 471) and a control group (n = 654). Salivary cortisol samples were collected to assess HPA-axis function (awakening level, 1-h awakening response, evening level, diurnal slope and post-dexamethasone level). In comparison with the control group, subjects with chronic multi-site musculoskeletal pain showed significantly lower cortisol level at awakening, lower evening level and a blunted diurnal slope. Lower cortisol level at awakening and a blunted diurnal slope appeared to be restricted to those without depressive and/or anxiety disorders, who also showed a lower 1-h awakening response. Our results suggest hypocortisolemia in chronic multi-site musculoskeletal pain. However, if chronic pain is accompanied by a depressive or anxiety disorder, typically related to hypercortisolemia, the association between cortisol levels and chronic multi-site musculoskeletal pain appears to be partly masked. Future studies should take psychopathology into account when examining HPA-axis function in chronic pain.

  15. Reduced hypothalamic-pituitary-adrenal axis activity in chronic multi-site musculoskeletal pain: partly masked by depressive and anxiety disorders

    PubMed Central

    2014-01-01

    Background Studies on hypothalamic-pituitary-adrenal axis (HPA-axis) function amongst patients with chronic pain show equivocal results and well-controlled cohort studies are rare in this field. The goal of our study was to examine whether HPA-axis dysfunction is associated with the presence and the severity of chronic multi-site musculoskeletal pain. Methods Data are from the Netherlands Study of Depression and Anxiety including 1125 subjects with and without lifetime depressive and anxiety disorders. The Chronic Pain Grade questionnaire was used to determine the presence and severity of chronic multi-site musculoskeletal pain. Subjects were categorized into a chronic multi-site musculoskeletal pain group (n = 471) and a control group (n = 654). Salivary cortisol samples were collected to assess HPA-axis function (awakening level, 1-h awakening response, evening level, diurnal slope and post-dexamethasone level). Results In comparison with the control group, subjects with chronic multi-site musculoskeletal pain showed significantly lower cortisol level at awakening, lower evening level and a blunted diurnal slope. Lower cortisol level at awakening and a blunted diurnal slope appeared to be restricted to those without depressive and/or anxiety disorders, who also showed a lower 1-h awakening response. Conclusions Our results suggest hypocortisolemia in chronic multi-site musculoskeletal pain. However, if chronic pain is accompanied by a depressive or anxiety disorder, typically related to hypercortisolemia, the association between cortisol levels and chronic multi-site musculoskeletal pain appears to be partly masked. Future studies should take psychopathology into account when examining HPA-axis function in chronic pain. PMID:25007969

  16. Biological stress systems, adverse life events and the onset of chronic multisite musculoskeletal pain: a 6-year cohort study.

    PubMed

    Generaal, Ellen; Vogelzangs, Nicole; Macfarlane, Gary J; Geenen, Rinie; Smit, Johannes H; de Geus, Eco J C N; Penninx, Brenda W J H; Dekker, Joost

    2016-05-01

    Dysregulated biological stress systems and adverse life events, independently and in interaction, have been hypothesised to initiate chronic pain. We examine whether (1) function of biological stress systems, (2) adverse life events, and (3) their combination predict the onset of chronic multisite musculoskeletal pain. Subjects (n=2039) of the Netherlands Study of Depression and Anxiety, free from chronic multisite musculoskeletal pain at baseline, were identified using the Chronic Pain Grade Questionnaire and followed up for the onset of chronic multisite musculoskeletal pain over 6 years. Baseline assessment of biological stress systems comprised function of the hypothalamic-pituitary-adrenal axis (1-h cortisol awakening response, evening levels, postdexamethasone levels), the immune system (basal and lipopolysaccharide-stimulated inflammation) and the autonomic nervous system (heart rate, pre-ejection period, SD of the normal-to-normal interval, respiratory sinus arrhythmia). The number of recent adverse life events was assessed at baseline using the List of Threatening Events Questionnaire. Hypothalamic-pituitary-adrenal axis, immune system and autonomic nervous system functioning was not associated with onset of chronic multisite musculoskeletal pain, either by itself or in interaction with adverse life events. Adverse life events did predict onset of chronic multisite musculoskeletal pain (HR per event=1.14, 95% CI 1.04 to 1.24, p=0.005). This longitudinal study could not confirm that dysregulated biological stress systems increase the risk of developing chronic multisite musculoskeletal pain. Adverse life events were a risk factor for the onset of chronic multisite musculoskeletal pain, suggesting that psychosocial factors play a role in triggering the development of this condition. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  17. Teaching in a Digital Age: How Educators Use Technology to Improve Student Learning

    ERIC Educational Resources Information Center

    McKnight, Katherine; O'Malley, Kimberly; Ruzic, Roxanne; Horsley, Maria Kelly; Franey, John J.; Bassett, Katherine

    2016-01-01

    A successful digital conversion for classrooms, districts, and states is not determined by the technology, but by how technology enables teaching and learning. The purpose of our multisite case study was to document digital instructional strategies teachers use to enhance and transform student learning, and align that use with learning research.…

  18. Progressive Educational Practices and Environments in Sweden: Preparing Students to Live and Work in the Global Age

    ERIC Educational Resources Information Center

    Nordgren, R. D.

    2006-01-01

    A multi-site case study of three Swedish schools examined the dimensions of trust, responsibility, shared power (democracy), and global workforce competence as required by a decade-old national education reforms. A key finding was the existence of progressive educational practices including constructivist epistemology, evidenced by the schools'…

  19. The Meaning Students Make as Participants in Short-Term Immersion Programs

    ERIC Educational Resources Information Center

    Jones, Susan R.; Rowan-Kenyon, Heather T.; Ireland, S. Mei-Yen; Niehaus, Elizabeth; Skendall, Kristan Cilente

    2012-01-01

    The purpose of this article is to present the results of a multi-site case study designed to investigate students' experiences as participants in four week-long immersion programs (New York City, Peru, the Czech Republic, Chicago). Results highlight the significance of the context of the trips and specific characteristics of the trip (e.g.,…

  20. Exploring the Establishment of the Office of the Chief Diversity Officer in Higher Education: A Multisite Case Study

    ERIC Educational Resources Information Center

    Parker, Eugene T., III

    2015-01-01

    Our nation is experiencing a demographic shift. The proportion of racial minorities will significantly increase during the next several decades. Higher education will similarly experience a demographic shift among its students. Institutions of higher education will have to navigate issues of multiculturalism on campus. Issues of diversity, equity…

  1. Discussions That "Tickle Our Brains": Constructing Interpretations through Multiple Ethnographic Data-Sets

    ERIC Educational Resources Information Center

    Lahelma, Elina; Lappalainen, Sirpa; Mietola, Reetta; Palmu, Tarja

    2014-01-01

    In this article, we discuss the usefulness of collaborative, multi-sited and cross-cultural ethnography. Giving three examples from our work, we suggest that it is possible to find new kinds of interpretations by joint reflections that draw from several studies with their own research questions. The cases presented discuss teachers' embodiment and…

  2. The Role of Leadership in Starting and Operating Blended Learning Charter Schools: A Multisite Case Study

    ERIC Educational Resources Information Center

    Agostini, Michael Eric

    2013-01-01

    Heavily utilizing both instructional technology and face-to-face instruction within a bricks-and-mortar school environment, blended learning charter schools are gaining attention as a cost-effective school design. As educators turn to these blended learning school models to improve both the operational efficiency and student outcomes of America's…

  3. Challenges for a New Bilingual Program: Implementing the International Baccalaureate Primary Years Programme in Four Colombian Schools

    ERIC Educational Resources Information Center

    Lochmiller, Chad R.; Lucero, Audrey; Lester, Jessica Nina

    2016-01-01

    The International Baccalaureate (IB) has expanded in Latin America. Drawing from a larger multi-sited qualitative case study, we examined the challenges associated with the implementation of the IB Primary Years Programme (PYP) in a Colombian and bilingual context. Findings highlight (1) the intersecting nature of challenges associated with the…

  4. "The Only Mexican in the Room": "Sobrevivencia" as a Way of Knowing for Mexican Transnational Students and Families

    ERIC Educational Resources Information Center

    Kasun, G. Sue

    2015-01-01

    Drawing upon multisited ethnographic case studies in the United States and Mexico, I demonstrate "sobrevivencia", a survivalist way of knowing of Mexican-origin families. Through an underdog mentality, family members persisted and sometimes thrived. However, the grittiness of the underdog mentality did not always work out. By…

  5. Multi-site pain and working conditions as predictors of work ability in a 4-year follow-up among food industry employees.

    PubMed

    Neupane, S; Virtanen, P; Leino-Arjas, P; Miranda, H; Siukola, A; Nygård, C-H

    2013-03-01

    We investigated the separate and joint effects of multi-site musculoskeletal pain and physical and psychosocial exposures at work on future work ability. A survey was conducted among employees of a Finnish food industry company in 2005 (n = 1201) and a follow-up survey in 2009 (n = 734). Information on self-assessed work ability (current work ability on a scale from 0 to 10; 7 = poor work ability), multi-site musculoskeletal pain (pain in at least two anatomical areas of four), leisure-time physical activity, body mass index and physical and psychosocial exposures was obtained by questionnaire. The separate and joint effects of multi-site pain and work exposures on work ability at follow-up, among subjects with good work ability at baseline, were assessed by logistic regression, and p-values for the interaction derived. Compared with subjects with neither multi-site pain nor adverse work exposure, multi-site pain at baseline increased the risk of poor work ability at follow-up, allowing for age, gender, occupational class, body mass index and leisure-time physical activity. The separate effects of the work exposures on work ability were somewhat smaller than those of multi-site pain. Multi-site pain had an interactive effect with work environment and awkward postures, such that no association of multi-site pain with poor work ability was seen when work environment was poor or awkward postures present. The decline in work ability connected with multi-site pain was not increased by exposure to adverse physical or psychosocial factors at work. © 2012 European Federation of International Association for the Study of Pain Chapters.

  6. Analytic hierarchy process-based approach for selecting a Pareto-optimal solution of a multi-objective, multi-site supply-chain planning problem

    NASA Astrophysics Data System (ADS)

    Ayadi, Omar; Felfel, Houssem; Masmoudi, Faouzi

    2017-07-01

    The current manufacturing environment has changed from traditional single-plant to multi-site supply chain where multiple plants are serving customer demands. In this article, a tactical multi-objective, multi-period, multi-product, multi-site supply-chain planning problem is proposed. A corresponding optimization model aiming to simultaneously minimize the total cost, maximize product quality and maximize the customer satisfaction demand level is developed. The proposed solution approach yields to a front of Pareto-optimal solutions that represents the trade-offs among the different objectives. Subsequently, the analytic hierarchy process method is applied to select the best Pareto-optimal solution according to the preferences of the decision maker. The robustness of the solutions and the proposed approach are discussed based on a sensitivity analysis and an application to a real case from the textile and apparel industry.

  7. High prevalence of daily and multi-site pain – a cross-sectional population-based study among 3000 Danish adolescents

    PubMed Central

    2013-01-01

    Background Daily pain and multi-site pain are both associated with reduction in work ability and health-related quality of life (HRQoL) among adults. However, no population-based studies have yet investigated the prevalence of daily and multi-site pain among adolescents and how these are associated with respondent characteristics. The purpose of this study was to investigate the prevalence of self-reported daily and multi-site pain among adolescents aged 12–19 years and associations of almost daily pain and multi-site pain with respondent characteristics (sex, age, body mass index, HRQoL and sports participation). Methods A population-based cross-sectional study was conducted among 4,007 adolescents aged 12–19 years in Denmark. Adolescents answered an online questionnaire during physical education lessons. The questionnaire contained a mannequin divided into 12 regions on which the respondents indicated their current pain sites and pain frequency (rarely, monthly, weekly, more than once per week, almost daily pain), characteristics, sports participation and HRQoL measured by the EuroQoL 5D. Multivariate regression was used to calculate the odds ratio for the association between almost daily pain, multi-site pain and respondent characteristics. Results The response rate was 73.7%. A total of 2,953 adolescents (62% females) answered the questionnaire. 33.3% reported multi-site pain (pain in >1 region) while 19.8% reported almost daily pain. 61% reported current pain in at least one region with knee and back pain being the most common sites. Female sex (OR: 1.35-1.44) and a high level of sports participation (OR: 1.51-2.09) were associated with increased odds of having almost daily pain and multi-site pain. Better EQ-5D score was associated with decreased odds of having almost daily pain or multi-site pain (OR: 0.92-0.94). Conclusion In this population-based cohort of school-attending Danish adolescents, nearly two out of three reported current pain and, on average, one out of three reported pain in more than one body region. Female sex, and high level of sports participation were associated with increased odds of having almost daily pain and multi-site pain. The study highlights an important health issue that calls for investigations to improve our understanding of adolescent pain and our capacity to prevent and treat this condition. PMID:24252440

  8. Reading Profiles in Multi-Site Data With Missingness.

    PubMed

    Eckert, Mark A; Vaden, Kenneth I; Gebregziabher, Mulugeta

    2018-01-01

    Children with reading disability exhibit varied deficits in reading and cognitive abilities that contribute to their reading comprehension problems. Some children exhibit primary deficits in phonological processing, while others can exhibit deficits in oral language and executive functions that affect comprehension. This behavioral heterogeneity is problematic when missing data prevent the characterization of different reading profiles, which often occurs in retrospective data sharing initiatives without coordinated data collection. Here we show that reading profiles can be reliably identified based on Random Forest classification of incomplete behavioral datasets, after the missForest method is used to multiply impute missing values. Results from simulation analyses showed that reading profiles could be accurately classified across degrees of missingness (e.g., ∼5% classification error for 30% missingness across the sample). The application of missForest to a real multi-site dataset with missingness ( n = 924) showed that reading disability profiles significantly and consistently differed in reading and cognitive abilities for cases with and without missing data. The results of validation analyses indicated that the reading profiles (cases with and without missing data) exhibited significant differences for an independent set of behavioral variables that were not used to classify reading profiles. Together, the results show how multiple imputation can be applied to the classification of cases with missing data and can increase the integrity of results from multi-site open access datasets.

  9. The importance of the verbal shift handover report: a multi-site case study.

    PubMed

    Randell, Rebecca; Wilson, Stephanie; Woodward, Peter

    2011-11-01

    Shift handover is seen as a key tool in ensuring continuity of care yet a number of studies have highlighted the role of shift handovers in adverse events. This, combined with the increased frequency of shift handovers, has led to interest in providing technological support for handover to enhance safety. The aim of this paper is to describe current practices for the conduct of shift handovers and to use this as a basis for considering the role that technology could play in supporting handover. A multi-site case study of handover was conducted. Data included observations of 15 medical shift handovers and 33 nursing shift handovers across three case sites. The findings highlight the way in which the verbal shift handover report is practically focused, displaying the healthcare professional's ability to know what information is required and where further explanation is needed. As well as supporting teaching and team cohesion, shift handover can provide an opportunity to reflect on the previous shift and for discussion with patients and their families. The benefits provided by a face to face handover suggest that technology should focus on supporting rather than replacing the verbal shift handover report, providing a flexible solution that allows handover participants to gather more information as it is required. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  10. Teachers' Perceptions of the Socioemotional Development of Intellectually Gifted Primary Aged Students and Their Attitudes towards Ability Grouping and Acceleration

    ERIC Educational Resources Information Center

    Gallagher, Selena; Smith, Susen R.; Merrotsy, Peter

    2011-01-01

    This qualitative multi-site case study sought to examine the current educational provisions in place for intellectually gifted primary school students in Queensland and to consider how the beliefs and attitudes of primary school stakeholders were reflected in the production of their school gifted education policies. Attitudes and perceptions of…

  11. What Are We Educating Our Youth for? The Role of Education in the Era of Vocational Schools for "Dummies" and Diploma Mill Universities in Ukraine

    ERIC Educational Resources Information Center

    Korzh, Alla

    2013-01-01

    This qualitative multisite case study contextualized in the political economy of Ukraine examines orphanage youth's conceptualization of the role of vocational and higher education in the neoliberal era and highlights educational transformations in Ukraine. Drawing on Bourdieu's forms of capital (cultural, social, and economic), this research…

  12. Student Achievement in High Performing, Suburban Middle Schools and Low Performing, Urban Middle Schools: Plausible Explanations for the Differences

    ERIC Educational Resources Information Center

    Brown, Kathleen M.; Anfara, Vincent A., Jr.; Roney, Kathleen

    2004-01-01

    Utilizing a qualitative, multisite case study design and the theoretical framework of Hoy and Hannum (1997), the design and execution of this research investigates plausible explanations for the difference in student achievement between high performing (HPS) suburban middle schools and low performing (LPS) urban middle schools. Aside from the…

  13. Youth Arts, Media, and Critical Literacies as Forms of Public Engagement in the Local/Global Interface

    ERIC Educational Resources Information Center

    Rogers, Theresa

    2016-01-01

    This article provides a reanalysis of a multisited case study of youth arts, media, and critical literacy to theorize the role of networked and physical "publics" within which youth engage with issues they care about, making claims about their lived experiences. An understanding of the nature and role of publics is crucial to productive…

  14. Mo' Money, Mo' Problems? High-Achieving Black High School Students' Experiences with Resources, Racial Climate, and Resilience

    ERIC Educational Resources Information Center

    Allen, Walter; Griffin, Kimberly

    2006-01-01

    A multi-site case study analyzed the college preparatory processes of nine African American high achievers attending a well-resourced, suburban high school and eight academically successful African Americans attending a low-resourced urban school. Students at both schools experienced barriers, that is, racial climate and a lack of resources, that…

  15. You Turn up the First Day and They Expect You to Come Back! Gifted Students' Perspectives on School and Being Smart

    ERIC Educational Resources Information Center

    Gallagher, Selena; Smith, Susen; Merrotsy, Peter

    2013-01-01

    This qualitative multi-site case study sought to examine the current educational provisions in place for intellectually gifted primary school students in Queensland, and to consider the attitudes and perceptions of a range of different stakeholders, including teachers, parents and students. The perspectives of students towards their school and…

  16. Multi-site precipitation downscaling using a stochastic weather generator

    NASA Astrophysics Data System (ADS)

    Chen, Jie; Chen, Hua; Guo, Shenglian

    2018-03-01

    Statistical downscaling is an efficient way to solve the spatiotemporal mismatch between climate model outputs and the data requirements of hydrological models. However, the most commonly-used downscaling method only produces climate change scenarios for a specific site or watershed average, which is unable to drive distributed hydrological models to study the spatial variability of climate change impacts. By coupling a single-site downscaling method and a multi-site weather generator, this study proposes a multi-site downscaling approach for hydrological climate change impact studies. Multi-site downscaling is done in two stages. The first stage involves spatially downscaling climate model-simulated monthly precipitation from grid scale to a specific site using a quantile mapping method, and the second stage involves the temporal disaggregating of monthly precipitation to daily values by adjusting the parameters of a multi-site weather generator. The inter-station correlation is specifically considered using a distribution-free approach along with an iterative algorithm. The performance of the downscaling approach is illustrated using a 10-station watershed as an example. The precipitation time series derived from the National Centers for Environment Prediction (NCEP) reanalysis dataset is used as the climate model simulation. The precipitation time series of each station is divided into 30 odd years for calibration and 29 even years for validation. Several metrics, including the frequencies of wet and dry spells and statistics of the daily, monthly and annual precipitation are used as criteria to evaluate the multi-site downscaling approach. The results show that the frequencies of wet and dry spells are well reproduced for all stations. In addition, the multi-site downscaling approach performs well with respect to reproducing precipitation statistics, especially at monthly and annual timescales. The remaining biases mainly result from the non-stationarity of NCEP precipitation. Overall, the proposed approach is efficient for generating multi-site climate change scenarios that can be used to investigate the spatial variability of climate change impacts on hydrology.

  17. Work-related determinants of multi-site musculoskeletal pain among employees in the health care sector.

    PubMed

    Neupane, Subas; Nygård, Clas-Håkan; Oakman, Jodi

    2016-06-16

    Work-related musculoskeletal pain is a major occupational problem. Those with pain in multiple sites usually report worse health outcomes than those with pain in one site. This study explored prevalence and associated predictors of multi-site pain in health care sector employees. Survey responses from 1348 health care sector employees across three organisations (37% response rate) collected data on job satisfaction, work life balance, psychosocial and physical hazards, general health and work ability. Musculoskeletal discomfort was measured across 5 body regions with pain in ≥ 2 sites defined as multi-site pain. Generalized linear models were used to identify relationships between work-related factors and multi-site pain. Over 52% of the employees reported pain in multiple body sites and 19% reported pain in one site. Poor work life balance (PRR = 2.33, 95% CI = 1.06-5.14). physical (PRR = 7.58, 95% CI = 4.89-11.77) and psychosocial (PRR = 1.59, 95% CI = 1.00-2.57) hazard variables were related to multi-site pain (after controlling for age, gender, health and work ability. Older employees and females were more likely to report multi-site pain. Effective risk management of work related multi-site pain must include identification and control of psychosocial and physical hazards.

  18. The Impact of Sexual Assault Nurse Examiner Programs on Criminal Justice Case Outcomes: A Multisite Replication Study.

    PubMed

    Campbell, Rebecca; Bybee, Deborah; Townsend, Stephanie M; Shaw, Jessica; Karim, Nidal; Markowitz, Jenifer

    2014-05-01

    To address the underreporting and underprosecution of adult sexual assaults, communities throughout the United States have implemented multidisciplinary interventions to improve postassault care for victims and the criminal justice system response. One such model is the Sexual Assault Nurse Examiner (SANE) Program, whereby specially trained nurses provide comprehensive psychological, medical, and forensic services for sexual assault. In this study, we conducted a multisite evaluation of six SANE programs (two rural programs, two serving midsized communities, two urban) to assess how implementation of SANE programs affects adult sexual assault prosecution rates. At each site, most sexual assaults reported to law enforcement were never referred by police to prosecutors or were not charged by the prosecutor's office (80%-89%). Individually, none of the sites had a statistically significant increase in prosecution rates pre-SANE to post-SANE. However, when the data were aggregated across sites, thereby increasing statistical power, there was a significant effect such that cases were more likely to be prosecuted post-SANE as compared with pre-SANE. These findings suggest that the SANE intervention model does have a positive impact on sexual assault case progression in the criminal justice system. Nevertheless, there is still a pressing need for improvement as the vast majority of both pre-SANE and post-SANE resulted in nonreferral/no charges filed. © The Author(s) 2014.

  19. Coordination and Management of Multisite Complementary and Alternative Medicine (CAM) Therapies: Experience from a Multisite Reflexology Intervention Trial

    PubMed Central

    Rahbar, Mohammad H.; Wyatt, Gwen; Sikorskii, Alla; Victorson, David; Ardjomand-Hessabi, Manouchehr

    2011-01-01

    Background Multisite randomized clinical trials allow for increased research collaboration among investigators and expedite data collection efforts. As a result, government funding agencies typically look favorably upon this approach. As the field of complementary and alternative medicine (CAM) continues to evolve, so do increased calls for the use of more rigorous study design and trial methodologies, which can present challenges for investigators. Purpose To describe the processes involved in the coordination and management of a multisite randomized clinical trial of a CAM intervention. Methods Key aspects related to the coordination and management of a multisite CAM randomized clinical trial are presented, including organizational and site selection considerations, recruitment concerns and issues related to data collection and randomization to treatment groups. Management and monitoring of data, as well as quality assurance procedures are described. Finally, a real world perspective is shared from a recently conducted multisite randomized clinical trial of reflexology for women diagnosed with advanced breast cancer. Results The use of multiple sites in the conduct of CAM-based randomized clinical trials can provide an efficient, collaborative and robust approach to study coordination and data collection that maximizes efficiency and ensures the quality of results. Conclusions Multisite randomized clinical trial designs can offer the field of CAM research a more standardized and efficient approach to examine the effectiveness of novel therapies and treatments. Special attention must be given to intervention fidelity, consistent data collection and ensuring data quality. Assessment and reporting of quantitative indicators of data quality should be required. PMID:21664296

  20. Developing Leadership Capacity in Others: An Examination of High School Principals' Personal Capacities for Fostering Leadership

    ERIC Educational Resources Information Center

    Huggins, Kristin Shawn; Klar, Hans W.; Hammonds, Hattie L.; Buskey, Frederick C.

    2017-01-01

    In this multisite case study, we examine the personal capacities of six high school principals who have developed the leadership capacities of other leaders in their respective schools. Participants were purposefully selected by two teams of researchers in two states of the United States, one on the east coast and one on the west coast, who…

  1. Provision of pandemic disease information by health sciences librarians: a multisite comparative case series.

    PubMed

    Featherstone, Robin M; Boldt, R Gabriel; Torabi, Nazi; Konrad, Shauna-Lee

    2012-04-01

    The research provides an understanding of pandemic information needs and informs professional development initiatives for librarians in disaster medicine. Utilizing a multisite, comparative case series design, the researchers conducted semi-structured interviews and examined supplementary materials in the form of organizational documents, correspondence, and websites to create a complete picture of each case. The rigor of the case series was ensured through data and investigator triangulation. Interview transcripts were coded using NVivo to identify common themes and points of comparison. Comparison of the four cases revealed a distinct difference between "client-initiated" and "librarian-initiated" provision of pandemic information. Librarian-initiated projects utilized social software to "push" information, whereas client-initiated projects operated within patron-determined parameters to deliver information. Health care administrators were identified as a key audience for pandemic information, and news agencies were utilized as essential information sources. Librarians' skills at evaluating available information proved crucial for selecting best-quality evidence to support administrative decision making. Qualitative analysis resulted in increased understanding of pandemic information needs and identified best practices for disseminating information during periods of high organizational stress caused by an influx of new cases of an unknown infectious disease.

  2. Early Intervention to Reduce Alcohol Misuse and Abuse in the Ohio Army National Guard

    DTIC Science & Technology

    2016-09-01

    Brittany Brownrigg, Data Coordinator at Case Western Reserve University, with the opportunity to work on a large-scale, multi-site, USAMRAA funded study ...CHCR have completed the intro video which will be posted on the app stores. The following meetings took place between study staff and OHARNG members...background/rationale, the design and methodology of the study and study progress as of that date. She also got their feedback on the first iteration of

  3. Applying probabilistic temporal and multisite data quality control methods to a public health mortality registry in Spain: a systematic approach to quality control of repositories.

    PubMed

    Sáez, Carlos; Zurriaga, Oscar; Pérez-Panadés, Jordi; Melchor, Inma; Robles, Montserrat; García-Gómez, Juan M

    2016-11-01

    To assess the variability in data distributions among data sources and over time through a case study of a large multisite repository as a systematic approach to data quality (DQ). Novel probabilistic DQ control methods based on information theory and geometry are applied to the Public Health Mortality Registry of the Region of Valencia, Spain, with 512 143 entries from 2000 to 2012, disaggregated into 24 health departments. The methods provide DQ metrics and exploratory visualizations for (1) assessing the variability among multiple sources and (2) monitoring and exploring changes with time. The methods are suited to big data and multitype, multivariate, and multimodal data. The repository was partitioned into 2 probabilistically separated temporal subgroups following a change in the Spanish National Death Certificate in 2009. Punctual temporal anomalies were noticed due to a punctual increment in the missing data, along with outlying and clustered health departments due to differences in populations or in practices. Changes in protocols, differences in populations, biased practices, or other systematic DQ problems affected data variability. Even if semantic and integration aspects are addressed in data sharing infrastructures, probabilistic variability may still be present. Solutions include fixing or excluding data and analyzing different sites or time periods separately. A systematic approach to assessing temporal and multisite variability is proposed. Multisite and temporal variability in data distributions affects DQ, hindering data reuse, and an assessment of such variability should be a part of systematic DQ procedures. © 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.

  4. Shared worlds: multi-sited ethnography and nursing research.

    PubMed

    Molloy, Luke; Walker, Kim; Lakeman, Richard

    2017-03-22

    Background Ethnography, originally developed for the study of supposedly small-scale societies, is now faced with an increasingly mobile, changing and globalised world. Cultural identities can exist without reference to a specific location and extend beyond regional and national boundaries. It is therefore no longer imperative that the sole object of the ethnographer's practice should be a geographically bounded site. Aim To present a critical methodological review of multi-sited ethnography. Discussion Understanding that it can no longer be taken with any certainty that location alone determines culture, multi-sited ethnography provides a method of contextualising multi-sited social phenomena. The method enables researchers to examine social phenomena that are simultaneously produced in different locations. It has been used to undertake cultural analysis of diverse areas such as organ trafficking, global organisations, technologies and anorexia. Conclusion The authors contend that multi-sited ethnography is particularly suited to nursing research as it provides researchers with an ethnographic method that is more relevant to the interconnected world of health and healthcare services. Implications for practice Multi-sited ethnography provides nurse researchers with an approach to cultural analysis in areas such as the social determinants of health, healthcare services and the effects of health policies across multiple locations.

  5. Ethics Review for a Multi-Site Project Involving Tribal Nations in the Northern Plains.

    PubMed

    Angal, Jyoti; Petersen, Julie M; Tobacco, Deborah; Elliott, Amy J

    2016-04-01

    Increasingly, Tribal Nations are forming ethics review panels, which function separately from institutional review boards (IRBs). The emergence of strong community representation coincides with a widespread effort supported by the U.S. Department of Health & Human Services and other federal agencies to establish a single IRB for all multi-site research. This article underscores the value of a tribal ethics review board and describes the tribal oversight for the Safe Passage Study-a multi-site, community-based project in the Northern Plains. Our experience demonstrates the benefits of tribal ethics review and makes a strong argument for including tribal oversight in future regulatory guidance for multi-site, community-based research. © The Author(s) 2016.

  6. Challenges and lessons learned in conducting comparative-effectiveness trials.

    PubMed

    Herrick, Linda M; Locke, G Richard; Zinsmeister, Alan R; Talley, Nicholas J

    2012-05-01

    The current health-care environment is demanding evidence-based medicine that relies on clinical trials as the basis for decisions. Clinician investigators are more often finding that they are personally responsible for coordinating large, multisite trials. We present strategies for successful implementation and management of multisite clinical trials and knowledge gained through an international, multisite randomized clinical trial. Topics include team composition, regulatory requirements, study organization and governance, communication strategies, recruitment and retention efforts, budget, technology transfer, and publication.

  7. Challenges and Lessons Learned in Conducting Comparative-Effectiveness Trials

    PubMed Central

    Herrick, Linda M.; Locke, G. Richard; Zinsmeister, Alan R.; Talley, Nicholas J.

    2014-01-01

    The current health-care environment is demanding evidence-based medicine that relies on clinical trials as the basis for decisions. Clinician investigators are more often finding that they are personally responsible for coordinating large, multisite trials. We present strategies for successful implementation and management of multisite clinical trials and knowledge gained through an international, multisite randomized clinical trial. Topics include team composition, regulatory requirements, study organization and governance, communication strategies, recruitment and retention efforts, budget, technology transfer, and publication. PMID:22552235

  8. Psychosocial stress and multi-site musculoskeletal pain: a cross-sectional survey of patient care workers.

    PubMed

    Sembajwe, Grace; Tveito, Torill Helene; Hopcia, Karen; Kenwood, Christopher; O'Day, Elizabeth Tucker; Stoddard, Anne M; Dennerlein, Jack T; Hashimoto, Dean; Sorensen, Glorian

    2013-03-01

    The aim of this study was to assess the relationship between psychosocial factors at work and multi-site musculoskeletal pain among patient care workers. In a survey of 1,572 workers from two hospitals, occupational psychosocial factors and health outcomes of workers with single and multi-site pain were evaluated using items from the Job Content Questionnaire that was designed to measure psychological demands, decision latitude, and social support. An adapted Nordic Questionnaire provided data on the musculoskeletal pain outcome. Covariates included body mass index, age, gender, and occupation. The analyses revealed statistically significant associations between psychosocial demands and multi-site musculoskeletal pain among patient care associates, nurses, and administrative personnel, both men and women. Supervisor support played a significant role for nurses and women. These results remained statistically significant after adjusting for covariates. These results highlight the associations between workplace psychosocial strain and multi-site musculoskeletal pain, setting the stage for future longitudinal explorations. Copyright 2013, SLACK Incorporated.

  9. Brief Treatments for Cannabis Dependence: Findings From a Randomized Multisite Trial

    ERIC Educational Resources Information Center

    Babor, Thomas F.

    2004-01-01

    This study evaluated the efficacy of 2 brief interventions for cannabis-dependent adults. A multisite randomized controlled trial compared cannabis use outcomes across 3 study conditions: (a) 2 sessions of motivational enhancement therapy (MET); (b) 9 sessions of multicomponent therapy that included MET, cognitive-behavioral therapy, and case…

  10. Voxel-based morphometric multisite collaborative study on schizophrenia.

    PubMed

    Segall, Judith M; Turner, Jessica A; van Erp, Theo G M; White, Tonya; Bockholt, H Jeremy; Gollub, Randy L; Ho, Beng C; Magnotta, Vince; Jung, Rex E; McCarley, Robert W; Schulz, S Charles; Lauriello, John; Clark, Vince P; Voyvodic, James T; Diaz, Michele T; Calhoun, Vince D

    2009-01-01

    Regional gray matter (GM) abnormalities are well known to exist in patients with chronic schizophrenia. Voxel-based morphometry (VBM) has been previously used on structural magnetic resonance images (MRI) data to characterize these abnormalities. Two multisite schizophrenia studies, the Functional Biomedical Informatics Research Network and the Mind Clinical Imaging Consortium, which include 9 data collection sites, are evaluating the efficacy of pooling structural imaging data across imaging centers. Such a pooling of data could yield the increased statistical power needed to elucidate effects that may not be seen with smaller samples. VBM analyses were performed to evaluate the consistency of patient versus control gray matter concentration (GMC) differences across the study sites, as well as the effects of combining multisite data. Integration of data from both studies yielded a large sample of 503 subjects, including 266 controls and 237 patients diagnosed with schizophrenia, schizoaffective or schizophreniform disorder. The data were analyzed using the combined sample, as well as analyzing each of the 2 multisite studies separately. A consistent pattern of reduced relative GMC in schizophrenia patients compared with controls was found across all study sites. Imaging center-specific effects were evaluated using a region of interest analysis. Overall, the findings support the use of VBM in combined multisite studies. This analysis of schizophrenics and controls from around the United States provides continued supporting evidence for GM deficits in the temporal lobes, anterior cingulate, and frontal regions in patients with schizophrenia spectrum disorders.

  11. 78 FR 13904 - Notice of Availability of Funds and Solicitation for Grant Applications for Intermediary...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-01

    ... to operate multi-site projects to serve juvenile offenders and in-school youth at-risk of involvement... development, education and training, case management, mentoring, restorative justice, community- wide violence...

  12. Multisite Phosphorylation Modulates the T Cell Receptor ζ-Chain Potency but not the Switchlike Response.

    PubMed

    Mukhopadhyay, Himadri; de Wet, Ben; Clemens, Lara; Maini, Philip K; Allard, Jun; van der Merwe, P Anton; Dushek, Omer

    2016-04-26

    Multisite phosphorylation is ubiquitous in cellular signaling and is thought to provide signaling proteins with additional regulatory mechanisms. Indeed, mathematical models have revealed a large number of mechanisms by which multisite phosphorylation can produce switchlike responses. The T cell antigen receptor (TCR) is a multisubunit receptor on the surface of T cells that is a prototypical multisite substrate as it contains 20 sites that are distributed on 10 conserved immunoreceptor tyrosine-based activation motifs (ITAMs). The TCR ζ-chain is a homodimer subunit that contains six ITAMs (12 sites) and exhibits a number of properties that are predicted to be sufficient for a switchlike response. We have used cellular reconstitution to systematically study multisite phosphorylation of the TCR ζ-chain. We find that multisite phosphorylation proceeds by a nonsequential random mechanism, and find no evidence that multiple ITAMs modulate a switchlike response but do find that they alter receptor potency and maximum phosphorylation. Modulation of receptor potency can be explained by a reduction in molecular entropy of the disordered ζ-chain upon phosphorylation. We further find that the tyrosine kinase ZAP-70 increases receptor potency but does not modulate the switchlike response. In contrast to other multisite proteins, where phosphorylations act in strong concert to modulate protein function, we suggest that the multiple ITAMs on the TCR function mainly to amplify subsequent signaling. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  13. Finding Efficiency in the Design of Large Multisite Evaluations: Estimating Variances for Science Achievement Studies

    ERIC Educational Resources Information Center

    Westine, Carl D.

    2016-01-01

    Little is known empirically about intraclass correlations (ICCs) for multisite cluster randomized trial (MSCRT) designs, particularly in science education. In this study, ICCs suitable for science achievement studies using a three-level (students in schools in districts) MSCRT design that block on district are estimated and examined. Estimates of…

  14. The ability of multi-site, multi-depth sacral lateral branch blocks to anesthetize the sacroiliac joint complex.

    PubMed

    Dreyfuss, Paul; Henning, Troy; Malladi, Niriksha; Goldstein, Barry; Bogduk, Nikolai

    2009-01-01

    To determine the physiologic effectiveness of multi-site, multi-depth sacral lateral branch injections. Double-blind, randomized, placebo-controlled study. Outpatient pain management center. Twenty asymptomatic volunteers. The dorsal innervation to the sacroiliac joint (SIJ) is from the L5 dorsal ramus and the S1-3 lateral branches. Multi-site, multi-depth lateral branch blocks were developed to compensate for the complex regional anatomy that limited the effectiveness of single-site, single-depth lateral branch injections. Bilateral multi-site, multi-depth lateral branch green dye injections and subsequent dissection on two cadavers revealed a 91% accuracy with this technique. Session 1: 20 asymptomatic subjects had a 25-g spinal needle probe their interosseous (IO) and dorsal sacroiliac (DSI) ligaments. The inferior dorsal SIJ was entered and capsular distension with contrast medium was performed. Discomfort had to occur with each provocation maneuver and a contained arthrogram was necessary to continue in the study. Session 2: 1 week later; computer randomized, double-blind multi-site, multi-depth lateral branch blocks injections were performed. Ten subjects received active (bupivicaine 0.75%) and 10 subjects received sham (normal saline) multi-site, multi-depth lateral branch injections. Thirty minutes later, provocation testing was repeated with identical methodology used in session 1. Presence or absence of pain for ligamentous probing and SIJ capsular distension. Seventy percent of the active group had an insensate IO and DSI ligaments, and inferior dorsal SIJ vs 0-10% of the sham group. Twenty percent of the active vs 10% of the sham group did not feel repeat capsular distension. Six of seven subjects (86%) retained the ability to feel repeat capsular distension despite an insensate dorsal SIJ complex. Multi-site, multi-depth lateral branch blocks are physiologically effective at a rate of 70%. Multi-site, multi-depth lateral branch blocks do not effectively block the intra-articular portion of the SIJ. There is physiological evidence that the intra-articular portion of the SIJ is innervated from both ventral and dorsal sources. Comparative multi-site, multi-depth lateral branch blocks should be considered a potentially valuable tool to diagnose extra-articular SIJ pain and determine if lateral branch radiofrequency neurotomy may assist one with SIJ pain.

  15. How Can Multi-Site Evaluations Be Participatory?

    ERIC Educational Resources Information Center

    Lawrenz, Frances; Huffman, Douglas

    2003-01-01

    Multi-site evaluations are becoming increasingly common in federal funding portfolios. Although much thought has been given to multi-site evaluation, there has been little emphasis on how it might interact with participatory evaluation. Therefore, this paper reviews several National Science Foundation educational, multi-site evaluations for the…

  16. A Multi-Site Study on Medical School Selection, Performance, Motivation and Engagement

    ERIC Educational Resources Information Center

    Wouters, A.; Croiset, G.; Schripsema, N. R.; Cohen-Schotanus, J.; Spaai, G. W.; Hulsman, R. L.; Kusurkar, R. A.

    2017-01-01

    Medical schools seek ways to improve their admissions strategies, since the available methods prove to be suboptimal for selecting the best and most motivated students. In this multi-site cross-sectional questionnaire study, we examined the value of (different) selection procedures compared to a weighted lottery procedure, which includes direct…

  17. Development and Implementation of a Multisite Evaluation for the Women, Co-Occurring Disorders and Violence Study

    ERIC Educational Resources Information Center

    Giard, Julienne; Hennigan, Karen; Huntington, Nicholas; Vogel, Wendy; Rinehart, Debbie; Mazelis, Ruta; Nadlicki, Terri; Veysey, Bonita M.

    2005-01-01

    In this article we describe the development and implementation of the Substance Abuse and Mental Health Services Administration's (SAMHSA's) multisite Women, Co-Occurring Disorders and Violence Study (WCDVS), highlighting some of the challenges encountered, decisions made, and lessons learned. Four themes are discussed. First, the unique…

  18. Power Calculations for Moderators in Multi-Site Cluster Randomized Trials

    ERIC Educational Resources Information Center

    Spybrook, Jessaca; Kelcey, Ben; Dong, Nianbo

    2016-01-01

    Cluster randomized trials (CRTs), or studies in which intact groups of individuals are randomly assigned to a condition, are becoming more common in evaluation studies of educational programs. A specific type of CRT in which clusters are randomly assigned to treatment within blocks or sites, known as multisite cluster randomized trials (MSCRTs),…

  19. Reliability of instruments in a cooperative, multisite study: employment intervention demonstration program.

    PubMed

    Salyers, M P; McHugo, G J; Cook, J A; Razzano, L A; Drake, R E; Mueser, K T

    2001-09-01

    Reliability of well-known instruments was examined in 202 people with severe mental illness participating in a multisite vocational study. We examined interrater reliability of the Positive and Negative Syndrome Scale (PANSS) and the internal consistency and test-retest reliability of the PANSS, the Rosenberg Self-Esteem Scale, the Medical Outcomes Study Short Form-36 (SF-36), and the Quality of Life Interview. Most scales had good levels of reliability, with intraclass correlation coefficients (ICCs) and coefficient alphas above .70. However, the SF-36 scales were generally less stable over time, particularly Social Functioning (ICC = .55). Test-retest reliability was lower among less educated respondents and among ethnic minorities. We recommend close monitoring of psychometric issues in future multisite studies.

  20. Informatics tools to improve clinical research study implementation.

    PubMed

    Brandt, Cynthia A; Argraves, Stephanie; Money, Roy; Ananth, Gowri; Trocky, Nina M; Nadkarni, Prakash M

    2006-04-01

    There are numerous potential sources of problems when performing complex clinical research trials. These issues are compounded when studies are multi-site and multiple personnel from different sites are responsible for varying actions from case report form design to primary data collection and data entry. We describe an approach that emphasizes the use of a variety of informatics tools that can facilitate study coordination, training, data checks and early identification and correction of faulty procedures and data problems. The paper focuses on informatics tools that can help in case report form design, procedures and training and data management. Informatics tools can be used to facilitate study coordination and implementation of clinical research trials.

  1. Distributed data networks: a blueprint for Big Data sharing and healthcare analytics.

    PubMed

    Popovic, Jennifer R

    2017-01-01

    This paper defines the attributes of distributed data networks and outlines the data and analytic infrastructure needed to build and maintain a successful network. We use examples from one successful implementation of a large-scale, multisite, healthcare-related distributed data network, the U.S. Food and Drug Administration-sponsored Sentinel Initiative. Analytic infrastructure-development concepts are discussed from the perspective of promoting six pillars of analytic infrastructure: consistency, reusability, flexibility, scalability, transparency, and reproducibility. This paper also introduces one use case for machine learning algorithm development to fully utilize and advance the portfolio of population health analytics, particularly those using multisite administrative data sources. © 2016 New York Academy of Sciences.

  2. Provision of pandemic disease information by health sciences librarians: a multisite comparative case series*†‡§

    PubMed Central

    Featherstone, Robin M; Boldt, R. Gabriel; Torabi, Nazi; Konrad, Shauna-Lee

    2012-01-01

    Objective: The research provides an understanding of pandemic information needs and informs professional development initiatives for librarians in disaster medicine. Methods: Utilizing a multisite, comparative case series design, the researchers conducted semi-structured interviews and examined supplementary materials in the form of organizational documents, correspondence, and websites to create a complete picture of each case. The rigor of the case series was ensured through data and investigator triangulation. Interview transcripts were coded using NVivo to identify common themes and points of comparison. Results: Comparison of the four cases revealed a distinct difference between “client-initiated” and “librarian-initiated” provision of pandemic information. Librarian-initiated projects utilized social software to “push” information, whereas client-initiated projects operated within patron-determined parameters to deliver information. Health care administrators were identified as a key audience for pandemic information, and news agencies were utilized as essential information sources. Librarians' skills at evaluating available information proved crucial for selecting best-quality evidence to support administrative decision making. Conclusions: Qualitative analysis resulted in increased understanding of pandemic information needs and identified best practices for disseminating information during periods of high organizational stress caused by an influx of new cases of an unknown infectious disease. PMID:22514506

  3. An Examination of Diversity within Three Southeastern Academic Libraries: A Mixed-Methods, Multi-Site Study

    ERIC Educational Resources Information Center

    Shaffer, Christopher A.

    2014-01-01

    The purpose of this study was to determine the extent to which three academic libraries in the Southeastern United States could be considered diverse. This was a multi-site, mixed methods study. It examined the climate and culture of the libraries, which was assessed through two methods; the first, through survey responses from full-time faculty…

  4. A Hierarchical Modeling Approach to Data Analysis and Study Design in a Multi-Site Experimental fMRI Study

    ERIC Educational Resources Information Center

    Zhou, Bo; Konstorum, Anna; Duong, Thao; Tieu, Kinh H.; Wells, William M.; Brown, Gregory G.; Stern, Hal S.; Shahbaba, Babak

    2013-01-01

    We propose a hierarchical Bayesian model for analyzing multi-site experimental fMRI studies. Our method takes the hierarchical structure of the data (subjects are nested within sites, and there are multiple observations per subject) into account and allows for modeling between-site variation. Using posterior predictive model checking and model…

  5. Research staff training in a multisite randomized clinical trial: Methods and recommendations from the Stimulant Reduction Intervention using Dosed Exercise (STRIDE) trial.

    PubMed

    Walker, Robrina; Morris, David W; Greer, Tracy L; Trivedi, Madhukar H

    2014-01-01

    Descriptions of and recommendations for meeting the challenges of training research staff for multisite studies are limited despite the recognized importance of training on trial outcomes. The STRIDE (STimulant Reduction Intervention using Dosed Exercise) study is a multisite randomized clinical trial that was conducted at nine addiction treatment programs across the United States within the National Drug Abuse Treatment Clinical Trials Network (CTN) and evaluated the addition of exercise to addiction treatment as usual (TAU), compared to health education added to TAU, for individuals with stimulant abuse or dependence. Research staff administered a variety of measures that required a range of interviewing, technical, and clinical skills. In order to address the absence of information on how research staff are trained for multisite clinical studies, the current manuscript describes the conceptual process of training and certifying research assistants for STRIDE. Training was conducted using a three-stage process to allow staff sufficient time for distributive learning, practice, and calibration leading up to implementation of this complex study. Training was successfully implemented with staff across nine sites. Staff demonstrated evidence of study and procedural knowledge via quizzes and skill demonstration on six measures requiring certification. Overall, while the majority of staff had little to no experience in the six measures, all research assistants demonstrated ability to correctly and reliably administer the measures throughout the study. Practical recommendations are provided for training research staff and are particularly applicable to the challenges encountered with large, multisite trials.

  6. Biological Stress Systems, Adverse Life Events, and the Improvement of Chronic Multisite Musculoskeletal Pain Across a 6-Year Follow-Up.

    PubMed

    Generaal, Ellen; Vogelzangs, Nicole; Macfarlane, Gary J; Geenen, Rinie; Smit, Johannes H; de Geus, Eco J C N; Dekker, Joost; Penninx, Brenda W J H

    2017-02-01

    Dysfunction of biological stress systems and adverse life events, independently and in interaction, have been hypothesized to predict chronic pain persistence. Conversely, these factors may hamper the improvement of chronic pain. Longitudinal evidence is currently lacking. We examined whether: 1) function of biological stress systems, 2) adverse life events, and 3) their combination predict the improvement of chronic multisite musculoskeletal pain. Subjects of the Netherlands Study of Depression and Anxiety (NESDA) with chronic multisite musculoskeletal pain at baseline (N = 665) were followed-up 2, 4, and 6 years later. The Chronic Pain Grade Questionnaire was used to determine improvement (not meeting the criteria) of chronic multisite musculoskeletal pain at follow-up. Baseline assessment of biological stress systems included function of hypothalamic-pituitary-adrenal axis (1-hour cortisol awakening response, evening level, and post dexamethasone level), the immune system (basal and lipopolysaccharide-stimulated inflammatory markers), the autonomic nervous system (heart rate, pre-ejection period, SD of the normal-to-normal interval, and respiratory sinus arrhythmia). The number of adverse life events were assessed at baseline and 2-year follow-up using the List of Threatening Events Questionnaire. We showed that hypothalamic-pituitary-adrenal axis, immune system, and autonomic nervous system functioning and adverse life events were not associated with the improvement of chronic multisite musculoskeletal pain, either as a main effect or in interaction. This longitudinal study could not confirm that biological stress system dysfunction and adverse life events affect the course of chronic multisite musculoskeletal pain. Biological stress systems and adverse life events are not associated with the improvement of chronic multisite musculoskeletal pain over 6 years of follow-up. Other determinants should thus be considered in future research to identify in which persons pain symptoms will improve. Copyright © 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.

  7. Intra-operative multi-site stimulation: Expanding methodology for cortical brain mapping of language functions

    PubMed Central

    Korn, Akiva; Kirschner, Adi; Perry, Daniella; Hendler, Talma; Ram, Zvi

    2017-01-01

    Direct cortical stimulation (DCS) is considered the gold-standard for functional cortical mapping during awake surgery for brain tumor resection. DCS is performed by stimulating one local cortical area at a time. We present a feasibility study using an intra-operative technique aimed at improving our ability to map brain functions which rely on activity in distributed cortical regions. Following standard DCS, Multi-Site Stimulation (MSS) was performed in 15 patients by applying simultaneous cortical stimulations at multiple locations. Language functioning was chosen as a case-cognitive domain due to its relatively well-known cortical organization. MSS, performed at sites that did not produce disruption when applied in a single stimulation point, revealed additional language dysfunction in 73% of the patients. Functional regions identified by this technique were presumed to be significant to language circuitry and were spared during surgery. No new neurological deficits were observed in any of the patients following surgery. Though the neuro-electrical effects of MSS need further investigation, this feasibility study may provide a first step towards sophistication of intra-operative cortical mapping. PMID:28700619

  8. Intra-operative multi-site stimulation: Expanding methodology for cortical brain mapping of language functions.

    PubMed

    Gonen, Tal; Gazit, Tomer; Korn, Akiva; Kirschner, Adi; Perry, Daniella; Hendler, Talma; Ram, Zvi

    2017-01-01

    Direct cortical stimulation (DCS) is considered the gold-standard for functional cortical mapping during awake surgery for brain tumor resection. DCS is performed by stimulating one local cortical area at a time. We present a feasibility study using an intra-operative technique aimed at improving our ability to map brain functions which rely on activity in distributed cortical regions. Following standard DCS, Multi-Site Stimulation (MSS) was performed in 15 patients by applying simultaneous cortical stimulations at multiple locations. Language functioning was chosen as a case-cognitive domain due to its relatively well-known cortical organization. MSS, performed at sites that did not produce disruption when applied in a single stimulation point, revealed additional language dysfunction in 73% of the patients. Functional regions identified by this technique were presumed to be significant to language circuitry and were spared during surgery. No new neurological deficits were observed in any of the patients following surgery. Though the neuro-electrical effects of MSS need further investigation, this feasibility study may provide a first step towards sophistication of intra-operative cortical mapping.

  9. Interracial Contact and Racial Constancy: A Multi-Site Study of Racial Intergroup Bias in 3-5 Year Old Anglo-British Children

    ERIC Educational Resources Information Center

    Rutland, Adam; Cameron, Lindsey; Bennett, Laura; Ferrell, Jennifer

    2005-01-01

    This paper examined the influence of interracial contact and racial constancy on the racial intergroup bias of young Anglo-British children. This multi-site study was conducted in areas of Great Britain that varied in terms of racial diversity. The study also investigated whether preschool children express bias on positive, but not negative,…

  10. The Study to Explore Early Development (SEED): A Multisite Epidemiologic Study of Autism by the Centers for Autism and Developmental Disabilities Research and Epidemiology (CADDRE) Network

    ERIC Educational Resources Information Center

    Schendel, Diana E.; DiGuiseppi, Carolyn; Croen, Lisa A.; Fallin, M. Daniele; Reed, Philip L.; Schieve, Laura A.; Wiggins, Lisa D.; Daniels, Julie; Grether, Judith; Levy, Susan E.; Miller, Lisa; Newschaffer, Craig; Pinto-Martin, Jennifer; Robinson, Cordelia; Windham, Gayle C.; Alexander, Aimee; Aylsworth, Arthur S.; Bernal, Pilar; Bonner, Joseph D.; Blaskey, Lisa; Bradley, Chyrise; Collins, Jack; Ferretti, Casara J.; Farzadegan, Homayoon; Giarelli, Ellen; Harvey, Marques; Hepburn, Susan; Herr, Matthew; Kaparich, Kristina; Landa, Rebecca; Lee, Li-Ching; Levenseller, Brooke; Meyerer, Stacey; Rahbar, Mohammad H.; Ratchford, Andria; Reynolds, Ann; Rosenberg, Steven; Rusyniak, Julie; Shapira, Stuart K.; Smith, Karen; Souders, Margaret; Thompson, Patrick Aaron; Young, Lisa; Yeargin-Allsopp, Marshalyn

    2012-01-01

    The Study to Explore Early Development (SEED), a multisite investigation addressing knowledge gaps in autism phenotype and etiology, aims to: (1) characterize the autism behavioral phenotype and associated developmental, medical, and behavioral conditions and (2) investigate genetic and environmental risks with emphasis on immunologic, hormonal,…

  11. Partnership-driven Resources to Improve and Enhance Research (PRIMER): a survey of community-engaged researchers and creation of an online toolkit.

    PubMed

    Dolor, Rowena J; Greene, Sarah M; Thompson, Ella; Baldwin, Laura-Mae; Neale, Anne Victoria

    2011-08-01

    This project aimed to develop an open-access website providing adaptable resources to facilitate best practices for multisite research from initiation to closeout. methods: A web-based assessment was sent to the leadership of the Clinical and Translational Science Award (CTSA) Community Engagement Key Functions Committee (n= 38) and the CTSA-affiliated Primary Care Practice-based Research Networks (PBRN, n= 55). Respondents rated the benefits and barriers of multisite research, the utility of available resources, and indicated their level of interest in unavailable resources. Then, existing research resources were evaluated for relevance to multisite research, adaptability to other projects, and source credibility. Fifty-five (59%) of invited participants completed the survey. Top perceived benefits of multisite research were the ability to conduct community-relevant research through academic-community partnerships (34%) and accelerating translation of research into practice (31%). Top perceived barriers were lack of research infrastructure to support PBRNs and community partners (31%) and inadequate funding to support multisite collaborations (26%). Over 200 resources were evaluated, of which 120 unique resources were included in the website. The PRIMER Research Toolkit (http://www.researchtoolkit.org) provides an array of peer-reviewed resources to facilitate translational research for the conduct of multisite studies within PBRNs and community-based organizations. © 2011 Wiley Periodicals, Inc.

  12. Partnership‐Driven Resources to Improve and Enhance Research (PRIMER): A Survey of Community‐Engaged Researchers and Creation of an Online Toolkit

    PubMed Central

    Dolor, Rowena J.; Greene, Sarah M.; Thompson, Ella; Baldwin, Laura‐Mae; Neale, Anne Victoria

    2011-01-01

    Abstract Objective: This project aimed to develop an open‐access website providing adaptable resources to facilitate best practices for multisite research from initiation to closeout. Methods: A web‐based assessment was sent to the leadership of the Clinical and Translational Science Award (CTSA) Community Engagement Key Functions Committee (n= 38) and the CTSA‐affiliated Primary Care Practice‐based Research Networks (PBRN, n= 55). Respondents rated the benefits and barriers of multisite research, the utility of available resources, and indicated their level of interest in unavailable resources. Then, existing research resources were evaluated for relevance to multisite research, adaptability to other projects, and source credibility. Results: Fifty‐five (59%) of invited participants completed the survey. Top perceived benefits of multisite research were the ability to conduct community‐relevant research through academic–community partnerships (34%) and accelerating translation of research into practice (31%). Top perceived barriers were lack of research infrastructure to support PBRNs and community partners (31%) and inadequate funding to support multisite collaborations (26%). Over 200 resources were evaluated, of which 120 unique resources were included in the website. Conclusion: The PRIMER Research Toolkit (http://www.researchtoolkit.org) provides an array of peer‐reviewed resources to facilitate translational research for the conduct of multisite studies within PBRNs and community‐based organizations. Clin Trans Sci 2011; Volume 4: 259–265 PMID:21884512

  13. Multi-Site Quality Assurance Project Plan for Wisconsin Public Service Corporation, Peoples Gas Light and Coke Company, and North Shore Gas

    EPA Pesticide Factsheets

    This Multi-Site QAPP presents the organization, data quality objectives (DQOs), a set of anticipated activities, sample analysis, data handling and specific Quality Assurance/Quality Control (QA/QC) procedures associated with Studies done in EPA Region 5

  14. Biphasic responses in multi-site phosphorylation systems.

    PubMed

    Suwanmajo, Thapanar; Krishnan, J

    2013-12-06

    Multi-site phosphorylation systems are repeatedly encountered in cellular biology and multi-site modification is a basic building block of post-translational modification. In this paper, we demonstrate how distributive multi-site modification mechanisms by a single kinase/phosphatase pair can lead to biphasic/partial biphasic dose-response characteristics for the maximally phosphorylated substrate at steady state. We use simulations and analysis to uncover a hidden competing effect which is responsible for this and analyse how it may be accentuated. We build on this to analyse different variants of multi-site phosphorylation mechanisms showing that some mechanisms are intrinsically not capable of displaying this behaviour. This provides both a consolidated understanding of how and under what conditions biphasic responses are obtained in multi-site phosphorylation and a basis for discriminating between different mechanisms based on this. We also demonstrate how this behaviour may be combined with other behaviour such as threshold and bistable responses, demonstrating the capacity of multi-site phosphorylation systems to act as complex molecular signal processors.

  15. Awareness of Diagnosis and Knowledge of HPV in Women Patients: Data from a Multi-Site Study

    ERIC Educational Resources Information Center

    McCree, Donna Hubbard; Daley, Ellen M.; Gorbach, Pamina; Hamm, Robert M.; Sharpe, Patricia A.; Brandt, Heather M.; McFarlane, Mary; Kerndt, Peter; McDermott, Robert J.; Perrin, Karen M.; St. Lawrence, Janet S.

    2010-01-01

    Background: Persistent infection with high-risk types of human papillomavirus (HPV) is associated with cervical and other anogenital cancers. Purpose: This paper reports results of awareness of an HPV diagnosis and HPV knowledge from a multi-site study of HPV knowledge, attitudes and behavior, and the impact of an HPV diagnosis on women and their…

  16. WWC Review of the Report "Transfer Incentives for High-Performing Teachers: Final Results from a Multisite Randomized Experiment." What Works Clearinghouse Single Study Review

    ERIC Educational Resources Information Center

    What Works Clearinghouse, 2015

    2015-01-01

    For the 2013 study, "Transfer Incentives for High-Performing Teachers: Final Results from a Multisite Randomized Experiment," researchers examined the impact of the Talent Transfer Initiative (TTI) on students' reading and mathematics achievement in 10 school districts. The TTI enabled principals of low-performing schools to provide…

  17. Replication and Comparison of the Newly Proposed ADOS-2, Module 4 Algorithm in ASD without ID: A Multi-Site Study

    ERIC Educational Resources Information Center

    Pugliese, Cara E.; Kenworthy, Lauren; Bal, Vanessa Hus; Wallace, Gregory L.; Yerys, Benjamin E.; Maddox, Brenna B.; White, Susan W.; Popal, Haroon; Armour, Anna Chelsea; Miller, Judith; Herrington, John D.; Schultz, Robert T.; Martin, Alex; Anthony, Laura Gutermuth

    2015-01-01

    Recent updates have been proposed to the Autism Diagnostic Observation Schedule-2 Module 4 diagnostic algorithm. This new algorithm, however, has not yet been validated in an independent sample without intellectual disability (ID). This multi-site study compared the original and revised algorithms in individuals with ASD without ID. The revised…

  18. Essential Resources for Implementation and Sustainability of Evidence-Based Health Promotion Programs: A Mixed Methods Multi-Site Case Study.

    PubMed

    Dattalo, M; Wise, M; Ford Ii, J H; Abramson, B; Mahoney, J

    2017-04-01

    As of October 2016, use of federal Older Americans Act funds for health promotion and disease prevention will be restricted to the Administration on Aging's criteria for high-level evidence-based health promotion programs. Dissemination of these programs to rural communities remains limited. Therefore a strong need exists to identify strategies that facilitate program implementation and sustainability. The objective of this study was to compare organizational readiness and implementation strategies used by rural communities that achieved varying levels of success in sustaining evidence-based health promotion programs for older adults. We utilized a qualitative multi-site case study design to analyze the longitudinal experiences of eight rural sites working to implement evidence-based health promotion program over 3 years (8/2012-7/2015). Multiple sources of data (interviews, documents, reports, surveys) from each site informed the analysis. We used conventional content analysis to conduct a cross-case comparison to identify common features of rural counties that successfully implemented and sustained their target evidence-based health promotion program. Readiness to implement evidence-based programs as low at baseline as all site leaders described needing to secure additional resources for program implementation. Sites that successfully utilized six essential resources implemented and sustained greater numbers of workshops: (1) External Partnerships, (2) Agency Leadership Commitment, (3) Ongoing Source of Workshop Leaders, (4) Health Promotion Coordination Tasks Assigned to Specific Staff, (5) Organizational Stability, and (6) Change Team Engagement. The six essential resources described in this study can help rural communities assess their readiness to implement health promotion programs and work secure the resources necessary for successful implementation.

  19. The burden of healthcare-associated Clostridium difficile infection in a non-metropolitan setting.

    PubMed

    Bond, S E; Boutlis, C S; Yeo, W W; Pratt, W A B; Orr, M E; Miyakis, S

    2017-04-01

    Healthcare-associated Clostridium difficile infection (HCA-CDI) remains a major cause of morbidity and mortality in industrialized countries. However, few data exist on the burden of HCA-CDI in multi-site non-metropolitan settings. This study examined the introduction of an antimicrobial stewardship programme (ASP) in relation to HCA-CDI rates, and the effect of HCA-CDI on length of stay (LOS) and hospital costs. A comparative before-and-after intervention study of patients aged ≥16 years with HCA-CDI from December 2010 to April 2016 across the nine hospitals of a non-metropolitan health district in New South Wales, Australia was undertaken. The intervention comprised a multi-site ASP supported by a clinical decision support system, with subsequent introduction of email feedback of HCA-CDI cases to admitting medical officers. HCA-CDI rates, comparative LOS and hospital costs, prior use of antimicrobials and proton pump inhibitors, and appropriateness of CDI treatment. HCA-CDI rates rose from 3.07 to 4.60 cases per 10,000 occupied bed-days pre-intervention, and remained stable at 4 cases per 10,000 occupied bed-days post-intervention (P=0.24). Median LOS (17 vs six days; P<0.01) and hospital costs (AU$19,222 vs $7861; P<0.01) were significantly greater for HCA-CDI cases (N=91) than for matched controls (N=172). Half of the patients with severe HCA-CDI (4/8) did not receive initial appropriate treatment (oral vancomycin). HCA-CDI placed a significant burden on the regional and rural health service through increased LOS and hospital costs. Interventions targeting HCA-CDI could be employed to consolidate the effects of ASPs. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

  20. Evaluating Area-Based Interventions: The Case of "Communities for Children"

    ERIC Educational Resources Information Center

    Cortis, Natasha

    2008-01-01

    Increasingly, governments in wealthy countries are designing early intervention initiatives around principles of "community regeneration" or "place management". Because these initiatives are multi-site, aimed at long-term systemic change, and implemented amidst a range of other initiatives, assessing their quality and outcomes…

  1. Use of personal digital assistants for data collection in a multi-site AIDS stigma study in rural south Nyanza, Kenya.

    PubMed

    Onono, M A; Carraher, N; Cohen, R C; Bukusi, E A; Turan, J M

    2011-09-01

    To describe the development, cost effectiveness and implementation of a PDA based electronic system to collect, verify and manage data from a multi-site study on HIV/AIDS stigma and pregnancy in a rural, resource-poor area. We worked within a large prevention of mother-to-child-transmission (PMTCT) program in nine rural health facilities to implement a PDA-based data collection system and to study the feasibility of its use in a multisite HIV research study in rural Kenya. The PDAs were programmed for collecting screening and eligibility data, and responses to structured interviews on HIV/AIDS stigma and violence in three local languages. Between November 2007 and December 2008, nine PDAs were used by Clinic and Community Health Assistants to enrol 1,270 participants on to the PMTCT program. Successes included: capacity-building of interviewers, low cost of implementation, quick turnaround time of data entry with good data quality, and convenience. Our study demonstrated the feasibility of utilizing PDAs for data collection in a multi-site observational study on HIV/AIDS stigma conducted in remote rural health facilities in Kenya. However, appropriate and frequent data backup protocols need to be established and paper forms are still needed as backup tools in resource-poor settings.

  2. Reduced-complexity multi-site rainfall generation: one million years over night using the model TripleM

    NASA Astrophysics Data System (ADS)

    Breinl, Korbinian; Di Baldassarre, Giuliano; Girons Lopez, Marc

    2017-04-01

    We assess uncertainties of multi-site rainfall generation across spatial scales and different climatic conditions. Many research subjects in earth sciences such as floods, droughts or water balance simulations require the generation of long rainfall time series. In large study areas the simulation at multiple sites becomes indispensable to account for the spatial rainfall variability, but becomes more complex compared to a single site due to the intermittent nature of rainfall. Weather generators can be used for extrapolating rainfall time series, and various models have been presented in the literature. Even though the large majority of multi-site rainfall generators is based on similar methods, such as resampling techniques or Markovian processes, they often become too complex. We think that this complexity has been a limit for the application of such tools. Furthermore, the majority of multi-site rainfall generators found in the literature are either not publicly available or intended for being applied at small geographical scales, often only in temperate climates. Here we present a revised, and now publicly available, version of a multi-site rainfall generation code first applied in 2014 in Austria and France, which we call TripleM (Multisite Markov Model). We test this fast and robust code with daily rainfall observations from the United States, in a subtropical, tropical and temperate climate, using rain gauge networks with a maximum site distance above 1,000km, thereby generating one million years of synthetic time series. The modelling of these one million years takes one night on a recent desktop computer. In this research, we first start the simulations with a small station network of three sites and progressively increase the number of sites and the spatial extent, and analyze the changing uncertainties for multiple statistical metrics such as dry and wet spells, rainfall autocorrelation, lagged cross correlations and the inter-annual rainfall variability. Our study contributes to the scientific community of earth sciences and the ongoing debate on extreme precipitation in a changing climate by making a stable, and very easily applicable, multi-site rainfall generation code available to the research community and providing a better understanding of the performance of multi-site rainfall generation depending on spatial scales and climatic conditions.

  3. MultiSite Gateway-Compatible Cell Type-Specific Gene-Inducible System for Plants1[OPEN

    PubMed Central

    Siligato, Riccardo; Wang, Xin; Yadav, Shri Ram; Lehesranta, Satu; Ma, Guojie; Ursache, Robertas; Sevilem, Iris; Zhang, Jing; Gorte, Maartje; Prasad, Kalika; Heidstra, Renze

    2016-01-01

    A powerful method to study gene function is expression or overexpression in an inducible, cell type-specific system followed by observation of consequent phenotypic changes and visualization of linked reporters in the target tissue. Multiple inducible gene overexpression systems have been developed for plants, but very few of these combine plant selection markers, control of expression domains, access to multiple promoters and protein fusion reporters, chemical induction, and high-throughput cloning capabilities. Here, we introduce a MultiSite Gateway-compatible inducible system for Arabidopsis (Arabidopsis thaliana) plants that provides the capability to generate such constructs in a single cloning step. The system is based on the tightly controlled, estrogen-inducible XVE system. We demonstrate that the transformants generated with this system exhibit the expected cell type-specific expression, similar to what is observed with constitutively expressed native promoters. With this new system, cloning of inducible constructs is no longer limited to a few special cases but can be used as a standard approach when gene function is studied. In addition, we present a set of entry clones consisting of histochemical and fluorescent reporter variants designed for gene and promoter expression studies. PMID:26644504

  4. MULTI-SITE EVALUATIONS OF CANDIDATE METHODOLOGIES FOR DETERMINING COARSE PARTICULATE (PM 10-2.5) CONCENTRATIONS: AUGUST 2005 UPDATED REPORT REGARDING SECOND-GENERATION AND NEW PM 10-2.5 SAMPLERS

    EPA Science Inventory

    Multi-site field studies were conducted to evaluate the performance of sampling methods for measuring the coarse fraction of PM10 (PM10 2.5) in ambient air. The field studies involved the use of both time-integrated filter-based and direct continuous methods. Despite operationa...

  5. Testing the Feasibility of Fidelity Evaluation in a Multisite, Multiprogram Initiative

    ERIC Educational Resources Information Center

    Cornish, Disa Lubker; Losch, Mary E.; Avery, Mitchell

    2016-01-01

    Monitoring fidelity of implementation is a critical task when initiating evidence-based programs. This pilot study sought to identify best practices in a fidelity monitoring process and determine the feasibility of continuing a fidelity monitoring process with a multisite, multiprogram initiative. A fidelity log was created for each of 11…

  6. Intraclass Correlations for Three-Level Multi-Site Cluster-Randomized Trials of Science Achievement

    ERIC Educational Resources Information Center

    Westine, Carl D.

    2015-01-01

    A cluster-randomized trial (CRT) relies on random assignment of intact clusters to treatment conditions, such as classrooms or schools (Raudenbush & Bryk, 2002). One specific type of CRT, a multi-site CRT (MSCRT), is commonly employed in educational research and evaluation studies (Spybrook & Raudenbush, 2009; Spybrook, 2014; Bloom,…

  7. Toward Better Research on--and Thinking about--Evaluation Influence, Especially in Multisite Evaluations

    ERIC Educational Resources Information Center

    Mark, Melvin M.

    2011-01-01

    Evaluation is typically carried out with the intention of making a difference in the understandings and actions of stakeholders and decision makers. The author provides a general review of the concepts of evaluation "use," evaluation "influence," and "influence pathways," with connections to multisite evaluations. The study of evaluation influence…

  8. A Multisite Psychotherapy and Medication Trial for Depressed Adolescents: Background and Benefits

    ERIC Educational Resources Information Center

    Kratochvil, Christopher J.; Simons, Anne; Vitiello, Benedetto; Walkup, John; Emslie, Graham; Rosenberg, David; March, John S.

    2005-01-01

    The Treatment for Adolescents With Depression Study (TADS) is an NIMH-supported multisite clinical trial that compares the effectiveness of a depression-specific cognitive behavioral therapy (CBT), medication management with fluoxetine (FLX), the combination of CBT and FLX (COMB), and medical management with pill placebo (PBO). TADS was…

  9. How Many Interviews Are Enough to Identify Metathemes in Multisited and Cross-Cultural Research? Another Perspective on Guest, Bunce, and Johnson's (2006) Landmark Study

    ERIC Educational Resources Information Center

    Hagaman, Ashley K.; Wutich, Amber

    2017-01-01

    There is much debate over the number of interviews needed to reach data saturation for themes and metathemes in qualitative research. The primary purpose of this study is to determine the number of interviews needed to reach data saturation for metathemes in multisited and cross-cultural research. The analysis is based on a cross-cultural study on…

  10. Perceived sleep deficit is a strong predictor of RLS in multisite pain - A population based study in middle aged females.

    PubMed

    Stehlik, Romana; Ulfberg, Jan; Zou, Ding; Hedner, Jan; Grote, Ludger

    2017-10-01

    Chronic pain conditions as well as Restless Legs Syndrome (RLS) are known to be associated with subjectively and objectively disturbed sleep. RLS has been recently described as highly prevalent in multisite pain and the role of sleep as a modifying factor in this RLS phenotype is unknown. This study aimed to investigate if perceived sleep deficit and other sleep related parameters predict RLS in subjects with multisite pain. We have recently demonstrated a strong association between Restless Legs Syndrome (RLS) and number of pain locations. In the current analysis we hypothesized that impaired sleep predicts RLS in subjects with multisite pain. Questionnaire-based data from 2727 randomly selected women aged 18-64 years were used to analyze RLS symptoms, self-reported sleep quality, and the degree of daytime sleepiness (Epworth Sleepiness Scale (ESS)) in relation to type, degree and localization of body pain. Potential confounders including anthropometrics, pain localization, co-morbidities, and medication were adjusted for in the Generalized Linear Models (GLM). Perceived sleep deficit ≥90min (OR 2.4 (1.5-3.8), p<0.001) and frequent nocturnal awakenings (OR 2.3 (1.4-3.6), p<0.001) were the strongest sleep related predictors for RLS in subjects with multisite pain. Additional factors include prolonged sleep latency (≥30min, OR 1.8 (1.1-2.8), p=0.01) and daytime symptoms like elevated daytime sleepiness (ESS score ≥9, OR 1.8 (1.2-2.7), p=0.005). Accordingly, RLS diagnosis was associated with impaired sleep quality (TST (Total Sleep Time) -8.2min, sleep latency +8.0min, and number of awakenings from sleep +0.4, p<0.01). ESS score increased with RLS diagnosis (+0.74, p<0.01) and number of pain locations (0.5, 1.7, and 1.8 for 1, 3, and 5 pain areas, p<0.001). In addition, confounders like pain severity, the history of psychiatric disease, and current smoking were associated with impaired sleep quality in this group of females. Perceived sleep deficit and sleep fragmentation are the strongest sleep related predictors of RLS in multisite pain. Potential implication of our results are that clinical management programmes of RLS in subjects with multisite pain need to consider both sleep quality and sleep quantity for individually tailored treatment regimes. RLS, pain, and sleep disorders are highly interrelated. Our study strongly suggests that clinical management of RLS in patients with multisite pain needs to consider sleep quality as an independent risk factor. Copyright © 2017 Scandinavian Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  11. Childhood Traumatic Grief: A Multi-Site Empirical Examination of the Construct and Its Correlates

    ERIC Educational Resources Information Center

    Brown, Elissa J.; Amaya-Jackson, Lisa; Cohen, Judith; Handel, Stephanie; De Bocanegra, Heike Thiel; Zatta, Eileen; Goodman, Robin F.; Mannarino, Anthony

    2008-01-01

    This study evaluated the construct of childhood traumatic grief (CTG) and its correlates through a multi-site assessment of 132 bereaved children and adolescents. Youth completed a new measure of the characteristics, attributions, and reactions to exposure to death (CARED), as well as measures of CTG, posttraumatic stress disorder (PTSD),…

  12. Positive Family Intervention for Severe Challenging Behavior I: A Multisite Randomized Clinical Trial

    ERIC Educational Resources Information Center

    Durand, V. Mark; Hieneman, Meme; Clarke, Shelley; Wang, Mo; Rinaldi, Melissa L.

    2013-01-01

    The present study was a multisite randomized clinical trial assessing the effects of adding a cognitive-behavioral intervention to positive behavior support (PBS). Fifty-four families who met the criteria of (a) having a child with a developmental disability, (b) whose child displayed serious challenging behavior (e.g., aggression, self-injury,…

  13. Collaborative Imaginaries and Multi-Sited Ethnography: Space-Time Dimensions of Engagement in an Afterschool Science Programme for Girls

    ERIC Educational Resources Information Center

    Rahm, Jrene

    2012-01-01

    Temporal and spatial configurations that constitute learning and identity work across practices have been little explored in studies of science literacy development. Grounded in multi-sited ethnography, this paper explores diverse girls' engagement with and identity work in science locally, inside a newsletter activity in an afterschool programme…

  14. Multi-Site Ethnography, Hypermedia and the Productive Hazards of Digital Methods: A Struggle for Liveness

    ERIC Educational Resources Information Center

    Gallagher, Kathleen; Freeman, Barry

    2011-01-01

    This article explores the possibilities and frustrations of using digital methods in a multi-sited ethnographic research project. The project, "Urban School Performances: The interplay, through live and digital drama, of local-global knowledge about student engagement", is a study of youth and teachers in drama classrooms in contexts of…

  15. A Discipline-Based Professional Development Faculty: A Case for Multiple-Site Collaborative Reform in the Disciplines.

    ERIC Educational Resources Information Center

    Hudson-Ross, Sally

    1998-01-01

    Describes a partnership among English-education faculty members and secondary English teachers, arguing that a multisite, discipline-based professional-development faculty provides an alternative for secondary-level Professional Development School principles-in-action. The paper discusses reform, departmentalization of high school and college…

  16. Dissemination: Handmaiden to Evaluation Use

    ERIC Educational Resources Information Center

    Lawrenz, Frances; Gullickson, Arlen; Toal, Stacie

    2007-01-01

    Use of evaluation findings is a valued outcome for most evaluators. However, to optimize use, the findings need to be disseminated to potential users in formats that facilitate use of the information. This reflective case narrative uses a national evaluation of a multisite National Science Foundation (NSF) program as the setting for describing the…

  17. Planning and conducting a multi-institutional project on fatigue.

    PubMed

    Nail, L M; Barsevick, A M; Meek, P M; Beck, S L; Jones, L S; Walker, B L; Whitmer, K R; Schwartz, A L; Stephen, S; King, M E

    1998-09-01

    To describe the process used in proposal development and study implementation for a complex multisite project on cancer treatment-related fatigue (CRF), identify strategies used to manage the project, and provide recommendations for teams planning multisite research. Information derived from project team meeting records, correspondence, proposals, and personal recollection. The project was built on preexisting relationships among the three site investigators who then built a team including faculty, research coordinators, staff nurses, and students. Study sites had a range of organizational models, and the proposal was designed to capitalize on the organizational and resource strengths of each setting. Three team members drawn from outside oncology nursing provided expertise in measurement and experience with fatigue in other populations. Planning meetings were critical to the success of the project. Conference calls, fax technology, and electronic mail were used for communication. Flexibility was important in managing crises and shifting responsibility for specific components of the work. The team documented and evaluated the process used for multisite research, completed a major instrumentation study, and developed a cognitive-behavioral intervention for CRF. Accomplishments during the one-year planning grant exceeded initial expectations. The process of conducting multisite research is complex, especially when the starting point is a planning grant with specific research protocols to be developed and implemented over one year. Explicit planning for decision-making processes to be used throughout the project, acknowledging the differences among the study settings and planning the protocols to capitalize upon those differences, and recruiting a strong research team that included a member with planning grant and team-building expertise were essential elements for success. Specific recommendations for others planning multisite research are related to team-building, team membership, communication, behavioral norms, role flexibility, resources, feedback, problem management, and shared recognition.

  18. Ultrasensitivity and sharp threshold theorems for multisite systems

    NASA Astrophysics Data System (ADS)

    Dougoud, M.; Mazza, C.; Vinckenbosch, L.

    2017-02-01

    This work studies the ultrasensitivity of multisite binding processes where ligand molecules can bind to several binding sites. It considers more particularly recent models involving complex chemical reactions in allosteric phosphorylation processes and for transcription factors and nucleosomes competing for binding on DNA. New statistics-based formulas for the Hill coefficient and the effective Hill coefficient are provided and necessary conditions for a system to be ultrasensitive are exhibited. It is first shown that the ultrasensitivity of binding processes can be approached using sharp-threshold theorems which have been developed in applied probability theory and statistical mechanics for studying sharp threshold phenomena in reliability theory, random graph theory and percolation theory. Special classes of binding process are then introduced and are described as density dependent birth and death process. New precise large deviation results for the steady state distribution of the process are obtained, which permits to show that switch-like ultrasensitive responses are strongly related to the multi-modality of the steady state distribution. Ultrasensitivity occurs if and only if the entropy of the dynamical system has more than one global minimum for some critical ligand concentration. In this case, the Hill coefficient is proportional to the number of binding sites, and the system is highly ultrasensitive. The classical effective Hill coefficient I is extended to a new cooperativity index I q , for which we recommend the computation of a broad range of values of q instead of just the standard one I  =  I 0.9 corresponding to the 10%-90% variation in the dose-response. It is shown that this single choice can sometimes mislead the conclusion by not detecting ultrasensitivity. This new approach allows a better understanding of multisite ultrasensitive systems and provides new tools for the design of such systems.

  19. The Trauma Symptom Checklist for Young Children (TSCYC): reliability and association with abuse exposure in a multi-site study.

    PubMed

    Briere, J; Johnson, K; Bissada, A; Damon, L; Crouch, J; Gil, E; Hanson, R; Ernst, V

    2001-08-01

    The Trauma Symptom Checklist for Young Children (TSCYC) is a 90-item caretaker-report measure of children's trauma- and abuse-related symptomatology. It contains two reporter validity scales and eight clinical scales [Post-traumatic Stress-Intrusion (PTS-I), Post-traumatic Stress-Avoidance (PTS-AV), Post-traumatic Stress-Arousal (PTS-AR), Post-traumatic Stress-Total (PTS-TOT), Sexual Concerns (SC), Dissociation (DIS), Anxiety (ANX), Depression (DEP), and Anger/Aggression (ANG)], as well as an item assessing hours per week of caretaker contact with the child. This paper introduces the TSCYC and describes its psychometric properties in a multisite validity study. A total of 219 TSCYCs administered by six clinician/researchers across the United States were analyzed for scale reliability and association with several types of childhood maltreatment. The TSCYC clinical scales have good reliability and are associated with exposure to childhood sexual abuse, physical abuse, and witnessing domestic violence. The PTS-I, PTS-AV, PTS-AR, and PTS-TOT scales were most predictive, followed by SC in the case of sexual abuse and DIS in the case of physical abuse. There were a small number of age, sex, and race effects on TSCYC scores. The TSCYC appears to have reasonable psychometric characteristics, and correlates as expected with various types of trauma exposure. Subject to continued validation and the development of general population norms, its use as a clinical measure is supported.

  20. Multifocal multi-site Warthin tumour.

    PubMed

    Hilton, Jennifer M; Phillips, John S; Hellquist, Henrik B; Premachandra, Don J

    2008-12-01

    The unique case of a 55-year-old man with multifocal adenolymphoma (Warthin's tumour) of both parotid glands, the neck and post-nasal space is presented. Warthin tumour is almost exclusively a parotid tumour but is known to be bilateral in 7-10% of cases and multifocal in 2% of cases. Most extraglandular Warthin tumours have been located in neck lymph nodes and only a few cases have been reported from other sites. The presented case is unique in having synchronous and metachronous Warthin tumours, as well as one of the tumours being neither truly parotid, nor within a lymph node.

  1. Single-site neural tube closure in human embryos revisited.

    PubMed

    de Bakker, Bernadette S; Driessen, Stan; Boukens, Bastiaan J D; van den Hoff, Maurice J B; Oostra, Roelof-Jan

    2017-10-01

    Since the multi-site closure theory was first proposed in 1991 as explanation for the preferential localizations of neural tube defects, the closure of the neural tube has been debated. Although the multi-site closure theory is much cited in clinical literature, single-site closure is most apparent in literature concerning embryology. Inspired by Victor Hamburgers (1900-2001) statement that "our real teacher has been and still is the embryo, who is, incidentally, the only teacher who is always right", we decided to critically review both theories of neural tube closure. To verify the theories of closure, we studied serial histological sections of 10 mouse embryos between 8.5 and 9.5 days of gestation and 18 human embryos of the Carnegie collection between Carnegie stage 9 (19-21 days) and 13 (28-32 days). Neural tube closure was histologically defined by the neuroepithelial remodeling of the two adjoining neural fold tips in the midline. We did not observe multiple fusion sites in neither mouse nor human embryos. A meta-analysis of case reports on neural tube defects showed that defects can occur at any level of the neural axis. Our data indicate that the human neural tube fuses at a single site and, therefore, we propose to reinstate the single-site closure theory for neural tube closure. We showed that neural tube defects are not restricted to a specific location, thereby refuting the reasoning underlying the multi-site closure theory. Clin. Anat. 30:988-999, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  2. Patterns of disclosure among youth who are HIV-positive: a multisite study.

    PubMed

    Dempsey, Allison G; MacDonell, Karen E; Naar-King, Sylvie; Lau, Chuen-Yen

    2012-03-01

    Disclosure of serostatus is critical in preventing the transmission of HIV among youth. The purpose of this exploratory study was to describe serostatus disclosure in a multisite study of youth living with HIV. This study investigated serostatus disclosure and its relationship to unprotected sex among 146 youth participating in a multisite study of young people living with HIV who were sexually active within the past 3 months. Forty percent of participants reported a sexual relationship with a partner to whom they had not disclosed their serostatus. Participants with multiple sexual partners were less likely to disclose their serostatus than those with one partner. Disclosure was more frequent when the serostatus of the sexual partner was known. Disclosure was not associated with unprotected sex. Prevention initiatives should focus on both disclosure and condom use in this high-risk population, particularly for youth with multiple sexual partners. Copyright © 2012 Society for Adolescent Health and Medicine. All rights reserved.

  3. Multisite rainfall downscaling and disaggregation in a tropical urban area

    NASA Astrophysics Data System (ADS)

    Lu, Y.; Qin, X. S.

    2014-02-01

    A systematic downscaling-disaggregation study was conducted over Singapore Island, with an aim to generate high spatial and temporal resolution rainfall data under future climate-change conditions. The study consisted of two major components. The first part was to perform an inter-comparison of various alternatives of downscaling and disaggregation methods based on observed data. This included (i) single-site generalized linear model (GLM) plus K-nearest neighbor (KNN) (S-G-K) vs. multisite GLM (M-G) for spatial downscaling, (ii) HYETOS vs. KNN for single-site disaggregation, and (iii) KNN vs. MuDRain (Multivariate Rainfall Disaggregation tool) for multisite disaggregation. The results revealed that, for multisite downscaling, M-G performs better than S-G-K in covering the observed data with a lower RMSE value; for single-site disaggregation, KNN could better keep the basic statistics (i.e. standard deviation, lag-1 autocorrelation and probability of wet hour) than HYETOS; for multisite disaggregation, MuDRain outperformed KNN in fitting interstation correlations. In the second part of the study, an integrated downscaling-disaggregation framework based on M-G, KNN, and MuDRain was used to generate hourly rainfall at multiple sites. The results indicated that the downscaled and disaggregated rainfall data based on multiple ensembles from HadCM3 for the period from 1980 to 2010 could well cover the observed mean rainfall amount and extreme data, and also reasonably keep the spatial correlations both at daily and hourly timescales. The framework was also used to project future rainfall conditions under HadCM3 SRES A2 and B2 scenarios. It was indicated that the annual rainfall amount could reduce up to 5% at the end of this century, but the rainfall of wet season and extreme hourly rainfall could notably increase.

  4. Multi-Sited Global Ethnography and Travel: Gendered Journeys in Three Registers

    ERIC Educational Resources Information Center

    Epstein, Debbie; Fahey, Johannah; Kenway, Jane

    2013-01-01

    This paper joins a barely begun conversation about multi-sited and global ethnography in educational research; a conversation that is likely to intensify along with growing interest in the links between education, globalisation, internationalisation and transnationalism. Drawing on an ongoing multi-sited global ethnography of elite schools and…

  5. A Multisite Study of the Prevalence of HIV With Rapid Testing in Mental Health Settings

    PubMed Central

    Blank, Michael B.; Himelhoch, Seth S.; Balaji, Alexandra B.; Metzger, David S.; Dixon, Lisa B.; Rose, Charles E.; Oraka, Emeka; Davis-Vogel, Annet; Thompson, William W.; Heffelfinger, James D.

    2014-01-01

    Objectives. We estimated HIV prevalence and risk factors among persons receiving mental health treatment in Philadelphia, Pennsylvania, and Baltimore, Maryland, January 2009 to August 2011. Methods. We used a multisite, cross-sectional design stratified by clinical setting. We tested 1061 individuals for HIV in university-based inpatient psychiatric units (n = 287), intensive case-management programs (n = 273), and community mental health centers (n = 501). Results. Fifty-one individuals (4.8%) were HIV-infected. Confirmed positive HIV tests were 5.9% (95% confidence interval [CI] = 3.7%, 9.4%) for inpatient units, 5.1% (95% CI = 3.1%, 8.5%) for intensive case-management programs, and 4.0% (95% CI = 2.6%, 6.1%) for community mental health centers. Characteristics associated with HIV included Black race, homosexual or bisexual identity, and HCV infection. Conclusions. HIV prevalence for individuals receiving mental health services was about 4 times as high as in the general population. We found a positive association between psychiatric symptom severity and HIV infection, indicating that engaging persons with mental illness in appropriate mental health treatment may be important to HIV prevention. These findings reinforce recommendations for routine HIV testing in all clinical settings to ensure that HIV-infected persons receiving mental health services are identified and referred to timely infectious disease care. PMID:24524493

  6. Integrating qualitative research into occupational health: a case study among hospital workers.

    PubMed

    Gordon, Deborah R; Ames, Genevieve M; Yen, Irene H; Gillen, Marion; Aust, Birgit; Rugulies, Reiner; Frank, John W; Blanc, Paul D

    2005-04-01

    We sought to better use qualitative approaches in occupational health research and integrate them with quantitative methods. We systematically reviewed, selected, and adapted qualitative research methods as part of a multisite study of the predictors and outcomes of work-related musculoskeletal disorders among hospital workers in two large urban tertiary hospitals. The methods selected included participant observation; informal, open-ended, and semistructured interviews with individuals or small groups; and archival study. The nature of the work and social life of the hospitals and the foci of the study all favored using more participant observation methods in the case study than initially anticipated. Exploiting the full methodological spectrum of qualitative methods in occupational health is increasingly relevant. Although labor-intensive, these approaches may increase the yield of established quantitative approaches otherwise used in isolation.

  7. Managing Communication among Geographically Distributed Teams: A Brazilian Case

    NASA Astrophysics Data System (ADS)

    Almeida, Ana Carina M.; de Farias Junior, Ivaldir H.; de S. Carneiro, Pedro Jorge

    The growing demand for qualified professionals is making software companies opt for distributed software development (DSD). At the project conception, communication and synchronization of information are critical factors for success. However problems such as time-zone difference between teams, culture, language and different development processes among sites could difficult the communication among teams. In this way, the main goal of this paper is to describe the solution adopted by a Brazilian team to improve communication in a multisite project environment. The purposed solution was based on the best practices described in the literature, and the communication plan was created based on the infrastructure needed by the project. The outcome of this work is to minimize the impact of communication issues in multisite projects, increasing productivity, good understanding and avoiding rework on code and document writing.

  8. Sources of Site Differences in the Efficacy of a Multisite Clinical Trial: The Treatment of SSRI-Resistant Depression in Adolescents

    ERIC Educational Resources Information Center

    Spirito, Anthony; Abebe, Kaleab Z.; Iyengar, Satish; Brent, David; Vitiello, Benedetto; Clarke, Gregory; Wagner, Karen Dineen; Asarnow, Joan; Emslie, Graham; Keller, Martin

    2009-01-01

    Site differences in treatment outcomes are not often highlighted when the results of multisite randomized clinical trials (MRCTs) are reported. The primary analyses of a 6-site MRCT, the Treatment of SSRI-Resistant Depression in Adolescents (TORDIA) study, showed substantial variation by site in the performance of a medication-only condition and a…

  9. Year One Results from the Multisite Randomized Evaluation of the i3 Scale-Up of Reading Recovery

    ERIC Educational Resources Information Center

    May, Henry; Gray, Abigail; Sirinides, Philip; Goldsworthy, Heather; Armijo, Michael; Sam, Cecile; Gillespie, Jessica N.; Tognatta, Namrata

    2015-01-01

    Reading Recovery (RR) is a short-term, one-to-one intervention designed to help the lowest achieving readers in first grade. This article presents first-year results from the multisite randomized controlled trial (RCT) and implementation study under the $55 million Investing in Innovation (i3) Scale-Up Project. For the 2011-2012 school year, the…

  10. Orthopaedic resident preparedness for closed reduction and pinning of pediatric supracondylar fractures is improved by e-learning: a multisite randomized controlled study.

    PubMed

    Hearty, Thomas; Maizels, Max; Pring, Maya; Mazur, John; Liu, Raymond; Sarwark, John; Janicki, Joseph

    2013-09-04

    There is a need to provide more efficient surgical training methods for orthopaedic residents. E-learning could possibly increase resident surgical preparedness, confidence, and comfort for surgery. Using closed reduction and pinning of pediatric supracondylar humeral fractures as the index case, we hypothesized that e-learning could increase resident knowledge acquisition for case preparation in the operating room. An e-learning surgical training module was created on the Computer Enhanced Visual Learning platform. The module provides a detailed and focused road map of the procedure utilizing a multimedia format. A multisite prospective randomized controlled study design compared residents who used a textbook for case preparation (control group) with residents who used the same textbook plus completed the e-learning module (test group). All subjects completed a sixty-question test on the theory and methods of the case. After completion of the test, the control group then completed the module as well. All subjects were surveyed on their opinion regarding the effectiveness of the module after performing an actual surgical case. Twenty-eight subjects with no previous experience in this surgery were enrolled at four academic centers. Subjects were randomized into two equal groups. The test group scored significantly better (p < 0.001) and demonstrated competence on the test compared with the control group; the mean correct test score (and standard deviation) was 90.9% ± 6.8% for the test group and 73.5% ± 6.4% for the control group. All residents surveyed (n = 27) agreed that the module is a useful supplement to traditional methods for case preparation and twenty-two of twenty-seven residents agreed that it reduced their anxiety during the case and improved their attention to surgical detail. E-learning using the Computer Enhanced Visual Learning platform significantly improved preparedness, confidence, and comfort with percutaneous closed reduction and pinning of a pediatric supracondylar humeral fracture. We believe that adapting such methods into residency training programs will improve efficiency in surgical training.

  11. Sex-specific impact of early-life adversity on chronic pain: a large population-based study in Japan.

    PubMed

    Yamada, Keiko; Matsudaira, Ko; Tanaka, Eizaburo; Oka, Hiroyuki; Katsuhira, Junji; Iso, Hiroyasu

    2017-01-01

    Responses to early-life adversity may differ by sex. We investigated the sex-specific impact of early-life adversity on chronic pain, chronic multisite pain, and somatizing tendency with chronic pain. We examined 4229 respondents aged 20-79 years who participated in the Pain Associated Cross-Sectional Epidemiological Survey in Japan. Outcomes were: 1) chronic pain prevalence, 2) multisite pain (≥3 sites) prevalence, and 3) multiple somatic symptoms (≥3 symptoms) among respondents with chronic pain related to the presence or absence of early-life adversity. Multivariable-adjusted odds ratios (ORs) were calculated with 95% confidence intervals using a logistic regression model including age, smoking status, exercise routine, sleep time, body mass index, household expenditure, and the full distribution of scores on the Mental Health Inventory-5. We further adjusted for pain intensity when we analyzed the data for respondents with chronic pain. The prevalence of chronic pain was higher among respondents reporting the presence of early-life adversity compared with those reporting its absence, with multivariable ORs of 1.62 (1.22-2.15, p <0.01) in men and 1.47 (1.13-1.90, p <0.01) in women. Among women with chronic pain, early-life adversity was associated with multisite pain and multiple somatic symptoms; multivariable ORs were 1.78 (1.22-2.60, p <0.01) for multisite pain and 1.89 (1.27-2.83, p <0.01) for ≥3 somatic symptoms. No associations were observed between early-life adversity and chronic multisite pain or multiple somatic symptoms among men with chronic pain. Early-life adversity may be linked to a higher prevalence of chronic pain among both sexes and to multisite pain and somatizing tendency among women with chronic pain.

  12. Methodological challenges in conducting a multi-site randomized clinical trial of massage therapy in hospice.

    PubMed

    Kutner, Jean; Smith, Marlaine; Mellis, Karen; Felton, Sue; Yamashita, Traci; Corbin, Lisa

    2010-06-01

    Researchers conducting multi-site studies of interventions for end-of-life symptom management face significant challenges with respect to obtaining an adequate sample and training and retaining on-site study teams. The purpose of this paper is to describe the strategies and responses to these challenges in a multi-site randomized clinical trial (RCT) of the efficacy of massage therapy for decreasing pain among patients with advanced cancer in palliative care/hospice settings. Over a period of 36 months, we enrolled 380 participants across 15 sites; 27% of whom withdrew prior to study completion (less than the anticipated 30% rate). We saw an average of 68% turnover amongst study staff. Three key qualities characterized successful on-site study teams: (1) organizational commitment; (2) strong leadership from on-site study coordinators; and (3) effective lines of communication between the on-site study coordinators and both their teams and the university-based research team. Issues of recruitment, retention and training should be accounted for in hospice-based research study design and budgeting.

  13. Creative Entextualizations of Discourses about Race in Multi-Sited Discursive Practices in the Brazilian "Periphery"

    ERIC Educational Resources Information Center

    Guimarães, Thayse Figueira; Moita-Lopes, Luiz Paulo

    2017-01-01

    This paper focuses on Luan's race performances both on the web and in classroom interaction. Luan is a black young man, who identifies himself as gay. The study is part of a multi-sited ethnographic piece of research on a group of high-school students in the state sector, in the "periphery" of a town on the Rio de Janeiro State north…

  14. Exploiting Multisite Gateway and pENFRUIT plasmid collection for fruit genetic engineering.

    PubMed

    Estornell, Leandro H; Granell, Antonio; Orzaez, Diego

    2012-01-01

    MultiSite Gateway cloning techniques based on homologous recombination facilitate the combinatorial assembly of basic genetic pieces (i.e., promoters, CDS, and terminators) into gene expression or gene silencing cassettes. pENFRUIT is a collection of MultiSite Triple Gateway Entry vectors dedicated to genetic engineering in fruits. It comprises a number of fruit-operating promoters as well as C-terminal tags adapted to the Gateway standard. In this way, flanking regulatory/labeling sequences can be easily Gateway-assembled with a given gene of interest for its ectopic expression or silencing in fruits. The resulting gene constructs can be analyzed in stable transgenic plants or in transient expression assays, the latter allowing fast testing of the increasing number of combinations arising from MultiSite methodology. A detailed description of the use of MultiSite cloning methodology for the assembly of pENFRUIT elements is presented.

  15. Implementation Considerations for Multisite Clinical Trials with Cognitive Neuroscience Tasks

    PubMed Central

    Keefe, Richard S. E.; Harvey, Philip D.

    2008-01-01

    Multisite clinical trials aimed at cognitive enhancement across various neuropsychiatric conditions have employed standard neuropsychological tests as outcome measures. While these tests have enjoyed wide clinical use and have proven reliable and predictive of functional disability, a number of implementation challenges have arisen when these tests are used in clinical trials. These issues are likely to be magnified in future studies when cognitive neuroscience (CN) procedures are explored in these trials, because in their current forms CN procedures are less standardized and more difficult to teach and monitor. For multisite trials, we anticipate that the most challenging issues will include assuring tester competence, monitoring tester performance, specific challenges with complex assessment methods, and having resources available for adequate monitoring of data quality. Suggestions for overcoming these implementation challenges are offered. PMID:18495645

  16. CliniProteus: A flexible clinical trials information management system

    PubMed Central

    Mathura, Venkatarajan S; Rangareddy, Mahendiranath; Gupta, Pankaj; Mullan, Michael

    2007-01-01

    Clinical trials involve multi-site heterogeneous data generation with complex data input-formats and forms. The data should be captured and queried in an integrated fashion to facilitate further analysis. Electronic case-report forms (eCRF) are gaining popularity since it allows capture of clinical information in a rapid manner. We have designed and developed an XML based flexible clinical trials data management framework in .NET environment that can be used for efficient design and deployment of eCRFs to efficiently collate data and analyze information from multi-site clinical trials. The main components of our system include an XML form designer, a Patient registration eForm, reusable eForms, multiple-visit data capture and consolidated reports. A unique id is used for tracking the trial, site of occurrence, the patient and the year of recruitment. Availability http://www.rfdn.org/bioinfo/CTMS/ctms.html. PMID:21670796

  17. Managing personal health information in distributed research network environments.

    PubMed

    Bredfeldt, Christine E; Butani, Amy L; Pardee, Roy; Hitz, Paul; Padmanabhan, Sandy; Saylor, Gwyn

    2013-10-08

    Studying rare outcomes, new interventions and diverse populations often requires collaborations across multiple health research partners. However, transferring healthcare research data from one institution to another can increase the risk of data privacy and security breaches. A working group of multi-site research programmers evaluated the need for tools to support data security and data privacy. The group determined that data privacy support tools should: 1) allow for a range of allowable Protected Health Information (PHI); 2) clearly identify what type of data should be protected under the Health Insurance Portability and Accountability Act (HIPAA); and 3) help analysts identify which protected health information data elements are allowable in a given project and how they should be protected during data transfer. Based on these requirements we developed two performance support tools to support data programmers and site analysts in exchanging research data. The first tool, a workplan template, guides the lead programmer through effectively communicating the details of multi-site programming, including how to run the program, what output the program will create, and whether the output is expected to contain protected health information. The second performance support tool is a checklist that site analysts can use to ensure that multi-site program output conforms to expectations and does not contain protected health information beyond what is allowed under the multi-site research agreements. Together the two tools create a formal multi-site programming workflow designed to reduce the chance of accidental PHI disclosure.

  18. Risk and direct protective factors for youth violence: results from the Centers for Disease Control and Prevention's Multisite Violence Prevention Project.

    PubMed

    Henry, David B; Tolan, Patrick H; Gorman-Smith, Deborah; Schoeny, Michael E

    2012-08-01

    This study was conducted as part of a multisite effort to examine risk and direct protective factors for youth violence. The goal was to identify those factors in the lives of young people that increase or decrease the risk of violence. These analyses fill an important gap in the literature, as few studies have examined risk and direct protective factors for youth violence across multiple studies. Data on 4432 middle-school youth, from the CDC Multisite Violence Prevention Project were used. Evaluations were made of effects of variables coded as risk and direct protective factors in the fall of 6th grade on violence measured in spring of 7th and 8th grades. Factors tested included depression, delinquency, alcohol and drug involvement, involvement in family activities, academic achievement, attitudes toward school, truancy, and peer deviance. Most variables were coded with two sets of dummy variables indicating risk and protective directions of effects. Results showed that higher teacher-rated study skills were associated with lower subsequent violence across genders and ethnic groups. Affiliation with deviant peers was significantly associated with increased subsequent violence among youth reporting their race/ethnicity as white or other, marginally associated with increased violence among African-American youth, and unrelated among Latino youth. This study identified some factors than should be areas of interest for effective prevention programs. Some ethnic differences also should be considered in planning of prevention. The CDC Multisite Violence Prevention Project completed enrollment prior to July 2005. Copyright © 2012. Published by Elsevier Inc.

  19. Reliability of an fMRI Paradigm for Emotional Processing in a Multisite Longitudinal Study

    PubMed Central

    Gee, Dylan G.; McEwen, Sarah C.; Forsyth, Jennifer K.; Haut, Kristen M.; Bearden, Carrie E.; Addington, Jean; Goodyear, Bradley; Cadenhead, Kristin S.; Mirzakhanian, Heline; Cornblatt, Barbara A.; Olvet, Doreen; Mathalon, Daniel H.; McGlashan, Thomas H.; Perkins, Diana O.; Belger, Aysenil; Seidman, Larry J.; Thermenos, Heidi; Tsuang, Ming T.; van Erp, Theo G.M.; Walker, Elaine F.; Hamann, Stephan; Woods, Scott W.; Constable, Todd; Cannon, Tyrone D.

    2015-01-01

    Multisite neuroimaging studies can facilitate the investigation of brain-related changes in many contexts, including patient groups that are relatively rare in the general population. Though multisite studies have characterized the reliability of brain activation during working memory and motor functional magnetic resonance imaging tasks, emotion processing tasks, pertinent to many clinical populations, remain less explored. A traveling participants study was conducted with eight healthy volunteers scanned twice on consecutive days at each of the eight North American Longitudinal Prodrome Study sites. Tests derived from generalizability theory showed excellent reliability in the amygdala (Eρ2=0.82), inferior frontal gyrus (IFG;Eρ2=0.83), anterior cingulate cortex (ACC;Eρ2=0.76), insula (Eρ2=0.85), and fusiform gyrus (Eρ2=0.91) for maximum activation and fair to excellent reliability in the amygdala (Eρ2=0.44), IFG (Eρ2=0.48), ACC (Eρ2=0.55), insula (Eρ2=0.42), and fusiform gyrus (Eρ2=0.83) for mean activation across sites and test days. For the amygdala, habituation (Eρ2=0.71) was more stable than mean activation. In a second investigation, data from 111 healthy individuals across sites were aggregated in a voxelwise, quantitative meta-analysis. When compared with a mixed effects model controlling for site, both approaches identified robust activation in regions consistent with expected results based on prior single-site research. Overall, regions central to emotion processing showed strong reliability in the traveling participants study and robust activation in the aggregation study. These results support the reliability of blood oxygen level-dependent signal in emotion processing areas across different sites and scanners and may inform future efforts to increase efficiency and enhance knowledge of rare conditions in the population through multisite neuroimaging paradigms. PMID:25821147

  20. Increasing the ranks of academic researchers in mental health: a multisite approach to postdoctoral fellowship training.

    PubMed

    O'Hara, Ruth; Cassidy-Eagle, Erin L; Beaudreau, Sherry A; Eyler, Lisa T; Gray, Heather L; Giese-Davis, Janine; Hubbard, Jeffrey; Yesavage, Jerome A

    2010-01-01

    This report highlights the use of multisite training for psychiatry and psychology postdoctoral fellows developing careers in academic clinical research in the field of mental health. The objective is to describe a model of training for young investigators to establish independent academic clinical research careers, including (1) program structure and eligibility, (2) program goals and development of a multisite curriculum, (3) use of technology for implementing the program across multiple sites, and (4) advantages and challenges of this multisite approach. In 2000, in collaboration with the Veterans Affairs (VA) Mental Illness Research, Education and Clinical Centers (MIRECCs), the VA Office of Academic Affiliations launched the Special Fellowship Program in Advanced Psychiatry and Psychology. Each of the 10 currently participating VA sites across the United States is affiliated with a MIRECC and an academic medical institution. In the first five years of this fellowship program, 83 fellows (34 psychiatrists and 49 psychologists) have participated. The success of this multisite approach is evidenced by the 58 fellows who have already graduated from the program: 70% have entered academic clinical research positions, and over 25 have obtained independent extramural grant support from the VA or the National Institutes of Health. Multisite training results in a greater transfer of knowledge and capitalizes on the nationwide availability of experts, creating unique networking and learning opportunities for trainees. The VA's multisite fellowship program plays a valuable role in preparing substantial numbers of psychiatry and psychology trainees for a range of academic clinical research and leadership positions in the field of mental health.

  1. A hierarchical modeling approach to estimate regional acute health effects of particulate matter sources

    PubMed Central

    Krall, J. R.; Hackstadt, A. J.; Peng, R. D.

    2017-01-01

    Exposure to particulate matter (PM) air pollution has been associated with a range of adverse health outcomes, including cardiovascular disease (CVD) hospitalizations and other clinical parameters. Determining which sources of PM, such as traffic or industry, are most associated with adverse health outcomes could help guide future recommendations aimed at reducing harmful pollution exposure for susceptible individuals. Information obtained from multisite studies, which is generally more precise than information from a single location, is critical to understanding how PM impacts health and to informing local strategies for reducing individual-level PM exposure. However, few methods exist to perform multisite studies of PM sources, which are not generally directly observed, and adverse health outcomes. We developed SHARE, a hierarchical modeling approach that facilitates reproducible, multisite epidemiologic studies of PM sources. SHARE is a two-stage approach that first summarizes information about PM sources across multiple sites. Then, this information is used to determine how community-level (i.e. county- or city-level) health effects of PM sources should be pooled to estimate regional-level health effects. SHARE is a type of population value decomposition that aims to separate out regional-level features from site-level data. Unlike previous approaches for multisite epidemiologic studies of PM sources, the SHARE approach allows the specific PM sources identified to vary by site. Using data from 2000–2010 for 63 northeastern US counties, we estimated regional-level health effects associated with short-term exposure to major types of PM sources. We found PM from secondary sulfate, traffic, and metals sources was most associated with CVD hospitalizations. PMID:28098412

  2. Multisite Ion Model in Concentrated Solutions of Divalent Cations (MgCl2 and CaCl2): Osmotic Pressure Calculations

    PubMed Central

    2015-01-01

    Accurate force field parameters for ions are essential for meaningful simulation studies of proteins and nucleic acids. Currently accepted models of ions, especially for divalent ions, do not necessarily reproduce the right physiological behavior of Ca2+ and Mg2+ ions. Saxena and Sept (J. Chem. Theor. Comput.2013, 9, 3538–3542) described a model, called the multisite-ion model, where instead of treating the ions as an isolated sphere, the charge was split into multiple sites with partial charge. This model provided accurate inner shell coordination of the ion with biomolecules and predicted better free energies for proteins and nucleic acids. Here, we expand and refine the multisite model to describe the behavior of divalent ions in concentrated MgCl2 and CaCl2 electrolyte solutions, eliminating the unusual ion–ion pairing and clustering of ions which occurred in the original model. We calibrate and improve the parameters of the multisite model by matching the osmotic pressure of concentrated solutions of MgCl2 to the experimental values and then use these parameters to test the behavior of CaCl2 solutions. We find that the concentrated solutions of both divalent ions exhibit the experimentally observed behavior with correct osmotic pressure, the presence of solvent separated ion pairs instead of direct ion pairs, and no aggregation of ions. The improved multisite model for (Mg2+ and Ca2+) can be used in classical simulations of biomolecules at physiologically relevant salt concentrations. PMID:25482831

  3. Applying the Brakes to Multi-Site SR Protein Phosphorylation: Substrate-Induced Effects on the Splicing Kinase SRPK1†

    PubMed Central

    Aubol, Brandon E.; Adams, Joseph A.

    2011-01-01

    To investigate how a protein kinase interacts with its protein substrate during extended, multi-site phosphorylation, the kinetic mechanism of a protein kinase involved in mRNA splicing control was investigated using rapid quench flow techniques. The protein kinase SRPK1 phosphorylates approximately 10 serines in the arginine-serine-rich domain (RS domain) of the SR protein SRSF1 in a C-to-N-terminal direction, a modification that directs this essential splicing factor from the cytoplasm to the nucleus. Transient-state kinetic experiments illustrate that the first phosphate is added rapidly onto the RS domain of SRSF1 (t1/2 = 0.1 sec) followed by slower, multi-site phosphorylation at the remaining serines (t1/2 = 15 sec). Mutagenesis experiments suggest that efficient phosphorylation rates are maintained by an extensive hydrogen bonding and electrostatic network between the RS domain of the SR protein and the active site and docking groove of the kinase. Catalytic trapping and viscosometric experiments demonstrate that while the phosphoryl transfer step is fast, ADP release limits multi-site phosphorylation. By studying phosphate incorporation into selectively pre-phosphorylated forms of the enzyme-substrate complex, the kinetic mechanism for site-specific phosphorylation along the reaction coordinate was assessed. The binding affinity of the SR protein, the phosphoryl transfer rate and ADP exchange rate were found to decline significantly as a function of progressive phosphorylation in the RS domain. These findings indicate that the protein substrate actively modulates initiation, extension and termination events associated with prolonged, multi-site phosphorylation. PMID:21728354

  4. Estimation of future flow regime for a spatially varied Himalayan watershed using improved multi-site calibration method of SWAT model.

    NASA Astrophysics Data System (ADS)

    Pradhanang, S. M.; Hasan, M. A.; Booth, P.; Fallatah, O.

    2016-12-01

    The monsoon and snow driven regime in the Himalayan region has received increasing attention in the recent decade regarding the effects of climate change on hydrologic regimes. Modeling streamflow in such spatially varied catchment requires proper calibration and validation in hydrologic modeling. While calibration and validation are time consuming and computationally intensive, an effective regionalized approach with multi-site information is crucial for flow estimation, especially in daily scale. In this study, we adopted a multi-site approach to calibration and validation of the Soil Water Assessment Tool (SWAT) model for the Karnali river catchment, which is characterized as being the most vulnerable catchment to climate change in the Himalayan region. APHRODITE's (Asian Precipitation - Highly-Resolved Observational Data Integration Towards Evaluation) daily gridded precipitation data, one of the accurate and reliable weather date over this region were utilized in this study. The model evaluation of the entire catchment divided into four sub-catchments, utilizing discharge records from 1963 to 2010. In previous studies, multi-site calibration used only a single set of calibration parameters for all sub-catchment of a large watershed. In this study, we introduced a technique that can incorporate different sets of calibration parameters for each sub-basin, which eventually ameliorate the flow of the whole watershed. Results show that the calibrated model with new method can capture almost identical pattern of flow over the region. The predicted daily streamflow matched the observed values, with a Nash-Sutcliffe coefficient of 0.73 during calibration and 0.71 during validation period. The method perfumed better than existing multi-site calibration methods. To assess the influence of continued climate change on hydrologic processes, we modified the weather inputs for the model using precipitation and temperature changes for two Representative Concentration Pathways (RCPs) scenarios, RCP 4.5 and 8.5. Climate simulation for RCP scenarios were conducted from 1981-2100, where 1981-2005 was considered as baseline and 2006-2100 was considered as the future projection. The result shows that probability of flooding will eventually increase in future years due to increased flow in both scenarios.

  5. Methods for using clinical laboratory test results as baseline confounders in multi-site observational database studies when missing data are expected.

    PubMed

    Raebel, Marsha A; Shetterly, Susan; Lu, Christine Y; Flory, James; Gagne, Joshua J; Harrell, Frank E; Haynes, Kevin; Herrinton, Lisa J; Patorno, Elisabetta; Popovic, Jennifer; Selvan, Mano; Shoaibi, Azadeh; Wang, Xingmei; Roy, Jason

    2016-07-01

    Our purpose was to quantify missing baseline laboratory results, assess predictors of missingness, and examine performance of missing data methods. Using the Mini-Sentinel Distributed Database from three sites, we selected three exposure-outcome scenarios with laboratory results as baseline confounders. We compared hazard ratios (HRs) or risk differences (RDs) and 95% confidence intervals (CIs) from models that omitted laboratory results, included only available results (complete cases), and included results after applying missing data methods (multiple imputation [MI] regression, MI predictive mean matching [PMM] indicator). Scenario 1 considered glucose among second-generation antipsychotic users and diabetes. Across sites, glucose was available for 27.7-58.9%. Results differed between complete case and missing data models (e.g., olanzapine: HR 0.92 [CI 0.73, 1.12] vs 1.02 [0.90, 1.16]). Across-site models employing different MI approaches provided similar HR and CI; site-specific models provided differing estimates. Scenario 2 evaluated creatinine among individuals starting high versus low dose lisinopril and hyperkalemia. Creatinine availability: 44.5-79.0%. Results differed between complete case and missing data models (e.g., HR 0.84 [CI 0.77, 0.92] vs. 0.88 [0.83, 0.94]). HR and CI were identical across MI methods. Scenario 3 examined international normalized ratio (INR) among warfarin users starting interacting versus noninteracting antimicrobials and bleeding. INR availability: 20.0-92.9%. Results differed between ignoring INR versus including INR using missing data methods (e.g., RD 0.05 [CI -0.03, 0.13] vs 0.09 [0.00, 0.18]). Indicator and PMM methods gave similar estimates. Multi-site studies must consider site variability in missing data. Different missing data methods performed similarly. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  6. Supervision of Facilitators in a Multisite Study: Goals, Process, and Outcomes

    PubMed Central

    2010-01-01

    Objective To describe the aims, implementation, and desired outcomes of facilitator supervision for both interventions (treatment and control) in Project Eban and to present the Eban Theoretical Framework for Supervision that guided the facilitators’ supervision. The qualifications and training of supervisors and facilitators are also described. Design This article provides a detailed description of supervision in a multisite behavioral intervention trial. The Eban Theoretical Framework for Supervision is guided by 3 theories: cognitive behavior therapy, the Life-long Model of Supervision, and “Empowering supervisees to empower others: a culturally responsive supervision model.” Methods Supervision is based on the Eban Theoretical Framework for Supervision, which provides guidelines for implementing both interventions using goals, process, and outcomes. Results Because of effective supervision, the interventions were implemented with fidelity to the protocol and were standard across the multiple sites. Conclusions Supervision of facilitators is a crucial aspect of multisite intervention research quality assurance. It provides them with expert advice, optimizes the effectiveness of facilitators, and increases adherence to the protocol across multiple sites. Based on the experience in this trial, some of the challenges that arise when conducting a multisite randomized control trial and how they can be handled by implementing the Eban Theoretical Framework for Supervision are described. PMID:18724192

  7. Identifying Patterns in Implementation of Hospital Pressure Ulcer Prevention Programs: A Multisite Qualitative Study.

    PubMed

    Soban, Lynn M; Finley, Erin P; Miltner, Rebecca S

    2016-01-01

    To describe the presence or absence of key components of hospital pressure ulcer (PU) prevention programs in 6 acute care hospitals. Multisite comparative case study. Using purposeful selection based on PU rates (high vs low) and hospital size, 6 hospitals within the Veterans Health Administration health care system were invited to participate. Key informant interviews (n = 48) were conducted in each of the 6 participating hospitals among individuals playing key roles in PU prevention: senior nursing leadership (n = 9), nurse manager (n = 7), wound care specialist (n = 6), frontline RNs (n = 26). Qualitative data were collected during face-to-face, semistructured interviews. Interview protocols were tailored to each interviewee's role with a core set of common questions covering 3 major content areas: (1) practice environment (eg, policies and wound care specialists), (2) current prevention practices (eg, conduct of PU risk assessment and skin inspection), and (3) barriers to PU prevention. We conducted structured coding of 5 key components of PU prevention programs and cross-case analysis to identify patterns in operationalization and implementation of program components across hospitals based on facility size and PU rates (low vs high). All hospitals had implemented all PU prevention program components. Component operationalization varied considerably across hospitals. Wound care specialists were integral to the operationalization of the 4 other program components examined; however, staffing levels and work assignments of wound care specialists varied widely. Patterns emerged among hospitals with low and high PU rates with respect to wound care specialist staffing, data monitoring, and staff education. We found hospital-level variations in PU prevention programs. Wound care specialist staffing may represent a potential point of leverage in achieving other PU program components, particularly performance monitoring and staff education.

  8. Does physical or psychosocial workload modify the effect of musculoskeletal pain on sickness absence? A prospective study among the Finnish population.

    PubMed

    Neupane, Subas; Pensola, Tiina; Haukka, Eija; Ojajärvi, Anneli; Leino-Arjas, Päivi

    2016-07-01

    Previously, among food industry workers, multisite pain predicted sickness absence (SA) only in those with low biomechanical workload. Here we studied among a wide range of occupations whether the relationship of pain with SA was modified by the level of physical or psychosocial workload. A nationally representative sample (Health 2000 Survey) comprised 3420 occupationally active Finns aged 30-55 years. Baseline data on musculoskeletal pain during the preceding month, strenuous work history, current physical workload, job demands, job control, support at work, lifestyle, and chronic diseases were obtained in 2000/2001 by questionnaire, interview, and clinical examination. Musculoskeletal pain in 18 body locations was combined into four sites (neck, upper limbs, low back, and lower limbs) and classified as no pain, single-site pain, and multisite pain (2-4 sites). The data were linked with information from national registers on annual SA periods lasting ≥10 workdays for 2002-2008. Negative binomial regression analysis was used. At baseline, one-third of the study sample reported single-site and one-third multisite pain. Allowing for gender and age, the employees with multisite pain in strata with high physical workload and high job demands tended to have the highest risk of SA, but no statistically significant interactive effects between work factors and pain were observed. Further adjustment for health-related lifestyle and chronic diseases decreased the risk estimates in all strata. We did not find evidence for significant modification by physical or psychosocial workload of the relationship between musculoskeletal pain and SA periods lasting ≥10 workdays.

  9. Safety and Clinical Activity of Pembrolizumab and Multisite Stereotactic Body Radiotherapy in Patients With Advanced Solid Tumors.

    PubMed

    Luke, Jason J; Lemons, Jeffrey M; Karrison, Theodore G; Pitroda, Sean P; Melotek, James M; Zha, Yuanyuan; Al-Hallaq, Hania A; Arina, Ainhoa; Khodarev, Nikolai N; Janisch, Linda; Chang, Paul; Patel, Jyoti D; Fleming, Gini F; Moroney, John; Sharma, Manish R; White, Julia R; Ratain, Mark J; Gajewski, Thomas F; Weichselbaum, Ralph R; Chmura, Steven J

    2018-02-13

    Purpose Stereotactic body radiotherapy (SBRT) may stimulate innate and adaptive immunity to augment immunotherapy response. Multisite SBRT is an emerging paradigm for treating metastatic disease. Anti-PD-1-treatment outcomes may be improved with lower disease burden. In this context, we conducted a phase I study to evaluate the safety of pembrolizumab with multisite SBRT in patients with metastatic solid tumors. Patients and Methods Patients progressing on standard treatment received SBRT to two to four metastases. Not all metastases were targeted, and metastases > 65 mL were partially irradiated. SBRT dosing varied by site and ranged from 30 to 50 Gy in three to five fractions with predefined dose de-escalation if excess dose-limiting toxicities were observed. Pembrolizumab was initiated within 7 days after completion of SBRT. Pre- and post-SBRT biopsy specimens were analyzed in a subset of patients to quantify interferon-γ-induced gene expression. Results A total of 79 patients were enrolled; three patients did not receive any treatment and three patients only received SBRT. Patients included in the analysis were treated with SBRT and at least one cycle of pembrolizumab. Most (94.5%) of patients received SBRT to two metastases. Median follow-up for toxicity was 5.5 months (interquartile range, 3.3 to 8.1 months). Six patients experienced dose-limiting toxicities with no radiation dose reductions. In the 68 patients with imaging follow-up, the overall objective response rate was 13.2%. Median overall survival was 9.6 months (95% CI, 6.5 months to undetermined) and median progression-free survival was 3.1 months (95% CI, 2.9 to 3.4 months). Expression of interferon-γ-associated genes from post-SBRT tumor biopsy specimens significantly correlated with nonirradiated tumor response. Conclusion Multisite SBRT followed by pembrolizumab was well tolerated with acceptable toxicity. Additional studies exploring the clinical benefit and predictive biomarkers of combined multisite SBRT and PD-1-directed immunotherapy are warranted.

  10. Integrating ecosystems measurements from multiple eddy-covariance sites to a simple model of ecosystem process - Are there possibilities for a uniform model calibration?

    NASA Astrophysics Data System (ADS)

    Minunno, Francesco; Peltoniemi, Mikko; Launiainen, Samuli; Mäkelä, Annikki

    2014-05-01

    Biogeochemical models quantify the material and energy flux exchanges between biosphere, atmosphere and soil, however there is still considerable uncertainty underpinning model structure and parametrization. The increasing availability of data from of multiple sources provides useful information for model calibration and validation at different space and time scales. We calibrated a simplified ecosystem process model PRELES to data from multiple sites. In this work we had the following objective: to compare a multi-site calibration and site-specific calibrations, in order to test if PRELES is a model of general applicability, and to test how well one parameterization can predict ecosystem fluxes. Model calibration and evaluation were carried out by the means of the Bayesian method; Bayesian calibration (BC) and Bayesian model comparison (BMC) were used to quantify the uncertainty in model parameters and model structure. Evapotranspiration (ET) and gross primary production (GPP) measurements collected in 9 sites of Finland and Sweden were used in the study; half dataset was used for model calibrations and half for the comparative analyses. 10 BCs were performed; the model was independently calibrated for each of the nine sites (site-specific calibrations) and a multi-site calibration was achieved using the data from all the sites in one BC. Then 9 BMCs were carried out, one for each site, using output from the multi-site and the site-specific versions of PRELES. Similar estimates were obtained for the parameters at which model outputs are most sensitive. Not surprisingly, the joint posterior distribution achieved through the multi-site calibration was characterized by lower uncertainty, because more data were involved in the calibration process. No significant differences were encountered in the prediction of the multi-site and site-specific versions of PRELES, and after BMC, we concluded that the model can be reliably used at regional scale to simulate carbon and water fluxes of Boreal forests. Despite being a simple model, PRELES provided good estimates of GPP and ET; only for one site PRELES multi-site version underestimated water fluxes. Our study implies convergence of GPP and water processes in boreal zone to the extent that their plausible prediction is possible with a simple model using global parameterization.

  11. Domestic Violence Courts: A Multisite Test of Whether and How They Change Offender Outcomes.

    PubMed

    Cissner, Amanda B; Labriola, Melissa; Rempel, Michael

    2015-09-01

    Findings are from an investigation of 24 criminal domestic violence courts (DVCs) across New York, testing their effect on recidivism, case processing, and case resolutions. Overall, we found a small positive impact on recidivism among convicted offenders. We further found that the sex of defendants moderated the court impact on case resolutions; that is, among male defendants only, DVCs increased conviction rates and sentences involving jail or prison. In addition, multi-level, multivariate analyses found that court policies specifically designed to increase victim safety, hold offenders accountable, and reduce offender recidivism (through deterrence or rehabilitation) were instrumental in reducing recidivism. © The Author(s) 2015.

  12. Multisite musculoskeletal pain in adolescence as a predictor of medical and social welfare benefits in young adulthood: The Norwegian Arctic Adolescent Health Cohort Study.

    PubMed

    Eckhoff, C; Straume, B; Kvernmo, S

    2017-11-01

    Pain in adolescence is associated with mental health problems, the main reason for work disability in young adults. This study explores the relationship between multisite musculoskeletal pain in adolescence and later medical (sickness and medical rehabilitation benefits) and social welfare benefits, adjusted for sociodemographic, adolescent psychosocial and mental health problems. Data were obtained by linkage between the National Insurance Registry (2003-11) and the Norwegian Arctic Adolescent Health Study, a school-based survey in North Norway (2003-05), accepted by 3987 fifteen- to sixteen-year-olds (68% of the total population). The start of the follow-up time was July 1st of the corresponding year the participants responded to the health study. Musculoskeletal pain was measured by the number of musculoskeletal pain sites. We found a positive linear relationship between adolescent musculoskeletal pain sites and the occurrence of medical and social welfare benefits in young adulthood (p ≤ 0.001). Adolescent musculoskeletal pain was a significant predictor of sickness (p < 0.001) and social welfare benefits in females (p = 0.036), when adjusted for adolescent psychosocial and mental health problems. The most important adolescent psychosocial predictors were externalizing problems, less parental involvement and adverse life events. Adolescent multisite musculoskeletal pain was found to be an important predictor of later sickness and social welfare benefit receipt from adolescence to young adulthood. Adolescents with multisite musculoskeletal pain are at substantially increased risk of health and social difficulties into young adulthood. Identification and interventions for these adolescent problems could alleviate this risk and be a sound socioeconomic investment. © 2017 European Pain Federation - EFIC®.

  13. Quantification of source impact to PM using three-dimensional weighted factor model analysis on multi-site data

    NASA Astrophysics Data System (ADS)

    Shi, Guoliang; Peng, Xing; Huangfu, Yanqi; Wang, Wei; Xu, Jiao; Tian, Yingze; Feng, Yinchang; Ivey, Cesunica E.; Russell, Armistead G.

    2017-07-01

    Source apportionment technologies are used to understand the impacts of important sources of particulate matter (PM) air quality, and are widely used for both scientific studies and air quality management. Generally, receptor models apportion speciated PM data from a single sampling site. With the development of large scale monitoring networks, PM speciation are observed at multiple sites in an urban area. For these situations, the models should account for three factors, or dimensions, of the PM, including the chemical species concentrations, sampling periods and sampling site information, suggesting the potential power of a three-dimensional source apportionment approach. However, the principle of three-dimensional Parallel Factor Analysis (Ordinary PARAFAC) model does not always work well in real environmental situations for multi-site receptor datasets. In this work, a new three-way receptor model, called "multi-site three way factor analysis" model is proposed to deal with the multi-site receptor datasets. Synthetic datasets were developed and introduced into the new model to test its performance. Average absolute error (AAE, between estimated and true contributions) for extracted sources were all less than 50%. Additionally, three-dimensional ambient datasets from a Chinese mega-city, Chengdu, were analyzed using this new model to assess the application. Four factors are extracted by the multi-site WFA3 model: secondary source have the highest contributions (64.73 and 56.24 μg/m3), followed by vehicular exhaust (30.13 and 33.60 μg/m3), crustal dust (26.12 and 29.99 μg/m3) and coal combustion (10.73 and 14.83 μg/m3). The model was also compared to PMF, with general agreement, though PMF suggested a lower crustal contribution.

  14. UPMC Prescription for Wellness: A Quality Improvement Case Study for Supporting Patient Engagement and Health Behavior Change.

    PubMed

    Maners, Rebecca J; Bakow, Eric; Parkinson, Michael D; Fischer, Gary S; Camp, Geoffrey R

    Addressing patient health and care behaviors that underlie much of chronic disease continues to challenge providers, medical practices, health systems, and insurers. Improving health and care as described by the Quadruple Aim requires innovation at the front lines of clinical care: the doctor-patient interaction and office practice. This article describes the use of Lean Six Sigma in a quality improvement (QI) effort to design an effective and scalable method for physicians to prescribe health coaching for healthy behaviors in a primary care medical home within a large integrated delivery and financing system. Building on the national Agency for Healthcare Research and Quality and Robert Wood Johnson Foundation-funded Prescription for Health multisite demonstration, this QI case study provides important lessons for transforming patient-physician-practice support systems to better address lifestyle and care management challenges critical to producing better outcomes.

  15. Quality assurance of data collection in the multi-site community randomized trial and prevalence survey of the children's healthy living program.

    PubMed

    Yamanaka, Ashley; Fialkowski, Marie Kainoa; Wilkens, Lynne; Li, Fenfang; Ettienne, Reynolette; Fleming, Travis; Power, Julianne; Deenik, Jonathan; Coleman, Patricia; Leon Guerrero, Rachael; Novotny, Rachel

    2016-09-02

    Quality assurance plays an important role in research by assuring data integrity, and thus, valid study results. We aim to describe and share the results of the quality assurance process used to guide the data collection process in a multi-site childhood obesity prevalence study and intervention trial across the US Affiliated Pacific Region. Quality assurance assessments following a standardized protocol were conducted by one assessor in every participating site. Results were summarized to examine and align the implementation of protocol procedures across diverse settings. Data collection protocols focused on food and physical activity were adhered to closely; however, protocols for handling completed forms and ensuring data security showed more variability. Quality assurance protocols are common in the clinical literature but are limited in multi-site community-based studies, especially in underserved populations. The reduction in the number of QA problems found in the second as compared to the first data collection periods for the intervention study attest to the value of this assessment. This paper can serve as a reference for similar studies wishing to implement quality assurance protocols of the data collection process to preserve data integrity and enhance the validity of study findings. NIH clinical trial #NCT01881373.

  16. Brain white matter changes associated with urological chronic pelvic pain syndrome: multisite neuroimaging from a MAPP case-control study.

    PubMed

    Huang, Lejian; Kutch, Jason J; Ellingson, Benjamin M; Martucci, Katherine T; Harris, Richard E; Clauw, Daniel J; Mackey, Sean; Mayer, Emeran A; Schaeffer, Anthony J; Apkarian, A Vania; Farmer, Melissa A

    2016-12-01

    Clinical phenotyping of urological chronic pelvic pain syndromes (UCPPSs) in men and women have focused on end organ abnormalities to identify putative clinical subtypes. Initial evidence of abnormal brain function and structure in male pelvic pain has necessitated large-scale, multisite investigations into potential UCPPS brain biomarkers. We present the first evidence of regional white matter (axonal) abnormalities in men and women with UCPPS, compared with positive (irritable bowel syndrome, IBS) and healthy controls. Epidemiological and neuroimaging data were collected from participants with UCPPS (n = 52), IBS (n = 39), and healthy sex- and age-matched controls (n = 61). White matter microstructure, measured as fractional anisotropy (FA), was examined by diffusion tensor imaging. Group differences in regional FA positively correlated with pain severity, including segments of the right corticospinal tract and right anterior thalamic radiation. Increased corticospinal FA was specific and sensitive to UCPPS, positively correlated with pain severity, and reflected sensory (not affective) features of pain. Reduced anterior thalamic radiation FA distinguished patients with IBS from those with UCPPS and controls, suggesting greater microstructural divergence from normal tract organization. Findings confirm that regional white matter abnormalities characterize UCPPS and can distinguish between visceral diagnoses, suggesting that regional axonal microstructure is either altered with ongoing pain or predisposes its development.

  17. Evaluating effective pair and multisite interactions for Ni-Mo system

    NASA Astrophysics Data System (ADS)

    Banerjee, Rumu H.; Arya, A.; Banerjee, S.

    2018-04-01

    Cluster expansion (CE) method was used to calculate the energies of various Ni-Mo phases. The clusters comprising of few nearest neighbours can describe any phase of Ni-Mo system by suitable choice of effective pair and multisite interaction parameters (ECI). The ECIs were evaluated in present study by fitting the ground state energies obtained by first principle calculations. The ECIs evaluated for Ni-Mo system were mostly pair clusters followed by triplets and quadruplet clusters with cluster diameters in the range 2.54 - 10.20 Å. The ECI values diminished for multi-body (triplets and quadruplets) clusters as compared to 2-point or pair clusters indicating a good convergence of CE model. With these ECIs the predicted energies of all the Ni-Mo structures across the Mo concentration range 0-100 at% were obtained. The quantitative error in the energies calculated by CE approach and first principle is very small (< 0.026 meV/atom). The appreciable values of 2-point ECIs upto 4th nearest neighbour reveal that two body interactions are dominant in the case of Ni-Mo system. These ECIs are compared with the reported values of compositional dependent effective pair interactions evaluated by first principle as well as by Monte Carlo method.

  18. Brain white matter changes associated with urological chronic pelvic pain syndrome: Multi-site neuroimaging from a MAPP case-control study

    PubMed Central

    Huang, Lejian; Kutch, Jason J.; Ellingson, Benjamin M.; Martucci, Katherine T.; Harris, Richard E.; Clauw, Daniel J.; Mackey, Sean; Mayer, Emeran A.; Schaeffer, Anthony J.; Apkarian, A. Vania; Farmer, Melissa A.

    2016-01-01

    Clinical phenotyping of urological chronic pelvic pain syndromes (UCPPS) in men and women has focused on end-organ abnormalities to identify putative clinical subtypes. Initial evidence of abnormal brain function and structure in male pelvic pain has necessitated large-scale, multi-site investigations into potential UCPPS brain biomarkers. We present the first evidence of regional white matter (axonal) abnormalities in men and women with UCPPS, compared to positive (irritable bowel syndrome, IBS) and healthy controls. Epidemiological and neuroimaging data was collected from participants with UCPPS (n=52), IBS (n=39), and healthy, sex- and age-matched controls (n=61). White matter microstructure, measured as fractional anisotropy (FA), was examined with diffusion tensor imaging (DTI). Group differences in regional FA positively correlated with pain severity, including segments of the right corticospinal tract and right anterior thalamic radiation. Increased corticospinal FA was specific and sensitive to UCPPS, positively correlated with pain severity, and reflected sensory (not affective) features of pain. Reduced anterior thalamic radiation FA distinguished IBS from UCPPS patients and controls, suggesting greater microstructural divergence from normal tract organization. Findings confirm that regional white matter abnormalities characterize UCPPS and can distinguish between visceral diagnoses, suggesting that regional axonal microstructure is either altered with ongoing pain or predisposes its development. PMID:27842046

  19. Multisite HPV16/18 Vaccine Efficacy Against Cervical, Anal, and Oral HPV Infection

    PubMed Central

    Kreimer, Aimée R.; Schiffman, Mark; Herrero, Rolando; Wacholder, Sholom; Rodriguez, Ana Cecilia; Lowy, Douglas R.; Porras, Carolina; Schiller, John T.; Quint, Wim; Jimenez, Silvia; Safaeian, Mahboobeh; Struijk, Linda; Schussler, John; Hildesheim, Allan; Gonzalez, Paula

    2016-01-01

    Background: Previous Costa Rica Vaccine Trial (CVT) reports separately demonstrated vaccine efficacy against HPV16 and HPV18 (HPV16/18) infections at the cervical, anal, and oral regions; however, the combined overall multisite efficacy (protection at all three sites) and vaccine efficacy among women infected with HPV16 or HPV18 prior to vaccination are less known. Methods: Women age 18 to 25 years from the CVT were randomly assigned to the HPV16/18 vaccine (Cervarix) or a hepatitis A vaccine. Cervical, oral, and anal specimens were collected at the four-year follow-up visit from 4186 women. Multisite and single-site vaccine efficacies (VEs) and 95% confidence intervals (CIs) were computed for one-time detection of point prevalent HPV16/18 in the cervical, anal, and oral regions four years after vaccination. All statistical tests were two-sided. Results: The multisite woman-level vaccine efficacy was highest among “naïve” women (HPV16/18 seronegative and cervical HPV high-risk DNA negative at vaccination) (vaccine efficacy = 83.5%, 95% CI = 72.1% to 90.8%). Multisite woman-level vaccine efficacy was also demonstrated among women with evidence of a pre-enrollment HPV16 or HPV18 infection (seropositive for HPV16 and/or HPV18 but cervical HPV16/18 DNA negative at vaccination) (vaccine efficacy = 57.8%, 95% CI = 34.4% to 73.4%), but not in those with cervical HPV16 and/or HPV18 DNA at vaccination (anal/oral HPV16/18 VE = 25.3%, 95% CI = -40.4% to 61.1%). Concordant HPV16/18 infections at two or three sites were also less common in HPV16/18-infected women in the HPV vaccine vs control arm (7.4% vs 30.4%, P < .001). Conclusions: This study found high multisite vaccine efficacy among “naïve” women and also suggests the vaccine may provide protection against HPV16/18 infections at one or more anatomic sites among some women infected with these types prior to HPV16/18 vaccination. PMID:26467666

  20. Demographic characteristics and employment among people with severe mental illness in a multisite study.

    PubMed

    Burke-Miller, Jane K; Cook, Judith A; Grey, Dennis D; Razzano, Lisa A; Blyler, Crystal R; Leff, H Stephen; Gold, Paul B; Goldberg, Richard W; Mueser, Kim T; Cook, William L; Hoppe, Sue K; Stewart, Michelle; Blankertz, Laura; Dudek, Kenn; Taylor, Amanda L; Carey, Martha Ann

    2006-04-01

    People with psychiatric disabilities experience disproportionately high rates of unemployment. As research evidence is mounting regarding effective vocational programs, interest is growing in identifying subgroup variations. Data from a multisite research and demonstration program were analyzed to identify demographic characteristics associated with employment outcomes, after adjusting for the effects of program, services, and study site. Longitudinal analyses found that people with more recent work history, younger age, and higher education were more likely to achieve competitive employment and to work more hours per month, while race and gender effects varied by employment outcome. Results provide strong evidence of demographic subgroup variation and need.

  1. Evaluation of Intervention Fidelity in a Multisite Clinical Trial in Persons With Multiple Sclerosis.

    PubMed

    Morrison, Janet D; Becker, Heather; Stuifbergen, Alexa K

    2017-12-01

    Careful consideration of intervention fidelity is critical to establishing the validity and reliability of research findings, yet such reports are often lacking in the research literature. It is imperative that intervention fidelity be methodically evaluated and reported to promote the translation of effective interventions into sound evidence-based practice. The purpose of this article is to explore strategies used to promote intervention fidelity, incorporating examples from a multisite clinical trial, that illustrate the National Institutes of Health Behavior Change Consortium's 5 domains for recommended treatment practices: (1) study design, (2) facilitator training, (3) intervention delivery, (4) intervention receipt, and (5) intervention enactment. A multisite randomized clinical trial testing the efficacy of a computer-assisted cognitive rehabilitation intervention for adults with multiple sclerosis is used to illustrate strategies promoting intervention fidelity. Data derived from audiotapes of intervention classes, audits of computer exercises completed by participants, participant class attendance, and goal attainment scaling suggested relatively high fidelity to the intervention protocol. This study illustrates how to report intervention fidelity in the literature guided by best practice strategies, which may serve to promote fidelity monitoring and reporting in future studies.

  2. Ensuring treatment fidelity in a multi-site behavioral intervention study: implementing NIH Behavior Change Consortium recommendations in the SMART trial.

    PubMed

    Robb, Sheri L; Burns, Debra S; Docherty, Sharron L; Haase, Joan E

    2011-11-01

    The Stories and Music for Adolescent/Young Adult Resilience during Transplant (SMART) study (R01NR008583; U10CA098543; U10CA095861) is an ongoing multi-site Children's Oncology Group randomized clinical trial testing the efficacy of a therapeutic music video intervention for adolescents/young adults (11-24 years of age) with cancer undergoing stem cell transplant. Treatment fidelity strategies from our trial are consistent with the National Institutes of Health (NIH) Behavior Change Consortium Treatment Fidelity Workgroup (BCC) recommendations and provide a successful working model for treatment fidelity implementation in a large, multi-site behavioral intervention study. In this paper, we summarize 20 specific treatment fidelity strategies used in the SMART trial and how these strategies correspond with NIH BCC recommendations in five specific areas: (1) study design, (2) training providers, (3) delivery of treatment, (4) receipt of treatment, and (5) enactment of treatment skills. Increased use and reporting of treatment fidelity procedures is essential in advancing the reliability and validity of behavioral intervention research. The SMART trial provides a strong model for the application of fidelity strategies to improve scientific findings and addresses the absence of published literature, illustrating the application of BCC recommendations in behavioral intervention studies. Copyright © 2010 John Wiley & Sons, Ltd.

  3. Tools and Methods for Risk Management in Multi-Site Engineering Projects

    NASA Astrophysics Data System (ADS)

    Zhou, Mingwei; Nemes, Laszlo; Reidsema, Carl; Ahmed, Ammar; Kayis, Berman

    In today's highly global business environment, engineering and manufacturing projects often involve two or more geographically dispersed units or departments, research centers or companies. This paper attempts to identify the requirements for risk management in a multi-site engineering project environment, and presents a review of the state-of-the-art tools and methods that can be used to manage risks in multi-site engineering projects. This leads to the development of a risk management roadmap, which will underpin the design and implementation of an intelligent risk mapping system.

  4. Supporting successful inclusive practices for learners with disabilities in high schools: a multisite, mixed method collective case study.

    PubMed

    Maciver, Donald; Hunter, Cathleen; Adamson, Amanda; Grayson, Zoe; Forsyth, Kirsty; McLeod, Iona

    2018-07-01

    The increase in the number of individuals with disabilities in general education has led to an increased interest in how to best provide support. Despite an emphasis on inclusion and participation in policy and practice, defining and describing the support provided for these learners is still an important task. This multisite, mixed method collective case study reports on 125 education and other staff from seven schools who took part in interviews and focus groups to reflect on a range of topics related to learners with disabilities in high schools. We focused on what the participants did, what they considered to be successful and what their "best" practices were. Descriptions of practices were rich, nuanced and complex. The analysis identified over 200 "strategies" which were synthesized into two meta-themes and eight subthemes. We discuss the results in the context of an ecological perspective, and the importance of focusing on the full range of influences and outcomes for young people in designing supports. We have drawn on evidence from this study as a basis for professional development activities and identified that focusing on the environment and the role of practitioners has a potential to improve the inclusion outcomes for older learners with disabilities. Implications for Rehabilitation Inclusion is influenced by the physical environment, attitudes, expectations and opportunities, in addition to a learner's skills and abilities. Schools should focus on the environment and teachers' practices, rather than on what an individual learner can or cannot do. The practices discussed in this study reflect those that a range of educators and related services personnel agree are realistic, appropriate and effective. Change may be led by the school management team; however, there are many ways in which all staff can contribute; indeed, approaches will not work effectively unless they are understood and implemented by everyone.

  5. Multisite musculoskeletal pain in adolescence and later mental health disorders: a population-based registry study of Norwegian youth: the NAAHS cohort study

    PubMed Central

    Eckhoff, Christian; Straume, Bjørn; Kvernmo, Siv

    2017-01-01

    Objectives To examine the association between multisite musculoskeletal pain in adolescence and mental health disorders in young adulthood. Design and setting Data were obtained from a linkage between the Norwegian Patient Registry (2008–2012) and the Norwegian Arctic Adolescent Health Study, a school-based survey conducted among 10th grade students in North Norway (2003–2005). Participants In total, 3987 (68%) of all 5877 invited participants consented to the registry linkage. Outcome measures Mental healthcare use and disorders from age 18–20 to 23–25 years (5 years). Methods Musculoskeletal pain was measured by the number of musculoskeletal pain sites. Multivariable logistic regression was used to explore the association with later mental healthcare use and disorders. Results Multisite adolescent musculoskeletal pain was significantly associated with an increase in mental healthcare use and mental health disorders in young adulthood. The relationship was stronger for anxiety and mood disorders, in both genders. Overall, the association between musculoskeletal pain and later mental health problems was attenuated after controlling for adolescent psychosocial and mental health problems, not by physical or sedentary activity. This could be due to confounding or mediation. However, when examining different mental health disorders, we found musculoskeletal pain to be significantly associated with anxiety disorders, and showing a strong trend in mood disorders, when adjusted for the adolescent factors. Conclusions Physicians should be aware that multisite adolescent pain is associated with mental health problems in adolescence, and that these adolescents are at increased risk of mental health disorders in young adulthood. As youth troubled by mental health problems commonly present physical symptoms it is important to examine for psychosocial problems in order to offer early interventions. PMID:28188150

  6. Insomnia, Sleep Duration, Depressive Symptoms, and the Onset of Chronic Multisite Musculoskeletal Pain.

    PubMed

    Generaal, Ellen; Vogelzangs, Nicole; Penninx, Brenda W J H; Dekker, Joost

    2017-01-01

    The temporal relationships among sleep, depressive symptoms, and pain are unclear. This longitudinal study examines whether insomnia and sleep duration predict the onset of chronic multisite musculoskeletal pain over 6 years and whether this association is mediated by depressive symptoms. 1860 subjects of the Netherlands Study of Depression and Anxiety, free from chronic multisite musculoskeletal pain at baseline, were followed up for the onset of chronic multisite musculoskeletal pain over 6 years (Chronic Pain Grade Questionnaire). We determined baseline insomnia (Women's Health Initiative Insomnia Rating Scale ≥9) and sleep duration (short: ≤6 hr, normal: 7-9 hr, long: ≥10 hr). Depressive symptoms were assessed at baseline and as a change score over time (Inventory of Depressive Symptomatology). Insomnia (hazard ratio [HR] [95% confidence interval, 95%CI] = 1.60 [1.30-1.96], p < .001) and short sleep duration (HR [95%CI] = 1.52 [1.22-1.90], p < .001) were associated with chronic pain onset. Adding baseline depressive symptoms as a mediator attenuated the associations for insomnia and short sleep with chronic pain onset (∆B = 40% and 26%, respectively). Adding the change score of depressive symptoms further weakened the association for insomnia (∆B = 16%) but not for short sleep. All direct effects for sleep measures with chronic pain onset remained statistically significant (p < .05). This longitudinal study shows that insomnia and short sleep duration are risk factors for developing chronic pain. Depressive symptoms partially mediate the effect for insomnia and short sleep with developing chronic pain. © Sleep Research Society 2016. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  7. Multisite occupation of divalent dopants in barium and strontium titanates

    NASA Astrophysics Data System (ADS)

    Zulueta, Yohandys A.; Nguyen, Minh Tho

    2018-10-01

    Based on recent experimental and theoretical proofs of calcium multisite occupation in barium titanate, we investigated a mixed incorporation mechanism for divalent dopants in barium and strontium titanates (BaTiO3 and SrTiO3). Our present theoretical results demonstrated the multisite occupation of divalent dopants in both perovskite structures. We determined the dependences of the solution, binding energies, and final solution energies with respect to the ionic radii of the dopants. Calculated results obtained based on classical simulations showed that the divalent dopants can occupy both A- and Ti- cation sites in ATiO3 perovskite structures. Such a multisite occupation has direct implications for other experimental findings regarding BaTiO3, such as non-stabilization of the tetragonal phase, shifts in the Curie temperature, intensification of the diffuse phase transition, and shifts in the absorption of ultraviolet light to the visible range in photocatalytic applications related to solar cells for producing energy.

  8. Transmission Heterogeneity and Autoinoculation in a Multisite Infection Model of HPV

    PubMed Central

    Brouwer, Andrew F.; Meza, Rafael; Eisenberg, Marisa C.

    2015-01-01

    The human papillomavirus (HPV) is sexually transmitted and can infect oral, genital, and anal sites in the human epithelium. Here, we develop a multisite transmission model that includes autoinoculation, to study HPV and other multisite diseases. Under a homogeneous-contacts assumption, we analyze the basic reproduction number R0, as well as type and target reproduction numbers, for a two-site model. In particular, we find that R0 occupies a space between taking the maximum of next generation matrix terms for same site transmission and taking the geometric average of cross-site transmission terms in such a way that heterogeneity in the same-site transmission rates increases R0 while heterogeneity in the cross-site transmission decreases it. Additionally, autoinoculation adds considerable complexity to the form of R0. We extend this analysis to a heterosexual population, which additionally yields dynamics analogous to those of vector–host models. We also examine how these issues of heterogeneity may affect disease control, using type and target reproduction numbers. PMID:26518265

  9. Development of a continuous multisite accelerometry system for studying movements during sleep.

    PubMed

    Terrill, Philip I; Mason, David G; Wilson, Stephen J

    2010-01-01

    Actigraphy has proven to be a useful tool in the assessment of circadian rhythms, and more recently in the automatic staging of sleep and wake states. Whilst accuracy of commercial systems appears good over 24 hour periods, the sensitivity of detecting wake during time in bed is poor. One possible explanation for these poor results is the technical limitations of currently available commercial actigraphs. In particular, raw data is generally not available to the user. Instead, activity counts for each epoch (typically between 10-60 secs) are calculated using various algorithms, from which sleep state is identified. Consequently morphologically different movements observed during sleep and wake states may not be detected as such. In this paper, the development of a continuous multisite, accelerometry system (CMAS) is described. Initial results, comparing data collected using a commercial actigraph (Actiwatch- Mini Motionlogger), and the continuous multisite accelerometry system are presented. The CMAS is able to differentiate brief movement "twitches" from postural changes.

  10. The effect of simulation courseware on critical thinking in undergraduate nursing students: multi-site pre-post study.

    PubMed

    Shin, Hyunsook; Ma, Hyunhee; Park, Jiyoung; Ji, Eun Sun; Kim, Dong Hee

    2015-04-01

    The use of simulations has been considered as opportunities for students to enhance their critical thinking (CT), but previous studies were limited because they did not provide in-depth information on the working dynamics of simulation or on the effects of the number of simulation exposures on CT. This study examined the effect of an integrated pediatric nursing simulation used in a nursing practicum on students' CT abilities and identified the effects of differing numbers of simulation exposures on CT in a multi-site environment. The study used a multi-site, pre-test, post-test design. A total of 237 nursing students at three universities enrolled in a pediatric practicum participated in this study from February to December 2013. All three schools used the same simulation courseware, including the same simulation scenarios, evaluation tools, and simulation equipment. The courseware incorporated high-fidelity simulators and standardized patients. Students at school A completed one simulation session, whereas students at schools B and C completed two and three simulation sessions, respectively. Yoon's Critical Thinking Disposition tool (2008) was used to measure students' CT abilities. The gains in students' CT scores varied according to their numbers of exposures to the simulation courseware. With a single exposure, there were no statistically significant gains in CT, whereas three exposures to the courseware produced significant gains in CT. In seven subcategories of critical thinking, three exposures to the simulation courseware produced CT gains in the prudence and intellectual eagerness subcategories, and the overall simulation experience produced CT gains in the prudence, systematicity, healthy skepticism, and intellectual eagerness subcategories. Simulation courseware may produce positive learning outcomes for prudence in nursing education. In addition, the findings from the multi-site comparative study may contribute to greater understanding of how patient simulation experiences impact students' CT abilities. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. Computer-aided resource planning and scheduling for radiological services

    NASA Astrophysics Data System (ADS)

    Garcia, Hong-Mei C.; Yun, David Y.; Ge, Yiqun; Khan, Javed I.

    1996-05-01

    There exists tremendous opportunity in hospital-wide resource optimization based on system integration. This paper defines the resource planning and scheduling requirements integral to PACS, RIS and HIS integration. An multi-site case study is conducted to define the requirements. A well-tested planning and scheduling methodology, called Constrained Resource Planning model, has been applied to the chosen problem of radiological service optimization. This investigation focuses on resource optimization issues for minimizing the turnaround time to increase clinical efficiency and customer satisfaction, particularly in cases where the scheduling of multiple exams are required for a patient. How best to combine the information system efficiency and human intelligence in improving radiological services is described. Finally, an architecture for interfacing a computer-aided resource planning and scheduling tool with the existing PACS, HIS and RIS implementation is presented.

  12. Women, Co-occurring Disorders, and Violence Study: evaluation design and study population.

    PubMed

    McHugo, G J; Kammerer, N; Jackson, E W; Markoff, L S; Gatz, M; Larson, M J; Mazelis, R; Hennigan, K

    2005-03-01

    The Women, Co-occurring Disorders, and Violence Study (WCDVS) was a multi-site cooperative study to evaluate new service models for women with co-occurring mental health and substance use disorders and a history of physical and/or sexual abuse. Despite common features in the service interventions and evaluation procedures, diversity across the nine sites plus differences introduced by non-random assignment led to numerous methodological challenges. This article describes the design, measurement, and analysis decisions behind the WCDVS and lays the foundation for understanding participant-level outcomes and service costs. This article also describes the study population, as recruited and following attrition at the 6-month follow-up, in order to address the threat of selection bias to inferences drawn from this multi-site study.

  13. Multi-site Study of Diffusion Metric Variability: Characterizing the Effects of Site, Vendor, Field Strength, and Echo Time using the Histogram Distance.

    PubMed

    Helmer, K G; Chou, M-C; Preciado, R I; Gimi, B; Rollins, N K; Song, A; Turner, J; Mori, S

    2016-02-27

    MRI-based multi-site trials now routinely include some form of diffusion-weighted imaging (DWI) in their protocol. These studies can include data originating from scanners built by different vendors, each with their own set of unique protocol restrictions, including restrictions on the number of available gradient directions, whether an externally-generated list of gradient directions can be used, and restrictions on the echo time (TE). One challenge of multi-site studies is to create a common imaging protocol that will result in a reliable and accurate set of diffusion metrics. The present study describes the effect of site, scanner vendor, field strength, and TE on two common metrics: the first moment of the diffusion tensor field (mean diffusivity, MD), and the fractional anisotropy (FA). We have shown in earlier work that ROI metrics and the mean of MD and FA histograms are not sufficiently sensitive for use in site characterization. Here we use the distance between whole brain histograms of FA and MD to investigate within- and between-site effects. We concluded that the variability of DTI metrics due to site, vendor, field strength, and echo time could influence the results in multi-center trials and that histogram distance is sensitive metrics for each of these variables.

  14. Implementation of case studies in undergraduate didactic nursing courses: a qualitative study.

    PubMed

    Dutra, Danette K

    2013-07-04

    The implementation of unfolding scenario-based case studies in the didactic classroom is associated with learner-centered education. The utilization of learner-centered pedagogies, such as case studies, removes the focus from the instructor and instead places it on the student. Learner-centered pedagogies are believed to improve students' levels of cognition. The purpose of this study was to examine how nurse educators are implementing the pedagogies of case studies in their undergraduate didactic courses. The goal was to examine, document, report, and, ultimately, implement the strategies. Purposeful sampling was utilized in this qualitative, multisite-designed study. For each of the four participants, three separate site visits were completed. Observations and post-observational interviews took place at each site visit. Transcribed data from interviews, observations, and course documents were imported into the computer program Nvivo8. Repetitive comparative analysis was utilized to complete the data coding process. The guiding research question of this study sought to investigate the implementation strategies of case studies in didactic nursing courses. The implementation of case studies by the participants reflected two primary patterns: Formal Implementation (FI) and Informal Implementation (II) of case studies. The FI of case studies was further divided into two subcategories: Formal Implementation of case studies used Inside the Classroom setting (FIIC) and Formal Implementation of cases studies used Outside of the Classroom (FIOC). Results of this investigation have led to an increased understanding of implementation strategies of unfolding scenario-based case studies in undergraduate nursing didactic courses. Data collected were rich in the description of specific methodologies for utilization of case studies and may serve as a resource for faculty in development of creative strategies to enhance the didactic classroom experience.

  15. Implementation of case studies in undergraduate didactic nursing courses: a qualitative study

    PubMed Central

    2013-01-01

    Background The implementation of unfolding scenario-based case studies in the didactic classroom is associated with learner-centered education. The utilization of learner-centered pedagogies, such as case studies, removes the focus from the instructor and instead places it on the student. Learner-centered pedagogies are believed to improve students’ levels of cognition. The purpose of this study was to examine how nurse educators are implementing the pedagogies of case studies in their undergraduate didactic courses. The goal was to examine, document, report, and, ultimately, implement the strategies. Methods Purposeful sampling was utilized in this qualitative, multisite-designed study. For each of the four participants, three separate site visits were completed. Observations and post-observational interviews took place at each site visit. Transcribed data from interviews, observations, and course documents were imported into the computer program Nvivo8. Repetitive comparative analysis was utilized to complete the data coding process. Results The guiding research question of this study sought to investigate the implementation strategies of case studies in didactic nursing courses. The implementation of case studies by the participants reflected two primary patterns: Formal Implementation (FI) and Informal Implementation (II) of case studies. The FI of case studies was further divided into two subcategories: Formal Implementation of case studies used Inside the Classroom setting (FIIC) and Formal Implementation of cases studies used Outside of the Classroom (FIOC). Conclusion Results of this investigation have led to an increased understanding of implementation strategies of unfolding scenario-based case studies in undergraduate nursing didactic courses. Data collected were rich in the description of specific methodologies for utilization of case studies and may serve as a resource for faculty in development of creative strategies to enhance the didactic classroom experience. PMID:23826925

  16. How Accurately Do Consecutive Cohort Audits Predict Phase III Multisite Clinical Trial Recruitment in Palliative Care?

    PubMed

    McCaffrey, Nikki; Fazekas, Belinda; Cutri, Natalie; Currow, David C

    2016-04-01

    Audits have been proposed for estimating possible recruitment rates to randomized controlled trials (RCTs), but few studies have compared audit data with subsequent recruitment rates. To compare the accuracy of estimates of potential recruitment from a retrospective consecutive cohort audit of actual participating sites and recruitment to four Phase III multisite clinical RCTs. The proportion of potentially eligible study participants estimated from an inpatient chart review of people with life-limiting illnesses referred to six Australian specialist palliative care services was compared with recruitment data extracted from study prescreening information from three sites that participated fully in four Palliative Care Clinical Studies Collaborative RCTs. The predominant reasons for ineligibility in the audit and RCTs were analyzed. The audit overestimated the proportion of people referred to the palliative care services who could participate in the RCTs (pain 17.7% vs. 1.2%, delirium 5.8% vs. 0.6%, anorexia 5.1% vs. 0.8%, and bowel obstruction 2.8% vs. 0.5%). Approximately 2% of the referral base was potentially eligible for these effectiveness studies. Ineligibility for general criteria (language, cognition, and geographic proximity) varied between studies, whereas the reasons for exclusion were similar between the audit and pain and anorexia studies but not for delirium or bowel obstruction. The retrospective consecutive case note audit in participating sites did not predict realistic recruitment rates, mostly underestimating the impact of study-specific inclusion criteria. These findings have implications for the applicability of the results of RCTs. Prospective pilot studies are more likely to predict actual recruitment. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  17. Analysis Concerning the Inspection Threshold for Multi-Site Damage.

    DOT National Transportation Integrated Search

    1993-12-01

    Periodic inspections, at a prescribed interval, for Multi-Site Damage (MS) in longitudinal fuselage lap-joints start when the aircraft has accumulated a certain number of flights, the inspection threshold. The work reported here was an attempt to obt...

  18. Multisite tumor sampling enhances the detection of intratumor heterogeneity at all different temporal stages of tumor evolution.

    PubMed

    Erramuzpe, Asier; Cortés, Jesús M; López, José I

    2018-02-01

    Intratumor heterogeneity (ITH) is an inherent process of tumor development that has received much attention in previous years, as it has become a major obstacle for the success of targeted therapies. ITH is also temporally unpredictable across tumor evolution, which makes its precise characterization even more problematic since detection success depends on the precise temporal snapshot at which ITH is analyzed. New and more efficient strategies for tumor sampling are needed to overcome these difficulties which currently rely entirely on the pathologist's interpretation. Recently, we showed that a new strategy, the multisite tumor sampling, works better than the routine sampling protocol for the ITH detection when the tumor time evolution was not taken into consideration. Here, we extend this work and compare the ITH detections of multisite tumor sampling and routine sampling protocols across tumor time evolution, and in particular, we provide in silico analyses of both strategies at early and late temporal stages for four different models of tumor evolution (linear, branched, neutral, and punctuated). Our results indicate that multisite tumor sampling outperforms routine protocols in detecting ITH at all different temporal stages of tumor evolution. We conclude that multisite tumor sampling is more advantageous than routine protocols in detecting intratumor heterogeneity.

  19. Contextual Factors Related to Implementation and Reach of a Pragmatic Multisite Trial– The My Own Health Report (MOHR) Study

    PubMed Central

    Balasubramanian, Bijal A.; Heurtin-Roberts, Suzanne; Krasny, Sarah; Rohweder, Catherine; Fair, Kayla; Olmos, Tanya; Stange, Kurt C.; Gorin, Sherri Sheinfeld

    2018-01-01

    Background Contextual factors relevant to health care improvement studies are important for translating findings to other settings; however, these are rarely collected systematically and reported. This study articulates a prospective method for assessing contextual factors and describes factors related to implementation and patient reach of a pragmatic multisite trial conducted in nine primary care practices. Methods In a qualitative case-series, contextual factors were assessed from the My Own Health Report (MOHR) study, focused on systematically conducting health risk assessments and goal setting for unhealthy behaviors and behavioral health in primary care. Data were collected prospectively at baseline, mid-point, and end of intervention using a template that guided conduct of interviews and observations at practice sites. A multidisciplinary team used an iterative process to summarize themes describing contextual factors related to intervention implementation and patient reach, calculated by dividing the number of patients who completed the MOHR assessment by the number of patients offered MOHR. Results Contextual factors operational both within and external to the practice environment influenced implementation and patient reach over time. These included practice members’ motivations towards the MOHR intervention, practice staff capacity to take on additional responsibilities for implementation, practice information system capacity, external resources to support quality improvement, linkages with community resources, and fit of implementation strategy to patient populations. Conclusions Systematic assessment of contextual factors throughout implementation of quality improvement initiatives is needed to meaningfully interpret findings and translate lessons learned to other health care settings. Thus, knowledge of contextual factors is essential for scaling up of effective improvement strategies. PMID:28484066

  20. The impact of lymphatic filariasis on labour inputs in southern India: results of a multi-site study.

    PubMed

    Ramaiah, K D; Radhamani, M P; John, K R; Evans, D B; Guyatt, H; Joseph, A; Datta, M; Vanamail, P

    2000-06-01

    A multi-site study was undertaken, in the rural areas of three districts in Tamil Nadu state, in southern India, to examine the impact of acute and chronic forms of lymphatic filariasis, caused by infection with Wuchereria bancrofti, on labour inputs. More than half of the acute episodes of adenolymphangitis (ADL) observed in the study communities caused total disability. The mean (S.D.) time that each ADL case was able to allocate to economic activity each day during these acute episodes was much less than seen in the controls matched for sex, age and occupation [0.97 (2.36) v. 4.48 (3.82) h; P < 0.01]. The acute disease also severely affected domestic activities, with female ADL cases spending only 1.54 (2.12) h/day on domestic activity, compared with 4.18 (2.61) h by controls. The subjects with chronic filariasis also spent significantly less time in economic activity than their matched controls [4.40 (3.79) v. 5.13 (3.83) h/day; P < 0.01). Although the acute episodes have a dramatic effect on the productivity of the affected individual, the labour loss caused by chronic disease is more serious, as the manifestations of chronic disease mostly affect the most productive age-groups, persist for life and are mostly irreversible. The adverse impact of acute and chronic filariasis was observed in males and females, farmers and non-farmers and during the rainy, winter and summer seasons. It is estimated that about 3.8% of the potential labour inputs of the men and 0.77% of those of the women were lost because of lymphatic filariasis. In addition to this loss, the total economic burden of the disease must include the costs of treatment and other health care and of the resources spent on control programmes. Estimates of the disease burden are likely to be useful in determining the costs and benefits of the recently launched campaign to eliminate lymphatic filariasis.

  1. History of chickenpox in glioma risk: a report from the glioma international case-control study (GICC).

    PubMed

    Amirian, E Susan; Scheurer, Michael E; Zhou, Renke; Wrensch, Margaret R; Armstrong, Georgina N; Lachance, Daniel; Olson, Sara H; Lau, Ching C; Claus, Elizabeth B; Barnholtz-Sloan, Jill S; Il'yasova, Dora; Schildkraut, Joellen; Ali-Osman, Francis; Sadetzki, Siegal; Jenkins, Robert B; Bernstein, Jonine L; Merrell, Ryan T; Davis, Faith G; Lai, Rose; Shete, Sanjay; Amos, Christopher I; Melin, Beatrice S; Bondy, Melissa L

    2016-06-01

    Varicella zoster virus (VZV) is a neurotropic α-herpesvirus that causes chickenpox and establishes life-long latency in the cranial nerve and dorsal root ganglia of the host. To date, VZV is the only virus consistently reported to have an inverse association with glioma. The Glioma International Case-Control Study (GICC) is a large, multisite consortium with data on 4533 cases and 4171 controls collected across five countries. Here, we utilized the GICC data to confirm the previously reported associations between history of chickenpox and glioma risk in one of the largest studies to date on this topic. Using two-stage random-effects restricted maximum likelihood modeling, we found that a positive history of chickenpox was associated with a 21% lower glioma risk, adjusting for age and sex (95% confidence intervals (CI): 0.65-0.96). Furthermore, the protective effect of chickenpox was stronger for high-grade gliomas. Our study provides additional evidence that the observed protective effect of chickenpox against glioma is unlikely to be coincidental. Future studies, including meta-analyses of the literature and investigations of the potential biological mechanism, are warranted. © 2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  2. The added value of auditory cortex transcranial random noise stimulation (tRNS) after bifrontal transcranial direct current stimulation (tDCS) for tinnitus.

    PubMed

    To, Wing Ting; Ost, Jan; Hart, John; De Ridder, Dirk; Vanneste, Sven

    2017-01-01

    Tinnitus is the perception of a sound in the absence of a corresponding external sound source. Research has suggested that functional abnormalities in tinnitus patients involve auditory as well as non-auditory brain areas. Transcranial electrical stimulation (tES), such as transcranial direct current stimulation (tDCS) to the dorsolateral prefrontal cortex and transcranial random noise stimulation (tRNS) to the auditory cortex, has demonstrated modulation of brain activity to transiently suppress tinnitus symptoms. Targeting two core regions of the tinnitus network by tES might establish a promising strategy to enhance treatment effects. This proof-of-concept study aims to investigate the effect of a multisite tES treatment protocol on tinnitus intensity and distress. A total of 40 tinnitus patients were enrolled in this study and received either bifrontal tDCS or the multisite treatment of bifrontal tDCS before bilateral auditory cortex tRNS. Both groups were treated on eight sessions (two times a week for 4 weeks). Our results show that a multisite treatment protocol resulted in more pronounced effects when compared with the bifrontal tDCS protocol or the waiting list group, suggesting an added value of auditory cortex tRNS to the bifrontal tDCS protocol for tinnitus patients. These findings support the involvement of the auditory as well as non-auditory brain areas in the pathophysiology of tinnitus and demonstrate the idea of the efficacy of network stimulation in the treatment of neurological disorders. This multisite tES treatment protocol proved to be save and feasible for clinical routine in tinnitus patients.

  3. Tender point count, pain, and mobility in the older population: the mobilize Boston study.

    PubMed

    Eggermont, Laura H P; Shmerling, Robert H; Leveille, Suzanne G

    2010-01-01

    Prevalence of tender points (TP), and widespread pain and fibromyalgia, as well as the relationship between TP and widespread pain and mobility, was examined in 585 community-dwelling older adults (mean age 78.2 years, 63.4% female). Pain was based on location (none, single site, multisite, widespread). Mobility was measured by the Short Physical Performance Battery (SPPB), gait speed, and self-reported (S-R) mobility difficulty. Tender-point count and health characteristics (ie, BMI, chronic conditions, analgesic use, number of medications, depression, and blocks walked per week) were assessed. Several participants had 3 or more TP (22.1%) although prevalence of criteria-based fibromyalgia was low (.3%). Mobility was more limited in persons with higher tender-point counts. After adjustment for pain and other risk factors, higher tender-point count was associated with poorer SPPB performance (score < 10, aOR = 1.09 per TP, 95%CI, 1.01-1.17), and slow gait speed (< .784m/sec, aOR = 1.14 per TP, 95%CI, 1.05-1.24), but not with S-R mobility difficulty. S-R mobility difficulty was associated with more disseminated pain (multisite pain, aOR = 2.01, 95%CI, 1.21-3.34; widespread pain, aOR = 2.47, 95%CI, 1.09-5.62). These findings portray a significant mobility burden related to tender-point count and multisite and widespread pain in the older population. Future studies using longitudinal methods are warranted. Higher tender-point count, multisite pain, and widespread pain are common in community-dwelling older adults and associated with mobility problems. Both the manual tender-point exam and the McGill Pain Map may provide important yet different information about risks for mobility disability in older individuals. Copyright 2010 American Pain Society. All rights reserved.

  4. Expansion of the gateway multisite recombination cloning toolkit.

    PubMed

    Shearin, Harold K; Dvarishkis, Alisa R; Kozeluh, Craig D; Stowers, R Steven

    2013-01-01

    Precise manipulation of transgene expression in genetic model organisms has led to advances in understanding fundamental mechanisms of development, physiology, and genetic disease. Transgene construction is, however, a precondition of transgene expression, and often limits the rate of experimental progress. Here we report an expansion of the modular Gateway MultiSite recombination-cloning platform for high efficiency transgene assembly. The expansion includes two additional destination vectors and entry clones for the LexA binary transcription system, among others. These new tools enhance the expression levels possible with Gateway MultiSite generated transgenes and make possible the generation of LexA drivers and reporters with Gateway MultiSite cloning. In vivo data from transgenic Drosophila functionally validating each novel component are presented and include neuronal LexA drivers, LexAop2 red and green fluorescent synaptic vesicle reporters, TDC2 and TRH LexA, GAL4, and QF drivers, and LexAop2, UAS, and QUAS channelrhodopsin2 T159C reporters.

  5. Expansion of the Gateway MultiSite Recombination Cloning Toolkit

    PubMed Central

    Shearin, Harold K.; Dvarishkis, Alisa R.; Kozeluh, Craig D.; Stowers, R. Steven

    2013-01-01

    Precise manipulation of transgene expression in genetic model organisms has led to advances in understanding fundamental mechanisms of development, physiology, and genetic disease. Transgene construction is, however, a precondition of transgene expression, and often limits the rate of experimental progress. Here we report an expansion of the modular Gateway MultiSite recombination-cloning platform for high efficiency transgene assembly. The expansion includes two additional destination vectors and entry clones for the LexA binary transcription system, among others. These new tools enhance the expression levels possible with Gateway MultiSite generated transgenes and make possible the generation of LexA drivers and reporters with Gateway MultiSite cloning. In vivo data from transgenic Drosophila functionally validating each novel component are presented and include neuronal LexA drivers, LexAop2 red and green fluorescent synaptic vesicle reporters, TDC2 and TRH LexA, GAL4, and QF drivers, and LexAop2, UAS, and QUAS channelrhodopsin2 T159C reporters. PMID:24204935

  6. Multi-level assessment protocol (MAP) for adoption in multi-site clinical trials

    PubMed Central

    Guydish, J.; Manser, S.T.; Jessup, M.; Tajima, B.; Sears, C.; Montini, T.

    2010-01-01

    The National Institute on Drug Abuse (NIDA) Clinical Trials Network (CTN) is intended to test promising drug abuse treatment models in multi-site clinical trials, and to support adoption of new interventions into clinical practice. Using qualitative research methods we asked: How might the technology of multi-site clinical trials be modified to better support adoption of tested interventions? A total of 42 participants, representing 8 organizational levels ranging from clinic staff to clinical trial leaders, were interviewed about their role in the clinical trial, its interactions with clinics, and intervention adoption. Among eight clinics participating in the clinical trial, we found adoption of the tested intervention in one clinic only. In analysis of interview data we identified four conceptual themes which are likely to affect adoption and may be informative in future multi-site clinical trials. We offer the conclusion that planning for adoption in the early stages of protocol development will better serve the aim of integrating new interventions into practice. PMID:20890376

  7. Implementing an error disclosure coaching model: A multicenter case study.

    PubMed

    White, Andrew A; Brock, Douglas M; McCotter, Patricia I; Shannon, Sarah E; Gallagher, Thomas H

    2017-01-01

    National guidelines call for health care organizations to provide around-the-clock coaching for medical error disclosure. However, frontline clinicians may not always seek risk managers for coaching. As part of a demonstration project designed to improve patient safety and reduce malpractice liability, we trained multidisciplinary disclosure coaches at 8 health care organizations in Washington State. The training was highly rated by participants, although not all emerged confident in their coaching skill. This multisite intervention can serve as a model for other organizations looking to enhance existing disclosure capabilities. Success likely requires cultural change and repeated practice opportunities for coaches. © 2017 American Society for Healthcare Risk Management of the American Hospital Association.

  8. The dragnet of children's feeding programs in Atlantic Canada.

    PubMed

    Dayle, J B; McIntyre, L; Raine-Travers, K D

    2000-12-01

    Ivan Illich's 1976 prediction that medical dragnets will continue was correct. Now quasi-health dragnets are being established ostensibly to feed children perceived to be hungry. Our qualitative, multi-site case study found that programs justify their expansion to non-target group children as a means of reducing stigmatization, while reaching only an estimated one-third of targeted children. The dragnet continues as new services are added and franchising is proposed while the purpose of the program feeding healthy foods to children ultimately succumbs to drives for efficiency and the desire to maintain the program itself. In this field of social power relations, children become commodified through dialectical interplays among fundamental needs, manipulated needs, benevolence, and domination.

  9. Multisite Infection with Mycobacterium abscessus after Replacement of Breast Implants and Gluteal Lipofilling

    PubMed Central

    Rüegg, Eva; Cheretakis, Alexandre; Modarressi, Ali; Harbarth, Stephan; Pittet-Cuénod, Brigitte

    2015-01-01

    Introduction. Medical tourism for aesthetic surgery is popular. Nontuberculous mycobacteria (NTM) occasionally cause surgical-site infections. As NTM grow in biofilms, implantations of foreign bodies are at risk. Due to late manifestation, infections occur when patients are back home, where they must be managed properly. Case Report. A 39-year-old healthy female was referred for acute infection of the right gluteal area. Five months before, she had breast implants replacement, abdominal liposuction, and gluteal lipofilling in Mexico. Three months postoperatively, implants were removed for NTM-infection in Switzerland. Adequate antibiotic treatment was stopped after seven days for drug-related hepatitis. At entrance, gluteal puncture for bacterial analysis was performed. MRI showed large subcutaneous collection. Debridement under general anaesthesia was followed by open wound management. Total antibiotic treatment was 20 weeks. Methods. Bacterial analysis of periprosthetic and gluteal liquids included Gram-stain plus acid-fast stain, and aerobic, anaerobic and mycobacterial cultures.  Results. In periprosthetic fluid, Mycobacterium abscessus, Propionibacterium, and Staphylococcus epidermidis were identified. The same M. abscessus strain was found gluteally. The gluteal wound healed within six weeks. At ten months' follow-up, gluteal asymmetry persists for deep scarring. Conclusion. This case presents major complications of multisite aesthetic surgery. Surgical-site infections in context of medical tourism need appropriate bacteriological investigations, considering potential NTM-infections. PMID:25893122

  10. SPICODYN: A Toolbox for the Analysis of Neuronal Network Dynamics and Connectivity from Multi-Site Spike Signal Recordings.

    PubMed

    Pastore, Vito Paolo; Godjoski, Aleksandar; Martinoia, Sergio; Massobrio, Paolo

    2018-01-01

    We implemented an automated and efficient open-source software for the analysis of multi-site neuronal spike signals. The software package, named SPICODYN, has been developed as a standalone windows GUI application, using C# programming language with Microsoft Visual Studio based on .NET framework 4.5 development environment. Accepted input data formats are HDF5, level 5 MAT and text files, containing recorded or generated time series spike signals data. SPICODYN processes such electrophysiological signals focusing on: spiking and bursting dynamics and functional-effective connectivity analysis. In particular, for inferring network connectivity, a new implementation of the transfer entropy method is presented dealing with multiple time delays (temporal extension) and with multiple binary patterns (high order extension). SPICODYN is specifically tailored to process data coming from different Multi-Electrode Arrays setups, guarantying, in those specific cases, automated processing. The optimized implementation of the Delayed Transfer Entropy and the High-Order Transfer Entropy algorithms, allows performing accurate and rapid analysis on multiple spike trains from thousands of electrodes.

  11. On-chip, multisite extracellular and intracellular recordings from primary cultured skeletal myotubes

    PubMed Central

    Rabieh, Noha; Ojovan, Silviya M.; Shmoel, Nava; Erez, Hadas; Maydan, Eilon; Spira, Micha E.

    2016-01-01

    In contrast to the extensive use of microelectrode array (MEA) technology in electrophysiological studies of cultured neurons and cardiac muscles, the vast field of skeletal muscle research has yet to adopt the technology. Here we demonstrate an empowering MEA technology for high quality, multisite, long-term electrophysiological recordings from cultured skeletal myotubes. Individual rat skeletal myotubes cultured on micrometer sized gold mushroom-shaped microelectrode (gMμE) based MEA tightly engulf the gMμEs, forming a high seal resistance between the myotubes and the gMμEs. As a consequence, spontaneous action potentials generated by the contracting myotubes are recorded as extracellular field potentials with amplitudes of up to 10 mV for over 14 days. Application of a 10 ms, 0.5–0.9 V voltage pulse through the gMμEs electroporated the myotube membrane, and transiently converted the extracellular to intracellular recording mode for 10–30 min. In a fraction of the cultures stable attenuated intracellular recordings were spontaneously produced. In these cases or after electroporation, subthreshold spontaneous potentials were also recorded. The introduction of the gMμE-MEA as a simple-to-use, high-quality electrophysiological tool together with the progress made in the use of cultured human myotubes opens up new venues for basic and clinical skeletal muscle research, preclinical drug screening, and personalized medicine. PMID:27812002

  12. What is the benefit of driving a hydrological model with data from a multi-site weather generator compared to data from a simple delta change approach?"

    NASA Astrophysics Data System (ADS)

    Rössler, Ole; Keller, Denise; Fischer, Andreas

    2016-04-01

    In 2011 the Swiss national consortium C2SM providednew climate change scenarios were released in Switzerland that came with a comprehensive data set of temperature and precipitation changes under climate change conditions for every a large network of meteorological stations, and for aggregated as well as regions in across Switzerland. These climate change signals were generated for three emission scenarios and three different future time-periods and designed to be used asbased on a delta change factors approach. This data set proved to be very successful in Switzerland as many different users, researchers, private companies, and societal users were able to use and interpret the climate data set. Thus, a range of applications that are all based on the same climate data set enabled a comparable view on climate change impact in several disciplines. The main limitation and criticism to this data set was the usage of the delta change approach for downscaling as it comes with severe limitations such as underestimatinges changes in extreme values and neglecting changes in variability and changes in temporal sequencesneglecting changes in variability, be it year-to-year or day-to-day, and changes in temporal sequences . lacks a change in the day-to-day-variability. One way to overcome this the latter limitation is the usage of stochastic weather generators in a downscaling context. Weather generators are known to be one suitable downscaling technique, but A common limitation of most weather generators is the absence of spatial consistency rrelation in the generated daily time-series, resulting in an underestimation of areal means over several stations that are often low-biased. refer to one point scale (single-site) and lacks the spatial representation of weather. The latter A realistic representation of the inter-station correlation in the downscaled time-series This is of high particular importance in some impact studies, especially infor any hydrological impact studiesy. Recently, a multi-site weather generator was developed and tested for downscaling purposes over Switzerland. The weather generator is of type Richardson, that is run with spatially correlated random number streams to ensure spatial consistency. As a downside, multi-site weather generators are much more complex to develop, but they are a very promising alternative downscaling technique. A new multi-site-weather generator was developed for Switzerland in a previous study (Keller et al. 2014). In this study, we tested this new multi-site-weather generator against the "standard" delta change derived data in a hydrological impact assessment study that focused on runoff in the meso-scale catchment of the river Thur catchment. Two hydrological models of different complexity were run with the data sets under present (1980-2009) and under future conditions (2070-2099), assuming the SRES A1B emission2070-2100 scenario conditions. Eight meteorological stations were used to interpolate a meteorological field that served as input to calibrate and validate the two hydrological models against runoff. The downscaling intercomparison was done for We applied 10 GCM-RCM combinations simulations of the ENSEMBLES. In case of the weather generator, that allows for multiple synthetic realizations, we generated for which change factors for each station (delta change approach) were available and generated 25 realizations of multi-site weather. with each climate model projection. Results show that the delta change driven data constitutes only one appropriate representation compared to theof a bandwidth of runoff projections yielded by the multi-site weather generator data. Especially oOn average, differences between both the two approaches are small. Low and high runoff Runoff values to both extremes are however better reproduced with the weather generator driven data set. The stochastic representation of multiday rainfall events are considered as the main reason. Hence, tThere is a clear yet small added value to the delta change approach that in turn performs rather well. Although these small but considerable differences might questioning the need to construct a multi-site-weather generator with a huge effort, the potential and possibilities to further develop the multi-site weather generator is undoubted.

  13. Summarising climate and air quality (ozone) data on self-organising maps: a Sydney case study.

    PubMed

    Jiang, Ningbo; Betts, Alan; Riley, Matt

    2016-02-01

    This paper explores the classification and visualisation utility of the self-organising map (SOM) method in the context of New South Wales (NSW), Australia, using gridded NCEP/NCAR geopotential height reanalysis for east Australia, together with multi-site meteorological and air quality data for Sydney from the NSW Office of Environment and Heritage Air Quality Monitoring Network. A twice-daily synoptic classification has been derived for east Australia for the period of 1958-2012. The classification has not only reproduced the typical synoptic patterns previously identified in the literature but also provided an opportunity to visualise the subtle, non-linear change in the eastward-migrating synoptic systems influencing NSW (including Sydney). The summarisation of long-term, multi-site air quality/meteorological data from the Sydney basin on the SOM plane has identified a set of typical air pollution/meteorological spatial patterns in the region. Importantly, the examination of these patterns in relation to synoptic weather types has provided important visual insights into how local and synoptic meteorological conditions interact with each other and affect the variability of air quality in tandem. The study illustrates that while synoptic circulation types are influential, the within-type variability in mesoscale flows plays a critical role in determining local ozone levels in Sydney. These results indicate that the SOM can be a useful tool for assessing the impact of weather and climatic conditions on air quality in the regional airshed. This study further promotes the use of the SOM method in environmental research.

  14. Multi-site Study of Diffusion Metric Variability: Characterizing the Effects of Site, Vendor, Field Strength, and Echo Time using the Histogram Distance

    PubMed Central

    Helmer, K. G.; Chou, M-C.; Preciado, R. I.; Gimi, B.; Rollins, N. K.; Song, A.; Turner, J.; Mori, S.

    2016-01-01

    MRI-based multi-site trials now routinely include some form of diffusion-weighted imaging (DWI) in their protocol. These studies can include data originating from scanners built by different vendors, each with their own set of unique protocol restrictions, including restrictions on the number of available gradient directions, whether an externally-generated list of gradient directions can be used, and restrictions on the echo time (TE). One challenge of multi-site studies is to create a common imaging protocol that will result in a reliable and accurate set of diffusion metrics. The present study describes the effect of site, scanner vendor, field strength, and TE on two common metrics: the first moment of the diffusion tensor field (mean diffusivity, MD), and the fractional anisotropy (FA). We have shown in earlier work that ROI metrics and the mean of MD and FA histograms are not sufficiently sensitive for use in site characterization. Here we use the distance between whole brain histograms of FA and MD to investigate within- and between-site effects. We concluded that the variability of DTI metrics due to site, vendor, field strength, and echo time could influence the results in multi-center trials and that histogram distance is sensitive metrics for each of these variables. PMID:27350723

  15. Supporting research sites in resource-limited settings: Challenges in implementing IT infrastructure

    PubMed Central

    Whalen, Christopher; Donnell, Deborah; Tartakovsky, Michael

    2014-01-01

    As Information and Communication Technology infrastructure becomes more reliable, new methods of Electronic Data Capture (EDC), datamarts/Data warehouses, and mobile computing provide platforms for rapid coordination of international research projects and multisite studies. However, despite the increasing availability of internet connectivity and communication systems in remote regions of the world, there are still significant obstacles. Sites with poor infrastructure face serious challenges participating in modern clinical and basic research, particularly that relying on EDC and internet communication technologies. This report discusses our experiences in supporting research in resource-limited settings (RLS). We describe examples of the practical and ethical/regulatory challenges raised by use of these newer technologies for data collection in multisite clinical studies. PMID:24321986

  16. Childhood traumatic grief: a multi-site empirical examination of the construct and its correlates.

    PubMed

    Brown, Elissa J; Amaya-Jackson, Lisa; Cohen, Judith; Handel, Stephanie; Thiel De Bocanegra, Heike; Zatta, Eileen; Goodman, Robin F; Mannarino, Anthony

    2008-01-01

    This study evaluated the construct of childhood traumatic grief (CTG) and its correlates through a multi-site assessment of 132 bereaved children and adolescents. Youth completed a new measure of the characteristics, attributions, and reactions to exposure to death (CARED), as well as measures of CTG, posttraumatic stress disorder (PTSD), depression, and anger. CTG was distinct from but highly correlated with PTSD, depression, and, to a lesser degree, anger. In contrast to a recent study of complicated grief, CTG severity was significantly associated with the degree to which the death was viewed as traumatic. CTG was also associated with caregivers' emotional reaction at the time of the death and caregivers' current sadness. Clinical implications and recommendations for future research are discussed.

  17. Supporting research sites in resource-limited settings: challenges in implementing information technology infrastructure.

    PubMed

    Whalen, Christopher J; Donnell, Deborah; Tartakovsky, Michael

    2014-01-01

    As information and communication technology infrastructure becomes more reliable, new methods of electronic data capture, data marts/data warehouses, and mobile computing provide platforms for rapid coordination of international research projects and multisite studies. However, despite the increasing availability of Internet connectivity and communication systems in remote regions of the world, there are still significant obstacles. Sites with poor infrastructure face serious challenges participating in modern clinical and basic research, particularly that relying on electronic data capture and Internet communication technologies. This report discusses our experiences in supporting research in resource-limited settings. We describe examples of the practical and ethical/regulatory challenges raised by the use of these newer technologies for data collection in multisite clinical studies.

  18. The Growth of Multi-Site Fatigue Damage in Fuselage Lap Joints

    NASA Technical Reports Server (NTRS)

    Piascik, Robert S.; Willard, Scott A.

    1999-01-01

    Destructive examinations were performed to document the progression of multi-site damage (MSD) in three lap joint panels that were removed from a full scale fuselage test article that was tested to 60,000 full pressurization cycles. Similar fatigue crack growth characteristics were observed for small cracks (50 microns to 10 mm) emanating from counter bore rivets, straight shank rivets, and 100 deg counter sink rivets. Good correlation of the fatigue crack growth data base obtained in this study and FASTRAN Code predictions show that the growth of MSD in the fuselage lap joint structure can be predicted by fracture mechanics based methods.

  19. A Bayesian comparative effectiveness trial in action: developing a platform for multisite study adaptive randomization.

    PubMed

    Brown, Alexandra R; Gajewski, Byron J; Aaronson, Lauren S; Mudaranthakam, Dinesh Pal; Hunt, Suzanne L; Berry, Scott M; Quintana, Melanie; Pasnoor, Mamatha; Dimachkie, Mazen M; Jawdat, Omar; Herbelin, Laura; Barohn, Richard J

    2016-08-31

    In the last few decades, the number of trials using Bayesian methods has grown rapidly. Publications prior to 1990 included only three clinical trials that used Bayesian methods, but that number quickly jumped to 19 in the 1990s and to 99 from 2000 to 2012. While this literature provides many examples of Bayesian Adaptive Designs (BAD), none of the papers that are available walks the reader through the detailed process of conducting a BAD. This paper fills that gap by describing the BAD process used for one comparative effectiveness trial (Patient Assisted Intervention for Neuropathy: Comparison of Treatment in Real Life Situations) that can be generalized for use by others. A BAD was chosen with efficiency in mind. Response-adaptive randomization allows the potential for substantially smaller sample sizes, and can provide faster conclusions about which treatment or treatments are most effective. An Internet-based electronic data capture tool, which features a randomization module, facilitated data capture across study sites and an in-house computation software program was developed to implement the response-adaptive randomization. A process for adapting randomization with minimal interruption to study sites was developed. A new randomization table can be generated quickly and can be seamlessly integrated in the data capture tool with minimal interruption to study sites. This manuscript is the first to detail the technical process used to evaluate a multisite comparative effectiveness trial using adaptive randomization. An important opportunity for the application of Bayesian trials is in comparative effectiveness trials. The specific case study presented in this paper can be used as a model for conducting future clinical trials using a combination of statistical software and a web-based application. ClinicalTrials.gov Identifier: NCT02260388 , registered on 6 October 2014.

  20. A Multisite Evaluation of Reading Is Fundamental: Summary Report.

    ERIC Educational Resources Information Center

    Parker, Ronald K.; And Others

    Reading Is Fundamental (RIF) is a national program that seeks to motivate children to read. Implemented by local sponsors and aimed at disadvantaged groups, it offers participating children a wide selection of attractive paperback books about interesting people, places, and events. The multisite evaluation summarized in this report studied…

  1. A Multisite Evaluation of Reading Is Fundamental: Technical Report.

    ERIC Educational Resources Information Center

    Parker, Ronald K.; And Others

    Reading Is Fundamental (RIF) is a national program that seeks to motivate children to read. Implemented by local sponsors and aimed at disadvantaged groups, it offers participating children a wide selection of attractive paperbound books about interesting people, places, and events. The multisite evaluation discussed in this technical report…

  2. Network cyberinfrastructure as a shared platform to support multi-site research

    USDA-ARS?s Scientific Manuscript database

    Multi-site research across the Long-term Agroecosystem Research (LTAR) network requires access to data and information. We present some existing examples where you can get data from across the network and summarize the rich inventory of measurements taken across LTAR sites. But data management suppo...

  3. The National Trauma Institute: Lessons learned in the funding and conduct of 16 trauma research studies.

    PubMed

    Price, Michelle A; Beilman, Gregory J; Fabian, Timothy C; Hoyt, David B; Jurkovich, Gregory J; Knudson, M Margaret; MacKenzie, Ellen J; Marshall, Vivienne S; Overton, Kimberly E; Peitzman, Andrew B; Phillips, Monica J; Pruitt, Basil A; Smith, Sharon L; Stewart, Ronald M; Jenkins, Donald H

    2016-09-01

    To increase trauma-related research and elevate trauma on the national research agenda, the National Trauma Institute (NTI) issued calls for proposals, selected funding recipients, and coordinated 16 federally funded (Department of Defense) trauma research awards over a 4-year period. We sought to collect and describe the lessons learned from this activity to inform future researchers of barriers and facilitators. Fifteen principal investigators participated in semistructured interviews focused on study management issues such as securing institutional approvals, screening and enrollment, multisite trials management, project funding, staffing, and institutional support. NTI Science Committee meeting minutes and study management data were included in the analysis. Simple descriptive statistics were generated and textual data were analyzed for common themes. Principal investigators reported challenges in obtaining institutional approvals, delays in study initiation, screening and enrollment, multisite management, and study funding. Most were able to successfully resolve challenges and have been productive in terms of scholarly publications, securing additional research funding, and training future trauma investigators. Lessons learned in the conduct of the first two funding rounds managed by NTI are instructive in four key areas: regulatory processes, multisite coordination, adequate funding, and the importance of an established research infrastructure to ensure study success. Recommendations for addressing institution-related and investigator-related challenges are discussed along with ongoing advocacy efforts to secure sustained federal funding of a national trauma research program commensurate with the burden of injury.

  4. The work of commissioning: a multisite case study of healthcare commissioning in England's NHS

    PubMed Central

    Shaw, Sara E; Smith, Judith A; Porter, Alison; Rosen, Rebecca; Mays, Nicholas

    2013-01-01

    Objective To examine the work of commissioning care for people with long-term conditions and the factors inhibiting or facilitating commissioners making service change. Design Multisite mixed methods case study research, combining qualitative analysis of interviews, documents and observation of meetings. Participants Primary care trust managers and clinicians, general practice-based commissioners, National Health Service trust and foundation trust senior managers and clinicians, voluntary sector and local government representatives. Setting Three ‘commissioning communities’ (areas covered by a primary care trust) in England, 2010–2012. Results Commissioning services for people with long-term conditions was a long drawn-out process involving a range of activities and partners. Only some of the activities undertaken by commissioners, such as assessment of local health needs, coordination of healthcare planning and service specification, appeared in the official ‘commissioning cycle’ promoted by the Department of Health. Commissioners undertook a significant range of additional activities focused on reviewing and redesigning services and providing support for implementation of new services. These activities often involved partnership working with providers and other stakeholders and appeared to be largely divorced from contracting and financial negotiations. At least for long-term condition services, the time and effort involved in such work appeared to be disproportionate to the anticipated or likely service gains. Commissioners adopting an incremental approach to service change in defined and manageable areas of work appeared to be more successful in terms of delivering planned changes in service delivery than those attempting to bring about wide-scale change across complex systems. Conclusions Commissioning for long-term condition services challenges the conventional distinction between commissioners and providers with a significant amount of work focused on redesigning services in partnership with providers. Such work is labour-intensive and potentially unsustainable at a time of reduced finances. New clinical commissioning groups will need to determine how best to balance the relational and transactional elements of commissioning. PMID:24014483

  5. Integration of DNA sample collection into a multi-site birth defects case-control study.

    PubMed

    Rasmussen, Sonja A; Lammer, Edward J; Shaw, Gary M; Finnell, Richard H; McGehee, Robert E; Gallagher, Margaret; Romitti, Paul A; Murray, Jeffrey C

    2002-10-01

    Advances in quantitative analysis and molecular genotyping have provided unprecedented opportunities to add biological sampling and genetic information to epidemiologic studies. The purpose of this article is to describe the incorporation of DNA sample collection into the National Birth Defects Prevention Study (NBDPS), an ongoing case-control study in an eight-state consortium with a primary goal to identify risk factors for birth defects. Babies with birth defects are identified through birth defects surveillance systems in the eight participating centers. Cases are infants with one or more of over 30 major birth defects. Controls are infants without defects from the same geographic area. Epidemiologic information is collected through an hour-long interview with mothers of both cases and controls. We added the collection of buccal cytobrush DNA samples for case-infants, control-infants, and their parents to this study. We describe here the methods by which the samples have been collected and processed, establishment of a centralized resource for DNA banking, and quality control, database management, access, informed consent, and confidentiality issues. Biological sampling and genetic analyses are important components to epidemiologic studies of birth defects aimed at identifying risk factors. The DNA specimens collected in this study can be used for detection of mutations, study of polymorphic variants that confer differential susceptibility to teratogens, and examination of interactions among genetic risk factors. Information on the methods used and issues faced by the NBDPS may be of value to others considering the addition of DNA sampling to epidemiologic studies.

  6. Lessons learned from a practice-based, multi-site intervention study with nurse participants

    PubMed Central

    Friese, Christopher R.; Mendelsohn-Victor, Kari; Ginex, Pamela; McMahon, Carol M.; Fauer, Alex J.; McCullagh, Marjorie C.

    2016-01-01

    Purpose To identify challenges and solutions to the efficient conduct of a multi-site, practice-based randomized controlled trial to improve nurses’ adherence to personal protective equipment use in ambulatory oncology settings. Design The Drug Exposure Feedback and Education for Nurses’ Safety (DEFENS) study is a clustered, randomized, controlled trial. Participating sites are randomized to web-based feedback on hazardous drug exposures in the sites plus tailored messages to address barriers versus a control intervention of a web-based continuing education video. Approach The study principal investigator, the study coordinator, and two site leaders identified challenges to study implementation and potential solutions, plus potential methods to prevent logistical challenges in future studies. Findings Noteworthy challenges included variation in human subjects protection policies, grants and contracts budgeting, infrastructure for nursing-led research, and information technology variation. Successful strategies included scheduled web conferences, site-based study champions, site visits by the principal investigator, and centrally-based document preparation. Strategies to improve efficiency in future studies include early and continued engagement with contract personnel in sites, and proposed changes to the common rule concerning human subjects. The DEFENS study successfully recruited 393 nurses across 12 sites. To date, 369 have completed surveys and 174 nurses have viewed educational materials. Conclusions Multi-site studies of nursing personnel are rare and challenging to existing infrastructure. These barriers can be overcome with strong engagement and planning. Clinical Relevance Leadership engagement, onsite staff support, and continuous communication can facilitate successful recruitment to a workplace-based randomized, controlled behavioral trial. PMID:28098951

  7. Issues in the design of multisite clinical trials of psychotherapy: VA Cooperative Study No. 494 as an example.

    PubMed

    Schnurr, Paula P; Friedman, Matthew J; Engel, Charles C; Foa, Edna B; Shea, M Tracie; Resick, Patricia M; James, Kenneth E; Chow, Bruce K

    2005-12-01

    This article describes issues in the design of an ongoing multisite randomized clinical trial of psychotherapy for treating posttraumatic stress disorder (PTSD) in female veterans and active duty personnel. Research aimed at testing treatments for PTSD in women who have served in the military is especially important due to the high prevalence of PTSD in this population. VA Cooperative Study 494 was designed to enroll 384 participants across 12 sites. Participants are randomly assigned to receive 10 weekly sessions of individual psychotherapy: Prolonged Exposure, a specific cognitive-behavioral therapy protocol for PTSD, or present-centered therapy, a comparison treatment that addresses current interpersonal problems but avoids a trauma focus. PTSD is the primary outcome. Additional outcomes are comorbid problems such as depression and anxiety; psychosocial function and quality of life; physical health status; satisfaction with treatment; and service utilization. Follow-up assessments are conducted at the end of treatment and then 3 and 6 months after treatment. Both treatments are delivered according to a manual. Videotapes of therapy sessions are viewed by experts who provide feedback to therapists throughout the trial to ensure adherence to the treatment manual. Discussion includes issues encountered in multisite psychotherapy trials along with the rationale for our decisions about how we addressed these issues in CSP #494.

  8. Ten Steps to Conducting a Large, Multi-Site, Longitudinal Investigation of Language and Reading in Young Children

    PubMed Central

    Farquharson, Kelly; Murphy, Kimberly A.

    2016-01-01

    Purpose: This paper describes methodological procedures involving execution of a large-scale, multi-site longitudinal study of language and reading comprehension in young children. Researchers in the Language and Reading Research Consortium (LARRC) developed and implemented these procedures to ensure data integrity across multiple sites, schools, and grades. Specifically, major features of our approach, as well as lessons learned, are summarized in 10 steps essential for successful completion of a large-scale longitudinal investigation in early grades. Method: Over 5 years, children in preschool through third grade were administered a battery of 35 higher- and lower-level language, listening, and reading comprehension measures (RCM). Data were collected from children, their teachers, and their parents/guardians at four sites across the United States. Substantial and rigorous effort was aimed toward maintaining consistency in processes and data management across sites for children, assessors, and staff. Conclusion: With appropriate planning, flexibility, and communication strategies in place, LARRC developed and executed a successful multi-site longitudinal research study that will meet its goal of investigating the contribution and role of language skills in the development of children's listening and reading comprehension. Through dissemination of our design strategies and lessons learned, research teams embarking on similar endeavors can be better equipped to anticipate the challenges. PMID:27064308

  9. Learning "about" and "from" Variation in Program Impacts Using Multisite Trials. MDRC Working Papers on Research Methodology

    ERIC Educational Resources Information Center

    Raudenbush, Stephen W.; Bloom, Howard S.

    2015-01-01

    The present paper, which is intended for a diverse audience of evaluation researchers, applied social scientists, and research funders, provides a broad overview of the conceptual and statistical issues involved in using multisite randomized trials to learn "about" and "from" variation in program effects across…

  10. Learning about and from a Distribution of Program Impacts Using Multisite Trials

    ERIC Educational Resources Information Center

    Raudenbush, Stephen W.; Bloom, Howard S.

    2015-01-01

    The present article provides a synthesis of the conceptual and statistical issues involved in using multisite randomized trials to learn about and from a distribution of heterogeneous program impacts across individuals and/or program sites. Learning "about" such a distribution involves estimating its mean value, detecting and quantifying…

  11. Statistical Analysis for Multisite Trials Using Instrumental Variables with Random Coefficients

    ERIC Educational Resources Information Center

    Raudenbush, Stephen W.; Reardon, Sean F.; Nomi, Takako

    2012-01-01

    Multisite trials can clarify the average impact of a new program and the heterogeneity of impacts across sites. Unfortunately, in many applications, compliance with treatment assignment is imperfect. For these applications, we propose an instrumental variable (IV) model with person-specific and site-specific random coefficients. Site-specific IV…

  12. How Does a Multi-Site Institution Plan Effectively?

    ERIC Educational Resources Information Center

    Jefferson, Curtis F.

    A multi-site college plans effectively by having in place planning and evaluation systems that enhance its capability to respond effectively to changes in the environment in order to continue to provide high quality educational programs and services for the people in its service area. The effectiveness of these systems is dependent on clearly…

  13. Site Matters: Multisite Randomized Trial of Motivational Enhancement Therapy in Community Drug Abuse Clinics

    ERIC Educational Resources Information Center

    Ball, Samuel A.; Martino, Steve; Nich, Charla; Frankforter, Tami L.; Van Horn, Deborah; Crits-Christoph, Paul; Woody, George E.; Obert, Jeanne L.; Farentinos, Christiane; Carroll, Kathleen M.

    2007-01-01

    The effectiveness of motivational enhancement therapy (MET) in comparison with counseling as usual (CAU) for increasing retention and reducing substance use was evaluated in a multisite randomized clinical trial. Participants were 461 outpatients treated by 31 therapists within 1 of 5 outpatient substance abuse programs. There were no retention…

  14. Non-Gaussian spatiotemporal simulation of multisite daily precipitation: downscaling framework

    NASA Astrophysics Data System (ADS)

    Ben Alaya, M. A.; Ouarda, T. B. M. J.; Chebana, F.

    2018-01-01

    Probabilistic regression approaches for downscaling daily precipitation are very useful. They provide the whole conditional distribution at each forecast step to better represent the temporal variability. The question addressed in this paper is: how to simulate spatiotemporal characteristics of multisite daily precipitation from probabilistic regression models? Recent publications point out the complexity of multisite properties of daily precipitation and highlight the need for using a non-Gaussian flexible tool. This work proposes a reasonable compromise between simplicity and flexibility avoiding model misspecification. A suitable nonparametric bootstrapping (NB) technique is adopted. A downscaling model which merges a vector generalized linear model (VGLM as a probabilistic regression tool) and the proposed bootstrapping technique is introduced to simulate realistic multisite precipitation series. The model is applied to data sets from the southern part of the province of Quebec, Canada. It is shown that the model is capable of reproducing both at-site properties and the spatial structure of daily precipitations. Results indicate the superiority of the proposed NB technique, over a multivariate autoregressive Gaussian framework (i.e. Gaussian copula).

  15. A Meta-Analysis and Multisite Time-Series Analysis of the Differential Toxicity of Major Fine Particulate Matter Constituents

    PubMed Central

    Levy, Jonathan I.; Diez, David; Dou, Yiping; Barr, Christopher D.; Dominici, Francesca

    2012-01-01

    Health risk assessments of particulate matter less than 2.5 μm in diameter (PM2.5) often assume that all constituents of PM2.5 are equally toxic. While investigators in previous epidemiologic studies have evaluated health risks from various PM2.5 constituents, few have conducted the analyses needed to directly inform risk assessments. In this study, the authors performed a literature review and conducted a multisite time-series analysis of hospital admissions and exposure to PM2.5 constituents (elemental carbon, organic carbon matter, sulfate, and nitrate) in a population of 12 million US Medicare enrollees for the period 2000–2008. The literature review illustrated a general lack of multiconstituent models or insight about probabilities of differential impacts per unit of concentration change. Consistent with previous results, the multisite time-series analysis found statistically significant associations between short-term changes in elemental carbon and cardiovascular hospital admissions. Posterior probabilities from multiconstituent models provided evidence that some individual constituents were more toxic than others, and posterior parameter estimates coupled with correlations among these estimates provided necessary information for risk assessment. Ratios of constituent toxicities, commonly used in risk assessment to describe differential toxicity, were extremely uncertain for all comparisons. These analyses emphasize the subtlety of the statistical techniques and epidemiologic studies necessary to inform risk assessments of particle constituents. PMID:22510275

  16. A P&T Committee’s Transition to a Complete Electronic Meeting System—A Multisite Institution Experience

    PubMed Central

    Al-Jedai, Ahmed H.; Algain, Roaa A.; Alghamidi, Said A.; Al-Jazairi, Abdulrazaq S.; Amin, Rashid; Bin Hussain, Ibrahim Z.

    2017-01-01

    Purpose In the last few decades, changes to formulary management processes have taken place in institutions with closed formulary systems. However, many P&T committees continued to operate using traditional paper-based systems. Paper-based systems have many limitations, including confidentiality, efficiency, open voting, and paper wastage. This becomes more challenging when dealing with a multisite P&T committee that handles formulary matters across the whole health care system. In this paper, we discuss the implementation of the first paperless, completely electronic, Web-based formulary management system across a large health care system in the Middle East. Summary We describe the transitioning of a multisite P&T committee in a large tertiary care institution from a paper-based to an all-electronic system. The challenges and limitations of running a multisite P&T committee utilizing a paper system are discussed. The design and development of a Web-based committee floor management application that can be used from notebooks, tablets, and hand-held devices is described. Implementation of a flexible, interactive, easy-to-use, and efficient electronic formulary management system is explained in detail. Conclusion The development of an electronic P&T committee meeting system that encompasses electronic document sharing, voting, and communication could help multisite health care systems unify their formularies across multiple sites. Our experience might not be generalizable to all institutions because this depends heavily on system features, existing processes and workflow, and implementation across different sites. PMID:29018301

  17. A P&T Committee's Transition to a Complete Electronic Meeting System-A Multisite Institution Experience.

    PubMed

    Al-Jedai, Ahmed H; Algain, Roaa A; Alghamidi, Said A; Al-Jazairi, Abdulrazaq S; Amin, Rashid; Bin Hussain, Ibrahim Z

    2017-10-01

    In the last few decades, changes to formulary management processes have taken place in institutions with closed formulary systems. However, many P&T committees continued to operate using traditional paper-based systems. Paper-based systems have many limitations, including confidentiality, efficiency, open voting, and paper wastage. This becomes more challenging when dealing with a multisite P&T committee that handles formulary matters across the whole health care system. In this paper, we discuss the implementation of the first paperless, completely electronic, Web-based formulary management system across a large health care system in the Middle East. We describe the transitioning of a multisite P&T committee in a large tertiary care institution from a paper-based to an all-electronic system. The challenges and limitations of running a multisite P&T committee utilizing a paper system are discussed. The design and development of a Web-based committee floor management application that can be used from notebooks, tablets, and hand-held devices is described. Implementation of a flexible, interactive, easy-to-use, and efficient electronic formulary management system is explained in detail. The development of an electronic P&T committee meeting system that encompasses electronic document sharing, voting, and communication could help multisite health care systems unify their formularies across multiple sites. Our experience might not be generalizable to all institutions because this depends heavily on system features, existing processes and workflow, and implementation across different sites.

  18. Replication and Comparison of the Newly Proposed ADOS-2, Module 4 Algorithm in ASD Without ID: A Multi-site Study.

    PubMed

    Pugliese, Cara E; Kenworthy, Lauren; Bal, Vanessa Hus; Wallace, Gregory L; Yerys, Benjamin E; Maddox, Brenna B; White, Susan W; Popal, Haroon; Armour, Anna Chelsea; Miller, Judith; Herrington, John D; Schultz, Robert T; Martin, Alex; Anthony, Laura Gutermuth

    2015-12-01

    Recent updates have been proposed to the Autism Diagnostic Observation Schedule-2 Module 4 diagnostic algorithm. This new algorithm, however, has not yet been validated in an independent sample without intellectual disability (ID). This multi-site study compared the original and revised algorithms in individuals with ASD without ID. The revised algorithm demonstrated increased sensitivity, but lower specificity in the overall sample. Estimates were highest for females, individuals with a verbal IQ below 85 or above 115, and ages 16 and older. Best practice diagnostic procedures should include the Module 4 in conjunction with other assessment tools. Balancing needs for sensitivity and specificity depending on the purpose of assessment (e.g., clinical vs. research) and demographic characteristics mentioned above will enhance its utility.

  19. Self-adaptive tensor network states with multi-site correlators

    NASA Astrophysics Data System (ADS)

    Kovyrshin, Arseny; Reiher, Markus

    2017-12-01

    We introduce the concept of self-adaptive tensor network states (SATNSs) based on multi-site correlators. The SATNS ansatz gradually extends its variational space incorporating the most important next-order correlators into the ansatz for the wave function. The selection of these correlators is guided by entanglement-entropy measures from quantum information theory. By sequentially introducing variational parameters and adjusting them to the system under study, the SATNS ansatz achieves keeping their number significantly smaller than the total number of full-configuration interaction parameters. The SATNS ansatz is studied for manganocene in its lowest-energy sextet and doublet states; the latter of which is known to be difficult to describe. It is shown that the SATNS parametrization solves the convergence issues found for previous correlator-based tensor network states.

  20. Randomized Multi-site Trial of the Job Seekers’ Workshop in Patients with Substance Use Disorders

    PubMed Central

    Svikis, Dace S.; Keyser-Marcus, Lori; Stitzer, Maxine; Rieckmann, Traci; Safford, Lauretta; Loeb, Peter; Allen, Tim; Luna-Anderson, Carol; Back, Sudie E.; Cohen, Judith; DeBernardi, Michael A.; Dillard, Bruce; Forcehimes, Alyssa; Jaffee, William; Killeen, Therese; Kolodner, Ken; Levy, Michael; Pallas, Diane; Perl, Harold I.; Potter, Jennifer Sharpe; Provost, Scott; Reese, Karen; Sampson, Royce R.; Sepulveda, Allison; Snead, Ned; Wong, Conrad J.; Zweben, Joan

    2012-01-01

    Background Unemployment is associated with negative outcomes both during and after drug abuse treatment. Interventions designed to increase rates of employment may also improve drug abuse treatment outcomes. The purpose of this multi-site clinical trial was to evaluate the Job Seekers’ Workshop (JSW), a three session, manualized program designed to train patients in the skills needed to find and secure a job. Method Study participants were recruited through the NIDA Clinical Trials Network (CTN) from six psychosocial counseling (n=327) and five methadone maintenance (n=301) drug treatment programs. Participants were randomly assigned to either standard care (program-specific services plus brochure with local employment resources) (SC) or standard care plus JSW. Three 4-hr small group JSW sessions were offered weekly by trained JSW facilitators with ongoing fidelity monitoring. Results JSW and SC participants had similar 12- and 24-week results for the primary outcome measure (i.e., obtaining a new taxed job or enrollment in a training program), Specifically, one-fifth of participants at 12 weeks (20.1 – 24.3%) and nearly one-third at 24 weeks (31.4–31.9%) had positive outcomes, with “obtaining a new taxed job” accounting for the majority of cases. Conclusion JSW group participants did not have higher rates of employment/training than SC controls. Rates of job acquisition were modest for both groups, suggesting more intensive interventions may be needed. Alternate targets (e.g., enhancing patient motivation, training in job-specific skills) warrant further study as well. PMID:21802222

  1. Negotiation of gender responsibilities in resettled refugee populations through Relationship Enhancement training.

    PubMed

    Bellinger, Goli Amin

    2013-06-01

    Being uprooted, displaced, and resettled can produce great tension in refugee marriages. This paper details a technique to help refugees recognize and manage changes and threats to traditional gender roles after resettlement to western countries. A case study from a multisite psycho-educational marriage project illustrates the application of the Relationship Enhancement model with a Bhutanese couple. Through empathy and structured dialogue, the couple is coached to identify their core concerns about the changes in their lives and come up with mutually beneficial solutions. Focusing on the redistribution of each gender's prescribed responsibilities allows the clinician to respond to the cultural structuring of equitable division of labor while helping families to address new responsibilities in managing household duties, parenting, employment, and finances.

  2. Multi-site study of diffusion metric variability: effects of site, vendor, field strength, and echo time on regions-of-interest and histogram-bin analyses.

    PubMed

    Helmer, K G; Chou, M-C; Preciado, R I; Gimi, B; Rollins, N K; Song, A; Turner, J; Mori, S

    2016-02-27

    It is now common for magnetic-resonance-imaging (MRI) based multi-site trials to include diffusion-weighted imaging (DWI) as part of the protocol. It is also common for these sites to possess MR scanners of different manufacturers, different software and hardware, and different software licenses. These differences mean that scanners may not be able to acquire data with the same number of gradient amplitude values and number of available gradient directions. Variability can also occur in achievable b-values and minimum echo times. The challenge of a multi-site study then, is to create a common protocol by understanding and then minimizing the effects of scanner variability and identifying reliable and accurate diffusion metrics. This study describes the effect of site, scanner vendor, field strength, and TE on two diffusion metrics: the first moment of the diffusion tensor field (mean diffusivity, MD), and the fractional anisotropy (FA) using two common analyses (region-of-interest and mean-bin value of whole brain histograms). The goal of the study was to identify sources of variability in diffusion-sensitized imaging and their influence on commonly reported metrics. The results demonstrate that the site, vendor, field strength, and echo time all contribute to variability in FA and MD, though to different extent. We conclude that characterization of the variability of DTI metrics due to site, vendor, field strength, and echo time is a worthwhile step in the construction of multi-center trials.

  3. What Works Clearinghouse Quick Review: "Transfer Incentives for High-Performing Teachers: Final Results from a Multisite Experiment"

    ERIC Educational Resources Information Center

    What Works Clearinghouse, 2014

    2014-01-01

    "Transfer Incentives for High-Performing Teachers: Final Results from a Multisite Experiment," examined the impact of the Talent Transfer Initiative (TTI) on both student achievement and teacher retention in 10 school districts across seven states. The initiative gave bonuses to high-performing teachers for them to transfer to and stay…

  4. Latent Variable Regression 4-Level Hierarchical Model Using Multisite Multiple-Cohorts Longitudinal Data. CRESST Report 801

    ERIC Educational Resources Information Center

    Choi, Kilchan

    2011-01-01

    This report explores a new latent variable regression 4-level hierarchical model for monitoring school performance over time using multisite multiple-cohorts longitudinal data. This kind of data set has a 4-level hierarchical structure: time-series observation nested within students who are nested within different cohorts of students. These…

  5. Multi-Sited Ethnography and the Field of Educational Research

    ERIC Educational Resources Information Center

    Pierides, Dean

    2010-01-01

    This paper responds to the challenge of how educational research might be practised in a contemporary world that is no longer necessarily organised by nearness and unity. Focusing on ethnography, it argues for what a multi-sited imaginary contributes to research in the field of education. By giving prominence to the notion of multi-sited…

  6. Documenting the Impact of Multisite Evaluations on the Science, Technology, Engineering, and Mathematics Field

    ERIC Educational Resources Information Center

    Roseland, Denise; Greenseid, Lija O.; Volkov, Boris B.; Lawrenz, Frances

    2011-01-01

    This chapter discusses the impact that four multisite National Science Foundation (NSF) evaluations had on the broader field of science, technology, engineering, and mathematics education and evaluation. Three approaches were used to investigate the broader impact of these evaluations on the field: (a) a citation analysis, (b) an on-line survey,…

  7. A Multisite Cluster Randomized Field Trial of Open Court Reading

    ERIC Educational Resources Information Center

    Borman, Geoffrey D.; Dowling, N. Maritza; Schneck, Carrie

    2008-01-01

    In this article, the authors report achievement outcomes of a multisite cluster randomized field trial of Open Court Reading 2005 (OCR), a K-6 literacy curriculum published by SRA/McGraw-Hill. The participants are 49 first-grade through fifth-grade classrooms from predominantly minority and poor contexts across the nation. Blocking by grade level…

  8. Gray Matter Features of Reading Disability: A Combined Meta-Analytic and Direct Analysis Approach1234

    PubMed Central

    Berninger, Virginia W.; Gebregziabher, Mulugeta; Tsu, Loretta

    2016-01-01

    Abstract Meta-analysis of voxel-based morphometry dyslexia studies and direct analysis of 293 reading disability and control cases from six different research sites were performed to characterize defining gray matter features of reading disability. These analyses demonstrated consistently lower gray matter volume in left posterior superior temporal sulcus/middle temporal gyrus regions and left orbitofrontal gyrus/pars orbitalis regions. Gray matter volume within both of these regions significantly predicted individual variation in reading comprehension after correcting for multiple comparisons. These regional gray matter differences were observed across published studies and in the multisite dataset after controlling for potential age and gender effects, and despite increased anatomical variance in the reading disability group, but were not significant after controlling for total gray matter volume. Thus, the orbitofrontal and posterior superior temporal sulcus gray matter findings are relatively reliable effects that appear to be dependent on cases with low total gray matter volume. The results are considered in the context of genetics studies linking orbitofrontal and superior temporal sulcus regions to alleles that confer risk for reading disability. PMID:26835509

  9. Multiyear and multisite photometric campaigns on the bright high-amplitude pulsating subdwarf B star EC 01541-1409

    NASA Astrophysics Data System (ADS)

    Reed, M. D.; Kilkenny, D.; O'Toole, S.; Østensen, R. H.; Honer, C.; Gilker, J. T.; Quint, A. C.; Doennig, A. M.; Hicks, L. H.; Thompson, M. A.; McCart, P. A.; Zietsman, E.; Chen, W.-P.; Chen, C.-W.; Lin, C.-C.; Beck, P.; Degroote, P.; Barlow, B. N.; Reichart, D. E.; Nysewander, M. C.; Lacluyze, A. P.; Ivarsen, K. M.; Haislip, J. B.; Baran, A.; Winiarski, M.; Drozdz, M.

    2012-03-01

    We present follow-up observations of the pulsating subdwarf B (sdB) star EC 01541-1409 as part of our efforts to resolve pulsation spectra for use in asteroseismological analyses. This paper reports on data obtained from a single-site campaign, during 2008, and a multisite campaign, during 2009. From limited 2008 data, we were able to clearly resolve and pre-whiten 24 periods. A subsequent multisite campaign spanning nearly 2 months found over 30 individual periodicities most of which were unstable in amplitude and/or phase. Pulsation amplitudes were found to the detection limit, meaning that further observations would likely reveal more periodicities. EC 01541-1409 reveals itself to be one of two sdB pulsators with many pulsation frequencies covering a large frequency range. Unlike the other star of this type (PG 0048+091), it has one high-amplitude periodicity which appears phase stable, making EC 01541-1409 an excellent candidate for exoplanet studies via pulsation phases. No multiplets were detected leaving EC 01541-1409 as yet another rich p-mode sdB pulsator without these features, limiting observational constraints on pulsation modes.

  10. Use of focus groups in multi-site, multi-ethnic research projects for women's health: a Study of Women Across the Nation (swan) example.

    PubMed

    Kagawa-Singer, Marjorie; Adler, Shelley R; Mouton, Charles E; Ory, Marcia; Underwood, Lynne G

    2009-01-01

    To outline the lessons learned about the use of focus groups for the multisite, multi-ethnic longitudinal Study of Women Across the Nation (SWAN). Focus groups were designed to identify potential cultural differences in the incidence of symptoms and the meaning of transmenopause among women of diverse cultures, and to identify effective recruitment and retention strategies. Inductive and deductive focus groups for a multi-ethnic study. Seven community research sites across the United States conducted focus groups with six ethnic populations: African American, Chinese American, Japanese American, Mexican American, non-Hispanic white, and Puerto Rican. Community women from each ethnic group of color. A set of four/five focus groups in each ethnic group as the formative stage of the deductive, quantitative SWAN survey. Identification of methodological advantages and challenges to the successful implementation of formative focus groups in a multi-ethnic, multi-site population-based epidemiologic study. We provide recommendations from our lessons learned to improve the use of focus groups in future studies with multi-ethnic populations. Mixed methods using inductive and deductive approaches require the scientific integrity of both research paradigms. Adequate resources and time must be budgeted as essential parts of the overall strategy from the outset of study. Inductive cross-cultural researchers should be key team members, beginning with inception through each subsequent design phase to increase the scientific validity, generalizability, and comparability of the results across diverse ethnic groups, to assure the relevance, validity and applicability of the findings to the multicultural population of focus.

  11. Unveiling a novel transient druggable pocket in BACE-1 through molecular simulations: Conformational analysis and binding mode of multisite inhibitors

    PubMed Central

    Di Pietro, Ornella; Laughton, Charles A.

    2017-01-01

    The critical role of BACE-1 in the formation of neurotoxic ß-amyloid peptides in the brain makes it an attractive target for an efficacious treatment of Alzheimer’s disease. However, the development of clinically useful BACE-1 inhibitors has proven to be extremely challenging. In this study we examine the binding mode of a novel potent inhibitor (compound 1, with IC50 80 nM) designed by synergistic combination of two fragments—huprine and rhein—that individually are endowed with very low activity against BACE-1. Examination of crystal structures reveals no appropriate binding site large enough to accommodate 1. Therefore we have examined the conformational flexibility of BACE-1 through extended molecular dynamics simulations, paying attention to the highly flexible region shaped by loops 8–14, 154–169 and 307–318. The analysis of the protein dynamics, together with studies of pocket druggability, has allowed us to detect the transient formation of a secondary binding site, which contains Arg307 as a key residue for the interaction with small molecules, at the edge of the catalytic cleft. The formation of this druggable “floppy” pocket would enable the binding of multisite inhibitors targeting both catalytic and secondary sites. Molecular dynamics simulations of BACE-1 bound to huprine-rhein hybrid compounds support the feasibility of this hypothesis. The results provide a basis to explain the high inhibitory potency of the two enantiomeric forms of 1, together with the large dependence on the length of the oligomethylenic linker. Furthermore, the multisite hypothesis has allowed us to rationalize the inhibitory potency of a series of tacrine-chromene hybrid compounds, specifically regarding the apparent lack of sensitivity of the inhibition constant to the chemical modifications introduced in the chromene unit. Overall, these findings pave the way for the exploration of novel functionalities in the design of optimized BACE-1 multisite inhibitors. PMID:28505196

  12. The Setting-up of Multi-Site School Collaboratives: The Benefits of This Organizational Reform in Terms of Networking Opportunities and Their Effects

    ERIC Educational Resources Information Center

    Mifsud, Denise

    2015-01-01

    This article, which is set within the Maltese education scenario of unfolding decentralization through the setting-up of multi-site school collaboratives (legally termed "colleges") via a policy mandate, explores a particular aspect of this reform--that of "networking". This is examined in terms of the potential for…

  13. How Much Do the Effects of Education and Training Programs Vary across Sites? Evidence from Past Multisite Randomized Trials

    ERIC Educational Resources Information Center

    Weiss, Michael J.; Bloom, Howard S.; Verbitsky-Savitz, Natalya; Gupta, Himani; Vigil, Alma E.; Cullinan, Daniel N.

    2017-01-01

    Multisite trials, in which individuals are randomly assigned to alternative treatment arms within sites, offer an excellent opportunity to estimate the cross-site average effect of treatment assignment (intent to treat or ITT) "and" the amount by which this impact varies across sites. Although both of these statistics are substantively…

  14. Sensitivity of the Modified Children's Yale-Brown Obsessive Compulsive Scale to Detect Change: Results from Two Multi-Site Trials

    ERIC Educational Resources Information Center

    Scahill, Lawrence; Sukhodolsky, Denis G.; Anderberg, Emily; Dimitropoulos, Anastasia; Dziura, James; Aman, Michael G.; McCracken, James; Tierney, Elaine; Hallett, Victoria; Katz, Karol; Vitiello, Benedetto; McDougle, Christopher

    2016-01-01

    Repetitive behavior is a core feature of autism spectrum disorder. We used 8-week data from two federally funded, multi-site, randomized trials with risperidone conducted by the Research Units on Pediatric Psychopharmacology Autism Network to evaluate the sensitivity of the Children's Yale-Brown Obsessive Compulsive Scale modified for autism…

  15. Gene Expression-Based Survival Prediction in Lung Adenocarcinoma: A Multi-Site, Blinded Validation Study

    PubMed Central

    Shedden, Kerby; Taylor, Jeremy M.G.; Enkemann, Steve A.; Tsao, Ming S.; Yeatman, Timothy J.; Gerald, William L.; Eschrich, Steve; Jurisica, Igor; Venkatraman, Seshan E.; Meyerson, Matthew; Kuick, Rork; Dobbin, Kevin K.; Lively, Tracy; Jacobson, James W.; Beer, David G.; Giordano, Thomas J.; Misek, David E.; Chang, Andrew C.; Zhu, Chang Qi; Strumpf, Dan; Hanash, Samir; Shepherd, Francis A.; Ding, Kuyue; Seymour, Lesley; Naoki, Katsuhiko; Pennell, Nathan; Weir, Barbara; Verhaak, Roel; Ladd-Acosta, Christine; Golub, Todd; Gruidl, Mike; Szoke, Janos; Zakowski, Maureen; Rusch, Valerie; Kris, Mark; Viale, Agnes; Motoi, Noriko; Travis, William; Sharma, Anupama

    2009-01-01

    Although prognostic gene expression signatures for survival in early stage lung cancer have been proposed, for clinical application it is critical to establish their performance across different subject populations and in different laboratories. Here we report a large, training-testing, multi-site blinded validation study to characterize the performance of several prognostic models based on gene expression for 442 lung adenocarcinomas. The hypotheses proposed examined whether microarray measurements of gene expression either alone or combined with basic clinical covariates (stage, age, sex) can be used to predict overall survival in lung cancer subjects. Several models examined produced risk scores that substantially correlated with actual subject outcome. Most methods performed better with clinical data, supporting the combined use of clinical and molecular information when building prognostic models for early stage lung cancer. This study also provides the largest available set of microarray data with extensive pathological and clinical annotation for lung adenocarcinomas. PMID:18641660

  16. The Study to Explore Early Development (SEED): A Multisite Epidemiologic Study of Autism by the Centers for Autism and Developmental Disabilities Research and Epidemiology (CADDRE) Network

    PubMed Central

    Schendel, Diana; DiGuiseppi, Carolyn; Croen, Lisa; Fallin, M Danielle; Reed, Philip L.; Schieve, Laura; Wiggins, Lisa; Daniels, Julie; Grether, Judith; Levy, Susan; Miller, Lisa; Newschaffer, Craig; Pinto-Martin, Jennifer; Robinson, Cordelia; Windham, Gayle; Alexander, Aimee; Aylsworth, Arthur; Bernal, Pilar; Bonner, Joseph D.; Blaskey, Lisa; Bradley, Chyrise; Collins, Jack; Ferretti, Casara; Farzadegan, Homayoon; Giarelli, Ellen; Harvey, Marques; Hepburn, Susan; Herr, Matthew; Kaparich, Kristina; Landa, Rebecca; Lee, Li-Ching; Levenseller, Brooke; Meyerer, Stacey; Rahbar, Mohammad H.; Ratchford, Andria; Reynolds, Ann; Rosenberg, Steve; Rusyniak, Julie; Shapira, Stuart K.; Smith, Karen; Souders, Margaret; AaronThompson, Patrick; Young, Lisa; Yeargin-Allsopp, Marshalyn

    2015-01-01

    The Study to Explore Early Development (SEED), a multisite investigation addressing knowledge gaps in autism phenotype and etiology, aims to: (1) characterize the autism behavioral phenotype and associated developmental, medical, and behavioral conditions and (2) investigate genetic and environmental risks with emphasis on immunologic, hormonal, gastrointestinal, and sociodemographic characteristics. SEED uses a case–control design with population-based ascertainment of children aged 2–5 years with an autism spectrum disorder (ASD) and children in two control groups—one from the general population and one with non-ASD developmental problems. Data from parent-completed questionnaires, interviews, clinical evaluations, biospecimen sampling, and medical record abstraction focus on the prenatal and early postnatal periods. SEED is a valuable resource for testing hypotheses regarding ASD characteristics and causes. PMID:22350336

  17. Validation of Mismatch Negativity and P3a for Use in Multi-Site Studies of Schizophrenia: Characterization of Demographic, Clinical, Cognitive, and Functional Correlates in COGS-2

    PubMed Central

    Light, Gregory A.; Swerdlow, Neal R.; Thomas, Michael L.; Calkins, Monica E.; Green, Michael F.; Greenwood, Tiffany A.; Gur, Raquel E.; Gur, Ruben C.; Lazzeroni, Laura C.; Nuechterlein, Keith H.; Pela, Marlena; Radant, Allen D.; Seidman, Larry J.; Sharp, Richard F.; Siever, Larry J.; Silverman, Jeremy M.; Sprock, Joyce; Stone, William S.; Sugar, Catherine A.; Tsuang, Debby W.; Tsuang, Ming T.; Braff, David L.; Turetsky, Bruce I.

    2014-01-01

    Mismatch negativity (MMN) and P3a are auditory event-related potential (ERP) components that show robust deficits in schizophrenia (SZ) patients and exhibit qualities of endophenotypes, including substantial heritability, test-retest reliability, and trait-like stability. These measures also fulfill criteria for use as cognition and function-linked biomarkers in outcome studies, but have not yet been validated for use in large-scale multi-site clinical studies. This study tested the feasibility of adding MMN and P3a to the ongoing Consortium on the Genetics of Schizophrenia (COGS) study. The extent to which demographic, clinical, cognitive, and functional characteristics contribute to variability in MMN and P3a amplitudes was also examined. Participants (HCS n=824, SZ n=966) underwent testing at 5 geographically distributed COGS laboratories. Valid ERP data was obtained from 91% of HCS and 91% of SZ patients. Highly significant MMN (d=0.96) and P3a (d=0.93) amplitude reductions were observed in SZ patients, comparable in magnitude to those observed in single-lab studies with no appreciable differences across laboratories. Demographic characteristics accounted for 26% and 18% of the variance in MMN and P3a amplitudes, respectively. Significant relationships were observed among demographically-adjusted MMN and P3a measures and medication status as well as several clinical, cognitive, and functional characteristics of the SZ patients. This study demonstrates that MMN and P3a ERP biomarkers can be feasibly used in multi-site clinical studies. As with many clinical tests of brain function, demographic factors contribute to MMN and P3a amplitudes and should be carefully considered in future biomarker-informed clinical studies. PMID:25449710

  18. Validation of mismatch negativity and P3a for use in multi-site studies of schizophrenia: characterization of demographic, clinical, cognitive, and functional correlates in COGS-2.

    PubMed

    Light, Gregory A; Swerdlow, Neal R; Thomas, Michael L; Calkins, Monica E; Green, Michael F; Greenwood, Tiffany A; Gur, Raquel E; Gur, Ruben C; Lazzeroni, Laura C; Nuechterlein, Keith H; Pela, Marlena; Radant, Allen D; Seidman, Larry J; Sharp, Richard F; Siever, Larry J; Silverman, Jeremy M; Sprock, Joyce; Stone, William S; Sugar, Catherine A; Tsuang, Debby W; Tsuang, Ming T; Braff, David L; Turetsky, Bruce I

    2015-04-01

    Mismatch negativity (MMN) and P3a are auditory event-related potential (ERP) components that show robust deficits in schizophrenia (SZ) patients and exhibit qualities of endophenotypes, including substantial heritability, test-retest reliability, and trait-like stability. These measures also fulfill criteria for use as cognition and function-linked biomarkers in outcome studies, but have not yet been validated for use in large-scale multi-site clinical studies. This study tested the feasibility of adding MMN and P3a to the ongoing Consortium on the Genetics of Schizophrenia (COGS) study. The extent to which demographic, clinical, cognitive, and functional characteristics contribute to variability in MMN and P3a amplitudes was also examined. Participants (HCS n=824, SZ n=966) underwent testing at 5 geographically distributed COGS laboratories. Valid ERP recordings were obtained from 91% of HCS and 91% of SZ patients. Highly significant MMN (d=0.96) and P3a (d=0.93) amplitude reductions were observed in SZ patients, comparable in magnitude to those observed in single-lab studies with no appreciable differences across laboratories. Demographic characteristics accounted for 26% and 18% of the variance in MMN and P3a amplitudes, respectively. Significant relationships were observed among demographically-adjusted MMN and P3a measures and medication status as well as several clinical, cognitive, and functional characteristics of the SZ patients. This study demonstrates that MMN and P3a ERP biomarkers can be feasibly used in multi-site clinical studies. As with many clinical tests of brain function, demographic factors contribute to MMN and P3a amplitudes and should be carefully considered in future biomarker-informed clinical studies. Published by Elsevier B.V.

  19. Artificial redirection of sensation from prosthetic fingers to the phantom hand map on transradial amputees: vibrotactile versus mechanotactile sensory feedback.

    PubMed

    Antfolk, Christian; D'Alonzo, Marco; Controzzi, Marco; Lundborg, Göran; Rosén, Birgitta; Sebelius, Fredrik; Cipriani, Christian

    2013-01-01

    This work assesses the ability of transradial amputees to discriminate multi-site tactile stimuli in sensory discrimination tasks. It compares different sensory feedback modalities using an artificial hand prosthesis in: 1) a modality matched paradigm where pressure recorded on the five fingertips of the hand was fed back as pressure stimulation on five target points on the residual limb; and 2) a modality mismatched paradigm where the pressures were transformed into mechanical vibrations and fed back. Eight transradial amputees took part in the study and were divided in two groups based on the integrity of their phantom map; group A had a complete phantom map on the residual limb whereas group B had an incomplete or nonexisting map. The ability in localizing stimuli was compared with that of 10 healthy subjects using the vibration feedback and 11 healthy subjects using the pressure feedback (in a previous study), on their forearms, in similar experiments. Results demonstrate that pressure stimulation surpassed vibrotactile stimulation in multi-site sensory feedback discrimination. Furthermore, we demonstrate that subjects with a detailed phantom map had the best discrimination performance and even surpassed healthy participants for both feedback paradigms whereas group B had the worst performance overall. Finally, we show that placement of feedback devices on a complete phantom map improves multi-site sensory feedback discrimination, independently of the feedback modality.

  20. Replication and Comparison of the Newly Proposed ADOS-2, Module 4 Algorithm in ASD without ID: A Multi-site Study

    PubMed Central

    Pugliese, Cara E.; Kenworthy, Lauren; Bal, Vanessa Hus; Wallace, Gregory L; Yerys, Benjamin E; Maddox, Brenna B.; White, Susan W.; Popal, Haroon; Armour, Anna Chelsea; Miller, Judith; Herrington, John D.; Schultz, Robert T.; Martin, Alex; Anthony, Laura Gutermuth

    2015-01-01

    Recent updates have been proposed to the Autism Diagnostic Observation Schedule-2 Module 4 diagnostic algorithm. This new algorithm, however, has not yet been validated in an independent sample without intellectual disability (ID). This multi-site study compared the original and revised algorithms in individuals with ASD without ID. The revised algorithm demonstrated increased sensitivity, but lower specificity in the overall sample. Estimates were highest for females, individuals with a verbal IQ below 85 or above 115, and ages 16 and older. Best practice diagnostic procedures should include the Module 4 in conjunction with other assessment tools. Balancing needs for sensitivity and specificity depending on the purpose of assessment (e.g., clinical vs. research) and demographic characteristics mentioned above will enhance its utility. PMID:26385796

  1. Evaluation of vSim for Nursing in an Adult Health Nursing Course: A Multisite Pilot Study.

    PubMed

    Wright, Renée R; Tinnon, Elizabeth A; Newton, Rebecca H

    2018-02-01

    Virtual simulation technology is the next step in using simulation as an accepted teaching-learning pedagogy in nursing. The purpose of this multisite, quasi-experimental, three-group, posttest-only design was to evaluate the effectiveness and participant satisfaction of vSim for Nursing in an Adult Health Nursing course. Although the quantitative findings (examination scores and postsimulation scores) were not statistically significant, participants overwhelmingly found vSim for Nursing to be a positive experiential learning endeavor. Ninety-one percent of the participants (n = 61) indicated that vSim for Nursing helped them understand adult health concepts and that vSim for Nursing was beneficial to learning. vSim for Nursing warrants further investigation, using other methods to measure effectiveness to ascertain whether knowledge acquisition is indeed improved as indicated by participant data in this study.

  2. Use of the World Wide Web for multisite data collection.

    PubMed

    Subramanian, A K; McAfee, A T; Getzinger, J P

    1997-08-01

    As access to the Internet becomes increasingly available, research applications in medicine will increase. This paper describes the use of the Internet, and, more specifically, the World Wide Web (WWW), as a channel of communication between EDs throughout the world and investigators who are interested in facilitating the collection of data from multiple sites. Data entered into user-friendly electronic surveys can be transmitted over the Internet to a database located at the site of the study, rendering geographic separation less of a barrier to the conduction of multisite studies. The electronic format of the data can enable real-time statistical processing while data are stored using existing database technologies. In theory, automated processing of variables within such a database enables early identification of data trends. Methods of ensuring validity, security, and compliance are discussed.

  3. Clinical Findings and Pain Symptoms as Potential Risk Factors for Chronic TMD: Descriptive Data and Empirically Identified Domains from the OPPERA Case-Control Study

    PubMed Central

    Ohrbach, Richard; Fillingim, Roger B.; Mulkey, Flora; Gonzalez, Yoly; Gordon, Sharon; Gremillion, Henry; Lim, Pei-Feng; Ribeiro-Dasilva, Margarete; Greenspan, Joel D.; Knott, Charles; Maixner, William; Slade, Gary

    2011-01-01

    Clinical characteristics might be associated with temporomandibular disorders (TMD) because they are antecedent risk factors that increase the likelihood of a healthy person developing the condition or because they represent signs or symptoms of either subclinical or overt TMD. In this baseline case-control study of the multisite Orofacial Pain: Prospective Evaluation and Risk Assessment (OPPERA) project, 1,633 controls and 185 cases with chronic, painful TMD completed questionnaires and received clinical examinations. Odds ratios measuring association between each clinical factor and TMD were computed, with adjustment for study-site as well as age, sex, and race/ethnicity. Compared to controls, TMD cases reported more trauma, greater parafunction, more headaches and other pain disorders, more functional limitation in using the jaw, more nonpain symptoms in the facial area, more temporomandibular joint noises and jaw locking, more neural or sensory medical conditions, and worse overall medical status. They also exhibited on examination reduced jaw mobility, more joint noises, and a greater number of painful masticatory, cervical, and body muscles upon palpation. The results indicated that TMD cases differ substantially from controls across almost all variables assessed. Future analyses of follow-up data will determine whether these clinical characteristics predict increased risk for developing first-onset pain-related TMD Perspective Clinical findings from OPPERA’s baseline case-control study indicate significant differences between chronic TMD cases and controls with respect to trauma history, parafunction, other pain disorders, health status, and clinical examination data. Future analyses will examine their contribution to TMD onset. PMID:22074750

  4. A study of science leadership and science standards in exemplary standards-based science programs

    NASA Astrophysics Data System (ADS)

    Carpenter, Wendy Renae

    The purpose for conducting this qualitative study was to explore best practices of exemplary standards-based science programs and instructional leadership practices in a charter high school and in a traditional high school. The focus of this study included how twelve participants aligned practices to National Science Education Standards to describe their science programs and science instructional practices. This study used a multi-site case study qualitative design. Data were obtained through a review of literature, interviews, observations, review of educational documents, and researcher's notes collected in a field log. The methodology used was a multi-site case study because of the potential, through cross analysis, for providing greater explanation of the findings in the study (Merriam, 1988). This study discovered six characteristics about the two high school's science programs that enhance the literature found in the National Science Education Standards; (a) Culture of expectations for learning-In exemplary science programs teachers are familiar with a wide range of curricula. They have the ability to examine critically and select activities to use with their students to promote the understanding of science; (b) Culture of varied experiences-In exemplary science programs students are provided different paths to learning, which help students, take in information and make sense of concepts and skills that are set forth by the standards; (c) Culture of continuous feedback-In exemplary science programs teachers and students work together to engage students in ongoing assessments of their work and that of others as prescribed in the standards; (d) Culture of Observations-In exemplary science programs students, teachers, and principals reflect on classroom instructional practices; teachers receive ongoing evaluations about their teaching and apply feedback towards improving practices as outlined in the standards; (e) Culture of continuous learning-In exemplary science programs teachers value continuous personal development, teachers are provided on-going science professional development opportunities to improve instructional practices, teachers reflect and share professional practices, and teachers establish professional learning communities within their classrooms; and (f) Culture of shared leadership-In exemplary science programs instructional leadership purposes and values are consistently shared among all stakeholders which are outlined in the standards. These results are potentially useful for understanding exemplary standards-based science programs and science instructional leadership practices as a model for science programs trying to improve science education so that all students can have a true scientific learning experience.

  5. Dynamic NMR under nonstationary conditions: Theoretical model, numerical calculation, and potential of application

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

    Babailov, S. P., E-mail: babajlov@niic.nsc.ru; National Research Tomsk Polytechnic University, Lenin Avenue 30, Tomsk 634050; Purtov, P. A.

    An expression has been derived for the time dependence of the NMR line shape for systems with multi-site chemical exchange in the absence of spin-spin coupling, in a zero saturation limit. The dynamics of variation of the NMR line shape with time is considered in detail for the case of two-site chemical exchange. Mathematical programs have been designed for numerical simulation of the NMR spectra of chemical exchange systems. The analytical expressions obtained are useful for NMR line shape simulations for systems with photoinduced chemical exchange.

  6. Multisite EPR oximetry from multiple quadrature harmonics.

    PubMed

    Ahmad, R; Som, S; Johnson, D H; Zweier, J L; Kuppusamy, P; Potter, L C

    2012-01-01

    Multisite continuous wave (CW) electron paramagnetic resonance (EPR) oximetry using multiple quadrature field modulation harmonics is presented. First, a recently developed digital receiver is used to extract multiple harmonics of field modulated projection data. Second, a forward model is presented that relates the projection data to unknown parameters, including linewidth at each site. Third, a maximum likelihood estimator of unknown parameters is reported using an iterative algorithm capable of jointly processing multiple quadrature harmonics. The data modeling and processing are applicable for parametric lineshapes under nonsaturating conditions. Joint processing of multiple harmonics leads to 2-3-fold acceleration of EPR data acquisition. For demonstration in two spatial dimensions, both simulations and phantom studies on an L-band system are reported. Copyright © 2011 Elsevier Inc. All rights reserved.

  7. Multisite Reliability of MR-Based Functional Connectivity

    PubMed Central

    Noble, Stephanie; Scheinost, Dustin; Finn, Emily S.; Shen, Xilin; Papademetris, Xenophon; McEwen, Sarah C.; Bearden, Carrie E.; Addington, Jean; Goodyear, Bradley; Cadenhead, Kristin S.; Mirzakhanian, Heline; Cornblatt, Barbara A.; Olvet, Doreen M.; Mathalon, Daniel H.; McGlashan, Thomas H.; Perkins, Diana O.; Belger, Aysenil; Seidman, Larry J.; Thermenos, Heidi; Tsuang, Ming T.; van Erp, Theo G.M.; Walker, Elaine F.; Hamann, Stephan; Woods, Scott W.; Cannon, Tyrone D.; Constable, R. Todd

    2016-01-01

    Recent years have witnessed an increasing number of multisite MRI functional connectivity (fcMRI) studies. While multisite studies are an efficient way to speed up data collection and increase sample sizes, especially for rare clinical populations, any effects of site or MRI scanner could ultimately limit power and weaken results. Little data exists on the stability of functional connectivity measurements across sites and sessions. In this study, we assess the influence of site and session on resting state functional connectivity measurements in a healthy cohort of traveling subjects (8 subjects scanned twice at each of 8 sites) scanned as part of the North American Prodrome Longitudinal Study (NAPLS). Reliability was investigated in three types of connectivity analyses: (1) seed-based connectivity with posterior cingulate cortex (PCC), right motor cortex (RMC), and left thalamus (LT) as seeds; (2) the intrinsic connectivity distribution (ICD), a voxel-wise connectivity measure; and (3) matrix connectivity, a whole-brain, atlas-based approach assessing connectivity between nodes. Contributions to variability in connectivity due to subject, site, and day-of-scan were quantified and used to assess between-session (test-retest) reliability in accordance with Generalizability Theory. Overall, no major site, scanner manufacturer, or day-of-scan effects were found for the univariate connectivity analyses; instead, subject effects dominated relative to the other measured factors. However, summaries of voxel-wise connectivity were found to be sensitive to site and scanner manufacturer effects. For all connectivity measures, although subject variance was three times the site variance, the residual represented 60–80% of the variance, indicating that connectivity differed greatly from scan to scan independent of any of the measured factors (i.e., subject, site, and day-of-scan). Thus, for a single 5 min scan, reliability across connectivity measures was poor (ICC=0.07–0.17), but increases with increasing scan duration (ICC=0.21–0.36 at 25 min). The limited effects of site and scanner manufacturer support the use of multisite studies, such as NAPLS, as a viable means of collecting data on rare populations and increasing power in univariate functional connectivity studies. However, the results indicate that aggregation of fcMRI data across longer scan durations is necessary to increase the reliability of connectivity estimates at the single-subject level. PMID:27746386

  8. The Challenges and Benefits of Employing a Mobile Research Fellow to Facilitate Team Work on a Large, Interdisciplinary, Multi-Sited Project

    ERIC Educational Resources Information Center

    Sugden, Fraser; Punch, Samantha

    2014-01-01

    Over the last few years research funding has increasingly moved in favour of large, multi-partner, interdisciplinary and multi-site research projects. This article explores the benefits and challenges of employing a full-time research fellow to work across multiple field sites, with all the local research teams, on an international,…

  9. Distortions in Distributions of Impact Estimates in Multi-Site Trials: The Central Limit Theorem Is Not Your Friend

    ERIC Educational Resources Information Center

    May, Henry

    2014-01-01

    Interest in variation in program impacts--How big is it? What might explain it?--has inspired recent work on the analysis of data from multi-site experiments. One critical aspect of this problem involves the use of random or fixed effect estimates to visualize the distribution of impact estimates across a sample of sites. Unfortunately, unless the…

  10. A Multisite Study of Learning in Introductory Psychology Courses

    ERIC Educational Resources Information Center

    Gurung, Regan A. R.; Daniel, David B.; Landrum, R. Eric

    2012-01-01

    Four hundred and fifty-four students enrolled in introductory psychology at different institutions across the nation participated in a study of factors related to learning. Key measures included an instructor rating, ratings of textbook quality and helpfulness, study time, student self-evaluations of study behaviors, approach to learning,…

  11. Improving Parolees' Participation in Drug Treatment and Other Services through Strengths Case Management.

    PubMed

    Prendergast, Michael; Cartier, Jerome J

    2008-01-01

    In an effort to increase participation in community aftercare treatment for substance-abusing parolees, an intervention based on a transitional case management (TCM) model that focuses mainly on offenders' strengths has been developed and is under testing. This model consists of completion, by the inmate, of a self-assessment of strengths that informs the development of the continuing care plan, a case conference call shortly before release, and strengths case management for three months post-release to promote retention in substance abuse treatment and support the participant's access to designated services in the community. The post-release component consists of a minimum of one weekly client/case manager meeting (in person or by telephone) for 12 weeks. The intervention is intended to improve the transition process from prison to community at both the individual and systems level. Specifically, the intervention is designed to improve outcomes in parolee admission to, and retention in, community-based substance-abuse treatment, parolee access to other needed services, and recidivism rates during the first year of parole. On the systems level, the intervention is intended to improve the communication and collaboration between criminal justice agencies, community-based treatment organizations, and other social and governmental service providers. The TCM model is being tested in a multisite study through the Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) research cooperative funded by the National Institute of Drug Abuse.

  12. Multisite accelerometry for sleep and wake classification in children.

    PubMed

    Lamprecht, Marnie L; Bradley, Andrew P; Tran, Tommy; Boynton, Alison; Terrill, Philip I

    2015-01-01

    Actigraphy is a useful alternative to the gold standard polysomnogram for non-invasively measuring sleep and wakefulness. However, it is unable to accurately assess sleep fragmentation due to its inability to differentiate restless sleep from wakefulness and quiet wake from sleep. This presents significant limitations in the assessment of sleep-related breathing disorders where sleep fragmentation is a common symptom. We propose that this limitation may be caused by hardware constraints and movement representation techniques. Our objective was to determine if multisite tri-axial accelerometry improves sleep and wake classification. Twenty-four patients aged 6-15 years (median: 8 years, 16 male) underwent a diagnostic polysomnogram while simultaneously recording motion from the left wrist and index fingertip, upper thorax and left ankle and great toe using a custom accelerometry system. Movement was quantified using several features and two feature selection techniques were employed to select optimal features for restricted feature set sizes. A heuristic was also applied to identify movements during restless sleep. The sleep and wake classification performance was then assessed and validated against the manually scored polysomnogram using discriminant analysis. Tri-axial accelerometry measured at the wrist significantly improved the wake detection when compared to uni-axial accelerometry (specificity at 85% sensitivity: 71.3(14.2)% versus 55.2(24.7)%, p < 0.01). Multisite accelerometry significantly improved the performance when compared to the single wrist placement (specificity at 85% sensitivity: 82.1(12.5)% versus 71.3(14.2)%, p < 0.05). Our results indicate that multisite accelerometry offers a significant performance benefit which could be further improved by analysing movement in raw multisite accelerometry data.

  13. Which sexual abuse victims receive a forensic medical examination? The impact of Children's Advocacy Centers.

    PubMed

    Walsh, Wendy A; Cross, Theodore P; Jones, Lisa M; Simone, Monique; Kolko, David J

    2007-10-01

    This study examines the impact of Children's Advocacy Centers (CAC) and other factors, such as the child's age, alleged penetration, and injury on the use of forensic medical examinations as part of the response to reported child sexual abuse. This analysis is part of a quasi-experimental study, the Multi-Site Evaluation of Children's Advocacy Centers, which evaluated four CACs relative to within-state non-CAC comparison communities. Case abstractors collected data on forensic medical exams in 1,220 child sexual abuse cases through review of case records. Suspected sexual abuse victims at CACs were two times more likely to have forensic medical examinations than those seen at comparison communities, controlling for other variables. Girls, children with reported penetration, victims who were physically injured while being abused, White victims, and younger children were more likely to have exams, controlling for other variables. Non-penetration cases at CACs were four times more likely to receive exams as compared to those in comparison communities. About half of exams were conducted the same day as the reported abuse in both CAC and comparison communities. The majority of caregivers were very satisfied with the medical professional. Receipt of a medical exam was not associated with offenders being charged. Results of this study suggest that CACs are an effective tool for furthering access to forensic medical examinations for child sexual abuse victims.

  14. SHRINE: Enabling Nationally Scalable Multi-Site Disease Studies

    PubMed Central

    McMurry, Andrew J.; Murphy, Shawn N.; MacFadden, Douglas; Weber, Griffin; Simons, William W.; Orechia, John; Bickel, Jonathan; Wattanasin, Nich; Gilbert, Clint; Trevvett, Philip; Churchill, Susanne; Kohane, Isaac S.

    2013-01-01

    Results of medical research studies are often contradictory or cannot be reproduced. One reason is that there may not be enough patient subjects available for observation for a long enough time period. Another reason is that patient populations may vary considerably with respect to geographic and demographic boundaries thus limiting how broadly the results apply. Even when similar patient populations are pooled together from multiple locations, differences in medical treatment and record systems can limit which outcome measures can be commonly analyzed. In total, these differences in medical research settings can lead to differing conclusions or can even prevent some studies from starting. We thus sought to create a patient research system that could aggregate as many patient observations as possible from a large number of hospitals in a uniform way. We call this system the ‘Shared Health Research Information Network’, with the following properties: (1) reuse electronic health data from everyday clinical care for research purposes, (2) respect patient privacy and hospital autonomy, (3) aggregate patient populations across many hospitals to achieve statistically significant sample sizes that can be validated independently of a single research setting, (4) harmonize the observation facts recorded at each institution such that queries can be made across many hospitals in parallel, (5) scale to regional and national collaborations. The purpose of this report is to provide open source software for multi-site clinical studies and to report on early uses of this application. At this time SHRINE implementations have been used for multi-site studies of autism co-morbidity, juvenile idiopathic arthritis, peripartum cardiomyopathy, colorectal cancer, diabetes, and others. The wide range of study objectives and growing adoption suggest that SHRINE may be applicable beyond the research uses and participating hospitals named in this report. PMID:23533569

  15. Supporting the use of theory in cross-country health services research: a participatory qualitative approach using Normalisation Process Theory as an example

    PubMed Central

    Mair, Frances S; Dowrick, Christopher; Brún, Mary O’Reilly-de; de Brún, Tomas; Burns, Nicola; Lionis, Christos; Saridaki, Aristoula; Papadakaki, Maria; van den Muijsenbergh, Maria; van Weel-Baumgarten, Evelyn; Gravenhorst, Katja; Cooper, Lucy; Princz, Christine; Teunissen, Erik; Mareeuw, Francine van den Driessen; Vlahadi, Maria; Spiegel, Wolfgang; MacFarlane, Anne

    2017-01-01

    Objectives To describe and reflect on the process of designing and delivering a training programme supporting the use of theory, in this case Normalisation Process Theory (NPT), in a multisite cross-country health services research study. Design Participatory research approach using qualitative methods. Setting Six European primary care settings involving research teams from Austria, England, Greece, Ireland, The Netherlands and Scotland. Participants RESTORE research team consisting of 8 project applicants, all senior primary care academics, and 10 researchers. Professional backgrounds included general practitioners/family doctors, social/cultural anthropologists, sociologists and health services/primary care researchers. Primary outcome measures Views of all research team members (n=18) were assessed using qualitative evaluation methods, analysed qualitatively by the trainers after each session. Results Most of the team had no experience of using NPT and many had not applied theory to prospective, qualitative research projects. Early training proved didactic and overloaded participants with information. Drawing on RESTORE’s methodological approach of Participatory Learning and Action, workshops using role play, experiential interactive exercises and light-hearted examples not directly related to the study subject matter were developed. Evaluation showed the study team quickly grew in knowledge and confidence in applying theory to fieldwork. Recommendations applicable to other studies include: accepting that theory application is not a linear process, that time is needed to address researcher concerns with the process, and that experiential, interactive learning is a key device in building conceptual and practical knowledge. An unanticipated benefit was the smooth transition to cross-country qualitative coding of study data. Conclusion A structured programme of training enhanced and supported the prospective application of a theory, NPT, to our work but raised challenges. These were not unique to NPT but could arise with the application of any theory, especially in large multisite, international projects. The lessons learnt are applicable to other theoretically informed studies. PMID:28827231

  16. The importance of endophenotypes in schizophrenia research.

    PubMed

    Braff, David L

    2015-04-01

    Endophenotypes provide a powerful neurobiological platform from which we can understand the genomic and neural substrates of schizophrenia and other common complex neuropsychiatric disorders. The Consortium on the Genetics of Schizophrenia (COGS) has conducted multisite studies on carefully selected key neurocognitive and neurophysiological endophenotypes in 300 families (COGS-1) and then in a follow up multisite case-control study of 2471 subjects (COGS-2). Endophenotypes are neurobiologically informed quantitative measures that show deficits in probands and their first degree relatives. They are more amenable to statistical analysis than are "fuzzy" qualitative clinical traits or confoundingly heterogeneous diagnostic categories. Endophenotypes are also viewed as uniquely informative in traditional diagnosis-based as well as emerging NIMH Research Domain (RDoC) contexts, offering a bridge between the two approaches to psychopathology classification and research. Endo- or intermediate phenotypes are heritable, and in the COGS-1 cohort their level of heritability is in the same range as is the heritability of schizophrenia itself, using the same statistical methods and subjects to assess both. Because we can demonstrate endophenotypes link to both gene networks and neural circuits on the one hand and also to real-life function, endophenotypes provide a critically important bridge for "connecting the dots" between genes, cells, circuits, information processing, neurocognition and functional impairment and personalized treatment selection in schizophrenia patients. By connecting schizophrenia risk genes with neurobiologically informed endophenotypes, and via the use of association, linkage, sequencing, stem cell and other strategies, we can provide our field with new neurobiologically informed information in our efforts to understand and treat schizophrenia. Evolving views, data and new analytic strategies about schizophrenia risk, pathology and treatment are described in this Viewpoint and in the accompanying Special Issue reports. Published by Elsevier B.V.

  17. A Comparison of Diarrheal Severity Scores in the MAL-ED Multisite Community-Based Cohort Study

    PubMed Central

    Lee, Gwenyth O.; Richard, Stephanie A.; Kang, Gagandeep; Houpt, Eric R.; Seidman, Jessica C.; Pendergast, Laura L.; Bhutta, Zulfiqar A.; Ahmed, Tahmeed; Mduma, Estomih R.; Lima, Aldo A.; Bessong, Pascal; Jennifer, Mats Steffi; Hossain, Md. Iqbal; Chandyo, Ram Krishna; Nyathi, Emanuel; Lima, Ila F.; Pascal, John; Soofi, Sajid; Ladaporn, Bodhidatta; Guerrant, Richard L.; Caulfield, Laura E.; Black, Robert E.; Kosek, Margaret N.

    2016-01-01

    ABSTRACT Objectives: There is a lack of consensus on how to measure diarrheal severity. Within the context of a multisite, prospective cohort study, we evaluated the performance of a modified Vesikari score (MAL-ED), 2 previously published scores (Clark and CODA [a diarrheal severity score (Community DiarrheA) published by Lee et al]), and a modified definition of moderate-to-severe diarrhea (MSD) based on dysentery and health care worker diagnosed dehydration. Methods: Scores were built using maternally reported symptoms or fieldworker-reported clinical signs obtained during the first 7 days of a diarrheal episode. The association between these and the risk of hospitalization were tested using receiver operating characteristic analysis. Severity scores were also related to illness etiology, and the likelihood of the episode subsequently becoming prolonged or persistent. Results: Of 10,159 episodes from 1681 children, 143 (4.0%) resulted in hospitalization. The area under the curve of each score as a predictor of hospitalization was 0.84 (95% confidence interval: 0.81, 0.87) (Clark), 0.85 (0.82, 0.88) (MAL-ED), and 0.87 (0.84, 0.89) (CODA). Severity was also associated with etiology and episode duration. Although families were more likely to seek care for severe diarrhea, approximately half of severe cases never reached the health system. Conclusions: Community-based diarrheal severity scores are predictive of relevant child health outcomes. Because they require no assumptions about health care access or utilization, they are useful in refining estimates of the burden of diarrheal disease, in estimating the effect of disease control interventions, and in triaging children for referral in low- and middle-income countries in which the rates of morbidity and mortality after diarrhea remain high. PMID:27347723

  18. [Clinical epidemiological study of neural tube defects classified according to the five sites of closure].

    PubMed

    Sanchis Calvo, A; Martínez- Frías, M

    2001-02-01

    To identify the frequency at birth of neural tube defects (NTD) in the Spanish population. NTDs were considered as a whole as well as according to the different sites of closure failure, following the theory of multisite closure of the neural tube. To analyze the epidemiological characteristics of the different sites. Data derived from the Spanish Collaborative Study of Congenital Malformations (ECEMC), from April 1976 to March 1995. Among the 1,222,698 live births during this period, 784 infants had NTD were controlled. Among these, 784 infants had NTD. The prevalence of NTD in our population was 1.01 per 1,000 births, a frequency which is considered medium-to low. Only 5.74% of the NTD were of known etiology: 2.17% were genic, 1.27% were chromosomic and 2.29% were environmental. Excluding NTD of genetic etiology, whether genic or chromosomic, most of the remaining were isolated defects (multifactorial) and 16.78% multiple malformations. Site 1, where the closure of the neural tube starts, represented 24% of all the affected sites. However, more than 50% of the NTDs corresponded to closure failure at the junction of two sites. As in other populations with a low prevalence of NTD at birth, the prevalence of these defects in our population showed a trend to decrease with time, due to the possibility of interrupting gestation after prenatal diagnosis. All the NTD could be classified according to the theory of multisite closure of the neural tube, including 13 cases with several noncontiguous affected sites. Two types of NTD were observed: in the first, closure failed to occur and in the second, two closures failed to meet.

  19. Pediatric Idiopathic Intracranial Hypertension: Age, Gender, and Anthropometric Features at Diagnosis in a Large, Retrospective, Multisite Cohort.

    PubMed

    Sheldon, Claire A; Paley, Grace L; Xiao, Rui; Kesler, Anat; Eyal, Ori; Ko, Melissa W; Boisvert, Chantal J; Avery, Robert A; Salpietro, Vincenzo; Phillips, Paul H; Heidary, Gena; McCormack, Shana E; Liu, Grant T

    2016-11-01

    To examine anthropometric and maturational characteristics at diagnosis in pediatric idiopathic intracranial hypertension (IIH). Retrospective, international, multisite study. Pediatric patients (2-18 years of age at diagnosis) with IIH. Body mass index (BMI), height, and weight Z-scores; sexual maturation. Cases of IIH were identified retrospectively based on diagnostic code, pediatric neuro-ophthalmologist databases, or both and updated diagnostic criteria (2013) were applied to confirm definite IIH. Anthropometric measurements were converted into age- and gender-specific height, weight, and BMI Z-scores CDC 2000 growth charts. When available, sexual maturation was noted. Two hundred thirty-three cases of definite IIH were identified across 8 sites. In boys, a moderate association between age and BMI Z-scores was noted (Pearson's correlation coefficient, 0.50; 95% confidence interval [CI], 0.30-0.66; P < 0.001; n = 72), and in girls, a weak association was noted (Pearson's correlation coefficient, 0.34; 95% CI, 0.20-0.47; P < 0.001; n = 161). The average patient was more likely to be overweight at diagnosis at age 6.7 years in girls and 8.7 years in boys, and obese at diagnosis at age 12.5 years in girls and 12.4 years in boys. Compared with age- and gender-matched reference values, early adolescent patients were taller for age (P = 0.002 in girls and P = 0.02 in boys). Data on Tanner staging, menarchal status, or both were available in 25% of cases (n = 57/233). Prepubertal participants (n = 12) had lower average BMI Z-scores (0.95±1.98) compared with pubertal participants (n = 45; 1.92±0.60), but this result did not reach statistical significance (P = 0.09). With updated diagnostic criteria and pediatric-specific assessments, the present study identifies 3 subgroups of pediatric IIH: a young group that is not overweight, an early adolescent group that is either overweight or obese, and a late adolescent group that is mostly obese. Data also suggest that the early adolescent group with IIH may be taller than age- and gender-matched reference values. Understanding these features of pediatric IIH may help to illuminate the complex pathogenesis of this condition. Copyright © 2016 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  20. Variability of acute extracellular action potential measurements with multisite silicon probes

    PubMed Central

    Scott, Kimberly M.; Du, Jiangang; Lester, Henry A.; Masmanidis, Sotiris C.

    2012-01-01

    Device miniaturization technologies have led to significant advances in sensors for extracellular measurements of electrical activity in the brain. Multisite, silicon-based probes containing implantable electrode arrays afford greater coverage of neuronal activity than single electrodes and therefore potentially offer a more complete view of how neuronal ensembles encode information. However, scaling up the number of sites is not sufficient to ensure capture of multiple neurons, as action potential signals from extracellular electrodes may vary due to numerous factors. In order to understand the large-scale recording capabilities and potential limitations of multisite probes, it is important to quantify this variability, and to determine whether certain key device parameters influence the recordings. Here we investigate the effect of four parameters, namely, electrode surface, width of the structural support shafts, shaft number, and position of the recording site relative to the shaft tip. This study employs acutely implanted silicon probes containing up to 64 recording sites, whose performance is evaluated by the metrics of noise, spike amplitude, and spike detection probability. On average, we find no significant effect of device geometry on spike amplitude and detection probability but we find significant differences among individual experiments, with the likelihood of detecting spikes varying by a factor of approximately three across trials. PMID:22971352

  1. Robust multi-site MR data processing: iterative optimization of bias correction, tissue classification, and registration.

    PubMed

    Young Kim, Eun; Johnson, Hans J

    2013-01-01

    A robust multi-modal tool, for automated registration, bias correction, and tissue classification, has been implemented for large-scale heterogeneous multi-site longitudinal MR data analysis. This work focused on improving the an iterative optimization framework between bias-correction, registration, and tissue classification inspired from previous work. The primary contributions are robustness improvements from incorporation of following four elements: (1) utilize multi-modal and repeated scans, (2) incorporate high-deformable registration, (3) use extended set of tissue definitions, and (4) use of multi-modal aware intensity-context priors. The benefits of these enhancements were investigated by a series of experiments with both simulated brain data set (BrainWeb) and by applying to highly-heterogeneous data from a 32 site imaging study with quality assessments through the expert visual inspection. The implementation of this tool is tailored for, but not limited to, large-scale data processing with great data variation with a flexible interface. In this paper, we describe enhancements to a joint registration, bias correction, and the tissue classification, that improve the generalizability and robustness for processing multi-modal longitudinal MR scans collected at multi-sites. The tool was evaluated by using both simulated and simulated and human subject MRI images. With these enhancements, the results showed improved robustness for large-scale heterogeneous MRI processing.

  2. Evaluation of a multi-site program designed to strengthen relational bonds for siblings separated by foster care.

    PubMed

    Waid, Jeffrey; Wojciak, Armeda Stevenson

    2017-10-01

    Sibling relationships in foster care settings have received increased attention in recent years. Despite growing evidence regarding the protective potential of sibling relationships for youth in care, some sibling groups continue to experience foster care related separation, and few programs exist to address the needs of these youth. This study describes and evaluates Camp To Belong, a multi-site program designed to provide short-term reunification to separated sibling groups through a week-long summer camp experience. Using a pre-test post-test survey design, this paper examines changes in youth ratings of sibling conflict and sibling support across camps located in six geographically distinct regions of the United States. The effects of youth age, number of prior camp exposures, and camp location were tested using multilevel modeling procedures. Findings suggest that participation in Camp To Belong may reduce sibling conflict, and improvements in sibling support are noted for youth who have had prior exposure to the camp's programming. Camp-level variance in the sibling support outcome highlight the complex nature of relationships for siblings separated by foster care, and suggest the need for additional research. Lessons learned from this multi-site evaluation and future directions are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Caring letters for suicide prevention: implementation of a multi-site randomized clinical trial in the U.S. military and Veteran Affairs healthcare systems.

    PubMed

    Luxton, David D; Thomas, Elissa K; Chipps, Joan; Relova, Rona M; Brown, Daphne; McLay, Robert; Lee, Tina T; Nakama, Helenna; Smolenski, Derek J

    2014-03-01

    Caring letters is a suicide prevention intervention that entails the sending of brief messages that espouse caring concern to patients following discharge from treatment. First tested more than four decades ago, this intervention is one of the only interventions shown in a randomized controlled trial to reduce suicide mortality rates. Due to elevated suicide risk among patients following psychiatric hospitalization and the steady increase in suicide rates among the U.S. military personnel, it is imperative to test interventions that may help prevent suicide among high-risk military personnel and veterans. This paper describes the design, methods, study protocol, and regulatory implementation processes for a multi-site randomized controlled trial that aims to evaluate the effectiveness of a caring emails intervention for suicide prevention in the military and VA healthcare systems. The primary outcome is suicide mortality rates to be determined 24 months post-discharge from index hospital stay. Healthcare re-utilization rates will also be evaluated and comprehensive data will be collected regarding suicide risk factors. Recommendations for navigating the military and VA research regulatory processes and implementing a multi-site clinical trial at military and VA hospitals are discussed. Published by Elsevier Inc.

  4. Proton adsorption onto alumina: extension of multisite complexation (MUSIC) theory

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

    Nagashima, K.; Blum, F.D.

    1999-09-01

    The adsorption isotherm of protons onto a commercial {gamma}-alumina sample was determined in aqueous nitric acid with sodium nitrate as a background electrolyte. Three discrete regions could be discerned in the log-log plots of the proton isotherm determined at the solution pH 5 to 2. The multisite complexation (MUSIC) model was modified to analyze the simultaneous adsorption of protons onto various kinds of surface species.

  5. The value and potential of multisited ethnography for science education research: a review of Jrène Rahm's Science in the Making at the Margin

    NASA Astrophysics Data System (ADS)

    Beeman-Cadwallader, Nicole

    2012-03-01

    Rahm sought to illuminate how children and youth make meaning of science in three out-of-school time programs, and the identity work that is done through the trajectory of their youth toward their young adulthood. Through using multisited ethnography, she asserts that we can learn more about what the youth say about their science learning and science literacy development in these programs. She has revealed through her rich data the potential value of multisited ethnography for science education research. A similar theme of insider/outsider status to science emerged in each of the three sites. The nature of the data collected in Rahm's multisited ethnography allowed for the unveiling of the similarities in this theme, but also made evident the nuanced ways that this theme presented itself differently across the three sites. The additional potential came through in the varied data Rahm could have delved into and did not. A unique characteristic of ethnographic research, that is not necessarily present in other research methods, is that a wide array of varied data is collected. An analysis of documents, images, and observational field notes, which go beyond interview data, may provide deeper understandings previously untouched in science education.

  6. Effect Sizes in Cluster-Randomized Designs

    ERIC Educational Resources Information Center

    Hedges, Larry V.

    2007-01-01

    Multisite research designs involving cluster randomization are becoming increasingly important in educational and behavioral research. Researchers would like to compute effect size indexes based on the standardized mean difference to compare the results of cluster-randomized studies (and corresponding quasi-experiments) with other studies and to…

  7. Lifestyle interventions and independence for elders study: Recruitment and baseline characteristics

    USDA-ARS?s Scientific Manuscript database

    Recruitment of older adults into long-term clinical trials involving behavioral interventions is a significant challenge. The Lifestyle Interventions and Independence for Elders (LIFE) Study is a Phase 3 multicenter randomized controlled multisite trial, designed to compare the effects of a moderate...

  8. NCORP Gets Underway

    Cancer.gov

    NCI has awarded 53 new 5-year grants to researchers across the country to conduct multi-site cancer clinical trials and cancer care delivery research studies in their communities. The grants are being awarded under the NCI Community Oncology Research Prog

  9. Characteristics of the Healthy Brain Project Sample: Representing Diversity among Study Participants

    ERIC Educational Resources Information Center

    Bryant, Lucinda L.; Laditka, James N.; Laditka, Sarah B.; Mathews, Anna E.

    2009-01-01

    Purpose: Description of study participants and documentation of the desired diversity in the Prevention Research Centers Healthy Aging Research Network's Workgroup on Promoting Cognitive Health large multisite study designed to examine attitudes about brain health, behaviors associated with its maintenance, and information-receiving preferences…

  10. The subchronic phencyclidine rat model: relevance for the assessment of novel therapeutics for cognitive impairment associated with schizophrenia.

    PubMed

    Janhunen, Sanna K; Svärd, Heta; Talpos, John; Kumar, Gaurav; Steckler, Thomas; Plath, Niels; Lerdrup, Linda; Ruby, Trine; Haman, Marie; Wyler, Roger; Ballard, Theresa M

    2015-11-01

    Current treatments for schizophrenia have modest, if any, efficacy on cognitive dysfunction, creating a need for novel therapies. Their development requires predictive animal models. The N-methyl-D-aspartate (NMDA) hypothesis of schizophrenia indicates the use of NMDA antagonists, like subchronic phencyclidine (scPCP) to model cognitive dysfunction in adult animals. The objective of this study was to assess the scPCP model by (1) reviewing published findings of scPCP-induced neurochemical changes and effects on cognitive tasks in adult rats and (2) comparing findings from a multi-site study to determine scPCP effects on standard and touchscreen cognitive tasks. Across four research sites, the effects of scPCP (typically 5 mg/kg twice daily for 7 days, followed by at least 7-day washout) in adult male Lister Hooded rats were studied on novel object recognition (NOR) with 1-h delay, acquisition and reversal learning in Morris water maze and touchscreen-based visual discrimination. Literature findings showed that scPCP impaired attentional set-shifting (ASST) and NOR in several labs and induced a variety of neurochemical changes across different labs. In the multi-site study, scPCP impaired NOR, but not acquisition or reversal learning in touchscreen or water maze. Yet, this treatment regimen induced locomotor hypersensitivity to acute PCP until 13-week post-cessation. The multi-site study confirmed that scPCP impaired NOR and ASST only and demonstrated the reproducibility and usefulness of the touchscreen approach. Our recommendation, prior to testing novel therapeutics in the scPCP model, is to be aware that further work is required to understand the neurochemical changes and specificity of the cognitive deficits.

  11. Muscular Dystrophy Surveillance Tracking and Research Network (MD STARnet): case definition in surveillance for childhood-onset Duchenne/Becker muscular dystrophy.

    PubMed

    Mathews, Katherine D; Cunniff, Chris; Kantamneni, Jiji R; Ciafaloni, Emma; Miller, Timothy; Matthews, Dennis; Cwik, Valerie; Druschel, Charlotte; Miller, Lisa; Meaney, F John; Sladky, John; Romitti, Paul A

    2010-09-01

    The Muscular Dystrophy Surveillance Tracking and Research Network (MD STARnet) is a multisite collaboration to determine the prevalence of childhood-onset Duchenne/Becker muscular dystrophy and to characterize health care and health outcomes in this population. MD STARnet uses medical record abstraction to identify patients with Duchenne/Becker muscular dystrophy born January 1, 1982 or later who resided in 1 of the participating sites. Critical diagnostic elements of each abstracted record are reviewed independently by >4 clinicians and assigned to 1 of 6 case definition categories (definite, probable, possible, asymptomatic, female, not Duchenne/Becker muscular dystrophy) by consensus. As of November 2009, 815 potential cases were reviewed. Of the cases included in analysis, 674 (82%) were either ''definite'' or ''probable'' Duchenne/Becker muscular dystrophy. These data reflect a change in diagnostic testing, as case assignment based on genetic testing increased from 67% in the oldest cohort (born 1982-1987) to 94% in the cohort born 2004 to 2009.

  12. Overcoming the Challenges of Unstructured Data in Multisite, Electronic Medical Record-based Abstraction.

    PubMed

    Polnaszek, Brock; Gilmore-Bykovskyi, Andrea; Hovanes, Melissa; Roiland, Rachel; Ferguson, Patrick; Brown, Roger; Kind, Amy J H

    2016-10-01

    Unstructured data encountered during retrospective electronic medical record (EMR) abstraction has routinely been identified as challenging to reliably abstract, as these data are often recorded as free text, without limitations to format or structure. There is increased interest in reliably abstracting this type of data given its prominent role in care coordination and communication, yet limited methodological guidance exists. As standard abstraction approaches resulted in substandard data reliability for unstructured data elements collected as part of a multisite, retrospective EMR study of hospital discharge communication quality, our goal was to develop, apply and examine the utility of a phase-based approach to reliably abstract unstructured data. This approach is examined using the specific example of discharge communication for warfarin management. We adopted a "fit-for-use" framework to guide the development and evaluation of abstraction methods using a 4-step, phase-based approach including (1) team building; (2) identification of challenges; (3) adaptation of abstraction methods; and (4) systematic data quality monitoring. Unstructured data elements were the focus of this study, including elements communicating steps in warfarin management (eg, warfarin initiation) and medical follow-up (eg, timeframe for follow-up). After implementation of the phase-based approach, interrater reliability for all unstructured data elements demonstrated κ's of ≥0.89-an average increase of +0.25 for each unstructured data element. As compared with standard abstraction methodologies, this phase-based approach was more time intensive, but did markedly increase abstraction reliability for unstructured data elements within multisite EMR documentation.

  13. Tender Point Count, Pain, and Mobility in the Older Population: The MOBILIZE Boston Study

    PubMed Central

    Eggermont, Laura H.P.; Shmerling, Robert H.; Leveille, Suzanne G.

    2011-01-01

    Prevalence of tender points (TP), widespread pain and fibromyalgia, as well as the relationship between TP, widespread pain and mobility was examined in 585 community-dwelling older adults (mean age 78.2 years, 63.4% female). Pain was based on location (none, single site, multisite, widespread). Mobility was measured by the Short Physical Performance Battery (SPPB), gait speed, and self-reported (S–R) mobility difficulty. Tender point count and health characteristics (i.e. BMI, chronic conditions, analgesic use, number of medications, depression, and blocks walked per week) were assessed. Results Several participants had 3 or more TP (22.1%) although prevalence of criteria-based fibromyalgia was low (0.3%). Mobility was more limited in persons with higher tender point counts. After adjustment for pain and other risk factors, higher tender point count was associated with poorer SPPB performance (score<10, aOR=1.09 per TP, 95%CI, 1.01–1.17), and slow gait speed (<0.784m/sec, aOR=1.14 per TP, 95%CI, 1.05–1.24), but not with S–R mobility difficulty. S–R mobility difficulty was associated with more disseminated pain (multisite pain, aOR=2.01, 95%CI, 1.21–3.34; widespread pain, aOR=2.47, 95%CI, 1.09–5.62). These findings portray a significant mobility burden related to tender point count and multisite and widespread pain in the older population. Future studies using longitudinal methods are warranted. PMID:19665937

  14. Physical Therapy to Treat Torn Meniscus Comparable to Surgery for Many Patients

    MedlinePlus

    ... to Surgery for Many Patients Spotlight on Research Physical Therapy to Treat Torn Meniscus Comparable to Surgery ... to avoid surgery and achieve comparable relief from physical therapy, according to a recent, multisite study funded ...

  15. From Controlled Trial to Community Adoption: The Multisite Translational Community Trial

    PubMed Central

    Murimi, Mary; Gonzalez, Anjelica; Njike, Valentine; Green, Lawrence W.

    2011-01-01

    Methods for translating the findings of controlled trials, such as the Diabetes Prevention Program, into real-world community application have not been clearly defined. A standardized research methodology for making and evaluating such a transition is needed. We introduce the multisite translational community trial (mTCT) as the research analog to the multisite randomized controlled trial. The mTCT is adapted to incorporate the principles and practices of community-based participatory research and the increased relevance and generalizability gained from diverse community settings. The mTCT is a tool designed to bridge the gap between what a clinical trial demonstrates can work in principle and what is needed to make it workable and effective in real-world settings. Its utility could be put to the test, in particular with practice-based research networks such as the Prevention Research Centers. PMID:21680935

  16. Determination of emamectin benzoate in medicated fish feed: a multisite study.

    PubMed

    Farer, Leslie J

    2005-01-01

    A new method was developed for the quantitation of emamectin benzoate in medicated fish feed at levels between 1 and 30 ppm. The new procedure, based on a previously reported assay, consists of a wet methanolic extraction of ground feed, followed by solid-phase extraction and injection onto a gradient liquid chromatographic system. A multisite study involving 3 laboratories (the developing laboratory and 2 independent laboratories) was performed to evaluate precision, recovery, linearity, and sensitivity. Mean recove;ries for triplicate analyses at 3 levels, performed by 2 analysts per laboratory, were between 89 and 97%, with coefficients of variation ranging from 1.6 to 8.6%. Coefficients of determination (r2) obtained from the plotted data were > or =0.993. The precision of the method, determined from 6 replicate preparations from the same batch of medicated feed assayed in 3 separate trials per laboratory, was between 0.6 and 5.8%. The quantitation limit was established at 0.5 ppm. Specificity and robustness studies were performed by the developing laboratory.

  17. Provision of bednets and water filters to delay HIV-1 progression: cost-effectiveness analysis of a Kenyan multisite study.

    PubMed

    Kern, Eli; Verguet, Stéphane; Yuhas, Krista; Odhiambo, Frederick H; Kahn, James G; Walson, Judd

    2013-08-01

    To estimate the effectiveness, costs and cost-effectiveness of providing long-lasting insecticide-treated nets (LLINs) and point-of-use water filters to antiretroviral therapy (ART)-naïve HIV-infected adults and their family members, in the context of a multisite study in Kenya of 589 HIV-positive adults followed on average for 1.7 years. The effectiveness, costs and cost-effectiveness of the intervention were estimated using an epidemiologic-cost model. Model epidemiologic inputs were derived from the Kenya multisite study data, local epidemiological data and from the published literature. Model cost inputs were derived from published literature specific to Kenya. Uncertainty in the model estimates was assessed through univariate and multivariate sensitivity analyses. We estimated net cost savings of about US$ 26 000 for the intervention, over 1.7 years. Even when ignoring net cost savings, the intervention was found to be very cost-effective at a cost of US$ 3100 per death averted or US$ 99 per disability-adjusted life year (DALY) averted. The findings were robust to the sensitivity analysis and remained most sensitive to both the duration of ART use and the cost of ART per person-year. The provision of LLINs and water filters to ART-naïve HIV-infected adults in the Kenyan study resulted in substantial net cost savings, due to the delay in the initiation of ART. The addition of an LLIN and a point-of-use water filter to the existing package of care provided to ART-naïve HIV-infected adults could bring substantial cost savings to resource-constrained health systems in low- and middle-income countries. © 2013 Blackwell Publishing Ltd.

  18. Near-infrared spectroscopy as a predictor of clinical deterioration: a case report of two infants with duct-dependent congenital heart disease.

    PubMed

    Mebius, Mirthe J; du Marchie Sarvaas, Gideon J; Wolthuis, Diana W; Bartelds, Beatrijs; Kneyber, Martin C J; Bos, Arend F; Kooi, Elisabeth M W

    2017-03-16

    Some infants with congenital heart disease are at risk of in-hospital cardiac arrest. To better foresee cardiac arrest in infants with congenital heart disease, it might be useful to continuously assess end-organ perfusion. Near-infrared spectroscopy is a non-invasive method to continuously assess multisite regional tissue oxygen saturation. We report on two infants with duct-dependent congenital heart disease who demonstrated a gradual change in cerebral and/or renal tissue oxygen saturation before cardiopulmonary resuscitation was required. In both cases, other clinical parameters such as heart rate, arterial oxygen saturation and blood pressure did not indicate that deterioration was imminent. These two cases demonstrate that near-infrared spectroscopy might contribute to detecting a deteriorating clinical condition and might therefore be helpful in averting cardiopulmonary collapse and need for resuscitation in infants with congenital heart disease.

  19. Using and Experiencing the Academic Library: A Multisite Observational Study of Space and Place

    ERIC Educational Resources Information Center

    May, Francine; Swabey, Alice

    2015-01-01

    This study examines how students are using academic library spaces and the role these spaces are playing in the campus community. Data were collected on five campuses (two community colleges, two undergraduate universities, and one technical institute) via observational seating sweeps and questionnaires. The study found remarkably similar usage…

  20. Conceptualizing Social Integration among Formerly Homeless Adults with Severe Mental Illness

    ERIC Educational Resources Information Center

    Tsai, Jack; Rosenheck, Robert A.

    2012-01-01

    The multiple dimensions of social integration among formerly homeless adults with severe mental illness have not been well-studied. Previous studies have focused on clinical measures or narrow components of social integration. We used a multisite study of chronically homeless adults who were provided housing to (a) identify the main factors…

  1. Families' Goals, School Involvement, and Children's Academic Achievement: A Follow-Up Study Thirteen Years Later

    ERIC Educational Resources Information Center

    Kyle, Diane W.

    2011-01-01

    A study conducted from 1996-2000 focused on the academic development of children within a statewide educational reform effort, including changing the organizational structure of the early years of schooling into nongraded primary programs (formerly age-based classrooms for kindergarteners through third grade). The multisite study involved children…

  2. Multisite Studies and Scaling up in Educational Research

    ERIC Educational Resources Information Center

    Harwell, Michael

    2012-01-01

    A scale-up study in education typically expands the sample of students, schools, districts, and/or practices or materials used in smaller studies in ways that build in heterogeneity. Yet surprisingly little is known about the factors that promote successful scaling up efforts in education, in large part due to the absence of empirically supported…

  3. State-Space Analysis of Working Memory in Schizophrenia: An FBIRN Study

    ERIC Educational Resources Information Center

    Janoos, Firdaus; Brown, Gregory; Morocz, Istvan A.; Wells, William M., III

    2013-01-01

    The neural correlates of "working memory" (WM) in schizophrenia (SZ) have been extensively studied using the multisite fMRI data acquired by the Functional Biomedical Informatics Research Network (fBIRN) consortium. Although univariate and multivariate analysis methods have been variously employed to localize brain responses under differing task…

  4. Coherent Power Analysis in Multilevel Studies Using Parameters from Surveys

    ERIC Educational Resources Information Center

    Rhoads, Christopher

    2017-01-01

    Researchers designing multisite and cluster randomized trials of educational interventions will usually conduct a power analysis in the planning stage of the study. To conduct the power analysis, researchers often use estimates of intracluster correlation coefficients and effect sizes derived from an analysis of survey data. When there is…

  5. Enhanced efficiency fertilizers: A multi-site comparison of the effects on nitrous oxide emissions and agronomic performance

    USDA-ARS?s Scientific Manuscript database

    The need to understand the effects of enhanced efficiency fertilizers (EEF) for their effect on nitrous oxide emissions and agronomic performance was the motivation underpinning this multi-location study across North America. Research locations participating in this study included Ames, IA; Auburn, ...

  6. Developing Music Teacher Identities: An International Multi-Site Study

    ERIC Educational Resources Information Center

    Ballantyne, Julie; Kerchner, Jody L.; Arostegui, Jose Luis

    2012-01-01

    This study investigates pre-service music teacher's (PSMT) perceptions of their professional identities. University-level education students in the United States America (USA), Spain and Australia were all asked interview questions based on general themes relevant to teacher identity development, and their responses were subjected to content…

  7. Associations between maternal periconceptional exposure to secondhand tobacco smoke and major birth defects.

    PubMed

    Hoyt, Adrienne T; Canfield, Mark A; Romitti, Paul A; Botto, Lorenzo D; Anderka, Marlene T; Krikov, Sergey V; Tarpey, Morgan K; Feldkamp, Marcia L

    2016-11-01

    While associations between secondhand smoke and a few birth defects (namely, oral clefts and neural tube defects) have been noted in the scientific literature, to our knowledge, there is no single or comprehensive source of population-based information on its associations with a range of birth defects among nonsmoking mothers. We utilized data from the National Birth Defects Prevention Study, a large population-based multisite case-control study, to examine associations between maternal reports of periconceptional exposure to secondhand smoke in the household or workplace/school and major birth defects. The multisite National Birth Defects Prevention Study is the largest case-control study of birth defects to date in the United States. We selected cases from birth defect groups having >100 total cases, as well as all nonmalformed controls (10,200), from delivery years 1997 through 2009; 44 birth defects were examined. After excluding cases and controls from multiple births and whose mothers reported active smoking or pregestational diabetes, we analyzed data on periconceptional secondhand smoke exposure-encompassing the period 1 month prior to conception through the first trimester. For the birth defect craniosynostosis, we additionally examined the effect of exposure in the second and third trimesters as well due to the potential sensitivity to teratogens for this defect throughout pregnancy. Covariates included in all final models of birth defects with ≥5 exposed mothers were study site, previous live births, time between estimated date of delivery and interview date, maternal age at estimated date of delivery, race/ethnicity, education, body mass index, nativity, household income divided by number of people supported by this income, periconceptional alcohol consumption, and folic acid supplementation. For each birth defect examined, we used logistic regression analyses to estimate both crude and adjusted odds ratios and 95% confidence intervals for both isolated and total case groups for various sources of exposure (household only; workplace/school only; household and workplace/school; household or workplace/school). The prevalence of secondhand smoke exposure only across all sources ranged from 12.9-27.8% for cases and 14.5-15.8% for controls. The adjusted odds ratios for any vs no secondhand smoke exposure in the household or workplace/school and isolated birth defects were significantly elevated for neural tube defects (anencephaly: adjusted odds ratio, 1.66; 95% confidence interval, 1.22-2.25; and spina bifida: adjusted odds ratio, 1.49; 95% confidence interval, 1.20-1.86); orofacial clefts (cleft lip without cleft palate: adjusted odds ratio, 1.41; 95% confidence interval, 1.10-1.81; cleft lip with or without cleft palate: adjusted odds ratio, 1.24; 95% confidence interval, 1.05-1.46; cleft palate alone: adjusted odds ratio, 1.31; 95% confidence interval, 1.06-1.63); bilateral renal agenesis (adjusted odds ratio, 1.99; 95% confidence interval, 1.05-3.75); amniotic band syndrome-limb body wall complex (adjusted odds ratio, 1.66; 95% confidence interval, 1.10-2.51); and atrial septal defects, secundum (adjusted odds ratio, 1.37; 95% confidence interval, 1.09-1.72). There were no significant inverse associations observed. Additional studies replicating the findings are needed to better understand the moderate positive associations observed between periconceptional secondhand smoke and several birth defects in this analysis. Increased odds ratios resulting from chance (eg, multiple comparisons) or recall bias cannot be ruled out. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Existence of bound states of a polaron with a breather in soft potentials

    NASA Astrophysics Data System (ADS)

    Cuevas, J.; Kevrekidis, P. G.; Frantzeskakis, D. J.; Bishop, A. R.

    2006-08-01

    We consider polarons in models of coupled electronic and vibrational degrees of freedom, in the presence of a soft nonlinear substrate potential (Morse potential). In particular, we focus on a bound state of a polaron with a breather, a so-called “polarobreather.” We analyze the existence of these states based on frequency resonance conditions and illustrate their stability using Floquet spectrum techniques. Multisite solutions of this type are also obtained both in the stationary case (bond-centered and twisted polarons) and in the breathing case (bond-centered and twisted polarobreathers). For all the branches examined, the dynamical evolution of instabilities pertinent to the corresponding solutions are also briefly discussed. Finally, a different branch of so-called phantom polarobreathers is also demonstrated.

  9. Dissemination and implementation: INQRI's potential impact.

    PubMed

    Titler, Marita G; Wilson, Deleise S; Resnick, Barbara; Shever, Leah L

    2013-04-01

    Application of research evidence in care delivery improves patient outcomes. Large gaps still exist, however, between recommended care and that used in practice. To increase the understanding of implementation studies, and dissemination of research findings, we present the perspective of investigators from seven Interdisciplinary Nursing Quality Research Initiative (INQRI)-funded studies. To describe implementation strategies, challenges, and lessons learned from conducting 5 INQRI-funded implementation studies, and present 2 case examples of other INQRI studies to illustrate dissemination strategies. Potential impact of study findings are set forth. Qualitative descriptive methods were used for the implementation studies. Case examples were set forth by investigators using reflection questions. Four of the 5 implementation studies focused on clinical topics and 1 on professional development of nurse managers, 4 were multisite studies. Common implementation strategies used across studies addressed education, ongoing interaction with sites, use of implementation tools, and visibility of the projects on the study units. Major challenges were the Institutional Review Board approval process and the short length of time allocated for implementation. Successes and lessons learned included creating excitement about research, packaging of study tools and resources for use by other organizations, and understanding the importance of context when conducting this type of research. Case examples revealed that study findings have been disseminated to study sites and to the health care community through publications and presentations. The potential impact of all 7 studies is far reaching. This study captures several nuanced perspectives from 5 Principal Investigators, who were completing INQRI-funded implementation studies. These nuanced perspectives are important lessons for other scientists embarking on implementation studies. The INQRI case examples illustrate important dissemination strategies and impact of findings on quality of care.

  10. Designing an audio computer-assisted self-interview (ACASI) system in a multisite trial: a brief report.

    PubMed

    2008-09-01

    To describe the advantages and limitations of an audio computer-assisted self-interview (ACASI) system in a multisite trial with African American couples and to present the steps in designing, testing, and implementing a system. The ACASI system evolved from a paper and pencil interview that was pilot tested. Based on this initial work, the paper and pencil interview was translated into storyboards that were the basis of the development of ACASI system. Storyboards consisted of 1 page per question and provided the programmers with the test of the question, valid responses, and any instructions that were to be read to the participants. Storyboards were further translated into flow diagrams representing each module of the survey and illustrating the skip patterns used to navigate a participant through the survey. Provisions were also made to insert a face-to-face interview, into the ACASI assessment process, to elicit sexual abuse history data, which typically requires specially trained data collectors with active listening skills to help participants reframe and coordinate times, places and, emotionally difficult memories. The ACASI was successfully developed and implemented in the main trial. During an exit interview, respondents indicated that they liked using the ACASI and indicating that they favored it as the method to answer questions. It is feasible to implement an ACASI system in a multisite study in a timely and efficient way.

  11. Dealing with uncertainty in the probability of overtopping of a flood mitigation dam

    NASA Astrophysics Data System (ADS)

    Michailidi, Eleni Maria; Bacchi, Baldassare

    2017-05-01

    In recent years, copula multivariate functions were used to model, probabilistically, the most important variables of flood events: discharge peak, flood volume and duration. However, in most of the cases, the sampling uncertainty, from which small-sized samples suffer, is neglected. In this paper, considering a real reservoir controlled by a dam as a case study, we apply a structure-based approach to estimate the probability of reaching specific reservoir levels, taking into account the key components of an event (flood peak, volume, hydrograph shape) and of the reservoir (rating curve, volume-water depth relation). Additionally, we improve information about the peaks from historical data and reports through a Bayesian framework, allowing the incorporation of supplementary knowledge from different sources and its associated error. As it is seen here, the extra information can result in a very different inferred parameter set and consequently this is reflected as a strong variability of the reservoir level, associated with a given return period. Most importantly, the sampling uncertainty is accounted for in both cases (single-site and multi-site with historical information scenarios), and Monte Carlo confidence intervals for the maximum water level are calculated. It is shown that water levels of specific return periods in a lot of cases overlap, thus making risk assessment, without providing confidence intervals, deceiving.

  12. Risk factors for childhood burns: a case-control study of Ghanaian children.

    PubMed

    Forjuoh, S N; Guyer, B; Strobino, D M; Keyl, P M; Diener-West, M; Smith, G S

    1995-04-01

    To study risk factors for childhood burns in order to identify possible preventive strategies. Case-control design with pair matching of controls to cases in relation to age, sex, and area of residence. The cases and controls were identified by a community based, multisite survey. The effects of host and socioenvironmental variables reported by mothers were investigated in a multivariate analysis using conditional logistic regression. A developing country setting the Ashanti Region in Ghana. These comprised 610 cases aged 0-5 years who had been burned (as evidenced by a visible scar) and 610 controls with no burn history. The presence of a pre-existing impairment in a child was the strongest risk factor in this population (OR = 6.71; 95% CI 2.78, 16.16). Other significant risk factor included: sibling death from a burn (OR = 4.41; 95% CI 1.16, 16.68); history of burn in a sibling (OR = 1.79; 95% CI 1.24, 2.58); and storage of a flammable substance in the home (OR = 1.51; 95% CI 1.03; 2.21). Maternal education had a protective effect against childhood burns, although this effect was not strong (OR = 0.76; 95% CI 0.55, 1.05). Community programmes to ensure adequate child supervision and general child wellbeing, particularly for those with impairments, as well as parental education about burns are recommended, to reduce childhood burns in this region of Ghana. The public should bed advised against storing flammable substances in the home.

  13. HPV Vaccine Effective at Multiple Anatomic Sites

    Cancer.gov

    A new study from NCI researchers finds that the HPV vaccine protects young women from infection with high-risk HPV types at the three primary anatomic sites where persistent HPV infections can cause cancer. The multi-site protection also was observed at l

  14. Clinical Trials in Your Community

    Cancer.gov

    The NCI Community Oncology Research Program (NCORP) is a national network of investigators, cancer care providers, academic institutions, and other organizations. NCORP conducts multi-site cancer clinical trials and studies in diverse populations in community-based healthcare systems across the United States and Puerto Rico.

  15. Therapist strategies early in therapy associated with good or poor outcomes among clients with low proactive agency.

    PubMed

    von der Lippe, Anna Louise; Oddli, Hanne Weie; Halvorsen, Margrethe Seeger

    2017-09-10

    Within a mixed methods program of research the present study aimed at expanding knowledge about interactions in the initial therapeutic collaboration by combining focus on client interpersonal style and therapist contribution. The study involves in-depth analyses of therapist-client interactions in the initial two sessions of good and poor outcome therapies. Based on interpersonal theory and previous research, the Inventory of Interpersonal Problems (IIP-64-C) was used to define poor outcome cases, that is, low proactive agency cases. To compare good and poor outcome cases matched on this interpersonal pattern, cases were drawn from two different samples; nine poor outcome cases from a large multi-site outpatient clinic study and nine good outcome cases from a process-outcome study of highly experienced therapists. Qualitative analysis of therapist behaviors resulted in 2 main categories, fostering client's proactive agentic involvement in change work and discouraging client's proactive agentic involvement in change work, 8 categories and 22 sub-categories. The findings revealed distinct and cohesive differences in therapist behaviors between the two outcome groups, and point to the particular therapist role of fostering client agency through engagement in a shared work on change when clients display strong unassertiveness and low readiness for change. Clinical or Methodological Significance Summary: The present analysis combines focus on client interpersonal style, therapist strategies/process and outcome. The categories generated from the present grounded theory analysis may serve as a foundation for identifying interactions that are associated with agentic involvement in future process research and practice, and hence we have formulated principles/strategies that were identified by the analysis.

  16. Chest Radiograph Findings in Childhood Pneumonia Cases From the Multisite PERCH Study

    PubMed Central

    Deloria Knoll, Maria; Baggett, Henry C.; Brooks, W. Abdullah; Feikin, Daniel R.; Hammitt, Laura L.; Howie, Stephen R. C.; Kotloff, Karen L.; Levine, Orin S.; Madhi, Shabir A.; Murdoch, David R.; Scott, J. Anthony G.; Thea, Donald M.; Awori, Juliet O.; Barger-Kamate, Breanna; Chipeta, James; DeLuca, Andrea N.; Diallo, Mahamadou; Driscoll, Amanda J.; Ebruke, Bernard E.; Higdon, Melissa M.; Jahan, Yasmin; Karron, Ruth A.; Mahomed, Nasreen; Moore, David P.; Nahar, Kamrun; Naorat, Sathapana; Ominde, Micah Silaba; Park, Daniel E.; Prosperi, Christine; wa Somwe, Somwe; Thamthitiwat, Somsak; Zaman, Syed M. A.; Zeger, Scott L.; O’Brien, Katherine L.; O’Brien, Katherine L.; Levine, Orin S.; Knoll, Maria Deloria; Feikin, Daniel R.; DeLuca, Andrea N.; Driscoll, Amanda J.; Fancourt, Nicholas; Fu, Wei; Hammitt, Laura L.; Higdon, Melissa M.; Kagucia, E. Wangeci; Karron, Ruth A.; Li, Mengying; Park, Daniel E.; Prosperi, Christine; Wu, Zhenke; Zeger, Scott L.; Watson, Nora L.; Crawley, Jane; Murdoch, David R.; Brooks, W. Abdullah; Endtz, Hubert P.; Zaman, Khalequ; Goswami, Doli; Hossain, Lokman; Jahan, Yasmin; Ashraf, Hasan; Howie, Stephen R. C.; Ebruke, Bernard E.; Antonio, Martin; McLellan, Jessica; Machuka, Eunice; Shamsul, Arifin; Zaman, Syed M.A.; Mackenzie, Grant; Scott, J. Anthony G.; Awori, Juliet O.; Morpeth, Susan C.; Kamau, Alice; Kazungu, Sidi; Ominde, Micah Silaba; Kotloff, Karen L.; Tapia, Milagritos D.; Sow, Samba O.; Sylla, Mamadou; Tamboura, Boubou; Onwuchekwa, Uma; Kourouma, Nana; Toure, Aliou; Madhi, Shabir A.; Moore, David P.; Adrian, Peter V.; Baillie, Vicky L.; Kuwanda, Locadiah; Mudau, Azwifarwi; Groome, Michelle J.; Mahomed, Nasreen; Baggett, Henry C.; Thamthitiwat, Somsak; Maloney, Susan A.; Bunthi, Charatdao; Rhodes, Julia; Sawatwong, Pongpun; Akarasewi, Pasakorn; Thea, Donald M.; Mwananyanda, Lawrence; Chipeta, James; Seidenberg, Phil; Mwansa, James; wa Somwe, Somwe; Kwenda, Geoffrey

    2017-01-01

    Abstract Background. Chest radiographs (CXRs) are frequently used to assess pneumonia cases. Variations in CXR appearances between epidemiological settings and their correlation with clinical signs are not well documented. Methods. The Pneumonia Etiology Research for Child Health project enrolled 4232 cases of hospitalized World Health Organization (WHO)–defined severe and very severe pneumonia from 9 sites in 7 countries (Bangladesh, the Gambia, Kenya, Mali, South Africa, Thailand, and Zambia). At admission, each case underwent a standardized assessment of clinical signs and pneumonia risk factors by trained health personnel, and a CXR was taken that was interpreted using the standardized WHO methodology. CXRs were categorized as abnormal (consolidation and/or other infiltrate), normal, or uninterpretable. Results. CXRs were interpretable in 3587 (85%) cases, of which 1935 (54%) were abnormal (site range, 35%–64%). Cases with abnormal CXRs were more likely than those with normal CXRs to have hypoxemia (45% vs 26%), crackles (69% vs 62%), tachypnea (85% vs 80%), or fever (20% vs 16%) and less likely to have wheeze (30% vs 38%; all P < .05). CXR consolidation was associated with a higher case fatality ratio at 30-day follow-up (13.5%) compared to other infiltrate (4.7%) or normal (4.9%) CXRs. Conclusions. Clinically diagnosed pneumonia cases with abnormal CXRs were more likely to have signs typically associated with pneumonia. However, CXR-normal cases were common, and clinical signs considered indicative of pneumonia were present in substantial proportions of these cases. CXR-consolidation cases represent a group with an increased likelihood of death at 30 days post-discharge. PMID:28575361

  17. High Prevalence of Multiple Arterial Bed Lesions in Patients With Fibromuscular Dysplasia: The ARCADIA Registry (Assessment of Renal and Cervical Artery Dysplasia).

    PubMed

    Plouin, Pierre-François; Baguet, Jean-Philippe; Thony, Frédéric; Ormezzano, Olivier; Azarine, Arshid; Silhol, François; Oppenheim, Catherine; Bouhanick, Béatrice; Boyer, Louis; Persu, Alexandre; Hammer, Frank; Gosse, Philippe; Mounier-Vehier, Claire; Le Hello, Claire; Jeunemaitre, Xavier; Azizi, Michel; Amar, Laurence; Chatellier, Gilles; Mousseaux, Elie; Touzé, Emmanuel

    2017-09-01

    Fibromuscular dysplasia (FMD) commonly affects the renal and cervical arteries but has been described to affect other vascular beds as well. The prevalence of and clinical characteristics associated with multisite FMD (string-of-beds or focal stenoses affecting at least 2 vascular beds) are not known. In the prospective ARCADIA registry (Assessment of Renal and Cervical Artery Dysplasia), symptomatic patients with renal artery (RA) FMD underwent tomographic- or magnetic resonance-angiography from the aortic arch to the intracranial arteries and those with cervical FMD from the diaphragm to the pelvis. Of 469 patients (84.0% women), 225 (48.0%) had multisite FMD. In addition, 86 of 244 patients with single-site disease had dissections or aneurisms affecting other vascular beds, totaling 311 patients (66.3%) with lesions in >1 vascular bed. Among patients with a cerebrovascular presentation, the prevalence of RA lesions was higher in patients with than in those without hypertension (odds ratio, 3.4; 95% confidence interval, 1.99-6.15). Among patients with a renal presentation, the prevalence of cervical lesions was higher in patients with bilateral than in those with unilateral RA lesions (odds ratio, 1.9; 95% confidence interval, 0.99-3.57). In conclusion, FMD is a systemic arterial disease. At least 2 vascular beds were affected by dysplastic stenoses in 48.0% of cases and by dysplastic stenoses, aneurysms, and dissections in 66.1% of cases. RA imaging should be proposed to hypertensive patients with a cerebrovascular presentation. Cervical artery imaging should be considered in patients with a renal presentation and bilateral RA lesions. URL: www.Clinicaltrials.gov. Unique identifier: NCT02884141. © 2017 American Heart Association, Inc.

  18. The brain-derived neurotrophic factor pathway, life stress, and chronic multi-site musculoskeletal pain.

    PubMed

    Generaal, Ellen; Milaneschi, Yuri; Jansen, Rick; Elzinga, Bernet M; Dekker, Joost; Penninx, Brenda W J H

    2016-01-01

    Brain-derived neurotrophic factor (BDNF) disturbances and life stress, both independently and in interaction, have been hypothesized to induce chronic pain. We examined whether (a) the BDNF pathway (val(66)met genotype, gene expression, and serum levels), (b) early and recent life stress, and (c) their interaction are associated with the presence and severity of chronic multi-site musculoskeletal pain. Cross-sectional data are from 1646 subjects of the Netherlands Study of Depression and Anxiety. The presence and severity of chronic multi-site musculoskeletal pain were determined using the Chronic Pain Grade (CPG) questionnaire. The BDNF val(66)met polymorphism, BDNF gene expression, and BDNF serum levels were measured. Early life stress before the age of 16 was assessed by calculating a childhood trauma index using the Childhood Trauma Interview. Recent life stress was assessed as the number of recent adverse life events using the List of Threatening Events Questionnaire. Compared to val(66)val, BDNF met carriers more often had chronic pain, whereas no differences were found for BDNF gene expression and serum levels. Higher levels of early and recent stress were both associated with the presence and severity of chronic pain (p < 0.001). No interaction effect was found for the BDNF pathway with life stress in the associations with chronic pain presence and severity. This study suggests that the BDNF gene marks vulnerability for chronic pain. Although life stress did not alter the impact of BDNF on chronic pain, it seems an independent factor in the onset and persistence of chronic pain. © The Author(s) 2016.

  19. Overcoming the Challenges of Unstructured Data in Multi-site, Electronic Medical Record-based Abstraction

    PubMed Central

    Polnaszek, Brock; Gilmore-Bykovskyi, Andrea; Hovanes, Melissa; Roiland, Rachel; Ferguson, Patrick; Brown, Roger; Kind, Amy JH

    2014-01-01

    Background Unstructured data encountered during retrospective electronic medical record (EMR) abstraction has routinely been identified as challenging to reliably abstract, as this data is often recorded as free text, without limitations to format or structure. There is increased interest in reliably abstracting this type of data given its prominent role in care coordination and communication, yet limited methodological guidance exists. Objective As standard abstraction approaches resulted in sub-standard data reliability for unstructured data elements collected as part of a multi-site, retrospective EMR study of hospital discharge communication quality, our goal was to develop, apply and examine the utility of a phase-based approach to reliably abstract unstructured data. This approach is examined using the specific example of discharge communication for warfarin management. Research Design We adopted a “fit-for-use” framework to guide the development and evaluation of abstraction methods using a four step, phase-based approach including (1) team building, (2) identification of challenges, (3) adaptation of abstraction methods, and (4) systematic data quality monitoring. Measures Unstructured data elements were the focus of this study, including elements communicating steps in warfarin management (e.g., warfarin initiation) and medical follow-up (e.g., timeframe for follow-up). Results After implementation of the phase-based approach, inter-rater reliability for all unstructured data elements demonstrated kappas of ≥ 0.89 -- an average increase of + 0.25 for each unstructured data element. Conclusions As compared to standard abstraction methodologies, this phase-based approach was more time intensive, but did markedly increase abstraction reliability for unstructured data elements within multi-site EMR documentation. PMID:27624585

  20. Early Implementation Experiences of the 2010 Teacher Incentive Fund Grantees. NCEE Study Snapshot. NCEE 2014-4021

    ERIC Educational Resources Information Center

    National Center for Education Evaluation and Regional Assistance, 2014

    2014-01-01

    The Teacher Incentive Fund (TIF) provides grants to support performance-based compensation systems for teachers and principals in high-need schools. The study measures the impact of pay-for-performance bonuses as part of a comprehensive compensation system within a large, multisite random assignment study design. The treatment schools were to…

  1. Association Between Barriers and Facilitators to Meeting the Dietary Guidelines for Americans and Body Weight Status: The HEALTH Study

    USDA-ARS?s Scientific Manuscript database

    Few Americans meet the Dietary Guidelines for Americans (DGA). Objective: The goal of this research was to examine the association between barriers and facilitators to meeting the DGA and weight in a multi-site study. Design: A cross-sectional study. Participants/Setting: A total of 836 caregiver-ch...

  2. THE HEALTHY MEN STUDY: A MODEL APPROACH FOR EXAMINING POTENTIAL MALE REPRODUCTIVE HEALTH EFFECTS ASSOCIATED WITH EXPOSURE TO DISINFECTION BYPRODUCTS IN DRINKING WATER.

    EPA Science Inventory

    The Healthy Men Study (HMS) is a prospective multisite community study on drinking water disinfection byproducts (DBPs) and male reproductive health. We are testing whether exposure to DBPs in drinking water may be associated with altered semen quality, a hypothesis derived from...

  3. Striving for Effectiveness in the Treatment of Adolescent Depression: Cognitive Behavior Therapy for Multisite Community Intervention

    ERIC Educational Resources Information Center

    Curry, John F.; Wells, Karen C.

    2005-01-01

    The Treatment for Adolescents With Depression Study (TADS) was designed to compare the relative and combined effectiveness of cognitive behavior therapy (CBT) and fluoxetine, each of which had demonstrated efficacy in carefully controlled single-site studies. Models of CBT from these efficacy studies served as the foundation for the TADS…

  4. Osteoporosis prevention using soy: the OPUS study

    USDA-ARS?s Scientific Manuscript database

    Soy isoflavones are believed to have anti-osteoporotic properties. To evaluate the effect of soy isoflavones on bone loss, 403 early postmenopausal women (54.0+/-4.0 y) were enrolled in an intent-to-treat, multi-site, 2-year follow-up, randomized, double-blind study with 1/3 on placebo, 1/3 on 80 mg...

  5. Designing Large-Scale Multisite and Cluster-Randomized Studies of Professional Development

    ERIC Educational Resources Information Center

    Kelcey, Ben; Spybrook, Jessaca; Phelps, Geoffrey; Jones, Nathan; Zhang, Jiaqi

    2017-01-01

    We develop a theoretical and empirical basis for the design of teacher professional development studies. We build on previous work by (a) developing estimates of intraclass correlation coefficients for teacher outcomes using two- and three-level data structures, (b) developing estimates of the variance explained by covariates, and (c) modifying…

  6. Social Justice and Juvenile Offenders: Examples of Fairness, Respect, and Access in Education Settings

    ERIC Educational Resources Information Center

    Sander, Janay B.; Sharkey, Jill D.; Groomes, Amber N.; Krumholz, Lauren; Walker, Kimberly; Hsu, Julie Y.

    2011-01-01

    Youths involved in juvenile justice face unique barriers to educational and mental health services. This qualitative study illustrates social justice violations that are particularly salient for this population. Youths on probation, their mothers, and juvenile probation staff participated in interviews as part of a multisite study conducted in…

  7. Young Dual Language Learners' Emergent Writing Development

    ERIC Educational Resources Information Center

    Gillanders, Cristina; Franco, Ximena; Seidel, Kent; Castro, Dina C.; Méndez, Lucía I.

    2017-01-01

    This study examined how early writing develops in Spanish-English-speaking children of Mexican and Central American descent who are dual language learners (DLLs) in the United States. The emergent writing skills in Spanish and English of 140 preschoolers in a multisite study were assessed using name- and word-writing tasks during the children's…

  8. Functioning and Quality of Life in the Treatment for Adolescents with Depression Study (TADS)

    ERIC Educational Resources Information Center

    Vitiello, Benedetto; Rohde, Paul; Silva, Susan; Wells, Karen; Casat, Charles; Waslick, Bruce; Simons, Anne; Reinecke, Mark; Weller, Elizabeth; Kratochvil, Christopher; Walkup, John; Pathak, Sanjeev; Robins, Michele; March, John

    2006-01-01

    Obective: To test whether 12-week treatment of major depression improved the level of functioning, global health, and quality of life of adolescents. Method: The Treatment for Adolescents With Depression Study was a multisite, randomized clinical trial of fluoxetine, cognitive-behavioral therapy (CBT), their combination (COMB), or clinical…

  9. Risk factors for childhood burns: a case-control study of Ghanaian children.

    PubMed Central

    Forjuoh, S N; Guyer, B; Strobino, D M; Keyl, P M; Diener-West, M; Smith, G S

    1995-01-01

    STUDY OBJECTIVE--To study risk factors for childhood burns in order to identify possible preventive strategies. DESIGN--Case-control design with pair matching of controls to cases in relation to age, sex, and area of residence. The cases and controls were identified by a community based, multisite survey. The effects of host and socioenvironmental variables reported by mothers were investigated in a multivariate analysis using conditional logistic regression. SETTING--A developing country setting the Ashanti Region in Ghana. PARTICIPANTS--These comprised 610 cases aged 0-5 years who had been burned (as evidenced by a visible scar) and 610 controls with no burn history. MAIN RESULTS--The presence of a pre-existing impairment in a child was the strongest risk factor in this population (OR = 6.71; 95% CI 2.78, 16.16). Other significant risk factor included: sibling death from a burn (OR = 4.41; 95% CI 1.16, 16.68); history of burn in a sibling (OR = 1.79; 95% CI 1.24, 2.58); and storage of a flammable substance in the home (OR = 1.51; 95% CI 1.03; 2.21). Maternal education had a protective effect against childhood burns, although this effect was not strong (OR = 0.76; 95% CI 0.55, 1.05). CONCLUSIONS--Community programmes to ensure adequate child supervision and general child wellbeing, particularly for those with impairments, as well as parental education about burns are recommended, to reduce childhood burns in this region of Ghana. The public should bed advised against storing flammable substances in the home. PMID:7798049

  10. Associations between workplace factors and carpal tunnel syndrome: A multi-site cross sectional study.

    PubMed

    Fan, Z Joyce; Harris-Adamson, Carisa; Gerr, Fred; Eisen, Ellen A; Hegmann, Kurt T; Bao, Stephen; Silverstein, Barbara; Evanoff, Bradley; Dale, Ann Marie; Thiese, Matthew S; Garg, Arun; Kapellusch, Jay; Burt, Susan; Merlino, Linda; Rempel, David

    2015-05-01

    Few large epidemiologic studies have used rigorous case criteria, individual-level exposure measurements, and appropriate control for confounders to examine associations between workplace psychosocial and biomechanical factors and carpal tunnel syndrome (CTS). Pooling data from five independent research studies, we assessed associations between prevalent CTS and personal, work psychosocial, and biomechanical factors while adjusting for confounders using multivariable logistic regression. Prevalent CTS was associated with personal factors of older age, obesity, female sex, medical conditions, previous distal upper extremity disorders, workplace measures of peak forceful hand activity, a composite measure of force and repetition (ACGIH Threshold Limit Value for Hand Activity Level), and hand vibration. In this cross-sectional analysis of production and service workers, CTS prevalence was associated with workplace and biomechanical factors. The findings were similar to those from a prospective analysis of the same cohort with differences that may be due to recall bias and other factors. © 2015 Wiley Periodicals, Inc.

  11. MULTI-SITE FIELD EVALUATION OF CANDIDATE SAMPLERS FOR MEASURING COARSE-MODE PM

    EPA Science Inventory

    In response to expected changes to the National Ambient Air Quality Standards for particulate matter, comprehensive field studies were conducted to evaluate the performance of sampling methods for measuring coarse mode aerosols (i.e. PMc). Five separate PMc sampling approaches w...

  12. Kidney Injury Molecule-1 Outperforms Traditional Biomarkers of Kidney Injury in Multi-site Preclinical Biomarker Qualification Studies

    PubMed Central

    Vaidya, Vishal S.; Ozer, Josef S.; Frank, Dieterle; Collings, Fitz B.; Ramirez, Victoria; Troth, Sean; Muniappa, Nagaraja; Thudium, Douglas; Gerhold, David; Holder, Daniel J.; Bobadilla, Norma A.; Marrer, Estelle; Perentes, Elias; Cordier, André; Vonderscher, Jacky; Maurer, Gérard; Goering, Peter L.; Sistare, Frank D.; Bonventre, Joseph V.

    2010-01-01

    Kidney toxicity accounts for a significant percentage of morbidity and drug candidate failure. Serum creatinine (SCr) and blood urea nitrogen (BUN) have been used to monitor kidney dysfunction for over a century but these markers are insensitive and non-specific. In multi-site preclinical rat toxicology studies the diagnostic performance of urinary kidney injury molecule-1 (Kim-1) was compared to traditional biomarkers as predictors of kidney tubular histopathologic changes, currently considered the “gold standard” of nephrotoxicity. In multiple models of kidney injury, urinary Kim-1 significantly outperformed SCr and BUN. The area under the receiver operating characteristic curve for Kim-1 was between 0.91 and 0.99 as compared to 0.79 to 0.9 for BUN and 0.73 to 0.85 for SCr. Thus urinary Kim-1 is the first injury biomarker of kidney toxicity qualified by the FDA and EMEA and is expected to significantly improve kidney safety monitoring. PMID:20458318

  13. Real-Time Enrollment Dashboard For Multisite Clinical Trials.

    PubMed

    Mattingly, William A; Kelley, Robert R; Wiemken, Timothy L; Chariker, Julia H; Peyrani, Paula; Guinn, Brian E; Binford, Laura E; Buckner, Kimberley; Ramirez, Julio

    2015-10-30

    Achieving patient recruitment goals are critical for the successful completion of a clinical trial. We designed and developed a web-based dashboard for assisting in the management of clinical trial screening and enrollment. We use the dashboard to assist in the management of two observational studies of community-acquired pneumonia. Clinical research associates and managers using the dashboard were surveyed to determine its effectiveness as compared with traditional direct communication. The dashboard has been in use since it was first introduced in May of 2014. Of the 23 staff responding to the survey, 77% felt that it was easier or much easier to use the dashboard for communication than to use direct communication. We have designed and implemented a visualization dashboard for managing multi-site clinical trial enrollment in two community acquired pneumonia studies. Information dashboards are a useful tool for clinical trial management. They can be used as a standalone trial information tool or included into a larger management system.

  14. The opportunities and challenges of multi-site evaluations: lessons from the jail diversion and trauma recovery national cross-site evaluation.

    PubMed

    Stainbrook, Kristin; Penney, Darby; Elwyn, Laura

    2015-06-01

    Multi-site evaluations, particularly of federally funded service programs, pose a special set of challenges for program evaluation. Not only are there contextual differences related to project location, there are often relatively few programmatic requirements, which results in variations in program models, target populations and services. The Jail Diversion and Trauma Recovery-Priority to Veterans (JDTR) National Cross-Site Evaluation was tasked with conducting a multi-site evaluation of thirteen grantee programs that varied along multiple domains. This article describes the use of a mixed methods evaluation design to understand the jail diversion programs and client outcomes for veterans with trauma, mental health and/or substance use problems. We discuss the challenges encountered in evaluating diverse programs, the benefits of the evaluation in the face of these challenges, and offer lessons learned for other evaluators undertaking this type of evaluation. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. RFWD3-Dependent Ubiquitination of RPA Regulates Repair at Stalled Replication Forks.

    PubMed

    Elia, Andrew E H; Wang, David C; Willis, Nicholas A; Boardman, Alexander P; Hajdu, Ildiko; Adeyemi, Richard O; Lowry, Elizabeth; Gygi, Steven P; Scully, Ralph; Elledge, Stephen J

    2015-10-15

    We have used quantitative proteomics to profile ubiquitination in the DNA damage response (DDR). We demonstrate that RPA, which functions as a protein scaffold in the replication stress response, is multiply ubiquitinated upon replication fork stalling. Ubiquitination of RPA occurs on chromatin, involves sites outside its DNA binding channel, does not cause proteasomal degradation, and increases under conditions of fork collapse, suggesting a role in repair at stalled forks. We demonstrate that the E3 ligase RFWD3 mediates RPA ubiquitination. RFWD3 is necessary for replication fork restart, normal repair kinetics during replication stress, and homologous recombination (HR) at stalled replication forks. Mutational analysis suggests that multisite ubiquitination of the entire RPA complex is responsible for repair at stalled forks. Multisite protein group sumoylation is known to promote HR in yeast. Our findings reveal a similar requirement for multisite protein group ubiquitination during HR at stalled forks in mammalian cells. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Do Case Rates Affect Physicians' Clinical Practice in Radiation Oncology?: An Observational Study

    PubMed Central

    Loy, Bryan A.; Shkedy, Clive I.; Powell, Adam C.; Happe, Laura E.; Royalty, Julie A.; Miao, Michael T.; Smith, Gary L.; Long, James W.; Gupta, Amit K.

    2016-01-01

    Case rate payments combined with utilization monitoring may have the potential to improve the quality of care by reducing over and under-treatment. Thus, a national managed care organization introduced case rate payments at one multi-site radiation oncology provider while maintaining only fee-for-service payments at others. This study examined whether the introduction of the payment method had an effect on radiation fractions administered when compared to clinical guidelines. The number of fractions of radiation therapy delivered to patients with bone metastases, breast, lung, prostate, and skin cancer was assessed for concordance with clinical guidelines. The proportion of guideline-based care ascertained from the payer's claims database was compared before (2011) and after (2013) the payment method introduction using relative risks (RR). After the introduction of case rates, there were no significant changes in guideline-based care in breast, lung, and skin cancer; however, patients with bone metastases and prostate cancer were significantly more likely to have received guideline-based care (RR = 2.0 and 1.1, respectively, p<0.05). For the aggregate of all cancers, the under-treatment rate significantly declined (p = 0.008) from 4% to 0% after the introduction of case rate payments, while the over-treatment rate remained steady at 9%, with no significant change (p = 0.20). These findings suggest that the introduction of case rate payments did not adversely affect the rate of guideline-based care at the provider examined. Additional research is needed to isolate the effect of the payment model and assess implications in other populations. PMID:26870963

  17. Do Case Rates Affect Physicians' Clinical Practice in Radiation Oncology?: An Observational Study.

    PubMed

    Loy, Bryan A; Shkedy, Clive I; Powell, Adam C; Happe, Laura E; Royalty, Julie A; Miao, Michael T; Smith, Gary L; Long, James W; Gupta, Amit K

    2016-01-01

    Case rate payments combined with utilization monitoring may have the potential to improve the quality of care by reducing over and under-treatment. Thus, a national managed care organization introduced case rate payments at one multi-site radiation oncology provider while maintaining only fee-for-service payments at others. This study examined whether the introduction of the payment method had an effect on radiation fractions administered when compared to clinical guidelines. The number of fractions of radiation therapy delivered to patients with bone metastases, breast, lung, prostate, and skin cancer was assessed for concordance with clinical guidelines. The proportion of guideline-based care ascertained from the payer's claims database was compared before (2011) and after (2013) the payment method introduction using relative risks (RR). After the introduction of case rates, there were no significant changes in guideline-based care in breast, lung, and skin cancer; however, patients with bone metastases and prostate cancer were significantly more likely to have received guideline-based care (RR = 2.0 and 1.1, respectively, p<0.05). For the aggregate of all cancers, the under-treatment rate significantly declined (p = 0.008) from 4% to 0% after the introduction of case rate payments, while the over-treatment rate remained steady at 9%, with no significant change (p = 0.20). These findings suggest that the introduction of case rate payments did not adversely affect the rate of guideline-based care at the provider examined. Additional research is needed to isolate the effect of the payment model and assess implications in other populations.

  18. Fluconazole use and birth defects in the National Birth Defects Prevention Study.

    PubMed

    Howley, Meredith M; Carter, Tonia C; Browne, Marilyn L; Romitti, Paul A; Cunniff, Christopher M; Druschel, Charlotte M

    2016-05-01

    Low-dose fluconazole is used commonly to treat vulvovaginal candidiasis, a condition occurring frequently during pregnancy. Conflicting information exists on the association between low-dose fluconazole use among pregnant women and the risk of major birth defects. We used data from the National Birth Defects Prevention Study to examine this association. The National Birth Defects Prevention Study is a multisite, population-based, case-control study that includes pregnancies with estimated delivery dates from 1997 to 2011. Information on fluconazole use in early pregnancy was collected by self-report from 31,645 mothers of birth defect cases and 11,612 mothers of unaffected controls. Adjusted odds ratios and 95% confidence intervals were estimated for birth defects with 5 or more exposed cases; crude odds ratios and exact 95% confidence intervals were estimated for birth defects with 3-4 exposed cases. Of the 43,257 mothers analyzed, 44 case mothers and 6 control mothers reported using fluconazole. Six exposed infants had cleft lip with cleft palate, 4 had an atrial septal defect, and each of the following defects had 3 exposed cases: hypospadias, tetralogy of Fallot, d-transposition of the great arteries, and pulmonary valve stenosis. Fluconazole use was associated with cleft lip with cleft palate (odds ratio = 5.53; confidence interval = 1.68-18.24) and d-transposition of the great arteries (odds ratio = 7.56; confidence interval = 1.22-35.45). The associations between fluconazole and both cleft lip with cleft palate and d-transposition of the great arteries are consistent with earlier published case reports but not recent epidemiologic studies. Despite the larger sample size of the National Birth Defects Prevention Study, fluconazole use was rare. Further investigation is needed in large studies, with particular emphasis on oral clefts and conotruncal heart defects. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Crack Growth Prediction Methodology for Multi-Site Damage: Layered Analysis and Growth During Plasticity

    NASA Technical Reports Server (NTRS)

    James, Mark Anthony

    1999-01-01

    A finite element program has been developed to perform quasi-static, elastic-plastic crack growth simulations. The model provides a general framework for mixed-mode I/II elastic-plastic fracture analysis using small strain assumptions and plane stress, plane strain, and axisymmetric finite elements. Cracks are modeled explicitly in the mesh. As the cracks propagate, automatic remeshing algorithms delete the mesh local to the crack tip, extend the crack, and build a new mesh around the new tip. State variable mapping algorithms transfer stresses and displacements from the old mesh to the new mesh. The von Mises material model is implemented in the context of a non-linear Newton solution scheme. The fracture criterion is the critical crack tip opening displacement, and crack direction is predicted by the maximum tensile stress criterion at the crack tip. The implementation can accommodate multiple curving and interacting cracks. An additional fracture algorithm based on nodal release can be used to simulate fracture along a horizontal plane of symmetry. A core of plane strain elements can be used with the nodal release algorithm to simulate the triaxial state of stress near the crack tip. Verification and validation studies compare analysis results with experimental data and published three-dimensional analysis results. Fracture predictions using nodal release for compact tension, middle-crack tension, and multi-site damage test specimens produced accurate results for residual strength and link-up loads. Curving crack predictions using remeshing/mapping were compared with experimental data for an Arcan mixed-mode specimen. Loading angles from 0 degrees to 90 degrees were analyzed. The maximum tensile stress criterion was able to predict the crack direction and path for all loading angles in which the material failed in tension. Residual strength was also accurately predicted for these cases.

  20. Muscular Dystrophy Surveillance Tracking and Research Network (MD STARnet): Case Definition in Surveillance for Childhood-Onset Duchenne/Becker Muscular Dystrophy

    PubMed Central

    Mathews, Katherine D.; Cunniff, Chris; Kantamneni, Jiji R.; Ciafaloni, Emma; Miller, Timothy; Matthews, Dennis; Cwik, Valerie; Druschel, Charlotte; Miller, Lisa; Meaney, F. John; Sladky, John; Romitti, Paul A.

    2013-01-01

    The Muscular Dystrophy Surveillance Tracking and Research Network (MD STARnet) is a multisite collaboration to determine the prevalence of childhood-onset Duchenne/Becker muscular dystrophy and to characterize health care and health outcomes in this population. MD STARnet uses medical record abstraction to identify patients with Duchenne/Becker muscular dystrophy born January 1, 1982 or later who resided in one of the participating sites. Critical diagnostic elements of each abstracted record are reviewed independently by ≥4 clinicians and assigned to 1 of 6 case definition categories (definite, probable, possible, asymptomatic, female, not Duchenne/Becker muscular dystrophy) by consensus. As of November 2009, 815 potential cases were reviewed. Of the cases included in analysis, 674 (82%) were either “definite” or “probable” Duchenne/Becker muscular dystrophy. These data reflect a change in diagnostic testing, as case assignment based on genetic testing increased from 67% in the oldest cohort (born 1982–1987) to 94% in the cohort born 2004–2009. PMID:20817884

  1. Principles and strategies for monitoring data collection integrity in a multi-site randomized clinical trial of a behavioral intervention.

    PubMed

    Phillips-Salimi, Celeste R; Donovan Stickler, Molly A; Stegenga, Kristin; Lee, Melissa; Haase, Joan E

    2011-08-01

    Although treatment fidelity strategies for enhancing the integrity of behavioral interventions have been well described, little has been written about monitoring data collection integrity. This article describes the principles and strategies developed to monitor data collection integrity of the "Stories and Music for Adolescent/Young Adult Resilience During Transplant" study (R01NR008583, U10CA098543, and U10CA095861)-a multi-site Children's Oncology Group randomized clinical trial of a music therapy intervention for adolescents and young adults undergoing stem cell transplant. The principles and strategies outlined in this article provide one model for development and evaluation of a data collection integrity monitoring plan for behavioral interventions that may be adapted by investigators and may be useful to funding agencies and grant application reviewers in evaluating proposals. Copyright © 2011 Wiley Periodicals, Inc.

  2. Engaging with Drama

    ERIC Educational Resources Information Center

    Gallagher, Kathleen

    2013-01-01

    This article reports on a multi-site global, ethnographic, and mixed methods study on student engagement. Our research has closely examined how engagement and disengagement operate subtly, simultaneously and relationally in the places and spaces where drama is made. Through years of qualitative time in high school classrooms and two different…

  3. Talking with Abuelo: Performing Authenticity in a Multicultural, Multisited Family

    ERIC Educational Resources Information Center

    Vidal, Mónica

    2015-01-01

    Taking an interactional sociolinguistic approach, this study explores how multicultural and multilingual siblings interact with their Spanish grandfather and how, through the use of styling and stylization in these interactions, they negotiate and construct multicultural family identities. Using Tannen's power and solidarity framework, I analyze…

  4. An Analysis of the Demand for and Value of Outdoor Recreation in the United States.

    ERIC Educational Resources Information Center

    Bergstrom, John C.; Cordell, H. Ken

    1991-01-01

    Results of a study of demand equations for 37 outdoor recreational activities using a multicommunity, multisite travel cost model suggest that determinants of the demand for outdoor recreation include population, residence, income, age, price, quality, and recreational opportunity substitutes. (JD)

  5. 76 FR 44512 - Human Subjects Research Protections: Enhancing Protections for Research Subjects and Reducing...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-26

    ... research enterprise, the proliferation of multi-site clinical trials and observational studies, the... and Drug Administration 21 CFR Parts 50 and 56 Human Subjects Research Protections: Enhancing Protections for Research Subjects and Reducing Burden, Delay, and Ambiguity for Investigators AGENCIES: The...

  6. EFFECTS OF AMBIENT PM ON CYTOKINE PRODUCTION IN MOUSE MACHROPHAGES AND EPITHELIAL CELLS

    EPA Science Inventory

    The objective of the Multi-Site Ambient Particle Study (MAPS) was to collect ambient particles from different geographical regions, examine their health effects using various in vitro and in vivo experimental approaches, and ultimately relate the health effects to particle compon...

  7. EFFECTS OF AMBIENT PM ON CYTOKINE PRODUCTION IN MOUSE MACROPHAGES AND EPITHELIAL CELLS

    EPA Science Inventory

    The objective of the Multi-Site Ambient Particle Study (MAPS) was to collect ambient particles from different geographical regions, examine their health effects using various in vitro and in vivo experimental approaches, and ultimately relate the health effects to particle compon...

  8. Case studies combined with or without concept maps improve critical thinking in hospital-based nurses: a randomized-controlled trial.

    PubMed

    Huang, Yu-Chuan; Chen, Hsing-Hsia; Yeh, Mei-Ling; Chung, Yu-Chu

    2012-06-01

    Critical thinking (CT) is essential to the exercise of professional judgment. As nurses face increasingly complex health-care situations, critical thinking can promote appropriate clinical decision-making and improve the quality of nursing care. This study aimed to evaluate the effects of a program of case studies, alone (CS) or combined with concept maps (CSCM), on improving CT in clinical nurses. The study was a randomized controlled trial. The experimental group participated in a 16-week CSCM program, whereas the control group participated in a CS program of equal duration. A randomized-controlled trial with a multistage randomization process was used to select and to assign participants, ultimately resulting in 67 nurses in each group. Data were collected before and after the program using the California Critical Thinking Skill Test (CCTST) and the California Critical Thinking Disposition Inventory (CCTDI). After the programs, there were significant differences between the two groups in the critical thinking skills of analysis, evaluation, inference, deduction, and induction. There was also an overall significant difference, and a significant difference in the specific disposition of open-mindedness. This study supports the application of case studies combined with concept maps as a hospital-based teaching strategy to promote development of critical thinking skills and encourage dispositions for nurses. The CSCM resulted in greater improvements in all critical thinking skills of as well as the overall and open-minded affective dispositions toward critical thinking, compared with the case studies alone. An obvious improvement in the CSCM participants was the analytic skill and disposition. Further longitudinal studies and data collection from multisite evaluations in a range of geographic locales are warranted. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. The distribution and redistribution of fentanyl & norfentanyl in post mortem samples.

    PubMed

    Chatterton, C N; Scott-Ham, M

    2018-03-01

    This article compares 249 post mortem case reports that were positive for fentanyl/norfentanyl. All the cases were submitted to, and analyzed by, the toxicology department of the Office of the Chief Medical Examiner, Edmonton, Alberta, Canada. This study highlights the varied distribution of fentanyl in the body after death as a result of misadventure, i.e., these are accidental drug overdose cases as opposed to a study of analytical data resulting from fentanyl use/administration in a clinical environment and/or death as a result of suicide. Post mortem samples were collected from more than one anatomical site and analyzed for fentanyl and norfentanyl using liquid chromatography-tandem mass spectrometry. Ante-mortem samples were available in 4 of these cases and were also analyzed. Post mortem mean blood fentanyl concentrations were found to be 13.2ng/mL (femoral), 19.1ng/mL (iliac) and 42.0ng/mL (subclavian). For norfentanyl the mean concentrations were 4.6ng/mL (femoral), 4.6ng/mL (iliac) and 7.4ng/mL (subclavian). Mean vitreous fentanyl and norfentanyl concentrations were 10.8ng/mL and 3.5ng/mL respectively. Mean liver fentanyl and norfentanyl concentrations were found to be 185.5ng/g and 18.8ng/g respectively. This study demonstrates the importance of multi-site sample collection and subsequent analysis for a thorough post mortem toxicological investigation. The study also highlights the risks and limitations associated with the interpretation of post mortem analytical results concerning fentanyl. Copyright © 2018 Elsevier B.V. All rights reserved.

  10. Process evaluation of the Hunter Illawarra Kids Challenge Using Parent Support study: a multisite randomized controlled trial for the management of child obesity.

    PubMed

    Jones, Rachel A; Warren, Janet M; Okely, Anthony D; Collins, Clare E; Morgan, Philip J; Cliff, Dylan P; Burrows, Tracy; Cleary, Jane; Baur, Louise A

    2010-11-01

    The purposes of this article are to (a) outline findings from secondary or process outcome data of the Hunter Illawarra Kids Challenge Using Parent Support (HIKCUPS) study and (b) inform the design and development of future research interventions and practice in the management of child obesity. Data were collected by means of facilitator evaluations, independent session observation, attendance records, and parent questionnaires. Internal validity and reliability of the program delivery were high. All parents reported positive changes in their children as a result of the physical activity program, the dietary modification program, or both. Most participants completed the home activities, but more than half reported that finding time to do them was problematic. Facilitator review indicated that future programs should specifically cater to children of similar age or same sex, allow adequate time for explanation of complex nutritional concepts, and use intrinsic motivators for participants. Recommendations for future interventions, specifically the implementation of subsequent HIKCUPS or other multisite effectiveness studies, are detailed.

  11. Exploring dynamics of abusive lesbian relationships: preliminary analysis of a multisite, qualitative study.

    PubMed

    Ristock, Janice L

    2003-06-01

    This paper presents preliminary results from a multisite, qualitative study on violence in lesbian relationships. A framework for conducting community-based, empowerment research that draws on theories of community psychology, feminism, and postmodernism is presented. The study was designed to understand the dynamics of abusive lesbian relationships and social service providers' responses to the abuse. Results from 80 in-depth interviews with lesbians who have experienced relationship violence are examined with a particular focus on a pattern of first relationships being abusive and a theme of shifting power dynamics. Analysis of focus group discussions with 45 feminist service providers (e.g., counselors, shelter workers, social workers, healthcare providers) reveals the difficulties in assessing the power dynamics of abusive same-sex relationships and in developing appropriate responses when relying on heterosexually gendered models developed to address men's violence against women. The preliminary results present implications both for how we theorize and research this form of violence, and for improving the practices and policies of social services that work with lesbian, gay, bisexual, and transgendered communities.

  12. Battered Women's Perceptions of Risk Versus Risk Factors and Instruments in Predicting Repeat Reassault

    ERIC Educational Resources Information Center

    Heckert, D. Alex; Gondolf, Edward W.

    2004-01-01

    This study partially replicates and expands on a previous study that showed women's perceptions of risk to be a strong predictor of reassault among batterers. The current study employed a larger and multisite sample, a longer follow-up period of 15 months, and multiple outcomes including "repeated reassault" (n = 499). According to the multinomial…

  13. Maternal autoimmune disease and birth defects in the National Birth Defects Prevention Study.

    PubMed

    Howley, Meredith M; Browne, Marilyn L; Van Zutphen, Alissa R; Richardson, Sandra D; Blossom, Sarah J; Broussard, Cheryl S; Carmichael, Suzan L; Druschel, Charlotte M

    2016-11-01

    Little is known about the association between maternal autoimmune disease or its treatment and the risk of birth defects. We examined these associations using data from the National Birth Defects Prevention Study, a multi-site, population-based, case-control study. Analyses included 25,116 case and 9897 unaffected control infants with estimated delivery dates between 1997 and 2009. Information on autoimmune disease, medication use, and other pregnancy exposures was collected by means of telephone interview. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for birth defects with five or more exposed cases; crude ORs and exact 95% CIs were estimated for birth defects with three to four exposed cases. Autoimmune disease was reported by 373 mothers (279 case and 94 control mothers). The majority of birth defects evaluated were not associated with autoimmune disease; however, a statistically significant association between maternal autoimmune disease and encephalocele was observed (OR, 4.64; 95% CI, 1.95-11.04). Eighty-two mothers with autoimmune disease used an immune modifying/suppressing medication during pregnancy; this was associated with encephalocele (OR, 7.26; 95% CI, 1.37-24.61) and atrial septal defects (OR, 3.01; 95% CI, 1.16-7.80). Our findings suggest maternal autoimmune disease and treatment are not associated with the majority of birth defects, but may be associated with some defects, particularly encephalocele. Given the low prevalence of individual autoimmune diseases and the rare use of specific medications, we were unable to examine associations of specific autoimmune diseases and medications with birth defects. Other studies are needed to confirm these findings. Birth Defects Research (Part A) 106:950-962, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  14. Methods and Management of the Healthy Brain Study: A Large Multisite Qualitative Research Project

    ERIC Educational Resources Information Center

    Laditka, Sarah B.; Corwin, Sara J.; Laditka, James N.; Liu, Rui; Friedman, Daniela B.; Mathews, Anna E.; Wilcox, Sara

    2009-01-01

    Purpose of the study: To describe processes used in the Healthy Brain project to manage data collection, coding, and data distribution in a large qualitative project, conducted by researchers at 9 universities in 9 states. Design and Methods: Project management protocols included: (a) managing audiotapes and surveys to ensure data confidentiality,…

  15. "It's an Amazing Learning Curve to Be Part of the Project": Exploring Academic Identity in Collaborative Research

    ERIC Educational Resources Information Center

    Leibowitz, Brenda; Ndebele, Clever; Winberg, Christine

    2014-01-01

    This article reports on an investigation into the role of academic identity within collaborative research in higher education in South Africa. The study was informed by the literature on academic identities, collaborative research and communities of practice. It was located within a multi-site study, with involvement of researcher collaborators…

  16. Recruiting a Diverse Group of Middle School Girls into the Trial of Activity for Adolescent Girls

    ERIC Educational Resources Information Center

    Elder, John P.; Shuler, LaVerne; Moe, Stacey G.; Grieser, Mira; Pratt, Charlotte; Cameron, Sandra; Hingle, Melanie; Pickrel, Julie L.; Saksvig, Brit I.; Schachter, Kenneth; Greer, Susan; Bothwell, Elizabeth K. Guth

    2008-01-01

    Background: School-based study recruitment efforts are both time consuming and challenging. This paper highlights the recruitment strategies employed by the national, multisite Trial of Activity for Adolescent Girls (TAAG), a study designed to measure the effectiveness of an intervention to reduce the decline of physical activity levels among…

  17. Suicide Attempts within 12 Months of Treatment for Substance Use Disorders

    ERIC Educational Resources Information Center

    Britton, Peter C.; Conner, Kenneth R.

    2010-01-01

    There are limited prospective data on suicide attempts (SA) during the months following treatment for substance use disorders (SUD), a period of high risk. In an analysis of the Drug Abuse Treatment Outcomes Study, a longitudinal naturalistic multisite study of treated SUDs, variables associated with SA in the 12 months following SUD treatment…

  18. Remission and Residual Symptoms after Short-Term Treatment in the Treatment of Adolescents with Depression Study (TADS)

    ERIC Educational Resources Information Center

    Kennard, Betsy; Silva, Susan; Vitiello, Benedetto; Curry, John; Kratochvil, Christopher; Simons, Anne; Hughes, Jennifer; Feeny, Norah; Weller, Elizabeth; Sweeney, Michael; Reinecke, Mark; Pathak, Sanjeev; Ginsburg, Golda; Emslie, Graham; March, John

    2006-01-01

    Objective: To ascertain remission rates in depressed youth participating in the Treatment for Adolescents With Depression Study (TADS), a multisite clinical trial that randomized 439 adolescents with major depressive disorder (MDD) to a 12-week treatment of fluoxetine (FLX), cognitive-behavioral therapy (CBT), their combination (COMB), or clinical…

  19. A Comparison of Methods to Test for Mediation in Multisite Experiments

    ERIC Educational Resources Information Center

    Pituch, Keenan A.; Whittaker, Tiffany A.; Stapleton, Laura M.

    2005-01-01

    A Monte Carlo study extended the research of MacKinnon, Lockwood, Hoffman, West, and Sheets (2002) for single-level designs by examining the statistical performance of four methods to test for mediation in a multilevel experimental design. The design studied was a two-group experiment that was replicated across several sites, included a single…

  20. The MTA at 8 Years: Prospective Follow-Up of Children Treated for Combined-Type ADHD in a Multisite Study

    ERIC Educational Resources Information Center

    Molina, Brooke S. G.; Hinshaw, Stephen P.; Swanson, James W.; Arnold, L. Eugene; Vitiello, Benedetto; Jensen, Peter S.; Epstein, Jeffery N.; Hoza, Betsy; Hechtman, Lily; Abikoff, Howard B.; Elliott, Glen R.; Greenhill, Laurence L.; Newcorn, Jeffrey H.; Wells, Karen C.; Wigal, Timothy; Gibbons, Robert D.; Hur, Kwan; Houck, Patricia R.

    2009-01-01

    Participants of the Multimodal Treatment Study of Children with Attention Deficit and Hyperactivity Disorder (ADHD) eight years earlier do not differ significantly in repeated measures or newly analyzed variables that include school grades and psychiatric hospitalization. The treatment of childhood ADHD does not predict functioning six to eight…

  1. A Multisite Study of High School Mathematics Curricula and the Impact of Taking a Developmental Mathematics Course in College

    ERIC Educational Resources Information Center

    Harwell, Michael; Dupuis, Danielle; Post, Thomas R.; Medhanie, Amanuel; LeBeau, Brandon

    2014-01-01

    The relationship between high school mathematics curricula and the likelihood of students who enroll in a developmental (non-credit bearing) course in college taking additional mathematics courses was studied. The results showed that high school mathematics curriculum, years of high school mathematics completed, and ACT mathematics scores were…

  2. A Comparison of Rural and Urban Indian Children's Visual Detection of Threatening and Nonthreatening Animals

    ERIC Educational Resources Information Center

    Penkunas, Michael J.; Coss, Richard G.

    2013-01-01

    Recent studies indicate that young children preferentially attend to snakes, spiders, and lions compared with nondangerous species, but these results have yet to be replicated in populations that actually experience dangerous animals in nature. This multi-site study investigated the visual-detection biases of southern Indian children towards two…

  3. Issues in the Multi-Cultural Assessment of Parent-Child Interaction: An Exploratory Study from the Starting Early Starting Smart Collaboration

    ERIC Educational Resources Information Center

    Bernstein, V.J.; Harris, E.J.; Long, C.W.; Iida, E.; Hans, S.L.

    2005-01-01

    A national, multi-site study of behavioral health services integration developed a parent-child interaction assessment tool and culturally anchored videotape protocol. Representatives from programs serving Chinese, Native American, Latin-American, African-American, and Anglo-American families discussed cross-cultural issues in parenting and…

  4. Knowledge as a Service at the Point of Care.

    PubMed

    Shellum, Jane L; Freimuth, Robert R; Peters, Steve G; Nishimura, Rick A; Chaudhry, Rajeev; Demuth, Steve J; Knopp, Amy L; Miksch, Timothy A; Milliner, Dawn S

    2016-01-01

    An electronic health record (EHR) can assist the delivery of high-quality patient care, in part by providing the capability for a broad range of clinical decision support, including contextual references (e.g., Infobuttons), alerts and reminders, order sets, and dashboards. All of these decision support tools are based on clinical knowledge; unfortunately, the mechanisms for managing rules, order sets, Infobuttons, and dashboards are often unrelated, making it difficult to coordinate the application of clinical knowledge to various components of the clinical workflow. Additional complexity is encountered when updating enterprise-wide knowledge bases and delivering the content through multiple modalities to different consumers. We present the experience of Mayo Clinic as a case study to examine the requirements and implementation challenges related to knowledge management across a large, multi-site medical center. The lessons learned through the development of our knowledge management and delivery platform will help inform the future development of interoperable knowledge resources.

  5. Knowledge as a Service at the Point of Care

    PubMed Central

    Shellum, Jane L.; Freimuth, Robert R.; Peters, Steve G.; Nishimura, Rick A.; Chaudhry, Rajeev; Demuth, Steve J.; Knopp, Amy L.; Miksch, Timothy A.; Milliner, Dawn S.

    2016-01-01

    An electronic health record (EHR) can assist the delivery of high-quality patient care, in part by providing the capability for a broad range of clinical decision support, including contextual references (e.g., Infobuttons), alerts and reminders, order sets, and dashboards. All of these decision support tools are based on clinical knowledge; unfortunately, the mechanisms for managing rules, order sets, Infobuttons, and dashboards are often unrelated, making it difficult to coordinate the application of clinical knowledge to various components of the clinical workflow. Additional complexity is encountered when updating enterprise-wide knowledge bases and delivering the content through multiple modalities to different consumers. We present the experience of Mayo Clinic as a case study to examine the requirements and implementation challenges related to knowledge management across a large, multi-site medical center. The lessons learned through the development of our knowledge management and delivery platform will help inform the future development of interoperable knowledge resources. PMID:28269911

  6. Piercing the veil: the marginalization of midwives in the United States.

    PubMed

    Goodman, Steffie

    2007-08-01

    This paper investigates the marginalization of certified nurse-midwives (CNMs) in the US. This marginalization occurs despite ample evidence demonstrating that a midwifery model delivers high-quality cost-effective care. Currently midwives attend only 7% of births, compared to 50-75% of births in other developed countries. Given the escalating costs of health care and relatively poor maternal and child health indicators in comparison with other developed countries, these findings are disturbing. This paper investigates this paradox through a qualitative case study of two prestigious but declining midwifery services in a large US city. Fifty-two multi-sited in-depth interviews were conducted along with an analysis of relevant archival sources. It was found that institutions successfully altered maternity care and diminished midwifery services without accountability for their actions. These findings illuminate the larger political-economic forces that shape the marginalization of midwifery in the US.

  7. The At Home/Chez Soi trial protocol: a pragmatic, multi-site, randomised controlled trial of a Housing First intervention for homeless individuals with mental illness in five Canadian cities

    PubMed Central

    Streiner, David L; Adair, Carol; Aubry, Tim; Barker, Jayne; Distasio, Jino; Hwang, Stephen W; Komaroff, Janina; Latimer, Eric; Somers, Julian; Zabkiewicz, Denise M

    2011-01-01

    Introduction Housing First is a complex housing and support intervention for homeless individuals with mental health problems. It has a sufficient knowledge base and interest to warrant a test of wide-scale implementation in various settings. This protocol describes the quantitative design of a Canadian five city, $110 million demonstration project and provides the rationale for key scientific decisions. Methods A pragmatic, mixed methods, multi-site field trial of the effectiveness of Housing First in Vancouver, Winnipeg, Toronto, Montreal and Moncton, is randomising approximately 2500 participants, stratified by high and moderate need levels, into intervention and treatment as usual groups. Quantitative outcome measures are being collected over a 2-year period and a qualitative process evaluation is being completed. Primary outcomes are housing stability, social functioning and, for the economic analyses, quality of life. Hierarchical linear modelling is the primary data analytic strategy. Ethics and dissemination Research ethics board approval has been obtained from 11 institutions and a safety and adverse events committee is in place. The results of the multi-site analyses of outcomes at 12 months and 2 years will be reported in a series of core scientific journal papers. Extensive knowledge exchange activities with non-academic audiences will occur throughout the duration of the project. Trial registration number This study has been registered with the International Standard Randomised Control Trial Number Register and assigned ISRCTN42520374. PMID:22102645

  8. Facebook as a tool for communication, collaboration, and informal knowledge exchange among members of a multisite family health team.

    PubMed

    Lofters, Aisha K; Slater, Morgan B; Nicholas Angl, Emily; Leung, Fok-Han

    2016-01-01

    To implement and evaluate a private Facebook group for members of a large Ontario multisite Family Health Team (FHT) to facilitate improved communication and collaboration. Program implementation and subsequent survey of team members. A large multisite FHT in Toronto, Ontario. Health professionals of the FHT. Usage patterns and self-reported perceptions of the Facebook group by team members. At the time of the evaluation survey, the Facebook group had 43 members (37.4% of all FHT members). Activity in the group was never high, and posts by team members who were not among the researchers were infrequent throughout the study period. The content of posts fell into two broad categories: 1) information that might be useful to various team members and 2) questions posed by team members that others might be able to answer. Of the 26 team members (22.6%) who completed the evaluation survey, many reported that they never logged into the Facebook page (16 respondents), and never used it to communicate with team members outside of their own site of practice (19 respondents). Only six respondents reported no concerns with using Facebook as a professional communication tool; the most frequent concerns were regarding personal and patient privacy. The use of social media by health care practitioners is becoming ubiquitous. However, the issues of privacy concerns and determining how to use social media without adding to provider workload must be addressed to make it a useful tool in health care.

  9. The French prospective multisite registry on sudden unexpected infant death (OMIN): rationale and study protocol

    PubMed Central

    Levieux, Karine; Patural, Hugues; Harrewijn, Inge; Briand Huchet, Elisabeth; de Visme, Sophie; Gallot, Géraldine; Chalumeau, Martin; Gras Le Guen, Christèle; Hanf, Matthieu; Garcia-Meric, Patricia

    2018-01-01

    Introduction Even after ‘back-to-sleep’ campaigns, sudden unexpected infant death (SUID) continues to be the leading cause of death for infants 1 month to 1 year old in developed countries, with devastating social, psychological and legal implications for families. To sustainably tackle this problem and decrease the number of SUIDs, a French SUID registry was initiated in 2015 to (1) inform prevention with standardised data, (2) understand the mechanisms leading to SUID and the contribution of the already known or newly suggested risk factors and (3) gather a multidisciplinary group of experts to coordinate and develop innovative and urgent research in the SUID area. Methods and analysis This observational multisite prospective observatory includes all cases of sudden unexpected deaths in children younger than 2 years occurring in the French territory covered by the 35 participating French referral centres. From these cases, various data concerning sociodemographic conditions, death scene, personal and family medical history, parental behaviours, sleep environment, clinical examinations, biological and imagery investigations and autopsy are systematically collected. These data will be complemented as of 2018 with a biobank of diverse biological samples (blood, hair, urine, faeces and cerebrospinal fluid), with other administrative health-related data (health claim reimbursements and hospital admissions) and socioenvironmental data. Insights from exploratory descriptive statistics and thematic analysis will be combined for the design of targeted strategies to effectively reduce preventable infant deaths. Ethics and dissemination The French sudden unexpected infant death registry (Observatoire National des Morts Inattendues du Nourrisson registry;OMIN) was approved in 2015 by the French Data Protection Authority in clinical research (Commission Nationale de l’Informatique et des Libertés: number 915273) and by an independent ethics committee (Groupe Nantais d’Ethique dans le Domaine de la Santé: number 2015-01-27). Results will be discussed with associations of families affected by SUID, caregivers, funders of the registry, medical societies and researchers and will be submitted to international peer-reviewed journals and presented at international conferences. PMID:29666137

  10. Supporting the use of theory in cross-country health services research: a participatory qualitative approach using Normalisation Process Theory as an example.

    PubMed

    O'Donnell, Catherine A; Mair, Frances S; Dowrick, Christopher; Brún, Mary O'Reilly-de; Brún, Tomas de; Burns, Nicola; Lionis, Christos; Saridaki, Aristoula; Papadakaki, Maria; Muijsenbergh, Maria van den; Weel-Baumgarten, Evelyn van; Gravenhorst, Katja; Cooper, Lucy; Princz, Christine; Teunissen, Erik; Mareeuw, Francine van den Driessen; Vlahadi, Maria; Spiegel, Wolfgang; MacFarlane, Anne

    2017-08-21

    To describe and reflect on the process of designing and delivering a training programme supporting the use of theory, in this case Normalisation Process Theory (NPT), in a multisite cross-country health services research study. Participatory research approach using qualitative methods. Six European primary care settings involving research teams from Austria, England, Greece, Ireland, The Netherlands and Scotland. RESTORE research team consisting of 8 project applicants, all senior primary care academics, and 10 researchers. Professional backgrounds included general practitioners/family doctors, social/cultural anthropologists, sociologists and health services/primary care researchers. Views of all research team members (n=18) were assessed using qualitative evaluation methods, analysed qualitatively by the trainers after each session. Most of the team had no experience of using NPT and many had not applied theory to prospective, qualitative research projects. Early training proved didactic and overloaded participants with information. Drawing on RESTORE's methodological approach of Participatory Learning and Action, workshops using role play, experiential interactive exercises and light-hearted examples not directly related to the study subject matter were developed. Evaluation showed the study team quickly grew in knowledge and confidence in applying theory to fieldwork.Recommendations applicable to other studies include: accepting that theory application is not a linear process, that time is needed to address researcher concerns with the process, and that experiential, interactive learning is a key device in building conceptual and practical knowledge. An unanticipated benefit was the smooth transition to cross-country qualitative coding of study data. A structured programme of training enhanced and supported the prospective application of a theory, NPT, to our work but raised challenges. These were not unique to NPT but could arise with the application of any theory, especially in large multisite, international projects. The lessons learnt are applicable to other theoretically informed studies. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  11. Evaluating the financial impact of clinical trials in oncology: results from a pilot study from the Association of American Cancer Institutes/Northwestern University clinical trials costs and charges project.

    PubMed

    Bennett, C L; Stinson, T J; Vogel, V; Robertson, L; Leedy, D; O'Brien, P; Hobbs, J; Sutton, T; Ruckdeschel, J C; Chirikos, T N; Weiner, R S; Ramsey, M M; Wicha, M S

    2000-08-01

    Medical care for clinical trials is often not reimbursed by insurers, primarily because of concern that medical care as part of clinical trials is expensive and not part of standard medical practice. In June 2000, President Clinton ordered Medicare to reimburse for medical care expenses incurred as part of cancer clinical trials, although many private insurers are concerned about the expense of this effort. To inform this policy debate, the costs and charges of care for patients on clinical trials are being evaluated. In this Association of American Cancer Institutes (AACI) Clinical Trials Costs and Charges pilot study, we describe the results and operational considerations of one of the first completed multisite economic analyses of clinical trials. Our pilot effort included assessment of total direct medical charges for 6 months of care for 35 case patients who received care on phase II clinical trials and for 35 matched controls (based on age, sex, disease, stage, and treatment period) at five AACI member cancer centers. Charge data were obtained for hospital and ancillary services from automated claims files at individual study institutions. The analyses were based on the perspective of a third-party payer. The mean age of the phase II clinical trial patients was 58.3 years versus 57.3 years for control patients. The study population included persons with cancer of the breast (n = 24), lung (n = 18), colon (n = 16), prostate (n = 4), and lymphoma (n = 8). The ratio of male-to-female patients was 3:4, with greater than 75% of patients having stage III to IV disease. Total mean charges for treatment from the time of study enrollment through 6 months were similar: $57,542 for clinical trial patients and $63,721 for control patients (1998 US$; P =.4) Multisite economic analyses of oncology clinical trials are in progress. Strategies that are not likely to overburden data managers and clinicians are possible to devise. However, these studies require careful planning and coordination among cancer center directors, finance department personnel, economists, and health services researchers.

  12. Psychiatric Residents' Views of Quality of Psychotherapy Training and Psychotherapy Competencies: A Multisite Survey

    ERIC Educational Resources Information Center

    Calabrese, Christina; Sciolla, Andres; Zisook, Sidney; Bitner, Robin; Tuttle, Jeffrey; Dunn, Laura B.

    2010-01-01

    Objective: Few studies of residents' attitudes toward psychotherapy training exist. The authors examined residents' perceptions of the quality of their training, support for training, their own competence levels, and associations between self-perceived competence and perceptions of the training environment. Methods: An anonymous, web-based…

  13. Special Diabetes Program for Indians: Retention in Cardiovascular Risk Reduction

    ERIC Educational Resources Information Center

    Manson, Spero M.; Jiang, Luohua; Zhang, Lijing; Beals, Janette; Acton, Kelly J.; Roubideaux, Yvette

    2011-01-01

    Purpose: This study examined the associations between participant and site characteristics and retention in a multisite cardiovascular disease risk reduction project. Design and Methods: Data were derived from the Special Diabetes Program for Indians Healthy Heart Demonstration Project, an intervention to reduce cardiovascular risk among American…

  14. Accuracy of stated energy contents of restaurant foods in a multi-site study

    USDA-ARS?s Scientific Manuscript database

    Context National recommendations for prevention and treatment of obesity emphasize reducing energy intake. Foods purchased in restaurants provide approximately 35% of daily energy intake, but the accuracy of information on the energy contents of these foods is unknown. Objective To examine the a...

  15. Forest type influences transmission of Phytophthora ramorum in California oak woodlands

    Treesearch

    J. M. Davidson; H. A. Patterson; A. C. Wickland; E. J. Fichtner; D. M. Rizzo

    2011-01-01

    The transmission ecology of Phytophthora ramorum from bay laurel (Umbellularia californica) leaves was compared between mixed-evergreen and redwood forest types throughout winter and summer disease cycles in central, coastal California. In a preliminary multisite study, we found that abscission rates of infected leaves were higher at mixed...

  16. Reading Shop Windows in Globalized Neighborhoods: Multilingual Literacy Practices and Indexicality

    ERIC Educational Resources Information Center

    Collins, James; Slembrouck, Stef

    2007-01-01

    Shop and cafe signs in multiple languages are familiar features of polyglot immigrant neighborhoods. This paper examines such signs, presenting photographic, observational, and interview data from a multisited ethnographic study of language contact in Ghent, an urban Belgian city. Drawing upon diverse ethnographic sources, especially the…

  17. INFORMATION MANAGEMENT AND RELATED QUALITY ASSURANCE FOR A LARGE SCALE, MULTI-SITE RESEARCH PROJECT

    EPA Science Inventory

    During the summer of 2000, as part of a U.S. Environmental Protection Agency study designed to improve microbial water quality monitoring protocols at public beaches, over 11,000 water samples were collected at five selected beaches across the country. At each beach, samples wer...

  18. Teacher Evaluation Initial Policy Implementation: Superintendent and Principal Perceptions

    ERIC Educational Resources Information Center

    Derrington, Mary Lynne

    2014-01-01

    This multi-site qualitative study examined the perspectives of K-12 superintendents and principals in four districts of a Southeastern state during the implementation of a new teacher evaluation system required by the Race to the Top federal grant. Specifically, these educators' viewpoints regarding this two-year implementation's impact are…

  19. Estimating Cross-Site Impact Variation in the Presence of Heteroscedasticity

    ERIC Educational Resources Information Center

    Bloom, Howard S.; Porter, Kristin E.; Weiss, Michael J.; Raudenbush, Stephen

    2013-01-01

    To date, evaluation research and policy analysis have focused mainly on average program impacts and paid little systematic attention to their variation. Recently, the growing number of multi-site randomized trials that are being planned and conducted make it increasingly feasible to study "cross-site" variation in impacts. Important…

  20. Extra-team Connections for Knowledge Transfer between Staff Teams

    ERIC Educational Resources Information Center

    Ramanadhan, Shoba; Wiecha, Jean L.; Emmons, Karen M.; Gortmaker, Steven L.; Viswanath, Kasisomayajula

    2009-01-01

    As organizations implement novel health promotion programs across multiple sites, they face great challenges related to knowledge management. Staff social networks may be a useful medium for transferring program-related knowledge in multi-site implementation efforts. To study this potential, we focused on the role of extra-team connections (ties…

  1. Exploring Principals' Nonroutine Problems in Bilingual Immersion Schools: Lessons Learned for Multicultural Leadership

    ERIC Educational Resources Information Center

    Schwabsky, Nitza

    2013-01-01

    The present study examines the nonroutine problems that eight Anglo-American principals encountered in managing three elementary bilingual immersion schools in the Northwest United States. Using qualitative inquiry to collect data, I employed the multisited ethnographic research model. The principals reported nonroutine problems in the following…

  2. Domestic Violence and Dependency Courts: The "Greenbook" Demonstration Experience

    ERIC Educational Resources Information Center

    Malik, Neena M.; Silverman, Jerry; Wang, Kathleen; Janczewski, Colleen

    2008-01-01

    This field study reports on a cross-site evaluation of dependency courts in communities receiving federal funding to implement the "Greenbook" initiative, a multisite demonstration for community improvement of coordinated responses to families victimized by domestic violence and child maltreatment. This article focuses on the dependency court,…

  3. The Impact of E-Skills on the Settlement of Iranian Refugees in Australia

    ERIC Educational Resources Information Center

    Shariati, Saeed; Armarego, Jocelyn; Sudweeks, Fay

    2017-01-01

    Aim/Purpose: The research investigates the impact of Information and Communication Technologies (ICT) on Iranian refugees' settlement in Australia. Background: The study identifies the issues of settlement, such as language, cultural and social differences. Methodology: The Multi-Sited Ethnography (MSE), which is a qualitative methodology, has…

  4. MULTI-SITE PERFORMANCE EVALUATIONS OF CANDIDATE METHODOLOGIES FOR DETERMINING COARSE PARTICULATE MATTER (PMC) CONCENTRATIONS

    EPA Science Inventory

    Comprehensive field studies were conducted to evaluate the performance of sampling methods for measuring the coarse fraction of PM10 in ambient air. Five separate sampling approaches were evaluated at each of three sampling sites. As the primary basis of comparison, a discret...

  5. MULTI-SITE EVALUATIONS OF CANDIDATE METHODOLOGIES FOR DETERMINING COARSE PARTICULATE MATTER (PMC) CONCENTRATIONS

    EPA Science Inventory

    Comprehensive field studies were conducted to evaluate the performance of sampling methods for measuring the coarse fraction of PM10 in ambient air. Five separate sampling approaches were evaluated at each of three sampling sites. As the primary basis of comparison, a discret...

  6. MULTI-SITE EVALUATIONS OF CANDIDATE METHODOLOGIES FOR DETERMINING COARSE PARTICULATE MATTER (PMC) CONCENTRATIONS

    EPA Science Inventory

    Comprehensive field studies were conducted to evaluate the performance of sampling methods for measuring the coarse fraction of PM10 in ambient air. Five separate sampling approaches were evaluated at each of three sampling sites. As the primary basis of comparison, a discrete ...

  7. Multi-site p-loss assessment from privately owned cropland in Northeast Missouri

    USDA-ARS?s Scientific Manuscript database

    Phosphorus exported from watersheds can accelerate eutrophication and is identified as one of the main causes of water impairment. Accurate phosphorus (P) loss assessment has become vital for effective implementation of conservation measures. The study objective was to assess the validity of a cla...

  8. Demographic profile of families and children in the Study to Explore Early Development (SEED): Case-control study of autism spectrum disorder

    PubMed Central

    DiGuiseppi, Carolyn G.; Daniels, Julie L.; Fallin, Daniele M.; Rosenberg, Steven A.; Schieve, Laura A.; Thomas, Kathleen C.; Windham, Gayle C.; Goss, Cynthia W.; Soke, Gnakub N.; Currie, Dustin W.; Singer, Alison B.; Lee, Li-Ching; Bernal, Pilar; Croen, Lisa A.; Miller, Lisa A.; Pinto-Martin, Jennifer A.; Young, Lisa M.; Schendel, Diana E.

    2016-01-01

    Background The Study to Explore Early Development (SEED) is designed to enhance knowledge of autism spectrum disorder characteristics and etiologies. Objective This paper describes the demographic profile of enrolled families and examines sociodemographic differences between children with autism spectrum disorder and children with other developmental problems or who are typically developing. Methods This multi-site case-control study used health, education, and birth certificate records to identify and enroll children aged 2–5 years into one of three groups: 1) cases (children with autism spectrum disorder), 2) developmental delay or disorder controls, or 3) general population controls. Study group classification was based on sampling source, prior diagnoses, and study screening tests and developmental evaluations. The child's primary caregiver provided demographic characteristics through a telephone (or occasionally face-to-face) interview. Groups were compared using ANOVA, chi-squared test, or multinomial logistic regression as appropriate. Results Of 2768 study children, sizeable proportions were born to mothers of non-White race (31.7%), Hispanic ethnicity (11.4%), and foreign birth (17.6%); 33.0% of households had incomes below the US median. The autism spectrum disorder and population control groups differed significantly on nearly all sociodemographic parameters. In contrast, the autism spectrum disorder and developmental delay or disorder groups had generally similar sociodemographic characteristics. Conclusions SEED enrolled a sociodemographically diverse sample, which will allow further, in-depth exploration of sociodemographic differences between study groups and provide novel opportunities to explore sociodemographic influences on etiologic risk factor associations with autism spectrum disorder and phenotypic subtypes. PMID:26917104

  9. Demographic profile of families and children in the Study to Explore Early Development (SEED): Case-control study of autism spectrum disorder.

    PubMed

    DiGuiseppi, Carolyn G; Daniels, Julie L; Fallin, Daniele M; Rosenberg, Steven A; Schieve, Laura A; Thomas, Kathleen C; Windham, Gayle C; Goss, Cynthia W; Soke, Gnakub N; Currie, Dustin W; Singer, Alison B; Lee, Li-Ching; Bernal, Pilar; Croen, Lisa A; Miller, Lisa A; Pinto-Martin, Jennifer A; Young, Lisa M; Schendel, Diana E

    2016-07-01

    The Study to Explore Early Development (SEED) is designed to enhance knowledge of autism spectrum disorder characteristics and etiologies. This paper describes the demographic profile of enrolled families and examines sociodemographic differences between children with autism spectrum disorder and children with other developmental problems or who are typically developing. This multi-site case-control study used health, education, and birth certificate records to identify and enroll children aged 2-5 years into one of three groups: 1) cases (children with autism spectrum disorder), 2) developmental delay or disorder controls, or 3) general population controls. Study group classification was based on sampling source, prior diagnoses, and study screening tests and developmental evaluations. The child's primary caregiver provided demographic characteristics through a telephone (or occasionally face-to-face) interview. Groups were compared using ANOVA, chi-squared test, or multinomial logistic regression as appropriate. Of 2768 study children, sizeable proportions were born to mothers of non-White race (31.7%), Hispanic ethnicity (11.4%), and foreign birth (17.6%); 33.0% of households had incomes below the US median. The autism spectrum disorder and population control groups differed significantly on nearly all sociodemographic parameters. In contrast, the autism spectrum disorder and developmental delay or disorder groups had generally similar sociodemographic characteristics. SEED enrolled a sociodemographically diverse sample, which will allow further, in-depth exploration of sociodemographic differences between study groups and provide novel opportunities to explore sociodemographic influences on etiologic risk factor associations with autism spectrum disorder and phenotypic subtypes. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Future enhanced clinical role of pharmacists in Emergency Departments in England: multi-site observational evaluation.

    PubMed

    Hughes, Elizabeth; Terry, David; Huynh, Chi; Petridis, Konstantinos; Aiello, Matthew; Mazard, Louis; Ubhi, Hirminder; Terry, Alex; Wilson, Keith; Sinclair, Anthony

    2017-08-01

    Background There are concerns about maintaining appropriate clinical staffing levels in Emergency Departments. Pharmacists may be one possible solution. Objective To determine if Emergency Department attendees could be clinically managed by pharmacists with or without advanced clinical practice training. Setting Prospective 49 site cross-sectional observational study of patients attending Emergency Departments in England. Method Pharmacist data collectors identified patient attendance at their Emergency Department, recorded anonymized details of 400 cases and categorized each into one of four possible options: cases which could be managed by a community pharmacist; could be managed by a hospital pharmacist independent prescriber; could be managed by a hospital pharmacist independent prescriber with additional clinical training; or medical team only (unsuitable for pharmacists to manage). Impact indices sensitive to both workload and proportion of pharmacist manageable cases were calculated for each clinical group. Main outcome measure Proportion of cases which could be managed by a pharmacist. Results 18,613 cases were observed from 49 sites. 726 (3.9%) of cases were judged suitable for clinical management by community pharmacists, 719 (3.9%) by pharmacist prescribers, 5202 (27.9%) by pharmacist prescribers with further training, and 11,966 (64.3%) for medical team only. Impact Indices of the most frequent clinical groupings were general medicine (13.18) and orthopaedics (9.69). Conclusion The proportion of Emergency Department cases that could potentially be managed by a pharmacist was 36%. Greatest potential for pharmacist management was in general medicine and orthopaedics (usually minor trauma). Findings support the case for extending the clinical role of pharmacists.

  11. The Pediatric Imaging, Neurocognition, and Genetics (PING) Data Repository

    PubMed Central

    Jernigan, Terry L.; Brown, Timothy T.; Hagler, Donald J.; Akshoomoff, Natacha; Bartsch, Hauke; Newman, Erik; Thompson, Wesley K.; Bloss, Cinnamon S.; Murray, Sarah S.; Schork, Nicholas; Kennedy, David N.; Kuperman, Joshua M.; McCabe, Connor; Chung, Yoonho; Libiger, Ondrej; Maddox, Melanie; Casey, B. J.; Chang, Linda; Ernst, Thomas M.; Frazier, Jean A.; Gruen, Jeffrey R.; Sowell, Elizabeth R.; Kenet, Tal; Kaufmann, Walter E.; Mostofsky, Stewart; Amaral, David G.; Dale, Anders M.

    2015-01-01

    The main objective of the multi-site Pediatric Imaging, Neurocognition, and Genetics (PING) study was to create a large repository of standardized measurements of behavioral and imaging phenotypes accompanied by whole genome genotyping acquired from typically-developing children varying widely in age (3 to 20 years). This cross-sectional study produced sharable data from 1493 children, and these data have been described in several publications focusing on brain and cognitive development. Researchers may gain access to these data by applying for an account on the PING Portal and filing a Data Use Agreement. Here we describe the recruiting and screening of the children and give a brief overview of the assessments performed, the imaging methods applied, the genetic data produced, and the numbers of cases for whom different data types are available. We also cite sources of more detailed information about the methods and data. Finally we describe the procedures for accessing the data and for using the PING data exploration portal. PMID:25937488

  12. The Pediatric Imaging, Neurocognition, and Genetics (PING) Data Repository.

    PubMed

    Jernigan, Terry L; Brown, Timothy T; Hagler, Donald J; Akshoomoff, Natacha; Bartsch, Hauke; Newman, Erik; Thompson, Wesley K; Bloss, Cinnamon S; Murray, Sarah S; Schork, Nicholas; Kennedy, David N; Kuperman, Joshua M; McCabe, Connor; Chung, Yoonho; Libiger, Ondrej; Maddox, Melanie; Casey, B J; Chang, Linda; Ernst, Thomas M; Frazier, Jean A; Gruen, Jeffrey R; Sowell, Elizabeth R; Kenet, Tal; Kaufmann, Walter E; Mostofsky, Stewart; Amaral, David G; Dale, Anders M

    2016-01-01

    The main objective of the multi-site Pediatric Imaging, Neurocognition, and Genetics (PING) study was to create a large repository of standardized measurements of behavioral and imaging phenotypes accompanied by whole genome genotyping acquired from typically-developing children varying widely in age (3 to 20 years). This cross-sectional study produced sharable data from 1493 children, and these data have been described in several publications focusing on brain and cognitive development. Researchers may gain access to these data by applying for an account on the PING portal and filing a data use agreement. Here we describe the recruiting and screening of the children and give a brief overview of the assessments performed, the imaging methods applied, the genetic data produced, and the numbers of cases for whom different data types are available. We also cite sources of more detailed information about the methods and data. Finally we describe the procedures for accessing the data and for using the PING data exploration portal. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. 'No one to trust': the cultural embedding of atomism in financial markets.

    PubMed

    Ailon, Galit

    2018-05-13

    The paper ethnographically explores the cultural embedding of atomistic indifference in online, global financial markets: arenas that have been digitally designed according to economic ideals and that demand an extreme form of relational and social dissociation from the partners to exchange and from those affected by the transactions. Its case-study is lay financial-trading in Israel, a country undergoing extensive neoliberalization. The study shows that dissociation is embedded in an economic culture marked by constant, multi-sited declarations that economic-Others are cold, uncaring and manipulative. It takes shape as traders convert the distrust towards Others into distrust towards portions of the Self that represent links to these Others, namely their own social-psychology and social concern. Acting atomistically and selfishly in the market thus entails considerable reflexive work. The paper contributes to an ongoing debate on the moral and cultural embeddedness of markets in general and of the expanding financial markets in particular. © London School of Economics and Political Science 2018.

  14. View from the top: CEO perspectives on executive development and succession planning practices in healthcare organizations.

    PubMed

    Groves, Kevin S

    2006-01-01

    Many healthcare professionals question whether the industry's hospitals and multi-site systems are implementing the necessary executive development and succession planning systems to ensure that high potential managers are prepared and aptly selected to assume key executive roles. Survey data, case studies, and cross-industry comparisons suggest that healthcare organizations may face a leadership crisis as the current generation of chief executive officers (CEOs) nears retirement while traditional means of developing the leadership pipeline, including middle-management positions and graduate programs requiring formal residencies, continue to dissipate. Given the daunting challenges that accompany the healthcare industry's quest to identify, develop, and retain leadership talent, this article provides best practice findings from a qualitative study of 13 healthcare organizations with a record of exemplary executive development and succession planning practices. CEOs from six single-site hospitals, six healthcare systems, and one medical group were interviewed to identify industry best practices so that healthcare practitioners and educators may utilize the findings to enhance the industry's leadership capacity.

  15. Exploring and understanding academic leadership in family medicine

    PubMed Central

    Oandasan, Ivy; White, David; Hammond Mobilio, Melanie; Gotlib Conn, Lesley; Feldman, Kymm; Kim, Florence; Rouleau, Katherine; Sorensen, Leslie

    2013-01-01

    Abstract Objective To explore how family physicians understand the concept of academic leadership. Design Case study. Setting Department of Family and Community Medicine at the University of Toronto in Ontario. Participants Thirty family physician academic leaders. Methods Focus groups and interviews were conducted with family physicians from a large multisite urban university who were identified by peers as academic leaders at various career stages. Transcripts from the focus groups and interviews were anonymized and themes were analyzed and negotiated among 3 researchers. Main findings Participants identified qualities of leadership among academic leaders that align with those identified in the current literature. Despite being identified by others as academic leaders, participants were reluctant to self-identify as such. Participants believed they had taken on early leadership roles by default rather than through planned career development. Conclusion This study affirms the need to define academic leadership explicitly, advance a culture that supports it, and nurture leaders at all levels with a variety of strategies. PMID:23486818

  16. Chest Radiograph Findings in Childhood Pneumonia Cases From the Multisite PERCH Study.

    PubMed

    Fancourt, Nicholas; Deloria Knoll, Maria; Baggett, Henry C; Brooks, W Abdullah; Feikin, Daniel R; Hammitt, Laura L; Howie, Stephen R C; Kotloff, Karen L; Levine, Orin S; Madhi, Shabir A; Murdoch, David R; Scott, J Anthony G; Thea, Donald M; Awori, Juliet O; Barger-Kamate, Breanna; Chipeta, James; DeLuca, Andrea N; Diallo, Mahamadou; Driscoll, Amanda J; Ebruke, Bernard E; Higdon, Melissa M; Jahan, Yasmin; Karron, Ruth A; Mahomed, Nasreen; Moore, David P; Nahar, Kamrun; Naorat, Sathapana; Ominde, Micah Silaba; Park, Daniel E; Prosperi, Christine; Wa Somwe, Somwe; Thamthitiwat, Somsak; Zaman, Syed M A; Zeger, Scott L; O'Brien, Katherine L

    2017-06-15

    Chest radiographs (CXRs) are frequently used to assess pneumonia cases. Variations in CXR appearances between epidemiological settings and their correlation with clinical signs are not well documented. The Pneumonia Etiology Research for Child Health project enrolled 4232 cases of hospitalized World Health Organization (WHO)-defined severe and very severe pneumonia from 9 sites in 7 countries (Bangladesh, the Gambia, Kenya, Mali, South Africa, Thailand, and Zambia). At admission, each case underwent a standardized assessment of clinical signs and pneumonia risk factors by trained health personnel, and a CXR was taken that was interpreted using the standardized WHO methodology. CXRs were categorized as abnormal (consolidation and/or other infiltrate), normal, or uninterpretable. CXRs were interpretable in 3587 (85%) cases, of which 1935 (54%) were abnormal (site range, 35%-64%). Cases with abnormal CXRs were more likely than those with normal CXRs to have hypoxemia (45% vs 26%), crackles (69% vs 62%), tachypnea (85% vs 80%), or fever (20% vs 16%) and less likely to have wheeze (30% vs 38%; all P < .05). CXR consolidation was associated with a higher case fatality ratio at 30-day follow-up (13.5%) compared to other infiltrate (4.7%) or normal (4.9%) CXRs. Clinically diagnosed pneumonia cases with abnormal CXRs were more likely to have signs typically associated with pneumonia. However, CXR-normal cases were common, and clinical signs considered indicative of pneumonia were present in substantial proportions of these cases. CXR-consolidation cases represent a group with an increased likelihood of death at 30 days post-discharge. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  17. The Childhood Obesity Research Demonstration project: a team approach for supporting a multisite, multisector intervention.

    PubMed

    Williams, Nancy; Dooyema, Carrie A; Foltz, Jennifer L; Belay, Brook; Blanck, Heidi M

    2015-02-01

    Comprehensive multisector, multilevel approaches are needed to address childhood obesity. This article introduces the structure of a multidisciplinary team approach used to support and guide the multisite, multisector interventions implemented as part of the Childhood Obesity Research Demonstration (CORD) project. This article will describe the function, roles, and lessons learned from the CDC-CORD approach to project management. The CORD project works across multisectors and multilevels in three demonstration communities. Working with principal investigators and their research teams who are engaging multiple stakeholder groups, including community organizations, schools and child care centers, health departments, and healthcare providers, can be a complex endeavor. To best support the community-based research project, scientific and programmatic expertise in a wide range of areas was required. The team was configured based on the skill sets needed to interact with the various levels of staff working with the project. By thoughtful development of the team and processes, an efficient system for supporting the multisite, multisector intervention project sites was developed. The team approach will be formally evaluated at the end of the project period.

  18. Risperidone in Children with Disruptive Behavior Disorders and Subaverage Intelligence: A 1-Year, Open-Label Study of 504 Patients

    ERIC Educational Resources Information Center

    Croonenberghs, Jan; Fegert, Joerg M.; Findling, Robert L.; de Smedt, Goedele; van Dongen, Stefan

    2005-01-01

    Objective: To determine the long-term safety and effectiveness of risperidone for severe disruptive behaviors in children. Method: A multisite, 1-year, open-label study of patients aged 5 to 14 years with disruptive behaviors and subaverage intelligence was conducted. Results: Seventy-three percent of the 504 patients enrolled completed the study.…

  19. Association between barriers and facilitators to meeting the Dietary Guidelines for Americans and body weight status of caregiver-child dyads: The HEALTH study

    USDA-ARS?s Scientific Manuscript database

    Few Americans meet the Dietary Guidelines for Americans (DGA) yet, a large percentage are overweight. The goal of this research was to examine the association between barriers and facilitators to meeting the DGA and weight in a multi-site study. In a cross-sectional study, a total of 836 caregiver-c...

  20. Implementation and Impacts of Pay-for-Performance: The 2010 Teacher Incentive Fund (TIF) Grantees after Two Years. NCEE Study Snapshot. NCEE 2015-4022

    ERIC Educational Resources Information Center

    National Center for Education Evaluation and Regional Assistance, 2015

    2015-01-01

    The Teacher Incentive Fund (TIF) provides grants to support performance-based compensation systems for teachers and principals in high-need schools. The study measures the impact of pay-for-performance bonuses as part of a comprehensive compensation system within a large, multisite random assignment study design. The treatment schools were to…

  1. Maternal occupational pesticide exposure and risk of congenital heart defects in the National Birth Defects Prevention Study.

    PubMed

    Rocheleau, Carissa M; Bertke, Stephen J; Lawson, Christina C; Romitti, Paul A; Sanderson, Wayne T; Malik, Sadia; Lupo, Philip J; Desrosiers, Tania A; Bell, Erin; Druschel, Charlotte; Correa, Adolfo; Reefhuis, Jennita

    2015-10-01

    Congenital heart defects (CHDs) are common birth defects, affecting approximately 1% of live births. Pesticide exposure has been suggested as an etiologic factor for CHDs, but previous results were inconsistent. We examined maternal occupational exposure to fungicides, insecticides, and herbicides for 3328 infants with CHDs and 2988 unaffected control infants of employed mothers using data for 1997 through 2002 births from the National Birth Defects Prevention Study, a population-based multisite case-control study. Potential pesticide exposure from 1 month before conception through the first trimester of pregnancy was assigned by an expert-guided task-exposure matrix and job history details self-reported by mothers. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multivariable logistic regression. Maternal occupational exposure to pesticides was not associated with CHDs overall. In examining specific CHD subtypes compared with controls, some novel associations were observed with higher estimated pesticide exposure: insecticides only and secundum atrial septal defect (OR = 1.8; 95% CI, 1.3-2.7, 40 exposed cases); both insecticides and herbicides and hypoplastic left heart syndrome (OR = 5.1; 95% CI, 1.7-15.3, 4 exposed cases), as well as pulmonary valve stenosis (OR = 3.6; 95% CI, 1.3-10.1, 5 exposed cases); and insecticides, herbicides, and fungicides and tetralogy of Fallot (TOF) (OR = 2.2; 95% CI, 1.2-4.0, 13 exposed cases). Broad pesticide exposure categories were not associated with CHDs overall, but examining specific CHD subtypes revealed some increased odds ratios. These results highlight the importance of examining specific CHDs separately. Because of multiple comparisons, additional work is needed to verify these associations. © 2014 Wiley Periodicals, Inc.

  2. Scientific Growth and Identity Development during a Postbaccalaureate Program: Results from a Multisite Qualitative Study

    ERIC Educational Resources Information Center

    Remich, Robin; Naffziger-Hirsch, Michelle E.; Gazley, J. Lynn; McGee, Richard

    2016-01-01

    This report builds upon our previous study, which described five patterns of why college graduates join National Institutes of Health (NIH)-funded diversity-focused Postbaccalaureate Research Education Programs (PREP). A 2015 report from the NIH showed that a high fraction of PREP participants matriculate into PhD and MD/PhD programs. This current…

  3. Treatment of Adolescent Marijuana Abuse: A Randomized Clinical Trial. Presentation 1: Structure of the Cannabis Youth Treatment Study.

    ERIC Educational Resources Information Center

    Titus, Janet C.; Dennis, Michael L.; Diamond, Guy; Godley, Susan H.; Babor, Thomas; Donaldson, Jean; Herrell, James; Tims, Frank; Webb, Charles

    The Cannabis Youth Treatment (CYT) study is a multi-site randomized field experiment examining five outpatient treatment protocols for adolescents who abuse or are dependent on marijuana. The purpose of the CYT project is twofold: (a) to test the relative clinical effectiveness and cost-effectiveness of five promising interventions targeted at…

  4. Which Sexual Abuse Victims Receive a Forensic Medical Examination?: The Impact of Children's Advocacy Centers

    ERIC Educational Resources Information Center

    Walsh, Wendy A.; Cross, Theodore P.; Jones, Lisa M.; Simone, Monique; Kolko, David J.

    2007-01-01

    Objective: This study examines the impact of Children's Advocacy Centers (CAC) and other factors, such as the child's age, alleged penetration, and injury on the use of forensic medical examinations as part of the response to reported child sexual abuse. Methods: This analysis is part of a quasi-experimental study, the Multi-Site Evaluation of…

  5. Psychometric Study of the Aberrant Behavior Checklist in Fragile X Syndrome and Implications for Targeted Treatment

    ERIC Educational Resources Information Center

    Sansone, Stephanie M.; Widaman, Keith F.; Hall, Scott S.; Reiss, Allan L.; Lightbody, Amy; Kaufmann, Walter E.; Berry-Kravis, Elizabeth; Lachiewicz, Ave; Brown, Elaine C.; Hessl, David

    2012-01-01

    Animal studies elucidating the neurobiology of fragile X syndrome (FXS) have led to multiple controlled trials in humans, with the Aberrant Behavior Checklist-Community (ABC-C) commonly adopted as a primary outcome measure. A multi-site collaboration examined the psychometric properties of the ABC-C in 630 individuals (ages 3-25) with FXS using…

  6. Substance Abuse Treatment Outcomes: A Multi-Site Study of Male and Female Prison Programs

    ERIC Educational Resources Information Center

    Pelissier, Bernadette; Motivans, Mark; Rounds-Bryant, Jennifer L.

    2005-01-01

    The present study examined whether there were program differences with respect to post-release outcomes in 20 federal in-prison substance abuse programs which used a cognitive-behavioral treatment approach. Recidivism and post-release drug use were examined for a sample of 1,343 individuals--1,065 men and 278 women. Discrete time proportional…

  7. Strategies Pregnant Rural Women Employ to Deal with Intimate Partner Violence

    ERIC Educational Resources Information Center

    Bhandari, Shreya; Bullock, Linda F. C.; Sharps, Phyllis W.

    2013-01-01

    This study explored strategies from the Intimate Partner Violence Strategy Index (IPVSI) that a sub-set of 20 rural, low-income, abused women of a larger, multi-site, mixed-method study employed to deal with Intimate Partner Violence (IPV) during the perinatal period. We conducted 32 in-depth interviews with women who were pregnant (N = 12) and/or…

  8. Is There a "Regressive Phenotype" of Autism Spectrum Disorder Associated with the Measles-Mumps-Rubella Vaccine? A CPEA Study

    ERIC Educational Resources Information Center

    Richler, Jennifer; Luyster, Rhiannon; Risi, Susan; Hsu, Wan-Ling; Dawson, Geraldine; Bernier, Raphael; Dunn, Michelle; Hepburn, Susan; Hyman, Susan L.; McMahon, William M.; Goudie-Nice, Julie; Minshew, Nancy; Rogers, Sally; Sigman, Marian; Spence, M. Anne; Goldberg, Wendy A.; Tager-Flusbert, Helen; Volkmar, Fred R.; Lord, Catherine

    2006-01-01

    A multi-site study of 351 children with Autism Spectrum Disorders (ASD) and 31 typically developing children used caregiver interviews to describe the children's early acquisition and loss of social-communication milestones. For the majority of children with ASD who had experienced a regression, pre-loss development was clearly atypical. Children…

  9. Promoting Adolescent Health and Well-Being through Outdoor Youth Programs: Results from a Multisite Australian Study

    ERIC Educational Resources Information Center

    Rose, Lauren; Williams, Ian R.; Olsson, Craig A.; Allen, Nicholas B.

    2018-01-01

    The purpose of this study was to examine the extent to which participation in structured outdoor programs is associated with improvements in adolescent health and well-being. Students (n = 160) were recruited from three secondary schools in Victoria, Australia. Adolescents completed online surveys 3 weeks before camp (Time 1), 1 week before camp…

  10. Multisite Study of New Autism Diagnostic Interview-Revised (ADI-R) Algorithms for Toddlers and Young Preschoolers

    ERIC Educational Resources Information Center

    Kim, So Hyun; Thurm, Audrey; Shumway, Stacy; Lord, Catherine

    2013-01-01

    Using two independent datasets provided by National Institute of Health funded consortia, the Collaborative Programs for Excellence in Autism and Studies to Advance Autism Research and Treatment (n = 641) and the National Institute of Mental Health (n = 167), diagnostic validity and factor structure of the new Autism Diagnostic Interview (ADI-R)…

  11. Exploring Democracy: Nordic Music Teachers' Approaches to the Development of Immigrant Students' Musical Agency

    ERIC Educational Resources Information Center

    Karlsen, Sidsel

    2014-01-01

    In this article, a multi-sited ethnographic study was taken as a point of departure for exploring how Nordic music teachers, who work in multicultural environments, understand the development of their students' musical agency. The study was based on theories developed within general sociology and the sociology of music, as well as in previous…

  12. The Maternal Description of Child (MDoC): A New Audiotaped Measure of Maternal Affect

    ERIC Educational Resources Information Center

    Martin, Anne; Razza, Rachel A.; Brooks-Gunn, Jeanne

    2015-01-01

    We report on a new measure of maternal affect from an ongoing multi-site birth cohort study with primarily low-income families, the Fragile Families and Child Wellbeing Study. At child age of 5?years, mothers were asked to describe their child in a short, semi-structured home interview. One innovation of this measure--called the Maternal…

  13. Evaluation of the Teacher Incentive Fund: Implementation and Early Impacts of Pay-for-Performance after One Year. NCEE 2014-4019

    ERIC Educational Resources Information Center

    Max, Jeffrey; Constantine, Jill; Wellington, Alison; Hallgren, Kristin; Glazerman, Steven; Chiang, Hanley; Speroni, Cecilia

    2014-01-01

    The Teacher Incentive Fund (TIF) provides grants to support performance-based compensation systems for teachers and principals in high-need schools. The study measures the impact of pay-for-performance bonuses as part of a comprehensive compensation system within a large, multisite random assignment study design. The treatment schools were to…

  14. Evaluation of the Teacher Incentive Fund: Implementation and Impacts of Pay-for-Performance after Two Years. NCEE 2015-4020

    ERIC Educational Resources Information Center

    Chiang, Hanley; Wellington, Alison; Hallgren, Kristin; Speroni, Cecilia; Herrmann, Mariesa; Glazerman, Steven; Constantine, Jill

    2015-01-01

    The Teacher Incentive Fund (TIF) provides grants to support performance-based compensation systems for teachers and principals in high-need schools. The study measures the impact of pay-for-performance bonuses as part of a comprehensive compensation system within a large, multisite random assignment study design. The treatment schools were to…

  15. Is There a Magnet-School Effect? A Multisite Study of MSAP-Funded Magnet Schools

    ERIC Educational Resources Information Center

    Wang, Jia; Schweig, Jonathan D.; Herman, Joan L.

    2017-01-01

    Magnet schools are one of the largest sectors of choice schools in the United States. In this study, we explored the heterogeneity in magnet-school effects on student achievement by examining 24 magnet schools, funded under the Magnet Schools Assistance Program (MSAP), in 5 school districts across 4 states. The magnet effects were synthesized…

  16. Interpersonal art psychotherapy for the treatment of aggression in people with learning disabilities in secure care: a protocol for a randomised controlled feasibility study.

    PubMed

    Hackett, Simon S; Taylor, John L; Freeston, Mark; Jahoda, Andrew; McColl, Elaine; Pennington, Lindsay; Kaner, Eileen

    2017-01-01

    Art psychotherapy has greater potential for use with adults with mild to moderate learning disabilities as it places less of a burden on verbal interaction to achieve positive therapeutic, psychological, and behavioural goals. The feasibility study objectives include testing procedures, outcomes, validated tools, recruitment and attrition rates, acceptability, and treatment fidelity for manualised interpersonal art psychotherapy. Adult males and females with mild to moderate learning disabilities will be recruited from four NHS secure hospitals. Twenty patients will be recruited and randomly assigned to one of two treatment groups: fifteen 1-h individual sessions of manualised interpersonal art psychotherapy, or a treatment as usual waiting list control group. The Modified Overt Aggression Scale will be administered to both treatment arms. Four patients will be recruited to a single-case design component of the study exploring the acceptability of an attentional condition. This multi-site study will assist in future trial planning and inform feasibility including, procedures, treatment acceptability, therapist adherence, and estimation of samples size for a definitive RCT.

  17. Medical education practice-based research networks: Facilitating collaborative research.

    PubMed

    Schwartz, Alan; Young, Robin; Hicks, Patricia J

    2016-01-01

    Research networks formalize and institutionalize multi-site collaborations by establishing an infrastructure that enables network members to participate in research, propose new studies, and exploit study data to move the field forward. Although practice-based clinical research networks are now widespread, medical education research networks are rapidly emerging. In this article, we offer a definition of the medical education practice-based research network, a brief description of networks in existence in July 2014 and their features, and a more detailed case study of the emergence and early growth of one such network, the Association of Pediatric Program Directors Longitudinal Educational Assessment Research Network (APPD LEARN). We searched for extant networks through peer-reviewed literature and the world-wide web. We identified 15 research networks in medical education founded since 2002 with membership ranging from 8 to 120 programs. Most focus on graduate medical education in primary care or emergency medicine specialties. We offer four recommendations for the further development and spread of medical education research networks: increasing faculty development, obtaining central resources, studying networks themselves, and developing networks of networks.

  18. Medical education practice-based research networks: Facilitating collaborative research

    PubMed Central

    Schwartz, Alan; Young, Robin; Hicks, Patricia J.; APPD LEARN, For

    2016-01-01

    Abstract Background: Research networks formalize and institutionalize multi-site collaborations by establishing an infrastructure that enables network members to participate in research, propose new studies, and exploit study data to move the field forward. Although practice-based clinical research networks are now widespread, medical education research networks are rapidly emerging. Aims: In this article, we offer a definition of the medical education practice-based research network, a brief description of networks in existence in July 2014 and their features, and a more detailed case study of the emergence and early growth of one such network, the Association of Pediatric Program Directors Longitudinal Educational Assessment Research Network (APPD LEARN). Methods: We searched for extant networks through peer-reviewed literature and the world-wide web. Results: We identified 15 research networks in medical education founded since 2002 with membership ranging from 8 to 120 programs. Most focus on graduate medical education in primary care or emergency medicine specialties. Conclusions: We offer four recommendations for the further development and spread of medical education research networks: increasing faculty development, obtaining central resources, studying networks themselves, and developing networks of networks. PMID:25319404

  19. Introduction of shared electronic records: multi-site case study using diffusion of innovation theory.

    PubMed

    Greenhalgh, Trisha; Stramer, Katja; Bratan, Tanja; Byrne, Emma; Mohammad, Yara; Russell, Jill

    2008-10-23

    To explore the introduction of a centrally stored, shared electronic patient record (the summary care record (SCR)) in England and draw wider lessons about the implementation of large scale information technology projects in health care. Multi-site, mixed method case study applying utilisation focused evaluation. Four early adopter sites for the SCR in England-three in urban areas of relative socioeconomic deprivation and the fourth in a relatively affluent rural area. Data sources and analysis Data included 250 staff interviews, 1500 hours of ethnographic observation, interviews and focus groups with 170 patients and carers, 2500 pages of correspondence and documentary evidence, and incorporation of relevant surveys and statistics produced by others. These were analysed by using a thematic approach drawing on (and extending) a theoretical model of complex change developed in a previous systematic review. Main findings The mixed fortunes of the SCR programme in its first year were largely explained by eight interacting influences. The first was the SCR's material properties (especially technical immaturity and lack of interoperability) and attributes (especially the extent to which potential adopters believed the benefits outweighed the risks). The second was adopters' concerns (especially about workload and the ethicality of sharing "confidential" information on an implied consent model). The third influence was interpersonal influence (for example, opinion leaders, champions, facilitators), and the fourth was organisational antecedents for innovation (for example past experience with information technology projects, leadership and management capacity, effective data capture systems, slack resources). The fifth was organisational readiness for the SCR (for example, innovation-system fit, tension for change, power balances between supporters and opponents, baseline data quality). The sixth was the implementation process (including the nature of the change model and the extent to which new routines associated with the SCR aligned with existing organisational routines). The seventh influence was the nature and quality of links between different parts of the system, and the final one was the wider environment (especially the political context of the programme). Shared electronic records are not plug-in technologies. They are complex innovations that must be accepted by individual patients and staff and also embedded in organisational and inter-organisational routines. This process is heavily influenced at the micro-level by the material properties of the technology, individuals' attitudes and concerns, and interpersonal influence; at the meso-level by organisational antecedents, readiness, and operational aspects of implementation; and at the macro-level by institutional and socio-political forces. A case study approach and multi-level theoretical analysis can illuminate how contextual factors shape, enable, and constrain new, technology supported models of patient care.

  20. Introduction of shared electronic records: multi-site case study using diffusion of innovation theory

    PubMed Central

    Stramer, Katja; Bratan, Tanja; Byrne, Emma; Mohammad, Yara; Russell, Jill

    2008-01-01

    Objective To explore the introduction of a centrally stored, shared electronic patient record (the summary care record (SCR)) in England and draw wider lessons about the implementation of large scale information technology projects in health care. Design Multi-site, mixed method case study applying utilisation focused evaluation. Setting Four early adopter sites for the SCR in England—three in urban areas of relative socioeconomic deprivation and the fourth in a relatively affluent rural area. Data sources and analysis Data included 250 staff interviews, 1500 hours of ethnographic observation, interviews and focus groups with 170 patients and carers, 2500 pages of correspondence and documentary evidence, and incorporation of relevant surveys and statistics produced by others. These were analysed by using a thematic approach drawing on (and extending) a theoretical model of complex change developed in a previous systematic review. Main findings The mixed fortunes of the SCR programme in its first year were largely explained by eight interacting influences. The first was the SCR’s material properties (especially technical immaturity and lack of interoperability) and attributes (especially the extent to which potential adopters believed the benefits outweighed the risks). The second was adopters’ concerns (especially about workload and the ethicality of sharing “confidential” information on an implied consent model). The third influence was interpersonal influence (for example, opinion leaders, champions, facilitators), and the fourth was organisational antecedents for innovation (for example past experience with information technology projects, leadership and management capacity, effective data capture systems, slack resources). The fifth was organisational readiness for the SCR (for example, innovation-system fit, tension for change, power balances between supporters and opponents, baseline data quality). The sixth was the implementation process (including the nature of the change model and the extent to which new routines associated with the SCR aligned with existing organisational routines). The seventh influence was the nature and quality of links between different parts of the system, and the final one was the wider environment (especially the political context of the programme). Conclusion Shared electronic records are not plug-in technologies. They are complex innovations that must be accepted by individual patients and staff and also embedded in organisational and inter-organisational routines. This process is heavily influenced at the micro-level by the material properties of the technology, individuals’ attitudes and concerns, and interpersonal influence; at the meso-level by organisational antecedents, readiness, and operational aspects of implementation; and at the macro-level by institutional and socio-political forces. A case study approach and multi-level theoretical analysis can illuminate how contextual factors shape, enable, and constrain new, technology supported models of patient care. PMID:18948344

  1. Analytical recursive method to ascertain multisite entanglement in doped quantum spin ladders

    NASA Astrophysics Data System (ADS)

    Roy, Sudipto Singha; Dhar, Himadri Shekhar; Rakshit, Debraj; SenDe, Aditi; Sen, Ujjwal

    2017-08-01

    We formulate an analytical recursive method to generate the wave function of doped short-range resonating valence bond (RVB) states as a tool to efficiently estimate multisite entanglement as well as other physical quantities in doped quantum spin ladders. We prove that doped RVB ladder states are always genuine multipartite entangled. Importantly, our results show that within specific doping concentration and model parameter regimes, the doped RVB state essentially characterizes the trends of genuine multiparty entanglement in the exact ground states of the Hubbard model with large on-site interactions, in the limit that yields the t -J Hamiltonian.

  2. Becoming a Networked Public: Digital Ethnography, Youth and Global Research Collectives

    ERIC Educational Resources Information Center

    Gallagher, Kathleen; Wessels, Anne; Ntelioglou, Burcu Yaman

    2013-01-01

    The following article describes a research context that has privileged both virtual and placed-based ethnographic fieldwork, using a hybrid methodology of live and digital communications across school sites in Toronto, Canada; Lucknow, India; Taipei, Taiwan; and Boston, USA. The multi-site ethnographic study is concerned with questions of school…

  3. Teachers' Beliefs on Inclusion and Teaching Students with Disabilities: A Representation of Diverse Voices

    ERIC Educational Resources Information Center

    Hodge, Samuel R.; Sato, Takahiro; Samalot-Rivera, Amaury; Hersman, Bethany L.; LaMaster, Kathryn; Casebolt, Kevin M.; Ammah, Jonathan O. A.

    2009-01-01

    The purpose of this study was to analyze the beliefs of physical education teachers on teaching students with disabilities in inclusive classes. Participants were 29 physical education teachers from Ghana (Africa), Japan, the United States, and Puerto Rico. The research paradigm was qualitatively descriptive using a multisite interview design…

  4. Effectiveness of Abstinence-Based Incentives: Interaction with Intake Stimulant Test Results

    ERIC Educational Resources Information Center

    Stitzer, Maxine L.; Petry, Nancy; Peirce, Jessica; Kirby, Kimberly; Killeen, Therese; Roll, John; Hamilton, John; Stabile, Patricia Q.; Sterling, Robert; Brown, Chanda; Kolodner, Ken; Li, Rui

    2007-01-01

    Intake urinalysis test result (drug positive vs. negative) has been previously identified as a strong predictor of drug abuse treatment outcome, but there is little information about how this prognostic factor may interact with the type of treatment delivered. The authors used data from a multisite study of abstinence incentives for stimulant…

  5. Psychiatric Syndromes in Adolescents with Marijuana Abuse and Dependency in Outpatient Treatment

    ERIC Educational Resources Information Center

    Diamond, Guy; Panichelli-Mindel, Susan M.; Shera, David; Dennis, Mike; Tims, Frank; Ungemack, Jane

    2006-01-01

    Objective: The purpose of the current study to assist in understanding the prevalence and clinical correlates of psychiatric distress in adolescents seeking outpatient services for marijuana abuse or dependency. Methods: In a multi-site randomized clinical trial, 600 adolescents and their parents were assessed at intake using the Global Appraisals…

  6. The Relations among Measurements of Informant Discrepancies within a Multisite Trial of Treatments for Childhood Social Phobia

    ERIC Educational Resources Information Center

    De Los Reyes, Andres; Alfano, Candice A.; Beidel, Deborah C.

    2010-01-01

    Discrepancies between informants' reports of children's behavior are robustly observed in clinical child research and have important implications for interpreting the outcomes of controlled treatment trials. However, little is known about the basic psychometric properties of these discrepancies. This study examined the relation between…

  7. Family-Based Genome-Wide Association Scan of Attention-Deficit/Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Mick, Eric; Todorov, Alexandre; Smalley, Susan; Hu, Xiaolan; Loo, Sandra; Todd, Richard D.; Biederman, Joseph; Byrne, Deirdre; Dechairo, Bryan; Guiney, Allan; McCracken, James; McGough, James; Nelson, Stanley F.; Reiersen, Angela M.; Wilens, Timothy E.; Wozniak, Janet; Neale, Benjamin M.; Faraone, Stephen V.

    2010-01-01

    Objective: Genes likely play a substantial role in the etiology of attention-deficit/hyperactivity disorder (ADHD). However, the genetic architecture of the disorder is unknown, and prior genome-wide association studies (GWAS) have not identified a genome-wide significant association. We have conducted a third, independent, multisite GWAS of…

  8. Relationship between level of antibiotic use and resistance among Escherichia coli isolates from integrated multi-site cohorts of humans and swine

    USDA-ARS?s Scientific Manuscript database

    The objective of this longitudinal ecological study was to examine the relationship between the prevalence of antibiotic-resistant (AR) commensal E. coli isolates from both monthly human wastewater and composite swine fecal samples, and the concurrent aggregated monthly antibiotic use recorded withi...

  9. Personal Resources and Homelessness in Early Life: Predictors of Depression in Consumers of Homeless Multiservice Centers

    ERIC Educational Resources Information Center

    DeForge, Bruce R.; Belcher, John R.; O'Rourke, Michael; Lindsey, Michael A.

    2008-01-01

    This study explored the relationship between personal resources and previous adverse life events such as homelessness and depression. Participants were recruited from two church sponsored multisite social service centers in Anne Arundel County, Maryland. The interview included demographics and several standardized scales to assess history of…

  10. Traumatic Events among Undergraduate Students: Prevalence and Associated Symptoms

    ERIC Educational Resources Information Center

    Frazier, Patricia; Anders, Samantha; Perera, Sulani; Tennen, Howard; Tashiro, Ty; Park, Crystal; Tomich, Patricia

    2009-01-01

    This multisite study assessed the prevalence of exposure to traumatic events and associated symptoms among undergraduate students (N = 1,528) using online surveys. Most students (85%) reported having experienced a traumatic event in their lifetime (Time 1) and 21% reported experiencing an event over a 2-month period during college (Time 2). The…

  11. Educational Reforms in Malta: A Missed Opportunity to Establish Distributed Governance

    ERIC Educational Resources Information Center

    Cutajar, Mario; Bezzina, Christopher; James, Chris

    2013-01-01

    This article critically analyses the current Maltese educational reform process, which aimed to transform educational governance in Malta from a centralized system to a more decentralized one. This longitudinal study adopted a multi-site inquiry of a sample of the colleges involving different stakeholders, including key policy-makers, college…

  12. Effects of Comprehensive School Reform on Student Achievement and School Change: A Longitudinal Multi-Site Study

    ERIC Educational Resources Information Center

    Sterbinsky, Allan; Ross, Steven M.; Redfield, Doris

    2006-01-01

    The longitudinal impacts on school change and student achievement of implementing varied Comprehensive School Reform (CSR) models was investigated in 12 elementary schools in diverse geographic locations. Each school was individually matched and compared to a demographically similar control school on measures of school climate, teacher…

  13. Aggression in Children with Autism Spectrum Disorders and a Clinic-Referred Comparison Group

    ERIC Educational Resources Information Center

    Farmer, Cristan; Butter, Eric; Mazurek, Micah O.; Cowan, Charles; Lainhart, Janet; Cook, Edwin H.; DeWitt, Mary Beth; Aman, Michael

    2015-01-01

    A gap exists in the literature regarding aggression in autism spectrum disorders and how this behavior compares to other groups. In this multisite study, the "Children's Scale for Hostility and Aggression: Reactive/Proactive" and the Aggression subscale of the "Child Behavior Checklist" were rated for 414 children with autism…

  14. Levels and Growth of Specific and General Norms for Nonviolence among Middle School Students

    ERIC Educational Resources Information Center

    Dymnicki, Allison B.; Antonio, Tiago; Henry, David B.

    2011-01-01

    This study examined the levels and growth of specific and general normative beliefs about nonviolence (called norms for nonviolence). The sample consisted of 1254 middle school students from four metropolitan areas who participated in the control condition of the Multisite Violence Prevention Project. We predicted that the association and…

  15. Course and Severity of Maternal Depression: Associations with Family Functioning and Child Adjustment

    ERIC Educational Resources Information Center

    Foster, Cynthia Ewell; Webster, Melissa C.; Weissman, Myrna M.; Pilowsky, Daniel J.; Wickramaratne, Priya J.; Rush, A. John; Hughes, Carroll W.; Garber, Judy; Malloy, Erin; Cerda, Gabrielle; Kornstein, Susan G.; Alpert, Jonathan E.; Wisniewski, Stephen R.; Trivedi, Madhukar H.; Fava, Maurizio; King, Cheryl A.

    2008-01-01

    Number of lifetime episodes, duration of current episode, and severity of maternal depression were investigated in relation to family functioning and child adjustment. Participants were the 151 mother-child pairs in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) child multi-site study. Mothers were diagnosed with Major…

  16. Factors Contributing to the Attrition of Adult Basic and Secondary Education Students.

    ERIC Educational Resources Information Center

    Leonard, Rex; And Others

    Attrition among students in adult basic and secondary education programs has been a perennial problem. Conducting research on this population is also problematic once they have dropped out of a program. A study surveyed 76 dropouts and 35 General Educational Development (GED) program completers from two large, multisite programs about factors…

  17. Coordinated Community Response to Family Violence: The Role of Domestic Violence Service Organizations

    ERIC Educational Resources Information Center

    Malik, Neena M.; Ward, Kristin; Janczewski, Colleen

    2008-01-01

    There is increasing awareness that domestic violence (DV) and child maltreatment often overlap and that there are significant negative consequences to women and children who are victims in the same families. The present study contains data from a participatory evaluation of a multisite national demonstration project on family violence (the…

  18. Evaluating Federal Social Programs: Finding out What Works and What Does Not

    ERIC Educational Resources Information Center

    Muhlhausen, David B.

    2012-01-01

    Federal social programs are rarely evaluated to determine whether they are actually accomplishing their intended purposes. As part of its obligation to spend taxpayers' dollars wisely, Congress should mandate that experimental evaluations of every federal social program be conducted. The evaluations should be large-scale, multisite studies to…

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

    ERIC Educational Resources Information Center

    Reardon, Sean F.; Raudenbush, Stephen W.

    2013-01-01

    The increasing availability of data from multi-site randomized trials provides a potential opportunity to use instrumental variables methods to study the effects of multiple hypothesized mediators of the effect of a treatment. We derive nine assumptions needed to identify the effects of multiple mediators when using site-by-treatment interactions…

  20. Outcome Evaluation of a Community Center-Based Program for Mothers at High Psychosocial Risk

    ERIC Educational Resources Information Center

    Rodrigo, Maria Jose; Maiquez, Maria Luisa; Correa, Ana Delia; Martin, Juan Carlos; Rodriguez, Guacimara

    2006-01-01

    Objective: This study reported the outcome evaluation of the "Apoyo Personal y Familiar" (APF) program for poorly-educated mothers from multi-problem families, showing inadequate behavior with their children. APF is a community-based multi-site program delivered through weekly group meetings in municipal resource centers. Method: A total…

  1. A multi-site recycled tire crumb rubber characterization study: recruitment strategy and field sampling approach

    EPA Science Inventory

    Recently, concerns have been raised by the public about the safety of tire crumb rubber infill used in synthetic turf fields. In response, the 2016 Federal Research Action Plan on Recycled Tire Crumb Used on Playing Fields and Playgrounds (FRAP) was developed to examine key envir...

  2. Stakeholder Perspectives on Creating and Maintaining Trust in Community--Academic Research Partnerships

    ERIC Educational Resources Information Center

    Frerichs, Leah; Kim, Mimi; Dave, Gaurav; Cheney, Ann; Hassmiller Lich, Kristen; Jones, Jennifer; Young, Tiffany L.; Cene, Crystal W.; Varma, Deepthi S.; Schaal, Jennifer; Black, Adina; Striley, Catherine W.; Vassar, Stefanie; Sullivan, Greer; Cottler, Linda B.; Brown, Arleen; Burke, Jessica G.; Corbie-Smith, Giselle

    2017-01-01

    Community-academic research partnerships aim to build stakeholder trust in order to improve the reach and translation of health research, but there is limited empirical research regarding effective ways to build trust. This multisite study was launched to identify similarities and differences among stakeholders' perspectives of antecedents to…

  3. Becoming an Engineer in Public Universities: Pathways for Women and Minorities. Palgrave Studies in Urban Education

    ERIC Educational Resources Information Center

    Borman, Kathryn M., Ed.; Tyson, Will, Ed.; Halperin, Rhoda H., Ed.

    2010-01-01

    Based on research conducted in a three-year, mixed-method, multi-site National Science Foundation, Science, Technology, Engineering and Mathematics Talent Expansion Program (STEP) Project, this book offers a comprehensive look into how engineering department culture and climate impacts the successful retention of female and under-represented…

  4. Is a Response to Intervention (RTI) Approach to Preschool Language and Early Literacy Instruction Needed?

    ERIC Educational Resources Information Center

    Greenwood, Charles R.; Carta, Judith J.; Atwater, Jane; Goldstein, Howard; Kaminski, Ruth; McConnell, Scott

    2013-01-01

    Preschool experience plays a role in children's development. However, for programs with language and early literacy goals, the question remains whether preschool instructional experiences are sufficiently effective to achieve these goals for all children. In a multisite study, the authors conducted a process-product description of preschool…

  5. The Impact of Tutoring on Early Reading Achievement for Children with and without Attention Problems

    ERIC Educational Resources Information Center

    Rabiner, David L.; Malone, Patrick S.

    2004-01-01

    This study examined whether the benefits of reading tutoring in first grade were moderated by children's level of attention problems. Participants were 581 children from the intervention and control samples of Fast Track, a longitudinal multisite investigation of the development and prevention of conduct problems. Standardized reading achievement…

  6. Using Meta-Regression to Explore Moderating Effects in Surveys of International Achievement

    ERIC Educational Resources Information Center

    Benton, Tom

    2014-01-01

    This article demonstrates how meta-analytic techniques, that have typically been used to synthesize findings across numerous studies, can also be applied to examine the reasons why relationships between background characteristics and outcomes may vary across different locations in a single multi-site survey. This application is particularly…

  7. Students' Experience of Synchronous Learning in Distributed Environments

    ERIC Educational Resources Information Center

    Stewart, Anissa R.; Harlow, Danielle B.; DeBacco, Kim

    2011-01-01

    This article reports on a two-year ethnographic study of learners participating in multi-site, graduate-level education classes. Classes sometimes met face-to-face in the same physical location; at other times part of the class met physically elsewhere. Yet all were linked through the virtual space. Ethnographic analysis of four data types…

  8. Mobile Phone Use in Psychiatry Residents in the United States: Multisite Cross-Sectional Survey Study

    PubMed Central

    Torous, John; Boland, Robert; Conrad, Erich

    2017-01-01

    Background Mobile technology ownership in the general US population and medical professionals is increasing, leading to increased use in clinical settings. However, data on use of mobile technology by psychiatry residents remain unclear. Objective In this study, our aim was to provide data on how psychiatric residents use mobile phones in their clinical education as well as barriers relating to technology use. Methods An anonymous, multisite survey was given to psychiatry residents in 2 regions in the United States, including New Orleans and Boston, to understand their technology use. Results All participants owned mobile phones, and 79% (54/68) used them to access patient information. The majority do not use mobile phones to implement pharmacotherapy (62%, 42/68) or psychotherapy plans (90%, 61/68). The top 3 barriers to using mobile technology in clinical care were privacy concerns (56%, 38/68), lack of clinical guidance (40%, 27/68), and lack of evidence (29%, 20/68). Conclusions We conclude that developing a technology curriculum and engaging in research could address these barriers to using mobile phones in clinical practice. PMID:29092807

  9. Thyroid Medication Use and Birth Defects in the National Birth Defects Prevention Study.

    PubMed

    Howley, Meredith M; Fisher, Sarah C; Van Zutphen, Alissa R; Waller, Dorothy K; Carmichael, Suzan L; Browne, Marilyn L

    2017-11-01

    Thyroid disorders are common among reproductive-aged women, with hypothyroidism affecting 2 to 3% of pregnancies, and hyperthyroidism affecting an additional 0.1 to 1%. We examined associations between thyroid medications and individual birth defects using data from the National Birth Defects Prevention Study (NBDPS). The NBDPS is a multisite, population-based, case-control study that included pregnancies with estimated delivery dates from 1997 to 2011. We analyzed self-reported thyroid medication use from mothers of 31,409 birth defect cases and 11,536 unaffected controls. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression for birth defects with five or more exposed cases, controlling for maternal age, race/ethnicity, and study center. Crude ORs and exact 95% CIs were estimated for defects with 3 to 4 exposed cases. Thyroid hormone was used by 738 (2.3%) case and 237 (2.1%) control mothers, and was associated with anencephaly (OR = 1.68; 95% CI, 1.03-2.73), holoprosencephaly (OR = 2.48; 95% CI, 1.13-5.44), hydrocephaly (1.77; 95% CI, 1.07-2.95) and small intestinal atresia (OR = 1.81; 95% CI, 1.04-3.15). Anti-thyroid medication was used by 34 (0.1%) case and 10 (<0.1%) control mothers, and was associated with aortic valve stenosis (OR = 6.91; 95% CI, 1.21-27.0). While new associations were identified, our findings are relatively consistent with previous NBDPS analyses. Our findings suggest thyroid medication use is not associated with most birth defects studied in the NBDPS, but may be associated with some specific birth defects. These results should not be interpreted to suggest that medications used to treat thyroid disease are teratogens, as the observed associations may reflect effects of the underlying thyroid disease. Birth Defects Research 109:1471-1481, 2017.© 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  10. Telecommunications model for continuing education of health professionals: the Royal Brompton case.

    PubMed

    Kotis, Takis

    2003-01-01

    Telemedicine is said to be helpful to both patients and providers, but we need real-world examples to demonstrate its effectiveness. This paper presents such an example. Royal Brompton, under the Tele-remedy Program of EC Telecom, conducted a project with the Children's Hospital of Athens, Greece, to provide remote diagnosis management and continuing education for heart disease, using European ISDN technology. Preliminary results showed that, when carried out in a large scale multi-site environment, Teleremedy program significantly reduced geographic and socio-economic isolation for the patient and the professional isolation for the physician. Comparison of original vs. transmitted data revealed no significant differences, with diagnosis accuracy of 100%.

  11. Maternal Autoimmune Disease and Birth Defects in the National Birth Defects Prevention Study

    PubMed Central

    Howley, Meredith M.; Browne, Marilyn L.; Van Zutphen, Alissa R.; Richardson, Sandra D.; Blossom, Sarah J.; Broussard, Cheryl S.; Carmichael, Suzan L.; Druschel, Charlotte M.

    2017-01-01

    Background Little is known about the association between maternal autoimmune disease or its treatment and the risk of birth defects. We examined these associations using data from the National Birth Defects Prevention Study, a multi-site, population-based, case–control study. Methods Analyses included 25,116 case and 9897 unaffected control infants with estimated delivery dates between 1997 and 2009. Information on autoimmune disease, medication use, and other pregnancy exposures was collected by means of telephone interview. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for birth defects with five or more exposed cases; crude ORs and exact 95% CIs were estimated for birth defects with three to four exposed cases. Results Autoimmune disease was reported by 373 mothers (279 case and 94 control mothers). The majority of birth defects evaluated were not associated with autoimmune disease; however, a statistically significant association between maternal autoimmune disease and encephalocele was observed (OR, 4.64; 95% CI, 1.95–11.04). Eighty-two mothers with autoimmune disease used an immune modifying/suppressing medication during pregnancy; this was associated with encephalocele (OR, 7.26; 95% CI, 1.37–24.61) and atrial septal defects (OR, 3.01; 95% CI, 1.16–7.80). Conclusion Our findings suggest maternal autoimmune disease and treatment are not associated with the majority of birth defects, but may be associated with some defects, particularly encephalocele. Given the low prevalence of individual autoimmune diseases and the rare use of specific medications, we were unable to examine associations of specific autoimmune diseases and medications with birth defects. Other studies are needed to confirm these findings. PMID:27891777

  12. English and More: A Multisite Study of Roles and Conceptualisations of Language in English Medium Multilingual Universities from Europe to Asia

    ERIC Educational Resources Information Center

    Baker, Will; Hüttner, Julia

    2017-01-01

    The rapid increase in English medium instruction (EMI) in higher education has resulted in the need for a greater evidence base documenting EMI in practice spanning a range of settings. Studies of EMI focusing on linguistic issues are beginning to emerge but there are few comparative studies looking at multiple sites, levels and stakeholders. In…

  13. Evaluating Why and How the Teen Outreach Program Works: Years 3-5 of the Teen Outreach National Replication (1986/87-1988/89).

    ERIC Educational Resources Information Center

    Allen, Joseph P.; Philliber, Susan

    An evaluative study was done of the Teen Outreach Program, a national, multi-site effort to reduce teenage pregnancy, school failure, and dropout. The study sought to identify the critical "active ingredients" of the program responsible for its success. The study was based on analyses of data collected at 114 different sites nationally,…

  14. What Works in Gifted Education Mathematics Study: Impact of Pre-Differentiated and Enriched Curricula on General Education Teachers and Their Students. Research Monograph Series. RM13242

    ERIC Educational Resources Information Center

    Gubbins, E. Jean; McCoach, D. Betsy; Foreman, Jennifer L.; Gilson, Cindy M.; Bruce-Davis, Micah N.; Rubenstein, Lisa DaVia; Savino, Jennifer; Rambo, Karen; Waterman, Craig

    2013-01-01

    The present study seeks to determine how exposure to pre-differentiated and enriched curricula incorporating educative curriculum materials affects students' achievement as well as teacher and administrator responses to the intervention. A 2-year multi-site cluster randomized control trial study recruited a national sample of 4,530 grade 3…

  15. Online interviewing with interpreters in humanitarian contexts

    PubMed Central

    Chiumento, Anna; Rahman, Atif; Frith, Lucy

    2018-01-01

    ABSTRACT Purpose: Recognising that one way to address the logistical and safety considerations of research conducted in humanitarian emergencies is to use internet communication technologies to facilitate interviews online, this article explores some practical and methodological considerations inherent to qualitative online interviewing. Method: Reflections from a case study of a multi-site research project conducted in post-conflict countries are presented.  Synchronous online cross-language qualitative interviews were conducted in one country.  Although only a small proportion of interviews were conducted online (six out of 35), it remains important to critically consider the impact upon data produced in this way. Results: A range of practical and methodological considerations are discussed, illustrated with examples.  Results suggest that whilst online interviewing has methodological and ethical potential and versatility, there are inherent practical challenges in settings with poor internet and electricity infrastructure.  Notable methodological limitations include barriers to building rapport due to partial visual and non-visual cues, and difficulties interpreting pauses or silences. Conclusions: Drawing upon experiences in this case study, strategies for managing the practical and methodological limitations of online interviewing are suggested, alongside recommendations for supporting future research practice.  These are intended to act as a springboard for further reflection, and operate alongside other conceptual frameworks for online interviewing. PMID:29532739

  16. Online interviewing with interpreters in humanitarian contexts.

    PubMed

    Chiumento, Anna; Machin, Laura; Rahman, Atif; Frith, Lucy

    2018-12-01

    Recognising that one way to address the logistical and safety considerations of research conducted in humanitarian emergencies is to use internet communication technologies to facilitate interviews online, this article explores some practical and methodological considerations inherent to qualitative online interviewing. Reflections from a case study of a multi-site research project conducted in post-conflict countries are presented.  Synchronous online cross-language qualitative interviews were conducted in one country.  Although only a small proportion of interviews were conducted online (six out of 35), it remains important to critically consider the impact upon data produced in this way. A range of practical and methodological considerations are discussed, illustrated with examples.  Results suggest that whilst online interviewing has methodological and ethical potential and versatility, there are inherent practical challenges in settings with poor internet and electricity infrastructure.  Notable methodological limitations include barriers to building rapport due to partial visual and non-visual cues, and difficulties interpreting pauses or silences. Drawing upon experiences in this case study, strategies for managing the practical and methodological limitations of online interviewing are suggested, alongside recommendations for supporting future research practice.  These are intended to act as a springboard for further reflection, and operate alongside other conceptual frameworks for online interviewing.

  17. The impact of gender on treatment effectiveness of body psychotherapy for negative symptoms of schizophrenia: a secondary analysis of the NESS trial data

    PubMed Central

    Savill, Mark; Orfanos, Stavros; Bentall, Richard; Reininghaus, Ulrich; Wykes, Til; Priebe, Stefan

    2016-01-01

    Despite promising findings from small-scale studies suggesting that body psychotherapy may be an effective treatment for negative symptoms, these results were not replicated in a recent multisite trial. In this trial a far smaller proportion of women were recruited relative to earlier studies, which may be an issue given the gender mix of the sample evaluated has been found to affect trial outcomes in schizophrenia. Using data from our multisite trial, the interaction between gender and treatment allocation as a predictor of outcomes was examined in 275 participants (72 women and 203 men) randomised to either a body psychotherapy or Pilates group. Negative symptoms were found to significantly reduce in women randomised to the body psychotherapy condition in comparison to Pilates, while no such effect was detected in men. Consistent with the smaller trials, this improvement was found to relate predominantly to expressive deficits. These findings suggest that body psychotherapy may be an effective treatment for negative symptoms in women. These findings emphasise the importance of sample characteristics in determining trial outcome in psychological treatment studies. PMID:27871030

  18. Evaluation of the Teacher Incentive Fund: Final Report on Implementation and Impacts of Pay-for-Performance across Four Years: Executive Summary. NCEE 2018-4005

    ERIC Educational Resources Information Center

    Chiang, Hanley; Speroni, Cecilia; Herrmann, Mariesa; Hallgren, Kristin; Burkander, Paul; Wellington, Alison

    2017-01-01

    The Teacher Incentive Fund (TIF) provides grants to support performance-based compensation systems for teachers and principals in high-need schools. The study measures the impact of pay-for-performance bonuses as part of a comprehensive compensation system within a large, multisite random assignment study design. The treatment schools were to…

  19. Evaluation of the Teacher Incentive Fund: Final Report on Implementation and Impacts of Pay-for-Performance across Four Years. NCEE 2018-4004

    ERIC Educational Resources Information Center

    Chiang, Hanley; Speroni, Cecilia; Herrmann, Mariesa; Hallgren, Kristin; Burkander, Paul; Wellington, Alison

    2017-01-01

    The Teacher Incentive Fund (TIF) provides grants to support performance-based compensation systems for teachers and principals in high-need schools. The study measures the impact of pay-for-performance bonuses as part of a comprehensive compensation system within a large, multisite random assignment study design. The treatment schools were to…

  20. Evaluation of the Teacher Incentive Fund: Implementation and Early Impacts of Pay-for-Performance after One Year. Executive Summary. NCEE 2014-4020

    ERIC Educational Resources Information Center

    Max, Jeffrey; Constantine, Jill; Wellington, Alison; Hallgren, Kristin; Glazerman, Steven; Chiang, Hanley; Speroni, Cecilia

    2014-01-01

    The Teacher Incentive Fund (TIF) provides grants to support performance-based compensation systems for teachers and principals in high-need schools. The study measures the impact of pay-for-performance bonuses as part of a comprehensive compensation system within a large, multisite random assignment study design. The treatment schools were to…

  1. Machine Learning-Augmented Propensity Score-Adjusted Multilevel Mixed Effects Panel Analysis of Hands-On Cooking and Nutrition Education versus Traditional Curriculum for Medical Students as Preventive Cardiology: Multisite Cohort Study of 3,248 Trainees over 5 Years

    PubMed Central

    Dart, Lyn; Vanbeber, Anne; Smith-Barbaro, Peggy; Costilla, Vanessa; Samuel, Charlotte; Terregino, Carol A.; Abali, Emine Ercikan; Dollinger, Beth; Baumgartner, Nicole; Kramer, Nicholas; Seelochan, Alex; Taher, Sabira; Deutchman, Mark; Evans, Meredith; Ellis, Robert B.; Oyola, Sonia; Maker-Clark, Geeta; Budnick, Isadore; Tran, David; DeValle, Nicole; Shepard, Rachel; Chow, Erika; Petrin, Christine; Razavi, Alexander; McGowan, Casey; Grant, Austin; Bird, Mackenzie; Carry, Connor; McGowan, Glynis; McCullough, Colleen; Berman, Casey M.; Dotson, Kerri; Sarris, Leah; Harlan, Timothy S.; Co-investigators, on behalf of the CHOP

    2018-01-01

    Background Cardiovascular disease (CVD) annually claims more lives and costs more dollars than any other disease globally amid widening health disparities, despite the known significant reductions in this burden by low cost dietary changes. The world's first medical school-based teaching kitchen therefore launched CHOP-Medical Students as the largest known multisite cohort study of hands-on cooking and nutrition education versus traditional curriculum for medical students. Methods This analysis provides a novel integration of artificial intelligence-based machine learning (ML) with causal inference statistics. 43 ML automated algorithms were tested, with the top performer compared to triply robust propensity score-adjusted multilevel mixed effects regression panel analysis of longitudinal data. Inverse-variance weighted fixed effects meta-analysis pooled the individual estimates for competencies. Results 3,248 unique medical trainees met study criteria from 20 medical schools nationally from August 1, 2012, to June 26, 2017, generating 4,026 completed validated surveys. ML analysis produced similar results to the causal inference statistics based on root mean squared error and accuracy. Hands-on cooking and nutrition education compared to traditional medical school curriculum significantly improved student competencies (OR 2.14, 95% CI 2.00–2.28, p < 0.001) and MedDiet adherence (OR 1.40, 95% CI 1.07–1.84, p = 0.015), while reducing trainees' soft drink consumption (OR 0.56, 95% CI 0.37–0.85, p = 0.007). Overall improved competencies were demonstrated from the initial study site through the scale-up of the intervention to 10 sites nationally (p < 0.001). Discussion This study provides the first machine learning-augmented causal inference analysis of a multisite cohort showing hands-on cooking and nutrition education for medical trainees improves their competencies counseling patients on nutrition, while improving students' own diets. This study suggests that the public health and medical sectors can unite population health management and precision medicine for a sustainable model of next-generation health systems providing effective, equitable, accessible care beginning with reversing the CVD epidemic. PMID:29850526

  2. Machine Learning-Augmented Propensity Score-Adjusted Multilevel Mixed Effects Panel Analysis of Hands-On Cooking and Nutrition Education versus Traditional Curriculum for Medical Students as Preventive Cardiology: Multisite Cohort Study of 3,248 Trainees over 5 Years.

    PubMed

    Monlezun, Dominique J; Dart, Lyn; Vanbeber, Anne; Smith-Barbaro, Peggy; Costilla, Vanessa; Samuel, Charlotte; Terregino, Carol A; Abali, Emine Ercikan; Dollinger, Beth; Baumgartner, Nicole; Kramer, Nicholas; Seelochan, Alex; Taher, Sabira; Deutchman, Mark; Evans, Meredith; Ellis, Robert B; Oyola, Sonia; Maker-Clark, Geeta; Dreibelbis, Tomi; Budnick, Isadore; Tran, David; DeValle, Nicole; Shepard, Rachel; Chow, Erika; Petrin, Christine; Razavi, Alexander; McGowan, Casey; Grant, Austin; Bird, Mackenzie; Carry, Connor; McGowan, Glynis; McCullough, Colleen; Berman, Casey M; Dotson, Kerri; Niu, Tianhua; Sarris, Leah; Harlan, Timothy S; Co-Investigators, On Behalf Of The Chop

    2018-01-01

    Cardiovascular disease (CVD) annually claims more lives and costs more dollars than any other disease globally amid widening health disparities, despite the known significant reductions in this burden by low cost dietary changes. The world's first medical school-based teaching kitchen therefore launched CHOP-Medical Students as the largest known multisite cohort study of hands-on cooking and nutrition education versus traditional curriculum for medical students. This analysis provides a novel integration of artificial intelligence-based machine learning (ML) with causal inference statistics. 43 ML automated algorithms were tested, with the top performer compared to triply robust propensity score-adjusted multilevel mixed effects regression panel analysis of longitudinal data. Inverse-variance weighted fixed effects meta-analysis pooled the individual estimates for competencies. 3,248 unique medical trainees met study criteria from 20 medical schools nationally from August 1, 2012, to June 26, 2017, generating 4,026 completed validated surveys. ML analysis produced similar results to the causal inference statistics based on root mean squared error and accuracy. Hands-on cooking and nutrition education compared to traditional medical school curriculum significantly improved student competencies (OR 2.14, 95% CI 2.00-2.28, p < 0.001) and MedDiet adherence (OR 1.40, 95% CI 1.07-1.84, p = 0.015), while reducing trainees' soft drink consumption (OR 0.56, 95% CI 0.37-0.85, p = 0.007). Overall improved competencies were demonstrated from the initial study site through the scale-up of the intervention to 10 sites nationally ( p < 0.001). This study provides the first machine learning-augmented causal inference analysis of a multisite cohort showing hands-on cooking and nutrition education for medical trainees improves their competencies counseling patients on nutrition, while improving students' own diets. This study suggests that the public health and medical sectors can unite population health management and precision medicine for a sustainable model of next-generation health systems providing effective, equitable, accessible care beginning with reversing the CVD epidemic.

  3. Climate change impact assessment on flow regime by incorporating spatial correlation and scenario uncertainty

    NASA Astrophysics Data System (ADS)

    Vallam, P.; Qin, X. S.

    2017-07-01

    Flooding risk is increasing in many parts of the world and may worsen under climate change conditions. The accuracy of predicting flooding risk relies on reasonable projection of meteorological data (especially rainfall) at the local scale. The current statistical downscaling approaches face the difficulty of projecting multi-site climate information for future conditions while conserving spatial information. This study presents a combined Long Ashton Research Station Weather Generator (LARS-WG) stochastic weather generator and multi-site rainfall simulator RainSim (CLWRS) approach to investigate flow regimes under future conditions in the Kootenay Watershed, Canada. To understand the uncertainty effect stemming from different scenarios, the climate output is fed into a hydrologic model. The results showed different variation trends of annual peak flows (in 2080-2099) based on different climate change scenarios and demonstrated that the hydrological impact would be driven by the interaction between snowmelt and peak flows. The proposed CLWRS approach is useful where there is a need for projection of potential climate change scenarios.

  4. EMERGEncy ID NET: Review of a 20-Year Multisite Emergency Department Emerging Infections Research Network

    PubMed Central

    Santibanez, Scott; Fischer, Leah S; Krishnadasan, Anusha; Sederdahl, Bethany; Merlin, Toby; Moran, Gregory J; Talan, David A; Mower, William; Sullivan, Matthew; Abrahamian, Fredrick M; Ong, Sam; Gross, Eric; Salhi, Bisan; Heilpern, Katherine; Hess, Jeremy; Karras, David; Biros, Michelle; Dunbar, Lala; Takhar, Sukhjit; Pollack, Charles; Runge, Jeffrey; Cheney, Paul; Rothrock, Stephen; O’Brian, John; Citron, Diane; Goldstein, Ellie; Finegold, Sydney; Nakase, Janet; Newdow, Michael; Merchant, Guy; Pathmarajah, Kavitha; Gonzalez, Eva; Mulrow, Mary; Bussman, Silas; Kalugdnan, Vernon; Peterson, Stephen; Pitts, Seth; Narayan, Kamil; Rubin, Ada; Kemble, Laurie; Beckham, Danielle; Neal, Niccole; Yagapen, Annick; Von Hofen, Carol; Hatala, Kathleen; Fuentes, Shelley; Sibley, Debbi; Colucci, Ashley; Hernandez, Jackeline; Cruse, Hope; Usher, Sarah; Hendrickson, Audrey; Dehnkamp, Kimberly; Zeglin, Britney; Jambaulikar, Guruprasad; Gorwitz, Rachel; Limbago, Brandi; Kuehnert, Matthew; Jarvis, William; Slutsker, Larry; Arvay, Melissa; Conn, Laura

    2017-01-01

    Abstract As providers of frontline clinical care for patients with acute and potentially life-threatening infections, emergency departments (EDs) have the priorities of saving lives and providing care quickly and efficiently. Although these facilities see a diversity of patients 24 hours per day and can collect prospective data in real time, their ability to conduct timely research on infectious syndromes is not well recognized. EMERGEncy ID NET is a national network that demonstrates that EDs can also collect data and conduct research in real time. This network collaborates with the Centers for Disease Control and Prevention (CDC) and other partners to study and address a wide range of infectious diseases and clinical syndromes. In this paper, we review selected highlights of EMERGEncy ID NET’s history from 1995 to 2017. We focus on the establishment of this multisite research network and the network’s collaborative research on a wide range of ED clinical topics. PMID:29670931

  5. Did you know Medicare does not usually include a dental benefit? Findings from a multisite investigation of oral health literacy.

    PubMed

    Macek, Mark D; Atchison, Kathryn A; Wells, William; Haynes, Don; Parker, Ruth M; Chen, Haiyan

    2017-03-01

    Medicare does not usually include a dental benefit. Adults who are unaware of this fact risk unanticipated expenses after retirement. This report will explore the sociodemographic and oral health literacy determinants of this knowledge. Data came from the Multi-Site Oral Health Literacy Research Study, a survey of patients presenting to two university dental clinics. Sociodemographic descriptors included age, sex, race/ethnicity, education level, and dental insurance status. Oral health literacy was measured by the Rapid Estimate of Adult Literacy in Medicine and Dentistry (REALM-D). Only 34 percent of respondents knew the correct answer to the Medicare question. Knowledge was significantly associated with age, race/ethnicity, education level (bivariate only), and REALM-D score. Policymakers and those assisting in Medicare enrollment should ensure information regarding dental coverage is communicated in ways that individuals of varying literacy, language, and culture understand what is necessary to make appropriate decisions. © 2017 American Association of Public Health Dentistry.

  6. Can a workbook work? Examining whether a practitioner evaluation toolkit can promote instrumental use.

    PubMed

    Campbell, Rebecca; Townsend, Stephanie M; Shaw, Jessica; Karim, Nidal; Markowitz, Jenifer

    2015-10-01

    In large-scale, multi-site contexts, developing and disseminating practitioner-oriented evaluation toolkits are an increasingly common strategy for building evaluation capacity. Toolkits explain the evaluation process, present evaluation design choices, and offer step-by-step guidance to practitioners. To date, there has been limited research on whether such resources truly foster the successful design, implementation, and use of evaluation findings. In this paper, we describe a multi-site project in which we developed a practitioner evaluation toolkit and then studied the extent to which the toolkit and accompanying technical assistance was effective in promoting successful completion of local-level evaluations and fostering instrumental use of the findings (i.e., whether programs directly used their findings to improve practice, see Patton, 2008). Forensic nurse practitioners from six geographically dispersed service programs completed methodologically rigorous evaluations; furthermore, all six programs used the findings to create programmatic and community-level changes to improve local practice. Implications for evaluation capacity building are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Using interviews to understand the assignment mechanism in a nonexperimental study: the case of eighth grade algebra.

    PubMed

    Rickles, Jordan H

    2011-10-01

    Many inquiries regarding the causal effects of policies or programs are based on research designs where the treatment assignment process is unknown, and thus valid inferences depend on tenuous assumptions about the assignment mechanism. This article draws attention to the importance of understanding the assignment mechanism in policy and program evaluation studies, and illustrates how information collected through interviews can develop a richer understanding of the assignment mechanism. Focusing on the issue of student assignment to algebra in 8th grade, I show how a preliminary data collection effort aimed at understanding the assignment mechanism is particularly beneficial in multisite observational studies in education. The findings, based on ten interviews and administrative data from a large school district, draw attention to the often ignored heterogeneity in the assignment mechanism across schools. These findings likely extend beyond the current research project in question to related educational policy issues such as ability grouping, tracking, differential course taking, and curricular intensity, as well as other social programs in which the assignment mechanism can differ across sites.

  8. Development of a Lightweight, Portable, Minimally-Invasive Sensor for the Multi-Site Determination and Quantitation of Physiologic Lactate. Phase 1

    DTIC Science & Technology

    1996-10-01

    P13. IS THIS PUNCTUATION CORRECT? (.01 mm diameter polyimide ) 304 stainless steel core single strand wire over which a sheath of conductive plastic...atmospheric to 500 torr 02 Dimensions 0.38 mm Shelf Life Not studied Leachable Chemicals None Biocompatibility In whole blood for 10 hours

  9. Level 2 Screening with the PDD Behavior Inventory: Subgroup Profiles and Implications for Differential Diagnosis

    ERIC Educational Resources Information Center

    Cohen, Ira L.; Liu, Xudong; Hudson, Melissa; Gillis, Jennifer; Cavalari, Rachel N. S.; Romanczyk, Raymond G.; Karmel, Bernard Z.; Gardner, Judith M.

    2017-01-01

    The PDD Behavior Inventory (PDDBI) has recently been shown, in a large multisite study, to discriminate well between autism spectrum disorder (ASD) and other groups when its scores were examined using a machine learning tool, Classification and Regression Trees (CART). Discrimination was good for toddlers, preschoolers, and school-age children;…

  10. Borderline Personality Traits and Intimate Partner Aggression: An International Multisite, Cross-Gender Analysis

    ERIC Educational Resources Information Center

    Hines, Denise A.

    2008-01-01

    Although research has consistently shown that men and women use intimate partner aggression (IPA) at approximately equal rates, there is little empirical research on whether the predictors of IPA are the same for men and women. The current study investigated whether borderline personality (BP) differentially predicted the use of IPA for men and…

  11. Church-Based ESL Adult Programs: Social Mediators for Empowering "Family Literacy Ecology of Communities"

    ERIC Educational Resources Information Center

    Chao, Xia; Mantero, Miguel

    2014-01-01

    This multi-sited ethnographic study examines the ways in which Latino and Asian immigrant parents' English learning through two church-based ESL programs in a Southeastern U.S. city affects their family literacy and home language practices. It demonstrates that the parents' participation in the programs is an empowering experience promoting ESL…

  12. Parent and Peer Predictors of Physical Dating Violence Perpetration in Early Adolescence: Tests of Moderation and Gender Differences

    ERIC Educational Resources Information Center

    Miller, Shari; Gorman-Smith, Deborah; Sullivan, Terri; Orpinas, Pamela; Simon, Thomas R.

    2009-01-01

    This study examined parenting and peer predictors of physical dating violence perpetration during early adolescence and tested moderation among these predictors and gender. Participants were 2,824 ethnically diverse sixth-grade students with a recent boyfriend/girlfriend who was part of a multisite, longitudinal investigation of the development…

  13. Risk Factors and Neuropsychological Recovery in Clients with Alcohol Use Disorders Who Were Exposed to Different Treatments

    ERIC Educational Resources Information Center

    Bates, Marsha E.; Barry, Danielle; Labouvie, Erich W.; Fals-Stewart, William; Voelbel, Gerald; Buckman, Jennifer F.

    2004-01-01

    Risk covariates of neuropsychological ability (NA) at treatment entry and neuropsychological recovery (NR) across 15 months were examined and replicated in 2 samples (Ns = 952 and 774) from Project MATCH, a multisite study of alcoholism treatments. NA at treatment entry was associated with age, education, and other covariates. Statistically…

  14. The Effects of Collaborative Strategic Reading Instruction on the Reading Comprehension of Middle School Students: Year 1

    ERIC Educational Resources Information Center

    Mohammed, Sarojani S.; Swanson, Elizabeth; Roberts, Greg; Vaughn, Sharon; Klingner, Janette K.; Boardman, Alison Gould

    2010-01-01

    This project is a multi-site, multi-year study designed to test the efficacy of a fully developed intervention, Collaborative Strategic Reading (CSR), with adolescent readers. In year 1, the research questions were: (1) "Does CSR improve reading comprehension for adolescent readers attending relatively low SES schools?"; and (2)…

  15. Do Children's Advocacy Centers Improve Families' Experiences of Child Sexual Abuse Investigations?

    ERIC Educational Resources Information Center

    Jones, Lisa M.; Cross, Theodore P.; Walsh, Wendy A.; Simone, Monique

    2007-01-01

    Objective: The Children's Advocacy Center (CAC) model of child abuse investigation is designed to be more child and family-friendly than traditional methods, but there have been no rigorous studies of their effect on children's and caregivers' experience. Data collected as part of the Multi-Site Evaluation of Children's Advocacy Centers were used…

  16. Engaging High School Students as Co-Researchers in Qualitative Research: Logistical, Methodological and Ethical Issues.

    ERIC Educational Resources Information Center

    Miller, Dana L.; McVea, Kristine L. S. P.; Creswell, John W.; Harter, Lynn; Mickelson, William; McEntarffer, Rob

    This paper explores six phases of a research project designed specifically to engage high school students as co-researchers in a multisite qualitative study exploring perceptions of tobacco use among high school students in four schools. It describes how university researchers collaborated with the high school students and summarizes seven major…

  17. Constancy and Variability: Dialogic Literacy Events as Sites for Improvisation in Two 3rd-Grade Classrooms

    ERIC Educational Resources Information Center

    Jordan, Michelle E.; Santori, Diane

    2015-01-01

    This multisite study investigates dialogic literacy events that revolved around narrative and informational texts in two 3rd-grade classrooms. The authors offer a metaphor of musical improvisation to contemplate dialogic literacy events as part of the repertoire of teaching and learning experiences. In literacy learning, where there is much…

  18. Multisite Randomized Controlled Trial Examining Intelligent Tutoring of Structure Strategy for Fifth-Grade Readers

    ERIC Educational Resources Information Center

    Wijekumar, Kausalai; Meyer, Bonnie J. F.; Lei, Pui-Wa; Lin, Yu-Chu; Johnson, Lori A.; Spielvogel, James A.; Shurmatz, Kathryn M.; Ray, Melissa; Cook, Michael

    2014-01-01

    This article reports on a large scale randomized controlled trial to study the efficacy of a web-based intelligent tutoring system for the structure strategy designed to improve content area reading comprehension. The research was conducted with 128 fifth-grade classrooms within 12 school districts in rural and suburban settings. Classrooms within…

  19. The Effect of Art Therapy on Cognitive Performance among Ethnically Diverse Older Adults

    ERIC Educational Resources Information Center

    Pike, Amanda Alders

    2013-01-01

    This study examined the effect of art therapy on the cognitive performance of a multisite, ethnically diverse sample ("N" = 91) of older adults. Participants were recruited from several U.S. facilities that included a community center, a retirement center, an adult daycare, an assisted living facility, and a skilled nursing facility.…

  20. Binge Drinking and Rape: A Prospective Examination of College Women with a History of Previous Sexual Victimization

    ERIC Educational Resources Information Center

    McCauley, Jenna L.; Calhoun, Karen S.; Gidycz, Christine A.

    2010-01-01

    The current study prospectively examined the longitudinal relationships between binge drinking behavior and rape experiences among a multisite sample of college women with a history of prior attempted or completed rape (N = 228). Rates of binge drinking among this high-risk sample were high. Prospective analyses indicated that binge drinking…

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