Sample records for practice patterns results
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Leykum, Luci K; McDaniel, Reuben R
2011-01-01
Objective Despite efforts made by ambulatory care organizations to standardize the use of electronic health records (EHRs), practices often incorporate these systems into their work differently from each other. One potential factor contributing to these differences is within-practice communication patterns. The authors explore the linkage between within-practice communication patterns and practice-level EHR use patterns. Design Qualitative study of six practices operating within the same multi-specialty ambulatory care organization using the same EHR system. Semistructured interviews and direct observation were conducted with all physicians, nurses, medical assistants, practice managers, and non-clinical staff from each practice. Measurements An existing model of practice relationships was used to analyze communication patterns within the practices. Practice-level EHR use was defined and analyzed as the ways in which a practice uses an EHR as a collective or a group—including the degree of feature use, level of EHR-enabled communication, and frequency that EHR use changes in a practice. Interview and observation data were analyzed for themes. Based on these themes, within-practice communication patterns were categorized as fragmented or cohesive, and practice-level EHR use patterns were categorized as heterogeneous or homogeneous. Practices where EHR use was uniformly high across all users were further categorized as having standardized EHR use. Communication patterns and EHR use patterns were compared across the six practices. Results Within-practice communication patterns were associated with practice-level EHR use patterns. In practices where communication patterns were fragmented, EHR use was heterogeneous. In practices where communication patterns were cohesive, EHR use was homogeneous. Additional analysis revealed that practices that had achieved standardized EHR use (uniformly high EHR use across all users) exhibited high levels of mindfulness and respectful interaction, whereas practices that were furthest from achieving standardized EHR use exhibited low levels of mindfulness and respectful interaction. Conclusion Within-practice communication patterns provide a unique perspective for exploring the issue of standardization in EHR use. A major fallacy of setting homogeneous EHR use as the goal for practice-level EHR use is that practices with uniformly low EHR use could be considered successful. Achieving uniformly high EHR use across all users in a practice is more consistent with the goals of current EHR adoption and use efforts. It was found that some communication patterns among practice members may enable more standardized EHR use than others. Understanding the linkage between communication patterns and EHR use can inform understanding of the human element in EHR use and may provide key lessons for the implementation of EHRs and other health information technologies. PMID:21846780
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Patterns of marriage and reproductive practices: is there any relationship?
Vedadhir, Abouali; Taghizadeh, Ziba; Behmanesh, Fereshteh; Ebadi, Abbas; Pourreza, Abulghasem; Abbasi-Shavazi, Mohammad Jalal
2017-04-01
Today, a transition from traditional to modern marriages can be observed in many countries. This shift in patterns of marriage has evidently affected childbearing and reproductive practices. This study aimed to examine the relationship between patterns of marriage and reproductive practices in Iran. Hence, 880 married women, aged 15-49 years old, living in the North of Iran were selected using a multi-stage cluster sampling strategy and their patterns of marriage and reproductive practices were cross sectionally studied. The results revealed that there were no significant differences in the reproductive practices by three main patterns of marriage in Babol, Iran. The study also indicated that there were no significant differences in reproductive practices in three patterns of marriage after controlling for socio-economic variables. It seems that apart from the patterns of marriage, other influencing factors are the determinants of fertility in women, and the policy-makers of Iran need to pay attention to these determinants before making any decisions in this area.
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Lloyd, S M; Johnson, D G
1982-02-01
Over 600 Howard University medical alumni of seven representative classes graduating from 1955 to 1975 were surveyed by questionnaire in 1975 and 1976. Replies of the 252 black respondents confirm that these graduates are providing substantial care to blacks, the economically disadvantaged, and residents of the inner city. Survey findings reaffirm the necessity to train more black physicians and to provide data on current and future practice patterns. Comparisons are made between the practice patterns of earlier (1955 to 1970) and later (1973 to 1975) black graduates. A general bibliography of publications relevant to the practice patterns of black physicians is included.
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Scheduling observational and physical practice: influence on the coding of simple motor sequences.
Ellenbuerger, Thomas; Boutin, Arnaud; Blandin, Yannick; Shea, Charles H; Panzer, Stefan
2012-01-01
The main purpose of the present experiment was to determine the coordinate system used in the development of movement codes when observational and physical practice are scheduled across practice sessions. The task was to reproduce a 1,300-ms spatial-temporal pattern of elbow flexions and extensions. An intermanual transfer paradigm with a retention test and two effector (contralateral limb) transfer tests was used. The mirror effector transfer test required the same pattern of homologous muscle activation and sequence of limb joint angles as that performed or observed during practice, and the non-mirror effector transfer test required the same spatial pattern movements as that performed or observed. The test results following the first acquisition session replicated the findings of Gruetzmacher, Panzer, Blandin, and Shea (2011) . The results following the second acquisition session indicated a strong advantage for participants who received physical practice in both practice sessions or received observational practice followed by physical practice. This advantage was found on both the retention and the mirror transfer tests compared to the non-mirror transfer test. These results demonstrate that codes based in motor coordinates can be developed relatively quickly and effectively for a simple spatial-temporal movement sequence when participants are provided with physical practice or observation followed by physical practice, but physical practice followed by observational practice or observational practice alone limits the development of codes based in motor coordinates.
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ERIC Educational Resources Information Center
Koda-Kimble, Mary Anne; And Others
1989-01-01
The results of a 1982 survey of graduates of the University of California at San Francisco doctor of pharmacy degree program were re-analyzed to explore whether cultural differences between Asian and Caucasian graduates affected professional practice patterns, attitudes and activities. (Author/MLW)
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Casida, Jesus M; Pastor, Jessica
2012-09-01
Few data-based reports about the role and work environment of advanced practice nurses, specifically nurse practitioners in mechanical circulatory support programs, have been published. To describe the practice pattern and professional issues confronted by nurse practitioners in the rapidly evolving and expanding mechanical circulatory support programs in the United States. A descriptive research design was employed using the data from the 2010 mechanical circulatory support nurses survey. Quantitative and qualitative data that pertained to the demographic and practice profiles as well as barriers and overall issues faced by the nurse practitioners in their clinical practice were analyzed. Nonrandom sample of 48 nurse practitioners from 95 mechanical circulatory support programs nationwide. The practice pattern of nurse practitioners in mechanical circulatory support programs is similar to the practice pattern reported for nurse practitioners in acute and critical care settings. However, only 44% and 10% of nurse practitioners in mechanical circulatory support programs are authorized to admit and transfer patients into and out of the hospital, respectively. High workload, lack of institutional support, knowledge deficit, role ambiguity, lack of professional recognition, and burnout were the common issues faced by the participants in their clinical practice. The results provide preliminary evidence on the practice pattern, restrictions, and work environment issues that may threaten the viability of an mechanical circulatory support program in which nurse practitioners play a crucial role. Implications for clinical practice, research, and policy development are discussed.
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Yokoyama, Yoko; Kakudate, Naoki; Sumida, Futoshi; Matsumoto, Yuki; Gilbert, Gregg H; Gordan, Valeria V
2013-01-01
Objective The purposes of this study were to (1) quantify dentists' practice patterns regarding caries prevention and (2) test the hypothesis that certain dentists' characteristics are associated with these practice patterns. Design The study used a cross-sectional study design consisting of a questionnaire survey. Participants The study queried dentists who worked in outpatient dental practices who were affiliated with the Dental Practice-Based Research Network Japan, which seeks to engage dentists in investigating research questions and sharing experiences and expertise (n=282). Measurement Dentists were asked about their practice patterns regarding caries preventive dentistry. Background data on patients, practice and dentist were also collected. Results 38% of dentists (n=72) provided individualised caries prevention to more than 50% of their patients. Overall, 10% of the time in daily practice was spent on caries preventive dentistry. Dentists who provided individualised caries prevention to more than 50% of their patients spent significantly more time on preventive care and less time on removable prosthetics treatment, compared to dentists who did not provide individualised caries prevention. Additionally, they provided oral hygiene instruction, patient education, fluoride recommendations, intraoral photographs taken and diet counselling to their patients significantly more often than dentists who did not provide individualised caries prevention. Multiple logistic regression analysis suggested that the percentage of patients interested in caries prevention and the percentage of patients who received hygiene instruction, were both associated with the percentage of patients who receive individualised caries prevention. Conclusions We identified substantial variation in dentists' practice patterns regarding preventive dentistry. Individualised caries prevention was significantly related to provision of other preventive services and to having a higher percentage of patients interested in caries prevention, but not to the dentist's belief about the effectiveness of caries risk assessment. (Clinicaltrials.gov registration number NCT01 680 848). PMID:24068763
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Comparison of lifestyle and practice patterns between male and female Canadian ophthalmologists.
McAlister, Chryssa; Jin, Ya-Ping; Braga-Mele, Rosa; DesMarchais, Beatrice F; Buys, Yvonne M
2014-06-01
To identify sex differences in lifestyle and practice patterns of Canadian ophthalmologists. Web-based national survey. Members of the Canadian Ophthalmological Society. A 48-item questionnaire was sent electronically. Analysis of results was completed using χ(2) and Fisher's exact tests where appropriate. Of 385 respondents (30%), 102 were female and 283 male. Several statistically significant differences exist in lifestyle and practice patterns. Fifty-one percent of females operate less than 2 days per month as compared with 36% of males (p = 0.01) despite similar clinical hours. No statistically significant differences were found in other practice pattern parameters including laser refractive surgery, hospital affiliation, university appointment/rank, and number of peer-review publications. Ninety percent of males and 81% of females report having ≥1 children, but males report greater number of children (p < 0.001). Females are commonly the primary caregiver, whereas males report their partner as primary caregiver (p < 0.001). Fifty-two percent of females are unhappy with the amount of parental leave (p < 0.001). Fifty-one percent of females believe that childbearing slowed or markedly slowed career progress, as compared with 15% of males (p < 0.001). Both female (83%) and male (87%) ophthalmologists report high career satisfaction (p = 0.43). Differences in practice patterns between males and females in our analysis surround surgical time, with no difference seen in other practice patterns or academic achievements. Differences in family patterns surround household and childrearing duties. Despite differences, both males and females report high satisfaction across several professional and personal parameters. Compared with previous studies, this suggests a change in practice patterns over time. Copyright © 2014 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.
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Lanham, Holly Jordan; Leykum, Luci K; McDaniel, Reuben R
2012-01-01
Despite efforts made by ambulatory care organizations to standardize the use of electronic health records (EHRs), practices often incorporate these systems into their work differently from each other. One potential factor contributing to these differences is within-practice communication patterns. The authors explore the linkage between within-practice communication patterns and practice-level EHR use patterns. Qualitative study of six practices operating within the same multi-specialty ambulatory care organization using the same EHR system. Semistructured interviews and direct observation were conducted with all physicians, nurses, medical assistants, practice managers, and non-clinical staff from each practice. An existing model of practice relationships was used to analyze communication patterns within the practices. Practice-level EHR use was defined and analyzed as the ways in which a practice uses an EHR as a collective or a group-including the degree of feature use, level of EHR-enabled communication, and frequency that EHR use changes in a practice. Interview and observation data were analyzed for themes. Based on these themes, within-practice communication patterns were categorized as fragmented or cohesive, and practice-level EHR use patterns were categorized as heterogeneous or homogeneous. Practices where EHR use was uniformly high across all users were further categorized as having standardized EHR use. Communication patterns and EHR use patterns were compared across the six practices. Within-practice communication patterns were associated with practice-level EHR use patterns. In practices where communication patterns were fragmented, EHR use was heterogeneous. In practices where communication patterns were cohesive, EHR use was homogeneous. Additional analysis revealed that practices that had achieved standardized EHR use (uniformly high EHR use across all users) exhibited high levels of mindfulness and respectful interaction, whereas practices that were furthest from achieving standardized EHR use exhibited low levels of mindfulness and respectful interaction. Within-practice communication patterns provide a unique perspective for exploring the issue of standardization in EHR use. A major fallacy of setting homogeneous EHR use as the goal for practice-level EHR use is that practices with uniformly low EHR use could be considered successful. Achieving uniformly high EHR use across all users in a practice is more consistent with the goals of current EHR adoption and use efforts. It was found that some communication patterns among practice members may enable more standardized EHR use than others. Understanding the linkage between communication patterns and EHR use can inform understanding of the human element in EHR use and may provide key lessons for the implementation of EHRs and other health information technologies.
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de Castro, John M
2015-09-01
Contemplative practices can have profound effects on mindfulness and on physical and sensory and mystical experiences. Individuals who self-reported meditation, yoga, contemplative prayer, or a combination of practices and their patterns of practice were compared for mindfulness, kundalini effects, and mystical experiences. The results suggest that the amount of practice but not the pattern and social conditions of practice influences mindfulness and possibly mystical experiences. Meditation, yoga, contemplative prayer, or a combination of practices all were found to be associated with enhancements of mindfulness, kundalini effects, and mystical experiences, but meditation had particularly strong associations and may be the basis of the associations of yoga and prayer with these outcomes. The results further suggest that the primary association of contemplative practices is with the real time awareness and appreciation of sensory and perceptual experiences which may be the intermediary between disparate practices and mindfulness, kundalini effects, and mystical experiences. Copyright © 2015 Elsevier Inc. All rights reserved.
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Learning alternative movement coordination patterns using reinforcement feedback.
Lin, Tzu-Hsiang; Denomme, Amber; Ranganathan, Rajiv
2018-05-01
One of the characteristic features of the human motor system is redundancy-i.e., the ability to achieve a given task outcome using multiple coordination patterns. However, once participants settle on using a specific coordination pattern, the process of learning to use a new alternative coordination pattern to perform the same task is still poorly understood. Here, using two experiments, we examined this process of how participants shift from one coordination pattern to another using different reinforcement schedules. Participants performed a virtual reaching task, where they moved a cursor to different targets positioned on the screen. Our goal was to make participants use a coordination pattern with greater trunk motion, and to this end, we provided reinforcement by making the cursor disappear if the trunk motion during the reach did not cross a specified threshold value. In Experiment 1, we compared two reinforcement schedules in two groups of participants-an abrupt group, where the threshold was introduced immediately at the beginning of practice; and a gradual group, where the threshold was introduced gradually with practice. Results showed that both abrupt and gradual groups were effective in shifting their coordination patterns to involve greater trunk motion, but the abrupt group showed greater retention when the reinforcement was removed. In Experiment 2, we examined the basis of this advantage in the abrupt group using two additional control groups. Results showed that the advantage of the abrupt group was because of a greater number of practice trials with the desired coordination pattern. Overall, these results show that reinforcement can be successfully used to shift coordination patterns, which has potential in the rehabilitation of movement disorders.
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Paolone, Giovanna; Lee, Theresa M.; Sarter, Martin
2012-01-01
Although the impairments in cognitive performance that result from shifting or disrupting daily rhythms have been demonstrated, the neuronal mechanisms that optimize fixed time daily performance are poorly understood. We previously demonstrated that daily practice of a sustained attention task (SAT) evokes a diurnal activity pattern in rats. Here we report that SAT practice at a fixed time produced practice time-stamped increases in prefrontal cholinergic neurotransmission that persisted after SAT practice was terminated and in a different environment. SAT time-stamped cholinergic activation occurred irrespective of whether the SAT was practiced during the light or dark phase or in constant light conditions. In contrast, prior daily practice of an operant schedule of reinforcement, albeit generating more rewards and lever presses per session than the SAT, neither activated the cholinergic system nor affected the animals' nocturnal activity pattern. Likewise, food-restricted animals exhibited strong food anticipatory activity (FAA) and attenuated activity during the dark period but FAA was not associated with increases in prefrontal cholinergic activity. Removal of cholinergic neurons impaired SAT performance and facilitated the reemergence of nocturnality. Shifting SAT practice away from a fixed time resulted in significantly lower performance. In conclusion, these experiments demonstrated that fixed time, daily practice of a task assessing attention generates a precisely practice time-stamped activation of the cortical cholinergic input system. Time-stamped cholinergic activation benefits fixed time performance and, if practiced during the light phase, contributes to a diurnal activity pattern. PMID:22933795
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Paolone, Giovanna; Lee, Theresa M; Sarter, Martin
2012-08-29
Although the impairments in cognitive performance that result from shifting or disrupting daily rhythms have been demonstrated, the neuronal mechanisms that optimize fixed-time daily performance are poorly understood. We previously demonstrated that daily practice of a sustained attention task (SAT) evokes a diurnal activity pattern in rats. Here, we report that SAT practice at a fixed time produced practice time-stamped increases in prefrontal cholinergic neurotransmission that persisted after SAT practice was terminated and in a different environment. SAT time-stamped cholinergic activation occurred regardless of whether the SAT was practiced during the light or dark phase or in constant-light conditions. In contrast, prior daily practice of an operant schedule of reinforcement, albeit generating more rewards and lever presses per session than the SAT, neither activated the cholinergic system nor affected the animals' nocturnal activity pattern. Likewise, food-restricted animals exhibited strong food anticipatory activity (FAA) and attenuated activity during the dark phase but FAA was not associated with increases in prefrontal cholinergic activity. Removal of cholinergic neurons impaired SAT performance and facilitated the reemergence of nocturnality. Shifting SAT practice away from a fixed time resulted in significantly lower performance. In conclusion, these experiments demonstrated that fixed-time, daily practice of a task assessing attention generates a precisely practice time-stamped activation of the cortical cholinergic input system. Time-stamped cholinergic activation benefits fixed-time performance and, if practiced during the light phase, contributes to a diurnal activity pattern.
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Proactive transfer of learning depends on the evolution of prior learned task in memory.
Tallet, Jessica; Kostrubiec, Viviane; Zanone, Pier-Giorgio
2010-06-01
The aim of the present study was to investigate the processes underlying the proactive interference effect using bimanual coordination. Our rationale was that interference would only occur when the prior learned A coordination pattern enters in competition with the required subsequent B pattern. We hypothesized that competition would arise only if the A pattern persists in memory before introducing the B pattern. In the experimental group, both A and B patterns were practiced and recalled, whereas in the control group only the B pattern was practiced and recalled. In Experiment 1, which involved initially bistable participants, the persistence of the A pattern led to interference, while, surprisingly, the A pattern forgetting entailed facilitation. In Experiment 2, which involved initially tristable participants, no such transfer effect was found. The apparently contradictory results can be interpreted coherently in the light of dynamical principles of learning. (c) 2010 Elsevier B.V. All rights reserved.
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Miyawaki, Christina E
2016-03-01
This study is a cross-sectional investigation of caregiving practice patterns among Asian, Hispanic and non-Hispanic White American family caregivers of older adults across three immigrant generations. The 2009 California Health Interview Survey (CHIS) dataset was used, and 591 Asian, 989 Hispanic and 6537 non-Hispanic White American caregivers of older adults were selected. First, descriptive analyses of caregivers' characteristics, caregiving situations and practice patterns were examined by racial/ethnic groups and immigrant generations. Practice patterns measured were respite care use, hours and length of caregiving. Three hypotheses on caregiving patterns based on assimilation theory were tested and analyzed using logistic regression and generalized linear models by racial/ethnic groups and generations. Caregiving patterns of non-Hispanic White caregivers supported all three hypotheses regarding respite care use, caregiving hours and caregiving duration, showing less caregiving involvement in later generations. However, Asian and Hispanic counterparts showed mixed results. Third generation Asian and Hispanic caregivers used respite care the least and spent the most caregiving hours per week and had the longest caregiving duration compared to earlier generations. These caregiving patterns revealed underlying cultural values related to filial responsibility, even among later generations of caregivers of color. Findings suggest the importance of considering the cultural values of each racial/ethnic group regardless of generation when working with racially and ethnically diverse populations of family caregivers of older adults.
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Tong, Lin; Tentori, Francesca; Akiba, Takashi; Karaboyas, Angelo; Gillespie, Brenda; Akizawa, Tadao; Pisoni, Ronald L.; Bommer, Juergen; Port, Friedrich K.
2011-01-01
Summary Background and objectives Demand for hemodialysis among elderly patients is increasing worldwide. Although clinical care of this high-risk group is complex and challenging, no guidelines exist to inform hemodialysis practices. The Dialysis Outcomes and Practice Patterns Study (DOPPS) provides a unique opportunity to assess dialysis practices and associated outcomes among elderly versus younger patients on chronic in-center hemodialysis in 12 countries. Design, setting, participants, & measurements Clinical characteristics, dialysis practices, and outcomes of elderly versus younger patients were compared among participants in four DOPPS regions in 2005 through 2007. Results Although participant mean age increased over time in all DOPPS countries, the percentage of elderly varied widely. Overall, comorbidities and malnutrition were more common in the elderly. Fistulae were used less frequently among elderly versus younger patients in Europe and North America but not in Australia, New Zealand, and Japan. No difference in treatment time was observed between elderly and younger patients after normalizing for body weight. In all regions, ultrafiltration rates were lower among elderly patients. Elderly patients reported poorer quality of life with respect to the physical but not mental component scores. Mortality risk was three- to sixfold higher in the elderly group, whereas causes of death overall were similar for elderly and younger patients. Conclusions Elderly patients represent a different proportion of DOPPS participants across countries, possibly reflecting differences in policies and clinical practices. In general, hemodialysis practices in the elderly reflected each region's clinical patterns, with some variation by age group depending upon the practice. PMID:21734085
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Security practices and regulatory compliance in the healthcare industry
Kwon, Juhee; Johnson, M Eric
2013-01-01
Objective Securing protected health information is a critical responsibility of every healthcare organization. We explore information security practices and identify practice patterns that are associated with improved regulatory compliance. Design We employed Ward's cluster analysis using minimum variance based on the adoption of security practices. Variance between organizations was measured using dichotomous data indicating the presence or absence of each security practice. Using t tests, we identified the relationships between the clusters of security practices and their regulatory compliance. Measurement We utilized the results from the Kroll/Healthcare Information and Management Systems Society telephone-based survey of 250 US healthcare organizations including adoption status of security practices, breach incidents, and perceived compliance levels on Health Information Technology for Economic and Clinical Health, Health Insurance Portability and Accountability Act, Red Flags rules, Centers for Medicare and Medicaid Services, and state laws governing patient information security. Results Our analysis identified three clusters (which we call leaders, followers, and laggers) based on the variance of security practice patterns. The clusters have significant differences among non-technical practices rather than technical practices, and the highest level of compliance was associated with hospitals that employed a balanced approach between technical and non-technical practices (or between one-off and cultural practices). Conclusions Hospitals in the highest level of compliance were significantly managing third parties’ breaches and training. Audit practices were important to those who scored in the middle of the pack on compliance. Our results provide security practice benchmarks for healthcare administrators and can help policy makers in developing strategic and practical guidelines for practice adoption. PMID:22955497
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Extracting patterns of database and software usage from the bioinformatics literature
Duck, Geraint; Nenadic, Goran; Brass, Andy; Robertson, David L.; Stevens, Robert
2014-01-01
Motivation: As a natural consequence of being a computer-based discipline, bioinformatics has a strong focus on database and software development, but the volume and variety of resources are growing at unprecedented rates. An audit of database and software usage patterns could help provide an overview of developments in bioinformatics and community common practice, and comparing the links between resources through time could demonstrate both the persistence of existing software and the emergence of new tools. Results: We study the connections between bioinformatics resources and construct networks of database and software usage patterns, based on resource co-occurrence, that correspond to snapshots of common practice in the bioinformatics community. We apply our approach to pairings of phylogenetics software reported in the literature and argue that these could provide a stepping stone into the identification of scientific best practice. Availability and implementation: The extracted resource data, the scripts used for network generation and the resulting networks are available at http://bionerds.sourceforge.net/networks/ Contact: robert.stevens@manchester.ac.uk PMID:25161253
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Examining the contradiction in 'sustainable urban growth': an example of groundwater sustainability
Zellner, Moira L.; Reeves, Howard W.
2012-01-01
The environmental planning literature proposes a set of 'best management practices' for urban development that assumes improvement in environmental quality as a result of specific urban patterns. These best management practices, however, often do not recognise finite biophysical limits and social impacts that urban patterns alone cannot overcome. To shed light on this debate, we explore the effects of different degrees of urban clustering on groundwater levels using a coupled land-use change and groundwater-flow model. Our simulations show that specific urban forms only slow down the impact on groundwater. As population increases, the pattern in which it is accommodated ceases to matter, and widespread depletion ensues. These results are predictable, yet current planning practice tends to take growth for granted and is reluctant to envision either no-growth scenarios or the prospect of depletion. We propose to use simulations such as those presented here to aid in policy discussions that allow decision makers to question the assumption of sustainable growth and suggest alternative forms of development.
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Sheps, S B; Schechter, M T; Grantham, P; Finlayson, N; Sizto, R
1989-01-01
Are there differences in patterns of practice between actively practising physicians who have been certified after a 2-year family practice residency and matched physicians without certification who have completed the standard 1-year internship? With the use of billing files prepared by the British Columbia Medical Association a group of 65 family practice certificants in active practice in British Columbia was compared with a control group of 130 internship trainees matched by year and school of graduation, category of billing (i.e., solo or group) and region. A wide range of practice features was assessed for the fiscal years 1984-85, 1985-86 and 1986-87. No differences were detected between the groups in 1986-87 for the following practice variables: number of patients (1888 and 1842 respectively), number of personal services billed for (7265 and 7173), number of personal services per patient (3.9), amount of funding for personal services ($140,192 and $140,100) and amount per patient for personal services ($77 and $79). Age-adjusted costs for male and female patients were similar in the two groups. Of six services thought to be influenced by type of training, only maternity care generated a significantly higher number of billings in the study group (341 v. 249). These results suggest that there is no demonstrable effect of training on patterns of practice. However, the question of the effect of training on quality of care and whether the 2-year residency may have a longer effect on practice patterns should be the focus of future research. PMID:2702528
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Effects of practice schedule and task specificity on the adaptive process of motor learning.
Barros, João Augusto de Camargo; Tani, Go; Corrêa, Umberto Cesar
2017-10-01
This study investigated the effects of practice schedule and task specificity based on the perspective of adaptive process of motor learning. For this purpose, tasks with temporal and force control learning requirements were manipulated in experiments 1 and 2, respectively. Specifically, the task consisted of touching with the dominant hand the three sequential targets with specific movement time or force for each touch. Participants were children (N=120), both boys and girls, with an average age of 11.2years (SD=1.0). The design in both experiments involved four practice groups (constant, random, constant-random, and random-constant) and two phases (stabilisation and adaptation). The dependent variables included measures related to the task goal (accuracy and variability of error of the overall movement and force patterns) and movement pattern (macro- and microstructures). Results revealed a similar error of the overall patterns for all groups in both experiments and that they adapted themselves differently in terms of the macro- and microstructures of movement patterns. The study concludes that the effects of practice schedules on the adaptive process of motor learning were both general and specific to the task. That is, they were general to the task goal performance and specific regarding the movement pattern. Copyright © 2017 Elsevier B.V. All rights reserved.
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Alexander, Gina; Innes, Kim E.; Bourguignon, Cheryl; Bovbjerg, Viktor E.; Kulbok, Pamela; Taylor, Ann Gill
2012-01-01
Background The current study described patterns of yoga practice and examined differences in physical activity over time between individuals with or at risk for type 2 diabetes who completed an 8-week yoga intervention compared with controls. Methods A longitudinal comparative design measured the effect of a yoga intervention on yoga practice and physical activity, using data at baseline and postintervention months 3, 6, and 15. Results Disparate patterns of yoga practice occurred between intervention and control participants over time, but the subjective definition of yoga practice limits interpretation. Multilevel model estimates indicated that treatment group did not have a significant influence in the rate of change in physical activity over the study period. While age and education were not significant individual predictors, the inclusion of these variables in the model did improve fit. Conclusions Findings indicate that an 8-week yoga intervention had little effect on physical activity over time. Further research is necessary to explore the influence of yoga on behavioral health outcomes among individuals with or at risk for type 2 diabetes. PMID:22232506
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The impact of a general practice group intervention on prescribing costs and patterns.
Walker, Jane; Mathers, Nigel
2002-01-01
BACKGROUND: The formation of primary care groups (PCGs) and trusts (PCTs) has shifted the emphasis from individual practice initiatives to group-based efforts to control rising prescribing costs. However, there is a paucity of literature describing such group initiatives. We report the results of a multilevel group initiative, involving input from a pharmaceutical adviser, practice comparison feedback, and peer review meetings. AIM: To determine the impact of a prescribing initiative on the prescribing patterns of a group of general practices. DESIGN OF STUDY: A comparative study with non-matched controls. SETTING: Nine semi-rural/rural practices forming a commissioning group pilot, later a PCG, in Southern Derbyshire with nine practices as controls. METHOD: Practice data were collated for overall prescribing and for therapeutic categories, between the years 1997/1998 and 1998/1999 and analysed statistically. Prescribing expenditure trends were also collated. RESULTS: Although both groups came well within their prescribing budgets, in the study group this was for the first time in five years. Their rate of increase in expenditure slowed significantly following the initiative compared with that of the comparison group, which continued to rise (median practice net ingredient cost/patient unit (nic/PU) increase: Pound Sterling0.69 and Pound Sterling3.80 respectively; P = 0.03). The study group's nic/PU dropped below, and stayed below, that of the comparison group one month after the start of the initiative. For most therapeutic categories the study group had lower increases in costs and higher increases in percentage of generic items than the comparison group. Quality markers were unaffected. CONCLUSION: We suggest that practices with diverse prescribing patterns can work together effectively within a PCT locality to control prescribing costs. PMID:12030659
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Cha, Hyejung; Park, Hee Chul; Yu, Jeong Il; Kim, Tae Hyun; Nam, Taek-Keun; Yoon, Sang Min; Yoon, Won Sup; Kim, Jun Won; Kim, Mi Sook; Jang, Hong Seok; Choi, Youngmin; Kim, Jin Hee; Kay, Chul Seung; Jung, Inkyung; Seong, Jinsil
2017-01-01
Purpose The aim of this study was to examine patterns of radiotherapy (RT) in Korean patients with hepatocellular carcinoma (HCC) according to the evolving guideline for HCC established by the Korean Liver Cancer Study Group-National Cancer Center (KLCSG-NCC). Materials and Methods We reviewed 765 patients with HCC who were treated with RT between January 2011 and December 2012 in 12 institutions. Results The median follow-up period was 13.3 months (range, 0.2 to 51.7 months). Compared with previous data between 2004 and 2005, the use of RT as a first treatment has increased (9.0% vs. 40.8%). Increased application of intensity-modulated RT resulted in an increase in radiation dose (fractional dose, 1.8 Gy vs. 2.5 Gy; biologically effective dose, 53.1 Gy10 vs. 56.3 Gy10). Median overall survival was 16.2 months, which is longer than that reported in previous data (12 months). In subgroup analysis, treatments were significantly different according to stage (p < 0.001). Stereotactic body RT was used in patients with early HCC, and most patients with advanced stage were treated with three-dimensional conformal RT. Conclusion Based on the evolving KLCSG-NCC practice guideline for HCC, clinical practice patterns of RT have changed. Although RT is still used mainly in advanced HCC, the number of patients with good performance status who were treated with RT as a first treatment has increased. This change in practice patterns could result in improvement in overall survival. PMID:27338036
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Al-Sharif, Eman M; Stone, Donald U
2016-01-01
PRK is a refractive surgery that reshapes the corneal surface by excimer laser photoablation to correct refractive errors. The effect of increased ultraviolet (UV) exposure on promoting post-PRK corneal haze has been reported in the literature; however, information is lacking regarding the effect of ambient UV exposure on physician practice patterns. The aim of this study was to evaluate the effect of ophthalmologists' practice location on their reported practice patterns to prevent post-PRK corneal haze. A cross-sectional observational study was conducted through an online survey sent to ophthalmologists performing PRK. The survey recorded the primary city of practice from which the two independent variables, latitude and average annual sunshine days, were determined. It also measured the frequency of use of postoperative preventive interventions (dependent variables) which are as follows: intraoperative Mitomycin-C, oral vitamin C, sunglasses, topical corticosteroids, topical cyclosporine, oral tetracyclines and amniotic membrane graft. Fifty-one ophthalmologists completed the survey. Practice locations' mean latitude was 36.4 degrees north, and average sunshine days annually accounted for 60% of year days. There was no significant relation between latitude/average annual sunshine days and usual post-PRK prophylactic treatments ( P > 0.05). The commonest protective maneuvers were sunglasses (78%), prolonged topical corticosteroids (57%), Mitomycin-C (39%) and oral vitamin C (37%). We found no significant difference in ophthalmologists' practice patterns to prevent post-PRK corneal haze in relation to practice location latitude and average sunshine days. Moreover, the results demonstrated that the most widely used postoperative measures to prevent post-PRK haze are sunglasses, Mitomycin-C, topical corticosteroids, and oral Vitamin C.
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Action Research as a Practice-Based Practice
ERIC Educational Resources Information Center
Kemmis, Stephen
2009-01-01
Action research changes people's practices, their understandings of their practices, and the conditions under which they practice. It changes people's patterns of "saying", "doing" and "relating" to form new patterns--new ways of life. It is a meta-practice: a practice that changes other practices. It transforms the…
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Landscaping practices, land use patterns and stormwater quantity and quality in urban watersheds
NASA Astrophysics Data System (ADS)
Miles, B.; Band, L. E.
2011-12-01
Increasing quantity and decreasing quality of urban stormwater threatens biodiversity in local streams and reservoirs, jeopardizes water supplies, and ultimately contributes to estuarine eutrophication. To estimate the effects that present and alternative landscaping practices and land use patterns may have on urban stormwater quantity and quality, simulations of existing land use/land cover using the Regional Hydro-Ecologic Simulation System (RHESSys), a process-based surface hydrology and biogeochemistry model, were developed for watersheds in Baltimore, MD (as part of the Baltimore Ecosystem Study (BES) NSF Long-Term Ecological Research (LTER) site) and Durham, NC (as part of the NSF Urban Long-Term Research Area (ULTRA) program). The influence of land use patterns and landscaping practices on nutrient export in urban watersheds has been explored as part of the BES; this work has focused on improving our understanding of how residential landscaping practices (i.e. lawn fertilization rates) vary across land use and socioeconomic gradients. Elsewhere, others have explored the political ecology of residential landscaping practices - seeking to understand the economic, political, and cultural influences on the practice of high-input residential turf-grass management. Going forward, my research will synthesize and extend this prior work. Rather than pre-supposing predominant residential land use patterns and landscaping practices (i.e. lower-density periphery development incorporating high-input turf landscapes) alternate land use and landscaping scenarios (e.g. higher-density/transit-oriented development, rain gardens, vegetable gardens, native plant/xeriscaping) will be developed through interviews/focus groups with stakeholders (citizens, public officials, developers, non-profits). These scenarios will then be applied to the RHESSys models already developed for catchments in Baltimore and Durham. The modeled scenario results will be used to identify alternate land use patterns and landscaping practices that would: (1) help to reduce non-point sources of nutrient pollution in urban watersheds; and (2) be likely to gain public support. This research will inform sustainable development policy while furthering interdisciplinary research in the fields of planning and water resource management.
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Assessment of Vestibular Rehabilitation Therapy Training and Practice Patterns
Bush, Matthew L.; Dougherty, William
2015-01-01
Objective Vestibular rehabilitation therapy (VRT) can benefit patients with a variety of balance and vestibular disorders. This expanding field requires knowledgeable and experienced therapists; however, the practice and experience of those providing this care may vary greatly. The purpose of this study was to analyze variations in training and practice patterns among practicing vestibular rehabilitation therapists. Study Design Case-controlled cohort study Setting Investigation of outpatient physical therapy and audiology practices that offer vestibular rehabilitation conducted by a tertiary academic referral center. Main Outcome Measure Questionnaire-based investigation of level of training in vestibular disorders and therapy, practice patterns of vestibular rehabilitation, and referral sources for VRT patients. Results We identified 27 subjects within the state of Kentucky who practice vestibular rehabilitation and the questionnaire response rate was 63%. Responses indicated that 53% of respondents had no training in VRT during their professional degree program. Attendance of a course requiring demonstration of competence and techniques was 24% of participants. The development of VRT certification was significantly more favored by those who attended such courses compared with those who did not (p=0.01). 50% of therapists have direct access to patients without physician referrals. Conclusions There is a wide range of educational background and training among those practicing VRT. This variability in experience may affect care provided within some communities. Certification is not necessary for the practice of VRT but the development of certification is favored among some therapists to improve standardization of practice of this important specialty. PMID:25700790
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Siegfried, Elaine C; Jaworski, Jennifer C; Mina-Osorio, Paola
2018-06-01
Treatment guidelines endorse a variety of strategies for atopic dermatitis (AD) which may vary from published data and clinical practice patterns. The objective of this review was to quantify the volume of available medical literature supporting pediatric AD treatments and compare these patterns to those recommended by published guidelines and/or clinical practice patterns. Searches of Embase (2005-2016) and abstracts from selected meetings (2014-2016) related to AD treatment in patients younger than 17 years of age yielded references that were assessed by study design, primary treatment, age groups, and AD severity. Published literature partially supports clinical guidelines, with emollients and topical medications being the most investigated. There were disproportionately more publications for topical calcineurin inhibitors (TCI) compared with topical corticosteroids (TCS); however, the search interval may have biased the results toward treatments approved near the beginning of the time frame. In contrast, publications documenting clinical practice patterns reflect greater use of emollients and TCS (over TCI), as well as systemic corticosteroids. Data is relatively limited for long-term and combination treatment, treatment of severe AD, and patients younger than 2 years of age, and completely lacking for systemic corticosteroids. This scoping review demonstrates that available medical literature largely supports published guidelines for topical therapy; however, clinical practice patterns are less aligned. There is a lack of data for older, more frequently used generic treatments, including oral antihistamines, oral antibiotics, and systemic corticosteroids. Overall, literature is lacking for long-term treatment, treatment for patients younger than 2 years of age, and for systemic treatment for severe disease. Regeneron Pharmaceuticals Inc.
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Adoption of Requirements Engineering Practices in Malaysian Software Development Companies
NASA Astrophysics Data System (ADS)
Solemon, Badariah; Sahibuddin, Shamsul; Ghani, Abdul Azim Abd
This paper presents exploratory survey results on Requirements Engineering (RE) practices of some software development companies in Malaysia. The survey attempted to identify patterns of RE practices the companies are implementing. Information required for the survey was obtained through a survey, mailed self-administered questionnaires distributed to project managers and software developers who are working at software development companies operated across the country. The results showed that the overall adoption of the RE practices in these companies is strong. However, the results also indicated that fewer companies in the survey have use appropriate CASE tools or software to support their RE process and practices, define traceability policies and maintain traceability manual in their projects.
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Security practices and regulatory compliance in the healthcare industry.
Kwon, Juhee; Johnson, M Eric
2013-01-01
Securing protected health information is a critical responsibility of every healthcare organization. We explore information security practices and identify practice patterns that are associated with improved regulatory compliance. We employed Ward's cluster analysis using minimum variance based on the adoption of security practices. Variance between organizations was measured using dichotomous data indicating the presence or absence of each security practice. Using t tests, we identified the relationships between the clusters of security practices and their regulatory compliance. We utilized the results from the Kroll/Healthcare Information and Management Systems Society telephone-based survey of 250 US healthcare organizations including adoption status of security practices, breach incidents, and perceived compliance levels on Health Information Technology for Economic and Clinical Health, Health Insurance Portability and Accountability Act, Red Flags rules, Centers for Medicare and Medicaid Services, and state laws governing patient information security. Our analysis identified three clusters (which we call leaders, followers, and laggers) based on the variance of security practice patterns. The clusters have significant differences among non-technical practices rather than technical practices, and the highest level of compliance was associated with hospitals that employed a balanced approach between technical and non-technical practices (or between one-off and cultural practices). Hospitals in the highest level of compliance were significantly managing third parties' breaches and training. Audit practices were important to those who scored in the middle of the pack on compliance. Our results provide security practice benchmarks for healthcare administrators and can help policy makers in developing strategic and practical guidelines for practice adoption.
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[Practice patterns in Mexican allergologists about specific immunotherapy with allergens].
Larenas Linnemann, Désirée; Guidos Fogelbach, Guillermo Arturo; Arias Cruz, Alfredo
2008-01-01
Immunotherapy has been practiced since over a hundred years. Since the first applications up today changes have occurred in the preparation, dose and duration of the treatment, as well as in the extracts used. Guidelines have been published in Mexico and other countries to try to unify these practice patterns of immunotherapy. By means of a questionnaire, sent in various occasions to all members of the Colegio Mexicano de Inmunología Clínica y Alergia (CMICA) and of the Colegio Mexicano de Pediatras, Especialistas en Inmunología y Alergia (CoMPedIA) we tried to get a picture of the daily practice patterns of immunotherapy in the allergist's office. Results will be presented in a descriptive manner. A response rate of 61 (17%) was obtained from the College members. For immunotherapy allergists use locally made and imported extracts, generally mixed in their office (20% over 10 allergens in one bottle). Eighty percent adds bacterial vaccine at some point and 60% uses sublingual immunotherapy. Most use Evans without albumin as diluent, don't routinely premedicate, reach maintenance treatment after more than six months and 46% recommends a maximum duration of immunotherapy of two years or less. We present a diagnosis on the current situation of practice patterns concerning allergen immunotherapy among the members of both Mexican colleges of allergists. The methods used by the allergists for indication, preparation and administration are quite diverse.
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Rinaldi, Luca; Valente, Giovanna; Piai, Guido
2016-01-01
Background Liver transplanted patients need close surveillance for early signs of graft disease. Objectives Transient elastography can safely be repeated over time, offering serial liver stiffness measurement values. Serial stiffness measurements were compared to single baseline stiffness measurements in predicting the appearance of liver-related clinical events and guiding subsequent clinical decisions. Methods One hundred and sixty liver transplanted patients were observed for three years in our real-life practice. Results Liver stiffness measurements were stable in 75% of patients, decreased in 4% of patients, and increased in 21% of patients. The pattern of increased stiffness measurements was associated with both HCV-RNA positive status and the presence of an active biliary complication of liver transplantation and was more predictive of a clinically significant event resulting from any disease of the transplanted liver when compared to a stable pattern or to a single liver stiffness measurement. The procedures that were consequently performed were often diagnostic for unexpected situations, both in HCV-RNA positive and HCV-RNA negative patients. Conclusions The pattern of longitudinally increased liver stiffness measurements efficiently supported clinical decisions for individualized management strategies. Repeated transient elastography in real-life clinical practice appears to have a practical role in monitoring liver transplanted patients. PMID:28123442
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Ku, Leighton; Frogner, Bianca K; Steinmetz, Erika; Pittman, Patricia
2015-01-01
Community health centers are at the forefront of ambulatory care practices in their use of nonphysician clinicians and team-based primary care. We examined medical staffing patterns, the contributions of different types of staff to productivity, and the factors associated with staffing at community health centers across the United States. We identified four different staffing patterns: typical, high advanced-practice staff, high nursing staff, and high other medical staff. Overall, productivity per staff person was similar across the four staffing patterns. We found that physicians make the greatest contributions to productivity, but advanced-practice staff, nurses, and other medical staff also contribute. Patterns of community health center staffing are driven by numerous factors, including the concentration of clinicians in communities, nurse practitioner scope-of-practice laws, and patient characteristics such as insurance status. Our findings suggest that other group medical practices could incorporate more nonphysician staff without sacrificing productivity and thus profitability. However, the new staffing patterns that evolve may be affected by characteristics of the practice location or the types of patients served. Project HOPE—The People-to-People Health Foundation, Inc.
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Taghizadeh, Ziba; Vedadhir, Abouali; Behmanesh, Fereshteh; Ebadi, Abbas; Pourreza, Abulghasem; Abbasi-Shavazi, Mohammad Jalal
2015-09-18
Nowadays, nearly half of the world population lives in societies with low fertility or the below-replacement fertility. This potentially grounds the critical situation of reduction in the workforce and causes the aging of population due to an overall increase in life expectancy and standard of living. Hence, population and its transitions including the issue of fertility decline has become a topic of intense debate in the agenda-setting and policy-making processes in both the developed and developing countries. In this view, what can practically be done to respond to the fertility decline that entails effectively addressing the determinants of fertility change? In line with the literature, how people form their marriages or patterns of marriage is amongst influencing factors which potentially affect their reproductive practices as diverse societies recognize different conventions for marriage. This study is to examine women's reproductive practices by the various patterns of marriage using the explanatory sequential mixed methods design. This study has an explanatory sequential mixed methods design, the follow-up explanations variant model, with two strands. This design will be implemented in two distinct phases. In the first phase, a cross-sectional quantitative study will be done using a cluster sampling strategy on 850 married women 15-49 years old living in Babol city, Iran. In order to obtain a deeper understanding of the results of the quantitative phase, researchers will implement a qualitative research in the second phase of this study. This design will provide an explanation of the quantitative research results using the qualitative evidence. As patterns of marriage have implications for the status of women, their health and fertility, the result of this study can provide a rich source of information for the required health-related interventions and policies are required to put the demographic changes on the right track at micro and macro level and improve the reproductive practices of women at micro level.
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ERIC Educational Resources Information Center
Floyd, Randy G.; Cooley, Kathryn M.; Arnett, James E.; Fagan, Thomas K.; Mercer, Sterett H.; Hingle, Christine
2011-01-01
This article describes the results of three studies designed to understand better the journal operations, publishing practices, and impact of school psychology journals in recent years. The first study presents the results of a survey focusing on journal operations and peer-review practices that was completed by 61 journal editors of school…
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NASA Astrophysics Data System (ADS)
Inkoom, J. N.; Nyarko, B. K.
2014-12-01
The integration of geographic information systems (GIS) and agent-based modelling (ABM) can be an efficient tool to improve spatial planning practices. This paper utilizes GIS and ABM approaches to simulate spatial growth patterns of settlement structures in Shama. A preliminary household survey on residential location decision-making choice served as the behavioural rule for household agents in the model. Physical environment properties of the model were extracted from a 2005 image implemented in NetLogo. The resulting growth pattern model was compared with empirical growth patterns to ascertain the model's accuracy. The paper establishes that the development of unplanned structures and its evolving structural pattern are a function of land price, proximity to economic centres, household economic status and location decision-making patterns. The application of the proposed model underlines its potential for integration into urban planning policies and practices, and for understanding residential decision-making processes in emerging cities in developing countries. Key Words: GIS; Agent-based modelling; Growth patterns; NetLogo; Location decision making; Computational Intelligence.
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Jannat-Khah, Deanna P; McNeely, Jennifer; Pereyra, Margaret R; Parish, Carrigan; Pollack, Harold A; Ostroff, Jamie; Metsch, Lisa; Shelley, Donna R
2014-11-06
Dental visits represent an opportunity to identify and help patients quit smoking, yet dental settings remain an untapped venue for treatment of tobacco dependence. The purpose of this analysis was to assess factors that may influence patterns of tobacco-use-related practice among a national sample of dental providers. We surveyed a representative sample of general dentists practicing in the United States (N = 1,802). Multivariable analysis was used to assess correlates of adherence to tobacco use treatment guidelines and to analyze factors that influence providers' willingness to offer tobacco cessation assistance if reimbursed for this service. More than 90% of dental providers reported that they routinely ask patients about tobacco use, 76% counsel patients, and 45% routinely offer cessation assistance, defined as referring patients for cessation counseling, providing a cessation prescription, or both. Results from multivariable analysis indicated that cessation assistance was associated with having a practice with 1 or more hygienists, having a chart system that includes a tobacco use question, having received training on treating tobacco dependence, and having positive attitudes toward treating tobacco use. Providers who did not offer assistance but who reported that they would change their practice patterns if sufficiently reimbursed were more likely to be in a group practice, treat patients insured through Medicaid, and have positive attitudes toward treating tobacco dependence. Findings indicate the potential benefit of increasing training opportunities and promoting system changes to increase involvement of dental providers in conducting tobacco use treatment. Reimbursement models should be tested to assess the effect on dental provider practice patterns.
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Use of Simulators to Explore Specialty Recommendation for a Palpable Breast Mass
Laufer, Shlomi; Ray, Rebecca D.; D'Angelo, Anne-Lise D.; Jones, Grace F.; Pugh, Carla M.
2015-01-01
Background The study aim was to evaluate recommendation patterns of different specialties for the work-up of a palpable breast mass using simulated scenarios and clinical breast examination (CBE) models. Methods Study participants were a convenience sample of physicians (n=318) attending annual surgical, family practice and obstetrics and gynecology (OB/GYN) conferences. Two different silicone-based breast models (superficial mass vs chest wall mass) were used to test CBE skills and recommendation patterns (imaging, tissue sampling, and follow-up). Results Participants were more likely to recommend mammography (p<.001) and core biopsy (p<.0001) and less likely to recommend needle aspiration (p<.043) and 1-month follow up (p<.001) for the chest wall mass compared to the superficial mass. Family practitioners were less likely to recommend ultrasound (p<.001) and OB/GYNs were less likely to recommend mammogram (p<.006) across models. Surgeons were more likely to recommend core biopsy and less likely to recommend needle aspiration across models (p<.001) Conclusions Recommendation patterns differed across the two models in line with existing practice guidelines. Additionally, differences in practice patterns between primary care and specialty providers may represent varying clinician capabilities, health care resources, and individual preferences. Our work shows that simulation may be used to track adherence to practice guidelines for breast masses. PMID:26198334
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HemoVision: An automated and virtual approach to bloodstain pattern analysis.
Joris, Philip; Develter, Wim; Jenar, Els; Suetens, Paul; Vandermeulen, Dirk; Van de Voorde, Wim; Claes, Peter
2015-06-01
Bloodstain pattern analysis (BPA) is a subspecialty of forensic sciences, dealing with the analysis and interpretation of bloodstain patterns in crime scenes. The aim of BPA is uncovering new information about the actions that took place in a crime scene, potentially leading to a confirmation or refutation of a suspect's statement. A typical goal of BPA is to estimate the flight paths for a set of stains, followed by a directional analysis in order to estimate the area of origin for the stains. The traditional approach, referred to as stringing, consists of attaching a piece of string to each stain, and letting the string represent an approximation of the stain's flight path. Even though stringing has been used extensively, many (practical) downsides exist. We propose an automated and virtual approach, employing fiducial markers and digital images. By automatically reconstructing a single coordinate frame from several images, limited user input is required. Synthetic crime scenes were created and analysed in order to evaluate the approach. Results demonstrate the correct operation and practical advantages, suggesting that the proposed approach may become a valuable asset for practically analysing bloodstain spatter patterns. Accompanying software called HemoVision is currently provided as a demonstrator and will be further developed for practical use in forensic investigations. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
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Practical method for evaluating the visibility of moire patterns for CRT design
NASA Astrophysics Data System (ADS)
Shiramatsu, Naoki; Tanigawa, Masashi; Iwata, Shuji
1995-04-01
The high resolution CRT displays used for computer monitor and high performance TV often produce a pattern of bright and dark stripes on the screen called a moire pattern. The elimination of the moire is an important consideration in the CRT design. The objective of this study is to provide a practical method for estimating and evaluating a moire pattern considering the visibility by the human vision. On the basis of the mathematical model of a moire generation, precise value of the period and the intensity of a moire are calculated from the actual data of the electron beam profile and the transmittance distribution of apertures of the shadow mask. The visibility of the moire is evaluated by plotting the calculation results on the contrast-period plane, which consists of visible and invisible moire pattern regions based on experimental results of the psychological tests. Not only fundamental design parameters such as a shadow mask pitch and a scanning line pitch but also details of an electron beam profile such as a distortion or an asymmetry can be examined. In addition to the analysis, the image simulation of a moire using the image memory is also available.
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Food Preferences, Beliefs and Practices of Southeast Asian Refugee Adolescents.
ERIC Educational Resources Information Center
Story, Mary; Harris, Linda J.
1988-01-01
Results from a study of 207 Southeast Asian refugee high school students indicate that these students have maintained strong ties to their native foods and traditional meal patterns. Cambodian, Vietnamese, and Hmong students showed varying degrees of nutritional awareness. Implications of beliefs, preferences, and practices for nutrition education…
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Middle Level Practices in European International and Department of Defense Schools.
ERIC Educational Resources Information Center
Waggoner, V. Christine; McEwin, C. Kenneth
1993-01-01
Discusses results of a 1989-90 survey of 70 randomly selected international schools and 70 randomly selected Department of Defense Schools in Europe. Programs and practices surveyed included enrollments, grade organization, curriculum and instructional plans, core subjects, grouping patterns, exploratory courses, advisory programs, and scheduling.…
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Jacobs, Barbara Bennett
2013-01-01
Professional practice models have emerged as the way hospital-based nursing expresses its consensus-derived philosophy. Magnet recognition influences this practice, while extant nursing theories continue the quest to bridge scholarship with practice. The innovative model presented in this article is an adaptation of Carper's patterns of knowing into a nursing meta-language of science, ethics, art, and advocacy. In this model, boundaries of the patterns of knowing blur and synchronous movement of values, patterns of research, and Aristotelian intellectual virtues blend. Patient and nurse in an intersubjective relationship share the end of human flourishing as the patient's narrative evolves and shared meaning of the ultimate good is actualized.
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Grant, Andrew; Grant, Gwyneth; Gagné, Jean; Blanchette, Carl; Comeau, Émilie; Brodeur, Guillaume; Dionne, Jonathon; Ayite, Alphonse; Synak, Piotr; Wroblewski, Jakub; Apanowitz, Cas
2001-01-01
The patient centred electronic patient record enables retrospective analysis of practice patterns as one means to assist clinicians adjust and improve their practice. An interrogation of the data-warehouse linking test use to Diagnostic Related Group (DRG) of one years data of the Sherbrooke University Hospital showed that one-third of patients used two-thirds of these diagnostic tests. Using RoughSets analysis, zones of repeated tests were demonstrated where results remained within stable limits. It was concluded that 30% of fluid and electrolyte testing was probably unnecessary. These findings led to an endorsement of changing the test request formats in the hospital information system from profiles to individual tests requiring justification.
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SERENITY in Air Traffic Management
NASA Astrophysics Data System (ADS)
Felici, Massimo; Meduri, Valentino; Tedeschi, Alessandra; Riccucci, Carlo
This chapter is concerned with the validation of an implementation of the SERENITY Runtime Framework (SRF) tailored for the Air Traffic Management (ATM) domain. It reports our experience in the design and validation phases of a tool, which relies on the SRF in order to support Security and Dependability (S&D) Patterns into work practices. In particular, this chapter pinpoints the activities concerning the identification of S&D Patterns, the design of an ATM prototype and its validation. The validation activities involve qualitative as well as quantitative approaches. These activities as a whole highlight the validation process for adopting S&D Patterns within the ATM domain. Moreover, they stress how S&D Patters enhance and relate to critical features within an industry domain. The empirical results point out that S&D Patterns relate to work practices. Furthermore, they highlight design and validation activities in order to tailor systems relying on S&D Patterns to specific application domains. This strengths and supports the adoption of S&D Patterns in order to address AmI (Ambient Intelligence) requirements (e.g., awareness, proactiveness, resilience, etc.) within the ATM domain.
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Riley, Joseph L.; Gordan, Valeria V.; Rouisse, Kathleen M.; McClelland, Jocelyn; Gilbert, Gregg H.
2011-01-01
Objectives A number of articles have addressed gender differences in the productivity of dentists, but little is known about differences in practice patterns for caries management. This study compared the use of a comprehensive range of specific diagnostic methods, preventive agents, and restorative decision making for caries management between male and female dentists who were members of The Dental Practice-Based Research Network(DPBRN). Methods This study surveyed general dentists who were members of DPBRN and who practiced within the United States. The survey asked about dentist, practice, and patient characteristics, as well as prevention, assessment, and treatment of dental caries. Differences in years since dental school graduation, practice model, full/part-time status, and practice owner/employee were adjusted in the statistical models, before making conclusions about gender differences. Results Three hundred ninety-three male (84%) and seventy-three female (16%) dentists participated. Female dentists recommended at-home fluoride to a significantly larger proportion of their patients, whereas males had a preference for using in-office fluoride treatments with pediatric patients. Female dentists also choose to restore interproximal lesions at a significantly later stage of development, preferring to use preventive therapy more often at earlier stages of dental caries. There were few differences in diagnostic methods, time spent on or charges for restorative dentistry, and busyness of their practices. Conclusion DPBRN female dentists differ from their male counterparts in some aspects of the prevention, assessment, and treatment of dental caries, even with significant covariates taken into account. Practice patterns of female dentists suggest a greater caries preventive treatment philosophy. PMID:21454850
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The time course of cancer detection performance
NASA Astrophysics Data System (ADS)
Taylor-Phillips, Sian; Clarke, Aileen; Wallis, Matthew; Wheaton, Margot; Duncan, Alison; Gale, Alastair G.
2011-03-01
The purpose of this study was to measure how mammography readers' performance varies with time of day and time spent reading. This was investigated in screening practice and when reading an enriched case set. In screening practice records of time and date that each case was read, along with outcome (whether the woman was recalled for further tests, and biopsy results where performed) was extracted from records from one breast screening centre in UK (4 readers). Patterns of performance with time spent reading was also measured using an enriched test set (160 cases, 41% malignant, read three times by eight radiologists). Recall rates varied with time of day, with different patterns for each reader. Recall rates decreased as the reading session progressed both when reading the enriched test set and in screening practice. Further work is needed to expand this work to a greater number of breast screening centres, and to determine whether these patterns of performance over time can be used to optimize overall performance.
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Hankinson, Todd C.; Palmeri, Nicholas O.; Williams, Sarah A.; Torok, Michelle R.; Serrano, Cesar A.; Foreman, Nicholas K.; Handler, Michael H.; Liu, Arthur K.
2014-01-01
Background/Significance Initial therapy for craniopharyngioma remains controversial. Population-based datasets indicate that traditional algorithms (GTR versus STR +/− XRT) are often not employed. We investigated neurosurgical practice patterns. Methods A ten-question survey was electronically distributed to members of the American Association of Neurological Surgeons. Responses were analyzed using standard statistical techniques. Results One hundred-two responses were collected, with a median 25 craniopharyngiomas managed per respondent. 36% estimated their practice included ≥75% pediatrics and 61% had an academic practice. 36% would recommend observation or radiation therapy for a suspected craniopharyngioma in the absence of a tissue diagnosis, with 46% of these indicating this recommendation in ≥10% of cases. Following STR, 35% always recommend XRT and 59% recommend it in over half of cases. However, following STR or biopsy alone, 18% and 11% never recommend XRT. There was no association between type of practice (i.e. academic or ≥75% pediatrics) and practice patterns. Conclusions This survey verifies that deviation from established algorithms is common, underscoring the clinical complexity of these patients and recent secondary data analyses This should influence clinical researchers to investigate outcomes for patients treated using alternative methods. This will lend insight into appropriate treatment options and contribute to quality of life outcomes studies for craniopharyngioma. PMID:24577430
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Emergency physician evaluation of PA and NP practice patterns.
Phillips, Andrew W; Klauer, Kevin M; Kessler, Chad S
2018-05-01
The unprecedented surge in physician assistants (PAs) and NPs in the ED developed quickly in recent years, but scope of practice and practice patterns are not well described. We conducted two cross-sectional electronic surveys of the American College of Emergency Physicians' council. Survey construction was informed by interviews and evaluated with validity and reliability studies. Univariate analyses to establish associations also were performed. Most councilors' departments employ PAs and NPs (72.4% of 163 responses). Supervisory requirements varied greatly among respondents for the same emergency severity index (ESI) level. Regardless of experience level, NPs were reported to use significantly more resources than PAs; chi-square(4) = 105.292, P < .001 for less-experienced PAs or NPs; chi-square(4) = 120.415, P < .001 for more experienced PAs or NPs. Councilors reported great variation in PA and NP scope of practice. The results also suggest that new graduate PAs may be more clinically prepared to practice in the ED than new graduate NPs.
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NASA Astrophysics Data System (ADS)
Yalcinoglu, Pelin
This study aimed to explore high school biology teachers' epistemological criteria and their attention to reasoning and argumentation within their instructional practices. This study investigated: (1) what epistemological criteria do high school biology teachers use when justifying the validity of conclusions, (2) what is the frequency of the explicit use of reasoning and argumentation, if any, in high school biology teachers' instructional practices, and to what extend are reasoning and argumentation skills reflected, if at all, in high school biology teachers' modes of assessment. Three different data collection methods were employed in this study; face-to-face interviews, classroom observations, and document collections. Teachers' epistemological criteria were investigated to provide insight about their reasoning structures. This investigation was made possible by having teachers provide an argument about the validity of hypothetical conclusions drawn by the students based on two different scenarios related to evolution. Toulmin's Argument Pattern used to create rubric to analyze high school biology teachers' levels of reasoning through argumentation. Results of the data analysis suggested following findings. First, high school biology teachers participated in this study presented variety of epistemological criteria which were presented as high, moderate and low levels of reasoning through the argumentations. Second, elements of Toulmin's Argument Pattern were visible in the participants teaching practices, however students were not explicitly introduced to a well structured argument in those classrooms. High level of reasoning was not evident in the instructional practices of the observed teachers. High school biology classrooms which were observed in this study do not provide opportunities for students to practice high level of reasoning or improve their argumentation skills. Third, Interview Protocols designed for this study were found useful to identify the epistemological criteria and level of reasoning individuals presented through argumentation. Toulmin's Argument Pattern provides a practical method to analyze the structure of arguments. Results of this study suggest the following implications for improving science education. These implications might be helpful in increasing teacher awareness of the importance of explicit teaching of reasoning and argumentation in science classrooms. Toulmin's Argument Model should be introduced to teachers through teacher education or professional development programs to increase the use of reasoning and argumentation skills in instructional practices. Toulmin's Argument Pattern may be used to design lessons or unit plans which present science as argumentation. Therefore, by engaging students in argumentation, teachers may help students to improve their content knowledge along with reasoning and argumentation skills in science classrooms. The results of this study suggest that use of Toulmin's Argument Pattern to evaluate high school biology teachers' presented levels of reasoning is a promising approach to understanding the structure of reasoning and argumentation that biology teachers use when providing judgments about the validity of hypothetical conclusions. The interview protocols and the rubrics used in this study should be tested in different subject areas in order to enhance and validate the use of Toulmin's Argument Pattern in measuring individuals' epistemological criteria and level of reasoning.
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Ecological impact of historical and future land-use patterns in Senegal
Parton, W.; Tappan, G. Gray; Ojima, D.; Tschakert, P.
2004-01-01
The CENTURY model was used to simulate changes in total system carbon resulting from land-use history (1850–2000), and impacts of climatic changes and improved land-use management practices in Senegal. Results show that 0.477 Gtons of carbon have been lost from 1850 to 2000. Improved management practices have the potential of increasing carbon levels by 0.116 Gtons from 2000 to 2100. Potential to store carbon exists for improved forest management and agriculture practices in southern Senegal. Potential climatic changes decrease plant production (30 percent), total system carbon (14 percent), and the potential to store carbon from improved management practices (31 percent).
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The Profiles, Patterns, and Practices of Women Superintendents in Alabama's Public School Systems
ERIC Educational Resources Information Center
Brouillette, Janine E.
2009-01-01
The purpose of the study was to develop a profile that describes the patterns and practices of the 27 women who served as public school superintendents in Alabama during the 2006-2007 school year. This study explored the relationship between the profiles, patterns, and practices found in research and the manifestations in the lives and careers of…
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di Virgilio, Agustina; Morales, Juan Manuel
2016-01-01
Background. A large proportion of natural grasslands around the world is exposed to overgrazing resulting in land degradation and biodiversity loss. Although there is an increasing effort in the promotion of sustainable livestock management, rangeland degradation still occurs because animals' foraging behaviour is highly selective at different spatial scales. The assessment of the ecological mechanisms modulating the spatial distribution of grazing and how to control it has critical implications for long term conservation of resources and the sustainability of livestock production. Considering the relevance of social interactions on animals' space use patterns, our aim was to explore the potential effects of including animals' social context into management strategies using domestic sheep grazing in rangelands as case study. Methods. We used GPS data from 19 Merino sheep (approximately 10% of the flock) grazing on three different paddocks (with sizes from 80 to 1000 Ha) during a year, to estimate resource selection functions of sheep grazing in flocks of different levels of heterogeneity. We assessed the effects of sheep class (i.e., ewes, wethers, and hoggets), age, body condition and time since release on habitat selection patterns. Results. We found that social rank was reflected on sheep habitat use, where dominant individuals (i.e., reproductive females) used more intensively the most preferred areas and low-ranked (i.e., yearlings) used less preferred areas. Our results showed that when sheep grazed on more heterogeneous flocks, grazing patterns were more evenly distributed at all the paddocks considered in this study. On the other hand, when high-ranked individuals were removed from the flock, low-ranked sheep shifted their selection patterns by increasing the use of the most preferred areas and strongly avoided to use less preferred sites (i.e., a highly selective grazing behaviour). Discussion. Although homogenization and segregation of flocks by classes are common practices to increase flock productivity, we are proposing an alternative that employs behavioural interactions in heterogeneous flocks to generate more evenly distributed grazing patterns. This practice can be combined with other practices such as rotational grazing and guardian dogs (to decrease mortality levels that may be generated by sheep grazing on more risky habitats). This does not imply any modifications of livestock stocking rates and densities or any additional investments for labour and materials. Considering livestock behaviour is critical for the design of sustainable management practices that balance landscape conservation and livestock productivity.
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The Relationship Between School Health Curriculum and Family Practices.
ERIC Educational Resources Information Center
Hearne, Jill; Andrews, Richard L.
A study investigated the differential relationship between children's involvement in an experiential health curriculum and past-reported health practices and changes in family health practices. The research is based on the assumption that established patterns of health practices in families are not immutable patterns, but are susceptible to change…
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Newberg, Andrew B; Wintering, Nancy A; Yaden, David B; Waldman, Mark R; Reddin, Janet; Alavi, Abass
2015-12-01
This paper presents a case series with preliminary data regarding the neurophysiological effects of specific prayer practices associated with the Islamic religion. Such practices, like other prayer practices, are likely associated with several coordinated cognitive activities and a complex pattern of brain physiology. However, there may also be changes specific to the goals of Islamic prayer which has, as its most fundamental concept, the surrendering of one's self to God. To evaluate Islamic prayer practices, we measured changes in cerebral blood flow (CBF) using single photon emission computed tomography (SPECT) in three Islamic individuals while practicing two different types of Islamic prayer. In this case series, intense Islamic prayer practices generally showed decreased CBF in the prefrontal cortex and related frontal lobe structures, and the parietal lobes. However, there were also several regions that differed between the two types of prayer practices including increased CBF in the caudate nucleus, insula, thalamus, and globus pallidus. These patterns also appear distinct from concentrative techniques in which an individual focuses on a particular idea or object. It is hypothesized that the changes in brain activity may be associated with feelings of "surrender" and "connectedness with God" described to be experienced during these intense Islamic prayer practices. Overall, these results suggest that several coordinated cognitive processes occur during intense Islamic prayer. Methodological issues and implications of the results are also discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.
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A decision-support system for the analysis of clinical practice patterns.
Balas, E A; Li, Z R; Mitchell, J A; Spencer, D C; Brent, E; Ewigman, B G
1994-01-01
Several studies documented substantial variation in medical practice patterns, but physicians often do not have adequate information on the cumulative clinical and financial effects of their decisions. The purpose of developing an expert system for the analysis of clinical practice patterns was to assist providers in analyzing and improving the process and outcome of patient care. The developed QFES (Quality Feedback Expert System) helps users in the definition and evaluation of measurable quality improvement objectives. Based on objectives and actual clinical data, several measures can be calculated (utilization of procedures, annualized cost effect of using a particular procedure, and expected utilization based on peer-comparison and case-mix adjustment). The quality management rules help to detect important discrepancies among members of the selected provider group and compare performance with objectives. The system incorporates a variety of data and knowledge bases: (i) clinical data on actual practice patterns, (ii) frames of quality parameters derived from clinical practice guidelines, and (iii) rules of quality management for data analysis. An analysis of practice patterns of 12 family physicians in the management of urinary tract infections illustrates the use of the system.
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Turning a Molehill into a Mountain? How Reading Curricula Are Failing the Poor Worldwide
ERIC Educational Resources Information Center
Abadzi, Helen
2016-01-01
Reading programs for low-income populations often give disappointing results. Failures may be partly due to a neglect of practice in decoding letters. Visual stimuli are best learned symbol by symbol, with pattern analogies and much practice to unite smaller components and speed up identification. The prerequisite for comprehending volumes of text…
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A Gendered Study of the Working Patterns of Classical Musicians: Implications for Practice
ERIC Educational Resources Information Center
Bennett, Dawn
2008-01-01
Despite an increase in participation at all levels of the music profession, women continue to experience fewer opportunities to forge careers in music and are less likely than men to apply for leadership positions. This article presents results from a study in which 152 instrumental musicians reflected upon their professional practice and career…
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NASA Astrophysics Data System (ADS)
Beerenwinkel, Anne; von Arx, Matthias
2017-04-01
For the last three decades, moderate constructivism has become an increasingly prominent perspective in science education. Researchers have defined characteristics of constructivist-oriented science classrooms, but the implementation of such science teaching in daily classroom practice seems difficult. Against this background, we conducted a sub-study within the tri-national research project Quality of Instruction in Physics (QuIP) analysing 60 videotaped physics classes involving a large sample of students ( N = 1192) from Finland, Germany and Switzerland in order to investigate the kinds of constructivist components and teaching patterns that can be found in regular classrooms without any intervention. We applied a newly developed coding scheme to capture constructivist facets of science teaching and conducted principal component and cluster analyses to explore which components and patterns were most prominent in the classes observed. Two underlying components were found, resulting in two scales—Structured Knowledge Acquisition and Fostering Autonomy—which describe key aspects of constructivist teaching. Only the first scale was rather well established in the lessons investigated. Classes were clustered based on these scales. The analysis of the different clusters suggested that teaching physics in a structured way combined with fostering students' autonomy contributes to students' motivation. However, our regression models indicated that content knowledge is a more important predictor for students' motivation, and there was no homogeneous pattern for all gender- and country-specific subgroups investigated. The results are discussed in light of recent discussions on the feasibility of constructivism in practice.
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Birth Control Practices and Levels of Development in India.
ERIC Educational Resources Information Center
Karan, P.P.; And Others
1978-01-01
Analyzes the spatial patterns of acceptance of birth control practices in India and examines the relationship between these patterns and levels of economic development. Suggests implications of the area differences in acceptance patterns for family planning program policymakers. (Author)
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Vascular Access Practice Patterns in Canada: A National Survey
Dumaine, Chance; Kiaii, Mercedeh; Miller, Lisa; Moist, Louise; Oliver, Matthew J.; Lok, Charmaine E.; Hiremath, Swapnil; MacRae, Jennifer M.
2018-01-01
Background: One of the mandates of the Canadian Society of Nephrology’s (CSN) Vascular Access Working Group (VAWG) is to inform the nephrology community of the current status of vascular access (VA) practice within Canada. To better understand VA practice patterns across Canada, the CSN VAWG conducted a national survey. Objectives: (1) To inform on VA practice patterns, including fistula creation and maintenance, within Canada. (2) To determine the degree of consensus among Canadian clinicians regarding patient suitability for fistula creation and to assess barriers to and facilitators of fistula creation in Canada. Design: Development and implementation of a survey. Setting: Community and academic VA programs. Participants: Nephrologists, surgeons, and nurses who are involved in VA programs across Canada. Measurements: Practice patterns regarding access creation and maintenance, including indications and contraindications to fistula creation, as well as program-wide facilitators of and barriers to VA. Methods: A small group of CSN VAWG members determined the scope and created several VA questions which were then reviewed by 5 additional VAWG members (4 nephrologists and 1 VA nurse) to ensure that questions were clear and relevant. The survey was then tested by the remaining members of the VAWG and refinements were made. The final survey version was submitted electronically to relevant clinicians (nephrologists, surgeons, and nurses) involved or interested in VA across Canada. Questions centered around 4 major themes: (1) Practice patterns regarding access creation (preoperative assessment and maturation assessment), (2) Practice patterns regarding access maintenance (surveillance and salvage), (3) Indications and contraindications for arteriovenous (AV) access creation, and (4) Facilitators of and barriers to fistula creation and utilization. Results: Eighty-two percent (84 of 102) of invited participants completed the survey; the majority were nurses or VA coordinators (55%) with the remainder consisting of nephrologists (21%) and surgeons (20%). Variation in practice was noted in utility of preoperative Doppler ultrasound, interventions to assist nonmaturing fistulas, and procedures to salvage failing or thrombosed AV-access. Little consensus was seen regarding potential contraindications to AV-access creation (with the exception of limited life expectancy and poor vasculature on preoperative imaging, which had high agreement). Frequent barriers to fistula utilization were primary failure (77% of respondents) and long maturation times (73%). Respondents from centers with low fistula prevalence also cited long surgical wait times as an important barrier to fistula creation, whereas those from centers with high fistula prevalence cited access to multidisciplinary teams and interventional radiology as keys to successful fistula creation and utilization. Conclusions: There is significant variation in VA practice across Canada and little consensus among Canadian clinicians regarding contraindications to fistula creation. Further high-quality studies are needed with regard to appropriate fistula placement to help guide clinical practice. PMID:29511569
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Abdullah, Nurul-Fadhilah; Teo, Pey Sze; Foo, Leng Huat
2016-01-01
Objective: The aim of the study was to identify the ethnic differences in dietary patterns and its association with socio-economic, dietary and lifestyle practices among adolescents in Kelantan, Malaysia. Methods: A population-based study of 454 adolescents aged 12 to 19 years was included. A validated food frequency questionnaire was used to assess dietary patterns and three dietary patterns were identified based on the principal component analysis method. Results: Malay adolescents had significantly higher scores for the Western-based food pattern and local-based food pattern, whereas Chinese adolescents showed higher scores for the healthy-based food pattern. Multivariate analyses show that age and physical activity (PA) levels were positively associated with healthy-based food pattern in Malay (All, p < 0.001), whereas higher consumption of eating-out from home (EatOut) (p = 0.014) and fast food (p = 0.041) were negatively associated. High weekly breakfast skipping (p < 0.001) and EatOut (p = 0.003) were positively associated with a Western-based pattern, whereas age (p < 0.001) and household income (p = 0.005) were negatively associated. Higher frequency of daily snacking (p = 0.013) was positively associated with local-based food pattern. For Chinese adolescents, age (p < 0.001), PA levels (p < 0.001) and maternal education level (p = 0.035) showed positive associations with the healthy-based pattern, whereas high EatOut (p = 0.001) and fast food intakes (p = 0.001) were negatively associated. Higher weekly consumption of EatOut (p = 0.007), fast food (p = 0.023) and carbonated beverages (p = 0.023), and daily snacking practice (p = 0.004) were positively associated with higher Western-based food pattern, whereas age (p = 0.004) was inversely associated. Conclusion: This study showed that there were significant differences in dietary patterns and its association factors between Malay and Chinese adolescents. More importantly, these findings suggest that unhealthy dietary and lifestyle practices could increase the risk of adherence to unhealthy Western-based food pattern that is high in fat, sugar and salt contents, and, consequently, increase the risk of developing obesity and metabolic-related disorders during these critical years of growth. PMID:27626444
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ERIC Educational Resources Information Center
Kang, Che Chang
2014-01-01
The study aimed at investigating TOEIC score distribution patterns and learner satisfaction in an intensive TOEIC course and drew implications for pedagogical practice. A one-group pre-test post-test experiment and a survey on learner satisfaction were conducted on Taiwanese college EFL students (n = 50) in a case study. Results showed that the…
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Kelly, Kassandra C; Jordan, Erin M; Joyner, A Barry; Burdette, G Trey; Buckley, Thomas A
2014-01-01
A cornerstone of the recent consensus statements on concussion is a multifaceted concussion-assessment program at baseline and postinjury and when tracking recovery. Earlier studies of athletic trainers' (ATs') practice patterns found limited use of multifaceted protocols; however, these authors typically grouped diverse athletic training settings together. To (1) describe the concussion-management practice patterns of National Collegiate Athletic Association (NCAA) Division I ATs, (2) compare these practice patterns to earlier studies, and (3) objectively characterize the clinical examination. Cross-sectional study. Online survey. A total of 610 ATs from NCAA Division I institutions, for a response rate of 34.4%. The survey had 3 subsections: demographic questions related to the participant's experiences, concussion-assessment practice patterns, and concussion-recovery and return-to-participation practice patterns. Specific practice-pattern questions addressed balance, cognitive and mental status, neuropsychological testing, and self-reported symptoms. Finally, specific components of the clinical examination were examined. We identified high rates of multifaceted assessments (i.e., assessments using at least 3 techniques) during testing at baseline (71.2%), acute concussion assessment (79.2%), and return to participation (66.9%). The specific techniques used are provided along with their adherence with evidence-based practice findings. Respondents endorsed a diverse array of clinical examination techniques that often overlapped objective concussion-assessment protocols or were likely used to rule out associated potential conditions. Respondents were cognizant of the Third International Consensus Statement, the National Athletic Trainers' Association position statement, and the revised NCAA Sports Medicine Handbook recommendations. Athletic trainers in NCAA Division I demonstrated widespread use of multifaceted concussion-assessment techniques and appeared compliant with recent consensus statements and the NCAA Sports Medicine Handbook.
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James, Karin H; Atwood, Thea P
2009-02-01
Functional specialization in the brain is considered a hallmark of efficient processing. It is therefore not surprising that there are brain areas specialized for processing letters. To better understand the causes of functional specialization for letters, we explore the emergence of this pattern of response in the ventral processing stream through a training paradigm. Previously, we hypothesized that the specialized response pattern seen during letter perception may be due in part to our experience in writing letters. The work presented here investigates whether or not this aspect of letter processing-the integration of sensorimotor systems through writing-leads to functional specialization in the visual system. To test this idea, we investigated whether or not different types of experiences with letter-like stimuli ("pseudoletters") led to functional specialization similar to that which exists for letters. Neural activation patterns were measured using functional magnetic resonance imaging (fMRI) before and after three different types of training sessions. Participants were trained to recognize pseudoletters by writing, typing, or purely visual practice. Results suggested that only after writing practice did neural activation patterns to pseudoletters resemble patterns seen for letters. That is, neural activation in the left fusiform and dorsal precentral gyrus was greater when participants viewed pseudoletters than other, similar stimuli but only after writing experience. Neural activation also increased after typing practice in the right fusiform and left precentral gyrus, suggesting that in some areas, any motor experience may change visual processing. The results of this experiment suggest an intimate interaction among perceptual and motor systems during pseudoletter perception that may be extended to everyday letter perception.
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Hanselman, Bailey; Ambikapathi, Ramya; Mduma, Estomih; Svensen, Erling; Caulfield, Laura E; Patil, Crystal L
2018-01-19
Livelihoods strategies and food security experiences can positively and negatively affect infant and young child feeding (IYCF) practices. This study contributes to this literature by exploring how variation in household economics among rural farmers in Tanzania relates to IYCF patterns over the first 8 months of an infant's life. These data were produced from a longitudinal study in which a cohort of mother-infant dyads was followed from birth to 24 months. In addition to baseline maternal, infant, and household characteristics, mothers were queried twice weekly and monthly about infant feeding practices and diet. Weekly and monthly datasets were merged and analyzed to assess infant feeding patterns through the first 8 months. Standard statistical methods including survival and logistic regression analyses were used. Aside from breastfeeding initiation, all other IYCF practices were suboptimal in this cohort. Land and cattle ownership were associated with the early introduction of non-breastmilk food items. Food insecurity also played a role in patterning and inadequate complementary feeding was commonplace. Health promotion programs are needed to delay the introduction of animal milks and grain-based porridge, and to achieve a minimum acceptable diet after 6 months of age among smallholder farmers in rural Tanzania. Results highlight that livelihoods-based health promotion interventions, built from a flexible and integrated design, may be an important strategy to address community-level variation in infant feeding practices and promote optimal IYCF practices.
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Dworkin, Shari L; O'Sullivan, Lucia
2005-05-01
Research on men's sexual scripts has tended to overlook that some men do not endorse traditional scripts or that one or both members of a couple might desire a departure from culturally dominant sexual scripts. This study used in-depth interviews with 32 college-aged men from a community college in New York City to examine disjunctures between current and desired sexual initiation patterns. Results show that although men currently practice male-dominated patterns of sexual initiation, many men desire egalitarian patterns of initiation. Men offered clear preference to be an object of desire to their female partners, deployed narratives of wanting to share the "labor" of sexual initiation, and expressed ideologies of sexual egalitarianism. We consider how shifting terrains of gender relations in contemporary U.S. culture may shape masculinities and sexual scripts. We also consider how an examination of disjunctures between current and desired practices might be useful to HIV researchers interested in interviewing across multiple levels of the sexual script.
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Gevers, Dorus Wm; van Assema, Patricia; de Vries, Nanne K; Kremers, Stef Pj
2017-09-01
The high energy intake from energy-dense foods among children in developed countries is undesirable. Improving food parenting practices has the potential to lower snack intakes among children. To inform the development of interventions, we aimed to predict food parenting practice patterns around snacking (i.e. 'high covert control and rewarding', 'low covert control and non-rewarding', 'high involvement and supportive' and 'low involvement and indulgent'). A cross-sectional survey was conducted. To predict the patterns of food parenting practices, multinomial logistic regression analyses were run with 888 parents. Predictors included predisposing factors (i.e. parents' and children's demographics and BMI, parents' personality, general parenting, and parenting practices used by their own parents) and parents' cognitions (i.e. perceived behaviour of other parents, subjective norms, attitudes, self-efficacy and outcome expectations). The Netherlands (October-November 2014). Dutch parents of children aged 4-12 years old. After backward elimination, nineteen factors had a statistically significant contribution to the model (Nagelkerke R 2=0·63). Overall, self-efficacy and outcome expectations were among the strongest explanatory factors. Considering the predisposing factors only, the general parenting factor nurturance most strongly predicted the food parenting clusters. Nurturance particularly distinguished highly involved parents from parents employing a pattern of low involvement. Parental cognitions and nurturance are important factors to explain the use of food parenting practices around snacking. The results suggest that intervention developers should attempt to increase self-efficacy and educate parents about what constitute effective and ineffective parenting practices. Promoting nurturance might be a prerequisite to achieve prolonged change.
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ERIC Educational Resources Information Center
Cramm, Heidi; Egan, Mary
2015-01-01
Poor handwriting is a common reason for referral to school-based occupational therapy. A survey was used to explore the extent to which current practice patterns in Ontario, Canada, align with evidence on effective intervention for handwriting. Knowledge-to-practice gaps were identified related to focus on performance components versus…
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Encouraging Students To Think about How They Think!
ERIC Educational Resources Information Center
Reeves, Charles A. (Andy); Reeves, Rosemarie
2003-01-01
Suggests that teachers become knowledgeable about the effects of Einstellung (pattern seeking in the human mind that results in rigid behavior) and use that knowledge in their teaching practices. (YDS)
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NASA Astrophysics Data System (ADS)
Utama, M. Iqbal Bakti; Lu, Xin; Zhan, Da; Ha, Son Tung; Yuan, Yanwen; Shen, Zexiang; Xiong, Qihua
2014-10-01
Patterning two-dimensional materials into specific spatial arrangements and geometries is essential for both fundamental studies of materials and practical applications in electronics. However, the currently available patterning methods generally require etching steps that rely on complicated and expensive procedures. We report here a facile patterning method for atomically thin MoSe2 films using stripping with an SU-8 negative resist layer exposed to electron beam lithography. Additional steps of chemical and physical etching were not necessary in this SU-8 patterning method. The SU-8 patterning was used to define a ribbon channel from a field effect transistor of MoSe2 film, which was grown by chemical vapor deposition. The narrowing of the conduction channel area with SU-8 patterning was crucial in suppressing the leakage current within the device, thereby allowing a more accurate interpretation of the electrical characterization results from the sample. An electrical transport study, enabled by the SU-8 patterning, showed a variable range hopping behavior at high temperatures.Patterning two-dimensional materials into specific spatial arrangements and geometries is essential for both fundamental studies of materials and practical applications in electronics. However, the currently available patterning methods generally require etching steps that rely on complicated and expensive procedures. We report here a facile patterning method for atomically thin MoSe2 films using stripping with an SU-8 negative resist layer exposed to electron beam lithography. Additional steps of chemical and physical etching were not necessary in this SU-8 patterning method. The SU-8 patterning was used to define a ribbon channel from a field effect transistor of MoSe2 film, which was grown by chemical vapor deposition. The narrowing of the conduction channel area with SU-8 patterning was crucial in suppressing the leakage current within the device, thereby allowing a more accurate interpretation of the electrical characterization results from the sample. An electrical transport study, enabled by the SU-8 patterning, showed a variable range hopping behavior at high temperatures. Electronic supplementary information (ESI) available: Further experiments on patterning and additional electrical characterizations data. See DOI: 10.1039/c4nr03817g
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Changing patterns of brain activation during maze learning.
Van Horn, J D; Gold, J M; Esposito, G; Ostrem, J L; Mattay, V; Weinberger, D R; Berman, K F
1998-05-18
Recent research has found that patterns of brain activation involving the frontal cortex during novel task performance change dramatically following practice and repeat performance. Evidence for differential left vs. right frontal lobe activation, respectively, during episodic memory encoding and retrieval has also been reported. To examine these potentially related issues regional cerebral blood flow (rCBF) was measured in 15 normal volunteers using positron emission tomography (PET) during the naive and practiced performance of a maze task paradigm. SPM analysis indicated a largely right-sided, frontal lobe activation during naive performance. Following training and practice, performance of the same maze task elicited a more posterior pattern of rCBF activation involving posterior cingulate and precuneus. The change in the pattern of rCBF activation between novel and practiced task conditions agrees with results found in previous studies using repeat task methodology, and indicates that the neural circuitry required for encoding novel task information differs from that required when the same task has become familiar and information is being recalled. The right-sided preponderance of activation during naive performance may relate to task novelty and the spatially-based nature of the stimuli, whereas posterior areas activated during repeat performance are those previously found to be associated with visuospatial memory recall. Activation of these areas, however, does not agree with previously reported findings of left-sided activation during verbal episodic memory encoding and right-sided activation during retrieval, suggesting different neural substrates for verbal and visuospatial processing within memory. Copyright 1998 Elsevier Science B.V.
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ERIC Educational Resources Information Center
Sharp, Helen M.; Shega, Joseph W.
2009-01-01
Purpose: To describe the beliefs and practices of speech-language pathologists (SLPs) about the use of percutaneous endoscopic gastrostomy (PEG) among patients with advanced dementia and dysphagia. Method: A survey was mailed to a geographically stratified random sample of 1,050 medical SLPs. Results: The response rate was 57%, and 326 surveys met…
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Carlesso, Lisa C; Gross, Anita R; MacDermid, Joy C; Walton, David M; Santaguida, P Lina
2015-01-01
Examination of practice patterns compared to existing evidence identifies knowledge to practice gaps. To describe the utilization of pharmacological, patient education, primary psychological interventions and relaxation therapies in patients with neck pain by clinicians. An international cross-sectional survey was conducted to determine the use of these interventions amongst 326 clinicians treating patients with neck pain. Nineteen countries participated. Results were analyzed by usage amongst physical therapists (39%) and chiropractors (35%), as they were the predominant respondents. Patient education (95%) and relaxation therapies (59%) were the most utilized interventions. Tests of subgroup differences determined that physical therapists used patient education significantly more than chiropractors. Use of medications and primary psychological interventions were reported by most to be outside of scope of practice. The high rate of patient education is consistent with supporting evidence. However, usage of relaxation therapies is contrary to evidence suggesting no benefit for improved pain or function for chronic neck pain. This survey indicates that patient education and relaxation therapies are common treatments provided by chiropractors and physical therapists for patients with neck pain. Future research should address gaps associated with variable practice patterns and knowledge translation to reduce usage of interventions shown to be ineffective.
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Mandatory Nap Times and Group Napping Patterns in Child Care: An Observational Study.
Staton, Sally L; Smith, Simon S; Hurst, Cameron; Pattinson, Cassandra L; Thorpe, Karen J
2017-01-01
Policy provision for naps is typical in child care settings, but there is variability in the practices employed. One practice that might modify children's early sleep patterns is the allocation of a mandatory nap time in which all children are required to lie on their beds without alternate activity permitted. There is currently limited evidence of the effects of such practices on children's napping patterns. This study examined the association between duration of mandatory nap times and group-level napping patterns in child care settings. Observations were undertaken in a community sample of 113 preschool rooms with a scheduled nap time (N = 2,114 children). Results showed that 83.5% of child care settings implemented a mandatory nap time (range = 15-145 min) while 14.2% provided alternate activities for children throughout the nap time period. Overall, 31% of children napped during nap times. Compared to rooms with ≤ 30 min of mandatory nap time, rooms with 31-60 min and > 60 min of mandatory nap time had a two-and-a-half and fourfold increase, respectively, in the proportion of children napping. Nap onset latency did not significantly differ across groups. Among preschool children, exposure to longer mandatory nap times in child care may increase incidence of napping.
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ERIC Educational Resources Information Center
Andergassen, Monika; Mödritscher, Felix; Neumann, Gustaf
2014-01-01
Learner-centric research on factors influencing learning results has focused, among other things, on student characteristics, demographic data, and usage patterns in learning management systems (LMSs). This paper complements the existing research by investigating potential correlations between learning results and LMS usage during exam…
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Modeling the radiation pattern of LEDs.
Moreno, Ivan; Sun, Ching-Cherng
2008-02-04
Light-emitting diodes (LEDs) come in many varieties and with a wide range of radiation patterns. We propose a general, simple but accurate analytic representation for the radiation pattern of the light emitted from an LED. To accurately render both the angular intensity distribution and the irradiance spatial pattern, a simple phenomenological model takes into account the emitting surfaces (chip, chip array, or phosphor surface), and the light redirected by both the reflecting cup and the encapsulating lens. Mathematically, the pattern is described as the sum of a maximum of two or three Gaussian or cosine-power functions. The resulting equation is widely applicable for any kind of LED of practical interest. We accurately model a wide variety of radiation patterns from several world-class manufacturers.
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Practical relevance of pattern uniqueness in forensic science.
Jayaprakash, Paul T
2013-09-10
Uniqueness being unprovable, it has recently been argued that individualization in forensic science is irrelevant and, probability, as applied for DNA profiles, should be applied for all identifications. Critiques against uniqueness have omitted physical matching, a realistic and tangible individualization that supports uniqueness. Describing case examples illustrating pattern matches including physical matching, it is indicated that individualizations are practically relevant for forensic science as they establish facts on a definitive basis providing firm leads benefitting criminal investigation. As a tenet of forensic identification, uniqueness forms a fundamental paradigm relevant for individualization. Evidence on the indeterministic and stochastic causal pathways of characteristics in patterns available in the related fields of science sufficiently supports the proposition of uniqueness. Characteristics involved in physical matching and matching achieved in patterned evidence existing in the state of nature are not events amenable for counting; instead these are ensemble of visible units occupying the entire pattern area stretching the probability of re-occurrence of a verisimilitude pattern into infinity offering epistemic support to uniqueness. Observational methods are as respectable as instrumental or statistical methods since they are capable of generating results that are tangible and obviously valid as in physical matching. Applying the probabilistic interpretation used for DNA profiles to the other patterns would be unbefitting since these two are disparate, the causal pathways of the events, the loci, in the manipulated DNA profiles being determinable. While uniqueness enables individualizations, it does not vouch for eliminating errors. Instead of dismissing uniqueness and individualization, accepting errors as human or system failures and seeking remedial measures would benefit forensic science practice and criminal investigation. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
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An analysis of the attitudes of dental patients attending general dental practice in Galway.
Hayes, Martina; Burke, Francis; McKenna, Gerald; Madden, Jamie; Cronin, Michael
2013-01-01
To describe the patterns of dental attendance and attitudes towards tooth loss of general dental practice patients in Galway. 1. To determine the pattern of adult dental attendance in general practices in Galway; and, 2. To examine the oral health attitudes of these patients. Questionnaires were distributed to 311 consecutive adult patients in the waiting rooms of ten general dental practices in Galway, which were randomly selected from the telephone directory. A total of 254 of the 311 questionnaires distributed were fully completed, returned and included in the results, giving a response rate of 81.7%. A total of 59% of dentate participants attended their dentist for annual or biannual examinations compared to 23% of edentate patients. Some 10.5% of medical card holders and 0.5% of non-medical card holders were edentulous. The data from the survey indicated that medical card holders in Galway were more likely to be edentulous than nonmedical card holders. Edentate patients were less likely to be regular dental attenders than dentate patients.
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Diabetic retinopathy - eye exams; Diabetes - eye exams; Glaucoma - diabetic eye exam; Macular edema - diabetic eye exam ... Ophthalmology Retina/Vitreous Panel. Preferred Practice Pattern ... www.aao.org/preferred-practice-pattern/diabetic-retinopathy- ...
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ERIC Educational Resources Information Center
Richterich, Rene; And Others
This trilingual handbook (English, French, German) presents exercises for eight areas of language instruction: (1) practice in sentence patterns, (2) presentation and practice of a new item, (3) pronunciation, (4) use of pictures, (5) practicing the transfer from oral to written skills, (6) presentation and practice of conversational patterns, (7)…
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Comparison of female and male graduates of southern Appalachian family practice residencies.
Rosenfeld, J A; Zaborlik, P M
1996-11-01
One aim of Southern Appalachian family practice residencies is to produce graduates for surrounding physician-needy areas. Some evidence suggests that women are less likely to go to rural areas and that they practice differently than men. This study investigated the practice patterns and location of Appalachian family practice residency female and male graduates. Surveys were sent to graduates of seven family practice residencies from 1984 to 1994 in the Southern Appalachian area to determine practice patterns, locations, and reasons for choosing practices. Women were more likely than men to be single and not to have children. More women worked part-time. Women's and men's practice patterns and characteristics were similar except that women were more likely to provide prenatal care and do vaginal deliveries. Women in similar percentages practiced in small towns, and a greater percentage of women practiced in rural areas with populations of less than 2,500. Female family practice residency graduates from Appalachian residencies are fulfilling the purposes of their residencies as well as male graduates, although more of them are working part-time.
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Jackson, Jessica N; Zee, Rebecca S; Martin, Allison N; Corbett, Sean T; Herndon, C D Anthony
2017-12-01
Over the last decade the literature, including a multidisciplinary consensus statement, has supported a paradigm shift in management of urinary tract dilation, yet the impact on practice patterns has not been well documented. This study aims to elucidate specific practice patterns for treatment of prenatal unilateral urinary tract dilation and to assess surgical intervention patterns for ureteropelvic junction obstruction. An online survey was distributed to 234 pediatric urologists through the Society of Pediatric Urology. The survey was composed of five clinical case scenarios addressing evaluation and management of unilateral urinary tract dilation. The response rate was 71% (n = 168). Circumcision status, gender, and grade were significant factors in recommending prophylactic antibiotics for newborn urinary tract dilation. Prophylactic antibiotic use in the uncircumcised male and female was twice that of a circumcised male for grade 3 (Table). This difference was minimized for grade 4. Use of VCUG was high for circumcised males with grade 3 or 4 (Table). The choice of minimally invasive surgery for ureteropelvic junction repair increased with age from 19% for a 5-month-old, 49% for a 2-year-old, and 85% for a 10-year-old. Notably, 44% of respondents would observe a 10-year-old with intermittent obstruction. Retrograde pyelography was recommended in conjunction with repair in 65% of respondents. Antegrade stent placement was the most common choice (38-47%) for urinary diversion after pyeloplasty. Regarding postoperative imaging, only 5% opted for routine renal scan whereas most would perform renal ultrasound alone. Practice patterns seen for use of prophylactic antibiotics are in agreement with the literature, which promotes selective use in those at highest risk for urinary tract infections. Interestingly, use of aggressive screening was not concordant with this literature. Several studies have indicated an increased usage of robotic pyeloplasty; however, results indicate that minimally invasive surgery is not preferred in those younger than 6 months. Study limitations include use of clinical case scenarios as opposed to actual clinical practice. Practice patterns for prophylactic antibiotic use for neonatal urinary tract dilation are dependent on gender, circumcision status, and grade. The use of minimally invasive surgery for ureteropelvic junction repair increased with patient age, with 50% preferring this modality at 2 years. Copyright © 2017 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
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Pre- and postdoctoral dental education compared to practice patterns in special care dentistry.
Subar, Paul; Chávez, Elisa M; Miles, Jeffrey; Wong, Allen; Glassman, Paul; Labarre, Eugene
2012-12-01
There has been limited research into the impact of predoctoral experiences and postdoctoral general dentistry residencies on the practice patterns of dentists in the care of patients with special or complex needs. This study was undertaken to determine if educational experiences with special populations had a relationship to practice patterns after graduation or residency. University of the Pacific alumni who graduated between 1997 and 2007 were surveyed regarding their pre- and postdoctoral dental education and their practice patterns for the care of patients categorized as medically compromised, frail elders, and developmentally disabled. Definitions for each patient category were provided. Alumni were asked about their practice setting and postdoctoral education. Thirty-one percent (n=526) of those surveyed responded. Regression analyses showed respondents not in private practice were more likely to have completed a postdoctoral general dentistry program (Advanced Education in General Dentistry or General Practice Residency) after dental school compared to respondents in private practice (p<0.001). Across all age groups, respondents not in private practice treated significantly more patients with developmental disabilities than those in private practice (p<0.001). Respondents not in private practice treated more medically compromised patients younger than age sixty-five compared to respondents in private practice (p<0.01). Interestingly, those in private practice treated significantly more patients over sixty-five who were also classified as medically compromised (p<0.05). Pacific alumni who completed postdoctoral training in general dentistry were found to practice more often in non-private practice settings. Alumni in non-private practice settings reported treating a higher percentage of medically compromised patients below age sixty-five than their counterparts in a typical private practice. The pre- and postdoctoral experiences of treating special needs populations appear to have a relationship to graduates' practice setting and patient population.
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Spatiotemporal Symmetry in Rings of Coupled Biological Oscillators of Physarum Plasmodial Slime Mold
NASA Astrophysics Data System (ADS)
Takamatsu, Atsuko; Tanaka, Reiko; Yamada, Hiroyasu; Nakagaki, Toshiyuki; Fujii, Teruo; Endo, Isao
2001-08-01
Spatiotemporal patterns in rings of coupled biological oscillators of the plasmodial slime mold, Physarum polycephalum, were investigated by comparing with results analyzed by the symmetric Hopf bifurcation theory based on group theory. In three-, four-, and five-oscillator systems, all types of oscillation modes predicted by the theory were observed including a novel oscillation mode, a half period oscillation, which has not been reported anywhere in practical systems. Our results support the effectiveness of the symmetric Hopf bifurcation theory in practical systems.
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Takamatsu, A; Tanaka, R; Yamada, H; Nakagaki, T; Fujii, T; Endo, I
2001-08-13
Spatiotemporal patterns in rings of coupled biological oscillators of the plasmodial slime mold, Physarum polycephalum, were investigated by comparing with results analyzed by the symmetric Hopf bifurcation theory based on group theory. In three-, four-, and five-oscillator systems, all types of oscillation modes predicted by the theory were observed including a novel oscillation mode, a half period oscillation, which has not been reported anywhere in practical systems. Our results support the effectiveness of the symmetric Hopf bifurcation theory in practical systems.
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A discourse on the nature of dental hygiene knowledge and knowing.
Cobban, S J; Edgington, E M; Myrick, F; Keenan, L
2009-02-01
Historically, dental hygiene has adopted theory and research from other health disciplines, without adequately modifying these concepts to reflect the unique dental hygiene practice context, leaving dental hygiene's research and theory base underdeveloped. Dental hygiene has yet to articulate its epistemological assumptions--the nature, scope and object of dental hygiene knowledge--or to fully describe the patterns of knowing that are brought to practice. This paper uses a method of inquiry from philosophy to begin the discourse about dental hygiene ways of knowing. In nursing, Carper identified four fundamental patterns of knowing: empirics or the science of nursing; aesthetics or the art of nursing; personal knowledge and ethical or moral knowledge. These patterns were used to explore this concept within dental hygiene. There is more to the nature of dental hygiene knowledge and knowing than rote application of technique-related or research-based information in practice, including judgements about when and how to use different types of information that are used. Currently, empirical forms of knowledge seem to be disproportionately valued, yet evidence was found for all of Carper's four patterns of knowing. Carper's work on patterns of knowing in nursing provided a useful framework to initiate the discourse on ways of knowing in dental hygiene. These results are submitted for others to challenge, refine and extend, for continuing the discussion. Dental hygiene leaders and scholars need to engage in discourse about extending the epistemological assumptions to reflect reality.
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Towards evenly distributed grazing patterns: including social context in sheep management strategies
Morales, Juan Manuel
2016-01-01
Background. A large proportion of natural grasslands around the world is exposed to overgrazing resulting in land degradation and biodiversity loss. Although there is an increasing effort in the promotion of sustainable livestock management, rangeland degradation still occurs because animals’ foraging behaviour is highly selective at different spatial scales. The assessment of the ecological mechanisms modulating the spatial distribution of grazing and how to control it has critical implications for long term conservation of resources and the sustainability of livestock production. Considering the relevance of social interactions on animals’ space use patterns, our aim was to explore the potential effects of including animals’ social context into management strategies using domestic sheep grazing in rangelands as case study. Methods. We used GPS data from 19 Merino sheep (approximately 10% of the flock) grazing on three different paddocks (with sizes from 80 to 1000 Ha) during a year, to estimate resource selection functions of sheep grazing in flocks of different levels of heterogeneity. We assessed the effects of sheep class (i.e., ewes, wethers, and hoggets), age, body condition and time since release on habitat selection patterns. Results. We found that social rank was reflected on sheep habitat use, where dominant individuals (i.e., reproductive females) used more intensively the most preferred areas and low-ranked (i.e., yearlings) used less preferred areas. Our results showed that when sheep grazed on more heterogeneous flocks, grazing patterns were more evenly distributed at all the paddocks considered in this study. On the other hand, when high-ranked individuals were removed from the flock, low-ranked sheep shifted their selection patterns by increasing the use of the most preferred areas and strongly avoided to use less preferred sites (i.e., a highly selective grazing behaviour). Discussion. Although homogenization and segregation of flocks by classes are common practices to increase flock productivity, we are proposing an alternative that employs behavioural interactions in heterogeneous flocks to generate more evenly distributed grazing patterns. This practice can be combined with other practices such as rotational grazing and guardian dogs (to decrease mortality levels that may be generated by sheep grazing on more risky habitats). This does not imply any modifications of livestock stocking rates and densities or any additional investments for labour and materials. Considering livestock behaviour is critical for the design of sustainable management practices that balance landscape conservation and livestock productivity. PMID:27366650
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Practice-Relevant Pedagogy for Mining Software Engineering Curricula Assets
2007-06-20
permits the application of the Lean methods by virtually grouping shared services into eWorkcenters to which only non-routine requests are routed...engineering can be applied to IT shared services improvement and provide precise system improvement methods to complement the ITIL best practice. This...Vertical� or internal service- chain of primary business functions and enabling shared services Framework results - Mined patterns that relate
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The change of the brain activation patterns as children learn algebra equation solving
NASA Astrophysics Data System (ADS)
Qin, Yulin; Carter, Cameron S.; Silk, Eli M.; Stenger, V. Andrew; Fissell, Kate; Goode, Adam; Anderson, John R.
2004-04-01
In a brain imaging study of children learning algebra, it is shown that the same regions are active in children solving equations as are active in experienced adults solving equations. As with adults, practice in symbol manipulation produces a reduced activation in prefrontal cortex area. However, unlike adults, practice seems also to produce a decrease in a parietal area that is holding an image of the equation. This finding suggests that adolescents' brain responses are more plastic and change more with practice. These results are integrated in a cognitive model that predicts both the behavioral and brain imaging results.
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Taghian, Alphonse; Jagsi, Reshma; Makris, Andreas; Goldberg, Saveli; Ceilley, Elizabeth; Grignon, Laurent; Powell, Simon
2004-11-01
To examine the self-reported practice patterns of radiation oncologists in North America and Europe regarding radiotherapy to the internal mammary lymph node chain (IMC) in breast cancer patients. A survey questionnaire was sent in 2001 to physician members of the American Society for Therapeutic Radiology and Oncology and European Society for Therapeutic Radiology and Oncology regarding their management of breast cancer. Respondents were asked whether they would treat the IMC in several clinical scenarios. A total of 435 responses were obtained from European and 702 responses from North American radiation oncologists. Respondents were increasingly likely to report IMC irradiation in scenarios with greater axillary involvement. Responses varied widely among different European regions, the United States, and Canada (p < 0.01). European respondents were more likely to treat the IMC (p < 0.01) than their North American counterparts. Academic physicians were more likely to treat the IMC than those in nonacademic positions (p < 0.01). The results of this study revealed significant international variation in attitudes regarding treatment of the IMC. The international patterns of variation mirror the divergent conclusions of studies conducted in the different regions, indicating that physicians may rely preferentially on evidence from local studies when making difficult treatment decisions. These variations in self-reported practice patterns indicate the need for greater data in this area, particularly from international cooperative trials. The cultural predispositions documented in this study are important to recognize, because they may continue to affect physician attitudes and practices, even as greater evidence accumulates.
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Effect of NHS reforms on general practitioners' referral patterns.
Coulter, A; Bradlow, J
1993-01-01
OBJECTIVE--To compare outpatient referral patterns in fundholding and non-fundholding practices before and after the implementation of the NHS reforms in April 1991. DESIGN--Prospective collection of data on general practitioners' referrals to specialist outpatient clinics between June 1990 and March 1992 and detailed comparison of two time periods: October 1990 to March 1991 (phase 1) and October 1991 to March 1992 (phase 2). SETTING--10 fundholding practices and six non-fundholding practices in the Oxford region. SUBJECTS--Patients referred to consultant outpatient clinics. RESULTS--After implementation of the NHS reforms there was no change in the proportion of referrals from the two groups of practices which crossed district boundaries. Both groups of practices increased their referral rates in phase 2 of the study, the fundholders from 107.3 per 1000 patients per annum (95% confidence interval 106 to 109) to 111.4 (110 to 113) and the non-fundholders from 95.0 (93 to 97) to 112.0 (110 to 114). In phase 2 there was no difference in overall standardised referral rates between fundholders and non-fundholders. Just over 20% of referrals went to private clinics in phase 1. By phase 2 this proportion had reduced by 2.2% (1.0% to 3.4%) among the fundholders and by 2.7% (1.2% to 4.2%) among the non-fundholders. CONCLUSIONS--Referral patterns among fundholders and non-fundholders were strikingly similar after the implementation of the NHS reforms. There was no evidence that fundholding was encouraging a shift from specialist to general practice care or that budgetary pressures were affecting general practitioners' referral behaviour. PMID:8461728
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Ghosh, Uddipta; Chakraborty, Suman
2012-04-01
In the present study, we focus on alterations in flow physics as a consequence of interactions between patterned-wettability gradients on microfluidic substrates with modulated surface charge distributions, giving rise to an intricate electrohydrodynamic coupling over small scales. We demonstrate that by exploiting such intricate coupling, it may be possible to pattern vortices occurring in the fluidic confinement by exploiting an interplay between the Navier slip and electro-osmotic transport. Our studies do reveal that the resultant flow structure originating out of the spatially periodic variations in the surface charge and surface wettability may depend critically on several independently tunable controlling parameters, such as the amplitudes and frequencies of the respective patterning functions, the phase shift between the two, an asymmetry factor, and the channel height to Debye length ratio. We show that judicious choices with regard to the combinations of these parameters may result in significant augmentations in the corresponding mixing efficiency without any appreciable compromise in the net microfluidic throughput. Furthermore, our studies reveal an optimum patterning frequency, which results in the most efficient microfluidic mixing within the constraints of achieving a desired volumetric flow rate. Our results also demonstrate that the net flow rate is maximized when the surface wettability variation functions and surface charge-density functions are in phase, whereas mixing is best facilitated when they are in opposite phase. In practice, therefore, one may select an intermediate value of the phase angle depending on the extent of compromise necessary between flow rate and mixing characteristics, yielding far-ranging scientific and technological advances toward an improved design of miniaturized fluidic devices of practical relevance.
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Results of the 2012 CASE Compensation Survey: Institutionally Related Foundation Respondents
ERIC Educational Resources Information Center
Paradise, Andrew
2012-01-01
The IRF Compensation Report summarizes the results of CASE's most recent compensation survey just for institutionally related foundations (IRFs). The 42-page report contains data from 323 individuals employed at North American IRFs. The 2012 results provide a comprehensive view of compensation practices to help identify patterns across the…
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ERIC Educational Resources Information Center
Yamada, Shoko
2016-01-01
This paper explores the convergence and divergence in the discourses and practices of comparative education in Japan, North America, and Greater China. Research demands, institutional settings, and social and historical background determine the nature of the research discussed and practiced in each place. Some particular patterns were identified…
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The Influence of Advanced General Dentistry Training on Practice Patterns of Iowa Dental Graduates.
ERIC Educational Resources Information Center
Bolden, Aljernon J.; And Others
1992-01-01
A study compared the practice patterns of 41 dentists with graduate training in general dentistry with those of 41 dentists without such training, in terms of number and types of procedures performed, patient characteristics, professional and community activities, and practice characteristics. Some differences were found, particularly in patient…
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Belleville, Sylvie; Mellah, Samira; de Boysson, Chloé; Demonet, Jean-Francois; Bier, Bianca
2014-01-01
There is enormous interest in designing training methods for reducing cognitive decline in healthy older adults. Because it is impaired with aging, multitasking has often been targeted and has been shown to be malleable with appropriate training. Investigating the effects of cognitive training on functional brain activation might provide critical indication regarding the mechanisms that underlie those positive effects, as well as provide models for selecting appropriate training methods. The few studies that have looked at brain correlates of cognitive training indicate a variable pattern and location of brain changes - a result that might relate to differences in training formats. The goal of this study was to measure the neural substrates as a function of whether divided attentional training programs induced the use of alternative processes or whether it relied on repeated practice. Forty-eight older adults were randomly allocated to one of three training programs. In the SINGLE REPEATED training, participants practiced an alphanumeric equation and a visual detection task, each under focused attention. In the DIVIDED FIXED training, participants practiced combining verification and detection by divided attention, with equal attention allocated to both tasks. In the DIVIDED VARIABLE training, participants completed the task by divided attention, but were taught to vary the attentional priority allocated to each task. Brain activation was measured with fMRI pre- and post-training while completing each task individually and the two tasks combined. The three training programs resulted in markedly different brain changes. Practice on individual tasks in the SINGLE REPEATED training resulted in reduced brain activation whereas DIVIDED VARIABLE training resulted in a larger recruitment of the right superior and middle frontal gyrus, a region that has been involved in multitasking. The type of training is a critical factor in determining the pattern of brain activation. PMID:25119464
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Gwon, Hyeon-Cheol; Jeon, Dong Woon; Kang, Hyun-Jae; Jang, Jae-Sik; Park, Duk-Woo; Shin, Dong-Ho; Moon, Keon-Woong; Kim, Jung-Sun; Kim, Juhan; Bae, Jang-Whan; Hur, Seung-Ho; Kim, Byung Ok; Choi, Donghoon; Han, Kyoo-Rok; Kim, Hyo-Soo
2017-05-01
Appropriate use criteria (AUC) was developed to improve the quality of percutaneous coronary intervention (PCI). However, these criteria should consider the current practice pattern in the country where they are being applied. The algorithm for the Korean PCI practice pattern (KP3) was developed by modifying the United States-derived AUC in expert consensus meetings. KP3 class A was defined as any strategy with evidence from randomized trials that was more conservative for PCI than medical therapy or coronary artery bypass graft (CABG). Class C was defined as any strategy with less evidence from randomized trials and more aggressive for PCI than medical therapy or CABG. Class B was defined as a strategy that was partly class A and partly class C. We applied the KP3 classification system to the Korean PCI registry. The KP3 class A was noted in 67.7% of patients, class B in 28.8%, and class C in 3.5%. The median proportion of class C cases per center was 2.0%. The distribution of KP3 classes varied significantly depending on clinical and angiographic characteristics. The proportion of KP3 class C cases per center was not significantly dependent on PCI volume, but rather on the percentage of ACS cases in each center. We report the current PCI practice pattern by applying the new KP3 classification in a nationwide PCI registry. The results should be interpreted carefully with due regard for the complex relationships between the determining variables and the healthcare system in Korea.
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Current practice patterns in conservative thumb CMC joint care: survey results.
O'Brien, Virginia H; McGaha, Jamie L
2014-01-01
Cross-sectional descriptive survey Best practice for conservative clinical care pathways is not well outlined in the literature for patients with thumb carpometacarpal joint (CMCJ) pain. This self-report survey investigated the current practice patterns of assessments and conservative interventions for the painful thumb CMCJ among hand therapists. An online survey was distributed to members of the American Society of Hand Therapists (ASHT). Questions were included about evaluation measures and intervention techniques used for this population. A descriptive analysis was completed of the results. A total of 23.5% of the ASHT membership responded to the survey. Results were categorized using the International Classification of Functioning and Disability domains as a framework. The survey results report varying use of evaluation measures, therapeutic interventions, including orthotic fabrication, joint protection and patient education all therapeutic interventional techniques, and modalities. Therapists use a comprehensive array of evaluation measures and interventions for body functions and structures in the care of thumb CMC pain. In contrast, more consistent use is needed of psychometrically-sound functional outcome measures that show change in activities and participation. This survey highlights areas to employ current evidence, as well as, future research should address environmental factors and personal factors for this population Not applicable. Copyright © 2014 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.
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A survey of UK practice patterns in the delivery of intravitreal injections.
Samia-Aly, Emma; Cassels-Brown, Andrew; Morris, Daniel S; Stancliffe, Rachel; Somner, John E A
2015-07-01
To assess UK practice patterns related to the prescription of antibiotics before, during and after intravitreal injections, the location where injections are carried out and the qualifications of those administering the injections. Every ophthalmology unit featured in the Royal College of Ophthalmologists (UK) training directory was contacted. A healthcare professional involved in giving intravitreal injections at each institution completed a questionnaire regarding local practice patterns. A response rate of 85% (115/136) was achieved. Seventy four percent of hospitals (85/115) gave take home antibiotics post intravitreal injection. Twenty three percent (26/115) of hospitals employed non-medical healthcare professionals to administer injections and 83% (96/115) administered intravitreal injections in a dedicated clean room as opposed to an operating theatre. Practice patterns for intravitreal injection vary considerably. Guidelines alone do not appear to be effective in reducing practices which are considered wasteful and other approaches need to be developed. © 2015 The Authors Ophthalmic & Physiological Optics © 2015 The College of Optometrists.
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Biodiversity patterns along ecological gradients: unifying β-diversity indices.
Szava-Kovats, Robert C; Pärtel, Meelis
2014-01-01
Ecologists have developed an abundance of conceptions and mathematical expressions to define β-diversity, the link between local (α) and regional-scale (γ) richness, in order to characterize patterns of biodiversity along ecological (i.e., spatial and environmental) gradients. These patterns are often realized by regression of β-diversity indices against one or more ecological gradients. This practice, however, is subject to two shortcomings that can undermine the validity of the biodiversity patterns. First, many β-diversity indices are constrained to range between fixed lower and upper limits. As such, regression analysis of β-diversity indices against ecological gradients can result in regression curves that extend beyond these mathematical constraints, thus creating an interpretational dilemma. Second, despite being a function of the same measured α- and γ-diversity, the resultant biodiversity pattern depends on the choice of β-diversity index. We propose a simple logistic transformation that rids beta-diversity indices of their mathematical constraints, thus eliminating the possibility of an uninterpretable regression curve. Moreover, this transformation results in identical biodiversity patterns for three commonly used classical beta-diversity indices. As a result, this transformation eliminates the difficulties of both shortcomings, while allowing the researcher to use whichever beta-diversity index deemed most appropriate. We believe this method can help unify the study of biodiversity patterns along ecological gradients.
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Biodiversity Patterns along Ecological Gradients: Unifying β-Diversity Indices
Szava-Kovats, Robert C.; Pärtel, Meelis
2014-01-01
Ecologists have developed an abundance of conceptions and mathematical expressions to define β-diversity, the link between local (α) and regional-scale (γ) richness, in order to characterize patterns of biodiversity along ecological (i.e., spatial and environmental) gradients. These patterns are often realized by regression of β-diversity indices against one or more ecological gradients. This practice, however, is subject to two shortcomings that can undermine the validity of the biodiversity patterns. First, many β-diversity indices are constrained to range between fixed lower and upper limits. As such, regression analysis of β-diversity indices against ecological gradients can result in regression curves that extend beyond these mathematical constraints, thus creating an interpretational dilemma. Second, despite being a function of the same measured α- and γ-diversity, the resultant biodiversity pattern depends on the choice of β-diversity index. We propose a simple logistic transformation that rids beta-diversity indices of their mathematical constraints, thus eliminating the possibility of an uninterpretable regression curve. Moreover, this transformation results in identical biodiversity patterns for three commonly used classical beta-diversity indices. As a result, this transformation eliminates the difficulties of both shortcomings, while allowing the researcher to use whichever beta-diversity index deemed most appropriate. We believe this method can help unify the study of biodiversity patterns along ecological gradients. PMID:25330181
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Persons with Mental Retardation and Technology Use Patterns and Needs.
ERIC Educational Resources Information Center
Parette, Howard P., Jr.; VanBiervliet, Alan
A questionnaire examining consumer needs, spending, travel, credit options and utilization practices in adaptive/assistive and educational technology was answered by 2,201 Arkansans with disabilities of all ages. This paper emphasizes results relating to Arkansans with mental retardation. Results indicate Medicare/Medicaid as the single most…
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Kim, Tae Youn; Lang, Norma M; Berg, Karen; Weaver, Charlotte; Murphy, Judy; Ela, Sue
2007-10-11
Delivery of safe, effective and appropriate health care is an imperative facing health care organizations globally. While many initiatives have been launched in a number of countries to address this need from a medical perspective, a similar focus for generating evidence-based nursing knowledge has been missing. This paper reports on a collaborative evidence-based practice (EBP) research initiative that adds nursing knowledge into computerized care protocols. Here, a brief overview of the study's aims, purpose and methodology is presented as well as results of data analysis and lessons learned. The research team examined nurses' adoption patterns of EBP recommendations with respect to activity tolerance using four-month patient data collected from a pilot hospital. Study findings indicate a need for more focus on the system design and implementation process with the next rollout phase to promote evidence-based nursing practice.
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Kim, Tae Youn; Lang, Norma M.; Berg, Karen; Weaver, Charlotte; Murphy, Judy; Ela, Sue
2007-01-01
Delivery of safe, effective and appropriate health care is an imperative facing health care organizations globally. While many initiatives have been launched in a number of countries to address this need from a medical perspective, a similar focus for generating evidence-based nursing knowledge has been missing [1]. This paper reports on a collaborative evidence-based practice (EBP) research initiative that adds nursing knowledge into computerized care protocols. Here, a brief overview of the study’s aims, purpose and methodology is presented as well as results of data analysis and lessons learned. The research team examined nurses’ adoption patterns of EBP recommendations with respect to activity tolerance using four-month patient data collected from a pilot hospital. Study findings indicate a need for more focus on the system design and implementation process with the next rollout phase to promote evidence-based nursing practice. PMID:18693871
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Risky Decisions Despite Counter Evidence: Modeling a Culture of Safer Sexual Practices
Patel, Vimla L.; Yoskowitz, Nicole A.; Kaufman, David R.; Gutnik, Lily A.; Shortliffe, Edward H.
2005-01-01
To create a culture of safe practices, we need to understand how and under what conditions the public makes risky decisions about their health. Because risky sexual behaviors are known to be common in young adults, we investigated their decision making regarding sexual activities that could incur a high risk of HIV infection. Sixty young urban adults maintained journals for two weeks and were interviewed regarding condom use and sexual history. We characterized four patterns of condom use behavior: consistent (35.0%), inconsistent (16.7%), consistent to inconsistent (35.0%), and inconsistent to consistent (13.3%). Directionality of reasoning was analyzed in the explanations provided for condom use decisions. The consistent and inconsistent patterns were associated with data-driven heuristic reasoning, where behavior becomes automated and is associated with a high level of confidence in one’s judgment. In the other two patterns, the shift in behavior was due to a significant event that influenced a change in directionality to explanation-based reasoning. We discuss these results within the framework of identifying potentially high-risk groups for whom customized intervention strategies (such as computer-based educational programs) can be used to reduce risk, thereby creating a culture of safer sexual practices. PMID:16779109
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Risky decisions despite counter evidence: modeling a culture of safer sexual practices.
Patel, Vimla L; Yoskowitz, Nicole A; Kaufman, David R; Gutnik, Lily A; Shortliffe, Edward H
2005-01-01
To create a culture of safe practices, we need to understand how and under what conditions the public makes risky decisions about their health. Because risky sexual behaviors are known to be common in young adults, we investigated their decision making regarding sexual activities that could incur a high risk of HIV infection. Sixty young urban adults maintained journals for two weeks and were interviewed regarding condom use and sexual history. We characterized four patterns of condom use behavior: consistent (35.0%), inconsistent (16.7%), consistent to inconsistent (35.0%), and inconsistent to consistent (13.3%). Directionality of reasoning was analyzed in the explanations provided for condom use decisions. The consistent and inconsistent patterns were associated with data-driven heuristic reasoning, where behavior becomes automated and is associated with a high level of confidence in one's judgment. In the other two patterns, the shift in behavior was due to a significant event that influenced a change in directionality to explanation-based reasoning. We discuss these results within the framework of identifying potentially high-risk groups for whom customized intervention strategies (such as computer-based educational programs) can be used to reduce risk, thereby creating a culture of safer sexual practices.
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Dresden, Graham M.; Baldwin, Laura-Mae; Andrilla, C. Holly A.; Skillman, Susan M.; Benedetti, Thomas J.
2008-01-01
PURPOSE Obstetric practice among family physicians has declined in recent years. This study compared the practice patterns of family physicians and obstetrician-gynecologists with and without obstetric practices to provide objective information on one potential reason for this decline—the impact of obstetrics on physician lifestyle. METHODS In 2004, we surveyed all obstetrician-gynecologists, all rural family physicians, and a random sample of urban family physicians identified from professional association lists (N =2,564) about demographics, practice characteristics, and obstetric practices. RESULTS A total of 1,197 physicians (46.7%) overall responded to the survey (41.5% of urban family physicians, 54.7% of rural family physicians, and 55.0% of obstetrician-gynecologists). After exclusions, 991 were included in the final data set. Twenty-seven percent of urban family physicians, 46% of rural family physicians, and 79% of obstetrician-gynecologists practiced obstetrics. The mean number of total professional hours worked per week was greater with obstetric practice than without for rural family physicians (55.4 vs 50.2, P=.005) and for obstetrician-gynecologists (58.3 vs 43.5, P = .000), but not for urban family physicians (47.8 vs 49.5, P = .27). For all 3 groups, physicians practicing obstetrics were more likely to provide inpatient care and take call than physicians not practicing obstetrics. Large proportions of family physicians, but not obstetrician-gynecologists, took their own call for obstetrics. Concerns about the litigation environment and personal issues were the most frequent reasons for stopping obstetric practice. CONCLUSIONS Practicing obstetrics is associated with an increased workload for family physicians. Organizing practices to decrease the impact on lifestyle may support family physicians in practicing obstetrics. PMID:18195307
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Meyer, Craig; MacLehose, Richard F.; Loth, Katie; Neumark-Sztainer, Dianne
2016-01-01
Abstract Background: It is unknown if parents with more than one adolescent child use similar or different parenting practices of relevance to weight-related health with different children. In particular, it is unclear whether parenting practices differ based on whether siblings are discordant on weight status (i.e., one is overweight/obese, one is nonoverweight/obese) or are different sexes. Methods: Data from two linked population-based studies, Eating and Activity in Teens (EAT) 2010 and Families and Eating and Activity in Teens (F-EAT), were used in this exploratory cross-sectional analysis. Participants included socioeconomically and racially/ethnically diverse parents (n = 57; 93% females) and adolescent siblings (n = 57 pairs; 60% girls; mean age = 14.5, range = 11–18). Students filled out surveys and had anthropometric measures taken in school. Parents filled out mailed surveys in their homes. Results: Overall, results from this exploratory study showed limited evidence that parents use different parenting practices with adolescents of different weight status or sex. However, potentially important patterns emerged when exploring parenting practices and siblings' weight status. For example, within sibling dyads with discordant weight status, parents reported significantly more negative weight-related conversations with overweight/obese siblings compared to nonoverweight/obese siblings (p < 0.05). Although observed differences were not statistically significant, parents also reported higher levels of food restriction (p = 0.05) and encouragement to diet (p = 0.07) with overweight/obese siblings compared to nonoverweight/obese siblings. There were no significant differences in parenting practices by adolescent sex. Conclusions: Results generally suggest that parents use similar parenting practices with adolescent siblings. However, notable patterns emerged when examining parenting practices and siblings' weight status that may be important to explore in future research. PMID:26699095
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Tomljenović, Helena; Begić, Dražen; Maštrović, Zora
2016-03-01
The amount of studies showing different benefits of practicing meditation is growing. EEG brainwave patterns objectively reflect both the cognitive processes and objects of meditation. This study aimed to examine the effects of transcendental meditation (TM) practice on baseline EEG brainwave patterns (outside of meditation) and to examine weather TM reduces state and trait anxiety. Standard EEG recordings were conducted on volunteer participants (N=12), all students or younger employed people, before and after a three-month meditation training. Artifact-free 100-second epochs were selected and analyzed by Fast Fourier Transformation (FFT) analysis. Endlers Multidimensional Anxiety Scales (EMAS) were used to assess anxiety levels. Power (μV(2)) and coherence levels were compared in the alpha, beta, theta and delta frequency band. Changes in EEG patterns after meditation practice were found mostly in the theta band. An interaction effect was found on the left hemisphere (p<0.10). Theta power decreased on the left, but not on the right hemisphere. Increased theta coherence was found overall and in the central, temporal and occipital areas (p<0.10). Decrease in alpha power was found on channels T3 (p<0.10), O1 (p<0.05) and O2 (p<0.10). An interaction effect was found in the delta frequency band (p<0.06), too. A trend for power decreasing was found on the left, and a trend for power increasing on the right hemisphere. Also, power decreased on channel O1 (p<0.10). In the beta frequency band, a decrease was found on channel O2 (p<0.10). Trait anxiety did not differ, but a decrease in state anxiety and cognitive worry was found (p<0.05). Obtained results confirm the effects of TM on some baseline EEG brainwave patterns and state anxiety, suggesting that the left hemisphere is more sensitive to meditation practice. Most of the changes were found in the occipital and temporal areas, less in the central and frontal areas. State anxiety decreased after TM practice. Findings suggest TM practice could be helpful in treating different kinds of disorders, especially anxiety disorders.
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Jadalla, Ahlam A; Hattar, Marianne; Schubert, Christiane C
2015-01-01
A cross-sectional descriptive study was done using the Acculturation Rating scale of Arab Americans-II, and the Health Promotion and Lifestyle Profile II to assess the relationship between acculturation and health promotion practices among Arab Americans. Findings showed that attraction to American culture was the most important predictor of physical activity; whereas attraction to Arabic culture was the most important predictor of stress management and nutritional practices. Results suggest that, when demographics are controlled, acculturation predicts various health promotion practices in different patterns among members of this group. These findings contribute to a better understanding of acculturation's influence on immigrants' health promotion practices.
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ERIC Educational Resources Information Center
Garlick, Steve; Taylor, Mike; Plummer, Paul
2007-01-01
This report explores patterns of regional economic growth in Australia over the period 1984 to 2002 in order to determine how and why these patterns evolved. From the results, the authors have attempted to identify regional opportunities and the policies and practices that can assist in realising them and, in particular, the potential contribution…
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Dental therapy practice patterns in Minnesota: a baseline study.
Blue, Christine M; Kaylor, Mary Beth
2016-10-01
A chronic shortage of dentists, the importance of oral health, and the lack of access to care led to the introduction of a new oral health practitioner in Minnesota, the dental therapist. Dental therapy graduates from the University of Minnesota have been in practice since 2012. To date, there has been no formal study of how they have been incorporated into dental practice. The purpose of this study was to obtain baseline knowledge of dental therapists' practice patterns in Minnesota and determine if dentists' patterns of work changed after a dental therapist was employed. Four dental practices were sampled purposefully to obtain various practice types and geographic locations within Minnesota. Secondary data were collected from practice management software databases in each practice between January-March, 2015. Data were used to describe the work undertaken by dental therapists, the types of patients seen and payer mix. Additionally, data from 6 months before and after employment of the dental therapist were collected to determine whether dentists' practice patterns changed after a dental therapist was employed. Dental therapists were employed full-time, seeing an average of 6.8 patients per day. No distinct pattern emerged with regard to ages of patients seen by dental therapists. Dental therapists saw up to 90% of uninsured patients or patients on public assistance. Restorative services across practices comprised an average of 68% of work undertaken by dental therapists. Dentists delegated a full range of procedures within the dental therapy scope of practice indicating trust and acceptance of dental therapists. Dentists in two practices began to take on more complex dental procedures after a dental therapist joined the practice. Dental therapists are treating a high number of uninsured and underinsured patients, suggesting that they are expanding access to dental care in rural and metropolitan areas of Minnesota. Dentists appear to have an adequate workload for dental therapists and are delegating a full range of procedures within their scope of practice. Dentists performed fewer restorative and preventive procedures after a DT was hired. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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DiSantostefano, Rachael L; Davis, Kourtney J
2011-06-01
An association between salmeterol, a long-acting β(2)-agonist (LABA), use and rare serious asthma events or asthma mortality was observed in two large clinical trials. This has resulted in heightened scrutiny of LABAs and comprehensive reviews by regulatory agencies. The aim of this retrospective observational cohort study was to better characterize salmeterol medication use patterns in the UK. We describe asthma prescription patterns in a cohort of patients (n =17,745) in the General Practice Research Database who initiated treatment with salmeterol-containing prescriptions between 2003 and 2006, including salmeterol and salmeterol/fluticasone propionate in a single device. Prescriptions patterns by medication class, including concurrent prescription of salmeterol with inhaled corticosteroids (ICS), were described using 6-month intervals in the 1-year period before and after the salmeterol-containing index prescription. In the 0- to 6-month and 7- to 12-month periods prior to initiation of the salmeterol-containing prescription, the cohort experienced worsening of asthma, measured by an increase in the proportion of patients with prescriptions for short-acting β-agonists [SABA] (73-89%), ICS (70-81%) and systemic corticosteroids (14-28%). Nearly all patients prescribed salmeterol were concurrently prescribed ICS (≥95% within 90 days). In the 12 months following initiation of the salmeterol-containing prescription, a decrease in asthma prescriptions was observed. These results support the appropriate prescribing of salmeterol-containing medications, as per recommendations in asthma treatment guidelines in the UK. Salmeterol was consistently prescribed as an add-on asthma-controller with an ICS for most patients, and was associated with improvements in asthma control, as indicated by decreases in SABA and systemic corticosteroid prescriptions following salmeterol introduction.
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Practice and transfer of the frequency structures of continuous isometric force.
King, Adam C; Newell, Karl M
2014-04-01
The present study examined the learning, retention and transfer of task outcome and the frequency-dependent properties of isometric force output dynamics. During practice participants produced isometric force to a moderately irregular target pattern either under a constant or variable presentation. Immediate and delayed retention tests examined the persistence of practice-induced changes of force output dynamics and transfer tests investigated performance to novel (low and high) irregular target patterns. The results showed that both constant and variable practice conditions exhibited similar reductions in task error but that the frequency-dependent properties were differentially modified across the entire bandwidth (0-12Hz) of force output dynamics as a function of practice. Task outcome exhibited persistent properties on the delayed retention test whereas the retention of faster time scales processes (i.e., 4-12Hz) of force output was mediated as a function of frequency structure. The structure of the force frequency components during early practice and following a rest interval was characterized by an enhanced emphasis on the slow time scales related to perceptual-motor feedback. The findings support the proposition that there are different time scales of learning at the levels of task outcome and the adaptive frequency bandwidths of force output dynamics. Copyright © 2014 Elsevier B.V. All rights reserved.
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Generation of multifocal irradiance patterns by using complex Fresnel holograms.
Mendoza-Yero, Omel; Carbonell-Leal, Miguel; Mínguez-Vega, Gladys; Lancis, Jesús
2018-03-01
We experimentally demonstrate Fresnel holograms able to produce multifocal irradiance patterns with micrometric spatial resolution. These holograms are assessed from the coherent sum of multiple Fresnel lenses. The utilized encoded technique guarantees full control over the reconstructed irradiance patterns due to an optimal codification of the amplitude and phase information of the resulting complex field. From a practical point of view, a phase-only spatial light modulator is used in a couple of experiments addressed to obtain two- and three-dimensional distributions of focal points to excite both linear and non-linear optical phenomena.
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Smid, Marcela C; Dotters-Katz, Sarah K; Mcelwain, Cora-Ann; Volckmann, Eric T; Schulkin, Jay; Stuebe, Alison M
2017-09-01
The objective of this study is to survey a nationally representative sample of obstetricians regarding comfort, knowledge, and practice patterns of caring for pregnant women after bariatric surgery. We conducted an online survey of US obstetricians and describe obstetrician's demographics, practice settings, and practice patterns. We assessed respondent's knowledge and recommended practices. We compared provider knowledge by years since completing residency, scope of practice (generalist or specialist), and practice setting (academic setting or other). Statistical significance was set at p < 0.05. A total of 106 completed the survey (response rate of 54%). Respondents had a median age of 47 and median 17 years in practice. Sixty-two percent were generalists. Nearly all of the respondents (94%) had some experience with caring for pregnant women after bariatric surgery and 83% reported feeling "very comfortable" (48%) or "somewhat comfortable" (35%) providing care for this population. Most (74%) were aware of increased risk of small for gestational age after surgery. Only 13% were able to correctly identify all recommended nutritional labs and 20% reported that they "did not know" which labs are recommended. There were no differences in comfort, experience, knowledge, and practice patterns by physician characteristics and practice settings. While most obstetricians are aware of perinatal risks after bariatric surgery, a substantial percentage of obstetricians are unaware of recommended practices regarding nutrition and nutritional monitoring. As bariatric surgery becomes increasingly prevalent among reproductive age women, educational interventions to increase obstetricians' knowledge of optimal care of pregnant women after bariatric surgery are urgently needed.
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Kim, Hyunjee; Jung, Jeah Kyoungrae
2015-09-01
Medicare home health care spending increased under the prospective payment system (PPS) that was introduced specifically to control the rising spending. To explain this unexpected spending rise, we focused on new home health agencies that entered the market under the PPS. The high profit margins under the PPS attracted many new agencies to the market partially due to home health care's unique feature of low entry costs. We examined whether new entrants were more likely to adopt the practice patterns leading to higher profit margins than incumbent agencies that had been operating in the market before the PPS. Using 2008 to 2010 Medicare Home Health Claims and Provider of Services File, we estimated regressions of agencies' practice patterns controlling for agency and patient characteristics. We found that new entrants were more likely than incumbents to adopt practice patterns leading to high profit margins. They were more likely to target the 14th and 20th therapy visit where marginal revenue is relatively greater than that of other number of visits. Under the payment system that compensates extra therapy visits but not for other types of visits, entrants were also more likely to provide therapy visits, but less likely to provide medical social service visits. Given the high entry rates of agencies under the PPS, distinct practice patterns among entrants explain the drastic home health spending increase under the PPS. Heterogeneity in agencies' practice patterns also suggests an opportunity to improve efficiency in the Medicare home health care market. Copyright © 2015 Elsevier Inc. All rights reserved.
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Laska, Melissa N.; Hearst, Mary O.; Lust, Katherine; Lytle, Leslie; Story, Mary
2017-01-01
Objectives (a) To examine associations between young adult meal routines and practices (e.g., food preparation, meal skipping, eating on the run) and key dietary indicators (fruit/vegetable, fast food and sugar-sweetened beverage intake), and (b) to develop indices of protective and risky meal practices most strongly associated with diet. Design Cross-sectional survey. Setting Minneapolis/St. Paul metropolitan area, Minnesota (USA). Subjects A diverse sample of community college and public university (n=1,013) students. Results Meal routines and practices most strongly associated with healthy dietary patterns were related to home food preparation (i.e., preparing meals at home, preparing meals with vegetables) and meal regularity (i.e., routine consumption of evening meals and breakfast). In contrast, factors most strongly associated with poor dietary patterns included eating on the run, using media while eating, and purchasing foods/beverages on campus. A Protective Factors Index, summing selected protective meal routines and practices, was positively associated with fruit/vegetable consumption, and negatively associated with fast food and sugar-sweetened beverage consumption (p<0.001). A Risky Factors Index yielded significant, positive associations with fast food and sugar sweetened beverage (p<0.001) consumption. The probability test for the association between the Risky Factors Index and fruit/vegetable intake was p=0.05. Conclusions Meal routines and practices were significantly associated with young adult dietary patterns, suggesting that ways in which individuals structure mealtimes and contextual characteristics of eating likely influence food choice. Thus, in addition to considering specific food choices, it also may be important to consider the context of mealtimes in developing dietary messaging and guidelines. PMID:25439511
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Bultijnck, Renée; Surcel, Cristian; Ploussard, Guillaume; Briganti, Alberto; De Visschere, Pieter; Fütterer, Jurgen; Ghadjar, Pirus; Giannarini, Gianluca; Isbarn, Hendrik; Massard, Christophe; Sooriakumaran, Prasanna; Valerio, Massimo; van den Bergh, Roderick; Ost, Piet
2016-12-01
Evidence-based recommendations are available for the management of androgen deprivation therapy (ADT)-induced side effects; however, there are no data on the implementation of the recommendations into daily practice patterns. To compare practice patterns in the management of ADT-induced side effects with evidence-based strategies. A European Web-based survey was conducted from January 16, 2015, to June 24, 2015. The 25-item questionnaire was designed with the aid of expert opinion and covered general respondent information, ADT preference per disease stage, patient communication on ADT-induced side effects, and strategies to mitigate side effects. All questions referred to patients with long-term ADT use. Reported practice patterns were compared with available evidence-based strategies. Following data collection, descriptive statistics were used for analysis. Frequency distributions were compiled and compared using a generalised chi-square test. In total, 489 eligible respondents completed the survey. Luteinising hormone-releasing hormone-agonist with or without an antiandrogen was the preferred method of ADT in different settings. Patients were well informed about loss of libido (90%), hot flushes (85%), fatigue (67%), and osteoporosis (63%). An osteoporotic and metabolic risk assessment prior to commencing ADT was done by one-quarter of physicians. The majority (85%) took preventive measures and applied at least one evidence-based strategy. Exercise was recommended by three-quarters of physicians who advocate its positive effects; however, only 25% of physicians had access to exercise programmes. Although the minimum sample size was set at 400 participants, the current survey remains susceptible to volunteer and nonresponder bias. Patients were well informed about several ADT-induced complications but uncommonly underwent an osteoporotic and metabolic risk assessment. Nevertheless, physicians partially provided evidence-based strategies for the management of the complications. Physicians often advised exercise to reduce ADT-induced side effects, but programmes were not widely available. Implementation of evidence-based strategies for androgen deprivation therapy-induced side effects in real-life practice patterns should be improved. Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.
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Rapaport, Robert; Silverstein, Janet H; Garzarella, Linda; Rosenbloom, Arlan L
2004-06-01
To determine the relative frequency of type 2 diabetes mellitus (DM) in the US, and to assess diabetes practice patterns in the US. A questionnaire regarding pediatric diabetes practice patterns was distributed to the members of the Lawson Wilkins Pediatric Endocrine Society in 1999. Only one member of each practice group was requested to respond. Responses received through early 2000 were analyzed. One hundred and twenty-six practices representing 45% of the members of the Society responded. 11.9% of pediatric patients with DM were considered to have type 2 DM. On average 53 new patients with DM were seen each year. The average practice consisted of 2.5 physicians, 1.5 nurse educators, 1.3 dieticians, 1.0 social workers and 0.5 nurse practitioners. Management practices comply by and large with the recommendations of the American Diabetes Association and reflect a trend toward more intensive treatment and monitoring. Type 2 DM was seen in 11.9% of patients. Most diabetes practices in the US utilize a team approach to the management of youth with DM.
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Beyond ADHD: How Well Are We Doing?
Stein, Ruth EK; Storfer-Isser, Amy; Kerker, Bonnie D.; Garner, Andrew; Szilagyi, Moira; Hoagwood, Kimberly E.; O’Connor, Karen G.; Horwitz, Sarah McCue
2017-01-01
Background and Objectives There has been increasing emphasis on the role of the pediatrician with respect to behavioral, learning and mental health (MH) issues, and developmental behavioral rotations are now required in pediatric residency programs. We sought to examine whether this newer emphasis on MH is reflected in pediatricians’ reports of their current practices. Methods Data from two Periodic Surveys (PS) conducted in 2004 and 2013 by the American Academy of Pediatrics (AAP) were examined to see whether there were differences in self-reported behaviors of usually inquiring/screening, treating/managing/co-managing, or referring patients for ADHD, anxiety, depression, behavioral problems or learning problems. We examined patterns for all practicing members and for those who practiced general pediatrics exclusively. Results There were few changes over the decade in the percentage who inquired or screened among all clinicians; among those exclusively practicing general pediatrics, the percentage who inquired or screened increased about 10% for ADHD and depression. ADHD remained the only condition for which the majority of respondents treated/managed/co-managed (57%). While there was some increase in the percentages who treated other conditions, the other conditions were usually treated by < 30% of respondents. A similar pattern of results was observed in analyses adjusted for physician, practice, and patient characteristics. Conclusions Despite the changing nature of pediatric practice and increased efforts to emphasize the importance of behavior, learning and MH, the pediatric community appears to be making little progress toward providing for the long-term behavioral, learning and MH needs of children and adolescents in its care. PMID:26514649
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NASA Astrophysics Data System (ADS)
Wallow, Thomas I.; Zhang, Chen; Fumar-Pici, Anita; Chen, Jun; Laenens, Bart; Spence, Christopher A.; Rio, David; van Adrichem, Paul; Dillen, Harm; Wang, Jing; Yang, Peng-Cheng; Gillijns, Werner; Jaenen, Patrick; van Roey, Frieda; van de Kerkhove, Jeroen; Babin, Sergey
2017-03-01
In the course of assessing OPC compact modeling capabilities and future requirements, we chose to investigate the interface between CD-SEM metrology methods and OPC modeling in some detail. Two linked observations motivated our study: 1) OPC modeling is, in principle, agnostic of metrology methods and best practice implementation. 2) Metrology teams across the industry use a wide variety of equipment, hardware settings, and image/data analysis methods to generate the large volumes of CD-SEM measurement data that are required for OPC in advanced technology nodes. Initial analyses led to the conclusion that many independent best practice metrology choices based on systematic study as well as accumulated institutional knowledge and experience can be reasonably made. Furthermore, these choices can result in substantial variations in measurement of otherwise identical model calibration and verification patterns. We will describe several experimental 2D test cases (i.e., metal, via/cut layers) that examine how systematic changes in metrology practice impact both the metrology data itself and the resulting full chip compact model behavior. Assessment of specific methodology choices will include: • CD-SEM hardware configurations and settings: these may range from SEM beam conditions (voltage, current, etc.,) to magnification, to frame integration optimizations that balance signal-to-noise vs. resist damage. • Image and measurement optimization: these may include choice of smoothing filters for noise suppression, threshold settings, etc. • Pattern measurement methodologies: these may include sampling strategies, CD- and contour- based approaches, and various strategies to optimize the measurement of complex 2D shapes. In addition, we will present conceptual frameworks and experimental methods that allow practitioners of OPC metrology to assess impacts of metrology best practice choices on model behavior. Finally, we will also assess requirements posed by node scaling on OPC model accuracy, and evaluate potential consequences for CD-SEM metrology capabilities and practices.
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Is plant temporal beta diversity of field margins related to changes in management practices?
NASA Astrophysics Data System (ADS)
Alignier, Audrey; Baudry, Jacques
2016-08-01
Field margins have considerable ecological significance in agriculture-dominated landscapes by supporting biodiversity and associated services. However, agricultural changes during mid-20th century led to their drastic loss with a serious threat for biodiversity. Using time-series data, we aimed to get better insights into processes underlying plant patterns of field margins through time by i) quantifying plant temporal beta diversity components, ii) assessing whether the observed changes in plant communities can be related to changes in management practices applied to field margins. During the springs of 1994, 1998 and 2001, we surveyed plant communities and management practices of the same 116 field margins in three contrasted landscapes. We estimated temporal beta diversity in plant communities and partitioned it into its two dissimilarity resultant components, accounting for replacement of species (i.e. turnover) and for the nested gain or loss of species (i.e. nestedness). We then tested whether the observed changes in plant communities between 1994 and 1998 and, between 1998 and 2001 were related to changes in management practices using linear models. Plant communities of field margins exhibited strong temporal beta diversity dominated by turnover. Temporal turnover in plant communities was partly related to changes in management practices, i.e., a decrease of grazing concomitant to an increase of herbicide spraying. However, relationships were not consistent between all landscape contexts nor time period, suggesting that other unmeasured deterministic or stochastic processes could be driving the observed plant patterns. Taken together, our results suggest that maintaining a wide diversity of field margins with contrasted management contribute to maintaining plant diversity at a landscape scale. They underline the value of investigating plant temporal diversity patterns using time-series data and thus, the need to develop long-term studies making it possible to understand ecological processes shaping plant communities in agricultural landscapes.
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Nguyen, Kimberley; Mackenzie, Penny; Allen, Angela; Dreosti, Marcus; Morgia, Marita; Zissiadis, Yvonne; Lamoury, Gilian; Windsor, Apsara
2017-08-01
This patterns of practice study was conducted on behalf of the RANZCR Breast Interest Group in order to document current radiotherapy practices for breast cancer in Australia and New Zealand. The survey identifies variations and highlights potential contentious aspects of radiotherapy management of breast cancer. A fifty-eight question survey was disseminated via the Survey Monkey digital platform to 388 Radiation Oncologists in Australia and New Zealand. In total, 156 responses were received and collated. Areas of notable consensus among respondents included hypofractionation (77.3% of respondents would 'always' or 'sometimes' consider hypofractionation in the management of ductal carcinoma in-situ and 99.3% in early invasive breast cancer); margin status in early breast cancer (73.8% believe a clear inked margin is sufficient and does not require further surgery) and use of bolus in post-mastectomy radiotherapy (PMRT) (91.1% of participants use bolus in PMRT). Areas with a wider degree of variability amongst respondents included regional nodal irradiation and components of radiotherapy planning and delivery (examples include the technique used for delivery of boost and frequency of bolus application for PMRT). The results of these patterns of practice survey informs radiation oncologists in Australia and New Zealand of the current clinical practices being implemented by their peers. The survey identifies areas of consensus and contention, the latter of which may lead to a development of research trials and/or educational activities to address these areas of uncertainty. © 2016 The Royal Australian and New Zealand College of Radiologists.
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The roles of talent, physical precocity and practice in the development of soccer expertise.
Helsen, W F; Hodges, N J; Van Winckel, J; Starkes, J L
2000-09-01
Here we consider the potential contributions of talent, physical precocity and deliberate practice in the development of soccer expertise. After presenting a working definition of 'talent', we examine how coaches perceive and select potential talent. Our findings suggest that much of what coaches see as early talent may be explained by physical precocity associated with a relative age advantage. Finally, as a test of the model of Deliberate Practice, we review the results of studies that assessed the progress of international, national and provincial players based on accumulated practice, amount of practice per week and relative importance and demands of various practice and everyday activities. A positive linear relationship was found between accumulated individual plus team practice and skill. Various practical suggestions can be made to improve talent detection and selection and to optimize career practice patterns in soccer.
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Imaging Practice Patterns: Referral Network Analysis of a Single State of Origination.
Grayson, James; Basciano, Peter; Rawson, James V; Klein, Kandace
2015-12-01
The aim of this study was to examine the referral pattern of imaging studies requested in a single state compared with the potential location of interpretation. Analysis of Medicare patients in a DocGraph data set was performed to identify sequential different physician services claims for the same patient for which the second claim was for services provided by a radiologist. In the 2011 Medicare population, radiology referrals from physicians practicing in Georgia resulted in 76.5% of radiology interpretations by radiologists inside the state of Georgia. The states bordering Georgia accounted for 11.6% of interpretations in the Georgia market. The remaining interpretations were distributed throughout the remainder of the country. A significant proportion of routine imaging interpretation occurs outside the state in which an examination is performed. Additional studies are needed to identify complex drivers of imaging referral patterns, such as patient geographic location and demographics, radiologist workforce distribution, contractual obligations, and social relationships. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.
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Correspondence between mothers' self-reported and observed child-rearing practices.
Kochanska, G; Kuczynski, L; Radke-Yarrow, M
1989-02-01
The correspondence between self-reported child-rearing attitudes and practices and actual child management was examined among 68 mothers of young children. Data on mothers' verbal and physical control techniques along with children's responses (cooperation vs. resistance) were obtained during 90 min of spontaneous interaction in a naturalistic setting. Self-report data (the Block Q-Sort) were obtained 1-2 weeks later. The Block Q-Sort factors were combined to represent authoritarian and authoritative patterns of attitudes. The authoritarian pattern was positively associated with the use of direct commands, physical enforcements, reprimands, and prohibitive interventions, and negatively associated with the use of suggestions. The authoritative pattern was positively related to the use of suggestions and positive incentives, and negatively related to the use of physical enforcements, prohibitive interventions, and direct commands. Mothers' enjoyment of the parental role and their negative affect toward the child, as expressed in the Block Q-Sort, were more a result of the child's cooperation/resistance during the interaction than predictors of maternal control strategies.
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Post-treatment management options for patients with lung cancer.
Virgo, K S; McKirgan, L W; Caputo, M C; Mahurin, D M; Chao, L C; Caputo, N A; Naunheim, K S; Flye, M W; Gillespie, K N; Johnson, F E
1995-01-01
OBJECTIVES: The first objective was to identify variations in patient management practice patterns after potentially curative lung cancer surgery. Patient management practice patterns were expected to range from intensive follow-up to no active surveillance. The second objective was to measure whether intensity of follow-up was related to patient outcomes. METHODS: An 18-month retrospective analysis was conducted of 182 patients with low TNM stage (< or = IIIA) lung cancer who were surgically treated with curative intent over the 11-year period from 1982 through 1992 at the St. Louis Department of Veterans Affairs Medical Center. RESULTS: Patients were followed for a mean of 3.3 years, until death or the end of the study. Analyses of diagnostic test and outpatient visit frequency distributions and cluster analyses facilitated the identification of 62 nonintensively followed patients and 120 intensively followed patients. Both groups were comparable at baseline, and there were no significant differences in patient outcomes attributable to intensity of follow-up. Intensively followed patients did, however, live an average of 192 days longer than nonintensively followed patients. CONCLUSIONS: Significant variations in follow-up practice patterns can exist within a single health care facility. In this analysis, variations in test and visit frequency did not result in statistically significant differences in patient outcomes, though the survival difference between groups suggests that some benefit might exist. Only well-designed prospective trials are likely to answer the question of what constitutes optimal follow-up after potentially curative lung cancer treatment. PMID:8526576
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Perils of the new labor management guidelines.
Cohen, Wayne R; Friedman, Emanuel A
2015-04-01
Recent guidelines issued jointly by the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine for assessing labor progress differ substantially from those described initially by Friedman, which have guided clinical practice for decades. The guidelines are based on results obtained from new and untested methods of analyzing patterns of cervical dilatation and fetal descent. Before these new guidelines are adopted into clinical practice, the results obtained by these unconventional analytic approaches should be validated and shown to be superior, or at least equivalent, to currently accepted standards. The new guidelines indicate the patterns of labor originally described by Friedman are incorrect and, further, are inapplicable to modern obstetric practice. We contend that the original descriptions of normal and abnormal labor progress, which were based on direct clinical observations, accurately describe progress in dilatation and descent, and that the differences reported more recently are likely attributable to patient selection and the potential inaccuracy of very high-order polynomial curve-fitting methods. The clinical evaluation of labor is a process of serially estimating the likelihood of a safe vaginal delivery. Because many factors contribute to that likelihood, such as cranial molding, head position and attitude, and the bony architecture and capacity of the pelvis, graphic labor patterns should never be used in isolation. The new guidelines are based heavily on unvalidated notions of labor progress and ignore clinical parameters that should remain cornerstones of intrapartum decision-making. Copyright © 2015. Published by Elsevier Inc.
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Clinard, F; Sgro, C; Bardou, M; Dumas, M; Hillon, P; Bonithon-Kopp, C
2001-01-01
In order to assess biases occurring in primary care prescription studies, we compared non-steroidal anti-inflammatory drug (NSAID) prescribing patterns reported by general practitioners directly (GP-based survey) and from a pharmacy-based survey of general practitioner prescribing (pharmacy-based survey). Volunteer GPs of the administrative area of Côte d'Or (France) returned a mailed questionnaire on NSAID prescribing patterns for consecutive patients seen during a 2-month period. In order to obtain a reference basis, pharmacies of the same administrative area provided all prescriptions that included NSAIDs during a 1-week period originating in general practice. The rate of participation was 25% for the GPs and 40% for the pharmacies. Participant GPs were representative of GPs of the area with regard to sex, year of graduation and practice area but pharmacies from rural areas were over-represented. The GP-based survey and the pharmacy-based survey provided respectively 770 and 1050 prescriptions. There were no differences between either survey in the type of NSAIDs prescribed and in the most frequently associated drugs. GPs who volunteered in the GP survey prescribed NSAIDs more frequently orally and at higher doses than GPs involved in the pharmacy-based survey. They also prescribed more gastroprotective drugs, especially in the elderly. None of these results could be explained by differences in patient characteristics and GP practice areas. GPs who actively participate in prescription surveys exhibit prescribing patterns that fit better with official recommendations than the average. Although selection biases cannot be ruled out, it is suggested that some changes in GP prescription habits may have been induced by the survey itself.
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Train, Arianne T; Harmon, Carroll M; Rothstein, David H
2017-10-01
Although disparities in access to minimally invasive surgery are thought to exist in pediatric surgical patients in the United States, hospital-level practice patterns have not been evaluated as a possible contributing factor. Retrospective cohort study using the Kids' Inpatient Database, 2012. Odds ratios of undergoing a minimally invasive compared to open operation were calculated for six typical pediatric surgical operations after adjustment for multiple patient demographic and hospital-level variables. Further adjustment to the regression model was made by incorporating hospital practice patterns, defined as operation-specific minimally invasive frequency and volume. Age was the most significant patient demographic factor affecting application of minimally invasive surgery for all procedures. For several procedures, adjusting for individual hospital practice patterns removed race- and income-based disparities seen in performance of minimally invasive operations. Disparities related to insurance status were not affected by the same adjustment. Variation in the application of minimally invasive surgery in pediatric surgical patients is primarily influenced by patient age and the type of procedure performed. Perceived disparities in access related to some socioeconomic factors are decreased but not eliminated by accounting for individual hospital practice patterns, suggesting that complex underlying factors influence application of advanced surgical techniques. II. Copyright © 2017 Elsevier Inc. All rights reserved.
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Spatial and temporal variation in evapotranspiration
USDA-ARS?s Scientific Manuscript database
Spatial and temporal variation in evapotranspiration occurs at multiple scales as the result of several different spatial and temporal patterns in precipitation, soil water holding capacity, cloudiness (available energy), types of crops, and residue and tillage management practices. We have often as...
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NASA Technical Reports Server (NTRS)
Chittineni, C. B.
1979-01-01
The problem of estimating label imperfections and the use of the estimation in identifying mislabeled patterns is presented. Expressions for the maximum likelihood estimates of classification errors and a priori probabilities are derived from the classification of a set of labeled patterns. Expressions also are given for the asymptotic variances of probability of correct classification and proportions. Simple models are developed for imperfections in the labels and for classification errors and are used in the formulation of a maximum likelihood estimation scheme. Schemes are presented for the identification of mislabeled patterns in terms of threshold on the discriminant functions for both two-class and multiclass cases. Expressions are derived for the probability that the imperfect label identification scheme will result in a wrong decision and are used in computing thresholds. The results of practical applications of these techniques in the processing of remotely sensed multispectral data are presented.
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Heneghan, Steven J; Bordley, James; Dietz, Patrick A; Gold, Michael S; Jenkins, Paul L; Zuckerman, Randall J
2005-11-01
The purpose of this study is to determine the differences between rural and urban surgeons with regard to practice patterns, factors in choosing a practice location, and educational needs. A list of surgeons obtained from the American Medical Association was examined using the Office of Management and Budget definition of rural. Seventeen hundred rural surgeons were mailed surveys; 421 responded. One hundred fourteen urban surgeons were contacted by telephone. Questions were designed to measure job and community satisfaction, factors influencing their decision to practice in their current location, spectrum and volume of cases, and their perceived educational needs. Age distribution did not differ markedly between urban and rural surgeons. Motivation to practice in their current location varied considerably between urban and rural surgeons. Both groups equally rated quality of life as the leading factor influencing their current practice location. Urban surgeons rated other factors, such as income, practice growth, hospital facilities, and proximity to family, higher than rural surgeons. Practice patterns and educational needs also varied between the two groups. Rural surgeons performed more procedures per year with more variety in procedure type. Both groups felt that additional training in advanced laparoscopic techniques would be helpful, and rural surgeons felt that additional training in the surgical subspecialty areas was important. Although rural and urban surgeons do not differ in age or the importance of lifestyle in deciding career location, different factors do impact their choice of location. Practice pattern and educational needs varied markedly between rural and urban general surgeons.
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When kinesthetic information is neglected in learning a Novel bimanual rhythmic coordination.
Zhu, Qin; Mirich, Todd; Huang, Shaochen; Snapp-Childs, Winona; Bingham, Geoffrey P
2017-08-01
Many studies have shown that rhythmic interlimb coordination involves perception of the coupled limb movements, and different sensory modalities can be used. Using visual displays to inform the coupled bimanual movement, novel bimanual coordination patterns can be learned with practice. A recent study showed that similar learning occurred without vision when a coach provided manual guidance during practice. The information provided via the two different modalities may be same (amodal) or different (modality specific). If it is different, then learning with both is a dual task, and one source of information might be used in preference to the other in performing the task when both are available. In the current study, participants learned a novel 90° bimanual coordination pattern without or with visual information in addition to kinesthesis. In posttest, all participants were tested without and with visual information in addition to kinesthesis. When tested with visual information, all participants exhibited performance that was significantly improved by practice. When tested without visual information, participants who practiced using only kinesthetic information showed improvement, but those who practiced with visual information in addition showed remarkably less improvement. The results indicate that (1) the information is not amodal, (2) use of a single type of information was preferred, and (3) the preferred information was visual. We also hypothesized that older participants might be more likely to acquire dual task performance given their greater experience of the two sensory modes in combination, but results were replicated with both 20- and 50-year-olds.
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The role of family communication and parents' feeding practices in children's food preferences.
Alm, Siril; Olsen, Svein Ottar; Honkanen, Pirjo
2015-06-01
This study used Family Communication Patterns Theory (FCPT) to explore how family-dinner-related communication takes place and how parents' feeding practices may be associated with children's preferences for dinner meals. The sample consisted of 12 dyads with seven- and eight-year-old Norwegian children and their parents. In-depth photo interviews were used for collecting data. Interview transcripts and photographs were examined through content analysis. Results indicated that most families were conversation oriented, and communication tended to shift from consensual during weekdays to pluralistic at weekends. On weekdays, the dinner menu was often a compromise between children's preferences and parents' intentions to provide quick, healthy dinner options for the family. To a greater extent at weekends, children were allowed to choose dinner alternatives for the entire family. Restriction of unhealthy dinner alternatives was the practice most used to control children's diets and, in fact, might explain children's high preferences for unhealthy dinner alternatives. Results underline the importance of giving children control of what they eat and being responsive to children's preferences while guiding them towards healthy dinner alternatives rather than using force and restriction. From a more theoretical perspective, this study explored how FCPT could be combined with theories about parents' feeding practices to understand meal preferences and choices among young children and their families, and how time and situation (context) influence families' communication patterns and feeding practices in their homes. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Future Career Plans and Practice Patterns of Canadian Obstetrics and Gynaecology Residents in 2011.
Burrows, Jason; Coolen, Jillian
2016-01-01
The practice patterns of Obstetricians and Gynaecologists continue to evolve with each new generation of physicians. Diversifying subspecialties, changes in resident duty hours, job market saturation, and desire for work-life balance are playing stronger roles. Professional practice direction and needs assessment may be aided by awareness of future Obstetrics and Gynaecology physician career plans and expectations. The objective of this study was to determine the expected career plans and practice patterns of Canadian Obstetrics and Gynaecology residents following residency. The SOGC Junior Member Committee administered its third career planning survey to Canadian Obstetrics and Gynaecology residents electronically in December 2011. The data collected was statistically analyzed and compared to previous surveys. There were 183 responses giving a response rate of 43%. More than one half of all residents were considering postgraduate training (58%). Projected practice patterns included: 84% maintaining obstetrical practice, 60% locuming, and 50% job-sharing. The majority of residents expected to work in a 6 to 10 person call group (48%), work 3 to 5 call shifts per month (72%), work 41 to 60 hours weekly (69%), and practise in a city with a population greater than 500 000 (45%). Only 18% of residents surveyed were in favour of streaming residency programs in Obstetrics and Gynaecology. Canadian resident career plan and expected practice pattern assessment remains an important tool for aiding in resource allocation and strategic development of care and training in Obstetrics and Gynaecology in Canada. Copyright © 2016 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.
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Maddox, Thomas M.; Chan, Paul S.; Spertus, John A.; Tang, Fengming; Jones, Phil; Ho, P. Michael; Bradley, Steven M.; Tsai, Thomas T.; Bhatt, Deepak L.; Peterson, Pamela N.
2014-01-01
Objectives This study assesses practice variation of secondary prevention medication prescription among coronary artery disease (CAD) patients treated in outpatient practices participating in the NCDR® PINNACLE Registry®. Background Among patients with CAD, secondary prevention with a combination of beta-blockers, angiotensin converting enzyme inhibitors/angiotensin receptor blockers, and statins reduces cardiac mortality and myocardial infarction (MI). Accordingly, every CAD patient should receive the combination of these medications for which they are eligible. However, little is known about current prescription patterns of these medications and the variation in use among outpatient cardiology clinics. Methods Using data from NCDR® PINNACLE Registry®, a national outpatient cardiology practice registry, we assessed medication prescription patterns among eligible CAD patients between July 2008 and December 2010. Overall rates of prescription and variation by practice were calculated, adjusting for patient characteristics. Results Among 156,145 CAD patients in 58 practices, 103,830 (66.5%) were prescribed the optimal combination of medications for which they were eligible. The median rate of optimal combined prescription by practice was 73.5% and varied from 28.8% to 100%. After adjustment for patient factors, the practice median rate ratio for prescription was 1.25 (95% CI 1.2,1.32), indicating a 25% likelihood that 2 random practices would differ in treating identical CAD patients. Conclusions Among a national registry of CAD patients treated in outpatient cardiology practices, over one-third of patients failed to receive their optimal combination of secondary prevention medications. Significant variation was observed across practices, even after adjusting for patient characteristics, suggesting that quality improvement efforts may be needed to support more uniform practice. PMID:24184238
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Sabbar, Shaho; Hyun, Daiwon
2016-01-01
After a piece of information is put into a network, its fate depends on the behaviors of the nodes of the network; nodes that are equipped with the hardware and software of the age of information and are more powerful than any time in the past. This study suggests that a useful research for communication, marketing and advertising would be one that looks for patterns in the reactions of the nodes toward different pieces of information. This study has used Facebook to see how people have reacted to different types of messages in terms of liking, sharing and commenting. Rather than looking for universal, generalizable patterns we have tried to examine the practicality of the proposed method. The practical aspect of the study comes after a short theoretical discussion on the issue of flow of information in a digital world. The results revealed dozens of significant relations between the examined variables. This study, its theoretical discussion and results suggest that it would be practical to study the relations between the characteristics of Facebook messages and the type of reactions (liking, sharing and commenting) that they attract.
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Zhao, Hongyu; Zhang, Xiaohui
2017-01-01
The current study used mixed methods to research pre-service teachers' professional identity. Ninety-eight pre-service teachers were investigated and twelve teachers were interviewed in China. The results were as follows: (1) The results of quantitative data showed that compared with before the field teaching practice, pre-service teachers' professional identity increased after the field teaching practice-specifically, intrinsic value identity increased, and extrinsic value identity did not significantly change; (2) The results of qualitative data validated and elaborated the results of quantitative data in more detail with regard to changes in professional identity. Specifically, compared with before the field teaching practice, intrinsic value identity including work content, work pattern, etc., increased and extrinsic value identity including work environment, income, and social status, etc., did not significantly change after experiencing teaching practice; (3) The results of qualitative data also showed that mentor support at field school promoted the development of pre-service teachers' professional identity. Moreover, the development of pre-service teachers' professional identity during field teaching practice further promoted their professional commitment; that is, it promoted their emotional evaluation and belief in the teaching profession. The study discussed these results and proposed solutions and suggestions for future studies.
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Adolescent online gambling: the impact of parental practices and correlates with online activities.
Floros, Georgios D; Siomos, Konstantinos; Fisoun, Virginia; Geroukalis, Dimitrios
2013-03-01
We present results from a cross-sectional study of the entire adolescent student population aged 12-19 of the island of Kos and their parents, on the relationship between their Internet gambling and respective parental practices, including aspects of psychological bonding and online security measures. The sample consisted of 2,017 students (51.8% boys, 48.2% girls). Our results indicate that gender, parenting practices as perceived by the adolescents and distinct patterns of adolescent Internet activities are among the best predictor variables for Internet gambling. Security practices exercised by the parents failed to make an impact on the extent of Internet gambling, demonstrating the need for specific measures to tackle this phenomenon since the provision of simple education on the dangers of the Internet is not sufficient to this regard.
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Travis, F; Olson, T; Egenes, T; Gupta, H K
2001-07-01
This study tested the prediction that reading Vedic Sanskrit texts, without knowledge of their meaning, produces a distinct physiological state. We measured EEG, breath rate, heart rate, and skin conductance during: (1) 15-min Transcendental Meditation (TM) practice; (2) 15-min reading verses of the Bhagavad Gita in Sanskrit; and (3) 15-min reading the same verses translated in German, Spanish, or French. The two reading conditions were randomly counterbalanced, and subjects filled out experience forms between each block to reduce carryover effects. Skin conductance levels significantly decreased during both reading Sanskrit and TM practice, and increased slightly during reading a modern language. Alpha power and coherence were significantly higher when reading Sanskrit and during TM practice, compared to reading modern languages. Similar physiological patterns when reading Sanskrit and during practice of the TM technique suggests that the state gained during TM practice may be integrated with active mental processes by reading Sanskrit.
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Change the management of patients with heart failure: Rationale and design of the CHAMP-HF registry.
DeVore, Adam D; Thomas, Laine; Albert, Nancy M; Butler, Javed; Hernandez, Adrian F; Patterson, J Herbert; Spertus, John A; Williams, Fredonia B; Turner, Stuart J; Chan, Wing W; Duffy, Carol I; McCague, Kevin; Mi, Xiaojuan; Fonarow, Gregg C
2017-07-01
Heart failure (HF) with reduced ejection fraction (HFrEF) is a common and costly condition that diminishes patients' health status and confers a poor prognosis. Despite the availability of multiple guideline-recommended pharmacologic and cardiac device therapies for patients with chronic HFrEF, outcomes remain suboptimal. Currently, there is limited insight into the rationale underlying clinical decisions by health care providers and patient factors that guide the use and intensity of outpatient HF treatments. A better understanding of current practice patterns has the potential to improve patients' outcomes. The CHAnge the Management of Patients with Heart Failure (CHAMP-HF) registry will evaluate the care and outcomes of patients with chronic HFrEF by assessing real-world treatment patterns, as well as the reasons for and barriers to medication treatment changes. CHAMP-HF will enroll approximately 5,000 patients with chronic HFrEF (left ventricular ejection fraction ≤40%) at approximately 150 US sites, and patients will be followed for a maximum duration of 24 months. Participating sites will collect data from both providers (HF history, examination findings, results of diagnostic studies, pharmacotherapy treatment patterns, decision-making factors, and clinical outcomes) and patients (medication adherence and patient-reported outcomes). The CHAMP-HF registry will provide a unique opportunity to study practice patterns and the adoption of new HF therapies across a diverse mix of health care providers and outpatient practices in the United States that care for HFrEF patients. Copyright © 2017 Elsevier Inc. All rights reserved.
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Airborne antenna radiation pattern code user's manual
NASA Technical Reports Server (NTRS)
Burnside, Walter D.; Kim, Jacob J.; Grandchamp, Brett; Rojas, Roberto G.; Law, Philip
1985-01-01
The use of a newly developed computer code to analyze the radiation patterns of antennas mounted on a ellipsoid and in the presence of a set of finite flat plates is described. It is shown how the code allows the user to simulate a wide variety of complex electromagnetic radiation problems using the ellipsoid/plates model. The code has the capacity of calculating radiation patterns around an arbitrary conical cut specified by the user. The organization of the code, definition of input and output data, and numerous practical examples are also presented. The analysis is based on the Uniform Geometrical Theory of Diffraction (UTD), and most of the computed patterns are compared with experimental results to show the accuracy of this solution.
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Use of atropine penalization to treat amblyopia in UK orthoptic practice.
Piano, Marianne; O'Connor, Anna R; Newsham, David
2014-01-01
To compare clinical practice patterns regarding atropine penalization use by UK orthoptists to the current evidence base and identify any existing barriers against use of AP as first-line treatment. An online survey was designed to assess current practice patterns of UK orthoptists using atropine penalization. They were asked to identify issues limiting their use of atropine penalization and give opinions on its effectiveness compared to occlusion. Descriptive statistics and content analysis were applied to the results. Responses were obtained from 151 orthoptists throughout the United Kingdom. The main perceived barriers to use of atropine penalization were inability to prescribe atropine and supply difficulties. However, respondents also did not consider atropine penalization as effective as occlusion in treating amblyopia, contrary to recent research findings. Patient selection criteria and treatment administration largely follow current evidence. More orthoptists use atropine penalization as first-line treatment than previously reported. Practitioners tend to closely follow the current evidence base when using atropine penalization, but reluctance in offering it as first-line treatment or providing a choice for parents between occlusion and atropine still remains. This may result from concerns regarding atropine's general efficacy, side effects, and risk of reverse amblyopia. Alternatively, as demonstrated in other areas of medicine, it may reflect the inherent delay of research findings translating to clinical practice changes. Copyright 2014, SLACK Incorporated.
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McBride, Ruth; Leroux, Brian; Lindblad, Anne; Williams, O Dale; Lehmann, Maryann; Rindal, D Brad; Botello-Harbaum, Maria; Gilbert, Gregg H; Gillette, Jane; Demko, Catherine
2013-05-01
The National Institute of Dental and Craniofacial Research funded three practice-based research networks (PBRNs), NW-PRECEDENT, PEARL and DPBRN to conduct studies relevant to practicing general dentists. These PBRNs collaborated to develop a questionnaire to assess the impact of network participation on changes in practice patterns. This report presents results from the initial administration of the questionnaire. Questionnaires were administered to network dentists and a non-network reference group. Practice patterns including caries diagnosis and treatment, pulp cap materials, third molar extraction, dentine hypersensitivity treatments and endodontic treatment and restoration were assessed by network, years in practice, and level of network participation. Test-retest reliability of the questionnaire was evaluated. 950 practitioners completed the questionnaire. Test-retest reliability was good-excellent (kappa>0.4) for most questions. Significant differences in responses by network were not observed. The use of caries risk assessment forms differed by both network participation (p<0.001) and years since dental degree (p=0.026). Recent dental graduates are more likely to recommend third molar removal for preventive reasons (p=0.003). Practitioners in the CONDOR research networks are similar to their US colleagues. As a group, however, these practitioners show a more evidence-based approach to their practice. Dental PBRNs have the potential to improve the translation of evidence into daily practice. Designing methods to assess practice change and the associated factors is essential to addressing this important issue. Copyright © 2013 Elsevier Ltd. All rights reserved.
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2014-01-01
Background The utilisation of good design practices in the development of complex health services is essential to improving quality. Healthcare organisations, however, are often seriously out of step with modern design thinking and practice. As a starting point to encourage the uptake of good design practices, it is important to understand the context of their intended use. This study aims to do that by articulating current health service development practices. Methods Eleven service development projects carried out in a large mental health service were investigated through in-depth interviews with six operation managers. The critical decision method in conjunction with diagrammatic elicitation was used to capture descriptions of these projects. Stage-gate design models were then formed to visually articulate, classify and characterise different service development practices. Results Projects were grouped into three categories according to design process patterns: new service introduction and service integration; service improvement; service closure. Three common design stages: problem exploration, idea generation and solution evaluation - were then compared across the design process patterns. Consistent across projects were a top-down, policy-driven approach to exploration, underexploited idea generation and implementation-based evaluation. Conclusions This study provides insight into where and how good design practices can contribute to the improvement of current service development practices. Specifically, the following suggestions for future service development practices are made: genuine user needs analysis for exploration; divergent thinking and innovative culture for idea generation; and fail-safe evaluation prior to implementation. Better training for managers through partnership working with design experts and researchers could be beneficial. PMID:24438471
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Veneziano, Louis; Veneziano, Carol
2002-09-01
In order to provide an objective measure of problematic behavioral patterns among juvenile delinquents in residential facilities, the Dormitory Observation Report (DOR) was developed. The DOR assesses 11 dimensions of problematic behavioral patterns (e.g., physical assaultiveness, manipulativeness), as well as three dimensions of desirable behavioral patterns expected in an institutional setting (e.g., independent functioning, personal hygiene, care of surroundings). Empirical study regarding the reliability and validity of the DOR are reported, and the results are discussed in terms of the theoretical and practical implications of this instrument. Copyright 2002 Wiley Periodicals, Inc.
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Enabling a Community of Practice: Results of the LSCHE Web Portal Survey
ERIC Educational Resources Information Center
Hoff, Meagan A.; Hodges, Russ; Lin, Yuting; McConnell, Michael C.
2017-01-01
The study explored usage patterns of the Learning Support Centers in Higher Education (LSCHE) web portal, an open educational resource (OER) that serves learning support center professionals. Results of an online survey taken by LSCHE users (N = 41) tracked their self-reported usage and perceived value of resources on the web portal, which…
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Damiano, Stephanie R; Hart, Laura M; Paxton, Susan J
2016-06-01
Parental feeding practices have been linked to eating and weight status in young children; however, more research is needed to understand what influences these feeding practices. The aim of this study was to examine how parental feeding practices that are linked to unhealthy eating patterns in young children, are related to parental body image and eating knowledge, attitudes, and behaviours . Participants were 330 mothers of a 2- to 6-year-old child. Mothers completed measures of knowledge of child body image and eating patterns, overvaluation of weight and shape, internalization of general media and athletic ideals, dieting, and parental feeding practices. Higher maternal knowledge of strategies to promote positive child body image and eating patterns predicted lower weight restriction, instrumental, emotional, and pushing to eat feeding practices. Overvaluation of weight and shape predicted use of fat restriction. Maternal internalization of the athletic ideal predicted instrumental and pushing to eat feeding practices. As these feeding practices have been associated with long-term risk of children's weight gain and/or disordered eating, these findings highlight the need for prevention interventions to target knowledge, attitudes, and behaviours of parents of pre-schoolers. Copyright © 2016 Elsevier Ltd. All rights reserved.
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Is Reading Instruction Evidence-Based? Analyzing Teaching Practices Using T-Patterns.
Suárez, Natalia; Sánchez, Carmen R; Jiménez, Juan E; Anguera, M Teresa
2018-01-01
The main goal of this study was to analyze whether primary teachers use evidence-based reading instruction for primary-grade readers. The study sample consisted of six teachers whose teaching was recorded. The observation instrument used was developed ad hoc for this study. The recording instrument used was Match Vision Studio. The data analysis was performed using SAS, GT version 2.0 E, and THEME. The results indicated that the teaching practices used most frequently and for the longest duration were: feedback (i.e., correcting the student when reading); fluency (i.e., individual and group reading, both out loud and silently, with and without intonation); literal or inference comprehension exercises (i.e., summarizing, asking questions); and use of educational resources (i.e., stories, songs, poems). Later, we conducted analyses of T-Patterns that showed the sequence of instruction in detail. We can conclude that <50% of the teaching practices used by the majority of teachers were based on the recommendations of the National Reading Panel (NRP). Only one teacher followed best practices. The same was the case for instructional time spent on the five essential components of reading, with the exception of teacher E., who dedicated 70.31% of class time implementing best practices. Teaching practices (i.e., learners' activities) designed and implemented to exercise and master alphabetic knowledge and phonological awareness skills were used less frequently in the classroom.
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Is Reading Instruction Evidence-Based? Analyzing Teaching Practices Using T-Patterns
Suárez, Natalia; Sánchez, Carmen R.; Jiménez, Juan E.; Anguera, M. Teresa
2018-01-01
The main goal of this study was to analyze whether primary teachers use evidence-based reading instruction for primary-grade readers. The study sample consisted of six teachers whose teaching was recorded. The observation instrument used was developed ad hoc for this study. The recording instrument used was Match Vision Studio. The data analysis was performed using SAS, GT version 2.0 E, and THEME. The results indicated that the teaching practices used most frequently and for the longest duration were: feedback (i.e., correcting the student when reading); fluency (i.e., individual and group reading, both out loud and silently, with and without intonation); literal or inference comprehension exercises (i.e., summarizing, asking questions); and use of educational resources (i.e., stories, songs, poems). Later, we conducted analyses of T-Patterns that showed the sequence of instruction in detail. We can conclude that <50% of the teaching practices used by the majority of teachers were based on the recommendations of the National Reading Panel (NRP). Only one teacher followed best practices. The same was the case for instructional time spent on the five essential components of reading, with the exception of teacher E., who dedicated 70.31% of class time implementing best practices. Teaching practices (i.e., learners' activities) designed and implemented to exercise and master alphabetic knowledge and phonological awareness skills were used less frequently in the classroom. PMID:29449818
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Mirror neuron system and observational learning: behavioral and neurophysiological evidence.
Lago-Rodriguez, Angel; Lopez-Alonso, Virginia; Fernández-del-Olmo, Miguel
2013-07-01
Three experiments were performed to study observational learning using behavioral, perceptual, and neurophysiological data. Experiment 1 investigated whether observing an execution model, during physical practice of a transitive task that only presented one execution strategy, led to performance improvements compared with physical practice alone. Experiment 2 investigated whether performing an observational learning protocol improves subjects' action perception. In experiment 3 we evaluated whether the type of practice performed determined the activation of the Mirror Neuron System during action observation. Results showed that, compared with physical practice, observing an execution model during a task that only showed one execution strategy does not provide behavioral benefits. However, an observational learning protocol allows subjects to predict more precisely the outcome of the learned task. Finally, intersperse observation of an execution model with physical practice results in changes of primary motor cortex activity during the observation of the motor pattern previously practiced, whereas modulations in the connectivity between primary and non primary motor areas (PMv-M1; PPC-M1) were not affected by the practice protocol performed by the observer. Copyright © 2013 Elsevier B.V. All rights reserved.
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Carnivorous arthropods after spring flood
USDA-ARS?s Scientific Manuscript database
Spring flooding is a common practice in Wisconsin cranberries, but flooding as insect control produces variable results among marshes. This project is aimed at figuring out why it works, and why it sometimes doesn’t. We have focused on tracking arthropod populations to explain the observed patterns ...
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Sekerel, Bulent Enis; Seyhun, Oznur
2017-09-01
To evaluate practice patterns in the management of cow's milk protein allergy (CMPA) and associated economic burden of disease on health service in Turkey. This study was based on experts' views on the practice patterns in management of CMPA manifesting with either proctocolitis or eczema symptoms and, thereby, aimed to estimate economic burden of CMPA. Practice patterns were determined via patient flow charts developed by experts using the modified Delphi method for CMPA presented with proctocolitis and eczema. Per patient total 2-year direct medical costs were calculated, including cost items of physician visits, laboratory tests, and treatment. According to the consensus opinion of experts, 2-year total direct medical cost from a payer perspective and societal perspective was calculated to be $US2,116.05 and $US2,435.84, respectively, in an infant with CMPA presenting with proctocolitis symptoms, and $US4,001.65 and $US4,828.90, respectively, in an infant with CMPA presenting with eczema symptoms. Clinical nutrition was the primary cost driver that accounted for 89-92% of 2-year total direct medical costs, while the highest total direct medical cost estimated from a payer perspective and societal perspective was noted for the management of an exclusively formula-fed infant presenting either with proctocolitis ($US3,743.85 and $US4,025.63, respectively) or eczema ($US6,854.10 and $US7,917.30, respectively). The first line use of amino acid based formula (AAF) was associated with total direct cost increment $US1,848.08 and $US3,444.52 in the case of proctocolitis and eczema, respectively. Certain limitations to this study should be considered. First, being focused only on direct costs, the lack of data on indirect costs or intangible costs of illness seems to be a major limitation of the present study, which likely results in a downward bias in the estimates of the economic cost of CMPA. Second, given the limited number of studies concerning epidemiology and practice patterns in CMPA in Turkey, use of expert clinical opinion of the panel members rather than real-life data on practice patterns that were used to identify direct medical costs might raise a concern with the validity and reliability of the data. Also, while this was a three-step study with six experts included in the first stage (developing local guidelines for diagnosis, treatment, and follow-up of infants with CMPA in Turkey) and 410 pediatricians included in the second stage (a cross-sectional questionnaire-survey to determine pediatricians' awareness and practice of CMPA in infants and children), only four members were included in the present Delphi panel, which allows a limited discussion. Third, lack of sensitivity analyses and exclusion of indirect costs and costs related to alterations in quality of life, behavior of infants, and general well-being of infants and their parents from the cost-analysis seems to be another limitation that may have caused under-estimation of relative cost-effectiveness of the formulae. Fourth, calculation of costs per local guidelines rather than real-life practice patterns is another limitation that, otherwise, would extend the knowledge achieved in the current study. Notwithstanding these limitations, the present expert panel provided practice patterns in the management of CMPA and an estimate of the associated costs, depending on the symptom profile at initial admission for the first time in Turkey. In conclusion, in providing the first health economic data on CMPA in Turkey, the findings revealed that CMPA imposes a substantial burden on the Turkish healthcare system from both a payer perspective and societal perspective, and indicated clinical nutrition as a primary cost driver. Management of infants presenting with eczema, exclusively formula-fed infants, and first line use of AAF were associated with higher estimates for 2-year direct medical costs.
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Wides, Cynthia D.; Brody, Harvey A.; Alexander, Charles J.; Gansky, Stuart A.; Mertz, Elizabeth A.
2013-01-01
The University of California, San Francisco School of Dentistry established the Dental Postbaccalaureate Program in 1998 to provide reapplication assistance to students from economically and/or educationally disadvantaged backgrounds who were previously denied admission to dental school. The goals were to increase diversity in the dental school student population and improve access to dental services for underserved populations. This article assesses the program’s short-, mid-, and long-term outcomes and is the first to examine long-term practice patterns after a dental postbaccalaureate program. Data collected on all participant (n=94) demographics, pre/post-program DAT scores, and post-program dental school admission results were used to assess short- and mid-term outcomes. Long-term outcomes and practice patterns were assessed using results of a census survey administered between 2009 and 2011 to the participants who had completed dental school and been in practice for at least two years (n=57). The survey had a response rate of 93 percent (n=53). Descriptive statistical techniques were used to examine the responses and to compare them to U.S. Census Bureau data and nationally available practice data for new dental graduates. Program participants’ DAT scores improved by an average of two points, and 98 percent were accepted to dental school. All survey respondents were practicing dentistry, and 81 percent reported serving underserved populations. These participants treat more Medicaid recipients than do most dentists, and their patient population is more diverse than the general population. The outcomes demonstrate that the program’s graduates are increasing diversity in the dental student population and that their practices are providing access to care for underserved populations. PMID:23658398
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Effectiveness of conservation practices within watersheds: Case study in tile-drained systems
USDA-ARS?s Scientific Manuscript database
The effectiveness of conservation practices are governed in part by the spatial and temporal patterns of water flow as runoff and subsurface (tile) drainage. The variability in patterns of nitrate loss were examined using data from different sized catchments with four CEAP watersheds located in cent...
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Thickened Liquids: Practice Patterns of Speech-Language Pathologists
ERIC Educational Resources Information Center
Garcia, Jane Mertz; Chambers, Edgar, IV; Molander, Michelle
2005-01-01
This study surveyed the practice patterns of speech-language pathologists in their use of thickened liquids for patients with swallowing difficulties. A 25-item Internet survey about thickened liquids was posted via an e-mail list to members of the American Speech-Language-Hearing Association Division 13, Swallowing and Swallowing Disorders…
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Yiee, Jenny H.; Tasian, Gregory E.; Copp, Hillary L.
2011-01-01
Objectives Hydronephrosis is the most common abnormality found on prenatal ultrasound. The utility of prophylactic antibiotics in the postnatal management of this condition is controversial. No study has assessed practice patterns of general pediatricians in the management of prenatally-detected hydronephrosis. Methods An 18 question survey was sent to a random cross-sectional national sample of pediatricians from the American Medical Association Masterfile. Participants answered questions regarding practice location and type, practice experience, frequency of cases seen, familiarity with the literature, use of antibiotics, work-up of hydronephrosis, and specialist referral. Multivariate logistic regression identified factors associated with prescribing antibiotics. Results 244 of 461 (53%) subjects responded. 56% routinely prescribe antibiotics for prenatally-detected hydronephrosis. 57% perform postnatal work-up themselves. Of these, 98% routinely order ultrasounds while ~40% routinely order voiding cystourethrograms. 94% have specialists readily available, but only 41% always refer to a specialist. On multivariate logistic regression, those who believe prophylactic antibiotics to be beneficial are significantly more likely to prescribe antibiotics compared with those who have not read the literature (OR 6.1, 95%CI 2–15). Those without specialist consultation readily available have an increased odds of starting prophylactic antibiotics compared with those who have consultation available (OR 7.2, 95%CI 1.3–39). Conclusion Most pediatricians initiate postnatal management of prenatally-detected hydronephrosis, therefore pediatricians truly are gatekeepers to children with this condition. Knowledge of practice patterns is crucial for the dissemination of evidence-based information to the appropriate providers and enables us to learn more about the utility of antibiotic prophylaxis in future studies. PMID:21696811
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Effects of holistic nursing course: a paradigm shift for holistic health practices.
Downey, Marty
2007-06-01
A study of an undergraduate course in holistic nursing was conducted to determine its impact on personal and professional health care practices. A mixed method design was used to examine responses on a sample of 200 participants. Results indicated a positive personal impact with continued application of concepts into professional health practices. Personal and professional nursing practices were influenced from 1 to 7 years after completing the holistic nursing course. After introduction of the concepts of self-care and holistic approaches to health, students and graduates experienced a shift in values and beliefs related to their own health practices. Continued exposure to holistic practices creates a pattern of awareness toward health that affects future personal and professional nursing practice, creating a paradigm shift for emerging nursing students and graduates from the course. This affects the manner in which nurses meet the needs of their clients in a variety of settings.
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Jaric, S; Corcos, D M; Gottlieb, G L; Ilic, D B; Latash, M L
1994-01-01
Predictions of two views on single-joint motor control, namely programming of muscle force patterns and equilibrium-point control, were compared with the results of experiments with reproduction of movement distance and final location during fast unidirectional elbow flexions. Two groups of subjects were tested. The first group practiced movements over a fixed distance (36 degrees), starting from seven different initial positions (distance group, DG). The second group practiced movements from the same seven initial positions to a fixed final location (location group, LG). Later, all the subjects were tested at the practiced task with their eyes closed, and then, unexpectedly for the subjects, they were tested at the other, unpracticed task. In both groups, the task to reproduce final position had lower indices of final position variability than the task to reproduce movement distance. Analysis of the linear regression lines between initial position and final position (or movement distance) also demonstrated a better (more accurate) performance during final position reproduction than during distance reproduction. The data are in a good correspondence with the predictions of the equilibrium-point hypothesis, but not with the predictions of the force-pattern control approach.
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Welch, Cailee E.; Van Lunen, Bonnie L.; Hankemeier, Dorice A.; Wyant, Aimee L.; Mutchler, Jessica M.; Pitney, William A.; Hays, Danica G.
2014-01-01
Context: The release of evidence-based practice (EBP) Web-based learning modules to the membership of the National Athletic Trainers' Association has provided athletic trainers (ATs) the opportunity to enhance their knowledge of the various EBP concepts. Whereas increasing the knowledge of EBP among ATs is important, assessing whether this newfound knowledge is being translated into clinical practice and didactic education is crucial. Objective: To explore the effectiveness of an educational intervention regarding EBP on the didactic instruction patterns of athletic training educators and the clinical practice behaviors of clinicians. Design: Qualitative study. Setting: Individual telephone interviews. Patients or Other Participants: A total of 25 ATs (12 educators, 13 clinicians; experience as an AT = 16.00 ± 9.41 years) were interviewed. Data Collection and Analysis: We conducted 1 individual telephone interview with each participant. After transcription, the data were analyzed and coded into common themes and categories. Triangulation of the data occurred via the use of multiple researchers and member checking to confirm the accuracy of the data. Results: Participants perceived the EBP Web-based modules to produce numerous outcomes regarding education and clinical practice. These outcomes included perceived knowledge gain among participants, an increase in the importance and scope of EBP, a positive effect on educators' didactic instruction patterns and on instilling value and practice of EBP among students, and an enhanced ability among clinicians to implement EBP within clinical practice. However, some clinicians reported the Web-based modules had no current effect on clinical practice. Conclusions: Although the EBP Web-based modules were successful at enhancing knowledge among ATs, translation of knowledge into the classroom and clinical practice remains limited. Researchers should aim to identify effective strategies to help ATs implement EBP concepts into didactic education and clinical practice. PMID:24576306
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Sabus, Carla; Spake, Ellen
2016-01-01
Background and purpose New ideas, methods, and technologies spread through cultures through typical patterns described by diffusion of innovation (DOI) theory. Professional cultures, including the physical therapy profession, have distinctive features and traditions that determine the adoption of practice innovation. The Consolidated Framework for Implementation Research (CFIR) proposes a framework of innovation implementation specific to health care services. While the CFIR has been applied to medical and nursing practice, it has not been extended to rehabilitation professions. The purpose of this qualitative study was to verify the CFIR factors in outpatient physical therapy practice. Design Through a nomination process of area rehabilitation managers and area directors of clinical education, 2 exemplar, outpatient, privately owned physical therapy clinics were identified as innovation practices. A total of 18 physical therapists (PTs), including 3 owners and a manager, participated in the study. Methods The 2 clinics served as case studies within a qualitative approach of directed content analysis. Data were collected through observation, spontaneous, unstructured questioning, workflow analysis, structured focus group sessions, and artifact analysis including clinical documents. Focus group data were transcribed. All the data were analyzed and coded among 4 investigators. Results Through data analysis and alignment with literature in DOI theory in health care practice, the factors that determine innovation adoption were verified. The phenomena of implementation in PT practice are largely consistent with models of implementation in health care service. Within the outpatient practices studied, patient-centered care and collaborative learning were foundational elements to diffusion of an innovation. Conclusion Innovation in outpatient physical therapy practice can be understood as a social process situated within the culture of the physical therapy professional that follows predictable patterns that strongly align with DOI theory and the CFIR. PMID:29355199
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Citizen science: A new perspective to evaluate spatial patterns in hydrology.
NASA Astrophysics Data System (ADS)
Koch, J.; Stisen, S.
2016-12-01
Citizen science opens new pathways that can complement traditional scientific practice. Intuition and reasoning make humans often more effective than computer algorithms in various realms of problem solving. In particular, a simple visual comparison of spatial patterns is a task where humans are often considered to be more reliable than computer algorithms. However, in practice, science still largely depends on computer based solutions, which is inevitable giving benefits such as speed and the possibility to automatize processes. This study highlights the integration of the generally underused human resource into hydrology. We established a citizen science project on the zooniverse platform entitled Pattern Perception. The aim is to employ the human perception to rate similarity and dissimilarity between simulated spatial patterns of a hydrological catchment model. In total, the turnout counts more than 2,800 users that provided over 46,000 classifications of 1,095 individual subjects within 64 days after the launch. Each subject displays simulated spatial patterns of land-surface variables of a baseline model and six modelling scenarios. The citizen science data discloses a numeric pattern similarity score for each of the scenarios with respect to the reference. We investigate the capability of a set of innovative statistical performance metrics to mimic the human perception to distinguish between similarity and dissimilarity. Results suggest that more complex metrics are not necessarily better at emulating the human perception, but clearly provide flexibility and auxiliary information that is valuable for model diagnostics. The metrics clearly differ in their ability to unambiguously distinguish between similar and dissimilar patterns which is regarded a key feature of a reliable metric.
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1993-01-01
understanding of the disease and study the effect media coverage was having on young women’s use of menstrual hygiene products . Brooks-Gunn and Ruble...a role. In this study, the use of hygiene products , sexual practices, and other personal health history practices were not significant in the...tampon use patterns among women of childbearing age in north central Florida? Women were asked 29 what types of feminine hygiene products they used to
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Feng, Ziang; Gao, Zhan; Zhang, Xiaoqiong; Wang, Shengjia; Yang, Dong; Yuan, Hao; Qin, Jie
2015-09-01
Digital shearing speckle pattern interferometry (DSSPI) has been recognized as a practical tool in testing strain. The DSSPI system which is based on temporal analysis is attractive because of its ability to measure strain dynamically. In this paper, such a DSSPI system with Wollaston prism has been built. The principles and system arrangement are described and the preliminary experimental result of the displacement-derivative test of an aluminum plate is shown with the wavelet transformation method and the Fourier transformation method. The simulations have been conducted with the finite element method. The comparison of the results shows that quantitative measurement of displacement-derivative has been realized.
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Low-lift-to-drag-ratio approach and landing studies using a CV-990 airplane
NASA Technical Reports Server (NTRS)
Kock, B. M.; Fulton, F. L.; Drinkwater, F. J., III
1972-01-01
The results are presented of a flight-test program utilizing a CV-990 airplane, flow in low-lift-to-drag-ratio (L/D) configurations, to simulate terminal area operation, approach, and landing of large unpowered vehicles. The results indicate that unpowered approaches and landings are practical with vehicles of the size and performance characteristics of the proposed shuttle vehicle. Low L/D landings provided touchdown dispersion patterns acceptable for operation on runways of reasonable length. The dispersion pattern was reduced when guidance was used during the final approach. High levels of pilot proficiency were not required for acceptable performance.
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Chen, Elizabeth S.; Stetson, Peter D.; Lussier, Yves A.; Markatou, Marianthi; Hripcsak, George; Friedman, Carol
2007-01-01
Clinical knowledge, best evidence, and practice patterns evolve over time. The ability to track these changes and study practice trends may be valuable for performance measurement and quality improvement efforts. The goal of this study was to assess the feasibility and validity of methods to generate and compare trends in biomedical literature and clinical narrative. We focused on the challenge of detecting trends in medication usage over time for two diseases: HIV/AIDS and asthma. Information about disease-specific medications in published randomized control trials and discharge summaries at New York-Presbyterian Hospital over a ten-year period were extracted using Natural Language Processing. This paper reports on the ability of our semi-automated process to discover disease-drug practice pattern trends and interpretation of findings across the biomedical and clinical text sources. PMID:18693810
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Japanese haemodialysis anaemia management practices and outcomes (1999–2006): results from the DOPPS
Akizawa, Tadao; Pisoni, Ronald L.; Akiba, Takashi; Saito, Akira; Fukuhara, Shunichi; Asano, Yasushi; Hasegawa, Takeshi; Port, Friedrich K.; Kurokawa, Kiyoshi
2008-01-01
Background. Japanese haemodialysis (HD) patients not only have a very low mortality and hospitalization risk but also low haemoglobin (Hb) levels. Internationally, anaemia is associated with mortality, hospitalization and health-related quality of life (QoL) measures of HD patients. Methods. Longitudinal data collected from 1999 to 2006 from 60 to 64 representative Japanese dialysis units participating in the Dialysis Outcomes and Practice Patterns Study (DOPPS) were used to describe anaemia management practices and outcomes for Japanese HD patients. Results. From 1999 to 2006, patient mean Hb increased from 9.7 g/dl to 10.4 g/dl, and the percentage of facilities with median Hb ≥10 g/dl increased from 27% to 75%. Hb was measured in the supine position for 90% of patients, resulting in substantially lower reported Hb values than those seen in other countries. As of 2006, erythropoietin (Epo) was prescribed to 83% of HD patients; mean Epo dose was 5231 units/week; intravenous (IV) iron use was 33% and median IV iron dose was 160 mg/month. Many patient- and facility-level factors were significantly related to higher Hb. A consistent overall pattern of lower mortality risk with higher baseline Hb levels was seen (RR = 0.89 per 1 g/dl higher Hb, P = 0.003). Facilities with median Hb ≥10.4 displayed a lower mortality risk (RR = 0.77, P = 0.03) versus facility median Hb <10.4 g/dl. Lower Hb levels were not significantly related to hospitalization risk, but were associated with lower QoL scores. Conclusions. These results provide detailed information on anaemia management practices in Japan and the relationships of anaemia control with outcomes, with implications of anaemia management worldwide. PMID:18577535
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Setting Instructional Expectations: Patterns of Principal Leadership for Middle School Mathematics
ERIC Educational Resources Information Center
Katterfeld, Karin
2013-01-01
Principal instructional leadership has been found to support improved instruction. However, the methods through which principal leadership influences classroom instruction are less clear. This study investigates how principals' leadership may predict the expectations that mathematics teachers perceive for classroom practice. Results from a…
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Citizen science: A new perspective to advance spatial pattern evaluation in hydrology.
Koch, Julian; Stisen, Simon
2017-01-01
Citizen science opens new pathways that can complement traditional scientific practice. Intuition and reasoning often make humans more effective than computer algorithms in various realms of problem solving. In particular, a simple visual comparison of spatial patterns is a task where humans are often considered to be more reliable than computer algorithms. However, in practice, science still largely depends on computer based solutions, which inevitably gives benefits such as speed and the possibility to automatize processes. However, the human vision can be harnessed to evaluate the reliability of algorithms which are tailored to quantify similarity in spatial patterns. We established a citizen science project to employ the human perception to rate similarity and dissimilarity between simulated spatial patterns of several scenarios of a hydrological catchment model. In total, the turnout counts more than 2500 volunteers that provided over 43000 classifications of 1095 individual subjects. We investigate the capability of a set of advanced statistical performance metrics to mimic the human perception to distinguish between similarity and dissimilarity. Results suggest that more complex metrics are not necessarily better at emulating the human perception, but clearly provide auxiliary information that is valuable for model diagnostics. The metrics clearly differ in their ability to unambiguously distinguish between similar and dissimilar patterns which is regarded a key feature of a reliable metric. The obtained dataset can provide an insightful benchmark to the community to test novel spatial metrics.
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Maternal Dietary Patterns and Practices and Birth Weight in Northern Ghana
Jahn, Albrecht
2016-01-01
Background Adequate maternal nutrition is a key factor for achieving good pregnancy outcomes. Moreover, inadequate dietary intake during pregnancy is considered an important contributor to maternal malnutrition in developing countries. Although some studies have examined the effect of the entire diet on birth outcome, most studies have been very narrow because they considered the effect of single nutrient. The single nutrient approach is a major setback because usually several nutrient deficiencies are more likely to occur than single deficiencies especially in low-income settings. Objectives The main aim of this study was to investigate the association between maternal dietary patterns, and practices and birth weight in Northern Ghana. Participant Settings A facility-based cross-sectional survey was performed in two districts in the Northern Region of Ghana. The selected districts were the Tamale Metropolis and Savelugu-Nanton District. These districts were purposively sampled to represent a mix of urban, peri-urban and rural populations, therefore ensuring that the distribution in social groups of the study population was similar to the entire population of the region. In all, 578 mothers who were drawing antenatal and postnatal care services were interviewed using a questionnaire, which asked the mothers about their frequency of consumption of individual foods per week since they became pregnant or when they were pregnant. Statistical Analysis We determined dietary patterns by applying a factor analysis with a varimax rotation using STATA. Multivariate analysis was used to establish association between maternal factors and dietary patterns. Logistic regression was used to assess the association between dietary practices and patterns and birth weight. Results Women who ate outside the home twice a week (OR = 1.6 & 95% CI; 1.1–2.45, P; 0.017) and those who practiced ‘pica’ (OR = 1.7 & 95% CI; 1.16–2.75, P; 0.008) had increased odds for low birth. Two dietary patterns were identified—namely ‘health conscious’ and ‘non-health conscious’. Health conscious diet (OR = 0.23 95% CI 0.12–0.45 per standard deviation change in scores, P; <0.0001) and dietary diversity score (OR = 0.10 95% CI 0.04–0.13 per standard deviation change in scores, P; <0.0001) showed a protective effect for low birth weight respectively after adjusting for gestational age. Conclusion Mothers who practiced good nutrition such as consuming foods across and within the various food groups were less likely to have low birth weight babies. Our findings buttress the importance of optimal nutrition during pregnancy. PMID:27611597
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Temporal and geographic patterns in population trends of brown-headed cowbirds
Peterjohn, B.G.; Sauer, J.R.; Schwarz, S.
2000-01-01
The temporal and geographic patterns in the population trends of Brown-headed Cowbirds are summarized from the North American Breeding Bird Survey. During 1966-1992, the survey-wide population declined significantly, a result of declining populations in the Eastern BBS Region, southern Great Plains, and the Pacific coast states. Increasing populations were most evident in the northern Great Plains. Cowbird populations were generally stable or increasing during 1966-1976, but their trends became more negative after 1976. The trends in cowbird populations were generally directly correlated with the trends of both host and nonhost species, suggesting that large-scale factors such as changing weather patterns, land use practices, or habitat availability were responsible for the observed temporal and geographic patterns in the trends of cowbirds and their hosts.
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A Descriptive Study of the Practice Patterns of Massage New Zealand Massage Therapists
Smith, Joanna M.; Sullivan, S. John; Baxter, G. David
2011-01-01
Background: Massage therapy has grown in popularity, yet little is known globally or in New Zealand about massage therapists and their practices. Purpose and Setting: The aims of this study were to describe the practice patterns of trained Massage New Zealand massage therapists in New Zealand private practice, with regard to therapist characteristics; practice modes and settings, and therapy characteristics; referral patterns; and massage therapy as an occupation. Research Design and Participants: A survey questionnaire was mailed to 66 trained massage therapist members of Massage New Zealand who were recruiting massage clients for a concurrent study of massage therapy culture. Results: Most massage therapists were women (83%), NZ European (76%), and holders of a massage diploma qualification (89%). Massage therapy was both a full- (58%) and part-time (42%) occupation, with the practice of massage therapy being the only source of employment for 70% of therapists. Nearly all therapists (94%) practiced massage for more than 40 weeks in the year, providing a median of 16 – 20 hours of direct client care per week. Most massage therapists worked in a “solo practice” (58%) and used a wide and active referral network. Almost all therapists treated musculoskeletal symptoms: the most common client issues or conditions treated were back pain/problem (99%), neck/shoulder pain/problem (99%), headache or migraine (99%), relaxation and stress reduction (96%), and regular recovery or maintenance massage (89%). The most frequent client fee per treatment was NZ$60 per hour in a clinic and NZ$1 per minute at a sports event or in the workplace. Therapeutic massage, relaxation massage, sports massage, and trigger-point therapy were the most common styles of massage therapy offered. Nearly all massage therapists (99%) undertook client assessment; 95% typically provided self-care recommendations; and 32% combined other complementary and alternative medicine therapies with their massage consultations. Conclusions: This study provides new information about the practice of massage therapy by trained massage therapists. It will help to inform the massage industry and other health care providers, potential funders, and policymakers about the provision of massage therapy in the NZ health care system. PMID:21589692
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Goal setting education and counseling practices of diabetes educators.
Malemute, Charlene L; Shultz, Jill Armstrong; Ballejos, Miriam; Butkus, Sue; Early, Kathaleen Briggs
2011-01-01
The purpose of this study was to identify goal setting education practices used by diabetes educators working with type 2 diabetes patients. Data were collected by a mail questionnaire with 179 diabetes educators purposively selected from the 2008 American Association of Diabetes Educators membership listing. Many diabetes educators (52%) reported that more than 75% of their patients set goals for diabetes control. Independent factor patterns for the frequency of information collected from the patient for the first diabetes education session showed that educators either focused on patients' self-management practices (exercise and dietary practices, knowledge, and social impacts of diabetes) or issues with learning about self-management, such as understanding the patient's learning style and motivation for managing diabetes. Factor patterns overall showed diverse approaches to working with patients, including strategies used with patients struggling with dietary goals and the importance of tasks to complete during the first patient session. Although most educators reported practices that were largely patient centered as promoted by the American Diabetes Association (ADA) and models of chronic disease management, patterns of practice suggest that diabetes educators vary considerably in how they apply education practices, especially with dietary self-management education.
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Exploring the Role of Self-Esteem and Parenting Patterns on Alcohol Use and Abuse Among Adolescents
Glozah, Franklin N.
2014-01-01
The type of parental child-rearing practices used by parents and guardians substantially influence children’s self-esteem and consequently their decision to engage in alcohol use, its abuse. The aim of this study was to explore the role of self-esteem and parenting patterns on alcohol use and abuse among adolescents. Three hundred and sixteen boys and girls in Senior High Schools completed self-report questionnaires assessing self-esteem, parenting patterns and alcohol use and abuse. The results showed that while girls reported lesser self-esteem than boys, boys reported higher levels of alcohol use and abuse than girls. Also, authoritative parenting pattern had a positive effect on self-esteem and a negative effect on alcohol use. On the other hand, authoritarian and permissive parenting patterns had negative effects on self-esteem and positive effects on alcohol use, with slight variations. These results provide valuable information regarding strategies aimed at fostering parent-child relationship and rapport with the ultimate aim of bolstering the self-esteem of adolescents to subsequently eschew insalubrious behaviour, particularly alcohol use and abuse. PMID:26973951
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Exploring the Role of Self-Esteem and Parenting Patterns on Alcohol Use and Abuse Among Adolescents.
Glozah, Franklin N
2014-11-06
The type of parental child-rearing practices used by parents and guardians substantially influence children's self-esteem and consequently their decision to engage in alcohol use, its abuse. The aim of this study was to explore the role of self-esteem and parenting patterns on alcohol use and abuse among adolescents. Three hundred and sixteen boys and girls in Senior High Schools completed self-report questionnaires assessing self-esteem, parenting patterns and alcohol use and abuse. The results showed that while girls reported lesser self-esteem than boys, boys reported higher levels of alcohol use and abuse than girls. Also, authoritative parenting pattern had a positive effect on self-esteem and a negative effect on alcohol use. On the other hand, authoritarian and permissive parenting patterns had negative effects on self-esteem and positive effects on alcohol use, with slight variations. These results provide valuable information regarding strategies aimed at fostering parent-child relationship and rapport with the ultimate aim of bolstering the self-esteem of adolescents to subsequently eschew insalubrious behaviour, particularly alcohol use and abuse.
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Zhao, Hongyu; Zhang, Xiaohui
2017-01-01
The current study used mixed methods to research pre-service teachers’ professional identity. Ninety-eight pre-service teachers were investigated and twelve teachers were interviewed in China. The results were as follows: (1) The results of quantitative data showed that compared with before the field teaching practice, pre-service teachers’ professional identity increased after the field teaching practice—specifically, intrinsic value identity increased, and extrinsic value identity did not significantly change; (2) The results of qualitative data validated and elaborated the results of quantitative data in more detail with regard to changes in professional identity. Specifically, compared with before the field teaching practice, intrinsic value identity including work content, work pattern, etc., increased and extrinsic value identity including work environment, income, and social status, etc., did not significantly change after experiencing teaching practice; (3) The results of qualitative data also showed that mentor support at field school promoted the development of pre-service teachers’ professional identity. Moreover, the development of pre-service teachers’ professional identity during field teaching practice further promoted their professional commitment; that is, it promoted their emotional evaluation and belief in the teaching profession. The study discussed these results and proposed solutions and suggestions for future studies. PMID:28790956
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A Changing Health Care Environment: Its Impact on UCSF Graduates' Practice Patterns and Perceptions.
ERIC Educational Resources Information Center
Sauer, Barbara L.; Koda-Kimble, Mary Anne
1998-01-01
A survey of 754 University of California at San Francisco doctoral pharmacy graduates from 1980 to 1994 investigated how managed care affected practice patterns and perceptions of the profession. Graduates generally remained satisfied with their education and were optimistic about the profession. Although managed care has created a stressful…
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Marriage and Family Therapists and Psychotropic Medications: Practice Patterns from a National Study
ERIC Educational Resources Information Center
Hernandez, Barbara Couden; Doherty, William J.
2005-01-01
A national sample of marriage and family therapists (MFTs) was used to describe practice patterns of MFTs whose clients use psychotropics and to compare medicated and nonmedicated clients. Marriage and Family Therapists (n = 283) reported on 195 medicated and 483 nonmedicated adult clients. Clients (n = 375) rated their improvement and…
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Pattern Language Development in the Preparation of Inclusive Educators
ERIC Educational Resources Information Center
Bain, Alan; Lancaster, Julie; Zundans, Lucia
2008-01-01
Pattern language is the lexicon used to express the schema of a field of professional practice (Smethurst, 1997). This lexicon is frequently presumed to exist in communities of practice in educational settings, although the findings derived from the longitudinal study of schools (Elmore, 1996; Goodlad, 1984; Lortie, 1975; McLaughlin & Talbert,…
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ERIC Educational Resources Information Center
Jacobson, Linda; Rollins, S. Kwesi; Brown, Janet; Naviasky, Heather
2016-01-01
This "Patterns of Practice: Case Studies of Early Childhood Education & Family Engagement in Community Schools" report updates the community school case studies through a description of ongoing developments in Cincinnati, OH; Evansville, IN; Multnomah County, OR; and Tulsa, OK and adds to that knowledge base of early learning and…
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Patterns of Tasks, Patterns of Talk: L2 Literacy Building in University Spanish Classes
ERIC Educational Resources Information Center
Gleason, Jesse; Slater, Tammy
2017-01-01
Second language (L2) classroom research has sought to shed light on the processes and practices that develop L2 learners' abilities [Nunan, D. 2004. "Task-based language teaching." London: Continuum; Verplaetse, L. 2014. "Using big questions to apprentice students into language-rich classroom practices." "TESOL…
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Raterink, Ginger
2011-01-01
Nursing acknowledges critical thinking as an important guide to clinical decision making. Agreement on how to define, teach, and evaluate this skill is lacking. The purpose of this study was to evaluate critical thinking in practice using a survey that asked nurses to evaluate work-related factors that enhance or pose barriers to the use of critical thinking in practice. Results indicated that enhancers and barriers to practice included teamwork, staffing patterns, and staff and administrator support. A relationship with patients was the most satisfying factor, whereas paperwork was the least. Staff development educators must consider the work environment aspects that affect performance and create the life long learning needed for increased competency in practice.
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NASA Astrophysics Data System (ADS)
Li, Yi-hong; Bao, Yan-ping; Wang, Rui; Ma, Li-feng; Liu, Jian-sheng
2018-02-01
A water model and a high-speed video camera were utilized in the 300-t RH equipment to study the effect of steel flow patterns in a vacuum chamber on fast decarburization and a superior flow-pattern map was obtained during the practical RH process. There are three flow patterns with different bubbling characteristics and steel surface states in the vacuum chamber: boiling pattern (BP), transition pattern (TP), and wave pattern (WP). The effect of the liquid-steel level and the residence time of the steel in the chamber on flow patterns and decarburization reaction were investigated, respectively. The liquid-steel level significantly affected the flow-pattern transition from BP to WP, and the residence time and reaction area were crucial to evaluate the whole decarburization process rather than the circulation flow rate and mixing time. A superior flow-pattern map during the practical RH process showed that the steel flow pattern changed from BP to TP quickly, and then remained as TP until the end of decarburization.
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Knowing for Nursing Practice: Patterns of Knowledge and Their Emulation in Expert Systems
Abraham, Ivo L.; Fitzpatrick, Joyce J.
1987-01-01
This paper addresses the issue of clinical knowledge in nursing, and the feasibility of emulating this knowledge into expert system technology. The perspective on patterns of knowing for nursing practice, advanced by Carper (1978), serves as point of departure. The four patterns of knowing -- empirics, esthetics, ethics, personal knowledge -- are evaluated as to the extent to which they can be emulated in clinical expert systems, given constraints imposed by the current technology of these systems.
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Donnelly, Michael J; Lubrano, Lauren; Radabaugh, Carrie L; Lukela, Michael P; Friedland, Allen R; Ruch-Ross, Holly S
2015-11-01
There is no published literature about the med-peds hospitalist workforce, physicians dually trained in internal medicine and pediatrics. Our objective was to analyze this subset of physicians by using data from the American Academy of Pediatrics (AAP) workforce survey to assess practice patterns and workforce demographics. We hypothesized that demographic differences exist between hospitalists and nonhospitalists. The AAP surveyed med-peds physicians from the Society of Hospital Medicine and the AAP to define workforce demographics and patterns of practice. We compared self-identified hospitalists with nonhospitalist physicians on multiple characteristics. Almost one-half of the hospitalists self-identified as being both primary care physicians and hospitalists; we therefore also compared the physicians self-identifying as being both primary care physicians and hospitalists with those who identified themselves solely as hospitalists. Of 1321 respondents, 297 physicians (22.4%) self-reported practicing as hospitalists. Hospitalists were more likely than nonhospitalists to have been practicing<10 years (P<.001), be employed by a health care organization (P<.001), work>50 hours per week (P<.001), and see only adults (P<.001) or children (P=.03) in their practice rather than a mix of both groups. Most, 191/229 (83.4%), see both adults and children in practice, and 250/277 (90.3%) stated that their training left them well prepared to practice both adult and pediatric medicine. Med-peds hospitalists are more likely to be newer to practice and be employed by a health care organization than nonhospitalists and to report satisfaction that their training sufficiently prepared them to see adults and children in practice. Copyright © 2015 by the American Academy of Pediatrics.
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Huang, Stephanie; Huang, He
2018-04-01
Discrete, rapid (i.e., ballistic like) muscle activation patterns have been observed in ankle muscles (i.e., plantar flexors and dorsiflexors) of able-bodied individuals during voluntary posture control. This observation motivated us to investigate whether transtibial amputees are capable of generating such a ballistic-like activation pattern accurately using their residual ankle muscles in order to assess whether the volitional postural control of a powered ankle prosthesis using proportional myoelectric control via residual muscles could be feasible. In this paper, we asked ten transtibial amputees to generate ballistic-like activation patterns using their residual lateral gastrocnemius and residual tibialis anterior to control a computer cursor via proportional myoelectric control to hit targets positioned at 20% and 40% of maximum voluntary contraction of the corresponding residual muscle. During practice conditions, we asked amputees to hit a single target repeatedly. During testing conditions, we asked amputees to hit a random sequence of targets. We compared movement time to target and end-point accuracy. We also examined motor recruitment synchronization via time-frequency representations of residual muscle activation. The result showed that median end-point error ranged from -0.6% to 1% maximum voluntary contraction across subjects during practice, which was significantly lower compared to testing ( ). Average movement time for all amputees was 242 ms during practice and 272 ms during testing. Motor recruitment synchronization varied across subjects, and amputees with the highest synchronization achieved the fastest movement times. End-point accuracy was independent of movement time. Results suggest that it is feasible for transtibial amputees to generate ballistic control signals using their residual muscles. Future work on volitional control of powered power ankle prostheses might consider anticipatory postural control based on ballistic-like residual muscle activation patterns and direct continuous proportional myoelectric control.
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Mitchell, Jean M
2008-07-01
Although physician-owned specialty hospitals have become increasingly prevalent in recent years, little research has examined whether the financial incentives linked to ownership influence physicians' referral rates for services performed at the specialty hospital. We compared the practice patterns of physician owners of specialty hospitals in Oklahoma, before and after ownership, to the practice patterns of physician nonowners who treated similar cases over the same time period in Oklahoma markets without physician-owned specialty hospitals. We constructed episodes of care for injured workers with a primary diagnosis of back/spine disorders. We used pre-post comparisons and difference-in-differences analysis to evaluate changes in practice patterns for physician owners and nonowners over the time period spanned by the entry of the specialty hospital. Findings suggest the introduction of financial incentives linked to ownership coincided with a significant change in the practice patterns of physician owners, whereas such changes were not evident among physician nonowners. After physicians established ownership interests in a specialty hospital, the frequency of use of surgery, diagnostic, and ancillary services used in the treatment of injured workers with back/spine disorders increased significantly. Physician ownership of specialty hospitals altered the frequency of use for an array of procedures rendered to patients treated at these hospitals. Given the growth in physician-owned specialty hospitals, these findings suggest that health care expenditures will be substantially greater for patients treated at these institutions relative to persons who obtain care from nonself-referral providers.
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Abera, Goitom Gigar; Alemayehu, Yibeltal Kiflie; Herrin, Jeph
2017-11-10
Physicians who work in the private sector while also holding a salaried job in a public hospital, known as "dual practice," is one of the main retention strategies adopted by the government of Ethiopia. Dual practice was legally endorsed in Tigray National Regional State, Ethiopia in 2010. Therefore, the aim of this study was to explore the extent of dual practice, reasons why physicians engage in it, and its effects on public hospital services in this state in northern Ethiopia. A cross-sectional study using mixed methods was conducted from February to March 2011 in six geographically representative public hospitals of Tigray National Regional State. A semi-structured, self-administered questionnaire was distributed to all physicians working in the study hospitals, and an interviewer-administered, structured questionnaire was used to collect data from admitted patients. Focus group discussions were conducted with hospital governing boards. Quantitative and qualitative data were used in the analysis. Data were collected from 31 physicians and 449 patients in the six study hospitals. Six focus group discussions were conducted. Twenty-eight (90.3%) of the physicians were engaged in dual practice to some extent: 16 (51.6%) owned private clinics outside the public hospital, 5 (16.1%) worked part-time in outside private clinics, and 7 (22.6%) worked in the private wing of public hospitals. Income supplementation was the primary reason for engaging in dual practice, as reported by 100% of the physicians. The positive effects of dual practice from both managers' and physicians' perspectives were physician retention in the public sector. Ninety-one patients (20.3%) had been referred from a private clinic immediately prior to their current admission-a circular diversion pattern. Eighteen (19.8%) of the diverted patients reported that health workers in the public hospitals diverted them. Circular diversion pattern of referral system is the key negative consequence of dual practice. Physicians and hospital managers agreed that health worker retention was the main positive consequence of dual practice upon the public sector, and banning dual practice would result in a major loss of senior physicians. The motive behind the circular diversion pattern described by patients should be studied further.
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Practice patterns of graduates of 2- and 3-year family medicine programs: in Ontario, 1996 to 2004.
Green, Michael; Birtwhistle, Richard; Macdonald, Ken; Kane, John; Schmelzle, Jason
2009-09-01
To compare patterns of practice between graduates of core 2-year family medicine (FM) training programs and those completing an additional postgraduate year (PGY3) of training. Retrospective cohort study using administrative data from the Ontario Health Insurance Plan. Ontario. Graduates of Ontario FM residency programs from 1996 to 2002 who provided insured services in Ontario for 1 or more fiscal years between 1996 and 2004. Proportion of physician years of service in which a minimum number of services were provided in each of the following categories: anesthesia, emergency medicine (EM), home visits, hospital visits, nursing home visits, intrapartum obstetrics, palliative care, office-only practice, and rural locations, as well as deciles for proportion of billings for emergency department work and "quasi-specialty" designations based on billing patterns. Results are stratified by type of training and years in practice. Graduates of PGY3 programs are significantly more likely to practise in a range of nonoffice settings than their counterparts who completed core 2-year FM training programs. Differences were the most marked in areas in which additional training had been undertaken, but also extended to other categories. There was no effect on the proportion practising in rural locations, unless the training was undertaken in a rural setting or in anesthesia. Physicians including EM in their practices were more likely to practise mostly or almost all EM if they had undertaken either EM programs or self-directed programs at non-northern training sites. Very few graduates of any type were classified as belonging to a quasi-specialty group, other than those who completed care of the elderly or palliative care (hospitalist) and anesthesia programs. Completion of a PGY3 program is strongly associated with increased participation in practice outside the office, particularly in the area of the training provided.
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Practice patterns of academic general thoracic and adult cardiac surgeons.
Ingram, Michael T; Wisner, David H; Cooke, David T
2014-10-01
We hypothesized that academic adult cardiac surgeons (CSs) and general thoracic surgeons (GTSs) would have distinct practice patterns of, not just case-mix, but also time devoted to outpatient care, involvement in critical care, and work relative value unit (wRVU) generation for the procedures they perform. We queried the University Health System Consortium-Association of American Medical Colleges Faculty Practice Solution Center database for fiscal years 2007-2008, 2008-2009, and 2009-2010 for the frequency of inpatient and outpatient current procedural terminology coding and wRVU data of academic GTSs and CSs. The Faculty Practice Solution Center database is a compilation of productivity and payer data from 86 academic institutions. The greatest wRVU generating current procedural terminology codes for CSs were, in order, coronary artery bypass grafting, aortic valve replacement, and mitral valve replacement. In contrast, open lobectomy, video-assisted thoracic surgery wedge, and video-assisted thoracic surgery lobectomy were greatest for GTSs. The 10 greatest wRVU-generating procedures for CSs generated more wRVUs than those for GTSs (P<.001). Although CSs generated significantly more hospital inpatient evaluation and management (E & M) wRVUs than did GTSs (P<.001), only 2.5% of the total wRVUs generated by CSs were from E & M codes versus 18.8% for GTSs. Critical care codes were 1.5% of total evaluation and management billing for both CSs and GTSs. Academic CSs and GTSs have distinct practice patterns. CSs receive greater reimbursement for services because of the greater wRVUs of the procedures performed compared with GTSs, and evaluation and management coding is a more important wRVU generator for GTSs. The results of our study could guide academic CS and GTS practice structure and time prioritization. Copyright © 2014 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.
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A Decade of New Opportunity: Affirmative Action in the 1970s.
ERIC Educational Resources Information Center
Hammerman, Herbert
This study investigates whether there were significant changes in the employment patterns of minorities and women in the 1970s, whether any such changes resulted from affirmative action, and whether affirmative action brought about fundamental changes in discriminatory personnel practices and systems. (Affirmative action here refers to that…
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Neurologists' Views of Current Medications: Spasticity and Athetosis
ERIC Educational Resources Information Center
Obringer, S. John; Coffey, Kenneth
2008-01-01
Medications to treat individuals with cerebral palsy have increased significantly over the last few decades. The purpose of this article was to randomly survey practicing neurologists on a national level to determine prescribing patterns for both spasticity and athetosis. The results indicated that the most frequently prescribed medication for…
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Being Superintendent of a Small-Town District.
ERIC Educational Resources Information Center
Schmuck, Richard A.; Schmuck, Patricia A.
Because of their visibility at the center stage of community life, small-town superintendents have a greater opportunity to act as participatory managers and instructional leaders. This paper reports the results of surveys with 25 small-town school superintendents to discover rural/urban differences, work patterns, and exemplary practices in…
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Keng, T B; De La Salle, B; Bourner, G; Merino, A; Han, J-Y; Kawai, Y; Peng, M T; McCafferty, R
2016-10-01
These recommendations are intended to develop a consensus in the previously published papers as to which parameters and what values should be considered critical. A practical guide on the standardization of critical results management in haematology laboratories would be beneficial as part of good laboratory and clinical practice and for use by laboratory-accrediting agencies. A working group with members from Europe, America, Australasia and Asia was formed by International Council for Standardization in Haematology. A pattern of practice survey of 21 questions was distributed in 2014, and the data were collected electronically by Survey Monkey. The mode, or most commonly occurring value, was selected as the threshold for the upper and lower alert limits for critical results reporting. A total of 666 laboratories submitted data to this study and, of these, 499 submitted complete responses. Full blood count critical results alert thresholds, morphology findings that trigger critical result notification, critical results alert list, notification process and maintenance of critical results management protocol are described. This international survey provided a snapshot of the current practice worldwide and has identified the existence of considerable heterogeneity of critical results management. The recommendations in this study represent a consensus of good laboratory practice. They are intended to encourage the implementation of a standardized critical results management protocol in the laboratory. © 2016 John Wiley & Sons Ltd.
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Bikbov, Boris; Bieber, Brian; Andrusev, Anton; Tomilina, Natalia; Zemchenkov, Alexander; Zhao, Junhui; Port, Friedrich; Robinson, Bruce; Pisoni, Ronald
2017-07-01
There is little comparable information about hemodialysis (HD) practices in low- and middle income countries, including Russia. Evaluation of HD in Russia and its international comparisons could highlight factors providing opportunities for improvement. We examined treatment patterns for 481 prevalent HD patients in 20 Russian facilities, and compared them to contemporary data for 8512 patients from 311 facilities in seven European countries, Japan, and North America. Data were collected according to the uniform methodology of the Dialysis Outcomes and Practice Patterns Study, phase 5. Compared to other regions, Russian patients were younger (mean age 53.4 years), had a lower percent of males (52.5%), higher arteriovenous fistula use (89.7%), and longer treatment time (mean: 252 minutes, SD: 37 minutes). Mean single pool Kt/V was 1.49 (SD 0.58). Prescription of dialysate calcium 3.5 mEq/L and aluminum-based phosphate binders were high (15.2% and 17.6% of patients, respectively), while intravenous vitamin D and cinacalcet were low (3.3% and 2.2%, respectively). The percents with parathyroid hormone >600 pg/mL (30.9%) and serum phosphate >1.78 mmol/L (37.7%) were high. Use of erythropoetin stimulating agents (78%) was lower, but hemoglobin, ferritin, and transferrin saturation were generally comparable to North America and Europe. These detailed data for hemodialysis in Russia demonstrate that many practice patterns contrasted sharply to those in Europe, Japan, and North America, while other features were similar. Our analysis revealed several positive and some less favorable treatment patterns in Russia that represent opportunities for improving patient care and outcomes. © 2016 International Society for Hemodialysis.
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Utama, M Iqbal Bakti; Lu, Xin; Zhan, Da; Ha, Son Tung; Yuan, Yanwen; Shen, Zexiang; Xiong, Qihua
2014-11-07
Patterning two-dimensional materials into specific spatial arrangements and geometries is essential for both fundamental studies of materials and practical applications in electronics. However, the currently available patterning methods generally require etching steps that rely on complicated and expensive procedures. We report here a facile patterning method for atomically thin MoSe2 films using stripping with an SU-8 negative resist layer exposed to electron beam lithography. Additional steps of chemical and physical etching were not necessary in this SU-8 patterning method. The SU-8 patterning was used to define a ribbon channel from a field effect transistor of MoSe2 film, which was grown by chemical vapor deposition. The narrowing of the conduction channel area with SU-8 patterning was crucial in suppressing the leakage current within the device, thereby allowing a more accurate interpretation of the electrical characterization results from the sample. An electrical transport study, enabled by the SU-8 patterning, showed a variable range hopping behavior at high temperatures.
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Understanding practice patterns of glaucoma sub-specialists in India
Choudhari, Nikhil S.; Pathak-Ray, Vanita; Kaushik, Sushmita; Vyas, Prateep; George, Ronnie
2017-01-01
AIM To obtain information on the prevailing practice patterns of glaucoma specialists in India. METHODS Glaucoma specialists attending the Annual Conference of the Glaucoma Society of India (GSI) were surveyed. This survey, conducted in 2013, was based on an interactive audience response system. RESULTS The information was obtained from 146 glaucoma specialists. Approximately half (n=83; 57%) had ≥10y of experience in managing glaucoma and were in institutional practice (n=74, 51%). Goldmann applanation tonometry was preferred by 103 (72%) specialists whilst n=25 (17.4%) used non-contact tonometer. Indentation gonioscopy was favoured by two-thirds (n=90, 66%) whereas stereoscopic optic disc examination and visual fields using Humphrey perimeter was performed by a majority of the specialists surveyed (n=115, 86% and n=114; 83% respectively). Nearly three quarter specialists (n=96; 72%) preferred optical coherence tomography for imaging. The primary choice for treatment of angle closure disease and primary open angle glaucoma was laser (iridotomy, n=117; 93%) and medical management (prostaglandin analogue, n=104; 78%), respectively. Approximately only a third of the specialists surveyed (n=37; 28%) were performing both trabeculectomy and implantation of a glaucoma drainage device and about half (n=64; 47%) were not operating on congenital glaucoma at all. CONCLUSION This survey has found conformance with preferred practice patterns in several areas of diagnosis and management of glaucoma, but there was diversity in a few areas. The information is a significant step towards improvement of glaucoma care in India, including planning for future strategies. PMID:29062779
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Challenges in economic evaluation of new drugs: experience with rituximab in Hungary.
Brodszky, Valentin; Orlewska, Ewa; Pentek, Martha; Karpati, Krisztian; Skoupa, Jana; Gulacsi, Laszlo
2010-01-01
Implementation of a new therapy into clinical practice is a complex process. Various countries have different requirements for information but most often focus on economic evaluation, which often plays a stronger role in healthcare decision making than does clinical evidence. To identify all potential challenges in economic evaluation, the case of a new biological drug, rituximab, used to treat rheumatoid arthritis, has been taken as an example. We present methods and results of economic assessment, highlighting the specific issues that should be considered in countries with economic and health care conditions similar to those of Hungary. In principle, economic evaluation requires data on characteristics of target population, disease progression, treatment impact, preferences, resource utilization and unit prices. Treatment effect/relative risk reduction and clinical practice patterns (resource use) may be more generalizable, whereas prices and baseline risk need to be jurisdiction specific. In order to address issues of transferability, investments need to be made in the collection of epidemiological and demographic data, plus data on clinical practice patterns, resource use, costs and health state valuation. In Hungary this problem has been solved through conducting a well designed 255 patient cross-sectional study. The Hungarian example shows that there should be more investment in data collection for those parameters that are thought to differ most from place to place. Owing to the similarities between Central and Eastern Europe countries in health care systems, clinical practice patterns and economic indicators, they may be able to develop partnerships to develop relevant regional databases and registries.
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Self-controlled practice enhances motor learning in introverts and extroverts.
Kaefer, Angélica; Chiviacowsky, Suzete; Meira, Cassio de Miranda; Tani, Go
2014-06-01
The purpose of the present study was to investigate the effects of self-controlled feedback on the learning of a sequential-timing motor task in introverts and extroverts. Fifty-six university students were selected by the Eysenck Personality Questionnaire. They practiced a motor task consisting of pressing computer keyboard keys in a specific spatial and temporal pattern. The experiment consisted of practice, retention, and transfer phases. The participants were distributed into 4 groups, formed by the combination of personality trait (extraversion/introversion) and type of feedback frequency (self-controlled/yoked). The results showed superior learning for the groups that practiced in a self-controlled schedule, in relation to groups who practiced in an externally controlled schedule, F(1, 52) = 4.13, p < .05, eta2 = .07, regardless of personality trait. We conclude that self-controlled practice enhances motor learning in introverts and extroverts.
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[Practice patterns in Mexican allergologists about skin tests with allergens during 2005-2006].
Larenas Linnemann, Désirée; Fogelbach, Guillermo Arturo Guidos; Cruz, Alfredo Arias
2008-01-01
Immunotherapy has been practiced since over a hundred years. The exact composition of the immunotherapy concentrate, with which the patient is treated, depends partly on the results of the skin prick tests applied to the allergic patient. As such, the effectiveness of the immunotherapy depends heavily on the quality of the skin prick test. The detailed recommendations for the realization of the skin prick tests have evolved and changed over the years, leading to multiple variations in its application in Mexico. We tried to get a picture of the daily practice patterns of the members of CMICA and CoMPedIA concerning the application of skin prick tests. Aquestionnaire was sent in various occasions to all members of the Colegio Mexicano de Inmunologia Clinica y Alergia (CMICA) and of the Colegio Mexicano de Pediatras, Especialistas en Inmunologia y Alergia (CoMPedIA). The results are presented descriptively and by calculation of the frequency/percentages of intervals of replies, in the case of numerical responses. A response rate of 61 (17%) was obtained of the College members, showing consistency in some replies but a wide variation in others, for example in the time certain medication has to be suspended before the execution of the skin prick test. Comparing the replies obtained with recent recommendations in international publications, some discrepancy can be detected. In some aspects of the survey there is coincidence of the skin test practices among the participants; however, in other items there is an important variation.
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A paperless autoimmunity laboratory: myth or reality?
Lutteri, Laurence; Dierge, Laurine; Pesser, Martine; Watrin, Pascale; Cavalier, Etienne
2016-08-01
Testing for antinuclear antibodies is the most frequently prescribed analysis for the diagnosis of rheumatic diseases. Indirect immunofluorescence remains the gold standard method for their detection despite the increasing use of alternative techniques. In order to standardize the manual microscopy reading, automated acquisition and interpretation systems have emerged. This publication enables us to present our method of interpretation and characterization of antinuclear antibodies based on a cascade of analyses and to share our everyday experience of the G Sight from Menarini. The positive/negative discrimination on Hep cells 2000 is correct in 85% of the cases. In most of the false negative results, it is a question of aspecific or low titers patterns, but a few cases of SSA speckled patterns of low titers demonstrated a probability index below 8. Regarding the pattern recognition, some types and mixed patterns are not properly recognized. Concerning the probability index correlated in some studies to final titer, the weak fluorescence of certain patterns and the random presence of artifacts that distort the index don't lead us to continue it in our daily practice. In conclusion, automated reading systems facilitate the reporting of results and traceability of patterns but still require the expertise of a laboratory technologist for positive/negative discrimination and for pattern recognition.
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Trongnetrpunya, Amy; Nandi, Bijurika; Kang, Daesung; Kocsis, Bernat; Schroeder, Charles E; Ding, Mingzhou
2015-01-01
Multielectrode voltage data are usually recorded against a common reference. Such data are frequently used without further treatment to assess patterns of functional connectivity between neuronal populations and between brain areas. It is important to note from the outset that such an approach is valid only when the reference electrode is nearly electrically silent. In practice, however, the reference electrode is generally not electrically silent, thereby adding a common signal to the recorded data. Volume conduction further complicates the problem. In this study we demonstrate the adverse effects of common signals on the estimation of Granger causality, which is a statistical measure used to infer synaptic transmission and information flow in neural circuits from multielectrode data. We further test the hypothesis that the problem can be overcome by utilizing bipolar derivations where the difference between two nearby electrodes is taken and treated as a representation of local neural activity. Simulated data generated by a neuronal network model where the connectivity pattern is known were considered first. This was followed by analyzing data from three experimental preparations where a priori predictions regarding the patterns of causal interactions can be made: (1) laminar recordings from the hippocampus of an anesthetized rat during theta rhythm, (2) laminar recordings from V4 of an awake-behaving macaque monkey during alpha rhythm, and (3) ECoG recordings from electrode arrays implanted in the middle temporal lobe and prefrontal cortex of an epilepsy patient during fixation. For both simulation and experimental analysis the results show that bipolar derivations yield the expected connectivity patterns whereas the untreated data (referred to as unipolar signals) do not. In addition, current source density signals, where applicable, yield results that are close to the expected connectivity patterns, whereas the commonly practiced average re-reference method leads to erroneous results.
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Yang, Yingxin; Ma, Qiu-yan; Yang, Yue; He, Yu-peng; Ma, Chao-ting; Li, Qiang; Jin, Ming; Chen, Wei
2018-01-01
Abstract Background: Primary open angle glaucoma (POAG) is a chronic, progressive optic neuropathy. The aim was to develop an evidence-based clinical practice guideline of Chinese herbal medicine (CHM) for POAG with focus on Chinese medicine pattern differentiation and treatment as well as approved herbal proprietary medicine. Methods: The guideline development group involved in various pieces of expertise in contents and methods. Authors searched electronic databases include CNKI, VIP, Sino-Med, Wanfang data, PubMed, the Cochrane Library, EMBASE, as well as checked China State Food and Drug Administration (SFDA) from the inception of these databases to June 30, 2015. Systematic reviews and randomized controlled trials of Chinese herbal medicine treating adults with POAG were evaluated. Risk of bias tool in the Cochrane Handbook and evidence strength developed by the GRADE group were applied for the evaluation, and recommendations were based on the findings incorporating evidence strength. After several rounds of Expert consensus, the final guideline was endorsed by relevant professional committees. Results: CHM treatment principle and formulae based on pattern differentiation together with approved patent herbal medicines are the main treatments for POAG, and the diagnosis and treatment focusing on blood related patterns is the major domain. Conclusion: CHM therapy alone or combined with other conventional treatment reported in clinical studies together with Expert consensus were recommended for clinical practice. PMID:29595636
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Olashore, Anthony; Ayugi, James; Opondo, Philip
2017-01-01
Introduction There is a growing preference for psycho-pharmacological therapy over non-pharmacological care. The prescription pattern and the choice of psychotropic medications vary in different settings. Whilst newer agents and rational prescribing are favored in the more specialized settings, the pattern remains unclear in less specialized units, largely due to lack of data. The aims were to conduct a treatment audit in the only mental referral hospital in Botswana, which is a non-specialized child and adolescent care setting and see how it conforms to best practice. Methods A retrospective audit which involved the extraction of socio-demographic and clinical information from the records of patients who were ≤ 17 years and seen from January 1, 2012-July 31, 2016. Results A total of 238 files were used for this report. Mean age (SD) was 12.41 (4.1) years. Of the 120 (50.4%) patients who had pharmacological intervention, only 85(70.8%) had monotherapy. The most commonly prescribed psychotropic agents were antipsychotics (40%). Off-label use of antipsychotics and polypharmacy were 31.2% and 29.2% respectively. Conclusion The level of conformity to standard practice in terms of psychotropic prescribing in our setting is consistent with the reports from developed countries where more specialized care ostensibly exists. Further studies will be necessary to determine the scope of psychotropic use. PMID:28491214
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Analysis of sex-specific injury patterns and risk factors in young high-level athletes.
Frisch, A; Seil, R; Urhausen, A; Croisier, J L; Lair, M L; Theisen, D
2009-12-01
This study analyzed sex-specific injury patterns and risk factors in young athletes (n=256) from 12 sport disciplines practicing at the national or the international level in the Grand-Duchy of Luxembourg. Injury occurrence as a result of sport practice was analyzed retrospectively over the year 2006 using a standardized self-administered questionnaire. Overall incidence was not different between girls and boys (1.20 and 1.21 injuries/1000 athlete-hours, respectively), but in the context of team sport competition girls tended to be at a greater risk (rate ratio 2.05, P=0.053). Girls had a higher proportion of injuries in the ankle/foot region compared with boys (34.8% vs 16.8%). No sex-related differences were found regarding injury severity. Multivariate logistic regression (controlling for age and practice volume) revealed that girls' team sports were associated with a greater injury risk compared with individual sports [odds ratio (OR) of 4.76], while in boys this was observed for racket sports (OR=3.31). Furthermore, physical or emotional stress tended to be a specific risk factor in girls. There was a tendency for injury outside sports to be coupled to a higher injury risk in girls and boys. Consideration of sex-specific injury patterns and risk factors could be of importance for effective injury prevention.
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Zhang, Hui; Schaubel, Douglas E; Kalbfleisch, John D; Bragg-Gresham, Jennifer L; Robinson, Bruce M; Pisoni, Ronald L; Canaud, Bernard; Jadoul, Michel; Akiba, Takashi; Saito, Akira; Port, Friedrich K; Saran, Rajiv
2012-01-01
The risk of death for hemodialysis patients is thought to be highest on the days following the longest interval without dialysis (usually Mondays and Tuesdays); however, existing results are inconclusive. To clarify this we analyzed Dialysis Outcomes and Practice Patterns Study (DOPPS) data of 22,163 hemodialysis patients from the United States, Europe and Japan. Our study focused on the association between dialysis schedule and day-of-week of all-cause, cardiovascular and non-cardiovascular mortality with day-of-week coding as a time-dependent covariate. The models were adjusted for dialysis schedule, age, country, DOPPS Phase I or II, and other demographic and clinical covariates comparing mortality on each day to the 7-day average. Patients on a Monday-Wednesday-Friday (MFW) schedule had elevated all-cause mortality on Monday, and those on a Tuesday-Thursday-Saturday (TTS) schedule increased risk of mortality on Tuesday in all 3 regions. The association between day-of-week mortality and schedule was generally stronger for cardiovascular than non-cardiovascular mortality, and most pronounced in the United States. Unexpectedly, Japanese patients on a MWF schedule had a higher risk of non-cardiovascular mortality on Fridays, and European patients on a TTS schedule experienced an elevated cardiovascular mortality on Saturdays. Thus, future studies are needed to evaluate the influence of practice patterns on schedule-specific mortality and factors that could modulate this effect. PMID:22297673
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Clinical reports of pulmonary metastasectomy for colorectal cancer: a citation network analysis
Fiorentino, F; Vasilakis, C; Treasure, T
2011-01-01
Introduction: Pulmonary metastasectomy for colorectal cancer is a commonly performed and well-established practice of ∼50 years standing. However, there have been no controlled studies, randomised or otherwise. We sought to investigate the evidence base that has been used in establishing its status as a standard of care. Methods: Among 51 papers used in a recent systematic review and quantitative synthesis, a citation network analysis was performed. A total of 344 publications (the 51 index papers and a further 293 cited in them) constitute the citation network. Results: The pattern of citation is that of a citation cascade. Specific analyses show the frequent use of historical or landmark papers, which add authority. Papers expressing an opposing viewpoint are rarely cited. Conclusions: The citation network for this common and well-established practice provides an example of selective citation. This pattern of citation tends to escalate belief in a clinical practice even when it lacks a high-quality evidence base and may create an impression of more authority than is warranted. PMID:21386844
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Valentine, R James; Jones, Andrew; Biester, Thomas W; Cogbill, Thomas H; Borman, Karen R; Rhodes, Robert S
2011-09-01
To assess changes in general surgery workloads and practice patterns in the past decade. Nearly 80% of graduating general surgery residents pursue additional training in a surgical subspecialty. This has resulted in a shortage of general surgeons, especially in rural areas. The purpose of this study is to characterize the workloads and practice patterns of general surgeons versus certified surgical subspecialists and to compare these data with those from a previous decade. The surgical operative logs of 4968 individuals recertifying in surgery 2007 to 2009 were reviewed. Data from 3362 (68%) certified only in Surgery (GS) were compared with 1606 (32%) with additional American Board of Medical Specialties certificates (GS+). Data from GS surgeons were also compared with data from GS surgeons recertifying 1995 to 1997. Independent variables were compared using factorial ANOVA. GS surgeons performed a mean of 533 ± 365 procedures annually. Women GS performed far more breast operations and fewer abdomen, alimentary tract and laparoscopic procedures compared to men GS (P < 0.001). GS surgeons recertifying at 10 years performed more abdominal, alimentary tract and laparoscopic procedures compared to those recertifying at 20 or 30 years (P < 0.001). Rural GS surgeons performed far more endoscopic procedures and fewer abdominal, alimentary tract, and laparoscopic procedures than urban counterparts (P < 0.001). The United States medical school graduates had similar workloads and distribution of operations to international medical graduates. Compared to 1995 to 1997, GS surgeons from 2007 to 2009 performed more procedures, especially endoscopic and laparoscopic. GS+ surgeons performed 15% to 33% of all general surgery procedures. GS practice patterns are heterogeneous; gender, age, and practice setting significantly affect operative caseloads. A substantial portion of general surgery procedures currently are performed by GS+ surgeons, whereas GS surgeons continue to perform considerable numbers of specialty operations. Reduced general surgery operative experience in GS+ residencies may negatively impact access to general surgical care. Similarly, narrowing GS residency operative experience may impair specialty operation access.
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Gage, Julia C; Hunt, William C; Schiffman, Mark; Katki, Hormuzd A; Cheung, Li A; Myers, Orrin; Cuzick, Jack; Wentzensen, Nicolas; Kinney, Walter; Castle, Philip E; Wheeler, Cosette M
2016-12-01
To compare the risks of histologic high-grade cervical intraepithelial neoplasia (CIN) or worse after different cervical cancer screening test results between two of the largest U.S. clinical practice research data sets. The New Mexico Human Papillomavirus (HPV) Pap Registry is a statewide registry representing a diverse population experiencing varied clinical practice delivery. Kaiser Permanente Northern California is a large integrated health care delivery system practicing routine HPV cotesting since 2003. In this retrospective cohort study, a logistic-Weibull survival model was used to estimate and compare the cumulative 3- and 5-year risks of histologic CIN 3 or worse among women aged 21-64 years screened in 2007-2011 in the New Mexico HPV Pap Registry and 2003-2013 in Kaiser Permanente Northern California. Results were stratified by age and baseline screening result: negative cytology, atypical squamous cells of undetermined significance (ASC-US) (with or without HPV triage), low-grade squamous intraepithelial lesion, and high-grade squamous intraepithelial lesion. There were 453,618 women in the New Mexico HPV Pap Registry and 1,307,528 women at Kaiser Permanente Northern California. The 5-year CIN 3 or worse risks were similar within screening results across populations: cytology negative (0.52% and 0.30%, respectively, P<.001), HPV-negative and ASC-US (0.72% and 0.49%, respectively, P=.5), ASC-US (3.4% and 3.4%, respectively, P=.8), HPV-positive and ASC-US (7.7% and 7.1%, respectively, P=.3), low-grade squamous intraepithelial lesion (6.5% and 5.4%, respectively, P=.009), and high-grade squamous intraepithelial lesion (53.1% and 50.4%, respectively, P=.2). Cervical intraepithelial neoplasia grade 2 or worse risks and 3-year risks had similar trends across populations. Age-stratified analyses showed more variability, especially among women aged younger than 30 years, but patterns of risk stratification were comparable. Current U.S. cervical screening and management recommendations are based on comparative risks of histologic high-grade CIN after screening test results. The similar results from these two large cohorts from different real-life clinical practice settings support risk-based management thresholds across U.S. clinical populations and practice settings.
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Sharma, Giriraj K; Sofferman, Robert A; Armstrong, William B
2017-08-01
The American College of Surgeons Thyroid and Parathyroid Ultrasound Skills-Oriented Course (TPUSC) was designed to teach surgeons how to interpret and perform office-based head and neck ultrasound (HNUS). The objective of this study was to survey attendees of the TPUSC to evaluate the usefulness of the course, to track surgeon performed HNUS practice patterns, and to help identify potential roadblocks to incorporation of HNUS into a surgeon's practice. Cross-sectional survey. A Web-based survey was sent to 952 surgeons who completed the TPUSC between 2010 and 2014. Questions included surgeon specialty, practice type, Likert scale rating of the TPUSC, competency with different HNUS procedures, and current HNUS practice patterns. The response rate was 24%. On a scale from 1 (not useful) to 5 (extremely valuable), the mean course usefulness rating was 4.2. Educational goals were met for 194 (92%) surgeons, and 162 (77%) surgeons reported performing HNUS in their practice. Of 48 surgeons not performing HNUS, 24 (50%) attributed insufficient time in their clinic schedule, and 21 (44%) attributed high equipment costs. The TPUSC is a valuable educational experience for surgeons seeking to gain proficiency in HNUS. The majority of TPUSC graduates gain competency with at least one type of HNUS procedure following the course. NA Laryngoscope, 127:1950-1958, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.
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Lavi, Iris; Slone, Michelle
2012-10-01
Parental warmth and parental authority-control patterns have been documented as practices with highest significance for children's well-being and development in a variety of life areas. Various forms of these practices have been shown to have a direct positive effect on children and also to protect children from adverse effects of numerous stressors. However, surprisingly, few studies have examined the role of these practices as possible protective factors for children exposed to intractable conflict and political violence. Participants in this study were Jewish (n = 88) and Arab (n = 105) Israeli families, with children aged 7-12.5 (M = 10.73, SD = 0.99). Children completed questionnaires assessing political violence exposure, behavioral, psychological, and social difficulties, and perceived paternal and maternal warmth. Mothers and fathers completed questionnaires assessing parental warmth, parental authority-control, and the child's difficulties. Results showed parental warmth to be a significant moderator of political violence, related to low levels of behavioral and social difficulties of children. Parental authority-control patterns were not protectors from adverse effects of political violence exposure. Maternal authoritarian authority-control showed an effect resembling a risk factor. Differential roles of parental warmth and authority-control, fathers' versus mothers' roles, and ethnic differences are discussed, and practical clinical implications are proposed. © 2012 American Orthopsychiatric Association.
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ERIC Educational Resources Information Center
Wu, Will F. W.; Magill, Richard A.
2011-01-01
For this study, we investigated the effects of self-controlled practice on learning multiple motor skills. Thirty participants were randomly assigned to self-control or yoked conditions. Participants learned a three-keystroke pattern with three different relative time structures. Those in the self-control group chose one of three relative time…
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Trends in fire patterns in a southern African savanna under alternative land use practices
A. T. Hudak; D. H. K. Fairbanks; B. H. Brockett
2004-01-01
Climate, topography, vegetation and land use interact to influence fire regimes.Variable fire regimes may promote landscape heterogeneity, diversification in vegetation pattern and biotic diversity. The objective was to compare effects of alternative land use practices on landscape heterogeneity. Patch characteristics of fire scars were measured from 21 annual burn...
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ERIC Educational Resources Information Center
Carrillo, Edgardo Ruiz; González, José Luis Cruz; Martínez, Samuel Meraz; Sánchez, Luisa Bravo
2015-01-01
The purpose of this study is to analyze the discourse through IRE (Intervention-Response-Evaluation) in the co-construction of knowledge of Biology students during laboratory practices by applying the SDIS-GSEQ software to assess IRE discourse patterns developed during the same. The study group consisted of second semester students of the…
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Patterns of Teacher's Instructional Moves: What Makes Mathematical Instructional Practices Unique?
ERIC Educational Resources Information Center
Pinter, Holly Henderson
2013-01-01
The purpose of this study was to examine patterns in fourth-grade teachers' use of instructional moves in the implementation of standards-based mathematical teaching practices. Using a mixed methods sequential explanatory design, the study consisted of two phases: quantitative selection and qualitative analysis. The first phase of the study…
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Rapid Transfer of Abstract Rules to Novel Contexts in Human Lateral Prefrontal Cortex
Cole, Michael W.; Etzel, Joset A.; Zacks, Jeffrey M.; Schneider, Walter; Braver, Todd S.
2011-01-01
Flexible, adaptive behavior is thought to rely on abstract rule representations within lateral prefrontal cortex (LPFC), yet it remains unclear how these representations provide such flexibility. We recently demonstrated that humans can learn complex novel tasks in seconds. Here we hypothesized that this impressive mental flexibility may be possible due to rapid transfer of practiced rule representations within LPFC to novel task contexts. We tested this hypothesis using functional MRI and multivariate pattern analysis, classifying LPFC activity patterns across 64 tasks. Classifiers trained to identify abstract rules based on practiced task activity patterns successfully generalized to novel tasks. This suggests humans can transfer practiced rule representations within LPFC to rapidly learn new tasks, facilitating cognitive performance in novel circumstances. PMID:22125519
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Alignment of breast cancer screening guidelines, accountability metrics, and practice patterns.
Onega, Tracy; Haas, Jennifer S; Bitton, Asaf; Brackett, Charles; Weiss, Julie; Goodrich, Martha; Harris, Kimberly; Pyle, Steve; Tosteson, Anna N A
2017-01-01
Breast cancer screening guidelines and metrics are inconsistent with each other and may differ from breast screening practice patterns in primary care. This study measured breast cancer screening practice patterns in relation to common evidence-based guidelines and accountability metrics. Cohort study using primary data collected from a regional breast cancer screening research network between 2011 and 2014. Using information on women aged 30 to 89 years within 21 primary care practices of 2 large integrated health systems in New England, we measured the proportion of women screened overall and by age using 2 screening definition categories: any mammogram and screening mammogram. Of the 81,352 women in our cohort, 54,903 (67.5%) had at least 1 mammogram during the time period, 48,314 (59.4%) had a screening mammogram. Women aged 50 to 69 years were the highest proportion screened (82.4% any mammogram, 75% screening indication); 72.6% of women at age 40 had a screening mammogram with a median of 70% (range = 54.3%-84.8%) among the practices. Of women aged at least 75 years, 63.3% had a screening mammogram, with the median of 63.9% (range = 37.2%-78.3%) among the practices. Of women who had 2 or more mammograms, 79.5% were screened annually. Primary care practice patterns for breast cancer screening are not well aligned with some evidence-based guidelines and accountability metrics. Metrics and incentives should be designed with more uniformity and should also include shared decision making when the evidence does not clearly support one single conclusion.
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2014-01-01
Background Clinical practice guidelines on the management of neck pain make recommendations to help practitioners optimize patient care. By examining the practice patterns of practitioners, adherence to CPGs or lack thereof, is demonstrated. Understanding utilization of various treatments by practitioners and comparing these patterns to that of recommended guidelines is important to identify gaps for knowledge translation and improve treatment regimens. Aim To describe the utilization of interventions in patients with neck pain by clinicians. Methods A cross-sectional international survey was conducted from February 2012 to March 2013 to determine physical medicine, complementary and alternative medicine utilization amongst 360 clinicians treating patients with neck pain. Results The survey was international (19 countries) with Canada having the largest response (38%). Results were analyzed by usage amongst physical therapists (38%) and chiropractors (31%) as they were the predominant respondents. Within these professions, respondents were male (41-66%) working in private practice (69-95%). Exercise and manual therapies were consistently (98-99%) used by both professions but tests of subgroup differences determined that physical therapists used exercise, orthoses and ‘other’ interventions more, while chiropractors used phototherapeutics more. However, phototherapeutics (65%), Orthoses/supportive devices (57%), mechanical traction (55%) and sonic therapies (54%) were not used by the majority of respondents. Thermal applications (73%) and acupuncture (46%) were the modalities used most commonly. Analysis of differences across the subtypes of neck pain indicated that respondents utilize treatments more often for chronic neck pain and whiplash conditions, followed by radiculopathy, acute neck pain and whiplash conditions, and facet joint dysfunction by diagnostic block. The higher rates of usage of some interventions were consistent with supporting evidence (e.g. manual therapy). However, there was moderate usage of a number of interventions that have limited support or conflicting evidence (e.g. ergonomics). Conclusions This survey indicates that exercise and manual therapy are core treatments provided by chiropractors and physical therapists. Future research should address gaps in evidence associated with variable practice patterns and knowledge translation to reduce usage of some interventions that have been shown to be ineffective. PMID:24661461
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LaDuke, Casey; Barr, William; Brodale, Donald L; Rabin, Laura A
2018-01-01
This study investigated professional practice and common test use among clinical neuropsychologists engaging in forensic assessment. Doctorate-level psychologists active in the practice of neuropsychology and on the INS and NAN membership listings (n = 502) were surveyed about their demographics, professional practice, and common test use. Participants who reported engaging in forensic practice (n = 255) were further surveyed about their forensic practice. Forensic participants were more likely to be male and Caucasian, and reported higher ages, more years of professional experience, and a higher prevalence of board certification. While characteristics of their professional and forensic practice varied, forensic participants reported spending most of their professional time conducting neuropsychological assessments with adult clients in a private or group practice setting, focusing on civil referrals and civil legal questions involving older adult issues, developmental issues, head injury, and psychiatric issues. Common test use across neuropsychological assessment domains is presented for board-certified forensic participants (n = 77). An examination of these results reveals that the current pattern of test use is similar to the results of a more general survey of neuropsychological test use. The findings provide insight into the practice of forensic neuropsychological assessment, and further establish the admissibility of neuropsychological evidence in the United States legal system. Results will be useful for clinical neuropsychologists, field leaders, and legal professionals hoping to gain insight into the role of clinical neuropsychology in civil and criminal legal decision-making.
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ERIC Educational Resources Information Center
Prabpal, Jutamat; Vilaivan, Tirayut; Praneenararat, Thanit
2017-01-01
Tetrakis(4-sulfonatophenyl)porphyrin (TSPP) was immobilized on patterned paper and used as a sensor for heavy metal ions in an advanced organic chemistry course. The resulting sensor could detect Hg[superscript 2+] and Cd[superscript 2+] ions colorimetrically, while Cu[superscript 2+] ion resulted in fluorescence quenching, thus demonstrating a…
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Assessment of Vestibular Rehabilitation Therapy Training and Practice Patterns.
Bush, Matthew L; Dougherty, William
2015-08-01
Vestibular rehabilitation therapy (VRT) can benefit patients with a variety of balance and vestibular disorders. This expanding field requires knowledgeable and experienced therapists; however, the practice and experience of those providing this care may vary greatly. The purpose of this study was to analyze variations in training and practice patterns among practicing vestibular rehabilitation therapists. Case-controlled cohort study. Investigation of outpatient physical therapy and audiology practices that offer vestibular rehabilitation conducted by a tertiary academic referral center. Questionnaire-based investigation of level of training in vestibular disorders and therapy, practice patterns of vestibular rehabilitation, and referral sources for VRT patients. We identified 27 subjects within the state of Kentucky who practice vestibular rehabilitation and the questionnaire response rate was 63%. Responses indicated that 53% of respondents had no training in VRT during their professional degree program. Attendance of a course requiring demonstration of competence and techniques was 24% of participants. The development of VRT certification was significantly more favored by those who attended such courses compared with those who did not (p = 0.01). 50% of therapists have direct access to patients without physician referrals. There is a wide range of educational background and training among those practicing VRT. This variability in experience may affect care provided within some communities. Certification is not necessary for the practice of VRT but the development of certification is favored among some therapists to improve standardization of practice of this important specialty.
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Lottig, Noah R.; Tan, Pang-Ning; Wagner, Tyler; Cheruvelil, Kendra Spence; Soranno, Patricia A.; Stanley, Emily H.; Scott, Caren E.; Stow, Craig A.; Yuan, Shuai
2017-01-01
Ecology has a rich history of studying ecosystem dynamics across time and space that has been motivated by both practical management needs and the need to develop basic ideas about pattern and process in nature. In situations in which both spatial and temporal observations are available, similarities in temporal behavior among sites (i.e., synchrony) provide a means of understanding underlying processes that create patterns over space and time. We used pattern analysis algorithms and data spanning 22–25 yr from 601 lakes to ask three questions: What are the temporal patterns of lake water clarity at sub‐continental scales? What are the spatial patterns (i.e., geography) of synchrony for lake water clarity? And, what are the drivers of spatial and temporal patterns in lake water clarity? We found that the synchrony of water clarity among lakes is not spatially structured at sub‐continental scales. Our results also provide strong evidence that the drivers related to spatial patterns in water clarity are not related to the temporal patterns of water clarity. This analysis of long‐term patterns of water clarity and possible drivers contributes to understanding of broad‐scale spatial patterns in the geography of synchrony and complex relationships between spatial and temporal patterns across ecosystems.
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Putting humans in ecology: consistency in science and management.
Hobbs, Larry; Fowler, Charles W
2008-03-01
Normal and abnormal levels of human participation in ecosystems can be revealed through the use of macro-ecological patterns. Such patterns also provide consistent and objective guidance that will lead to achieving and maintaining ecosystem health and sustainability. This paper focuses on the consistency of this type of guidance and management. Such management, in sharp contrast to current management practices, ensures that our actions as individuals, institutions, political groups, societies, and as a species are applied consistently across all temporal, spatial, and organizational scales. This approach supplants management of today, where inconsistency results from debate, politics, and legal and religious polarity. Consistency is achieved when human endeavors are guided by natural patterns. Pattern-based management meets long-standing demands for enlightened management that requires humans to participate in complex systems in consistent and sustainable ways.
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Mukhabarah as Sharia Financing Model in Beef Cattle Farm Entrepise
NASA Astrophysics Data System (ADS)
Asnawi, A.; Amrawaty, A. A.; Nirwana
2018-02-01
Financing constraints on beef cattle farm nowadays have received attention by the government through distributed various assistance programs and program loans through implementing banks. The existing financing schemes are all still conventional yet sharia-based. The purpose of this research is to formulate financing pattern for sharia beef cattle farm. A qualitative and descriptive approach is used to formulate the pattern by considering the profit-sharing practices of the beef cattle farmers. The results of this study have formulated a financing pattern that integrates government, implementing banks, beef cattle farmers group and cooperative as well as breeders as its members. This pattern of financing is very accommodating of local culture that develops in rural communities. It is expected to be an input, especially in formulating a business financing policy Sharia-based beef cattle breeding.
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Moore, Kimberly Sena
2013-01-01
Emotion regulation (ER) is an internal process through which a person maintains a comfortable state of arousal by modulating one or more aspects of emotion. The neural correlates underlying ER suggest an interplay between cognitive control areas and areas involved in emotional reactivity. Although some studies have suggested that music may be a useful tool in ER, few studies have examined the links between music perception/production and the neural mechanisms that underlie ER and resulting implications for clinical music therapy treatment. Objectives of this systematic review were to explore and synthesize what is known about how music and music experiences impact neural structures implicated in ER, and to consider clinical implications of these findings for structuring music stimuli to facilitate ER. A comprehensive electronic database search resulted in 50 studies that met predetermined inclusion and exclusion criteria. Pertinent data related to the objective were extracted and study outcomes were analyzed and compared for trends and common findings. Results indicated there are certain music characteristics and experiences that produce desired and undesired neural activation patterns implicated in ER. Desired activation patterns occurred when listening to preferred and familiar music, when singing, and (in musicians) when improvising; undesired activation patterns arose when introducing complexity, dissonance, and unexpected musical events. Furthermore, the connection between music-influenced changes in attention and its link to ER was explored. Implications for music therapy practice are discussed and preliminary guidelines for how to use music to facilitate ER are shared.
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NASA Astrophysics Data System (ADS)
Nosov, V. V.; Lukin, V. P.; Nosov, E. V.; Torgaev, A. V.
2017-11-01
The structure of air turbulent motion inside the closed dome room of Big Telescope Alt-azimuth at Special Astrophysical Observatory of the Russian Academy of Sciences (RAS) has been experimentally and theoretically studied. Theoretical results have been reached by numerical solving of boundary value problem for Navier-Stokes equations. Solitary large vortices (coherent structures, topological solitons) are observed indoors. Coherent breakdown of these vortices leads to the coherent turbulence. In the case of identical boundary conditions the pattern of air motions as a result of the simulation and the pattern, registered experimentally using the compact portable ultrasonic weather station, are practically the same.
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Surender, R.; Bradlow, J.; Coulter, A.; Doll, H.; Brown, S. S.
1995-01-01
OBJECTIVE--To compare outpatient referral patterns in fundholding and non-fundholding practices before and after the NHS reforms in April 1991. DESIGN--Prospective collection of data on general practitioners' referrals to specialist outpatient clinics between June 1990 and January 1994 and detailed comparisons of three phases--October 1990 to March 1991 (phase 1), October 1991 to March 1992 (phase 2), and October 1993 to January 1994 (phase 3). SETTING--10 first wave fundholding practices and six non-fundholding practices in the Oxford region. SUBJECTS--Patients referred to consultant out-patient clinics. RESULTS--NHS referral rates increased in fundholding practices in phase 2 and phase 3 of the study by 8.1/1000 patients a year (95% confidence interval 5.7 to 10.5), an increase of 7.5% from phase 1 (107.3/1000) to phase 3 (115.4/1000). Non-fundholders' rates increased significantly, by 25.3/1000 patients (22.5-28.1), an increase of 26.6% from phase 1 (95.0/1000) to phase 3 (120.3/1000). The fundholders' referral rates to private clinics decreased by 8.8%, whereas those from non-fundholding practices increased by 12.2%. The proportion of referrals going outside district boundaries did not change significantly. Three of the four practices entering the third and fourth wave of fundholding increased their referral rates significantly in the year before becoming fundholders. CONCLUSIONS--No evidence existed that budgetary pressures caused first wave fundholders to reduce referral rates, although the method of budget allocation may have encouraged general practitioners to inflate their referral rates in the preparatory year. Despite investment in new practice based facilities, no evidence yet exists that fundholding encourages a shift away from specialist care. PMID:7488902
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Imbalanced target prediction with pattern discovery on clinical data repositories.
Chan, Tak-Ming; Li, Yuxi; Chiau, Choo-Chiap; Zhu, Jane; Jiang, Jie; Huo, Yong
2017-04-20
Clinical data repositories (CDR) have great potential to improve outcome prediction and risk modeling. However, most clinical studies require careful study design, dedicated data collection efforts, and sophisticated modeling techniques before a hypothesis can be tested. We aim to bridge this gap, so that clinical domain users can perform first-hand prediction on existing repository data without complicated handling, and obtain insightful patterns of imbalanced targets for a formal study before it is conducted. We specifically target for interpretability for domain users where the model can be conveniently explained and applied in clinical practice. We propose an interpretable pattern model which is noise (missing) tolerant for practice data. To address the challenge of imbalanced targets of interest in clinical research, e.g., deaths less than a few percent, the geometric mean of sensitivity and specificity (G-mean) optimization criterion is employed, with which a simple but effective heuristic algorithm is developed. We compared pattern discovery to clinically interpretable methods on two retrospective clinical datasets. They contain 14.9% deaths in 1 year in the thoracic dataset and 9.1% deaths in the cardiac dataset, respectively. In spite of the imbalance challenge shown on other methods, pattern discovery consistently shows competitive cross-validated prediction performance. Compared to logistic regression, Naïve Bayes, and decision tree, pattern discovery achieves statistically significant (p-values < 0.01, Wilcoxon signed rank test) favorable averaged testing G-means and F1-scores (harmonic mean of precision and sensitivity). Without requiring sophisticated technical processing of data and tweaking, the prediction performance of pattern discovery is consistently comparable to the best achievable performance. Pattern discovery has demonstrated to be robust and valuable for target prediction on existing clinical data repositories with imbalance and noise. The prediction results and interpretable patterns can provide insights in an agile and inexpensive way for the potential formal studies.
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Srinivasan, Nithin Keshav; John, Deepa; Rebekah, Grace; Kujur, Evon Selina; Paul, Padma
2017-01-01
Introduction Diabetic retinopathy is becoming an increasingly important cause of visual impairment in India. Many diabetic patients who come to our centre have undetected, advanced diabetic retinopathy. If diabetic retinopathy had been detected earlier in these patients, irreversible visual impairment could have been prevented. Aim To document Knowledge, Attitude and Practice (KAP) patterns of diabetic patients regarding diabetes and diabetic retinopathy, to determine association between them, and to identify barriers to compliance with follow up and treatment regimes. Materials and Methods This was a hospital-based, cross-sectional study, conducted at the Department of Ophthalmology at Christian Medical College, Vellore, Tamil Nadu, India, over a six-month period from June 2013 to November 2013. Two hundred and eighty eight diabetic patients, who fulfilled the eligibility criteria, were included in the study. KAP of patients was assessed using a 45-point, verbally administered questionnaire. Patients were placed in different categories, such as, ‘good/ poor’ knowledge, ‘positive/negative’ attitude and ‘good/poor’ practice. Data were analysed using Chi-square test and binary logistic regression, as appropriate. The proportion of patients with ‘good/poor’ knowledge, ‘positive/negative’ attitude and ‘good/poor’ practice, and the association between KAP were studied. Barriers to compliance with follow up/treatment regimes were identified. Results Out of the 288 patients in the study, 42% had good knowledge about diabetes, but only 4.5% had good knowledge about retinopathy. Good knowledge about diabetes was significantly associated with positive attitude towards diabetes and good practice patterns regarding retinopathy; awareness of retinopathy was also significantly associated with good practice. A total of 61.1% of patients did not have periodic eye examination; most common barrier identified was lack of awareness about the necessity for this (38.5%). Conclusion Good knowledge about the disease was significantly associated with positive attitude and good practice patterns. Knowledge about diabetic retinopathy was poor among the patients in our study. Lack of awareness concerning the need for screening for retinopathy was a major barrier to regular screening. There is an urgent need to educate diabetic patients about this potentially blinding complication of diabetes. PMID:28892947
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Kakudate, Naoki; Yokoyama, Yoko; Sumida, Futoshi; Matsumoto, Yuki; Gordan, Valeria V; Gilbert, Gregg H; Velly, Ana M; Schiffman, Eric L
2018-01-01
Aims This study quantified the practice pattern of Japanese dentists in the management of pain related to temporomandibular disorders (TMDs), and identified associations between dentist characteristics and the decision to perform occlusal adjustment for TMD-related pain. Methods A cross-sectional study was conducted consisting of a questionnaire survey of dentists affiliated with the Dental Practice-based Research Network Japan (JDPBRN) (n=148). Participants were asked how they diagnosed and treated TMD-related pain. Associations between dentist characteristics and their decision to perform occlusal adjustment were analyzed via multiple logistic regression. Results 113 clinicians responded the questionnaire for a 76% response rate. 81% of the participants (n=89) treated TMDs during the previous year. Dentists treated an average of 1.9±1.8 (SD) patients with TMD-related pain monthly. Most JDPBRN dentists used similar diagnostic protocols, including questions and examinations. The most frequent treatments were splints or mouthguards (97%), medications (85%), and self-care (69%). Fifty eight percent of the participants performed occlusal adjustment for TMD-related pain. Multiple logistic regression analysis identified two factors significantly associated with the decision to perform occlusal adjustment. Odds ratios (95%CI) were “dentist lack of confidence in curing TMD-related acute pain”, 5.60 (1.260–24.861) and “proportion of patients with severe TMD-related pain”, 0.95 (0.909–0.999). Conclusions The most common treatments for TMD-related pain were reversible treatments. However, over half of dentists performed occlusal adjustment for TMD-related pain. There was a significant association between the decision to perform occlusal adjustment and lack of therapeutic confidence. The results of this study suggest that an evidence-practice gap exists regarding occlusal adjustment for TMD-related pain. PMID:28437512
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Ogawa, Kazuhiko, E-mail: kogawa@med.u-ryukyu.ac.j; Ito, Yoshinori; Karasawa, Katsuyuki
2010-07-01
Purpose: To determine the patterns of radiotherapy practice for pancreatic cancer in Japan. Methods and Materials: A questionnaire-based national survey of radiotherapy for pancreatic cancer treated between 2000 and 2006 was conducted by the Japanese Radiation Oncology Study Group (JROSG). Detailed information on 870 patients from 34 radiation oncology institutions was accumulated. Results: The median age of all patients was 64 years (range, 36-88), and 80.2% of the patients had good performance status. More than 85% of patients had clinical Stage T3-T4 disease, and 68.9% of patients had unresectable disease at diagnosis. Concerning radiotherapy (RT), 49.8% of patients were treatedmore » with radical external beam RT (EBRT) (median dose, 50.4 Gy), 44.4% of patients were treated with intraoperative RT (median dose, 25 Gy) with or without EBRT (median dose, 45 Gy), and 5.9% of patients were treated with postoperative radiotherapy (median dose, 50 Gy). The treatment field consisted of the primary tumor (bed) only in 55.6% of the patients. Computed tomography-based treatment planning and conformal RT was used in 93.1% and 83.1% of the patients treated with EBRT, respectively. Chemotherapy was used for 691 patients (79.4%; before RT for 66 patients; during RT for 531; and after RT for 364). Gemcitabine was the most frequently used drug, followed by 5-fluorouracil. Conclusion: This study describes the general patterns of RT practice for pancreatic cancer in Japan. Most patients had advanced unresectable disease, and radical EBRT, as well as intraoperative RT with or without EBRT, was frequently used. Chemotherapy with gemcitabine was commonly used in conjunction with RT during the survey period.« less
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Functional brain activation associated with working memory training and transfer.
Clark, Cameron M; Lawlor-Savage, Linette; Goghari, Vina M
2017-09-15
While behavioural trials of working memory (WM) training have received much attention in recent years, a lesser explored parallel approach is functional neuroimaging. A small literature has suggested a complex time course for functional activation pattern changes following WM training (i.e. not simply increasing or decreasing due to training); however, no study to date has examined such neuroplastic effects in both the training task (dual n-back) and the fluid intelligence transfer task to which the training is purported to transfer (Raven's Matrices). This study investigated neural correlates of WM training in healthy young adults randomized to six weeks of WM training, or an active control condition (processing speed training) with a pre- and post-training fMRI design. Results indicated significant reductions in activation for the WM trained group in key WM-task related areas for trained WM tasks after training compared to the processing speed active control group. The same pattern of training related decreases in activation for the WM trained group was not observed for the transfer task, which is consistent with null results for all cognitive outcomes of the present trial. The observed pattern of results suggests that repetitive practice with a complex task does indeed lead to neuroplastic processes that very likely represent the reduced demand for attentional control while sub-components of the task become more routinized with practice. We suggest that future research investigate neural correlates of WM training in populations for which WM itself is impaired and/or behavioural trials of WM training have returned more promising results. Copyright © 2017 Elsevier B.V. All rights reserved.
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Practice variation on use of antibiotics: An international survey among pediatric urologists.
Kim, Jin K; Chua, Michael E; Ming, Jessica M; Braga, Luis H; Smith, Grahame H H; Driver, Christopher; Koyle, Martin A
2018-05-19
Although there is abundance in literature focusing on the use of prophylactic antibiotics for adult urological procedures, the evidence for using antibiotics following common pediatric urological procedures is limited with no specific guidelines for use. Consequently, current practices on antibiotic usage for common interventions may be variable among practicing pediatric urologists, lacking evidence-based support. The aim was to evaluate the current practice pattern on antibiotic usage for common interventions amongst pediatric urologists (PU) practicing in four English-speaking sectors of the world. An anonymous survey of five scenarios with multiple choice options was disseminated to all active practicing members of the Pediatric Urologist of Canada (PUC) and Society of Pediatric Urology of Australia and New Zealand (SPUNZA), as well as all those attending the 2016 British Association of Pediatric Urology (BAPU) and 2017 American Association of Pediatric Urology (AAPU) meetings. The response for each scenario was summarized for overall practice pattern variation and the pattern for each sector was compared using the Fisher exact test. A total of 126 respondents completed the survey (68.5% response rate) with at least a 65% response rate for each of the four sectors. The majority of respondents do not use antibiotics for indwelling urethral (46.8%) and suprapubic catheters (53.4%); however, they do give antibiotics for J-J stent placement (65.1%) and hypospadias surgery (84.9%), and use antibiotics after hypospadias surgery where catheters or stents are left indwelling (80.9%, 84.2%, respectively). Among those surveyed, the PUC members and AAPU PU demonstrated similar practice patterns which often significantly differed from that of SPUNZA members and BAPU attendees. Specifically, a significantly larger proportion of the North American pediatric urologists do not use antibiotics for common procedures compared with Australia, New Zealand, and the UK (Table). In the absence of prospective studies in antibiotic use for pediatric patients to guide clinicians, there is a clear variability among sectors in the use of antibiotics for most clinical scenarios investigated. With increasing resistance patterns and possible adverse effects of antibiotics, it is important that the international pediatric urology community engage in discussions and collaborations to address this issue. Practice patterns in antibiotic usage amongst PU varies widely, some of which may be associated with their local "culture." There is a need to understand these differences and begin to standardize treatment in the hopes of increasing appropriate use of antibiotics internationally. Copyright © 2018 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
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Physicians' opinions and clinical practice patterns for actinic keratosis management in Italy.
Peris, K; Neri, L; Calzavara Pinton, P; Catricalà, C; Pellacani, G; Pimpinelli, N; Peserico, A
2014-04-01
We report dermatologists' opinions and clinical practice patterns about clinical factors driving decision making in the management of actinic keratosis (AK) in Italy. We carried out a cross-sectional survey among 33 Italian dermatologists. Physicians were asked to report their management choices in consecutive patients with AK seen at their practice within 2 weeks since study initiation. We collected patients' clinical and socio-demographic characteristics with a standardized data collection form and assessed physicians' opinions on AK management with a self-reported questionnaire. Six hundred fifty-seven patients with new, single AK lesions without evidence of photo-damaged skin in the surrounding areas, were predominantly treated with lesion-directed therapies (primarily cryotherapy). In contrast, physicians preferentially prescribed field-directed therapies to patients with multiple lesions and evidence of photo-damaged skin in AK surrounding areas. However we observed a wide variation in treatment choices and physicians' opinions on AK management. Dermatologists underlined the importance of fostering patients' adherence and minimize therapy side effects. Overall, our results show that current guidelines regarding management of AK are only partially integrated in dermatology practice. The active dissemination of up-to-date national guidelines might help harmonize clinical decision making in this complex and fast growing therapeutic area.
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Patterns of diet-related practices and prevalence of gastro-esophageal reflux disease.
Esmaillzadeh, A; Keshteli, A H; Feizi, A; Zaribaf, F; Feinle-Bisset, C; Adibi, P
2013-10-01
No studies have evaluated associations between patterns of diet-related practices as determined by latent class analysis (LCA) and gastro-esophageal reflux disease (GERD). We aimed to assess this relationship in a large sample of Iranian adults. In a cross-sectional study in 4763 adults, diet-related practices were assessed in four domains, 'meal pattern', 'eating rate', 'intra-meal fluid intake', and 'meal-to-sleep interval', using a pretested questionnaire. LCA was applied to identify classes of diet-related practices. We defined GERD as the presence of heartburn sometimes, often or always. The prevalence of GERD in the study population was 23.5% (n = 1120). We identified two distinct classes of meal patterns: 'regular' and 'irregular', three classes of eating rates: 'moderate', 'moderate-to-slow', and 'moderate-to-fast', two major classes of fluid ingestion with meals: 'moderate' and 'much intra-meal drinking', and two classes regarding the interval between meals and sleeping: 'short' and 'long meal-to-sleep' interval. After adjustment for potential confounders, subjects with 'irregular meal pattern' had higher odds of GERD compared with subjects with 'regular meal pattern' (OR: 1.21; 1.00-1.46). However, when taking into account BMI, the association disappeared. 'Long meal-to-sleep interval' was inversely associated with GERD compared with 'short meal-to-sleep interval' (OR: 0.73; 95% CI: 0.57-0.95). 'Eating rate' and 'intra-meal fluid intake' were not significantly associated with GERD. Our data suggest certain associations between dietary patterns and GERD. These findings warrant evaluation in prospective studies to establish the potential value of modifications in dietary behaviors for the management of GERD. © 2013 John Wiley & Sons Ltd.
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Coppola, Sara L; Furgeson, Danielle; Fontana, Margherita; Kinney, Janet S; Gwozdek, Anne E
2017-10-01
Purpose: The purpose of this study was to investigate key factors associated with the economic sustainability of the Registered Dental Hygienist in Alternative Practice (RDHAP). Methods: An invitation to participate in a 38-question electronic survey was sent via postal mail to 440 RDHAP licentiate addressees obtained through the Dental Hygiene Committee of California (DHCC). Legal restrictions did not allow for obtaining the RDHAP licentiate email addresses from the DHCC. The survey was disseminated via email to the 254 RDHAPs who were members of the California Dental Hygienists' Association. Additional invitations to participate were made via flyer distribution at an RDHAP symposium, and on RDHAP only social media sites. Results: The response rate was an estimated 16%. While 44% of the RDHAPs reported some employment in a traditional dental practice, given the opportunity, 61% of these respondents indicated that they would practice exclusively as an RDHAP. With regard to practice strategic planning and alliances, 31% felt that dentists lacked knowledge of the RDHAP, and 25% indicated dentists were resistant to this workforce model. Regarding RDHAP practice staffing patterns, 75% indicated not having any employees. When asked about business systems, 64% had solo, portable practices and 16% had standalone practices. Economic sustainability challenges included practice business/equipment expenses (29%), insurance/reimbursement issues (21%), patient flow (19%) and RDHAP visibility (14%). Conclusions: RDHAP practices face challenges including the need for strategic planning and intra- and inter-professional alliances, efficient and effective patient flow, optimal staffing patterns and effective business systems. Focus on enhancing RDHAP visibility within the dental and medical communities should be a priority. In addition, further research should explore RDHAPs aligning with community-based clinics, Federally Qualified Health Centers and Dental Support Organizations (DSOs) with a commitment to disease prevention in addition to the financial resources and staff to manage practice business systems. Copyright © 2017 The American Dental Hygienists’ Association.
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Buchanan, John J; Ramos, Jorge; Robson, Nina
2015-04-01
Action competency is defined as the ability of an individual to self-evaluate their own performance capabilities. The current experiment demonstrated that physical and observational training with a motor skill alters action competency ratings in a similar manner. Using a pre-test and post-test protocol, the results revealed that action competency is constrained prior to training by the intrinsic dynamics of relative phase (ϕ), with in-phase (ϕ = 0°) and anti-phase (ϕ = 180°) patterns receiving higher competency ratings than other relative phase patterns. After 2 days of training, action competency ratings for two trained relative phase patterns, +60° and +120°, increased following physical practice or observational practice. A transfer test revealed that both physical performance ability and action competency ability transferred to the symmetry partners (-60° and -120°) of the two trained relative phase patterns following physical or observational training. The findings also revealed that relative motion direction acts as categorical information that helps to organize action production and facilitate action competency. The results are interpreted based on the coordination dynamics theory of perception-action coupling, and extend this theory by showing that visual perception, action production, and action competency are all constrained in a consistent manner by the dynamics of the order parameter relative phase. As a whole, the findings revealed that relative motion, relative phase, and possibly relative amplitude information are all distinct sources of information that contribute to the emergence of a kinematic understanding of action in the nervous system.
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Patterns of functional vision loss in glaucoma determined with archetypal analysis
Elze, Tobias; Pasquale, Louis R.; Shen, Lucy Q.; Chen, Teresa C.; Wiggs, Janey L.; Bex, Peter J.
2015-01-01
Glaucoma is an optic neuropathy accompanied by vision loss which can be mapped by visual field (VF) testing revealing characteristic patterns related to the retinal nerve fibre layer anatomy. While detailed knowledge about these patterns is important to understand the anatomic and genetic aspects of glaucoma, current classification schemes are typically predominantly derived qualitatively. Here, we classify glaucomatous vision loss quantitatively by statistically learning prototypical patterns on the convex hull of the data space. In contrast to component-based approaches, this method emphasizes distinct aspects of the data and provides patterns that are easier to interpret for clinicians. Based on 13 231 reliable Humphrey VFs from a large clinical glaucoma practice, we identify an optimal solution with 17 glaucomatous vision loss prototypes which fit well with previously described qualitative patterns from a large clinical study. We illustrate relations of our patterns to retinal structure by a previously developed mathematical model. In contrast to the qualitative clinical approaches, our results can serve as a framework to quantify the various subtypes of glaucomatous visual field loss. PMID:25505132
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Citizen science: A new perspective to advance spatial pattern evaluation in hydrology
Stisen, Simon
2017-01-01
Citizen science opens new pathways that can complement traditional scientific practice. Intuition and reasoning often make humans more effective than computer algorithms in various realms of problem solving. In particular, a simple visual comparison of spatial patterns is a task where humans are often considered to be more reliable than computer algorithms. However, in practice, science still largely depends on computer based solutions, which inevitably gives benefits such as speed and the possibility to automatize processes. However, the human vision can be harnessed to evaluate the reliability of algorithms which are tailored to quantify similarity in spatial patterns. We established a citizen science project to employ the human perception to rate similarity and dissimilarity between simulated spatial patterns of several scenarios of a hydrological catchment model. In total, the turnout counts more than 2500 volunteers that provided over 43000 classifications of 1095 individual subjects. We investigate the capability of a set of advanced statistical performance metrics to mimic the human perception to distinguish between similarity and dissimilarity. Results suggest that more complex metrics are not necessarily better at emulating the human perception, but clearly provide auxiliary information that is valuable for model diagnostics. The metrics clearly differ in their ability to unambiguously distinguish between similar and dissimilar patterns which is regarded a key feature of a reliable metric. The obtained dataset can provide an insightful benchmark to the community to test novel spatial metrics. PMID:28558050
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Alexander, Gina; Innes, Kim E; Bourguignon, Cheryl; Bovbjerg, Viktor E; Kulbok, Pamela; Taylor, Ann Gill
2012-01-01
The current study described patterns of yoga practice and examined differences in physical activity over time between individuals with or at risk for type 2 diabetes who completed an 8-week yoga intervention compared with controls. A longitudinal comparative design measured the effect of a yoga intervention on yoga practice and physical activity, using data at baseline and postintervention months 3, 6, and 15. Disparate patterns of yoga practice occurred between intervention and control participants over time, but the subjective definition of yoga practice limits interpretation. Multilevel model estimates indicated that treatment group did not have a significant influence in the rate of change in physical activity over the study period. While age and education were not significant individual predictors, the inclusion of these variables in the model did improve fit. Findings indicate that an 8-week yoga intervention had little effect on physical activity over time. Further research is necessary to explore the influence of yoga on behavioral health outcomes among individuals with or at risk for type 2 diabetes.
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Responding to the global economic crisis: inclusive social work practice.
Strier, Ron
2013-10-01
The present global economic crisis raises new concerns for social workers. One of its most visible results is the further socioeconomic decline and marginalization of excluded populations. This article suggests that the current circumstances require a much more engaged, egalitarian, and reflexive practice-a practice, based on social rights, that matches the magnitude of the crisis and its negative impact on traditional social work constituencies. Consequently, the article suggests the concept of inclusive social work practice (ISWP), a conceptual framework whose main principles respond to four processes of social exclusion closely related to the present global crisis: extreme social isolation, growing dependency, multiple deprivation, and internalized oppression. The author describes the impact of the global crisis on patterns of social exclusion and presents the methodological foundations of the ISWP framework.
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Van Kerkhove, Maria D.; Ly, Sowath; Holl, Davun; Guitian, Javier; Mangtani, Punam; Ghani, Azra C.; Vong, Sirenda
2008-01-01
Background Since 2004, H5N1 outbreaks have been recurrent in domestic poultry and humans in Cambodia. To date, seven human cases (100% CFR) and 22 outbreaks in poultry have been confirmed. Household ownership of backyard poultry (FAO Sector 4 poultry production) in rural Cambodia is high. An understanding of the extent and frequency of poultry handing behaviors in these settings is necessary to assess the risk associated with different practices and to formulate sensible recommendations to mitigate this risk. We collected new data from six geographic regions to examine patterns of human contact with poultry among rural farmers in Cambodia and identify populations with the highest potential exposure to H5N1. Methods and Findings A cross‐sectional survey was undertaken in which 3,600 backyard poultry owners from 115 randomly selected villages in six provinces throughout Cambodia were interviewed. Using risk assessment methods, patterns of contact with poultry as surrogate measures of exposure to H5N1 were used to generate risk indices of potential H5N1 transmission to different populations in contact with poultry. Estimates of human exposure risk for each study participant (n = 3600) were obtained by multiplying each reported practice with a transmission risk‐weighting factor and summing these over all practices reported by each individual. Exposure risk estimates were then examined stratified by age and gender. Subjects reported high contact with domestic poultry (chickens and ducks) through the daily care and food preparation practices, however contact patterns varied by gender and age. Males between the ages of 26‐40 reported practices of contact with poultry that give rise to the highest H5N1 transmission risk potential, followed closely by males between the ages of 16‐25. Overall, males had a higher exposure risk potential than females across all age groups (p < 0·001). Conclusions Our results demonstrate that most of the population in rural Cambodia is in frequent contact with domestic poultry. About half of the population in this study carried out on a regular basis at least one of the practices considered to be high risk for the effective transmission if the bird is infected. There was however substantial variation in the frequency of different practices and thus the potential risk of transmission of H5N1 from poultry to humans is not uniform across age and gender even amongst populations living in close proximity to poultry. PMID:19453420
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Labour Market Effects of Employment Protection. IAB Labour Market Research Topics.
ERIC Educational Resources Information Center
Walwei, Ulrich
The labor market effects of employment protection were examined in a study of Germany's employment protection regulations and their impact on employment practices and patterns. The following topics were considered: (1) the question of whether Germany's labor market problems are a result of regulations; (2) employment security as a subject of labor…
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The Art and the Science of Cultivation for Weed Control in Organic Peanut
USDA-ARS?s Scientific Manuscript database
Cultural weed control is the basis on which an integrated system of weed management in organic peanut is based. The cultural practices evaluated for weed control were row patterns and seeding rates, integrated with cultivation intensity. Results showed that peanut seeded in wide rows (two rows, 91...
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Robert A., II Pierce; D. Todd Farrand; William B. Kurtz; Jim Brandle; Ron Johnson
2003-01-01
Evolving agricultural policies and technologies have influenced land management practices within agroecosystems, impacting available habitats for many species of wildlife. Increasing available wildlife habitat and enhancing habitat quality have become an explicit objective of existing agricultural policy. Thus, there is renewed focus on utilizing shelterbelt...
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Classroom Interaction: Potential or Problem? The Case of Karagwe
ERIC Educational Resources Information Center
Wedin, Asa
2010-01-01
This paper discusses interactional patterns in classrooms in primary school in rural Tanzania, based on an ethnographic study on literacy practices. The paper argues that the official policy of Swahili-only in primary school, together with the huge gap between high expectations on educational outcome and lack of resources, have resulted in the…
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ERIC Educational Resources Information Center
Chakrani, Brahim; Huang, Jason L.
2014-01-01
This article investigates overt language attitudes and linguistic practices among French-taught university students in Morocco, showing the relationship between language behavior and attitudes. The results reveal a class-based divide in respondents' patterns of language use, in their support of the French monolingual sanitized classroom, and in…
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ERIC Educational Resources Information Center
Inan, Fethi A.; Lowther, Deborah L.; Ross, Steven M.; Strahl, Dan
2010-01-01
The purpose of this study was to identify instructional strategies used by teachers to support technology integration. In addition, relations between types of computer applications and teachers' classroom practices were examined. Data were direct observation results from 143 integration lessons implemented in schools receiving federal technology…
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Employee Turnover: Evidence from a Case Study.
ERIC Educational Resources Information Center
Borland, Jeff
1997-01-01
Patterns of employee turnover from a medium-sized law firm in Australia were examined in regard to theories of worker mobility (matching, sectoral shift, and incentive). Results support a role for matching effects, but personnel practices affect the timing of turnover. Matching and incentive-based theories do not explain the high rates of turnover…
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PATTERN PRACTICE IN THE TEACHING OF STANDARD ENGLISH TO STUDENTS WITH A NON-STANDARD DIALECT.
ERIC Educational Resources Information Center
LIN, SAN-SU C.
THE EXTENT TO WHICH PATTERN PRACTICE TECHNIQUES HELPED NEGRO STUDENTS WHO NEEDED TO MASTER STANDARD ENGLISH AS A SECOND LANGUAGE WAS INVESTIGATED. MATERIALS AND PROCEDURES TO IMPLEMENT SUCH TECHNIQUES WERE WORKED OUT. THE SUBJECTS ATTENDED CLAFLIN COLLEGE, AN ALL-NEGRO 4-YEAR COLLEGE IN SOUTH CAROLINA. APPROXIMATELY 65 TO 70 FRESHMEN WERE PLACED…
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ERIC Educational Resources Information Center
Kuruganti, Usha; Needham, Ted; Zundel, Pierre
2012-01-01
The concept of "practice makes perfect" was examined in this work in the context of effective learning. Specifically, we wanted to know how much practice was needed for students to demonstrate mastery of learning outcomes. Student learning patterns in two different university courses that use a similar education approach involving…
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Mathai, Elizabeth; Thomas, Raja John; Chandy, Sujith; Mathai, Matthews; Bergstrom, Staffan
2004-09-01
Although urinary tract infection (UTI) in pregnancy is a common medical problem, very little is known about the susceptibility patterns of bacteria causing UTI and the prescription practices for UTI in pregnancy in low-income countries. Studies were, therefore, carried out in southern India to document the susceptibility patterns and to compare these with prescription practices. Data on susceptibility patterns of bacteria isolated in significant counts from urine of pregnant women suspected to have urinary infection were collected. Prescribing patterns for these infections were ascertained using a questionnaire. About 90% of E. coli causing UTI is still susceptible to nitrofurantoin, a relatively inexpensive and safe drug. However, less than 25% of doctors used it for treatment of cystitis. Cephalosporins were most commonly used in hospital practice for the treatment of UTI. Amoxycillin was being used widely to treat UTI in pregnancy in spite of high prevalence of resistance. There were wide variations in the duration of therapy and use of prophylaxis. Our findings indicate an urgent need for proper guidelines, dissemination of information to practitioners and supervision of antimicrobial usage in low income countries like India. Irrational and unnecessary drug use can be expensive and harmful.
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Practice Patterns and Job Satisfaction of Mohs Surgeons.
Kohli, Nita; Golda, Nicholas
2018-01-01
There is a paucity of data on Mohs surgery workforce patterns. To identify if gender differences exist in practice patterns of Mohs surgeons, factors that influence these differences, and factors influencing job satisfaction among Mohs surgeons. An electronic survey was distributed to dermatology organizations targeting members of the American College of Mohs Surgery (ACMS), from October 2015 to April 2016. Two hundred twenty-seven ACMS members responded; 37% were women. Twenty-five percent of women and 19% of men work part time. Thirty-seven percent of women practice in academia versus 22% of men. Forty-three percent of women and 23% of men identified children as a factor affecting their ability to work full time. Gender comparisons for current job satisfaction show 57% of men and 35% of women being very satisfied. Supervision/feedback/recognition adds to satisfaction at a higher rate for women (53%) than for men (29%). For both genders combined, work content, patient base, and autonomy had the highest average job satisfaction ratings. Gender differences exist in practice patterns and job satisfaction of Mohs surgeons. This study demonstrates factors that could influence job satisfaction among female Mohs surgeons-knowledge that is important to individuals who lead, mentor, or supervise female Mohs surgeons.
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Scheduling admissions and reducing variability in bed demand.
Bekker, René; Koeleman, Paulien M
2011-09-01
Variability in admissions and lengths of stay inherently leads to variability in bed occupancy. The aim of this paper is to analyse the impact of these sources of variability on the required amount of capacity and to determine admission quota for scheduled admissions to regulate the occupancy pattern. For the impact of variability on the required number of beds, we use a heavy-traffic limit theorem for the G/G/∞ queue yielding an intuitively appealing approximation in case the arrival process is not Poisson. Also, given a structural weekly admission pattern, we apply a time-dependent analysis to determine the mean offered load per day. This time-dependent analysis is combined with a Quadratic Programming model to determine the optimal number of elective admissions per day, such that an average desired daily occupancy is achieved. From the mathematical results, practical scenarios and guidelines are derived that can be used by hospital managers and support the method of quota scheduling. In practice, the results can be implemented by providing admission quota prescribing the target number of admissions for each patient group.
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Optimization of landscape pattern [Chapter 8
John Hof; Curtis Flather
2007-01-01
A fundamental assumption in landscape ecology is that spatial patterns have significant influences on the flows of materials, energy, and information while processes create, modify, and maintain spatial patterns. Thus, it is of paramount importance in both theory and practice to address the questions of landscape pattern optimization ... For example, can landscape...
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Tolerance as a function of disapproval and respect: The case of Muslims.
Simon, Bernd; Schaefer, Christoph Daniel
2016-06-01
The article assesses a disapproval-respect model of tolerance according to which tolerance is made possible when disapproval of others' beliefs, preferences, or practices is balanced by respect for them as equal fellow citizens. Employing a sample of Muslims living in Germany, we predicted and found that such respect was more predictive of outgroup toleration when respondents disapproved rather than approved of the outgroups' beliefs, preferences, or practices. Moreover, respondents who displayed the critical combination of extreme disapproval and full respect indeed showed outgroup toleration. A parallel pattern of results was observed for willingness to engage in intergroup cooperation. Practical implications are discussed. © 2015 The British Psychological Society.
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Large-memory real-time multichannel multiplexed pattern recognition
NASA Technical Reports Server (NTRS)
Gregory, D. A.; Liu, H. K.
1984-01-01
The principle and experimental design of a real-time multichannel multiplexed optical pattern recognition system via use of a 25-focus dichromated gelatin holographic lens (hololens) are described. Each of the 25 foci of the hololens may have a storage and matched filtering capability approaching that of a single-lens correlator. If the space-bandwidth product of an input image is limited, as is true in most practical cases, the 25-focus hololens system has 25 times the capability of a single lens. Experimental results have shown that the interfilter noise is not serious. The system has already demonstrated the storage and recognition of over 70 matched filters - which is a larger capacity than any optical pattern recognition system reported to date.
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Message framing and defensive processing: a cultural examination.
Ko, Deborah M; Kim, Heejung S
2010-01-01
Past research has shown that health messages on safer sexual practices that focus on relational consequences are more persuasive than messages that focus on personal consequences. However, we theorize that it is defensiveness against personal risk framing that threatens the self among people from more individualistic cultures. Two studies tested this idea. Study 1 showed that European Americans were less persuaded by personal framing than by relational framing but that this pattern was not found for Asian Americans, who are more collectivistic. Study 2 showed that these defensive patterns were eliminated among European American participants when a person's self-image was affirmed. These results suggest defensive processes as the mechanism behind the differences in message framing effectiveness and motivate a closer look at cultural patterns.
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2010-01-01
Background Stair climbing up and down is an essential part of everyday's mobility. To enable wheelchair-dependent patients the repetitive practice of this task, a novel gait robot, G-EO-Systems (EO, Lat: I walk), based on the end-effector principle, has been designed. The trajectories of the foot plates are freely programmable enabling not only the practice of simulated floor walking but also stair climbing up and down. The article intended to compare lower limb muscle activation patterns of hemiparetic subjects during real floor walking and stairs climbing up, and during the corresponding simulated conditions on the machine, and secondly to demonstrate gait improvement on single case after training on the machine. Methods The muscle activation pattern of seven lower limb muscles of six hemiparetic patients during free and simulated walking on the floor and stair climbing was measured via dynamic electromyography. A non-ambulatory, sub-acute stroke patient additionally trained on the G-EO-Systems every workday for five weeks. Results The muscle activation patterns were comparable during the real and simulated conditions, both on the floor and during stair climbing up. Minor differences, concerning the real and simulated floor walking conditions, were a delayed (prolonged) onset (duration) of the thigh muscle activation on the machine across all subjects. Concerning stair climbing conditions, the shank muscle activation was more phasic and timely correct in selected patients on the device. The severely affected subject regained walking and stair climbing ability. Conclusions The G-EO-Systems is an interesting new option in gait rehabilitation after stroke. The lower limb muscle activation patterns were comparable, a training thus feasible, and the positive case report warrants further clinical studies. PMID:20584307
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A 2015 Survey of Clinical Practice Patterns in the Management of Thyroid Nodules.
Burch, Henry B; Burman, Kenneth D; Cooper, David S; Hennessey, James V; Vietor, Nicole O
2016-07-01
The management of thyroid nodules has changed dramatically over the past two decades. In the interim, technological advances including high-resolution ultrasound and molecular testing of thyroid nodules have been introduced. We sought to document current practices in the management thyroid nodules and assess the extent to which technological advances have been incorporated into current practice. We further sought to compare current practice to recommendations made in a recently updated American Thyroid Association (ATA) clinical practice guideline (CPG) and examine differences in thyroid nodule management among international members of U.S.-based endocrine societies. Members of The Endocrine Society, ATA, and American Association of Clinical Endocrinologists were invited to participate in a Web-based survey dealing with testing, treatment preference, and modulating factors in patients with thyroid nodules. A total of 897 respondents participated in the survey, including 661 members of The Endocrine Society, 454 American Association of Clinical Endocrinologists members, and 365 ATA members. Thyroid fine-needle aspiration (FNA) in 2015 is generally performed by endocrinologists (56.6%) and radiologists (31.9%), most frequently using ultrasound guidance (83.3%). Respondents in general have a lower threshold for FNA of thyroid nodules than that recommended in the updated ATA CPG. Management depends on the FNA result, with follicular lesion of undetermined significance/atypia of undetermined significance resulting in molecular testing (38.8% of respondents), repeat FNA cytology (31.5%), or immediate referral for thyroid surgery (24.4%). Nodules showing follicular neoplasm by FNA are referred for thyroid surgery by 61.2% of respondents (46.6 % lobectomy, 14.6 % total thyroidectomy) or molecular testing (29.0 %). Nodules found suspicious but not conclusive for malignancy (Bethesda category V), are referred for thyroid surgery (86.0%) and rarely undergo molecular testing (9.5%). During pregnancy, only 47.6% of respondents would perform FNA in the absence of nodular growth, with most respondents deferring FNA until after pregnancy. Endocrinologists are 64.2% less likely to perform FNA in an octogenarian than a younger patient with a comparable thyroid nodule. Striking international differences were identified in the routine measurement of calcitonin and in the use of molecular testing of thyroid nodules. In summary, our survey of clinical endocrinologists on the management of thyroid nodules documents current practice patterns and demonstrates both concordance and focal discordance with recently updated CPGs. Both international differences and a change in practice patterns during the past two decades are demonstrated.
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Mahmoudi, Babak; Erfanian, Abbas
2006-11-01
Mental imagination is the essential part of the most EEG-based communication systems. Thus, the quality of mental rehearsal, the degree of imagined effort, and mind controllability should have a major effect on the performance of electro-encephalogram (EEG) based brain-computer interface (BCI). It is now well established that mental practice using motor imagery improves motor skills. The effects of mental practice on motor skill learning are the result of practice on central motor programming. According to this view, it seems logical that mental practice should modify the neuronal activity in the primary sensorimotor areas and consequently change the performance of EEG-based BCI. For developing a practical BCI system, recognizing the resting state with eyes opened and the imagined voluntary movement is important. For this purpose, the mind should be able to focus on a single goal for a period of time, without deviation to another context. In this work, we are going to examine the role of mental practice and concentration skills on the EEG control during imaginative hand movements. The results show that the mental practice and concentration can generally improve the classification accuracy of the EEG patterns. It is found that mental training has a significant effect on the classification accuracy over the primary motor cortex and frontal area.
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Crain, A Lauren; Martinson, Brian C; Thrush, Carol R
2013-09-01
The Survey of Organizational Research Climate (SORC) is a validated tool to facilitate promotion of research integrity and research best practices. This work uses the SORC to assess shared and individual perceptions of the research climate in universities and academic departments and relate these perceptions to desirable and undesirable research practices. An anonymous web- and mail-based survey was administered to randomly selected biomedical and social science faculty and postdoctoral fellows in the United States. Respondents reported their perceptions of the research climates at their universities and primary departments, and the frequency with which they engaged in desirable and undesirable research practices. More positive individual perceptions of the research climate in one's university or department were associated with higher likelihoods of desirable, and lower likelihoods of undesirable, research practices. Shared perceptions of the research climate tended to be similarly predictive of both desirable and undesirable research practices as individuals' deviations from these shared perceptions. Study results supported the central prediction that more positive SORC-measured perceptions of the research climate were associated with more positive reports of research practices. There were differences with respect to whether shared or individual climate perceptions were related to desirable or undesirable practices but the general pattern of results provide empirical evidence that the SORC is predictive of self-reported research behavior.
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Extracting nursing practice patterns from structured labor and delivery data sets.
Hall, Eric S; Thornton, Sidney N
2007-10-11
This study was designed to demonstrate the feasibility of a computerized care process model that provides real-time case profiling and outcome forecasting. A methodology was defined for extracting nursing practice patterns from structured point-of-care data collected using the labor and delivery information system at Intermountain Healthcare. Data collected during January 2006 were retrieved from Intermountain Healthcare's enterprise data warehouse for use in the study. The knowledge discovery in databases process provided a framework for data analysis including data selection, preprocessing, data-mining, and evaluation. Development of an interactive data-mining tool and construction of a data model for stratification of patient records into profiles supported the goals of the study. Five benefits of the practice pattern extraction capability, which extend to other clinical domains, are listed with supporting examples.
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NASA Astrophysics Data System (ADS)
Benus, Matthew J.
The purpose of this study was to examine the patterns of dialogue that were established and emerged in one experienced fifth-grade science teacher's classroom that used the argument-based inquiry (ABI) and the ways in which these patterns of dialogue and consensus-making were used toward the establishment of a grasp of science practice. Most current studies on ABI agree that it does not come naturally and is only acquired through practice. Additionally, the quality of dialogue is also understood to be an important link in support of student learning. Few studies have examined the ways in which a teacher develops whole-class dialogue over time and the ways in which patterns of dialogue shift over time. The research questions that guided this study were: (1) What were the initial whole-class dialogue patterns established by a fifth-grade science teacher who engaged in ABI? (2) How did the science teacher help to refine whole-class dialogue to support the agreeability of ideas constructed over time? This eighteen week study that took place in a small city of less than 15,000 in Midwestern United States was grounded in interactive constructivism, and utilized a qualitative design method to identify the ways in which an experienced fifth-grade science teacher developed whole-class dialogue and used consensus-making activities to develop the practice of ABI with his students. The teacher in this study used the Science Writing Heuristic (SWH) approach to ABI with twenty-one students who had no previous experience engaging in ABI. This teacher with 10 of years teaching experience was purposefully selected because he was proficient and experienced in practicing ABI. Multiple sources of data were collected, including classroom video with transcriptions, semi-structured interviews, after lesson conversations, and researcher's field notes. Data analysis used a basic qualitative approach. The results showed (1) that the teacher principally engaged in three forms of whole-class dialogue with students; talking to, talking with, and thinking through ideas with students. As time went on, the teacher's interactions in whole-class dialogue became increasingly focused on thinking through ideas with students, while at the same time students also dialogued more as each unit progressed. (2) This teacher persistently engaged with students in consensus-making activities during whole-class dialogue.These efforts toward consensus-making over time became part of the students' own as each unit progressed. (3) The classroom did not engage in critique and construction of knowledge necessarily like the community of science but rather used agreeing and disagreeing and explaining why through purposeful dialogic interactions to construct a grasp of science classroom practice. The findings have informed theory and practice about science argumentation, the practice of whole-class dialogue, and grasp of science practice along four aspects: (1) patterns of dialogue within a unit of instruction and across units of instruction, (2) the teacher's ability to follow and develop students' ideas, (3) the role of early and persistent opportunities to engage novice students in consensus-making, and (4) the meaning of grasp of science practice in classroom. This study provides insight into the importance of prolonged and persistent engagement with ABI in classroom practice.
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Fowler, Patrick J.; Motley, Darnell; Zhang, Jinjin; Rolls-Reutz, Jennifer; Landsverk, John
2018-01-01
In this longitudinal study, we tested whether adolescent maltreatment and out-of-home placement as a response to maltreatment altered developmental patterns of sexual risk behaviors in a nationally representative sample of youth involved in the child welfare system. Participants included adolescents aged 13 to 17 (M=15.5, SD=1.49) at baseline (n=714), followed over 18 months. Computer-assisted interviews were used to collect self-reported sexual practices and experiences of physical and psychological abuse at both time points. Latent transition analyses were used to identify three patterns of sexual risk behaviors: abstainers, safe sex with multiple partners, and unsafe sex with multiple partners. Most adolescents transitioned to safer sexual behavior patterns over time. Adolescents exhibiting the riskiest sexual practices at baseline were most likely to report subsequent abuse and less likely to be placed into out-of-home care. Findings provide a more nuanced understanding of sexual risk among child welfare–involved adolescents and inform practices to promote positive transitions within the system. PMID:25155702
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Lindhiem, Oliver; Shaffer, Anne; Kolko, David J
2014-01-01
In the parent intervention outcome literatures, discipline practices are generally quantified as absolute frequencies or, less commonly, as relative frequencies. These differences in methodology warrant direct comparison as they have critical implications for study results and conclusions among treatments targeted at reducing parental aggression and harsh discipline. In this study, we directly compared the absolute frequency method and the relative frequency method for quantifying physically aggressive, psychologically aggressive, and nonaggressive discipline practices. Longitudinal data over a 3-year period came from an existing data set of a clinical trial examining the effectiveness of a psychosocial treatment in reducing parental physical and psychological aggression and improving child behavior (N = 139). Discipline practices (aggressive and nonaggressive) were assessed using the Conflict Tactics Scale. The two methods yielded different patterns of results, particularly for nonaggressive discipline strategies. We suggest that each method makes its own unique contribution to a more complete understanding of the association between parental aggression and intervention effects.
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AIDS-related dementia: a case report of rapid cognitive decline.
Morgan, M K; Clark, M E; Hartman, W L
1988-11-01
Little is known psychometrically about the pattern of cognitive decline associated with acquired immunodeficiency syndrome (AIDS)-related dementia. Pre- and posttest results are presented to illustrate a case example of rapid cognitive decline. Increased psychometric assessment is recommended with additional examination of inconsistent results, which may be dismissed mistakenly as related to psychiatric symptoms. Implications for clinical practice and the role of the psychologist are discussed.
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Gardner, B.; Sullivan, P.J.; Morreale, S.J.; Epperly, S.P.
2008-01-01
Loggerhead (Caretta caretta) and leatherback (Dermochelys coriacea) sea turtle distributions and movements in offshore waters of the western North Atlantic are not well understood despite continued efforts to monitor, survey, and observe them. Loggerhead and leatherback sea turtles are listed as endangered by the World Conservation Union, and thus anthropogenic mortality of these species, including fishing, is of elevated interest. This study quantifies spatial and temporal patterns of sea turtle bycatch distributions to identify potential processes influencing their locations. A Ripley's K function analysis was employed on the NOAA Fisheries Atlantic Pelagic Longline Observer Program data to determine spatial, temporal, and spatio-temporal patterns of sea turtle bycatch distributions within the pattern of the pelagic fishery distribution. Results indicate that loggerhead and leatherback sea turtle catch distributions change seasonally, with patterns of spatial clustering appearing from July through October. The results from the space-time analysis indicate that sea turtle catch distributions are related on a relatively fine scale (30-200 km and 1-5 days). The use of spatial and temporal point pattern analysis, particularly K function analysis, is a novel way to examine bycatch data and can be used to inform fishing practices such that fishing could still occur while minimizing sea turtle bycatch. ?? 2008 NRC.
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Cool, Simon R.; Pieters, Jan G.; Seatovic, Dejan; Mertens, Koen C.; Nuyttens, David; Van De Gucht, Tim C.; Vangeyte, Jürgen
2017-01-01
Centrifugal fertilizer spreaders are by far the most commonly used granular fertilizer spreader type in Europe. Their spread pattern however is error-prone, potentially leading to an undesired distribution of particles in the field and losses out of the field, which is often caused by poor calibration of the spreader for the specific fertilizer used. Due to the large environmental impact of fertilizer use, it is important to optimize the spreading process and minimize these errors. Spreader calibrations can be performed by using collection trays to determine the (field) spread pattern, but this is very time-consuming and expensive for the farmer and hence not common practice. Therefore, we developed an innovative multi-camera system to predict the spread pattern in a fast and accurate way, independent of the spreader configuration. Using high-speed stereovision, ejection parameters of particles leaving the spreader vanes were determined relative to a coordinate system associated with the spreader. The landing positions and subsequent spread patterns were determined using a ballistic model incorporating the effect of tractor motion and wind. Experiments were conducted with a commercial spreader and showed a high repeatability. The results were transformed to one spatial dimension to enable comparison with transverse spread patterns determined in the field and showed similar results. PMID:28617339
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Analysis of 1263 deaths in four general practices.
Holden, J; O'Donnell, S; Brindley, J; Miles, L
1998-01-01
BACKGROUND: The death of a patient is a significant event that occurs often enough in general practice for it to have the potential to tell us much about the care we provide. There are few large series in the literature and we still know little about the collaborative use of this outcome measure. AIM: To determine the pattern of deaths and potentially preventable factors in our practices. METHOD: We completed a standard data collection form after each death in four general practices over a 40-month period. The results were discussed at quarterly meetings. RESULTS: A total of 1263 deaths occurred among our registered patients during the period of the audit. Preventable factors contributing to deaths were considered to be attributable to: patients (40%): mainly cigarette smoking, poor compliance, and alcohol problems; general practice teams (5%): mainly delayed referral, diagnosis and treatment, and failure to prescribe aspirin to patients with vascular disease; hospitals (6%): mainly delayed diagnosis and perceived treatment problems; the environment (3%): mainly falls, principally resulting in fractured neck of femur. CONCLUSION: A simple audit of deaths along the lines that we describe gives important information about the care provided by general practice teams and those in hospital practice. It has both educational value and is a source of ideas for service improvement and further study, particularly when carried out over several years. PMID:9800400
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TCM Pattern Questionnaire for Lateral Elbow Pain: Development of an Instrument via a Delphi Process
Bian, Zhao-Xiang
2016-01-01
Individualized acupuncture treatment has been practiced for pain therapy. This study used acupuncture treatment for lateral elbow pain (LEP) as an example to study the diagnostic practice of individualized acupuncture treatment. A provisional version of LEP pattern questionnaire was developed based on a recent systematic review on TCM pattern diagnosis for LEP. A Delphi panel of 33 clinical experts from seven different countries was formed, and the Delphi survey was conducted in Chinese and English language for two rounds. Consensus was achieved from all 26 panelists who responded to the second round on 243 items of the instrument, which included a 72-question-long questionnaire. The mean level of expert consensus on the items of the final questionnaire was 85%. Consensus was found on four TCM patterns that could underlie LEP, namely, the wind-cold-dampness pattern, the qi stagnation and blood stasis pattern, the dual deficiency of qi and blood pattern, and the retained dampness-heat pattern. A list of signs and symptoms indicating one of the four TCM patterns and a list of preferred treatment modalities for each pattern were also generated. Our instrument shows considerable content validity. Further validity and reliability studies are under way. PMID:27525024
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Changes in Muscle and Joint Coordination in Learning to Direct Forces
Hasson, Christopher J.; Caldwell, Graham E.; van Emmerik, Richard E.A.
2008-01-01
While it has been suggested that biarticular muscles have a specialized role in directing external reaction forces, it is unclear how humans learn to coordinate mono- and bi-articular muscles to perform force-directing tasks. Subjects were asked to direct pedal forces in a specified target direction during one-legged cycling. We expected that with practice, performance improvement would be associated with specific changes in joint torque patterns and mono- and bi-articular muscular coordination. Nine male subjects practiced pedaling an ergometer with only their left leg, and were instructed to always direct their applied pedal force perpendicular to the crank arm (target direction) and to maintain a constant pedaling speed. After a single practice session, the mean error between the applied and target pedal force directions decreased significantly. This improved performance was accompanied by a significant decrease in the amount of ankle angular motion and a smaller increase in knee and hip angular motion. This coincided with a re-organization of lower extremity joint torques, with a decrease in ankle plantarflexor torque and an increase in knee and hip flexor torques. Changes were seen in both mono- and bi-articular muscle activity patterns. The monoarticular muscles exhibited greater alterations, and appeared to contribute to both mechanical work and force directing. With practice, a loosening of the coupling between biarticular thigh muscle activation and joint torque co-regulation was observed. The results demonstrated that subjects were able to learn a complex and dynamic force-directing task by changing the direction of their applied pedal forces through re-organization of joint torque patterns and mono- and bi-articular muscle coordination. PMID:18405988
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Woo, Jyh Haur; Ng, Wei Di; Salah, Maaz Mohammad; Neelam, Kumari; Eong, Kah-Guan Au; Kumar, Chandra Mohan
2016-01-01
INTRODUCTION Perioperative glycaemic control is an important aspect of clinical management in diabetic patients undergoing cataract surgery under local anaesthesia. While poor long-term glycaemic control has significant implications for surgery, perioperative hypoglycaemia or hyperglycaemia may also compromise patient safety and surgical outcomes. We aimed to survey ophthalmologists and anaesthesiologists on their approach and to identify the prevalent practice patterns in Singapore. METHODS This was a cross-sectional questionnaire-based survey conducted in four public hospitals in Singapore with established ophthalmology and anaesthesia units. Respondents were approached individually, and the self-administered questionnaires comprised questions related to practice patterns, clinical scenarios and awareness of pre-existing guidelines. RESULTS A total of 129 doctors responded to the questionnaire survey. 76 (58.9%) were from ophthalmology departments and 53 (41.1%) were from anaesthesia departments. The majority chose to withhold oral hypoglycaemic agents (82.9%) and/or insulin (69.8%), and keep the patient fasted preoperatively. A blood glucose level ≥ 17 mmol/L prompted 86.0%–93.8% of respondents to adopt a treat-and-defer strategy, while a level ≥ 23 mmol/L prompted 86.0%–96.9% of respondents to cancel the cataract surgery. The respondents were consistently more concerned about perioperative hyperglycaemia (n = 99, 76.7%) than intraoperative hypoglycaemia (n = 83, 64.3%). CONCLUSION The current study presented the prevalent practice patterns of ophthalmologists and anaesthesiologists in the perioperative management of diabetic patients undergoing cataract surgery in four public hospitals in Singapore. Further research in this field is required, and may be useful for the future formulation of formal guidelines and protocols. PMID:26892742
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Changes in muscle and joint coordination in learning to direct forces.
Hasson, Christopher J; Caldwell, Graham E; van Emmerik, Richard E A
2008-08-01
While it has been suggested that bi-articular muscles have a specialized role in directing external reaction forces, it is unclear how humans learn to coordinate mono- and bi-articular muscles to perform force-directing tasks. Participants were asked to direct pedal forces in a specified target direction during one-legged cycling. We expected that with practice, performance improvement would be associated with specific changes in joint torque patterns and mono- and bi-articular muscular coordination. Nine male participants practiced pedaling an ergometer with only their left leg, and were instructed to always direct their applied pedal force perpendicular to the crank arm (target direction) and to maintain a constant pedaling speed. After a single practice session, the mean error between the applied and target pedal force directions decreased significantly. This improved performance was accompanied by a significant decrease in the amount of ankle angular motion and a smaller increase in knee and hip angular motion. This coincided with a re-organization of lower extremity joint torques, with a decrease in ankle plantarflexor torque and an increase in knee and hip flexor torques. Changes were seen in both mono- and bi-articular muscle activity patterns. The mono-articular muscles exhibited greater alterations, and appeared to contribute to both mechanical work and force-directing. With practice, a loosening of the coupling between bi-articular thigh muscle activation and joint torque co-regulation was observed. The results demonstrated that participants were able to learn a complex and dynamic force-directing task by changing the direction of their applied pedal forces through re-organization of joint torque patterns and mono- and bi-articular muscle coordination.
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A Survey of Practice Patterns for Rehabilitation Post Elbow Fracture
MacDermid, Joy C; Vincent, Joshua I; Kieffer, Leah; Kieffer, Ashley; Demaiter, Jennifer; MacIntosh, Stephanie
2012-01-01
Background and Purpose: Elbow fractures amount to 4.3% of all the fractures. The elbow is prone to stiffness after injury and fractures can often lead to significant functional impairment. Rehabilitation is commonly used to restore range of motion (ROM) and function. Practice patterns in elbow fracture rehabilitation have not been defined. The purpose of this study was to describe current elbow fracture rehabilitation practices; and compare those to the existing evidence base. Methods: Hand therapists (n=315) from the USA (92%) and Canada (8%) completed a web-based survey on their practice patterns and beliefs related to the acute (0-6 weeks) and functional (6-12 weeks) phases of elbow fracture rehabilitation. Results: More than 99% of respondents agreed that fracture severity, co-morbidities, time since fracture, compliance with an exercise program, psychological factors, and occupational demands are important prognostic indicators for optimal function. Strong agreement was found with the use of patient education (95%) and active ROM (86%) in the acute stage while, home exercise programs (99%), active ROM (99%), stretching (97%), strengthening (97%), functional activities (ADLs and routine tasks) (97%), passive ROM (95%), and active assisted ROM (95%) were generally used in the functional stage. The most commonly used impairment measures were goniometry (99%), Jamar dynamometry (97%), and hand held dynamometry (97%). Agreement on the use of patient-reported outcome measures was very minimal (1.3%- 35.6%). Conclusions: Exercise, education, and functional activity have high consensus as components of elbo fracture rehabilitation. Future research should focus on defining the optimal dosage and type of exercise/activity, and establish core measures to monitor outcomes of these interventions. PMID:23115603
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Recognition and Management of Sepsis in Children: Practice Patterns in the Emergency Department.
Thompson, Graham C; Macias, Charles G
2015-10-01
Pediatric sepsis remains a leading cause of morbidity and mortality. Understanding current practice patterns and challenges is essential to inform future research and education strategies. Our aim was to describe the practice patterns of pediatric emergency physicians (PEPs) in the recognition and management of sepsis in children and to identify perceived priorities for future research and education. We conducted a cross-sectional, internet-based survey of members of the American Academy of Pediatrics, Section on Emergency Medicine and Pediatric Emergency Research Canada. The survey was internally derived, externally validated, and distributed using a modified Dillman methodology. Rank scores (RS) were calculated for responses using Likert-assigned frequency values. Tachycardia, mental-status changes, and abnormal temperature (RS = 83.7, 80.6, and 79.6) were the highest ranked clinical measures for diagnosing sepsis; white blood cell count, lactate, and band count (RS = 73.5, 70.9, and 69.1) were the highest ranked laboratory investigations. The resuscitation fluid of choice (85.5%) was normal saline. Dopamine was the first-line vasoactive medication (VAM) for cold (57.1%) and warm (42.2%) shock with epinephrine (18.5%) and norepinephrine (25.1%) as second-line VAMs (cold and warm, respectively). Steroid administration increased with complexity of presentation (all-comers 3.8%, VAM-resistant shock 54.5%, chronic steroid users 72.0%). Local ED-specific clinical pathways, national emergency department (ED)-specific guidelines, and identification of clinical biomarkers were described as future priorities. While practice variability exists among clinicians, PEPs continue to rely heavily on clinical metrics for recognizing sepsis. Improved recognition through clinical biomarkers and standardization of care were perceived as priorities. Our results provide a strong framework to guide future research and education strategies in pediatric sepsis. Copyright © 2015 Elsevier Inc. All rights reserved.
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Lenk, Kathleen M; Erickson, Darin J; Nelson, Toben F; Winters, Ken C; Toomey, Traci L
2012-05-01
The purpose of this study was to assess the prevalence of college alcohol policies and practices and to identify patterns of policies/practices across colleges. An online survey of administrators at a random sample of 351 4-year U.S. colleges was conducted in 2008. The prevalence of 31 alcohol policies and practices was assessed as well as differences across size and type of colleges. Latent class analyses identified classes of colleges based on their alcohol policies/practices. The majority of colleges prohibit alcohol use at sporting events, whereas less than half prohibit alcohol use at fraternity and sorority events. Less than half of the colleges also prohibit alcohol advertising in/on campus newspapers and radio stations. Small colleges are more likely than large colleges to prohibit alcohol use at tailgating events and to prohibit newspaper alcohol advertising. Public colleges are more likely than private colleges to prohibit alcohol use in dorms but less likely to prohibit alcohol advertising. We identified four classes of colleges-the largest class (38%) was characterized by having many alcohol policies/practices, the smallest class (13%) had none or few alcohol policies/practices, and the remainder fit into two middle classes that had certain policies/practices in place but lacked others. Most colleges report implementing some alcohol policies/ practices but are lacking others. Only two of every five colleges fit into a class that has many alcohol policies. More studies are needed to validate our findings and assess whether certain policies/practices and patterns of policies are associated with reducing student alcohol consumption and related problems.
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Synchronous Stroboscopic Electronic Speckle Pattern Interferometry
NASA Astrophysics Data System (ADS)
Soares, Oliverio D. D.
1986-10-01
Electronic Speckle Pattern Interferometry (E.S.P.I) oftenly called Electronic Holography is a practical powerful technique in non-destructive testing. Practical capabilities of the technique have been improved by fringe betterment and the control of analysis in the time domain, in particular, the scanning of the vibration cycle, with introduction of: synchronized amplitude and phase modulated pulse illumination, microcomputer control, fibre optics design, and moire evaluation techniques.
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Zhang, Qi; Gao, Bin; Chang, Yu
2017-02-27
BACKGROUND Partial support, as a novel support mode, has been widely applied in clinical practice and widely studied. However, the precise mechanism of partial support of LVAD in the intra-ventricular flow pattern is unclear. MATERIAL AND METHODS In this study, a patient-specific left ventricular geometric model was reconstructed based on CT data. The intra-ventricular flow pattern under 3 simulated conditions - "heart failure", "partial support", and "full support" - were simulated by using fluid-structure interaction (FSI). The blood flow pattern, wall shear stress (WSS), time-average wall shear stress (TAWSS), oscillatory shear index (OSI), and relative residence time (RRT) were calculated to evaluate the hemodynamic effects. RESULTS The results demonstrate that the intra-ventricular flow pattern is significantly changed by the support level of BJUT-II VAD. The intra-ventricular vortex was enhanced under partial support and was eliminated under full support, and the high OSI and RRT regions changed from the septum wall to the cardiac apex. CONCLUSIONS In brief, the support level of the BJUT-II VAD has significant effects on the intra-ventricular flow pattern. The partial support mode of BJUT-II VAD can enhance the intra-ventricular vortex, while the distribution of high OSI and RRT moved from the septum wall to the cardiac apex. Hence, the partial support mode of BJUT-II VAD can provide more benefit for intra-ventricular flow pattern.
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Power, uncertainty, self-transcendence, and quality of life in breast cancer survivors.
Farren, Arlene T
2010-01-01
The purpose of the study was to examine the relations among power, uncertainty, self-transcendence, and quality of life in breast cancer survivors from the perspective of Rogers' science of unitary human beings. A correlational, cross-sectional study with purposive sampling (n = 104) was conducted. The results included statistically significant correlations, explained variance, and mediating relations among the pattern manifestations. The researcher concluded that there are complex and synergistic relations among the cluster of field pattern manifestations that contribute to quality of life in breast cancer survivors. Implications for theory, research, and practice are discussed.
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Anselm, D; Danner, M; Kirmaier, N; König, H L; Müller-Limmroth, W; Reis, A; Schauerte, W
1977-06-10
In the relevant frequency range of about 10 Hertz cars can be considered very largely as Faraday cages and consequently as screens against air-electric fields. This may have a negative influence on driving and reaction patterns as a result. In an extensive investigation 48 subjects in a driving simulator were exposed to definite artificially produced air-electric fields. The self-rating of the performance and concentration of the subjects, reaction times and driving errors were determined. While the reaction times remained practically constant, the driving behavior of the subjects improved.
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River management impacts on riparian forest vegetation along the Middle Rio Grande: 1935-2014
NASA Astrophysics Data System (ADS)
Petrakis, Roy E.
Riparian ecosystems of the southwestern United States are highly valuable to both the ecological and human communities which surround them. Over the past century, they have been subject to shifting management practices to maximize human use, control, ecosystem service, and conservation. This creates a complex relationship between water policy, management, and the natural ecosystem necessitating research on spatial and temporal dynamics of riparian vegetation. The San Acacia Reach of the Middle Rio Grande, a 60 mile stretch from the San Acacia Diversion Dam to San Marcial, has experienced multiple management and river flow fluctuations over the past 80 years, resulting in threats to riparian and aquatic ecosystems. This research was completed through the use and analysis of multi-source remote sensing data, GIS, and a review of the on-the-ground management decisions to better understand how the location and composition of the riparian vegetation has been affected by these shifting practices. This research focused on four phases, each highlighting different management practices and river flow patterns during the last 80-years. Each of these periods provides a unique opportunity to observe a direct relationship between river management and riparian land cover response and change. Overall, management practices reduced surface river flows and limited overbank flooding and resulted in changes in the composition, density, and spatial patterns of the vegetation, including increased non-native vegetation growth. Restoration efforts over the past few decades have begun to reduce the presence of non-native species. Despite these changes, this ecosystem was shown to be extremely resilient in maintaining its function/service throughout the entire study time frame.
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Carotid Endarterectomy: Current Concepts and Practice Patterns
Saha, Sibu P.; Saha, Subhajit; Vyas, Krishna S.
2015-01-01
Background Stroke is the number one cause of disability and third leading cause of death among adults in the United States. A major cause of stroke is carotid artery stenosis (CAS) caused by atherosclerotic plaques. Randomized trials have varying results regarding the equivalence and perioperative complication rates of stents versus carotid endarterectomy (CEA) in the management of CAS. Objectives We review the evidence for the current management of CAS and describe the current concepts and practice patterns of CEA. Methods A literature search was conducted using PubMed to identify relevant studies regarding CEA and stenting for the management of CAS. Results The introduction of CAS has led to a decrease in the percentage of CEA and an increase in the number of CAS procedures performed in the context of all revascularization procedures. However, the efficacy of stents in patients with symptomatic CAS remains unclear because of varying results among randomized trials, but the perioperative complication rates exceed those found after CEA. Conclusions Vascular surgeons are uniquely positioned to treat carotid artery disease through medical therapy, CEA, and stenting. Although data from randomized trials differ, it is important for surgeons to make clinical decisions based on the patient. We believe that CAS can be adopted with low complication rate in a selected subgroup of patients, but CEA should remain the standard of care. This current evidence should be incorporated into practice of the modern vascular surgeon. PMID:26417192
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Barbarossa, A; Rambaldi, J; Miraglia, V; Giunti, M; Diegoli, G; Zaghini, A
2017-07-15
This investigation provides for the first time a general view of the prescribing patterns of antimicrobials in small animal practice in Emilia Romagna, Italy. In the context of a project on antimicrobial resistance managed by the Regional Veterinary Service, veterinary clinicians were invited to voluntarily complete an online questionnaire. This was designed to gather information on antimicrobial prescribing practices and biosecurity measures and to understand the perception of the issue specific to this region of Italy. In total, 266 questionnaires correctly completed were collected. Although clinicians seemed to follow different approaches when using antimicrobials, the data analysis revealed a general awareness on resistance. Penicillins were the most commonly prescribed class, followed by (fluoro)quinolones and cephalosporins. Among those who use laboratory testing more or less frequently (microbiological analysis and susceptibility testing) to support their prescribing habits, only 7 per cent make a habit of always waiting for the results before starting the treatment. Seventy-eight per cent of the respondents declared the use of antimicrobials licensed for human beings. Biosecurity measures were carefully taken into account by the majority of the veterinarians. The results identified the antimicrobial classes that are commonly prescribed and highlighted that perioperative hygiene measures and the use of laboratory diagnosis are critical aspects that need to be emphasised in drawing up guidelines on the prudent use of these drugs in pets.
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Optical coherence tomography in differential diagnosis of skin pathology
NASA Astrophysics Data System (ADS)
Gladkova, Natalia D.; Petrova, Galina P.; Derpaluk, Elena; Nikulin, Nikolai K.; Snopova, Ludmila; Chumakov, Yuri; Feldchtein, Felix I.; Gelikonov, Valentin M.; Gelikonov, Grigory V.; Kuranov, Roman V.
2000-05-01
The capabilities of optical coherence tomography (OCT) for imaging in vivo of optical patterns of pathomorphological processes in the skin and use of their optical patterns in clinical practice for differential diagnosis of dermatoses are presented. Images of skin tissue 0.8 - 1.5 mm deep were acquired with a resolution of 5, 12 and 20 micrometer using three compact fiber OCT devices developed at the Institute of Applied Physics RAS. The acquisition time of images of skin regions 2 - 6 mm in length was 2 - 4 s. The OCT capabilities were analyzed based on the study of 50 patients with different dermatoses. OCT images were interpreted by comparing with parallel histology. It is shown that OCT can detect in vivo optical patterns of morphological alterations in such general papulous dermatoses as lichen ruber planus and psoriasis, a capability that can be used in differential diagnosis of these diseases. Most informative are OCT images obtained with a resolution of 5 micrometer. The results of our study demonstrate the practical importance of OCT imaging for diagnosis of different dermatoses. OCT is noninvasive and, therefore, makes it possible to perform frequent multifocal examination of skin without any adverse effects.
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Yokoyama, Yoko; Kakudate, Naoki; Sumida, Futoshi; Matsumoto, Yuki; Gilbert, Gregg H; Gordan, Valeria V
2016-12-01
The study aims were: (i) to examine dentist practice patterns regarding treatment recommendations for dental sealants; and (ii) to identify characteristics associated with this recommendation. The study was performed using a cross-sectional questionnaire survey (Clinicaltrials.gov registration number NCT01680848). Participants were Japanese dentists (n = 282) recruited from the Dental Practice-based Research Network Japan. Three clinical photographs of the occlusal surface of a mandibular first molar were presented, portraying increasing depths of cavitation in a 12-year-old patient with high caries risk. Sealants would be an appropriate treatment in all three scenarios. We asked about the treatment decision for each case. We then performed multiple logistic regression analyses to evaluate associations between the decision to recommend sealants, and dentist, patient and practice characteristics. Responses were obtained from 189 dentists (response rate = 67%). In the hypothetical scenarios, dentists' recommendations for sealants for the 12-year-old patient varied from 16% to 26% across the three hypothetical clinical scenarios. Multiple logistic regression analysis indicated that dentist agreement with the efficacy of assessment for caries risk showed a significant association with the percentages of patients receiving sealants. Dentist practice patterns for sealant treatment recommendation show changes that are dependent on caries severity. The dentists' recommendations for sealants for the 12-year-old patient were low for all three selected scenarios, based on indications for sealants in the American Dental Association guidelines. Recommending a sealant showed a significant relationship with the dentist having a higher agreement with efficacy of caries risk assessment. © 2016 FDI World Dental Federation.
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Kral, Tanja V.E.; Chittams, Jesse; Moore, Reneé H.
2017-01-01
Purpose Prior studies showed that food insecurity may increase the odds of obesity in children and adults. We still know very little about the familial aggregation of obesity in food insecure households or the mechanisms by which food insecurity confers an increased risk of obesity to children. The purpose of this study was to compare children and mothers from food insecure and food secure households in their weight status, child eating patterns/behaviors, and maternal feeding practices. Design and Methods Fifty mothers of 8- to 10-year-old children were asked to complete questionnaires, including the U.S. Household Food Security survey, and had their own and their children’s heights and weights measured. Results The odds of a child being obese were 5 times higher for children from food insecure households compared to children from food secure households [95%CI: 1.15, 20.8]. In univariate analyses, children from food insecure households showed significantly greater external eating, both past satiation and in the absence of hunger (p < .03), and mothers from food insecure households expressed significantly greater concern about their children’s weight and used restrictive feeding practices to a greater extent (p < .03) when compared to families from food secure households. A greater proportion of children from food secure households consumed 3–4 snacks per day (45.9% vs. 15.4%) while a higher proportion of children from food insecure households consumed ≥ 5 snacks per day (15.4% vs. 0%; p = .02). Practice Implications These findings provide further support for an association between food insecurity and childhood obesity and suggest that differences in external eating, child snacking patterns, and select maternal feeding practices may be implicated in food-insecure children’s overconsumption of calories. When caring for food-insecure children, health care providers should screen for problematic eating patterns and feeding practices. PMID:28321980
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Socio-cultural and economic factors affecting food consumption patterns in the Arab countries.
Musaiger, A O
1993-04-01
Several factors have been found to determine the dietary habits of the people in the Arab world. Food consumption pattern has dramatically changed in some Arab countries as a result of sudden increase in income from oil revenue. It is believed that food subsidy policy has adversely affected the food habits in the Gulf states by encouraging the intake of fat, sugar, rice, wheat flour and meat. Socio-cultural factors such as religion, beliefs, food preferences, gender discrimination, education and women's employment all have a noticeable influence on food consumption patterns in this region. Mass media, especially televised food advertisements, play an important role in modifying the dietary habits. The migration movement, particularly that which was carried out during the 70s has a great impact on the food practices in many Arab countries. Comprehensive studies on social, cultural and economic factors associated with food consumption patterns in the Arab region are highly recommended.
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Jiang, Bowen; Bender, Matthew T.; Hasjim, Bima; Hsu, Frank P. K.; Tamargo, Rafael J.; Huang, Judy; Colby, Geoffrey P.; Coon, Alexander L.; Lin, Li-Mei
2017-01-01
Background: The practice patterns of a hybrid open cerebrovascular/neuroendovascular (CVNV) neurosurgeon in early academic practice is unknown. Methods: We performed a multi-institutional retrospective cohort study of patients with cerebral aneurysms that were treated within the first 24 months of the neurosurgeon’s practice. Results: A total of 533 aneurysms were treated by the three senior authors within the first 24 months of their academic practice. Of these aneurysms, 172 were treated with microsurgical clipping, 191 with coiling, and 170 with flow diversion. Treatment in the setting of acute subarachnoid hemorrhage (SAH) occurred in 23% (122/533) of the aneurysms. Majority of the clipped aneurysms (70%, 121/172) were anterior cerebral artery (ACA), anterior communicating artery (ACOM), or middle cerebral artery (MCA) in location. In comparison, only 23% (82/361) of aneurysms treated with coiling or flow diversion therapy were ACA, ACOM, or MCA in location (P < 0.05). Additionally, majority of the flow diverted aneurysm (65%, 111/170) were cavernous or ophthalmic/paraophthalmic in location. During the second year of practice, there appeared to be a trend towards more aneurysms treated with neuroendovascular techniques (22% increase), particularly in flow diversion. Conclusion: Although the CVNV neurosurgeon treats cerebral aneurysms more commonly with neuroendovascular techniques, a third of the cerebral aneurysms are still selected for microsurgical clipping. Aneurysms located along the ACA/ACOM or MCA are the most frequent aneurysms reserved for microsurgical clipping. The CVNV neurosurgeon must be prepared to manage a high percentage of ACA/ACOM or MCA aneurysms microsurgically. PMID:28808603
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Perl, Jeffrey; Davies, Simon J.; Lambie, Mark; Pisoni, Ronald L.; McCullough, Keith; Johnson, David W.; Sloand, James A.; Prichard, Sarah; Kawanishi, Hideki; Tentori, Francesca; Robinson, Bruce M.
2016-01-01
♦ Background: Extending technique survival on peritoneal dialysis (PD) remains a major challenge in optimizing outcomes for PD patients while increasing PD utilization. The primary objective of the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS) is to identify modifiable practices associated with improvements in PD technique and patient survival. In collaboration with the International Society for Peritoneal Dialysis (ISPD), PDOPPS seeks to standardize PD-related data definitions and provide a forum for effective international collaborative clinical research in PD. ♦ Methods: The PDOPPS is an international prospective cohort study in Australia, Canada, Japan, the United Kingdom (UK), and the United States (US). Each country is enrolling a random sample of incident and prevalent patients from national samples of 20 to 80 sites with at least 20 patients on PD. Enrolled patients will be followed over an initial 3-year study period. Demographic, comorbidity, and treatment-related variables, and patient-reported data, will be collected over the study course. The primary outcome will be all-cause PD technique failure or death; other outcomes will include cause-specific technique failure, hospitalizations, and patient-reported outcomes. ♦ Results: A high proportion of the targeted number of study sites has been recruited to date in each country. Several ancillary studies have been funded with high momentum toward expansion to new countries and additional participation. ♦ Conclusion: The PDOPPS is the first large, international study to follow PD patients longitudinally to capture clinical practice. With data collected, the study will serve as an invaluable resource and research platform for the international PD community, and provide a means to understand variation in PD practices and outcomes, to identify optimal practices, and to ultimately improve outcomes for PD patients. PMID:26526049
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Adaptive governance good practice: Show me the evidence!
Sharma-Wallace, Lisa; Velarde, Sandra J; Wreford, Anita
2018-09-15
Adaptive governance has emerged in the last decade as an intriguing avenue of theory and practice for the holistic management of complex environmental problems. Research on adaptive governance has flourished since the field's inception, probing the process and mechanisms underpinning the new approach while offering various justifications and prescriptions for empirical use. Nevertheless, recent reviews of adaptive governance reveal some important conceptual and practical gaps in the field, particularly concerning challenges in its application to real-world cases. In this paper, we respond directly to the empirical challenge of adaptive governance, specifically asking: which methods contribute to the implementation of successful adaptive governance process and outcomes in practice and across cases and contexts? We adopt a systematic literature review methodology which considers the current body of empirical literature on adaptive governance of social-ecological systems in order to assess and analyse the methods affecting successful adaptive governance practice across the range of existing cases. We find that methods contributing to adaptive governance in practice resemble the design recommendations outlined in previous adaptive governance scholarship, including meaningful collaboration across actors and scales; effective coordination between stakeholders and levels; building social capital; community empowerment and engagement; capacity development; linking knowledge and decision-making through data collection and monitoring; promoting leadership capacity; and exploiting or creating governance opportunities. However, we critically contextualise these methods by analysing and summarising their patterns-in-use, drawing examples from the cases to explore the specific ways they were successfully or unsuccessfully applied to governance issues on-the-ground. Our results indicate some important underlying shared patterns, trajectories, and lessons learned for evidence-based adaptive governance good practice within and across diverse sectors, issues, and contexts. Copyright © 2018. Published by Elsevier Ltd.
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Control and near-field detection of surface plasmon interference patterns.
Dvořák, Petr; Neuman, Tomáš; Břínek, Lukáš; Šamořil, Tomáš; Kalousek, Radek; Dub, Petr; Varga, Peter; Šikola, Tomáš
2013-06-12
The tailoring of electromagnetic near-field properties is the central task in the field of nanophotonics. In addition to 2D optics for optical nanocircuits, confined and enhanced electric fields are utilized in detection and sensing, photovoltaics, spatially localized spectroscopy (nanoimaging), as well as in nanolithography and nanomanipulation. For practical purposes, it is necessary to develop easy-to-use methods for controlling the electromagnetic near-field distribution. By imaging optical near-fields using a scanning near-field optical microscope, we demonstrate that surface plasmon polaritons propagating from slits along the metal-dielectric interface form tunable interference patterns. We present a simple way how to control the resulting interference patterns both by variation of the angle between two slits and, for a fixed slit geometry, by a proper combination of laser beam polarization and inhomogeneous far-field illumination of the structure. Thus the modulation period of interference patterns has become adjustable and new variable patterns consisting of stripelike and dotlike motifs have been achieved, respectively.
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Kang, Sangmin; Lim, Kyungmi; Park, Hyeokjun; Park, Jong Bo; Park, Seong Chae; Cho, Sung-Pyo; Kang, Kisuk; Hong, Byung Hee
2018-01-10
Carbon electrodes including graphene and thin graphite films have been utilized for various energy and sensor applications, where the patterning of electrodes is essentially included. Laser scribing in a DVD writer and inkjet printing were used to pattern the graphene-like materials, but the size and speed of fabrication has been limited for practical applications. In this work, we devise a simple strategy to use conventional laser-printer toner materials as precursors for graphitic carbon electrodes. The toner was laser-printed on metal foils, followed by thermal annealing in hydrogen environment, finally resulting in the patterned thin graphitic carbon or graphene electrodes for supercapacitors. The electrochemical cells made of the graphene-graphitic carbon electrodes show remarkably higher energy and power performance compared to conventional supercapacitors. Furthermore, considering the simplicity and scalability of roll-to-roll (R2R) electrode patterning processes, the proposed method would enable cheaper and larger-scale synthesis and patterning of graphene-graphitic carbon electrodes for various energy applications in the future.
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Miettinen, M K; Björkroth, K J; Korkeala, H J
1999-02-18
One dominating strain of serotype 1/2b was found when serotyping and pulsed-field gel electrophoresis (PFGE) patterns were used for the characterization of 41 Listeria monocytogenes isolates originating from an ice cream plant. Samples were taken from the production environment, equipment and ice cream during the years 1990-1997. Serotyping divided the isolates into two serovars, 1/2b and 4b. Three rare-cutting enzymes (ApaI, AscI and SmaI) were used in the creation of PFGE patterns. AscI resulted in the best restriction enzyme digestion patterns (REDPs) for visual comparison. Eight different AscI REDPs were obtained, whereas ApaI produced six and SmaI seven banding patterns. When one-band differences are taken into account, 12 different PFGE types were distinguished based on information obtained with all three enzymes. The dominant PFGE type was found to have persisted in the ice cream plant for seven years. Improved and precisely targeted cleaning and disinfection practices combined with structural changes making for easier cleaning of the packaging machine, resulted in eradication of L. monocytogenes from this plant.
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Cote, Claudia; MacLeod, Jeffrey B; Yip, Alexandra M; Ouzounian, Maral; Brown, Craig D; Forgie, Rand; Pelletier, Marc P; Hassan, Ansar
2015-01-01
Rates of perioperative transfusion vary widely among patients undergoing cardiac surgery. Few studies have examined factors beyond the clinical characteristics of the patients that may be responsible for such variation. The purpose of this study was to determine whether differing practice patterns had an impact on variation in perioperative transfusion at a single center. Patients who underwent cardiac surgery at a single center between 2004 and 2011 were considered. Comparisons were made between patients who had received a perioperative transfusion and those who had not from the clinical factors at baseline, intraoperative variables, and differing practice patterns, as defined by the surgeon, anesthesiologist, perfusionist, and the year in which the procedure was performed. The risk-adjusted effect of these factors on perioperative transfusion rates was determined using multivariable regression modeling techniques. The study population comprised 4823 patients, of whom 1929 (40.0%) received a perioperative transfusion. Significant variation in perioperative transfusion rates was noted between surgeons (from 32.4% to 51.5%, P < .0001), anesthesiologists (from 34.4% to 51.9%, P < .0001) and across year (from 28.2% in 2004 to 48.8% in 2008, P < .0001). After adjustment for baseline and intraoperative variables, surgeon, anesthesiologist, and year of procedure were each found to be independent predictors of perioperative transfusion. Differing practice patterns contribute to significant variation in rates of perioperative transfusion within a single center. Strategies aimed at reducing overall transfusion rates must take into account such variability in practice patterns and account for nonclinical factors as well as known clinical predictors of blood transfusions. Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.
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Meijer, Rob R; Niessen, A Susan M; Tendeiro, Jorge N
2016-02-01
Although there are many studies devoted to person-fit statistics to detect inconsistent item score patterns, most studies are difficult to understand for nonspecialists. The aim of this tutorial is to explain the principles of these statistics for researchers and clinicians who are interested in applying these statistics. In particular, we first explain how invalid test scores can be detected using person-fit statistics; second, we provide the reader practical examples of existing studies that used person-fit statistics to detect and to interpret inconsistent item score patterns; and third, we discuss a new R-package that can be used to identify and interpret inconsistent score patterns. © The Author(s) 2015.
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Doctors' experience with handheld computers in clinical practice: qualitative study
McAlearney, Ann Scheck; Schweikhart, Sharon B; Medow, Mitchell A
2004-01-01
Objective To examine doctors' perspectives about their experiences with handheld computers in clinical practice. Design Qualitative study of eight focus groups consisting of doctors with diverse training and practice patterns. Setting Six practice settings across the United States and two additional focus group sessions held at a national meeting of general internists. Participants 54 doctors who did or did not use handheld computers. Results Doctors who used handheld computers in clinical practice seemed generally satisfied with them and reported diverse patterns of use. Users perceived that the devices helped them increase productivity and improve patient care. Barriers to use concerned the device itself and personal and perceptual constraints, with perceptual factors such as comfort with technology, preference for paper, and the impression that the devices are not easy to use somewhat difficult to overcome. Participants suggested that organisations can help promote handheld computers by providing advice on purchase, usage, training, and user support. Participants expressed concern about reliability and security of the device but were particularly concerned about dependency on the device and over-reliance as a substitute for clinical thinking. Conclusions Doctors expect handheld computers to become more useful, and most seem interested in leveraging (getting the most value from) their use. Key opportunities with handheld computers included their use as a stepping stone to build doctors' comfort with other information technology and ehealth initiatives and providing point of care support that helps improve patient care. PMID:15142920
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Schwartz, J; Dube, K; Alexy, U; Kalhoff, H; Kersting, M
2010-02-01
An appropriate supply of n-3 long-chain polyunsaturated fatty acids (LC-PUFAs) during early childhood may enhance cognitive development. Little attention is paid to the fatty acid (FA) supply during the complementary feeding period. We examined the polyunsaturated fatty acids (PUFAs) and LC-PUFAs pattern in dietary practice of two study groups and evaluated the results against the present Dietary Guidelines in Germany. The food consumption and FA pattern of dietary practice in subjects from two prospective studies (n=102 and n=184, respectively) at the age of 3, 6 and 9 months was assessed by weighed diet records, and changes during the first year of life were compared with the food-based dietary guidelines for the first year of life. Dietary practice in the complementary feeding period was clearly dominated by commercial food products. The FA composition in dietary practice was different from the Guideline Diet and the ratio of n-6/n-3 PUFAs was less favorable. Consumption of breast milk or formula was still of major importance for the intake of LC-PUFAs in the complementary feeding period. LC-PUFAs are predominantly provided by breast milk and formula during the first year of life and consequently decrease when milk consumption decreases. For compensation, commercial complementary food might come closer to the Guideline Diet by lowering the n-6/n-3 PUFA ratio through appropriate vegetable oil along with an increase in total fat content up to the legal limit.
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Sun, Maryellen R M; Wagner, Andrew A; San Francisco, Ignacio F; Brook, Alexander; Kavoussi, Louis; Russo, Paul; Steele, Graeme; Viterbo, Rosalia; Pedrosa, Ivan
2012-03-01
This study aimed to evaluate the need for intraoperative ultrasound (IOUS) and recommendation for surgical approach in the resection of renal tumors through a survey of practicing urologists, with correlation to tumor imaging features and urologist practice pattern. An institutional review board-approved retrospective review, compliant with the Health Insurance Portability and Accountability Act, of 44 renal tumors that underwent laparoscopic partial nephrectomy at the study institution was performed. The numeric component of the RENAL nephrometry score (radius [diameter], % exophytic, nearness [to collecting system/renal sinus], location) was calculated for each case using preoperative computed tomography/magnetic resonance imaging. Five anonymized images of each tumor were presented to 4 academic urologists with varying practice patterns. Reviewers independently scored each case for its need for IOUS, for recommendation of a surgical technique, and for the difficulty of the proposed surgery. The RENAL scores were as follows: RENAL 1 (low complexity, score 4-6; n = 19); RENAL 2 (moderate complexity, score 7-9; n = 23); RENAL 3 (high complexity, score 10-12; n = 2). The only RENAL score component significantly influencing need for IOUS was percentage exophytic (P = 0.00002). There was an inverse relationship between normalized and averaged need for IOUS and percentage exophytic (P < 0.0001). The predominant influence for recommendation of surgical method was the reviewer him/herself, with each reviewer's recommendations closely matching his/her practice pattern. Size and percentage exophytic represented the only tumor features significantly (P = 0.03) influencing surgical recommendation. There was a significant difference in the perceived need for IOUS and surgical recommendation when 4 academic urologists reviewed a series of renal masses requiring resection. Percentage exophytic correlated inversely with need for IOUS. Urologist's practice pattern and tumor size and percentage exophytic were most predictive of surgical recommendation.
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Topographically-controlled site conditions drive vegetation pattern on inland dunes in Poland
NASA Astrophysics Data System (ADS)
Sewerniak, Piotr; Jankowski, Michał
2017-07-01
The inland dunes of Central Europe are commonly overplanted by Scots pine (Pinus sylvestris) monocultures in which the primary occurrence of the natural vegetation pattern is obliterated. We hypothesize that on naturally revegetated inland dunes the pattern is clear and driven by topographically-controlled site conditions. To test this hypothesis, we addressed the following research questions: (1) Does topography drive vegetation patterns on inland dunes and if so, what are main differences between vegetation in varying relief positions? (2) To what extent does topography involve the variability of microclimates and of soil properties, and how does the topographically-induced differentiation of these site conditions control vegetation patterns? We conducted interdisciplinary studies (applying floristic, pedological and microclimatic research techniques) on a naturally revegetated inland dune area situated on a military artillery training ground near Toruń, northern Poland. We investigated vegetation patterns with reference to three topographical position variants (north-facing slopes, south-facing slopes, and intra-dune depressions). We found distinct differences in vegetation characteristics covering the aforementioned topographical positions. This primarily concerned species composition of ground vegetation: Calluna vulgaris was dominant species on north-facing slopes, Corynephorus canescens on south-facing slopes, while Calamagrostis epigejos in intra-dune depressions. In comparison to dune slopes, the depressions were characterized by much higher biodiversity of vascular plant species. This followed the most favorable soil conditions for the existence of plants (higher moisture and nutrient pools) occurring in low topographical positions. However, tree succession was most advanced not in depressions, where the competitive impact of tall grasses on seedlings was recognized, but on north-facing slopes. Based on our results, we formulated some suggestions, which could be useful for both practical foresters to increase biodiversity of ecosystems and for practices that work on the fixation of dunes by restoring vegetation.
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Utilizing inventory information to calibrate a landscape simulation model
Steven R. Shifley; Frank R., III Thompson; David R. Larsen; David J. Mladenoff; Eric J. Gustafson
2000-01-01
LANDIS is a spatially explicit model that uses mapped landscape conditions as a starting point and projects the patterns in forest vegetation that will result from alternative harvest practices, alternative fire regimes, and wind events. LANDIS was originally developed for Lake States forests, but it is capable of handling the input, output, bookkeeping, and mapping...
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Implications on Pedagogy as a Result of Adopted CALL Practices
ERIC Educational Resources Information Center
Pagel, James W.; Lambacher, Stephen G.
2016-01-01
As part of a longitudinal study on learner and instructor attitudes and patterns of computer and mobile device usage, we have attempted to identify how language instructors and students value their use in L2 learning. During the past five years at Aoyama Gakuin University (AGU) in Tokyo, we have surveyed both students and instructors annually in…
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Validation of the ROMI-RIP rough mill simulator
Edward R. Thomas; Urs Buehlmann
2002-01-01
The USDA Forest Service's ROMI-RIP rough mill rip-first simulation program is a popular tool for analyzing rough mill conditions, determining more efficient rough mill practices, and finding optimal lumber board cut-up patterns. However, until now, the results generated by ROMI-RIP have not been rigorously compared to those of an actual rough mill. Validating the...
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Cordilleran forest scaling dynamics and disturbance regimes quantified by aerial LiDAR
Tyson L. Swetnam
2013-01-01
Semi-arid forests are in a period of rapid transition as a result of unprecedented landscape scale fires, insect outbreaks, drought, and anthropogenic land use practices. Understanding how historically episodic disturbances led to coherent forest structural and spatial patterns that promoted resilience and resistance is a critical part of addressing change. Here my...
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Climate change and farmers’ cropping patterns in Cemoro watershed area, Central Java, Indonesia
NASA Astrophysics Data System (ADS)
Sugihardjo; Sutrisno, J.; Setyono, P.; Suntoro
2018-03-01
Cropping pattern applied by farmers is usually based on the availability of water. Farmers cultivate rice when water is available. If it is unavailable, farmers will choose to plant crops that need less water. Climate change greatly affects to farmers in determining the cropping pattern as it alters the rainfall pattern and distribution in the region. This condition requires farmers to adjust the cropping pattern so that they can do the farming successfully. This study aims to examine the application of cropping patterns applied by the farmers in the Cemoro Watershed, Central Java, Indonesia. Descriptive analysis approach is employed in this research. The results showed that farmers’ cropping pattern is not based on the availability of water. However, it adopts a habit that has been practiced since long time ago or just adopt others farmer's habit. The cropping pattern applied by irrigated paddy farmers in Cemoro watershed area consists of two types: rice-rice-rice and rice-rice-secondary crops. Among those two types, most farmers apply the rice-rice-rice pattern. Meanwhile, there are three cropping patterns applied in the rain-land, namely rice-rice-rice, rice-rice-secondary crop, and rice-rice-fallow. The majority of farmers apply the second pattern (rice-rice-secondary crops). It was also found that farmers’ cropping pattern was not in accordance with the recommendation of the local government.
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Gong, Jerald Z; Cook, James R; Greiner, Timothy C; Hedvat, Cyrus; Hill, Charles E; Lim, Megan S; Longtine, Janina A; Sabath, Daniel; Wang, Y Lynn
2013-11-01
Recurrent mutations in JAK2 and MPL genes are genetic hallmarks of BCR-ABL1-negative myeloproliferative neoplasms. Detection of JAK2 and MPL mutations has been incorporated into routine diagnostic algorithms for these diseases. This Special Article summarizes results from a nationwide laboratory survey of JAK2 and MPL mutation analysis. Based on the current practice pattern and the literature, this Special Article provides recommendations and guidelines for laboratory practice for detection of mutations in the JAK2 and MPL genes, including clinical manifestations for prompting the mutation analysis, current and recommended methodologies for testing the mutations, and standardization for reporting the test results. This Special Article also points to future directions for genomic testing in BCR-ABL1-negative myeloproliferative neoplasms. Copyright © 2013 American Society for Investigative Pathology and the Association for Molecular Pathology. Published by Elsevier Inc. All rights reserved.
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Hill, Hamish R M; Crowe, Trevor P; Gonsalvez, Craig J
2016-01-01
To pilot an intervention involving reflective dialogue based on video recordings of clinical supervision. Fourteen participants (seven psychotherapists and their supervisors) completed a reflective practice protocol after viewing a video of their most recent supervision session, then shared their reflections in a second session. Thematic analysis of individual reflections and feedback resulted in the following dominant themes: (1) Increased discussion of supervisee anxiety and the tensions between autonomy and dependence; (2) intentions to alter supervisory roles and practice; (3) identification of and reflection on parallel process (defined as the dynamic transmission of relationship patterns between therapy and supervision); and (4) a range of perceived impacts including improvements in supervisory alliance. The results suggest that reflective dialogue based on supervision videos can play a useful role in psychotherapy supervision, including with relatively inexperienced supervisees. Suggestions are provided for the encouragement of ongoing reflective dialogue in routine supervision practice.
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Patients' Characteristics Affecting Physician-Patient Nonverbal Communication.
ERIC Educational Resources Information Center
Street, Richard L.; Buller, David B.
1988-01-01
Examines the impact of patients' characteristics on patterns of nonverbal communication exhibited in physician-patient interactions at a family practice clinic. Finds some general patterns of nonverbal behavioral differences, consistency, and adaptation characterizing the entire data set, and that patients' characteristics influenced patterns of…
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Physician pattern of patient notification of test results.
Thiedke, Carolyn C; Hoeft, Katherine A; Pearson, William S
2005-01-01
To discover how community-based family physicians notify patients of test results and whether there are differences based on sex, length of time in practice, reimbursement status, employment status,or percentage of practice in managed care. We mailed a survey to 500 randomly selected members of the South Carolina chapter of the American Academy of Family Physicians. All analyses were preformed using SASTM version 8.2. Both descriptive and inferential statistics were used to analyze the collected data. A total of 367 physicians responded (73% response rate). The main outcome variable was the time each physician spent notifying patients of test results: a mean of 20.86 +/- 18.3 minutes per day(range 0-120 minutes/day). Women physicians and those with more than 75% managed care were significantly more likely to spend more than the median time notifying patients of test results. Physicians vary in the amount of time they spend notifying patients of their test results, with female physicians and those with more than 75% of their practice in managed care spending more time than do male physicians and physicians with less managed care.
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Du, Xuemin; Wang, Juan; Cui, Huanqing; Zhao, Qilong; Chen, Hongxu; He, Le; Wang, Yunlong
2017-11-01
Surfaces patterned with hydrophilic and hydrophobic regions provide robust and versatile means for investigating the wetting behaviors of liquids, surface properties analysis, and producing patterned arrays. However, the fabrication of integral and uniform arrays onto these open systems remains a challenge, thus restricting them from being used in practical applications. Here, we present a simple yet powerful approach for the fabrication of water droplet arrays and the assembly of photonic crystal bead arrays based on hydrophilic-hydrophobic patterned substrates. Various integral arrays are simply prepared in a high-quality output with a low cost, large scale, and uniform size control. By simply taking a breath, which brings moisture to the substrate surface, complex hydrophilic-hydrophobic outlined images can be revisualized in the discontinuous hydrophilic regions. Integration of hydrogel photonic crystal bead arrays into the "breath-taking" process results in breath-responsive photonic crystal beads, which can change their colors upon a mild exhalation. This state-of-the-art technology not only provides an effective methodology for the preparation of patterned arrays but also demonstrates intriguing applications in information storage and biochemical sensors.
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Implications of current resident work-hour guidelines on the future practice of surgery in Canada.
Maruscak, Adam A; VanderBeek, Laura; Ott, Michael C; Kelly, Stephen; Forbes, Thomas L
2012-01-01
Work-hour restrictions have had a profound impact on surgical training. However, little is known of how work-hour restrictions may affect the future practice patterns of current surgical residents. The purpose of this study is to compare the anticipated career practice patterns of surgical residents who are training within an environment of work-hour restrictions with the current practice of faculty surgeons. An electronic survey was sent to all surgery residents and faculty at 2 Canadian university-affiliated medical centers. The survey consisted of questions regarding expected (residents) or current (faculty) practice patterns. A total of 149 residents and 125 faculty members completed the survey (50.3% and 52.3% response rates, respectively). A greater proportion of males were in the faculty cohort than in the resident group (77.6% vs 62.4%, p = 0.0003). More faculty than residents believed that work-hour restrictions have a negative impact on both residency education (40.8% vs 20.8%, p = 0.008) and preparation for a surgical career (56.8% vs 19.5%, p < 0.0001). Compared with current faculty, residents plan to take less call (p < 0.0003), work fewer days of the week (p < 0.0001), are more likely to limit their duty hours on postcall days (p = 0.009), and take parental leave (p = 0.02) once in practice. Male and female residents differed somewhat in their responses in that more female residents plan to limit their postcall duty hours (55.4% vs 36.5%, p = 0.009) and to take a parental leave (51.8% vs 16.1%, p < 0.0001) compared with their male resident colleagues. Current surgical residents expect to adopt components of resident work-hour guidelines into their surgical practices after completing their residency. These practice patterns will have surgical workforce implications and might require larger surgical groups and reconsideration of resource allocation. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
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Soil Carbon Recovery of Degraded Steppe Ecosystems of the Mongolian Plateau
NASA Astrophysics Data System (ADS)
Ojima, D. S.; Togtohyn, C.; Qi, J.
2013-12-01
Mongolian steppe grassland systems are critical source of ecosystem services to societal groups in temperate East Asia. These systems are characterized by their arid and semiarid environments where rainfall tends to be too variable or evaporative losses reduce water availability to reliably support cropping systems or substantial forest cover. These steppe ecosystems have supported land use practices to accommodate the variable rainfall patterns, and seasonal and spatial patterns of forage production displayed by the nomadic pastoral systems practiced across Asia. These pastoral systems are dependent on grassland ecosystem services, including forage production, wool, skins, meat and dairy products, and in many systems provide critical biodiversity and land and water protection services which serve to maintain pastoral livelihoods. Precipitation variability and associated drought conditions experienced frequently in these grassland systems are key drivers of these systems. However, during the past several decades climate change and grazing and land use conversion have resulted in degradation of ecosystem services and loss of soil organic matter. Recent efforts in China and Mongolia are investigating different grazing management practices to restore soil organic matter in these degraded systems. Simulation modeling is being applied to evaluate the long-term benefits of different grazing management regimes under various climate scenarios.
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The U.S. Pediatric Dermatology Workforce: An Assessment of Productivity and Practice Patterns.
Fogel, Alexander L; Teng, Joyce M C
2015-01-01
Pediatric dermatology has always played an important role in children's healthcare, but there has been a shortage of pediatric dermatologists nationwide for more than a decade, and few metrics of productivity and practice patterns exist. This study sought to provide insight into these and other factors of the pediatric dermatology workforce. Electronic surveys were distributed to all 226 U.S. board-certified pediatric dermatologists. A total of 108/226 (48%) of the electronic surveys were returned. Sixty percent of respondents were employed full- or part-time in academic environments and 81% were salaried. Respondents reported that children constituted 79.5% of their practice, and the average respondent spent 3.8 days/week treating 92.6 patients, considerably lower than the 136.3 patients/week that the average general dermatologist sees. The academic practice environment was associated with children constituting a larger proportion of the practice (p < 0.001), fewer patients seen per week (85.9, p < 0.001), and longer median new patient wait times (60 vs 15 days) than in other practice environments. Private practitioners saw significantly more patients per week than those in academic environments (112.7, p = 0.005). Male and female practitioners reported approximately equal patient care days per week, similar wait times, and similar proportions of children in their practices. This assessment revealed productivity and practice pattern differences between the various pediatric dermatology practice environments and between pediatric and general dermatology. This study provides important information for workforce planning and care availability assessments and baseline information for future studies. © 2015 Wiley Periodicals, Inc.
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Cost and performance: complements for improvement.
Rouse, Paul; Harrison, Julie; Turner, Nikki
2011-10-01
Activity-based costing (ABC) and Data Envelopment Analysis (DEA) share similar views of resource consumption in the production of outputs. While DEA has a high level focus typically using aggregated data in the form of inputs and outputs, ABC is more detailed and oriented around very disaggregated data. We use a case study of immunisation activities in 24 New Zealand primary care practices to illustrate how DEA and ABC can be used in conjunction to improve performance analysis and benchmarking. Results show that practice size, socio-economic environment, parts of the service delivery process as well as regular administrative tasks are major cost and performance drivers for general practices in immunisation activities. It is worth noting that initial analyses of the ABC results, using contextual information and conventional methods of analysis such as regression and correlations, did not result in any patterns of significance. Reorganising this information using the DEA efficiency scores has revealed trends that make sense to practitioners and provide insights into where to place efforts for improvement.
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ERIC Educational Resources Information Center
Moynihan, Christy; And Others
This study examined the relationship between graduate medical education (GME) and practice profiles in three specialties: family practice, psychiatry, and obstetrics/gynecology. Two analyses were performed, the first assessing the relationship between GME and current practice patterns and the second assessing the relationship between GME and…
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USDA-ARS?s Scientific Manuscript database
Our objective was to assess the agreement of posted menus with foods served to 3- to 5-year-old children attending federal Child and Adult Care Food Program (CACFP)-enrolled facilities, and the degree to which the facilities met the new meal patterns and best practices. On-site observations and menu...
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Grzybowski, Andrzej; Schwartz, Stephen G; Matsuura, Kazuki; Ong Tone, Stephan; Arshinoff, Steve; Ng, Jonathon Q; Meyer, Jay J; Liu, Wu; Jacob, Soosan; Packer, Mark; Lutfiamida, Rifna; Tahija, Sjakon; Roux, Paul; Malyugin, Boris; Urrets-Zavalia, Julio A; Crim, Nicolas; Esposito, Evangelina; Daponte, Pablo; Pellegrino, Fernando; Graue-Hernandez, Enrique O; Jimenez-Corona, Aida; Valdez-Garcia, Jorge E; Hernandez-Camarena, Julio C; Relhan, Nidhi; Flynn, Harry W; Ravindran, Ravilla D; Behnding, Anders
2017-01-01
Acute-onset postoperative endophthalmitis after cataract surgery remains a rare but important cause of visual loss. There is no global consensus regarding the optimal strategies for prophylaxis of endophthalmitis and practices vary substantially around the world, especially with respect to the use of intracameral antibiotics. The European Society of Cataract & Refractive Surgeons in a randomized clinical trial (2007) reported an approximately 5-fold reduction in endophthalmitis rates associated with the use of intracameral cefuroxime. Despite this report, the use of intracameral antibiotics has not been universally adopted. Various endophthalmitis prophylaxis patterns around the world (including the United States, Canada, Australia/New Zealand, Japan, China, India, Indonesia, South Africa, Argentina, Russia, Sweden and Mexico) are compared. Each contributing author was asked to provide similar information, including endophthalmitis rates based on published studies, current practice patterns, and in some cases original survey data. Various methods were used to obtain this information, including literature reviews, expert commentary, and some new survey data not previously published. Many different practice patterns were reported from around the world, specifically with respect to the use of intracameral antibiotics. There is no worldwide consensus regarding endophthalmitis prophylaxis with cataract surgery. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.
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Practice makes transfer of motor skills imperfect.
Boutin, Arnaud; Badets, Arnaud; Salesse, Robin N; Fries, Udo; Panzer, Stefan; Blandin, Yannick
2012-09-01
We investigated the practice-effects on motor skill transfer and the associated representational memory changes that occur during the within-practice and between-practice phases. In two experiments, participants produced extension-flexion movements with their dominant right arm for a limited or prolonged practice session arranged in either a single- or multi-session format. We tested the ability of participants to transfer the original pattern (extrinsic transformation) or the mirrored one (intrinsic transformation) to the non-dominant left arm, 10 min and 24 h after the practice sessions. Results showed that practice induces rapid motor skill improvements that are non-transferable irrespective of the amount of acquisition trials. Furthermore, the extrinsic component of the skill develops early and remains the dominant coding system during practice. Conversely, we found distinct between-practice memory changes: a limited practice induces an off-line development of the extrinsic component, whereas a prolonged practice session subserves the off-line development of the intrinsic component (experiment 2). We provided further evidence that the long-term representation of the motor skill also depends on the nature of the practice session itself: the parsing of practice into multiple sessions narrows the effector-transfer capacities in comparison to a single session (experiment 1). These findings yield theoretical and practical implications that are discussed in the context of recent motor skill learning models.
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Temporal Patterns of Behavior from the Scheduling of Psychology Quizzes
ERIC Educational Resources Information Center
Jarmolowicz, David P.; Hayashi, Yusuke; St. Peter Pipkin, Claire
2010-01-01
Temporal patterns of behavior have been observed in real-life performances such as bill passing in the U.S. Congress, in-class studying, and quiz taking. However, the practical utility of understanding these patterns has not been evaluated. The current study demonstrated the presence of temporal patterns of quiz taking in a university-level…
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NASA Astrophysics Data System (ADS)
Wardlow, Brian Douglas
The objectives of this research were to: (1) investigate time-series MODIS (Moderate Resolution Imaging Spectroradiometer) 250-meter EVI (Enhanced Vegetation Index) and NDVI (Normalized Difference Vegetation Index) data for regional-scale crop-related land use/land cover characterization in the U.S. Central Great Plains and (2) develop and test a MODIS-based crop mapping protocol. A pixel-level analysis of the time-series MODIS 250-m VIs for 2,000+ field sites across Kansas found that unique spectral-temporal signatures were detected for the region's major crop types, consistent with the crops' phenology. Intra-class variations were detected in VI data associated with different land use practices, climatic conditions, and planting dates for the crops. The VIs depicted similar seasonal variations and were highly correlated. A pilot study in southwest Kansas found that accurate and detailed cropping patterns could be mapped using the MODIS 250-m VI data. Overall and class-specific accuracies were generally greater than 90% for mapping crop/non-crop, general crops (alfalfa, summer crops, winter wheat, and fallow), summer crops (corn, sorghum, and soybeans), and irrigated/non-irrigated crops using either VI dataset. The classified crop areas also had a high level of agreement (<5% difference) with the USDA reported crop areas. Both VIs produced comparable crop maps with only a 1-2% difference between their classification accuracies and a high level of pixel-level agreement (>90%) between their classified crop patterns. This hierarchical crop mapping protocol was tested for Kansas and produced similar classification results over a larger and more diverse area. Overall and class-specific accuracies were typically between 85% and 95% for the crop maps. At the state level, the maps had a high level of areal agreement (<5% difference) with the USDA crop area figures and their classified patterns were consistent with the state's cropping practices. In general, the protocol's performance was relatively consistent across the state's range of environmental conditions, landscape patterns, and cropping practices. The largest areal differences occurred in eastern Kansas due to the omission of many small cropland areas that were not resolvable at MODIS' 250-m resolution. Notable regional deviations in classified areas also occurred for selected classes due to localized precipitation patterns and specific cropping practices.
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Westerveld, Donevan; Khullar, Vikas; Mramba, Lazarus; Ayoub, Fares; Brar, Tony; Agarwal, Mitali; Forde, Justin; Chakraborty, Joydeep; Riverso, Michael; Perbtani, Yaseen B; Gupte, Anand; Forsmark, Chris E; Draganov, Peter; Yang, Dennis
2018-03-01
Adherence to quality indicators and surveillance guidelines in the management of Barrett's esophagus (BE) promotes high-quality, cost-effective care. The aims of this study were (1) to evaluate adherence to standardized classification (Prague Criteria) and systematic (four-quadrant) biopsy protocol, (2) to identify predictors of practice patterns, and (3) to assess adherence to surveillance guidelines for non-dysplastic BE (NDBE). This was a single-center retrospective study of esophagogastroduodenoscopy (EGD) performed for BE (June 2008 to December 2015). Patient demographics, procedure characteristics, and histology results were obtained from the procedure report-generating database and chart review. Adherence to Prague Criteria and systematic biopsies was based on operative report documentation. Multiple logistic regression analysis was performed to identify predictors of practice patterns. Guideline adherent surveillance EGD was defined as those performed within 6 months of the recommended 3- to 5-year interval. In total, 397 patients (66.5 % male; mean age 60.1 ± 12.5 years) had an index EGD during the study period. Adherence to Prague Criteria and systematic biopsies was 27.4 % and 24.1 %, respectively. Endoscopists who performed therapeutic interventions for BE were more likely to use the Prague Criteria (OR: 3.16; 95 %CI: 1.47 - 6.82; P < 0.01) than those who did not. Longer time in practice was positively associated with adherence to Prague Criteria (OR 1.07; 95 %CI: 1.02 - 1.12; P < 0.01) but with a lower likelihood of performing systematic biopsies (OR 0.91; 95 %CI: 0.85 - 0.97; P < 0.01). More than half (55.6 %) of patients with NDBE underwent surveillance EGD sooner (range 1 - 29 months) than the recommended interval. Adherence to quality indicators and surveillance guidelines in BE is low. Operator characteristics, including experience with endoscopic therapy for BE and time in practice predicted practice pattern. Future efforts are needed to reduce variability in practice and promote high-value care.
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Glazier, Richard H.; Klein-Geltink, Julie; Kopp, Alexander; Sibley, Lyn M.
2009-01-01
Background Primary care reform in Ontario, Canada, included the initiation of a blended capitation model in 2001–2002 and an enhanced fee-for-service model in 2003. Both models involve patient rostering, incentives for preventive care and requirements for after-hours care. We evaluated practice characteristics and patterns of care under both models. Methods Using administrative data, we identified physicians belonging to either the capitation or the enhanced fee-for-service group throughout the period from Sept. 1, 2005, to Aug. 31, 2006, and their enrolled patients. Practices were stratified by location (urban v. rural). We compared the groups in terms of practice characteristics and patterns of care, including comprehensiveness of care, continuity of care, after-hours care, visits to the emergency department and uptake of new patients. Results Patients in the capitation and enhanced fee-for-service practices had similar demographic characteristics. Patients in capitation practices had lower morbidity and comorbidity indices. Comprehensiveness and continuity of care were similar between the 2 groups. Compared with patients in enhanced fee-for-service practices, those in capitation practices had less after-hours care (adjusted rate ratio [RR] 0.68, 95% confidence interval [CI] 0.61–0.75) and more visits to emergency departments (adjusted RR 1.20, 95% CI 1.15–1.25). Overall, physicians in the capitation group enrolled fewer new patients than did physicians in the enhanced fee-for-service group (37.0 v. 52.0 per physician); the same was true of new graduates (60.3 v. 72.1 per physician). Interpretation Physicians enrolled in the capitation model had different practice characteristics than those in the enhanced fee-for-service model. These characteristics appeared to be pre-existing and not due to enrolment in a new model. Although the capitation model provides an alternative to fee-for-service practice, its characteristics should be the focus of future policy development and research. PMID:19468106
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Concern about Child Weight among Parents of Children At-Risk for Obesity
Seburg, Elisabeth M.; Kunin-Batson, Alicia; Senso, Meghan M.; Crain, A. Lauren; Langer, Shelby L.; Levy, Rona L.; Sherwood, Nancy E.
2014-01-01
Objectives: This study investigated the relationship between parental concern about child weight and weight-related child behaviors, parenting practices, and household characteristics. Methods: Parent-child dyads (N=421) enrolled in a randomized, controlled obesity prevention trial were evaluated at baseline. Results: Parental concern regarding child weight was associated with greater use of restrictive and monitoring feeding practices and lower total child energy intake. Conclusions: Parents expressing greater concern about child weight were more likely to report engaging in strategies to regulate their child’s dietary intake, some of which may inadvertently have negative consequences. Intervention strategies that activate parental concern about child weight should include guidance and support for engaging in feeding practices that support healthful child eating patterns and growth. PMID:25364770
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NASA Astrophysics Data System (ADS)
Javahery, Homa; Deichman, Alexander; Seffah, Ahmed; Taleb, Mohamed
Patterns are a design tool to capture best practices, tackling problems that occur in different contexts. A user interface (UI) design pattern spans several levels of design abstraction ranging from high-level navigation to low-level idioms detailing a screen layout. One challenge is to combine a set of patterns to create a conceptual design that reflects user experiences. In this chapter, we detail a user-centered design (UCD) framework that exploits the novel idea of using personas and patterns together. Personas are used initially to collect and model user experiences. UI patterns are selected based on personas pecifications; these patterns are then used as building blocks for constructing conceptual designs. Through the use of a case study, we illustrate how personas and patterns can act as complementary techniques in narrowing the gap between two major steps in UCD: capturing users and their experiences, and building an early design based on that information. As a result of lessons learned from the study and by refining our framework, we define a more systematic process called UX-P (User Experiences to Pattern), with a supporting tool. The process introduces intermediate analytical steps and supports designers in creating usable designs.
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Purahong, Witoon; Schloter, Michael; Pecyna, Marek J; Kapturska, Danuta; Däumlich, Veronika; Mital, Sanchit; Buscot, François; Hofrichter, Martin; Gutknecht, Jessica L M; Krüger, Dirk
2014-11-12
The widespread paradigm in ecology that community structure determines function has recently been challenged by the high complexity of microbial communities. Here, we investigate the patterns of and connections between microbial community structure and microbially-mediated ecological function across different forest management practices and temporal changes in leaf litter across beech forest ecosystems in Central Europe. Our results clearly indicate distinct pattern of microbial community structure in response to forest management and time. However, those patterns were not reflected when potential enzymatic activities of microbes were measured. We postulate that in our forest ecosystems, a disconnect between microbial community structure and function may be present due to differences between the drivers of microbial growth and those of microbial function.
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Describing spatial pattern in stream networks: A practical approach
Ganio, L.M.; Torgersen, C.E.; Gresswell, R.E.
2005-01-01
The shape and configuration of branched networks influence ecological patterns and processes. Recent investigations of network influences in riverine ecology stress the need to quantify spatial structure not only in a two-dimensional plane, but also in networks. An initial step in understanding data from stream networks is discerning non-random patterns along the network. On the other hand, data collected in the network may be spatially autocorrelated and thus not suitable for traditional statistical analyses. Here we provide a method that uses commercially available software to construct an empirical variogram to describe spatial pattern in the relative abundance of coastal cutthroat trout in headwater stream networks. We describe the mathematical and practical considerations involved in calculating a variogram using a non-Euclidean distance metric to incorporate the network pathway structure in the analysis of spatial variability, and use a non-parametric technique to ascertain if the pattern in the empirical variogram is non-random.
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NASA Astrophysics Data System (ADS)
Stander, E. K.; Borst, M.; Ehrenfeld, J. G.; O'Connor, T. P.; Rowe, A. A.
2009-12-01
Traditional stormwater management practices, designed and constructed to rapidly and efficiently route runoff away from established infrastructure, have resulted in the disruption of natural drainage patterns in urban landscapes. The modified in-stream flow incises urban streams and reduces regional groundwater recharge, thus altering hydrologic patterns and regimes in urban wetlands and riparian zones. Water table dynamics and in situ nitrogen cycling processes were quantified in 14 palustrine, forested wetlands and correlated with watershed-scale land cover metrics in urban northern New Jersey. Variability in nitrogen cycling process rates was, in some cases, explained by altered hydrological regimes. However, land cover and hydrologic characteristics did not always exhibit the predicted effects, as demonstrated by dry and/or flashy water tables in less developed watersheds and denitrification rates that did not always reflect hydrological conditions. Inorganic nitrogen inputs and outputs were characterized in throughfall and soil leachate in nine of the 14 wetlands. Atmospheric nitrogen deposition rates were higher in wetlands located in more impervious and densely populated urban sub-watersheds, but nitrate losses through leaching were generally low and did not correlate with landscape-level descriptors of urban intensity. Two wetlands did display net loss of nitrate, and the results of dual isotope analysis suggested the direct pass-through of atmospheric nitrate on four sampling dates in two sites; these findings point to decreased nitrate retention capacity in some urban wetlands. New stormwater management practices designed to mimic natural drainage patterns are currently being developed and implemented in existing urban watersheds and new developments. These practices, which include rain gardens, pervious pavement, and green roofs, are intended to reduce peak flows to urban streams and, in many cases, also provide water quality functions. Rain gardens in particular have a documented ability to remove heavy metals and phosphorus from urban stormwater runoff, but their coarse-textured, low organic matter content soils are less able to remove nitrate through denitrification. Research at the US Environmental Protection Agency explores the use of media carbon amendments and deep zones of saturation to facilitate denitrification by providing labile carbon and anoxic conditions in experimental rain garden mesocosms. Initial results highlight the importance of conducting bench-scale testing of bioretention media before installation in full-scale, working rain gardens, particularly when media characteristics have been modified to promote stressor removal. If these low impact development practices can increase groundwater recharge and reduce stream incision, natural hydrologic regimes may be restored to urban wetlands and riparian zones.
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High-Tc superconductor coplanar waveguide filter
NASA Technical Reports Server (NTRS)
Chew, Wilbert; Bajuk, Louis J.; Cooley, Thomas W.; Foote, Marc C.; Hunt, Brian D.; Rascoe, Daniel L.; Riley, A. L.
1991-01-01
Coplanar waveguide (CPW) low-pass filters made of YBa2Cu3O(7-delta) (YBCO) on LaAlO3 substrates, with dimensions suited for integrated circuits, were fabricated and packaged. A complete filter gives a true idea of the advantages and difficulties in replacing thin-film metal with a high-temperature superconductor in a practical circuit. Measured insertion losses in liquid nitrogen were superior to the loss of a similar thin-film copper filter throughout the 0- to 9.5-GHz passband. These results demonstrate the performance of fully patterned YBCO in a practical CPW structure after sealing in a hermetic package.
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A practical perspective on remedial ethics: Minnesota Board of Dentistry.
Mensing, Candace; Shragg, Marshall
2009-01-01
The President and Executive Director of the Minnesota Board of Dentistry describe how the Bebeau course in ethics, for dentists referred because of ethical lapses, is used as part of the disciplinary process in the state. It is understood that breaches of ethical standards are a complex phenomenon, often engaged in by practitioners who know that they are doing wrong but nevertheless choose to do so. Typical patterns of transgression that result in referral to Dr. Bebeau's course include inappropriate billing practices, improper relations with staff or patients, questionable advertising, substandard care, "rough behavior," and gaps in infection control.
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Egger, G; Katz, D; Sagner, M; Dixon, J; Stevens, J
2014-12-01
Changes in patterns of living result in changes in the nature and causes of disease. The industrial revolution of the late 18th century, and the technological revolution of the late 20th century are cases in point. The former was associated with a decline in infectious diseases; the latter with an increase in lifestyle and environmentally induced chronic diseases . Health practices are typically modified to deal with such changes, hence the recent rise in interest in lifestyle-oriented forms of clinical practice. © 2014 John Wiley & Sons Ltd.
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Abdullah, Nurul-Fadhilah; Teo, Pey Sze; Foo, Leng Huat
2016-09-12
The aim of the study was to identify the ethnic differences in dietary patterns and its association with socio-economic, dietary and lifestyle practices among adolescents in Kelantan, Malaysia. A population-based study of 454 adolescents aged 12 to 19 years was included. A validated food frequency questionnaire was used to assess dietary patterns and three dietary patterns were identified based on the principal component analysis method. Malay adolescents had significantly higher scores for the Western-based food pattern and local-based food pattern, whereas Chinese adolescents showed higher scores for the healthy-based food pattern. Multivariate analyses show that age and physical activity (PA) levels were positively associated with healthy-based food pattern in Malay (All, p < 0.001), whereas higher consumption of eating-out from home (EatOut) (p = 0.014) and fast food (p = 0.041) were negatively associated. High weekly breakfast skipping (p < 0.001) and EatOut (p = 0.003) were positively associated with a Western-based pattern, whereas age (p < 0.001) and household income (p = 0.005) were negatively associated. Higher frequency of daily snacking (p = 0.013) was positively associated with local-based food pattern. For Chinese adolescents, age (p < 0.001), PA levels (p < 0.001) and maternal education level (p = 0.035) showed positive associations with the healthy-based pattern, whereas high EatOut (p = 0.001) and fast food intakes (p = 0.001) were negatively associated. Higher weekly consumption of EatOut (p = 0.007), fast food (p = 0.023) and carbonated beverages (p = 0.023), and daily snacking practice (p = 0.004) were positively associated with higher Western-based food pattern, whereas age (p = 0.004) was inversely associated. This study showed that there were significant differences in dietary patterns and its association factors between Malay and Chinese adolescents. More importantly, these findings suggest that unhealthy dietary and lifestyle practices could increase the risk of adherence to unhealthy Western-based food pattern that is high in fat, sugar and salt contents, and, consequently, increase the risk of developing obesity and metabolic-related disorders during these critical years of growth.
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Chen, Candice; Petterson, Stephen; Phillips, Robert; Bazemore, Andrew; Mullan, Fitzhugh
2014-12-10
Graduate medical education training may imprint young physicians with skills and experiences, but few studies have evaluated imprinting on physician spending patterns. To examine the relationship between spending patterns in the region of a physician's graduate medical education training and subsequent mean Medicare spending per beneficiary. Secondary multilevel multivariable analysis of 2011 Medicare claims data (Part A hospital and Part B physician) for a random, nationally representative sample of family medicine and internal medicine physicians completing residency between 1992 and 2010 with Medicare patient panels of 40 or more patients (2851 physicians providing care to 491,948 Medicare beneficiaries). Locations of practice and residency training were matched with Dartmouth Atlas Hospital Referral Region (HRR) files. Training and practice HRRs were categorized into low-, average-, and high-spending groups, with approximately equal distribution of beneficiary numbers. There were 674 physicians in low-spending training and low-spending practice HRRs, 180 in average-spending training/low-spending practice, 178 in high-spending training/low-spending practice, 253 in low-spending training/average-spending practice, 417 in average-spending training/average-spending practice, 210 in high-spending training/average-spending practice, 97 in low-spending training/high-spending practice, 275 in average-spending training/high-spending practice, and 567 in high-spending training/high-spending practice. Mean physician spending per Medicare beneficiary. For physicians practicing in high-spending regions, those trained in high-spending regions had a mean spending per beneficiary per year $1926 higher (95% CI, $889-$2963) than those trained in low-spending regions. For practice in average-spending HRRs, mean spending was $897 higher (95% CI, $71-$1723) for physicians trained in high- vs low-spending regions. For practice in low-spending HRRs, the difference across training HRR levels was not significant ($533; 95% CI, -$46 to $1112). After controlling for patient, community, and physician characteristics, there was a 7% difference (95% CI, 2%-12%) in patient expenditures between low- and high-spending training HRRs. Across all practice HRRs, this corresponded to an estimated $522 difference (95% CI, $146-$919) between low- and high-spending training regions. For physicians 1 to 7 years in practice, there was a 29% difference ($2434; 95% CI, $1004-$4111) in spending between those trained in low- and high-spending regions; however, after 16 to 19 years, there was no significant difference. Among general internists and family physicians who completed residency training between 1992 and 2010, the spending patterns in the HRR in which their residency program was located were associated with expenditures for subsequent care they provided as practicing physicians for Medicare beneficiaries. Interventions during residency training may have the potential to help control future health care spending.
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Shifting patterns of practice: nurse practitioners in a managed care environment.
Johnson, Rosemary
2005-01-01
The purpose of this qualitative study was to uncover patterns across nurse practitioner (NP) experiences that contribute to understanding their perceptions of managed care, how it affects daily practice, and how NPs respond to a changing managed care workplace. In-depth interviews were conducted with 14 NPs representing primary care, specialty, and independent practices. Over an 18-month period, data collection and analysis occurred simultaneously using standard methods of purposive sampling, constant comparison, memoing, and member checks. This study illuminates the tension NPs experience between a business and a professional ethic and the strategies they use to reconcile this difference with core nursing values. Type of setting, workplace dynamics, and length of time in practice contributed to variation in NP perspectives.
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Update on imbalanced distribution of endodontists: 1995-2006.
Waldman, H Barry; Bruder, George A
2009-05-01
Past studies on the number of endodontists in the United States indicated an imbalanced distribution of private practice endodontic practitioners in most regions, states, counties, and zip code areas of the country. The availability of more recent studies by the American Dental Association (ADA) provides an opportunity to follow up on these previous studies. The 2006 and past ADA surveys on the Distribution of Dentists in the United States, Advanced Dental Education, and Dental Practice were used to evaluate the number of graduates from advanced education programs in endodontics, the changing number and distribution of endodontists, full-time and part-time work patterns, and the income of private practicing endodontists. A gradual increase in the number of graduates from advanced education programs in endodontics is reflected in a continuing increase in the overall number of private practicing endodontists, but with ongoing differences in endodontists-to-population ratios at the regional and state levels. The findings follow previous study results confirming the increasing numbers of endodontists and continuing differences in the endodontists-to-population ratios at both the regional and state levels. Concerns about the distribution of endodontists in the future need to be considered in terms of evolving dental disease patterns, changing demands for services, evolving third-party mechanisms, and the increased number of female practitioners (with fewer reported working hours than their male counterparts).
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Maheux, B; Beaudoin, C; Jacques, A; Lambert, J; Lévesque, A
1992-01-01
OBJECTIVES: To determine whether the professional attitudes and practice patterns of physicians with residency training in family medicine differ from those of generalists with internship training. DESIGN: Mail survey conducted in 1985-86. SETTING: Province of Quebec. PARTICIPANTS: A stratified random sample of French-speaking family and general practitioners who graduated after 1972 (325 physicians with residency training and 304 with internship training) (response rate 82%). MAIN RESULTS: Physicians with residency training were 3 years younger on average than those with internship training, were more likely to be female (38% v. 18%, p less than 0.001) and were more likely to work on a salaried basis in CLSCs (public community health centres) (36% v. 14%, p less than 0.001). Even after these confounding factors were controlled for, physicians with residency training seemed to be more sensitive to the psychosocial aspects of patient care and tended to attach more importance to informing patients about useful materials and resources concerning their health problems. They were not, however, more likely to value health counselling or integrate it in medical practice. CONCLUSION: Our findings provide some evidence that the new requirement that physicians complete a residency in family medicine to obtain medical licensure in general practice in Quebec may foster a more patient-centred approach to health care. PMID:1544077
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Phonological and Lexical Effects in Verbal Recall by Children with Specific Language Impairments
Coady, Jeffry A.; Mainela-Arnold, Elina; Evans, Julia L.
2014-01-01
Background & Aims The present study examined how phonological and lexical knowledge influences memory in children with specific language impairments (SLI). Previous work showed recall advantages for typical adults and children due to word frequency and phonotactic pattern frequency and a recall disadvantage due to phonological similarity among words. While children with SLI have well documented memory difficulties, it is not clear whether these language knowledge factors also influence recall in this population. Methods & Procedures 16 children with SLI (mean age 10;2) and CAM controls recalled lists of words differing in phonological similarity, word frequency, and phonotactic pattern frequency. While previous studies used a small set of words appearing in multiple word lists, the current study used a larger set of words, without replacement, so that children could not gain practice with individual test items. Outcomes & Results All main effects were significant. Interactions revealed that children with SLI were affected by similarity, but less so than their peers, comparably affected by word frequency, and unaffected by phonotactic pattern frequency. Conclusions Results due to phonological similarity suggest that children with SLI use less efficient encoding, while results due to word frequency and phonotactic pattern frequency were mixed. Children with SLI used coarse-grained language knowledge (word frequency) comparably to peers, but were less able to use fine-grained knowledge (phonotactic pattern frequency). Paired with phonological similarity results, this suggests that children with SLI have difficulty establishing robust phonological knowledge for use in language tasks. PMID:23472955
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Liang, Geng; Wang, Hong; Li, Wen; Li, Dazhong
2010-10-01
Data exchange patterns between nodes in WorldFIP fieldbus network are quite important and meaningful in improving the communication performance of WorldFIP network. Based on the basic communication ways supported in WorldFIP protocol, we propose two patterns for implementation of data exchange between peer nodes over WorldFIP network. Effects on communication performance of WorldFIP network in terms of some network parameters, such as number of bytes in user's data and turn-around time, in both the proposed patterns, are analyzed at length when different network speeds are applied. Such effects with the patterns of periodic message transmission using acknowledged and non-acknowledged messages, are also studied. Communication performance in both the proposed patterns are analyzed and compared. Practical applications of the research are presented. Through the study, it can be seen that different data exchange patterns make a great difference in improving communication efficiency with different network parameters, which is quite useful and helpful in the practical design of distributed systems based on WorldFIP network. Copyright © 2010 ISA. Published by Elsevier Ltd. All rights reserved.
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DMT-TAFM: a data mining tool for technical analysis of futures market
NASA Astrophysics Data System (ADS)
Stepanov, Vladimir; Sathaye, Archana
2002-03-01
Technical analysis of financial markets describes many patterns of market behavior. For practical use, all these descriptions need to be adjusted for each particular trading session. In this paper, we develop a data mining tool for technical analysis of the futures markets (DMT-TAFM), which dynamically generates rules based on the notion of the price pattern similarity. The tool consists of three main components. The first component provides visualization of data series on a chart with different ranges, scales, and chart sizes and types. The second component constructs pattern descriptions using sets of polynomials. The third component specifies the training set for mining, defines the similarity notion, and searches for a set of similar patterns. DMT-TAFM is useful to prepare the data, and then reveal and systemize statistical information about similar patterns found in any type of historical price series. We performed experiments with our tool on three decades of trading data fro hundred types of futures. Our results for this data set shows that, we can prove or disprove many well-known patterns based on real data, as well as reveal new ones, and use the set of relatively consistent patterns found during data mining for developing better futures trading strategies.
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Fowler, Patrick J; Motley, Darnell; Zhang, Jinjin; Rolls-Reutz, Jennifer; Landsverk, John
2015-02-01
In this longitudinal study, we tested whether adolescent maltreatment and out-of-home placement as a response to maltreatment altered developmental patterns of sexual risk behaviors in a nationally representative sample of youth involved in the child welfare system. Participants included adolescents aged 13 to 17 (M = 15.5, SD = 1.49) at baseline (n = 714), followed over 18 months. Computer-assisted interviews were used to collect self-reported sexual practices and experiences of physical and psychological abuse at both time points. Latent transition analyses were used to identify three patterns of sexual risk behaviors: abstainers, safe sex with multiple partners, and unsafe sex with multiple partners. Most adolescents transitioned to safer sexual behavior patterns over time. Adolescents exhibiting the riskiest sexual practices at baseline were most likely to report subsequent abuse and less likely to be placed into out-of-home care. Findings provide a more nuanced understanding of sexual risk among child welfare-involved adolescents and inform practices to promote positive transitions within the system. © The Author(s) 2014.
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75 FR 52173 - Proposed Urban Area Criteria for the 2010 Census
Federal Register 2010, 2011, 2012, 2013, 2014
2010-08-24
... patterns and with changes in theoretical and practical approaches to interpreting and understanding the... density; to understand and account for actual settlement patterns on the ground in relation to boundaries... patterns were enumeration districts, but to facilitate and ease the delineation process, each incorporated...
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Essential Use Cases for Pedagogical Patterns
ERIC Educational Resources Information Center
Derntl, Michael; Botturi, Luca
2006-01-01
Coming from architecture, through computer science, pattern-based design spread into other disciplines and is nowadays recognized as a powerful way of capturing and reusing effective design practice. However, current pedagogical pattern approaches lack widespread adoption, both by users and authors, and are still limited to individual initiatives.…
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Mehta, V; Kushniruk, A; Gauthier, S; Richard, Y; Deland, E; Veilleux, M; Grant, A
1998-01-01
The Autocontrol Project is concerned with the accessing, processing and communication of high quality information so that a clinical team can make and implement decisions for practice change, and then evaluate if improvement has been achieved. High quality information is used as evidence for change. In this study, we have evaluated how evidence is used by a clinical team to explain an identified problem of inappropriate use of blood gas tests. In an experimental study of the Surgical Intensive Care Unit, video recordings of team meetings of nurses and doctors were undertaken, structured according to a problem-based format. Evidence of current practice patterns derived from the hospital information system, as well as the results of a questionnaire to the unit's staff about knowledge and use of blood gas measurements, were supplied to the participants beforehand. At the second meeting, the output of the first meetings and a summarised analysis of pertinent literature were made available. This second meeting was required to finalise the list of causes of inappropriate blood gas use and propose pragmatic strategies for practice change. The video data of the meetings were coded to analyse the use of evidence, the categories of causes, issues and solutions proposed, and the quality of team interaction. The results indicate that in order to achieve consensus, the team used different types of evidence, including objective evidence of practice patterns, personal experience about direct and indirect organisational influences, and literature-based research evidence of best practice. Furthermore, group dynamics were favoured by the problem-based meeting structure, and a high level of cognitive critiquing between team members was observed. This research suggests that a combination of approaches involving identification of both operational factors (e.g. appropriate access to different types of evidence and meeting structure) and cognitive and behavioural approaches (e.g. ensuring expression of different viewpoints) is needed to support strategic decision-making for practice change in a clinical unit. This combined approach should favourably influence the provision of an effective and efficient evidence support environment for the clinical team.
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Carlesso, Lisa C; Macdermid, Joy C; Gross, Anita R; Walton, David M; Santaguida, P Lina
2014-03-24
Clinical practice guidelines on the management of neck pain make recommendations to help practitioners optimize patient care. By examining the practice patterns of practitioners, adherence to CPGs or lack thereof, is demonstrated. Understanding utilization of various treatments by practitioners and comparing these patterns to that of recommended guidelines is important to identify gaps for knowledge translation and improve treatment regimens. To describe the utilization of interventions in patients with neck pain by clinicians. A cross-sectional international survey was conducted from February 2012 to March 2013 to determine physical medicine, complementary and alternative medicine utilization amongst 360 clinicians treating patients with neck pain. The survey was international (19 countries) with Canada having the largest response (38%). Results were analyzed by usage amongst physical therapists (38%) and chiropractors (31%) as they were the predominant respondents. Within these professions, respondents were male (41-66%) working in private practice (69-95%). Exercise and manual therapies were consistently (98-99%) used by both professions but tests of subgroup differences determined that physical therapists used exercise, orthoses and 'other' interventions more, while chiropractors used phototherapeutics more. However, phototherapeutics (65%), Orthoses/supportive devices (57%), mechanical traction (55%) and sonic therapies (54%) were not used by the majority of respondents. Thermal applications (73%) and acupuncture (46%) were the modalities used most commonly. Analysis of differences across the subtypes of neck pain indicated that respondents utilize treatments more often for chronic neck pain and whiplash conditions, followed by radiculopathy, acute neck pain and whiplash conditions, and facet joint dysfunction by diagnostic block. The higher rates of usage of some interventions were consistent with supporting evidence (e.g. manual therapy). However, there was moderate usage of a number of interventions that have limited support or conflicting evidence (e.g. ergonomics). This survey indicates that exercise and manual therapy are core treatments provided by chiropractors and physical therapists. Future research should address gaps in evidence associated with variable practice patterns and knowledge translation to reduce usage of some interventions that have been shown to be ineffective.
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Classroom Discussions as Distortions: Examining Discriminatory Teacher Practices
ERIC Educational Resources Information Center
Sosa, Teresa; Bhathena, Catherine D.
2017-01-01
Ms. Mendez, English Department chair in a large urban high school, has noticed a persistent pattern in the practices of her colleagues. These practices tend to be racially insensitive and emphasize a noncritical view that does not attend to students' experiences and positions students from a deficit perspective. Realizing that such practices serve…
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Representing Practice: Practice Models, Patterns, Bundles
ERIC Educational Resources Information Center
Falconer, Isobel; Finlay, Janet; Fincher, Sally
2011-01-01
This article critiques learning design as a representation for sharing and developing practice, based on synthesis of three projects. Starting with the findings of the Mod4L Models of Practice project, it argues that the technical origins of learning design, and the consequent focus on structure and sequence, limit its usefulness for sharing…
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Modeling biomass competition and invasion in a schematic wetland
NASA Astrophysics Data System (ADS)
Ursino, N.
2010-08-01
Plants growing along hydrologic gradients adjust their biomass allocation and distribution in response to interspecific competition. Furthermore, susceptibility of a community to invasion is to some extent mediated by differences in growth habit, including root architecture and canopy hight. With reference to the study of a schematic wetland, the aim of this paper is (1) to test, via numerical modeling, the capacity of native plants to counteract an alien dominant species and cause eco-hydrological shifts of the ecosystem by changing their growth habit (e.g. allocating biomass below ground and by so doing changing the evapotranspiration locally) and (2) to test the impact on biodiversity of management practices that alter nutrient supply. The results demonstrated that unique combinations of vegetation types characterized by different growth habits may lead to different vegetation patterns under the same hydrologic forcing, and additionally, the vegetation patterns may change in response to major hydrological shifts, which could be related to diverse wetland management and restoration practices.
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NASA Astrophysics Data System (ADS)
Seifert, C.; Lobell, D. B.
2014-12-01
In adapting U.S. agriculture to the climate of the 21st century, multiple cropping presents a unique opportunity to help offset projected negative trends in agricultural production while moving critical crop yield formation periods outside of the hottest months of the year. Critical constraints on this practice include moisture availability, and, more importantly, growing season length. We review evidence that this last constraint has decreased in the previous quarter century, allowing for more winter wheat/soybean double cropping in previously phenologically constrained areas. We also carry this pattern forward to 2100, showing a 126% to 211% increase in the area phenologically suitable for double cropping under the RCP45 and RCP85 scenarios respectively. These results suggest that climate change will relieve phenological constraints on wheat-soy double cropping systems over much of the United States, changing production patterns and crop rotations as areas become suitable for the practice.
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Option generation in the treatment of unstable patients: An experienced-novice comparison study.
Whyte, James; Pickett-Hauber, Roxanne; Whyte, Maria D
2016-09-01
There are a dearth of studies that quantitatively measure nurses' appreciation of stimuli and the subsequent generation of options in practice environments. The purpose of this paper was to provide an examination of nurses' ability to solve problems while quantifying the stimuli upon which they focus during patient care activities. The study used a quantitative descriptive method that gathered performance data from a simulated task environment using multi-angle video and audio. These videos were coded and transcripts of all of the actions that occurred in the scenario and the verbal reports of the participants were compiled. The results revealed a pattern of superiority of the experienced exemplar group. Novice actions were characterized by difficulty in following common protocols, inconsistencies in their evaluative approaches, and a pattern of omissions of key actions. The study provides support for the deliberate practice-based programs designed to facilitate higher-level performance in novices. © 2016 John Wiley & Sons Australia, Ltd.
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Park, Steve; Giri, Gaurav; Shaw, Leo; Pitner, Gregory; Ha, Jewook; Koo, Ja Hoon; Gu, Xiaodan; Park, Joonsuk; Lee, Tae Hoon; Nam, Ji Hyun; Hong, Yongtaek; Bao, Zhenan
2015-01-01
The electronic properties of solution-processable small-molecule organic semiconductors (OSCs) have rapidly improved in recent years, rendering them highly promising for various low-cost large-area electronic applications. However, practical applications of organic electronics require patterned and precisely registered OSC films within the transistor channel region with uniform electrical properties over a large area, a task that remains a significant challenge. Here, we present a technique termed “controlled OSC nucleation and extension for circuits” (CONNECT), which uses differential surface energy and solution shearing to simultaneously generate patterned and precisely registered OSC thin films within the channel region and with aligned crystalline domains, resulting in low device-to-device variability. We have fabricated transistor density as high as 840 dpi, with a yield of 99%. We have successfully built various logic gates and a 2-bit half-adder circuit, demonstrating the practical applicability of our technique for large-scale circuit fabrication. PMID:25902502
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Practice patterns and organizational commitment of inpatient nurse practitioners.
Johnson, Janet; Brennan, Mary; Musil, Carol M; Fitzpatrick, Joyce J
2016-07-01
Nurse practitioners (NPs) deliver a wide array of healthcare services in a variety of settings. The purpose of this study was to examine the practice patterns and organizational commitment of inpatient NPs. A quantitative design was used with a convenience sample (n = 183) of NPs who attended the American Association of Nurse Practitioners (AANP) national conference. The NPs were asked to complete a demographic questionnaire, the Practice Patterns of Acute Nurse Practitioners tool and the Organizational Commitment Questionnaire. Over 85% of inpatient practice time consists of direct and indirect patient care activities. The remaining nonclinical activities of education, research, and administration were less evident in the NP's workweek. This indicates that the major role of inpatient NPs continues to be management of acutely ill patients. Moderate commitment was noted in the Organizational Commitment Questionnaire. Supportive hospital/nursing leadership should acknowledge the value of the clinical and nonclinical roles of inpatient NPs as they can contribute to the operational effectiveness of their organization. By fostering the organizational commitment behaviors of identification, loyalty, and involvement, management can reap the benefits of these professionally dedicated providers. ©2015 American Association of Nurse Practitioners.
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Quantitative relations between soil heavy metal contamination and landscape pattern in Wuxi, China
NASA Astrophysics Data System (ADS)
Zhu, Ming; Pu, Lijie; Xu, Yan
2017-04-01
Land use practices changed landscape pattern and meanwhile, brought forth numerous environmental problems including heavy metal contamination in soil. In this study, we investigated the quantitative relations between soil heavy metal contamination and its surrounding landscape pattern based on topsoil samples and land use map of Wuxi in 2009. The results of vector fitting with Redundancy analysis in R package vegan showed that Percent Coverage of build-up area (PCB) within 2500 m, Perimeter-Area Fractal Dimension (PAFD) within 2500 m, Edge Density (ED) within 2500 m, Patch Density (PD) within 200 m, Percent Coverage of wetland (PCW) within 2000 m and Patch Cohesion (PC) within 200 m significantly affected the contents of heavy metal elements. The results of Stepwise regression suggested that increase of build-up area and fragmentation would increase Cu and Zn, while increase of wetland would decrease the contents of As and Cu. PAFD was negative with Cd, Hg, Pb and Zn.
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Radziszewska, B; Richardson, J L; Dent, C W; Flay, B R
1996-06-01
This paper examines whether the relationship between parenting style and adolescent depressive symptoms, smoking, and academic grades varies according to ethnicity, gender, and socioeconomic status. Four parenting styles are distinguished, based on patterns of parent-adolescent decision making: autocratic (parents decide), authoritative (joint process but parents decide), permissive (joint process but adolescent decides), and unengaged (adolescent decides). The sample included 3993 15-year-old White, Hispanic, African-American, and Asian adolescents. Results are generally consistent with previous findings: adolescents with authoritative parents had the best outcomes and those with unengaged parents were least well adjusted, while the permissive and the autocratic styles produced intermediate results. For the most part, this pattern held across ethnic and sociodemographic subgroups. There was one exception, suggesting that the relationship between parenting styles, especially the unengaged style, and depressive symptoms may vary according to gender and ethnicity. More research is needed to replicate and explain this pattern in terms of ecological factors, cultural norms, and socialization goals and practices.
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Active control of the spatial MRI phase distribution with optimal control theory
NASA Astrophysics Data System (ADS)
Lefebvre, Pauline M.; Van Reeth, Eric; Ratiney, Hélène; Beuf, Olivier; Brusseau, Elisabeth; Lambert, Simon A.; Glaser, Steffen J.; Sugny, Dominique; Grenier, Denis; Tse Ve Koon, Kevin
2017-08-01
This paper investigates the use of Optimal Control (OC) theory to design Radio-Frequency (RF) pulses that actively control the spatial distribution of the MRI magnetization phase. The RF pulses are generated through the application of the Pontryagin Maximum Principle and optimized so that the resulting transverse magnetization reproduces various non-trivial and spatial phase patterns. Two different phase patterns are defined and the resulting optimal pulses are tested both numerically with the ODIN MRI simulator and experimentally with an agar gel phantom on a 4.7 T small-animal MR scanner. Phase images obtained in simulations and experiments are both consistent with the defined phase patterns. A practical application of phase control with OC-designed pulses is also presented, with the generation of RF pulses adapted for a Magnetic Resonance Elastography experiment. This study demonstrates the possibility to use OC-designed RF pulses to encode information in the magnetization phase and could have applications in MRI sequences using phase images.
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Er Effect of Low Molecular Liquid Crystal on One-Sided Patterned Electrodes
NASA Astrophysics Data System (ADS)
Kikuchi, Takehito; Inoue, Akio; Furusho, Junji; Kawamuki, Ryohei
Several kinds of ER fluids (ERF) have been developed and have been applied to some mechatronics devices and processing technologies. In many conventional applications of ERFs, these devices consist of bilateral electrodes to apply electric field in ERF. However, the electric field of several kV/mm may be necessary to generate an ER effect sufficiently for practical purposes. The gap between a pair of electrodes should be, therefore, maintained narrowly and exactly for fears of short-circuit. At the same time, this electrode system also requires an interconnection on driving parts. To improve these disadvantages, we proposed "one-sided patterned electrode" (OSPE) systems in previous works. In this report, we confirmed the flow characteristics of low molecular liquid crystal (LMLC) on OSPE. Next, we also confirmed the different characteristics depending on the pattern type. Depending on results of electro-static analysis, we conclude that such a difference may results from the directors of LC molecules derived by electric field.
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Prediction of sound radiation from different practical jet engine inlets
NASA Technical Reports Server (NTRS)
Zinn, B. T.; Meyer, W. L.
1981-01-01
Computer codes, capable of producing accurate results for nondimensional wave numbers (based on duct radius) of up to 20, were developed and used to generate results for various other inlet configurations. Both reflection coefficients and radiation patterns were calculated by the integral solution procedure for the following five inlet configurations: the NASA Langley Bellmouth, the NASA Lewis JT-15D-1 ground test nacelle, and three hyperbolic inlets of 50, 70, and 90 degrees. Results obtained are compared with results from other experimental and theoretical studies.
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Practice Patterns of Speech-Language Pathologists in Pediatric Vocal Health.
Hartley, Naomi A; Braden, Maia; Thibeault, Susan L
2017-05-17
The purpose of this study was to investigate current practices of speech-language pathologists (SLPs) in the management of pediatric vocal health, with specific analysis of the influence of clinical specialty and workplace setting on management approaches. American Speech-Language-Hearing Association-certified clinicians providing services within the United States (1%-100% voice caseload) completed an anonymous online survey detailing clinician demographics; employment location and service delivery models; approaches to continuing professional development; and specifics of case management, including assessment, treatment, and discharge procedures. Current practice patterns were analyzed for 100 SLPs (0-42 years of experience; 77 self-identifying as voice specialists) providing services in 34 U.S. states across a range of metropolitan and nonmetropolitan workplace settings. In general, SLPs favored a multidisciplinary approach to management; included perceptual, instrumental, and quality of life measures during evaluation; and tailored intervention to the individual using a combination of therapy approaches. In contrast with current practice guidelines, only half reported requiring an otolaryngology evaluation prior to initiating treatment. Both clinical specialty and workplace setting were found to affect practice patterns. SLPs in school settings were significantly less likely to consider themselves voice specialists compared with all other work environments. Those SLPs who considered themselves voice specialists were significantly more likely to utilize voice-specific assessment and treatment approaches. SLP practice largely mirrors current professional practice guidelines; however, potential exists to further enhance client care. To ensure that SLPs are best able to support children in successful communication, further research, education, and advocacy are required.
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Ecological effects of variable retention harvests in the northwestern United States: the DEMO study.
Keith B. Aubry; Charles B. Halpern; Douglas A. Maguire
2004-01-01
The retention of trees in harvest units is an integral part of forest management practices on federal lands in the northwestern United States (U.S.), yet the ecological benefits that result from various levels or patterns of retained trees remain speculative. Large scale and long term silviculture experiments are needed to evaluate the effects of alternative forest...
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ERIC Educational Resources Information Center
Schmitz, Birgit; Klemke, Roland; Specht, Marcus
2013-01-01
Mobile and in particular pervasive games are a strong component of future scenarios for teaching and learning. Based on results from a previous review of practical papers, this work explores the educational potential of pervasive games for learning by analysing underlying game mechanisms. In order to determine and classify cognitive and affective…
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ERIC Educational Resources Information Center
Meeker, Mary; Meeker, Robert
In this analysis of intelligence testing of minority group children, the implications of inadequate testing practices are discussed. Several aspects of test design are examined: deficiencies in intelligence testing, cultural bias, construct validity, and diagnostic utility. A sample set of results derived from a Stanford-Binet test administered to…
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The impact of Nordic walking training on the gait of the elderly.
Ben Mansour, Khaireddine; Gorce, Philippe; Rezzoug, Nasser
2018-03-27
The purpose of the current study was to define the impact of regular practice of Nordic walking on the gait of the elderly. Thereby, we aimed to determine whether the gait characteristics of active elderly persons practicing Nordic walking are more similar to healthy adults than that of the sedentary elderly. Comparison was made based on parameters computed from three inertial sensors during walking at a freely chosen velocity. Results showed differences in gait pattern in terms of the amplitude computed from acceleration and angular velocity at the lumbar region (root mean square), the distribution (Skewness) quantified from the vertical and Euclidean norm of the lumbar acceleration, the complexity (Sample Entropy) of the mediolateral component of lumbar angular velocity and the Euclidean norm of the shank acceleration and angular velocity, the regularity of the lower limbs, the spatiotemporal parameters and the variability (standard deviation) of stance and stride durations. These findings reveal that the pattern of active elderly differs significantly from sedentary elderly of the same age while similarity was observed between the active elderly and healthy adults. These results advance that regular physical activity such as Nordic walking may counteract the deterioration of gait quality that occurs with aging.
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Diagnostic Utility of the Bannatyne WISC-III Pattern. Learning Disabilities Practice
ERIC Educational Resources Information Center
Smith, Courtney B.; Watkins, Marley W.
2004-01-01
Regrouping Wechsler Intelligence Scale for Children-Third Edition (WISC-III) subtests into Bannatyne's spatial, conceptual, and sequential patterns has been thought by many to identify children with learning disabilities (LD). This study investigated the prevalence and diagnostic utility of WISC-III Bannatyne patterns by comparing 1,302 children…
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Research in Review. Children's Eating: The Development of Food-Acceptance Patterns.
ERIC Educational Resources Information Center
Birch, Leann L.; And Others
1995-01-01
Reviews what is known about the factors that influence child's food-acceptance patterns, including children's sensory responsiveness, innate preferences, and ability to learn about food; the consequences of eating; and the effect of child-feeding practices on children's food-acceptance patterns. Suggests that early experience contributes to the…
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An Empirical Study on Students' Ability to Comprehend Design Patterns
ERIC Educational Resources Information Center
Chatzigeorgiou, Alexander; Tsantalis, Nikolaos; Deligiannis, Ignatios
2008-01-01
Design patterns have become a widely acknowledged software engineering practice and therefore have been incorporated in the curricula of most computer science departments. This paper presents an observational study on students' ability to understand and apply design patterns. Within the context of a postgraduate software engineering course,…
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Phillips, Robert L.; Petterson, Stephen M.; Bazemore, Andrew W.; Wingrove, Peter; Puffer, James C.
2017-01-01
PURPOSE Medicare beneficiary spending patterns reflect those of the 306 Hospital Referral Regions where physicians train, but whether this holds true for smaller areas or for quality is uncertain. This study assesses whether cost and quality imprinting can be detected within the 3,436 Hospital Service Areas (HSAs), 82.4 percent of which have only 1 teaching hospital, and whether sponsoring institution characteristics are associated. METHODS We conducted a secondary, multi-level, multivariable analysis of 2011 Medicare claims and American Medical Association Masterfile data for a random, nationally representative sample of family physicians and general internists who completed residency between 1992 and 2010 and had more than 40 Medicare patients (3,075 physicians providing care to 503,109 beneficiaries). Practice and training locations were matched with Dartmouth Atlas HSAs and categorized into low-, average-, and high-cost spending groups. Practice and training HSAs were assessed for differences in 4 diabetes quality measures. Institutional characteristics included training volume and percentage of graduates in rural practice and primary care. RESULTS The unadjusted, annual, per-beneficiary spending difference between physicians trained in high- and low-cost HSAs was $1,644 (95% CI, $1,253–$2,034), and the difference remained significant after controlling for patient and physician characteristics. No significant relationship was found for diabetes quality measures. General internists were significantly more likely than family physicians to train in high-cost HSAs. Institutions with more graduates in rural practice and primary care produced lower-spending physicians. CONCLUSIONS The “imprint” of training spending patterns on physicians is strong and enduring, without discernible quality effects, and, along with identified institutional features, supports measures and policy options for improved graduate medical education outcomes. PMID:28289113
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Sasaki, Noriko; Kunisawa, Susumu; Otsubo, Tetsuya; Ikai, Hiroshi; Fushimi, Kiyohide; Yasumura, Yoshio; Kimura, Takeshi; Imanaka, Yuichi
2014-01-01
Objectives Despite the increasing burden of acute heart failure (AHF) on healthcare systems, the association between centralised cardiovascular specialist care and the quality of AHF care remains unknown. We examine the relationship between the number of cardiologists per hospital and hospital practice variations. Design, setting and participants In a retrospective observational study, we analysed 38 668 patients with AHF admitted to 546 Japanese acute care hospitals between 2010 and 2011 using the Diagnosis Procedure Combination administrative claims database. Sample hospitals were categorised into four groups according to the number of cardiologists per facility (none, 1–4, 5–9 and ≥10). To confirm the capability of administrative data to identify patients with AHF, the ≥10 cardiologists group was compared with two recent clinical registries in Japan. Main outcome measures Using multivariable logistic regression models, patient risk-adjusted in-hospital mortality rates and age-sex-adjusted ORs of various AHF therapies were calculated and compared among four hospital groups. Results The ≥10 cardiologists group of hospitals from the administrative database had similar major underlying disease incidence and therapeutic practices to those of the clinical registry hospitals. Age-adjusted and sex-adjusted ORs of various AHF therapies in the four hospital groups revealed wide practice variations associated with the number of cardiologists. Adjusted in-hospital mortality demonstrated a negative association with the number of cardiologists. In addition, the different hospital-level distribution patterns of specific therapeutic practices illustrated the diffusion process of therapies across facilities. Conclusions Wide practice variations in AHF care were associated with the number of cardiologists per facility, indicating a possible relationship between the quality of AHF care and manpower resources. The provision of recommended therapies increased together with the number of cardiologists. PMID:25550294
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Pattern detection in forensic case data using graph theory: application to heroin cutting agents.
Terrettaz-Zufferey, Anne-Laure; Ratle, Frédéric; Ribaux, Olivier; Esseiva, Pierre; Kanevski, Mikhail
2007-04-11
Pattern recognition techniques can be very useful in forensic sciences to point out to relevant sets of events and potentially encourage an intelligence-led style of policing. In this study, these techniques have been applied to categorical data corresponding to cutting agents found in heroin seizures. An application of graph theoretic methods has been performed, in order to highlight the possible relationships between the location of seizures and co-occurrences of particular heroin cutting agents. An analysis of the co-occurrences to establish several main combinations has been done. Results illustrate the practical potential of mathematical models in forensic data analysis.
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AAN Epilepsy Quality Measures in clinical practice: a survey of neurologists.
Wasade, Vibhangini S; Spanaki, Marianna; Iyengar, Revathi; Barkley, Gregory L; Schultz, Lonni
2012-08-01
Epilepsy Quality Measures (EQM) were developed by the American Academy of Neurology (AAN) to convey standardization and eliminate gaps and variations in the delivery of epilepsy care (Fountain et al., 2011 [1]). The aim of this study was to identify adherence to these measures and other emerging practice standards in epilepsy care. A 15-item survey was mailed to neurologists in Michigan, USA, inquiring about their practice patterns in relation to EQM. One hundred thirteen of the 792 surveyed Michigan Neurologists responded (14%). The majority (83% to 94%) addressed seizure type and frequency, reviewed EEG and MRI, and provided pregnancy counseling to women of childbearing potential. Our survey identified gaps in practice patterns such as counseling about antiepileptic drug (AED) side effects and knowledge about referral for surgical therapy of intractable epilepsy. Statistical significance in the responses on the AAN EQM was noted in relation to number of years in practice, number of epilepsy patients seen, and additional fellowship training in epilepsy. Practice patterns assessment in relation to other comorbidities revealed that although bone health and sudden unexplained death in epilepsy are addressed mainly in patients at risk, depression is infrequently discussed. The findings in this study indicate that additional educational efforts are needed to increase awareness and to improve quality of epilepsy care at various points of health care delivery. Copyright © 2012 Elsevier Inc. All rights reserved.
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Lee, Jihong; Lee, Sun Haeng; Lee, Boram; Yang, In Jun; Chang, Gyu Tae
2018-03-13
The aim of this study was to investigate autism spectrum disorder (ASD) clinical practice patterns of Korean medicine doctors (KMDs) through questionnaire survey. Questionnaires on Korean medicine (KM) treatment for ASD were distributed to 255 KMDs on December 5, 2016. The KMDs were psychiatrists, pediatricians, or general practitioners, who treated patients with ASD. The questionnaire covered items on treatment methods, aims of treatment, KM syndrome differentiation, diagnostic tools, and sociodemographic characteristics. Frequency analysis was conducted to describe the participants and their practices. A total 22.4% KMDs (n = 57/255) completed the questionnaires and 54 KMDs (21.2%) matched the inclusion criteria. The KMDs utilized herbal medicine (27.3%), body acupuncture (17.6%), scalp acupuncture (10.7%), moxibustion (6.4%), and Korean medical psychotherapy (5.9%) to treat ASD. The most commonly prescribed herbal medicine was Yukmijihwang-tang. Forty-eight (88.9%) KMDs responded that they used KM syndrome differentiation. 'Organ system, Qi, Blood, Yin, Yang, Fluid and Humor diagnosis' was most frequently used for syndrome differentiation. ASD was mainly diagnosed based on the fourth edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM-IV) and DSM-5. The present study demonstrated the current status of KMDs' diagnosis and treatment of ASD. In future clinical trials and clinical practice guidelines, these findings will provide meaningful information on the actual practice patterns of KMDs.
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Ren, Weizheng; Hu, Liangliang; Guo, Liang; Zhang, Jian; Tang, Lu; Zhang, Entao; Zhang, Jiaen; Luo, Shiming; Tang, Jianjun; Chen, Xin
2018-01-01
We examined how traditional farmers preserve the genetic diversity of a local common carp (Cyprinus carpio), which is locally referred to as “paddy field carp” (PF-carp), in a “globally important agricultural heritage system” (GIAHS), i.e., the 1,200-y-old rice–fish coculture system in Zhejiang Province, China. Our molecular and morphological analysis showed that the PF-carp has changed into a distinct local population with higher genetic diversity and diverse color types. Within this GIAHS region, PF-carps exist as a continuous metapopulation, although three genetic groups could be identified by microsatellite markers. Thousands of small farmer households interdependently obtained fry and parental carps for their own rice–fish production, resulting in a high gene flow and large numbers of parent carps distributing in a mosaic pattern in the region. Landscape genetic analysis indicated that farmers’ connectivity was one of the major factors that shaped this genetic pattern. Population viability analysis further revealed that the numbers of these interconnected small farmer households and their connection intensity affect the carps’ inherent genetic diversity. The practice of mixed culturing of carps with diverse color types helped to preserve a wide range of genetic resources in the paddy field. This widespread traditional practice increases fish yield and resource use, which, in return, encourages famers to continue their practice of selecting and conserving diverse color types of PF-carp. Our results suggested that traditional farmers secure the genetic diversity of PF-carp and its viability over generations in this region through interdependently incubating and mixed-culturing practices within the rice−fish system. PMID:29295926
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Health spending in the 1980's: Integration of clinical practice patterns with management
Freeland, Mark S.; Schendler, Carol E.
1984-01-01
Health care spending in the United States more than tripled between 1972 and 1982, increasing from $94 billion to $322 billion. This growth substantially outpaced overall growth in the economy. National health expenditures are projected to reach approximately $690 billion in 1990 and consume roughly 12 percent of the gross national product. Government spending for health care is projected to reach $294 billion by 1990, with the Federal Government paying 72 percent. The Medicare prospective payment system and increasing competition in the health services sector are providing incentives to integrate clinical practice patterns with improved management practices. PMID:10310595
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Financial ratios in diagnostic radiology practices: variability and trends.
Hogan, Christopher; Sunshine, Jonathan H
2004-03-01
To evaluate variation in financial ratios for radiology practices nationwide and trends in these ratios and in payments. In 1999, the American College of Radiology surveyed radiology practices by mail. The final response rate was 66%. Weighting was used to make responses representative of all radiology practices in the United States. Self-reported financial ratios (payments, charges, accounts receivable turnover) were analyzed; 449 responses had usable data on these ratios. Comparison with results of a similar 1992 survey and combined analysis with Medicare data on billed charges provided information on trends. All measures of payment collections declined sharply from 1992 to 1999, with the gross collections rate (revenues as percentage of billed charges) decreasing from 71% to 55%. Average payment for a typical radiology service decreased approximately 4% in dollar terms or approximately 19% in inflation-adjusted terms. In 1999, nonmetropolitan practices appeared to fare better than others. Among insurers, Medicaid stood out as a low and slow payer, but neither managed care nor Medicare had a consistent effect on financial ratios. The gross collections rate varied substantially across geographic areas, as did, in an inverse pattern, the level of billed charges. One-quarter of practices had accounts receivable equal to 90 or more days of billings. The opposing geographic pattern of billed charges and gross collection rate suggests that geographic variation in the latter is driven more by variation in billed charges than by variation in payment levels. Radiologists saw a substantial decrease in the real (inflation-adjusted) value of payment per service during the 1990s. The large fraction of practices with accounts receivable of 90 or more days of billings-a level considered potentially imprudent by financial management advisors-suggests that many practices should improve financial management and that state prompt-payment laws have not had a substantial positive effect. Copyright RSNA, 2004
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Alexander, Jeffrey A; Lee, Shoou-Yih D; Wang, Virginia; Margolin, Frances S
2009-04-01
Despite the legal and practical importance of monitoring and oversight of management by hospital governing boards, there is little empirical evidence of how hospital boards fulfill these roles and the extent to which these practices have changed over time. We utilize data from three national surveys of hospital governance to examine how oversight and monitoring practices in public and private not-for-profit (NFP) hospital boards have changed over time. Findings suggest that board relations with CEOs in NFP hospitals display important but potentially contradictory patterns. On the one hand, NFP hospital boards appear to be exercising more stringent oversight of management and hospital performance. On the other hand, management is more actively involved with governance matters with less separation of board and management. This general pattern varies by the dimension of oversight and monitoring practice and by specific characteristics of NFP hospitals.
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Pericentral retinopathy and racial differences in hydroxychloroquine toxicity.
Melles, Ronald B; Marmor, Michael F
2015-01-01
To describe patterns of hydroxychloroquine retinopathy distinct from the classic parafoveal (bull's eye) maculopathy. Retrospective case series. Patients from a large multi-provider group practice and a smaller university referral practice diagnosed with hydroxychloroquine retinopathy. Patients with widespread or "end-stage" retinopathy were excluded. Review of ophthalmic studies (fundus photography, spectral-domain optical coherence tomography, fundus autofluorescence, multifocal electroretinography, visual fields) and classification of retinopathy into 1 of 3 patterns: parafoveal (retinal changes 2°-6° from the fovea), pericentral (retinal changes ≥ 8° from the fovea), or mixed (retinal changes in both parafoveal and pericentral areas). Relative frequency of different patterns of hydroxychloroquine retinopathy and comparison of risk factors. Of 201 total patients (18% Asian) with hydroxychloroquine retinopathy, 153 (76%) had typical parafoveal changes, 24 (12%) also had a zone of pericentral damage, and 24 (12%) had pericentral retinopathy without any parafoveal damage. Pericentral retinopathy alone was seen in 50% of Asian patients but only in 2% of white patients. Patients with the pericentral pattern were taking hydroxychloroquine for a somewhat longer duration (19.5 vs. 15.0 years, P < 0.01) and took a larger cumulative dose (2186 vs. 1813 g, P = 0.02) than patients with the parafoveal pattern, but they were diagnosed at a more severe stage of toxicity. Hydroxychloroquine retinopathy does not always develop in a parafoveal (bull's eye) pattern, and a pericentral pattern of damage is especially prevalent among Asian patients. Screening practices may need to be adjusted to recognize pericentral and parafoveal hydroxychloroquine retinopathy. Copyright © 2015 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
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NASA Technical Reports Server (NTRS)
Smyth, P.; Mellstrom, J.
1990-01-01
Initial results obtained from an investigation using pattern recognition techniques for identifying fault modes in the Deep Space Network (DSN) 70 m antenna control loops are described. The overall background to the problem is described, the motivation and potential benefits of this approach are outlined. In particular, an experiment is described in which fault modes were introduced into a state-space simulation of the antenna control loops. By training a multilayer feed-forward neural network on the simulated sensor output, classification rates of over 95 percent were achieved with a false alarm rate of zero on unseen tests data. It concludes that although the neural classifier has certain practical limitations at present, it also has considerable potential for problems of this nature.
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Physiological responses to single versus double stepping pattern of ascending the stairs.
Aziz, Abdul Rashid; Teh, Kong Chuan
2005-07-01
The aim of this study was to compare the physiological responses and energy cost between two ascending patterns, the single-step (SS) and the double-step (DS), in climbing a public staircase. In the SS pattern, a person climbs one step at a time whilst in the double-step (DS) pattern, the individual traverses two steps in a single stride. Advocates of each stepping pattern claimed that their type of ascent is physically more taxing and expends more calories. Thirty subjects (10 males and 20 females) climbed a typical 11-storey flat (each step height of 0.15 m, a total of 180 steps and a vertical displacement of 27.0 m). The subjects climbed using either the SS pattern at a tempo of 100 steps x min(-1) or the DS pattern at 50 steps x min(-1). The prescribed stepping frequencies ensured that an equal amount of total work was performed between the SS and DS patterns. The climbing patterns were performed in random order. Physiological measures during the last 30 s of the climbs were used in the comparative analysis. The results showed that ventilation, oxygen uptake and heart rate values were significantly higher (all p < 0.01) in the SS as compared to the DS pattern. However, the caloric expenditure during the SS pattern was calculated to be only marginally higher than the DS pattern. In conclusion, ascending with the SS pattern led to significantly higher physiological responses compared to the DS pattern. The higher calorie expended with the SS compared to the DS pattern was deemed to be of little practical significance.
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Lindhiem, Oliver; Shaffer, Anne; Kolko, David J.
2014-01-01
In the parent intervention outcome literatures, discipline practices are generally quantified as absolute frequencies or, less commonly, as relative frequencies. These differences in methodology warrant direct comparison as they have critical implications for study results and conclusions among treatments targeted at reducing parental aggression and harsh discipline. In this study, we directly compared the absolute frequency method and the relative frequency method for quantifying physically aggressive, psychologically aggressive, and nonaggressive discipline practices. Longitudinal data over a 3-year period came from an existing data set of a clinical trial examining the effectiveness of a psychosocial treatment in reducing parental physical and psychological aggression and improving child behavior (N = 139; Kolko et al., 2009). Discipline practices (both aggressive and nonaggressive) were assessed using the Conflict Tactics Scale (CTS; Straus et al., 1998). The two methods yielded different patterns of results, particularly for nonaggressive discipline strategies. We suggest that each method makes its own unique contribution to a more complete understanding of the association between parental aggression and intervention effects. PMID:24106146
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Examining learner-centered training with teen volunteer staff at an aquarium
NASA Astrophysics Data System (ADS)
Bautista, Raelene M.
This research project examined the effects of a training program that focused on helping youth volunteers create a learner-centered interaction at an Aquarium. This study explored whether this learner centered training resulted in an increased ability to identify learner-centered engagement as well as reported changes in practice. Most research on training programs and professional development, that introduces learner-centered strategies examines adult teachers working in formal environments. This study examined youth volunteer staff in an informal science institution that participated in a weekly one-hour training for four weeks during their eight week long summer volunteer program. The data showed that some of topics introduced in the learner centered training, such as the importance of visitors' prior knowledge and the use of objects, were identified more often as good practice after the training. In addition, participants seemed to hold on to some of their original perceptions of good practices, such as providing positive reinforcement and modifying their physical posture to make the visitors feel comfortable. The investigation also revealed that conversation patterns changed in some participants' practice as a result of the training.
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Organizational Patterns within an International Educational System
ERIC Educational Resources Information Center
Jackson, R.
1975-01-01
The organizational patterns of the European School system represent an amalgam of continental educational practices. The European School serves children from Belgium, France, Federal Germany, Italy, Luxembourg, and the Netherlands. (Author/IRT)
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Prevalent practice patterns in glaucoma: Poll of Indian ophthalmologists at a national conference
Choudhari, Nikhil Shreeram; Pathak-Ray, Vanita; Kaushik, Sushmita; Vyas, Prateep; George, Ronnie
2016-01-01
Purpose: The aim of this study is to explore and compare the prevailing practice patterns in the diagnosis and management of glaucoma among subspecialists and general ophthalmologists in India. Materials and Methods: This is an interactive audience response system (ARS) based poll of ophthalmologists attending the annual conference of the Glaucoma Society of India in 2013. Results: The information was obtained from 379 ophthalmologists (146 glaucoma specialists, 54 nonglaucoma subspecialists, and 179 general ophthalmologists). The majority of polled ophthalmologists (236; 62%) had 10 or more years of experience in ophthalmology. The glaucoma specialists differed from nonglaucomatologists in their preference for Goldmann applanation tonometer (P < 0.01), four-mirror gonioscope (P < 0.01), Humphrey perimeter (P < 0.01), laser peripheral iridotomy in primary angle closure disease (P = 0.03), postiridotomy gonioscopy (P < 0.01), and usage of antifibrotic agents during filtering surgery (P < 0.01). Optical coherence tomography was the most preferred imaging modality and was utilized more often by the subspecialists than general ophthalmologists. The ophthalmologists also differed in their choice of antiglaucoma medications. More glaucoma specialists were performing surgery on children with congenital glaucoma (P < 0.01), implanting glaucoma drainage devices (P < 0.01), and using scientific journals to upgrade knowledge (P = 0.03) than the other ophthalmologists. Conclusions: This poll is the first of its kind in India, in its usage of the ARS, and in comparing the practice patterns of care for glaucoma among subspecialists and general ophthalmologists. It has revealed substantial diversity in a few areas among those who did and did not receive specialty training in glaucoma. PMID:27905331
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Practice patterns of post-radical prostatectomy incontinence surgery in Ontario
Wallis, Christopher J.D.; Herschorn, Sender; Liu, Ying; Carr, Lesley K.; Kodama, Ronald T.; Klotz, Laurence H.; Saskin, Refik; Nam, Robert K.
2014-01-01
Introduction: We assess the practice patterns of artificial urinary sphincter (AUS) and urethral sling insertion after radical prostatectomy (RP) from a large population-based cohort. Methods: We examined 25 346 men in Ontario, Canada who underwent RP between 1993 and 2006. Using hospital and cancer registry data, we identified patients who subsequently underwent an incontinence procedure. We characterized the practice patterns of post-prostatectomy incontinence procedures across Ontario during the study interval. Results: A total of 703 (2.8%) men underwent subsequent insertion of an AUS and 282 (1.1%) underwent a urethral sling procedure (985 total incontinence procedures, 3.9%) over the study period. During the study period, 121 hospitals performed RP. Among them, 32 (26%) hospitals performed both RP and AUS/sling procedures, and 89 (74%) performed RP only. Four hospitals performed AUS/sling procedures but not RP. Of the 36 institutions that performed AUS/sling procedures, the median annual case volume was 0.29 (interquartile range: 0.083-0.75). Of all incontinence procedures, 56% were performed at 3 academic institutions. When examining observed rates of AUS/sling procedures compared with expected rates from the overall cohort, 15 of 32 hospitals (47%) performed significantly fewer incontinence procedures than expected given their RP case volume (p range: <0.0001–0.0390) and 5 (16%) performed significantly more (p range: <0.0001–0.038). Conclusions: A small number of academic institutions provide most of the surgical care for men with incontinence following RP in Ontario. Many centres that perform RP refer out to other centres to surgically manage their patients’ incontinence. PMID:25408805
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A Canadian perspective on anterior cervical discectomies: practice patterns and preferences
Bennardo, Michael; Farrokhyar, Forough; Martyniuk, Amanda; Reddy, Kesava
2018-01-01
Background The purpose of this study is to elucidate the current practice patterns of Canadian neurosurgeons with regards to anterior cervical discectomy (ACD). Methods A one-page questionnaire was sent out using SurveyMonkey to all neurosurgeon members of the Canadian Neurological Sciences Federation (CNSF). End points were surgeon preference for ACD surgical method, graft source, the length of collar usage and the recommended time before returning to work. Results Response rate was 74.0%. Of the responders, 75.0% performed single level ACD and 18.3% had completed spine fellowships. The majority (68.2%) chose ACD with fusion and plating (ACDFP) as their preferred method with allograft being the most popular choice of fusion material (44.3%). Most of the respondents did not prescribe collars (60.9%) and when they did, hard collar was prescribed most often (76.9%) and AspenTM collar was the most popular choice (67.7%). The majority of surgeons chose ‘other’ as their response for length of time for collar use (40.0%) while allowing them to take their collars off at night (78.1%). Most of the surgeons recommended physiotherapy post-operatively (58.1%) and time to physiotherapy was 6–8 weeks. Recommended back to work time was 6 weeks for 44.9% of respondents. In the cross analysis, surgeons who performed ACDF were more likely to prescribe collars (50%, P=0.01) versus surgeons who performed ACDFP (21.7%, P=0.01). Conclusions Our survey is an up to date description of current practice patterns for ACD amongst Canadian neurosurgeons. PMID:29732425
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Patterns of Morning and Evening Fatigue Among Adults with HIV/AIDS
Lerdal, Anners; Gay, Caryl L.; Aouizerat, Bradley E.; Portillo, Carmen J.; Lee, Kathryn A.
2011-01-01
Aims and objectives Describe patterns of morning and evening fatigue in adults with HIV and examine their relationship to demographic and clinical factors and other symptoms. Background Most studies of HIV-related fatigue assess average levels of fatigue and do not address its diurnal fluctuations. Patterns of fatigue over the course of the day may have important implications for assessment and treatment. Design A cross-sectional, correlational design was used with six repeated measures over 72 hours. Method A convenience sample of 318 HIV-infected adults was recruited in San Francisco. Socio-demographic, clinical and symptom data were collected with questionnaires. CD4+ T-cell count and viral load were obtained from medical records. Participants completed a four-item version of the Lee Fatigue Scale each morning and evening for three consecutive days. Participants were grouped based on their diurnal pattern of fatigue (high evening only, high morning only, high morning and evening and low morning and evening). Group comparisons and logistic regression were used to determine the unique predictors of each fatigue pattern. Results The high evening fatigue pattern was associated with anxiety and the high morning pattern was associated with anxiety and depression. The morning fatigue pattern showed very little fluctuation between morning and evening, the evening pattern showed the largest fluctuation. The high morning and evening pattern was associated with anxiety, depression and sleep disturbance and this group reported the most fatigue-related distress and interference in functioning. Conclusions These results provide initial evidence for the importance of assessing the patient’s daily pattern of fatigue fluctuation, as different patterns were associated with different symptom experiences and perhaps different etiologies. Relevance to clinical practice Different fatigue patterns may benefit from tailored intervention strategies. Management of depressive symptoms could be tested in patients who experience high levels of morning fatigue. PMID:21752119
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Shah, Reshma P; Kunnavakkam, Rangesh; Msall, Michael E
2013-01-01
The medical community has called upon pediatricians to be knowledgeable about an individualized education program (IEP). We sought to: 1) evaluate pediatricians' knowledge and attitudes regarding special education; 2) examine the relationship between perceived responsibilities and practice patterns; and 3) identify barriers that impact pediatricians' ability to provide comprehensive care to children with educational difficulties. Surveys were mailed to a national sample of 1000 randomly selected general pediatricians and pediatric residents from October 2010 to February 2011. The response rate was 47%. Of the knowledge items, respondents answered an average of 59% correctly. The majority of respondents thought pediatricians should be responsible for identifying children who may benefit from special education services and assist families in obtaining services, but less than 50% thought they should assist in the development of an IEP. The majority of pediatricians inquired whether a child is having difficulty at school, but far fewer conducted screening tests or asked parents if they needed assistance obtaining services. Overall, the prevalence of considering a practice a pediatrician's responsibility is significantly higher than examples of such a practice pattern being reported. Financial reimbursement and insufficient training were among the most significant barriers affecting a pediatrician's ability to provide care to children with educational difficulties. In order to provide a comprehensive medical home, pediatricians must be informed about the special education process. This study demonstrates that there are gaps in pediatricians' knowledge and practice patterns regarding special education that must be addressed. Copyright © 2013 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
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Sugrue, Conor M; McInerney, Niall; Joyce, Cormac W; Jones, Deidre; Hussey, Alan J; Kelly, Jack L; Kerin, Michael J; Regan, Padraic J
2015-01-01
Bilateral breast reduction (BBR) is one of the most frequently performed female breast operations. Despite no evidence supporting efficacy of drain usage in BBRs, postoperative insertion is common. Recent high quality evidence demonstrating potential harm from drain use has subsequently challenged this traditional practice. The aim of this study is to assess the current practice patterns of drains usage by Plastic & Reconstructive and Breast Surgeons in UK and Ireland performing BBRs. An 18 question survey was created evaluating various aspects of BBR practice. UK and Irish Plastic & Reconstructive and Breast Surgeons were invited to participate by an email containing a link to a web-based survey. Statistical analysis was performed with student t-test and chi-square test. Two hundred and eleven responding surgeons were analysed, including 80.1% (171/211) Plastic Surgeons and 18.9% (40/211) Breast Surgeons. Of the responding surgeons, 71.6% (151/211) routinely inserted postoperative drains, for a mean of 1.32 days. Drains were used significantly less by surgeons performing ≥20 BBRs (p = 0.02). With the majority of BBRs performed as an inpatient procedure, there was a trend towards less drain usage in surgeons performing this procedure as an outpatient; however, this was not statistically significant (p = 0.07). Even with the high level of evidence demonstrating the safety of BBR without drains, they are still routinely utilised. In an era of evidence- based medicine, surgeons performing breast reductions must adopt the results from scientific research into their clinical practice.
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Robinson, Bruce M.; Tong, Lin; Zhang, Jinyao; Wolfe, Robert A.; Goodkin, David A.; Greenwood, Roger N.; Kerr, Peter G.; Morgenstern, Hal; Li, Yun; Pisoni, Ronald L.; Saran, Rajiv; Tentori, Francesca; Akizawa, Tadao; Fukuhara, Shunichi; Port, Friedrich K.
2014-01-01
KDOQI practice guidelines recommend pre-dialysis blood pressure (BP) <140/90 mm Hg. However, most prior hemodialysis studies found elevated mortality with low, not high, systolic blood pressure (SBP), possibly due to unmeasured confounders affecting BP and mortality such as severity of comorbidities. To lessen this bias, we analyzed facility-level BP practices, relating patient-level survival to the fraction of patients in BP categories at each dialysis facility in Cox regression models adjusted for patient and facility characteristics. Analyses included 24,525 patients in the Dialysis Outcomes and Practice Patterns Study. Compared with pre-dialysis SBP 130–159 mm Hg, mortality was 13% higher in facilities with 20% more patients at SBP 110–129 mm Hg and 16% higher in facilities with 20% more patients at SBP ≥160 mm Hg. For patient-level SBP, mortality was elevated at low (<130 mm Hg), not high (up to ≥180 mm Hg) SBP. For pre-dialysis diastolic BP, mortality was lowest at 60–99 mm Hg, a wide range suggesting less chance to improve outcomes. Higher mortality at SBP <130 mm Hg is consistent with prior studies and may be due to excessive BP-lowering during dialysis. The lowest risk facility SBP range of 130–159 mm Hg indicates this range may be optimal, but may have been influenced by unmeasured facility practices. While additional study is needed, the findings contrast with KDOQI BP targets, and provide guidance on optimal BP range in absence of definitive clinical trial data. PMID:22718187
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Drinking Patterns, Gender and Health II: Predictors of Preventive Service Use
Green, Carla A.; Polen, Michael R.; Leo, Michael C.; Perrin, Nancy A.; Anderson, Bradley M.; Weisner, Constance M.
2012-01-01
Background Chronic diseases and injuries are elevated among people with substance use problems/dependence, yet heavier drinkers use fewer routine and preventive health services than non-drinkers and moderate drinkers, while former drinkers and abstainers use more than moderate drinkers. Researchers hypothesize that drinking clusters with attitudes and practices that produce better health among moderate drinkers and that heavy drinkers avoid doctors until becoming ill, subsequently quitting and using more services. Gender differences in alcohol consumption, health-related attitudes, practices, and prevention-services use may affect these relationships. Methods A stratified random sample of health-plan members (7884; 2995 males, 4889 females) completed a mail survey that was linked to 24 months of health-plan records. Data were used to examine relationships between alcohol use, gender, health-related attitudes/practices, health, and prevention-service use. Results Controlling for attitudes, practices, and health, female lifelong abstainers and former drinkers were less likely to have mammograms; individuals with alcohol use disorders and positive AUDIT scores were less likely to obtain influenza vaccinations. AUDIT-positive women were less likely to undergo colorectal screening than AUDIT-positive men. Consistent predictors of prevention-services use were: self-report of having a primary care provider (positive); disliking visiting the doctor (negative); smoking cigarettes (negative), and higher BMI (negative). Conclusions When factors associated with drinking are controlled, patterns of alcohol consumption have limited effects on preventive service use. Individuals with stigmatized behaviors (e.g., hazardous/harmful drinking, smoking, or high BMIs) are less likely to receive care. Making care experiences positive and carefully addressing stigmatized health practices could increase preventive service use. PMID:23814545
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Tian, He; Chen, Hong-Yu; Ren, Tian-Ling; Li, Cheng; Xue, Qing-Tang; Mohammad, Mohammad Ali; Wu, Can; Yang, Yi; Wong, H-S Philip
2014-06-11
Laser scribing is an attractive reduced graphene oxide (rGO) growth and patterning technology because the process is low-cost, time-efficient, transfer-free, and flexible. Various laser-scribed rGO (LSG) components such as capacitors, gas sensors, and strain sensors have been demonstrated. However, obstacles remain toward practical application of the technology where all the components of a system are fabricated using laser scribing. Memory components, if developed, will substantially broaden the application space of low-cost, flexible electronic systems. For the first time, a low-cost approach to fabricate resistive random access memory (ReRAM) using laser-scribed rGO as the bottom electrode is experimentally demonstrated. The one-step laser scribing technology allows transfer-free rGO synthesis directly on flexible substrates or non-flat substrates. Using this time-efficient laser-scribing technology, the patterning of a memory-array area up to 100 cm(2) can be completed in 25 min. Without requiring the photoresist coating for lithography, the surface of patterned rGO remains as clean as its pristine state. Ag/HfOx/LSG ReRAM using laser-scribing technology is fabricated in this work. Comprehensive electrical characteristics are presented including forming-free behavior, stable switching, reasonable reliability performance and potential for 2-bit storage per memory cell. The results suggest that laser-scribing technology can potentially produce more cost-effective and time-effective rGO-based circuits and systems for practical applications.
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Liu, Pang-Hsiang; Wang, Jung-Der
2008-01-01
Background Knowledge of existing prescription patterns in the treatment of newly-diagnosed hypertension can provide useful information for improving clinical practice in this field. The aims of this study are to determine the prescription patterns and time trends for antihypertensive medication in newly-diagnosed cases of uncomplicated hypertension in Taiwan and to compare these with current clinical guidelines. Methods A total of 6,536 newly-diagnosed patients with uncomplicated hypertension, aged ≥30 years, were identified from the representative 200,000-person sample in the computerized reimbursement database of the National Health Insurance in Taiwan. These patients were followed from 1998 to 2004 with all diagnoses, prescription data and medication charges being retrieved for subsequent analysis. Results Prescription patterns varied by age, gender and clinical facilities, with mono-therapies being found to be dominant in the first year, albeit declining over time. Calcium channel blockers and beta-blockers were the most frequently prescribed antihypertensive drugs, either alone or in combinations. Although least expensive, the prescription rates of diuretics were low, at 8.3% for mono-therapies and 19.9% overall. The prescription rate for angiotensin receptor blockers (ARBs) was elevated considerably over time. After controlling for other related factors by multiple logistic regression analysis, ARBs were found to be prescribed mainly by medical centers or regional hospitals. Conclusion These findings indicate the existence of a gap between current clinical practice and the desired goal of cost-effectiveness in antihypertensive treatment in Taiwan, which should be corrected. PMID:18559115
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New stimulation pattern design to improve P300-based matrix speller performance at high flash rate
NASA Astrophysics Data System (ADS)
Polprasert, Chantri; Kukieattikool, Pratana; Demeechai, Tanee; Ritcey, James A.; Siwamogsatham, Siwaruk
2013-06-01
Objective. We propose a new stimulation pattern design for the P300-based matrix speller aimed at increasing the minimum target-to-target interval (TTI). Approach. Inspired by the simplicity and strong performance of the conventional row-column (RC) stimulation, the proposed stimulation is obtained by modifying the RC stimulation through alternating row and column flashes which are selected based on the proposed design rules. The second flash of the double-flash components is then delayed for a number of flashing instants to increase the minimum TTI. The trade-off inherited in this approach is the reduced randomness within the stimulation pattern. Main results. We test the proposed stimulation pattern and compare its performance in terms of selection accuracy, raw and practical bit rates with the conventional RC flashing paradigm over several flash rates. By increasing the minimum TTI within the stimulation sequence, the proposed stimulation has more event-related potentials that can be identified compared to that of the conventional RC stimulations, as the flash rate increases. This leads to significant performance improvement in terms of the letter selection accuracy, the raw and practical bit rates over the conventional RC stimulation. Significance. These studies demonstrate that significant performance improvement over the RC stimulation is obtained without additional testing or training samples to compensate for low P300 amplitude at high flash rate. We show that our proposed stimulation is more robust to reduced signal strength due to the increased flash rate than the RC stimulation.
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Learning Patterns in Music Practice: Links between Disposition, Practice Strategies and Outcomes
ERIC Educational Resources Information Center
StGeorge, Jennifer Mary; Holbrook, Allyson Patricia; Cantwell, Robert H.
2012-01-01
Research into musical practice has over recent decades focused on the technical and organisational strategies employed by novices and experts. What has been less studied are the background factors or influences on the quality of this music practice. Drawing on interview data collected from 66 children and adults from a mixed methods project, we…
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Lines of Practice: A Practice-Centered Theory of Interest Relationships
ERIC Educational Resources Information Center
Azevedo, Flavio S.
2011-01-01
Based on a three-year-long ethnography of the hobby of model rocketry, I present a practice-centered theory of interest relationships--that is, the pattern of long-term, self-motivated engagement in open-ended practices that has been theorized under the concept of "individual interests". In contrast to extant theories of individual interests, in…
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Recognizing patterns of visual field loss using unsupervised machine learning
NASA Astrophysics Data System (ADS)
Yousefi, Siamak; Goldbaum, Michael H.; Zangwill, Linda M.; Medeiros, Felipe A.; Bowd, Christopher
2014-03-01
Glaucoma is a potentially blinding optic neuropathy that results in a decrease in visual sensitivity. Visual field abnormalities (decreased visual sensitivity on psychophysical tests) are the primary means of glaucoma diagnosis. One form of visual field testing is Frequency Doubling Technology (FDT) that tests sensitivity at 52 points within the visual field. Like other psychophysical tests used in clinical practice, FDT results yield specific patterns of defect indicative of the disease. We used Gaussian Mixture Model with Expectation Maximization (GEM), (EM is used to estimate the model parameters) to automatically separate FDT data into clusters of normal and abnormal eyes. Principal component analysis (PCA) was used to decompose each cluster into different axes (patterns). FDT measurements were obtained from 1,190 eyes with normal FDT results and 786 eyes with abnormal (i.e., glaucomatous) FDT results, recruited from a university-based, longitudinal, multi-center, clinical study on glaucoma. The GEM input was the 52-point FDT threshold sensitivities for all eyes. The optimal GEM model separated the FDT fields into 3 clusters. Cluster 1 contained 94% normal fields (94% specificity) and clusters 2 and 3 combined, contained 77% abnormal fields (77% sensitivity). For clusters 1, 2 and 3 the optimal number of PCA-identified axes were 2, 2 and 5, respectively. GEM with PCA successfully separated FDT fields from healthy and glaucoma eyes and identified familiar glaucomatous patterns of loss.
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Abouchacra, Samra; Obaidli, Ali; Al-Ghamdi, Saeed M G; Al Wakeel, Jamal; Al Salmi, Issa; Al Ghareeb, Sumaya; Al Azmi, Mohammad; Elsayed, Mohammed; Bieber, Brian A; Pisoni, Ronald L
2016-11-01
The Gulf Cooperation Council-Dialysis Outcomes and Practice Patterns Study (GCC-DOPPS) marks the joining of the six Gulf region countries including Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates to the main DOPPS study in 2012. The current review is a descriptive reporting on results related to the management of anemia from these countries. Our data demonstrate consistent anemia management patterns across the GCC countries allowing the achievement of international treatment levels. Overall, the majority of hemodialysis patients were prescribed appropriate erythropoiesis-stimulating agents (ESAs) and supplemental iron, enabling the attainment of mean hemoglobin (Hb) level of 10.9 g/dL. Comparisons of the individual country profiles reveal individual differences in the choice and mode of ESA and iron administration. However, all countries displayed good compliance with guideline recommendations. The same challenges as elsewhere are faced in the GCC, with respect to optimizing Hb levels and judiciously using ESA and iron supplements. Some opportunities exist for focused efforts to fine tune inter-facility variability in anemia management based on continued data tracking. The latter is vital in enabling adopting new trends to further improve not only anemia management but also the wholesome care of dialysis patients.
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Ultrafast learning in a hard-limited neural network pattern recognizer
NASA Astrophysics Data System (ADS)
Hu, Chia-Lun J.
1996-03-01
As we published in the last five years, the supervised learning in a hard-limited perceptron system can be accomplished in a noniterative manner if the input-output mapping to be learned satisfies a certain positive-linear-independency (or PLI) condition. When this condition is satisfied (for most practical pattern recognition applications, this condition should be satisfied,) the connection matrix required to meet this mapping can be obtained noniteratively in one step. Generally, there exist infinitively many solutions for the connection matrix when the PLI condition is satisfied. We can then select an optimum solution such that the recognition of any untrained patterns will become optimally robust in the recognition mode. The learning speed is very fast and close to real-time because the learning process is noniterative and one-step. This paper reports the theoretical analysis and the design of a practical charter recognition system for recognizing hand-written alphabets. The experimental result is recorded in real-time on an unedited video tape for demonstration purposes. It is seen from this real-time movie that the recognition of the untrained hand-written alphabets is invariant to size, location, orientation, and writing sequence, even the training is done with standard size, standard orientation, central location and standard writing sequence.
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Moramarco, Marc; Moramarco, Kathryn; Fadzan, Maja
2017-01-01
Introduction: It has long been said that exercise-based rehabilitation for scoliosis is ineffective, however, these reports studied general exercises. This case report is a prospective one-year follow-up of a nearly skeletally mature adolescent female (Risser 4) with idiopathic scoliosis treated with Pattern-Specific-Scoliosis Rehabilitation (PSSR). Methods: The 15-year old patient recommended for surgery (initial Cobb angle of 45°) completed a 16-hour scoliosis-specific back school (according to Schroth Best Practice®), over the course of five weeks. She continued with her program at home, and followed up with the lead author after 6 months and 1 year. Results: The patient achieved a 13° reduction in her primary thoracic Cobb angle. Postural improvement and reduction in trunk rotation (ATR) was also achieved (-4° in the thoracic spine, and -5° in the lumbar spine). Conclusion: Pattern-specific scoliosis rehabilitation (PSSR) works to reduce the asymmetrical load caused by scoliosis. PSSR is effective in stabilizing Cobb angle, and can, in some cases, reduce Cobb angle in adolescents. Patients recommended for surgery may be candidates for conservative treatment. This case suggests that the practice of discontinuing conservative treatment at Risser stage 4 should be re-evaluated. PMID:29399225
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ERIC Educational Resources Information Center
Peterson, Ivars
1991-01-01
The relationship between theories about electrical conductivity in microscopic wires and laser speckle patterns is described. Practical applications of laser speckle patterns are included. Wave ideas are being used to describe and predict novel phenomena in disordered solids. (KR)
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Dental family stress and coping patterns.
Nevin, R S; Sampson, V M
1986-10-01
This exploratory study of 28 married male dentists and their families was designed to gain an understanding about the stressors that dentists and their spouses experience, the life events and family strains they incur, the behavioral coping patterns they utilize, and their psychosocial characteristics. The study found that although stable dental families did encounter a significant number of stressors arising from both the dental practice and the family, they maintained their sense of balance through strong family coping skills and family resources. The effect of the dentist's office-related stress was directly felt in the family, especially by the spouse. Strong coping patterns resulted when dentists and spouses maintained a balance of time and responsibility, satisfaction in work and family activity, regular communication, sharing of decision making, good physical health, and the inclusion of an active exercise program within multiple demands on their time.
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Kinematic gait patterns in healthy runners: A hierarchical cluster analysis.
Phinyomark, Angkoon; Osis, Sean; Hettinga, Blayne A; Ferber, Reed
2015-11-05
Previous studies have demonstrated distinct clusters of gait patterns in both healthy and pathological groups, suggesting that different movement strategies may be represented. However, these studies have used discrete time point variables and usually focused on only one specific joint and plane of motion. Therefore, the first purpose of this study was to determine if running gait patterns for healthy subjects could be classified into homogeneous subgroups using three-dimensional kinematic data from the ankle, knee, and hip joints. The second purpose was to identify differences in joint kinematics between these groups. The third purpose was to investigate the practical implications of clustering healthy subjects by comparing these kinematics with runners experiencing patellofemoral pain (PFP). A principal component analysis (PCA) was used to reduce the dimensionality of the entire gait waveform data and then a hierarchical cluster analysis (HCA) determined group sets of similar gait patterns and homogeneous clusters. The results show two distinct running gait patterns were found with the main between-group differences occurring in frontal and sagittal plane knee angles (P<0.001), independent of age, height, weight, and running speed. When these two groups were compared to PFP runners, one cluster exhibited greater while the other exhibited reduced peak knee abduction angles (P<0.05). The variability observed in running patterns across this sample could be the result of different gait strategies. These results suggest care must be taken when selecting samples of subjects in order to investigate the pathomechanics of injured runners. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Wilms, M; Werner, R; Blendowski, M; Ortmüller, J; Handels, H
2014-01-01
A major problem associated with the irradiation of thoracic and abdominal tumors is respiratory motion. In clinical practice, motion compensation approaches are frequently steered by low-dimensional breathing signals (e.g., spirometry) and patient-specific correspondence models, which are used to estimate the sought internal motion given a signal measurement. Recently, the use of multidimensional signals derived from range images of the moving skin surface has been proposed to better account for complex motion patterns. In this work, a simulation study is carried out to investigate the motion estimation accuracy of such multidimensional signals and the influence of noise, the signal dimensionality, and different sampling patterns (points, lines, regions). A diffeomorphic correspondence modeling framework is employed to relate multidimensional breathing signals derived from simulated range images to internal motion patterns represented by diffeomorphic non-linear transformations. Furthermore, an automatic approach for the selection of optimal signal combinations/patterns within this framework is presented. This simulation study focuses on lung motion estimation and is based on 28 4D CT data sets. The results show that the use of multidimensional signals instead of one-dimensional signals significantly improves the motion estimation accuracy, which is, however, highly affected by noise. Only small differences exist between different multidimensional sampling patterns (lines and regions). Automatically determined optimal combinations of points and lines do not lead to accuracy improvements compared to results obtained by using all points or lines. Our results show the potential of multidimensional breathing signals derived from range images for the model-based estimation of respiratory motion in radiation therapy.
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Albuquerque, Pedro; Ribeiro, Niza; Almeida, Alexandre; Panschin, Irena; Porfirio, Afonso; Vales, Marta; Diniz, Francisca; Madeira, Helena; Tavares, Fernando
2017-01-01
Streptococcus uberis is considered one of the most important pathogens associated with bovine mastitis. While traditionally acknowledged as an environmental pathogen, S. uberis has been shown to adopt a contagious epidemiological pattern in several dairy herds. Since different control strategies are employed depending on the mode of transmission, in-depth studies of S. uberis populations are essential to determine the best practices to control this pathogen. In this work, we optimized and validated a dot blot platform, combined with automatic image analysis, to rapidly assess the population structure of infective S. uberis, and evaluated its efficiency when compared to multilocus sequence analysis (MLSA) genotyping. Two dairy herds with prevalent S. uberis infections were followed in a 6 month period, in order to collect and characterize isolates from cows with persistent infections. These herds, located in Portugal (Barcelos and Maia regions), had similar management practices, with the herd from Barcelos being smaller and having a better milking parlor management, since infected cow segregation was immediate. A total of 54 S. uberis isolates were obtained from 24 different cows from the two herds. To overcome operator-dependent analysis of the dot blots and increase the technique's consistency and reliability, the hybridization signals were converted into probability values, with average probabilities higher than 0.5 being considered positive results. These data allowed to confirm the isolates' identity as S. uberis using taxa-specific markers and to determine the presence of virulence- and antibiotic resistance-related genes. In addition, MLSA allowed to disclose the most prevalent S. uberis clonal lineages in both herds. Seven different clusters were identified, with Barcelos showing a high clonal diversity and Maia a dominant lineage infecting most cows, suggesting distinct epidemiological patterns, with S. uberis displaying an environmental or contagious transmission pattern depending on the herd. Overall, this work showed the utility of dot blot and MLSA to characterize population structure and epidemiological patterns of mastitis-causing S. uberis. This approach allowed to disclose prevalent virulence patterns and clonal lineages of S. uberis in two distinct herds, and gain insights on the impact of herd management practices on pathogen population structure. PMID:28174566
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Grootswagers, Tijl; Wardle, Susan G; Carlson, Thomas A
2017-04-01
Multivariate pattern analysis (MVPA) or brain decoding methods have become standard practice in analyzing fMRI data. Although decoding methods have been extensively applied in brain-computer interfaces, these methods have only recently been applied to time series neuroimaging data such as MEG and EEG to address experimental questions in cognitive neuroscience. In a tutorial style review, we describe a broad set of options to inform future time series decoding studies from a cognitive neuroscience perspective. Using example MEG data, we illustrate the effects that different options in the decoding analysis pipeline can have on experimental results where the aim is to "decode" different perceptual stimuli or cognitive states over time from dynamic brain activation patterns. We show that decisions made at both preprocessing (e.g., dimensionality reduction, subsampling, trial averaging) and decoding (e.g., classifier selection, cross-validation design) stages of the analysis can significantly affect the results. In addition to standard decoding, we describe extensions to MVPA for time-varying neuroimaging data including representational similarity analysis, temporal generalization, and the interpretation of classifier weight maps. Finally, we outline important caveats in the design and interpretation of time series decoding experiments.
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Velocity-curvature patterns limit human-robot physical interaction
Maurice, Pauline; Huber, Meghan E.; Hogan, Neville; Sternad, Dagmar
2018-01-01
Physical human-robot collaboration is becoming more common, both in industrial and service robotics. Cooperative execution of a task requires intuitive and efficient interaction between both actors. For humans, this means being able to predict and adapt to robot movements. Given that natural human movement exhibits several robust features, we examined whether human-robot physical interaction is facilitated when these features are considered in robot control. The present study investigated how humans adapt to biological and non-biological velocity patterns in robot movements. Participants held the end-effector of a robot that traced an elliptic path with either biological (two-thirds power law) or non-biological velocity profiles. Participants were instructed to minimize the force applied on the robot end-effector. Results showed that the applied force was significantly lower when the robot moved with a biological velocity pattern. With extensive practice and enhanced feedback, participants were able to decrease their force when following a non-biological velocity pattern, but never reached forces below those obtained with the 2/3 power law profile. These results suggest that some robust features observed in natural human movements are also a strong preference in guided movements. Therefore, such features should be considered in human-robot physical collaboration. PMID:29744380
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Velocity-curvature patterns limit human-robot physical interaction.
Maurice, Pauline; Huber, Meghan E; Hogan, Neville; Sternad, Dagmar
2018-01-01
Physical human-robot collaboration is becoming more common, both in industrial and service robotics. Cooperative execution of a task requires intuitive and efficient interaction between both actors. For humans, this means being able to predict and adapt to robot movements. Given that natural human movement exhibits several robust features, we examined whether human-robot physical interaction is facilitated when these features are considered in robot control. The present study investigated how humans adapt to biological and non-biological velocity patterns in robot movements. Participants held the end-effector of a robot that traced an elliptic path with either biological (two-thirds power law) or non-biological velocity profiles. Participants were instructed to minimize the force applied on the robot end-effector. Results showed that the applied force was significantly lower when the robot moved with a biological velocity pattern. With extensive practice and enhanced feedback, participants were able to decrease their force when following a non-biological velocity pattern, but never reached forces below those obtained with the 2/3 power law profile. These results suggest that some robust features observed in natural human movements are also a strong preference in guided movements. Therefore, such features should be considered in human-robot physical collaboration.
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NASA Astrophysics Data System (ADS)
Silva R., Santiago S.; Giraldo, Diana L.; Romero, Eduardo
2017-11-01
Structural Magnetic Resonance (MR) brain images should provide quantitative information about the stage and progression of Alzheimer's disease. However, the use of MRI is limited and practically reduced to corroborate a diagnosis already performed with neuropsychological tools. This paper presents an automated strategy for extraction of relevant anatomic patterns related with the conversion from mild cognitive impairment (MCI) to Alzheimer's disease (AD) using T1-weighted MR images. The process starts by representing each of the possible classes with models generated from a linear combination of volumes. The difference between models allows us to establish which are the regions where relevant patterns might be located. The approach searches patterns in a space of brain sulci, herein approximated by the most representative gradients found in regions of interest defined by the difference between the linear models. This hypothesis is assessed by training a conventional SVM model with the found relevant patterns under a leave-one-out scheme. The resultant AUC was 0.86 for the group of women and 0.61 for the group of men.
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Nor, Azimah; Zabedah, Md Yunus; Norsiah, Md Desa; Ngu, Lock Hock; Suhaila, Abd Rahman
2010-06-01
Mucopolysaccharidoses (MPS) are a group of inherited disorders caused by the deficiency of specific lysosomal enzymes involved in glycosaminoglycans (GAGs) degradation. Currently, there are 11 enzyme deficiencies resulting in seven distinct MPS clinical syndromes and their subtypes. Different MPS syndromes cannot be clearly distinguished clinically due to overlapping signs and symptoms. Measurement of GAGs content in urine and separation of GAGs using high-resolution electrophoresis (HRE) are very useful initial screening tests for isotyping of MPS before specific enzyme diagnostics. In this study, we measured total urinary GAGs by a method using dimethylmethylene blue (DMB), and followed by isolation and separation of GAGs using high resolution electrophoresis (HRE) technique. Of 760 urine samples analyzed, 40 have abnormal GAGs HRE patterns. Thirty-five of these 40 cases have elevated urinary GAGs levels as well. These abnormal HRE patterns could be classified into 4 patterns: Pattern A (elevated DS and HS; suggestive of MPS I, II or VII; 16 cases), Pattern B (elevated HS and CS; suggestive of MPS III; 17 cases), and Pattern C (elevated KS and CS; suggestive of MPS IV, 5 cases), and Pattern D (elevated DS; suggestive of MPS VI; 2 cases). Based on the GAGs HRE pattern and a few discriminating clinical signs, we performed selective enzymatic investigation in 16 cases. In all except one case with MPS VII, the enzymatic diagnosis correlated well with the provisional MPS type as suggested by the abnormal HRE pattern. Our results showed that GAGs HRE is a useful, inexpensive and practical first-line screening test when MPS is suspected clinically, and it provides an important guide to further enzymatic studies on a selective basis.
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Synonym set extraction from the biomedical literature by lexical pattern discovery.
McCrae, John; Collier, Nigel
2008-03-24
Although there are a large number of thesauri for the biomedical domain many of them lack coverage in terms and their variant forms. Automatic thesaurus construction based on patterns was first suggested by Hearst 1, but it is still not clear how to automatically construct such patterns for different semantic relations and domains. In particular it is not certain which patterns are useful for capturing synonymy. The assumption of extant resources such as parsers is also a limiting factor for many languages, so it is desirable to find patterns that do not use syntactical analysis. Finally to give a more consistent and applicable result it is desirable to use these patterns to form synonym sets in a sound way. We present a method that automatically generates regular expression patterns by expanding seed patterns in a heuristic search and then develops a feature vector based on the occurrence of term pairs in each developed pattern. This allows for a binary classifications of term pairs as synonymous or non-synonymous. We then model this result as a probability graph to find synonym sets, which is equivalent to the well-studied problem of finding an optimal set cover. We achieved 73.2% precision and 29.7% recall by our method, out-performing hand-made resources such as MeSH and Wikipedia. We conclude that automatic methods can play a practical role in developing new thesauri or expanding on existing ones, and this can be done with only a small amount of training data and no need for resources such as parsers. We also concluded that the accuracy can be improved by grouping into synonym sets.
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Meier Magistretti, Claudia; Downe, Soo; Lindstrøm, Bengt; Berg, Marie; Schwarz, Katharina Tritten
2016-01-01
There is a lack of systematic evidence concerning health orientation in maternity practice in the current climate of risk avoidance. The midwifery professional project is orientated toward the preservation of normal physiological processes during the maternity episode. This study investigates accounts of midwives who were working in health-orientated birth settings, to examine if and how they frame a health orientation in professional practice. Twenty-seven narrative interviews were conducted with midwives working in pre-, peri-, and postnatal care in different maternity care settings in Switzerland, Austria, and Germany. In-depth and comparative pattern data analyses were conducted. The distinct practice orientation of the participants was revealed in three main concepts, underpinned by a common framework mirroring the three parameters of the Sense of Coherence (comprehensibility, manageability, and meaningfulness) described in Aaron Antonovsky's salutogenic theory. The midwives’ implicit salutogenic knowledge shaped their reported actions in supporting mothers, fathers, and families to have health-promoting experiences in maternity care. These results suggest that an implicit health orientation in maternity care practice can be prefered through examination of the practice reports of midwives working in settings that have a health-promoting philosophy. Implications for midwifery practice and research are discussed. Consideration is given to the relevance of the results for debates about avoiding overtreatment and for the operationalization of salutogenic theory in health care practice.
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Infant feeding patterns over the first year of life: influence of family characteristics
Betoko, Aisha; Charles, Marie-Aline; Hankard, Régis; Forhan, Anne; Bonet, Mercedes; Saurel-Cubizolles, Marie-Josephe; Heude, Barbara; De Lauzon-Guillain, Blandine
2013-01-01
Background/Objectives Early eating patterns and behaviors can determine later eating habits and food preferences and they have been related to the development of childhood overweight and obesity. We aimed to identify patterns of feeding in the first year of life and to examine their associations with family characteristics. Subjects/Methods Our analysis included 1004 infants from the EDEN mother-child cohort. Feeding practices were assessed through maternal self-report at birth, 4, 8 and 12 months. Principal component analysis was applied to derive patterns from breastfeeding duration, age at complementary food (CF) introduction and type of food used at 1y. Associations between patterns and family characteristics were analyzed by linear regressions. Results The main source of variability in infant feeding was characterized by a pattern labeled ‘Late CF introduction and use of ready-prepared baby foods’. Older, more educated, primiparous women with high monthly income ranked high on this pattern. The second pattern, labeled ‘Longer breastfeeding, late CF introduction and use of home-made foods’ was the closest to infant feeding guidelines. Mothers ranking high on this pattern were older and more educated. The third pattern, labeled ‘Use of adults’ foods’ suggests a less age-specific diet for the infants. Mothers ranking high on this pattern were often younger and multiparous. Recruitment center was related to all patterns. Conclusion Not only maternal education level and age but also parity and region are important contributors to the variability in patterns. Further studies are needed to describe associations between these patterns and infant growth and later food preferences. PMID:23299715
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Very Similar Spacing-Effect Patterns in Very Different Learning/Practice Domains
Kornmeier, Jürgen; Spitzer, Manfred; Sosic-Vasic, Zrinka
2014-01-01
Temporally distributed (“spaced”) learning can be twice as efficient as massed learning. This “spacing effect” occurs with a broad spectrum of learning materials, with humans of different ages, with non-human vertebrates and also invertebrates. This indicates, that very basic learning mechanisms are at work (“generality”). Although most studies so far focused on very narrow spacing interval ranges, there is some evidence for a non-monotonic behavior of this “spacing effect” (“nonlinearity”) with optimal spacing intervals at different time scales. In the current study we focused both the nonlinearity aspect by using a broad range of spacing intervals and the generality aspect by using very different learning/practice domains: Participants learned German-Japanese word pairs and performed visual acuity tests. For each of six groups we used a different spacing interval between learning/practice units from 7 min to 24 h in logarithmic steps. Memory retention was studied in three consecutive final tests, one, seven and 28 days after the final learning unit. For both the vocabulary learning and visual acuity performance we found a highly significant effect of the factor spacing interval on the final test performance. In the 12 h-spacing-group about 85% of the learned words stayed in memory and nearly all of the visual acuity gain was preserved. In the 24 h-spacing-group, in contrast, only about 33% of the learned words were retained and the visual acuity gain dropped to zero. The very similar patterns of results from the two very different learning/practice domains point to similar underlying mechanisms. Further, our results indicate spacing in the range of 12 hours as optimal. A second peak may be around a spacing interval of 20 min but here the data are less clear. We discuss relations between our results and basic learning at the neuronal level. PMID:24609081
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ERIC Educational Resources Information Center
Bleimann, Robert L.; Smith, Lee W.
1985-01-01
A summary of Part II of a two-volume study of optometry graduates conducted by the Association of Schools and Colleges of Optometry is presented. Part II includes the analysis of the graduates' licensure and practice establishment experiences. (MLW)
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Almoghrabi, A.; Abu Shaban, N.
2011-01-01
Summary Burn patterns differ across the whole world and not only in relation to lack of education, overcrowding, and poverty. Cultures, habits, traditions, psychiatric illness, and epilepsy are strongly correlated to burn patterns. However, burns may also occur because of specific religious beliefs and activities, social events and festivals, traditional medical practices, occupational activities, and war. PMID:22639565
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Binary Coded Web Access Pattern Tree in Education Domain
ERIC Educational Resources Information Center
Gomathi, C.; Moorthi, M.; Duraiswamy, K.
2008-01-01
Web Access Pattern (WAP), which is the sequence of accesses pursued by users frequently, is a kind of interesting and useful knowledge in practice. Sequential Pattern mining is the process of applying data mining techniques to a sequential database for the purposes of discovering the correlation relationships that exist among an ordered list of…
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Deriving Process-Driven Collaborative Editing Pattern from Collaborative Learning Flow Patterns
ERIC Educational Resources Information Center
Marjanovic, Olivera; Skaf-Molli, Hala; Molli, Pascal; Godart, Claude
2007-01-01
Collaborative Learning Flow Patterns (CLFPs) have recently emerged as a new method to formulate best practices in structuring the flow of activities within various collaborative learning scenarios. The term "learning flow" is used to describe coordination and sequencing of learning tasks. This paper adopts the existing concept of CLFP and argues…
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Canada's Families Today: Some Policy Implications of Changing Forms and Patterns.
ERIC Educational Resources Information Center
Glossop, Robert
A summary review of facts, figures, and trends concerning family life in Canada reveals patterns of continuity and patterns of change. Generalizations about the average family no longer suffice (if ever they did) as the basis for government policies and programs, corporate personnel practices, and the organization and administration of schools.…
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Family Planning Practice by Patterns of Marriage in the North of Iran.
Taghizadeh, Ziba; Vedadhir, Abouali; Bayani, Fatemeh; Behmanesh, Fereshteh; Ebadi, Abbas; Pourreza, Abolghasem; Abbasi-Shavazi, Mohammad Jalal; Bijani, Ali
2017-01-01
The fertility experience in Iran suggests that the family planning programs had an effective role in the fertility reduction. This study aimed to specify patterns of marriage in Iran and especially in a northern city of Iran and to investigate the association between patterns of marriage and contraceptive use before first pregnancy and current contraceptive use. In this cross-sectional study, following the implementation of an expert panel in order to investigate marriage patterns, 880 women aged 15-49 yr old, were selected by multistage cluster sampling and completed the "reproductive practices" questionnaire in Babol City, northern Iran, in 2013. The data were analyzed using IBM SPSS ver.16 and descriptive and analytical parameters. There are three patterns of marriage in the northern part of Iran: Traditional, Mixed and Modern marriage and between different patterns there is no statistically significant difference in the contraceptive use. According to the lack of significant relationship between patterns of marriage and the contraceptives use, which is one of the proximate determinants of fertility, the policy makers should pay attention to other determinants of fertility in order to manage the problems and implications of population decline in the country.
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Faraday instability on patterned surfaces
NASA Astrophysics Data System (ADS)
Feng, Jie; Rubinstein, Gregory; Jacobi, Ian; Stone, Howard
2013-11-01
We show how micro-scale surface patterning can be used to control the onset of the Faraday instability in thin liquid films. It is well known that when a liquid film on a planar substrate is subject to sufficient vibrational accelerations, the free surface destabilizes, exhibiting a family of non-linear standing waves. This instability remains a canonical problem in the study of spontaneous pattern formation, but also has practical uses. For example, the surface waves induced by the Faraday instability have been studied as a means of enhanced damping for mechanical vibrations (Genevaux et al. 2009). Also the streaming within the unstable layer has been used as a method for distributing heterogeneous cell cultures on growth medium (Takagi et al. 2002). In each of these applications, the roughness of the substrate significantly affects the unstable flow field. We consider the effect of patterned substrates on the onset and behavior of the Faraday instability over a range of pattern geometries and feature heights where the liquid layer is thicker than the pattern height. Also, we describe a physical model for the influence of patterned roughness on the destabilization of a liquid layer in order to improve the design of practical systems which exploit the Faraday instability.
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Ranganathan, Rajiv
2017-09-11
Impairment of hand and finger function after stroke is common and affects the ability to perform activities of daily living. Even though many of these coordination deficits such as finger individuation have been well characterized, it is critical to understand how stroke survivors learn to explore and reorganize their finger coordination patterns for optimizing rehabilitation. In this study, I examine the use of a body-machine interface to assess how participants explore their movement repertoire, and how this changes with continued practice. Ten participants with chronic stroke wore a data glove and the finger joint angles were mapped on to the position of a cursor on a screen. The task of the participants was to move the cursor back and forth between two specified targets on a screen. Critically, the map between the finger movements and cursor motion was altered so that participants sometimes had to generate coordination patterns that required finger individuation. There were two phases to the experiment - an initial assessment phase on day 1, followed by a learning phase (days 2-5) where participants trained to reorganize their coordination patterns. Participants showed difficulty in performing tasks which had maps that required finger individuation, and the degree to which they explored their movement repertoire was directly related to clinical tests of hand function. However, over four sessions of practice, participants were able to learn to reorganize their finger movement coordination pattern and improve their performance. Moreover, training also resulted in improvements in movement repertoire outside of the context of the specific task during free exploration. Stroke survivors show deficits in movement repertoire in their paretic hand, but facilitating movement exploration during training can increase the movement repertoire. This suggests that exploration may be an important element of rehabilitation to regain optimal function.
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NASA Astrophysics Data System (ADS)
Zhang, Yongyong; Gao, Yang; Yu, Qiang
2017-09-01
Agricultural nitrogen loss becomes an increasingly important source of water quality deterioration and eutrophication, even threatens water safety for humanity. Nitrogen dynamic mechanism is still too complicated to be well captured at watershed scale due to its multiple existence forms and instability, disturbance of agricultural management practices. Stereoscopic agriculture is a novel agricultural planting pattern to efficiently use local natural resources (e.g., water, land, sunshine, heat and fertilizer). It is widely promoted as a high yield system and can obtain considerable economic benefits, particularly in China. However, its environmental quality implication is not clear. In our study, Qianyanzhou station is famous for its stereoscopic agriculture pattern of Southern China, and an experimental watershed was selected as our study area. Regional characteristics of runoff and nitrogen losses were simulated by an integrated water system model (HEQM) with multi-objective calibration, and multiple agriculture practices were assessed to find the effective approach for the reduction of diffuse nitrogen losses. Results showed that daily variations of runoff and nitrogen forms were well reproduced throughout watershed, i.e., satisfactory performances for ammonium and nitrate nitrogen (NH4-N and NO3-N) loads, good performances for runoff and organic nitrogen (ON) load, and very good performance for total nitrogen (TN) load. The average loss coefficient was 62.74 kg/ha for NH4-N, 0.98 kg/ha for NO3-N, 0.0004 kg/ha for ON and 63.80 kg/ha for TN. The dominating form of nitrogen losses was NH4-N due to the applied fertilizers, and the most dramatic zones aggregated in the middle and downstream regions covered by paddy and orange orchard. In order to control diffuse nitrogen losses, the most effective practices for Qianyanzhou stereoscopic agriculture pattern were to reduce farmland planting scale in the valley by afforestation, particularly for orchard in the downstream regions, followed by fertilizer application optimization.
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The Association between Acculturation and Dietary Patterns of South Asian Immigrants
Lesser, Iris A.; Gasevic, Danijela; Lear, Scott A.
2014-01-01
Dietary acculturation, specifically the adoption of western dietary habits, may result in adverse health effects such as obesity and type 2 diabetes. Therefore, it is necessary to explore the role of acculturation in dietary patterns as well as awareness and knowledge of healthy nutrition among South Asian immigrants. This is an especially important population to target as South Asians have higher prevalence rates of type 2 diabetes and cardiovascular disease, which may be magnified with immigration. The current investigation is a sub-study of the Multi-Cultural Community Health Assessment Trial (M-CHAT). There were 207 participants of South Asian origin included in the initial study, 129 were born outside of Canada and had immigrated after the age of 18. The length of residence in Canada was used as a marker for acculturation. A questionnaire addressing perceived changes in dietary patterns, food preparation, and nutrition knowledge and awareness since immigration was used to assess dietary practices. The association between length of residence and variables related to perceived changes in dietary patterns was explored with Spearman correlation and significant associations were subsequently analyzed with ordinal logistic regression analysis adjusted for age, sex, education and body mass index. South Asian immigrants in Canada reported a variety of positive dietary practices, including an increased consumption of fruits and vegetables and an improvement in food preparation (including an increase in grilling and a decrease in deep frying when cooking). However, there was a reported increase in the consumption of convenience foods, sugar-sweetened beverages, red meat and in dining out. South Asian immigrants in Canada reported a variety of positive dietary practices including an improvement in food preparation. Future health promotion strategies should encourage cultural sensitivity in efforts to reduce the consumption of sugar-sweetened beverage, convenience foods and to encourage eating at home rather than dining out. PMID:24558396
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The association between acculturation and dietary patterns of South Asian immigrants.
Lesser, Iris A; Gasevic, Danijela; Lear, Scott A
2014-01-01
Dietary acculturation, specifically the adoption of western dietary habits, may result in adverse health effects such as obesity and type 2 diabetes. Therefore, it is necessary to explore the role of acculturation in dietary patterns as well as awareness and knowledge of healthy nutrition among South Asian immigrants. This is an especially important population to target as South Asians have higher prevalence rates of type 2 diabetes and cardiovascular disease, which may be magnified with immigration. The current investigation is a sub-study of the Multi-Cultural Community Health Assessment Trial (M-CHAT). There were 207 participants of South Asian origin included in the initial study, 129 were born outside of Canada and had immigrated after the age of 18. The length of residence in Canada was used as a marker for acculturation. A questionnaire addressing perceived changes in dietary patterns, food preparation, and nutrition knowledge and awareness since immigration was used to assess dietary practices. The association between length of residence and variables related to perceived changes in dietary patterns was explored with Spearman correlation and significant associations were subsequently analyzed with ordinal logistic regression analysis adjusted for age, sex, education and body mass index. South Asian immigrants in Canada reported a variety of positive dietary practices, including an increased consumption of fruits and vegetables and an improvement in food preparation (including an increase in grilling and a decrease in deep frying when cooking). However, there was a reported increase in the consumption of convenience foods, sugar-sweetened beverages, red meat and in dining out. South Asian immigrants in Canada reported a variety of positive dietary practices including an improvement in food preparation. Future health promotion strategies should encourage cultural sensitivity in efforts to reduce the consumption of sugar-sweetened beverage, convenience foods and to encourage eating at home rather than dining out.
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Information retrieval from holographic interferograms: Fundamentals and problems
NASA Technical Reports Server (NTRS)
Vest, Charles M.
1987-01-01
Holographic interferograms can contain large amounts of information about flow and temperature fields. Their information content can be very high because they can be viewed from many different directions. This multidirectionality, and fringe localization add to the information contained in the fringe pattern if diffuse illumination is used. Additional information, and increased accuracy can be obtained through the use of dual reference wave holography to add reference fringes or to effect discrete phase shift or hetrodyne interferometry. Automated analysis of fringes is possible if interferograms are of simple structure and good quality. However, in practice a large number of practical problems can arise, so that a difficult image processing task results.
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ERIC Educational Resources Information Center
Sirotnik, Kenneth A.
Data from observations of 129 elementary, 362 junior, and 525 high school classes were analyzed to raise questions about classroom environment and classroom practices. Results gathered from four instruments are discussed: (1) physical environment inventory, which recorded classroom architectural arrangement, seating and grouping patterns,…
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K.B. Aubry; C.B. Halpern; C.E. Peterson
2009-01-01
In the Pacific Northwest (PNW) region of the contiguous United States, retention of live (green) trees in harvest units is an integral part of forest management practices on federal lands, yet the ecological benefits that result from various levels or patterns of retained trees remain speculative. The Demonstration of Ecosystem Management Options (DEMO) study was...
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ERIC Educational Resources Information Center
Agolli, Renata
2015-01-01
This paper aims to introduce pre-CLIL through the CLSL (content & languages [L1/L2] shared learning) model, which operates as a bridge for a full CLIL immersion. It analyses the characteristics of this new learning model that springs up from immanent needs of Italian educational reality by reporting results on the way content and language…
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Rehabilitation of Low Back Pain in Golfers
Finn, Christopher
2013-01-01
Context: Low back injuries are the most common injury in golf. Best practice guidelines for rehabilitation and prevention of these injuries are helpful for health care professionals and all golfers. Objective: To establish a best practice clinical model for low back pain in golfers from diagnosis through treatment and rehabilitation to return to golf. Evidence Acquisition: The PubMed database and Google Scholar were searched from 1993 to 2012 with the following keywords: golf and low back injury, low back injury, golf and low back pain, golf injury prevention, golf modern swing, muscles in golf swing, low back rehabilitation, diaphragm, and core stability. All studies addressed in some manner the rehabilitation, prevention, or return to sport from low back injury, preferably in direct relation to golf, as well as muscle firing patterns used during the golf swing. Results: Best practice for rehabilitation and prevention of low back injury in golf appears to be through a multidisciplinary approach. Conclusion: Movement patterns, muscle imbalances, and type of swing utilized all have a direct effect on the forces applied to the spine during the golf swing and need to be assessed to prevent or rehabilitate injury. Understanding the golf swing and how the body works during the swing is necessary. PMID:24459546
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Eklund, Mona; Orban, Kristina; Argentzell, Elisabeth; Bejerholm, Ulrika; Tjörnstrand, Carina; Erlandsson, Lena-Karin; Håkansson, Carita
2017-01-01
Patterns of daily occupations (PDO) and occupational balance (OB) are recurring phenomena in the literature. Both are related with health and well-being, which makes them central in occupational therapy practice and occupational science. The aim was to review how PDO and OB are described in the literature, to propose a view of how the two constructs may be linked, and elaborate on how such a view may benefit occupational science and occupational therapy. The literature was analysed by latent and manifest content analysis and comparative analysis. The findings were summarized in a model, framing PDO as the more objective and OB as the more subjective result from an interaction between personal preferences and environmental influences. The proposed model does not assume a cause-effect relationship between the targeted constructs, rather a mutual influence and a joint reaction to influencing factors. Indicators of PDO and OB were identified, as well as tools for assessing PDO and OB. The authors propose that discerning PDO and OB as separate but interacting phenomena may be useful in developing a theoretical discourse in occupational science and enhancing occupational therapy practice. Although the scope of this study was limited, the proposed view may hopefully inspire further scrutiny of constructs.
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Petrakis, Roy; van Leeuwen, Willem J.D.; Villarreal, Miguel; Tashjian, Paul; Dello Russo, Regina; Scott, Christopher A.
2017-01-01
Riparian ecosystems are valuable to the ecological and human communities that depend on them. Over the past century, they have been subject to shifting management practices to maximize human use and ecosystem services, creating a complex relationship between water policy, management, and the natural ecosystem. This has necessitated research on the spatial and temporal dynamics of riparian vegetation change. The San Acacia Reach of the Middle Rio Grande has experienced multiple management and river flow fluctuations, resulting in threats to its riparian and aquatic ecosystems. This research uses remote sensing data, GIS, a review of management decisions, and an assessment of climate to both quantify how riparian vegetation has been altered over time and provide interpretations of the relationships between riparian change and shifting climate and management objectives. This research focused on four management phases from 1935 to 2014, each highlighting different management practices and climate-driven river patterns, providing unique opportunities to observe a direct relationship between river management, climate, and riparian response. Overall, we believe that management practices coupled with reduced surface river-flows with limited overbank flooding influenced the compositional and spatial patterns of vegetation, including possibly increasing non-native vegetation coverage. However, recent restoration efforts have begun to reduce non-native vegetation coverage.
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Karami, Manoochehr; Khazaei, Salman
2017-12-06
Clinical decision makings according studies result require the valid and correct data collection, andanalysis. However, there are some common methodological and statistical issues which may ignore by authors. In individual matched case- control design bias arising from the unconditional analysis instead of conditional analysis. Using an unconditional logistic for matched data causes the imposition of a large number of nuisance parameters which may result in seriously biased estimates.
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Oropharyngeal dysphagia: surveying practice patterns of the speech-language pathologist.
Martino, Rosemary; Pron, Gaylene; Diamant, Nicholas E
2004-01-01
The present study was designed to obtain a comprehensive view of the dysphagia assessment practice patterns of speech-language pathologists and their opinion on the importance of these practices using survey methods and taking into consideration clinician, patient, and practice-setting variables. A self-administered mail questionnaire was developed following established methodology to maximize response rates. Eight dysphagia experts independently rated the new survey for content validity. Test-retest reliability was assessed with a random sample of 23 participants. The survey was sent to 50 speech-language pathologists randomly selected from the Canadian professional association database of members who practice in dysphagia. Surveys were mailed according to the Dillman Total Design Method and included an incentive offer. High survey (64%) and item response (95%) rates were achieved and clinicians were reliable reporters of their practice behaviors (ICC>0.60). Of all the clinical assessment items, 36% were reported with high (>80%) utilization and 24% with low (<20%) utilization, the former pertaining to tongue motion and vocal quality after food/fluid intake and the latter to testing of oral sensation without food. One-third (33%) of instrumental assessment items were highly utilized and included assessment of bolus movement and laryngeal response to bolus misdirection. Overall, clinician experience and teaching institutions influenced greater utilization. Opinions of importance were similar to utilization behaviors (r = 0.947, p = 0.01). Of all patients referred for dysphagia assessment, full clinical assessments were administered to 71% of patients but instrumental assessments to only 36%. A hierarchical model of practice behavior is proposed to explain this pattern of progressively decreasing item utilization.
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Practice Patterns of Dentist Anesthesiologists in North America.
Young, Andrew S; Fischer, Michael W; Lang, Nicholas S; Cooke, Matthew R
2018-01-01
This study provides trends in the discipline of dental anesthesiology. A questionnaire-based survey was sent to 338 members of the American Society of Dentist Anesthesiologists to evaluate practice patterns. One focus of the study was modality of sedation/anesthesia used for dentistry in North America. Age, gender, years in practice, and geographic region of practice were also obtained. Data gathered from the returned questionnaires were entered into an Excel spreadsheet and then imported into JMP Statistical Discovery Software (v12.2 Pro) for descriptive analysis. A total of 112 surveys were completed electronically and 102 surveys were returned via post, for a total response rate of 63.3% ( N = 214). Data from this survey suggested a wide variation of therapeutic practices among dentist anesthesiologists in North America. Of the surveyed dentist anesthesiologists, 58.7% (SE = 4.2%) practice as mobile providers, 32.2% (SE = 3.1%) provide care in an academic environment, and 27.7% (SE = 2.8%) function as operator/anesthetists. The majority of anesthesia is provided for pediatric dentistry (47.0%, SE = 4.2%), oral and maxillofacial surgery (18.5%, SE = 3.9%), and special needs (16.7%, SE = 3.6%). Open-airway (58.7%, SE = 5.5%) sedation/anesthesia was the preferred modality of delivery, compared with the use of advanced airway (41.3%, SE = 4.6%). The demographics show diverse practice patterns of dentist anesthesiologists in multiple regions of the continent. Despite concerns regarding specialty recognition, reimbursement difficulties, and competition from alternative anesthesia providers, the overall perceptions of dentist anesthesiologists and the future of the field seem largely favorable.
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Study of two-phase flow in helical and spiral coils
NASA Technical Reports Server (NTRS)
Keshock, Edward G.; Yan, AN; Omrani, Adel
1990-01-01
The principal purposes of the present study were to: (1) observe and develop a fundamental understanding of the flow regimes and their transitions occurring in helical and spiral coils; and (2) obtain pressure drop measurements of such flows, and, if possible, develop a method for predicting pressure drop in these flow geometries. Elaborating upon the above, the general intent is to develop criteria (preferably generalized) for establishing the nature of the flow dynamics (e.g. flow patterns) and the magnitude of the pressure drop in such configurations over a range of flow rates and fluid properties. Additionally, the visualization and identification of flow patterns were a fundamental objective of the study. From a practical standpoint, the conditions under which an annular flow pattern exists is of particular practical importance. In the possible practical applications which would implement these geometries, the working fluids are likely to be refrigerant fluids. In the present study the working fluids were an air-water mixture, and refrigerant 113 (R-113). In order to obtain records of flow patterns and their transitions, video photography was employed extensively. Pressure drop measurements were made using pressure differential transducers connected across pressure taps in lines immediately preceding and following the various test sections.
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Parental Influences on Adolescent Adjustment: Parenting Styles Versus Parenting Practices
ERIC Educational Resources Information Center
Lee, Sang Min; Daniels, M. Harry; Kissinger, Daniel B.
2006-01-01
The study identified distinct patterns of parental practices that differentially influence adolescent behavior using the National Educational Longitudinal Survey (NELS:88) database. Following Brenner and Fox's research model (1999), the cluster analysis was used to classify the four types of parental practices. The clusters of parenting practices…
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Public School Nursing Practice in the United States
ERIC Educational Resources Information Center
Willgerodt, Mayumi A.; Brock, Douglas M.; Maughan, Erin D.
2018-01-01
School nursing practice has changed dramatically over the past 20 years, yet few nationally representative investigations describing the school nursing workforce have been conducted. The National School Nurse Workforce Study describes the demographic and school nursing practice patterns among self-reported public school nurses and the number and…
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A Survey of Optometry Graduates to Determine Practice Patterns.
ERIC Educational Resources Information Center
Bleimann, Robert L.; Smith, Lee W.
1984-01-01
A summary of a study of optometry graduates conducted by the Association of Schools and Colleges of Optometry (ASCO) is provided. The data covered aspects of recently graduated O.D.s' experience in obtaining a state license, becoming established in practice, and their practice characteristics. (Author/MLW)
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ERIC Educational Resources Information Center
National Council of Teachers of English, Champaign, IL.
The 13 articles in this report fall into four categories: programs for the culturally disadvantaged, teaching composition, curriculum revision, and detailed classroom practices. Mildred A. Dawson outlines compensatory programs used in Sacramento, California, to prevent drop-outs; Lois Grose concentrates on the pattern-practice method of teaching…
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ERIC Educational Resources Information Center
Freudenberg, Nicholas; Picard Bradley, Sarah; Serrano, Monica
2009-01-01
Industry practices such as advertising, production of unsafe products, and efforts to defeat health legislation play a major role in current patterns of U.S. ill health. Changing these practices may be a promising strategy to promote health. The authors analyze 12 campaigns designed to modify the health-related practices of U.S. corporations in…
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NASA Astrophysics Data System (ADS)
Lee, Okhee
2004-01-01
This study examined patterns of change in beliefs and practices as elementary teachers learned to establish instructional congruence, a process of mediating academic disciplines with linguistic and cultural experiences of diverse student groups. The study focused on six bilingual Hispanic teachers working with fourth-grade, mostly Hispanic students. The results indicated that teacher learning and change occurred in different ways in the areas of science instruction, students' language and culture, English language and literacy instruction, and integration of these areas in establishing instructional congruence. The results also indicated that establishing instructional congruence was a gradual and demanding process requiring teacher reflection and insight, formal training, and extensive support and sharing. Implications for further research in promoting achievement for all students are discussed.
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A Worldwide Survey on Peyronie's Disease Surgical Practice Patterns Among Surgeons.
Chung, Eric; Wang, Run; Ralph, David; Levine, Laurence; Brock, Gerald
2018-04-01
Despite published guidelines on Peyronie's disease (PD), there are limited data on actual surgical practice among surgeons. To evaluate the surgical practice patterns in PD among surgeons from different continents and members of various sexual medicine societies. An anonymous survey on various pre-, intra-, and postoperative aspects of PD surgical care was distributed in printed format during International Society of Sexual Medicine meetings and as an online survey to International Society of Sexual Medicine members. 390 surgeons responded to the survey, with great variations in pre-, intra-, and postoperative strategies in PD surgical care. Most surgeons performed fewer than 10 penile plications and 10 graft surgeries per year. Modified Nesbit plication was the preferred option by most surgeons. Surgeons who received fellowship training were more likely to perform autologous than allograft surgery (odds ratio = 1.79, 95% CI = 1.13-2.82, P = .01). The use of penile color duplex ultrasound was inconsistently performed, with higher-volume surgeons (ie, >20 cases operated a year) more likely to use this diagnostic modality (odds ratio = 70.18, 95% CI = 20.99-234.6, P < .001). Most surgeons agreed that surgical intervention should be performed only after a 6-month history of stable penile curvature, although higher-volume surgeons were more inclined to perform surgery sooner (P = .08). Although it is unknown whether variations in PD surgery significantly affect clinical outcome and patient satisfaction rate, this worldwide survey study has the potential to assist in the formation of a new practice guideline and serve as the basis for future prospective multinational studies. This is one of the largest surveys on PD practice and, to our knowledge, the only survey conducted across various sexual medicine societies, with the inclusion of many high-volume and experienced PD surgeons. This also is the 1st study to comprehensively evaluate many key aspects in surgical practice patterns for PD. However, the categorization on the questionnaire used in this survey was not designed to allow for direct comparison given the possibility of some surgeons with dual society memberships, reporting biases, large CIs in outcomes, different patient demographics, and cultural acceptance. There is great variation in surgical practice patterns in PD management, including key differences among surgeons across different continents and sexual medicine societies. Chung E, Wang R, Ralph D, et al. A Worldwide Survey on Peyronie's Disease Surgical Practice Patterns Among Surgeons. J Sex Med 2018;15:568-575. Copyright © 2018. Published by Elsevier Inc.
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Culturally sensitive social work practice with Arab clients in mental health settings.
al-Krenawi, A; Graham, J R
2000-02-01
Several culturally specific practical considerations should inform social work interventions with ethnic Arab peoples in Arab countries or in Western nations. These include taking into account gender relations, individuals' places in their families and communities, patterns of mental health services use, and, for practice in Western nations, the client's level of acculturation. Such aspects provide the basis for specific guidelines in working with ethnic Arab mental health clients. These include an emphasis on short-term, directive treatment; communication patterns that are passive and informal; patients' understanding of external loci of control and their use of ethnospecific idioms of distress; and, where appropriate, the integration of modern and traditional healing systems.
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Motor learning in childhood reveals distinct mechanisms for memory retention and re-learning.
Musselman, Kristin E; Roemmich, Ryan T; Garrett, Ben; Bastian, Amy J
2016-05-01
Adults can easily learn and access multiple versions of the same motor skill adapted for different conditions (e.g., walking in water, sand, snow). Following even a single session of adaptation, adults exhibit clear day-to-day retention and faster re-learning of the adapted pattern. Here, we studied the retention and re-learning of an adapted walking pattern in children aged 6-17 yr. We found that all children, regardless of age, showed adult-like patterns of retention of the adapted walking pattern. In contrast, children under 12 yr of age did not re-learn faster on the next day after washout had occurred-they behaved as if they had never adapted their walking before. Re-learning could be improved in younger children when the adaptation time on day 1 was increased to allow more practice at the plateau of the adapted pattern, but never to adult-like levels. These results show that the ability to store a separate, adapted version of the same general motor pattern does not fully develop until adolescence, and furthermore, that the mechanisms underlying the retention and rapid re-learning of adapted motor patterns are distinct. © 2016 Musselman et al.; Published by Cold Spring Harbor Laboratory Press.
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Leblanc, Julie; Subrt, Peter; Paré, Michèle; Hartell, David; Sénécal, Lynne; Blydt-Hansen, Tom; Cardinal, Héloïse
2018-01-01
One of the goals of the Canadian National Transplant Research Program (CNTRP) is to develop novel therapies for acute rejection that could positively affect graft outcomes with greater efficacy or less toxicity. To develop innovative management strategies for kidney graft rejection, new modalities need to be compared with current clinical practices. However, there are no standardized practices concerning the management of acute T cell-mediated rejection (TCMR). To describe clinicians' practice patterns in the diagnosis, treatment, and monitoring of acute TCMR in Canada. Survey. Canadian transplant nephrologists and transplant surgeons involved in the management of acute TCMR. We developed an anonymous, web-based survey consisting of questions related to the diagnosis, treatment, and monitoring of TCMR. The survey was disseminated on 3 occasions between June and October 2016 through the Canadian Society of Transplantation (CST) kidney group electronic mailing list. Forty-seven respondents, mostly transplant nephrologists (97%), originating from at least 18 of the 25 Canadian centers offering adult or pediatric kidney transplantation, participated in the study. Surveillance biopsies were used by 28% of respondents to screen for kidney graft rejection. High-dose steroids were used by most of the respondents to treat clinical and subclinical Banff grade 1A and 1B rejections. Nine percent (95% confidence interval [CI]: 1-17) of practitioners used lymphocyte-depleting agents as the first-line approach for the treatment of Banff grade 1B acute rejection. Eighteen percent (95% CI: 7-29) and 36% (95% CI: 8-65) of respondents reported that they would not use high-dose steroids for treating clinical and subclinical borderline rejections, respectively. Seventy percent (95% CI: 54-83) of respondents answered that there was no indication to assess histological response to treatment independent of the change in kidney function. The limitations of this study are its limited sample size and the low representation of pediatric specialists. There is heterogeneity regarding the use of surveillance biopsies, treatment of borderline rejection, and modalities to monitor treatment response among transplant physicians. Our results illustrate the current state of practice patterns across Canada and can be used to inform the design of future trials.
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A real-time, practical sensor fault-tolerant module for robust EMG pattern recognition.
Zhang, Xiaorong; Huang, He
2015-02-19
Unreliability of surface EMG recordings over time is a challenge for applying the EMG pattern recognition (PR)-controlled prostheses in clinical practice. Our previous study proposed a sensor fault-tolerant module (SFTM) by utilizing redundant information in multiple EMG signals. The SFTM consists of multiple sensor fault detectors and a self-recovery mechanism that can identify anomaly in EMG signals and remove the recordings of the disturbed signals from the input of the pattern classifier to recover the PR performance. While the proposed SFTM has shown great promise, the previous design is impractical. A practical SFTM has to be fast enough, lightweight, automatic, and robust under different conditions with or without disturbances. This paper presented a real-time, practical SFTM towards robust EMG PR. A novel fast LDA retraining algorithm and a fully automatic sensor fault detector based on outlier detection were developed, which allowed the SFTM to promptly detect disturbances and recover the PR performance immediately. These components of SFTM were then integrated with the EMG PR module and tested on five able-bodied subjects and a transradial amputee in real-time for classifying multiple hand and wrist motions under different conditions with different disturbance types and levels. The proposed fast LDA retraining algorithm significantly shortened the retraining time from nearly 1 s to less than 4 ms when tested on the embedded system prototype, which demonstrated the feasibility of a nearly "zero-delay" SFTM that is imperceptible to the users. The results of the real-time tests suggested that the SFTM was able to handle different types of disturbances investigated in this study and significantly improve the classification performance when one or multiple EMG signals were disturbed. In addition, the SFTM could also maintain the system's classification performance when there was no disturbance. This paper presented a real-time, lightweight, and automatic SFTM, which paved the way for reliable and robust EMG PR for prosthesis control.
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Jacobs, G D; Lubar, J F
1989-01-01
This study examined the effects of the relaxation response, elicited by autogenic training, on central nervous system (CNS) activity. We used computerized spectral analysis of EEG activity as a dependent measure. After baseline EEG data were obtained for all subjects, the experimental group practiced standard autogenic exercises for 15 experimental sessions with home practice. The control subjects received the same number of sessions under identical conditions, except that they listened to a pleasant radio show without home practice. Subjects were then posttested to assess the acute and chronic effects of autogenic training and the relaxation response on CNS activity. The results indicated significant acute effects differences between groups; the experimental group showed greater increases in theta and greater decreases in alpha percent total power. The results suggest that the relaxation response elicited by autogenic training produces significant acute changes in EEG activity and a characteristic spectral pattern; the results also suggest that focusing attention on a repetitive, internal stimulus is a key element in Benson's relaxation response model.
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McFarlane, A; Aslan, B; Raby, A; Moffat, K A; Selby, R; Padmore, R
2015-12-01
Internal quality control (IQC) procedures are crucial for ensuring accurate patient test results. The IQMH Centre for Proficiency Testing conducted a web-based survey to gather information on the current IQC practices in coagulation testing. A questionnaire was distributed to 174 Ontario laboratories licensed to perform prothrombin time (PT) and activated partial thromboplastin time (APTT). All laboratories reported using two levels of commercial QC (CQC); 12% incorporate pooled patient plasma into their IQC program; >68% run CQC at the beginning of each shift; 56% following maintenance, with reagent changes, during a shift, or with every repeat sample; 6% only run CQC at the beginning of the day and 25% when the instruments have been idle for a defined period of time. IQC run frequency was determined by manufacturer recommendations (71%) but also influenced by the stability of test (27%), clinical impact of an incorrect test result (25%), and sample's batch number (10%). IQC was monitored using preset limits based on standard deviation (66%), precision goals (46%), or allowable performance limits (36%). 95% use multirules. Failure actions include repeating the IQC (90%) and reporting patient results; if repeat passes, 42% perform repeat analysis of all patient samples from last acceptable IQC. Variability exists in coagulation IQC practices among Ontario clinical laboratories. The recommendations presented here would be useful in encouraging standardized IQC practices. © 2015 John Wiley & Sons Ltd.
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Kim, Hyunjee; Norton, Edward C
2015-03-01
Home health care expenditures were the fastest growing part of Medicare from 2001-2009, despite the implementation of prospective payment. Prior research has shown that home health agencies adopted two specific strategies to take advantage of Medicare policies: provide at least 10 therapy visits to get an enormous marginal payment and recertify patients for additional episodes. We study whether there is heterogeneity in the adoption of those strategic behaviors between home health agency entrants and incumbents and find that entrants were more likely to adopt strategic practice patterns than were incumbents. We also find that for-profit incumbents mimicked one of the practice patterns following entrants in the same market. Our findings suggest that it is important to understand the heterogeneity in providers' behavior and how firms interact with each other in the same market. These findings help explain the rapid rise in expenditures in the home health care market. Copyright © 2015 John Wiley & Sons, Ltd.
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Pulmonary function outcomes for assessing cystic fibrosis care.
Wagener, Jeffrey S; Elkin, Eric P; Pasta, David J; Schechter, Michael S; Konstan, Michael W; Morgan, Wayne J
2015-05-01
Assessing cystic fibrosis (CF) patient quality of care requires the choice of an appropriate outcome measure. We looked systematically and in detail at pulmonary function outcomes that potentially reflect clinical practice patterns. Epidemiologic Study of Cystic Fibrosis data were used to evaluate six potential outcome variables (2002 best FVC, FEV(1), and FEF(25-75) and rate of decline for each from 2000 to 2002). We ranked CF care sites by outcome measure and then assessed any association with practice patterns and follow-up pulmonary function. Sites ranked in the top quartile had more frequent monitoring, treatment of exacerbations, and use of chronic therapies and oral corticosteroids. The follow-up rate of pulmonary function decline was not predicted by site ranking. Different pulmonary function outcomes associate slightly differently with practice patterns, although annual FEV(1) is at least as good as any other measure. Current site ranking only moderately predicts future ranking. Copyright © 2014 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.
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Lee, Jihyoun; Kang, Eunyoung; Park, Suyeon; Kim, Zisun; Lee, Min Hyuk
2017-01-01
Lack of awareness, the stigma of carrying a genetic mutation, and economic factors are barriers to acceptance of BRCA genetic testing or appropriate risk management. We aimed to investigate the influence of Angelina Jolie's announcement of her medical experience and also health insurance reimbursement for BRCA gene testing on practice patterns for hereditary breast and ovarian cancer (HBOC). A survey regarding changes in practice patterns for HBOC before and after the announcement was conducted online. The rate of BRCA gene testing was obtained from the National Health Insurance Review and Assessment Service database. From May to August 2016, 70 physicians responded to the survey. Genetic testing recommendations and prophylactic management were increased after the announcement. Risk-reducing salpingo-oophorectomy and contralateral prophylactic mastectomy was significantly increased in BRCA carriers with breast cancer. The BRCA testing rate increased annually. Health insurance and a celebrity announcement were associated with increased genetic testing. PMID:28690658
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Movement Pattern and Parameter Learning in Children: Effects of Feedback Frequency
ERIC Educational Resources Information Center
Goh, Hui-Ting; Kantak, Shailesh S.; Sullivan, Katherine J.
2012-01-01
Reduced feedback during practice has been shown to be detrimental to movement accuracy in children but not in young adults. We hypothesized that the reduced accuracy is attributable to reduced movement parameter learning, but not pattern learning, in children. A rapid arm movement task that required the acquisition of a motor pattern scaled to…
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Constructing Meaning in a Community of Learners: The "Star" Pattern of Talk
ERIC Educational Resources Information Center
Rachamim, Mirit; Orland-Barak, Lily
2016-01-01
We present findings from an in-depth study on a school-based multi-disciplinary learning community in the context of practice teaching in university pre-service education. We elaborate on one of the three predominant patterns of talk identified, the "star" pattern, and show how it created particular power relations in the discourse which…
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ERIC Educational Resources Information Center
Neblett, Enrique W., Jr.; White, Rhonda L.; Ford, Kahlil R.; Philip, Cheri L.; Nguye-N, Hoa X.; Sellers, Robert M.
2008-01-01
This study uses two waves of data to examine the relations among racial discrimination experiences, patterns of racial socialization practices, and psychological adjustment in a sample of 361 African American adolescents. Using latent class analyses, we identified four patterns of child-reported racial socialization experiences: Moderate Positive,…
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Li, Jie; Li, Rui; You, Leiming; Xu, Anlong; Fu, Yonggui; Huang, Shengfeng
2015-01-01
Switching between different alternative polyadenylation (APA) sites plays an important role in the fine tuning of gene expression. New technologies for the execution of 3’-end enriched RNA-seq allow genome-wide detection of the genes that exhibit significant APA site switching between different samples. Here, we show that the independence test gives better results than the linear trend test in detecting APA site-switching events. Further examination suggests that the discrepancy between these two statistical methods arises from complex APA site-switching events that cannot be represented by a simple change of average 3’-UTR length. In theory, the linear trend test is only effective in detecting these simple changes. We classify the switching events into four switching patterns: two simple patterns (3’-UTR shortening and lengthening) and two complex patterns. By comparing the results of the two statistical methods, we show that complex patterns account for 1/4 of all observed switching events that happen between normal and cancerous human breast cell lines. Because simple and complex switching patterns may convey different biological meanings, they merit separate study. We therefore propose to combine both the independence test and the linear trend test in practice. First, the independence test should be used to detect APA site switching; second, the linear trend test should be invoked to identify simple switching events; and third, those complex switching events that pass independence testing but fail linear trend testing can be identified. PMID:25875641
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Invariant ankle moment patterns when walking with and without a robotic ankle exoskeleton.
Kao, Pei-Chun; Lewis, Cara L; Ferris, Daniel P
2010-01-19
To guide development of robotic lower limb exoskeletons, it is necessary to understand how humans adapt to powered assistance. The purposes of this study were to quantify joint moments while healthy subjects adapted to a robotic ankle exoskeleton and to determine if the period of motor adaptation is dependent on the magnitude of robotic assistance. The pneumatically powered ankle exoskeleton provided plantar flexor torque controlled by the wearer's soleus electromyography (EMG). Eleven naïve individuals completed two 30-min sessions walking on a split-belt instrumented treadmill at 1.25m/s while wearing the ankle exoskeleton. After two sessions of practice, subjects reduced their soleus EMG activation by approximately 36% and walked with total ankle moment patterns similar to their unassisted gait (r(2)=0.98+/-0.02, THSD, p>0.05). They had substantially different ankle kinematic patterns compared to their unassisted gait (r(2)=0.79+/-0.12, THSD, p<0.05). Not all of the subjects reached a steady-state gait pattern within the two sessions, in contrast to a previous study using a weaker robotic ankle exoskeleton (Gordon and Ferris, 2007). Our results strongly suggest that humans aim for similar joint moment patterns when walking with robotic assistance rather than similar kinematic patterns. In addition, greater robotic assistance provided during initial use results in a longer adaptation process than lesser robotic assistance. Copyright 2009 Elsevier Ltd. All rights reserved.
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Buckley, Thomas A; Burdette, Glenn; Kelly, Kassandra
2015-08-01
The National Collegiate Athletic Association (NCAA) has published concussion-management practice guidelines consistent with recent position and consensus statements. Whereas NCAA Division I athletic trainers appear highly compliant, little is known about the concussion-management practice patterns of athletic trainers at smaller institutions where staffing and resources may be limited. To descriptively define the concussion-management practice patterns of NCAA Division II and III athletic trainers. Cross-sectional study. Web-based questionnaire. A total of 755 respondents (response rate = 40.2%) from NCAA Division II and Division III institutions. The primary outcome measures were the rate of multifaceted concussion-assessment techniques, defined as 3 or more assessments; the specific practice patterns of each assessment battery; and tests used during a clinical examination. Most respondents indicated using a multifaceted assessment during acute assessment (Division II = 76.9%, n = 473; Division III = 76.0%, n = 467) and determination of recovery (Division II = 65.0%, n = 194; Division III = 63.1%, n = 288) but not at baseline (Division II = 43.1%, n = 122; Division III = 41.0%, n = 176). Typically, when a postconcussion assessment was initiated, testing occurred daily until baseline values were achieved, and most respondents (80.6% [244/278]) reported using a graded exercise protocol before return to participation. We found limited use of the multifaceted assessment battery at baseline but higher rates at both acute assessment and return-to-participation time points. A primary reason cited for not using test-battery components was a lack of staffing or funding for the assessments. We observed limited use of neuropsychologists to interpret neuropsychological testing. Otherwise, most respondents reported concussion-management protocols consistent with recommendations, including a high level of use of objective measures and incorporation of a progressive return-to-participation protocol.
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Tsai, Pei-Shan; Lee, Pi-Hsia; Wang, Mei-Yeh
2008-12-01
The purpose of this study was to investigate the demographics, training, and practice patterns of folk medicine practitioners, their opinions toward statutory regulation of folk medicine, and the formal education and credentialing for folk medicine providers in the metropolitan Taipei area. A cross-sectional survey design was used. Included in the survey were 200 folk medicine practitioners in Taipei city and 200 folk medicine practitioners in Taipei county. The survey questionnaire consisted of 3 domains including demographics and training; practice patterns; and opinions toward statutory regulation of folk medicine and formal education and credentialing for Tuina, Ba Guan, Gua Sha, and reflexology providers. The response rates ranged from 86.3% to 99.5%. A typical folk medicine provider in the Taipei metropolitan area was a middle-aged man with a high school degree who worked about 50 hours a week. The majority of the providers in the Taipei metropolitan area received their training through apprenticeship. Years of training and experience varied widely among these practitioners. About 80% had received more than one year of training prior to starting their practice. Adult men and women were their major clientele. The major treatment modalities they offered were Tuina, Gua Sha, Ba Guan, reflexology, and meridian massage. The majority of the respondents agreed that practitioners should receive formal education and training and agreed that certifying the qualifications of folk medicine practitioners is necessary. Findings from the present survey provide an understanding of the training and practice patterns of Taiwanese folk medicine practitioners, highlight folk medicine practitioners' needs for formal education and training, and stress the importance of statutory regulation of folk medicine in Taiwan.
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Sidana, Abhinav; Donovan, James F; Gaitonde, Krishnanath
2014-08-01
Intraoperative frozen section (FS) evaluation for tumor margin during partial nephrectomy (PN) is a matter of controversy in urologic oncology. We evaluated the preferences and practice patterns of urologists regarding intraoperative FS during PN. A 17-item questionnaire was designed to collect information on surgeons' preferences and practice patterns regarding FS during PN. The survey was sent to the members of the Society of Urologic Oncology and Endourological Society. A total of 197 responses were received. Overall, 69% and 58% of respondents chose to obtain FS (always or sometimes) during open PN (OPN) and laparoscopic PN (LPN), respectively. There was a strong correlation between the surgeons' preferences during OPN and LPN. Younger surgeons are less likely to obtain FS during OPN. For surgeons who did not routinely obtain FS, "confidence about complete resection" was the most common reason (79%), followed by "no change in management with positive margins" (35%). Most surgeons (75%) believed the margins to be negative, if surgical margin was free of tumor microscopically by a single cell layer. Older surgeons considered negative margins to be free of tumor microscopically by ≥5 mm. Overall, 54% and 42% of respondents would repeat FS for positive microscopic margins during OPN and LPN, respectively. Of the respondents, 95% would not recommend additional treatment for positive margins on final pathology. Despite recent literature pointing to low clinical utility of FS, most surgeons still obtain FS during PN. Older surgeons tend to obtain FS more often. Fellowship training and practice type do not appear to influence preferences and practice patterns in regard to FS. Copyright © 2014 Elsevier Inc. All rights reserved.
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Henz, Diana; John, Alexander; Merz, Christian; Schöllhorn, Wolfgang I.
2018-01-01
A large body of research has shown superior learning rates in variable practice compared to repetitive practice. More specifically, this has been demonstrated in the contextual interference (CI) and in the differential learning (DL) approach that are both representatives of variable practice. Behavioral studies have indicate different learning processes in CI and DL. Aim of the present study was to examine immediate post-task effects on electroencephalographic (EEG) brain activation patterns after CI and DL protocols that reveal underlying neural processes at the early stage of motor consolidation. Additionally, we tested two DL protocols (gradual DL, chaotic DL) to examine the effect of different degrees of stochastic fluctuations within the DL approach with a low degree of fluctuations in gradual DL and a high degree of fluctuations in chaotic DL. Twenty-two subjects performed badminton serves according to three variable practice protocols (CI, gradual DL, chaotic DL), and a repetitive learning protocol in a within-subjects design. Spontaneous EEG activity was measured before, and immediately after each 20-min practice session from 19 electrodes. Results showed distinguishable neural processes after CI, DL, and repetitive learning. Increases in EEG theta and alpha power were obtained in somatosensory regions (electrodes P3, P7, Pz, P4, P8) in both DL conditions compared to CI, and repetitive learning. Increases in theta and alpha activity in motor areas (electrodes C3, Cz, C4) were found after chaotic DL compared to gradual DL, and CI. Anterior areas (electrodes F3, F7, Fz, F4, F8) showed increased activity in the beta and gamma bands after CI. Alpha activity was increased in occipital areas (electrodes O1, O2) after repetitive learning. Post-task EEG brain activation patterns suggest that DL stimulates the somatosensory and motor system, and engages more regions of the cortex than repetitive learning due to a tighter stimulation of the motor and somatosensory system during DL practice. CI seems to activate specifically executively controlled processing in anterior brain areas. We discuss the obtained patterns of post-training EEG traces as evidence for different underlying neural processes in CI, DL, and repetitive learning at the early stage of motor learning. PMID:29445334
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Miller, Preston R; Partrick, Matthew S; Hoth, J Jason; Meredith, J Wayne; Chang, Michael C
2006-04-01
Development of practice-based learning (PBL) is one of the core competencies required for resident education by the Accreditation Council for Graduate Medical Education, and specialty organizations including the American College of Surgeons have formed task forces to understand and disseminate information on this important concept. However, translating this concept into daily practice may be difficult. Our goal was to describe the successful application of PBL to patient care improvement with development of an algorithm for the empiric therapy of ventilator-associated pneumonia (VAP). The algorithm development occurred in two phases. In phase 1, the microbiology and timing of VAP as diagnosed by bronchoalveolar lavage was reviewed over a 2-year period to allow for recognition of patterns of infection. In phase 2, based on these data, an algorithm for empiric antibiotic coverage that would ensure that the large majority of patients with VAP received adequate initial empiric therapy was developed and put into practice. The period of algorithm use was then examined to determine rate of adequate coverage and outcome. : In Phase 1, from January 1, 2000 to December 31 2001, 110 patients were diagnosed with VAP. Analysis of microbiology revealed a sharp increase in the recovery of nosocomial pathogens on postinjury day 7 (19% < day 7 versus 47% > or = day 7, p = 0.003). Adequate initial antibiotic coverage was seen in 74%. In Phase 2, an algorithm employing ampicillin- sulbactam for coverage of community- acquired pathogens before day 7 and cefipime for nosocomial coverage > or =day 7 was then employed from January 1, 2002 to December 31, 2003. Evaluation of 186 VAP cases during this interval revealed a similar distribution of nosocomial cases (13% < day 7 versus 64% > or = day 7, p < 0.0001). Empiric antibiotic therapy was adequate in 82% of cases
or =day 7: overall accuracy improved to 83% (p = 0.05). Mortality from phase 1 to phase 2 trended toward a decrease (21% versus 13%, p = 0.1). Application of the concept of PBL allowed for identification of local patterns of infection and development of an institution specific treatment algorithm that resulted in >80% adequate initial empiric coverage for VAP with a trend toward decreased mortality. PBL allows for alteration in practice based on local patterns and outcomes and has the potential to improve patient care. -
Variable two-crystal cascade for conical refraction.
Peet, V
2015-05-15
The cascade conical refraction occurs when a collimated light beam is passed consequently along the optic axes of several biaxial crystals arranged in a series. For commonly used optical arrangements, the general structure of light emerging from such a cascade is rigorously determined by the used crystals, leaving few possibilities for the variations of the established light pattern. A simple modification of a two-crystal arrangement where one of the two crystals is placed beyond the imaging lens is reported. This modification adds an extreme versatility to the effect and allows one to tune continuously the actual cascade parameters. As a result, practically any pattern of two-crystal cascade conical refraction can be obtained for any pair of biaxial crystals.
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Friesem, David E.; Lavi, Noa; Madella, Marco; Ajithprasad, P.; French, Charles
2016-01-01
Hunter-gatherer societies have distinct social perceptions and practices which are expressed in unique use of space and material deposition patterns. However, the identification of archaeological evidence associated with hunter-gatherer activity is often challenging, especially in tropical environments such as rainforests. We present an integrated study combining ethnoarchaeology and geoarchaeology in order to study archaeological site formation processes related to hunter-gatherers’ ways of living in tropical forests. Ethnographic data was collected from an habitation site of contemporary hunter-gatherers in the forests of South India, aimed at studying how everyday activities and way of living dictate patterns of material deposition. Ethnoarchaeological excavations of abandoned open-air sites and a rock-shelter of the same group located deep in the forests, involved field observations and sampling of sediments from the abandoned sites and the contemporary site. Laboratory analyses included geochemical analysis (i.e., FTIR, ICP-AES), phytolith concentration analysis and soil micromorphology. The results present a dynamic spatial deposition pattern of macroscopic, microscopic and chemical materials, which stem from the distinctive ways of living and use of space by hunter-gatherers. This study shows that post-depositional processes in tropical forests result in poor preservation of archaeological materials due to acidic conditions and intensive biological activity within the sediments. Yet, the multiple laboratory-based analyses were able to trace evidence for activity surfaces and their maintenance practices as well as localized concentrations of activity remains such as the use of plants, metals, hearths and construction materials. PMID:27783683
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Characterization of the Fire Regime and Drivers of Fires in the West African Tropical Forest
NASA Astrophysics Data System (ADS)
Dwomoh, F. K.; Wimberly, M. C.
2016-12-01
The Upper Guinean forest (UGF), encompassing the tropical regions of West Africa, is a globally significant biodiversity hotspot and a critically important socio-economic and ecological resource for the region. However, the UGF is one of the most human-disturbed tropical forest ecosystems with the only remaining large patches of original forests distributed in protected areas, which are embedded in a hotspot of climate stress & land use pressures, increasing their vulnerability to fire. We hypothesized that human impacts and climate interact to drive spatial and temporal variability in fire, with fire exhibiting distinctive seasonality and sensitivity to drought in areas characterized by different population densities, agricultural practices, vegetation types, and levels of forest degradation. We used the MODIS active fire product to identify and characterize fire activity in the major ecoregions of the UGF. We used TRMM rainfall data to measure climatic variability and derived indicators of human land use from a variety of geospatial datasets. We employed time series modeling to identify the influences of drought indices and other antecedent climatic indicators on temporal patterns of active fire occurrence. We used a variety of modeling approaches to assess the influences of human activities and land cover variables on the spatial pattern of fire activity. Our results showed that temporal patterns of fire activity in the UGF were related to precipitation, but these relationships were spatially heterogeneous. The pattern of fire seasonality varied geographically, reflecting both climatological patterns and agricultural practices. The spatial pattern of fire activity was strongly associated with vegetation gradients and anthropogenic activities occurring at fine spatial scales. The Guinean forest-savanna mosaic ecoregion had the most fires. This study contributes to our understanding of UGF fire regime and the spatio-temporal dynamics of tropical forest fires in response to intense human and climatic drivers.
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Khunti, K; Goyder, E; Baker, R
1999-01-01
BACKGROUND: Different methods have been used to determine the prevalence and treatment of diabetes. Despite the large number of studies, previous estimations of prevalence and treatment have been carried out on relatively small numbers of patients, and then in only a few practices in single geographical regions. AIM: To investigate the feasibility of collating data from multi-practice audits organized by primary care audit groups in order to estimate the prevalence and treatment of patients with known diabetes, and to discuss the methodological issues and reasons for variation. METHOD: A postal questionnaire survey of all primary care audit groups in England and Wales that had conducted a multi-practice audit of diabetes between 1993-1995. Prevalence rates and patterns of diabetic care were compared with other community-based surveys of known diabetes from 1986-1996 identified on MEDLINE. RESULTS: Twenty-five (43%) audit groups supplied data from multi-practice audits of diabetes. Seven (28%) multi-practice audits involving 259 practices fulfilled the inclusion criteria for prevalence estimation. The overall prevalence of diabetes based on a population of 1,475,512 patients was 1.46% (range between audit groups = 1.18% to 1.66%; chi 2 = 308; df = 6; P < 0.0001). Male to female ratio was 1.15:1. Treatment of diabetes could be ascertained for 10 (40%) audit groups comprising 319 practices. Of these, 23.4% (range = 16.5%-27.4%) were controlled by diet, 48.5% (range = 43.6%-55.8%) were prescribed oral hypoglycaemic drugs, and 28.2% (range = 25.0%-32.4%) were treated with insulin. There were significant variations between audit groups in treatment pattern (chi 2 = 250; df = 18; P < 0.0001). CONCLUSION: Prevalence and treatment rates of diabetes and other chronic diseases can be assessed and compared using data from multi-practice audits. Collation of audit data could improve the precision of quantitative estimates of health status in populations. A standard method of data recording and collection may provide a new approach that could considerably improve our ability to monitor disease and its management. PMID:10736888
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Electrical stimulation therapy for dysphagia: a follow-up survey of USA dysphagia practitioners.
Barikroo, Ali; Carnaby, Giselle; Crary, Michael
2017-12-01
The aim of this study was to compare current application, practice patterns, clinical outcomes, and professional attitudes of dysphagia practitioners regarding electrical stimulation (e-stim) therapy with similar data obtained in 2005. A web-based survey was posted on the American Speech-Language-Hearing Association Special Interest Group 13 webpage for 1 month. A total of 271 survey responses were analyzed and descriptively compared with the archived responses from the 2005 survey. Results suggested that e-stim application increased by 47% among dysphagia practitioners over the last 10 years. The frequency of weekly e-stim therapy sessions decreased while the reported total number of treatment sessions increased between the two surveys. Advancement in oral diet was the most commonly reported improvement in both surveys. Overall, reported satisfaction levels of clinicians and patients regarding e-stim therapy decreased. Still, the majority of e-stim practitioners continue to recommend this treatment modality to other dysphagia practitioners. Results from the novel items in the current survey suggested that motor level e-stim (e.g. higher amplitude) is most commonly used during dysphagia therapy with no preferred electrode placement. Furthermore, the majority of clinicians reported high levels of self-confidence regarding their ability to perform e-stim. The results of this survey highlight ongoing changes in application, practice patterns, clinical outcomes, and professional attitudes associated with e-stim therapy among dysphagia practitioners.
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The demography, career pattern, and motivation of locum tenens physicians in the United States.
Simon, Arthur B; Alonzo, Angelo A
2004-01-01
The objective of this study was to provide a profile of locum tenens providers and their motivation for choosing this practice pattern. The research design used was a cross-sectional mailed survey questionnaire. Participants included the 1662 physicians who accepted at least one locum tenens assignment in 2001 from one physician staffing service. They were asked to complete a 50-element questionnaire; 776 (47 percent) responded. The average age of respondents was 53.0 years. Men represented 70.3 percent of the sample and were significantly older (56.3 years) than women providers who responded (45.3 years). One-third considered a locum tenens practice pattern permanent. Primary care locums were younger than specialists and subspecialists. Female providers were disproportionately practicing in primary care specialties (43.9 percent); 64 percent used locum income as their sole source of support and were frequently (31 percent) motivated by a need for a flexible work schedule. Male locum physicians were weighted toward the subspecialties and were motivated mostly (62 percent) by a desire to continue to practice part time. They used locum income as a secondary means of support (33 percent) or to augment pension and retirement resources (38 percent). A physician workforce from most major specialties and subspecialties and all age groups and career stages fulfills career and economic goals by working in a short-term, temporary employment pattern. Locum tenens appeals to physician providers who desire a healthier, more controllable lifestyle.
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Farrell, Ruth M; Agatisa, Patricia K; Mercer, Mary Beth; Mitchum, Ariane G; Coleridge, Marissa B
2016-06-01
The aim of this study was to identify how physicians develop their knowledge base and practice patterns regarding noninvasive prenatal testing (NIPT). A survey was used to assess physicians' informational sources and practice patterns regarding NIPT. While most of the 258 participants acquire knowledge about NIPT from the medical literature or didactic educational programming, 74 (28.7%) cite commercial laboratories as an initial source and 124 (47.8%) as a way to keep current with changes in NIPT. About one-third (n = 94, 36.4%) seek information about ethical issues related to NIPT. Half of the OB/GYN respondents (n = 136, 52.7%) provide pretest counseling; fewer refer to a genetic counselor or maternal fetal medicine specialist (MFM) (n = 94, 34.6%, n = 29, 11.2%, respectively). Pretest counseling content and the comfort with which participants discuss topics pertinent to patients' utilization of NIPT varied between OB/GYNs and MFMs. Advances in cff DNA technology emphasize the need for effective strategies for physicians to develop competency and practice patterns regarding NIPT. Study findings speak to the need for effective educational resources for obstetric providers, not just early adopters of NIPT but also for primary OB/GYNs as they serve in the role of the first point of contact for women considering their prenatal testing options. © 2016 John Wiley & Sons, Ltd. © 2016 John Wiley & Sons, Ltd.
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Testing promotes effector transfer.
Boutin, Arnaud; Panzer, Stefan; Salesse, Robin N; Blandin, Yannick
2012-11-01
The retrieval of information from memory during testing has recently been shown to promote transfer in the verbal domain. Motor-related research, however, has ignored testing as a relevant method to enhance motor transfer. We thus investigated whether testing has the potential to induce generalised motor memories by favouring effector transfer. Participants were required to reproduce a spatial-temporal pattern of elbow extensions and flexions with their dominant right arm. We tested the ability of participants to transfer the original pattern (extrinsic transformation; i.e., goal-based configuration) or the mirrored pattern (intrinsic transformation; i.e., movement-based configuration) to the unpractised non-dominant left arm. To evaluate how testing affects motor transfer at 24-h testing, participants were either administered an initial testing session during early practice (early testing group) or shortly after the end of practice (late testing group; i.e., no alternation between practice and testing sessions). No initial testing session was completed for the control group. We found better effector transfer at 24-h testing for the early testing group for both extrinsic and intrinsic transformations of the movement pattern when compared with the control group, while no testing benefit was observed for the late testing group. This indicates that testing positively affects motor learning, yielding enhanced long-term transfer capabilities. We thus demonstrate the critical role of retrieval practice via testing during the process of motor memory encoding, and provide the conditions under which testing effectively contributes to the generalisation of motor memories. Copyright © 2012 Elsevier B.V. All rights reserved.
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NASA Astrophysics Data System (ADS)
Unglert, K.; Radić, V.; Jellinek, A. M.
2016-06-01
Variations in the spectral content of volcano seismicity related to changes in volcanic activity are commonly identified manually in spectrograms. However, long time series of monitoring data at volcano observatories require tools to facilitate automated and rapid processing. Techniques such as self-organizing maps (SOM) and principal component analysis (PCA) can help to quickly and automatically identify important patterns related to impending eruptions. For the first time, we evaluate the performance of SOM and PCA on synthetic volcano seismic spectra constructed from observations during two well-studied eruptions at Klauea Volcano, Hawai'i, that include features observed in many volcanic settings. In particular, our objective is to test which of the techniques can best retrieve a set of three spectral patterns that we used to compose a synthetic spectrogram. We find that, without a priori knowledge of the given set of patterns, neither SOM nor PCA can directly recover the spectra. We thus test hierarchical clustering, a commonly used method, to investigate whether clustering in the space of the principal components and on the SOM, respectively, can retrieve the known patterns. Our clustering method applied to the SOM fails to detect the correct number and shape of the known input spectra. In contrast, clustering of the data reconstructed by the first three PCA modes reproduces these patterns and their occurrence in time more consistently. This result suggests that PCA in combination with hierarchical clustering is a powerful practical tool for automated identification of characteristic patterns in volcano seismic spectra. Our results indicate that, in contrast to PCA, common clustering algorithms may not be ideal to group patterns on the SOM and that it is crucial to evaluate the performance of these tools on a control dataset prior to their application to real data.
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New type of dummy layout pattern to control ILD etch rate
NASA Astrophysics Data System (ADS)
Pohland, Oliver; Spieker, Julie; Huang, Chih-Ta; Govindaswamy, Srikanth; Balasinski, Artur
2007-12-01
Adding dummy features (waffles) to drawn geometries of the circuit layout is a common practice to improve its manufacturability. As an example, local dummy pattern improves MOSFET line and space CD control by adjusting short range optical proximity and reducing the aggressiveness of its correction features (OPC) to widen the lithography process window. Another application of dummy pattern (waffles) is to globally equalize layout pattern density, to reduce long-range inter-layer dielectric (ILD) thickness variations after the CMP process and improve contact resistance uniformity over the die area. In this work, we discuss a novel type of dummy pattern with a mid-range interaction distance, to control the ILD composition driven by its deposition and etch process. This composition is reflected on sidewall spacers and depends on the topography of the underlying poly pattern. During contact etch, it impacts the etch rate of the ILD. As a result, the deposited W filling the damascene etched self-aligned trench contacts in the ILD may electrically short to the underlying gates in the areas of isolated poly. To mitigate the dependence of the ILD composition on poly pattern distribution, we proposed a special dummy feature generation with the interaction range defined by the ILD deposition and etch process. This helped equalize mid-range poly pattern density without disabling the routing capability with damascene trench contacts in the periphery which would have increased the layout footprint.
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Jacobson, Christine C; Resneck, Jack S; Kimball, Alexa Boer
2004-12-01
To examine the effect of age and other demographic factors on dermatologists' practice characteristics. Anonymous practice profile survey. Dermatologist members of the American Academy of Dermatology Association. Analyzed survey questions included information about legal practice entity, geographic area served, weekly patient care hours, patients seen per hour, and scope of patient care activities. Of 4090 surveys sent, 1425 (35%) were returned. As the age of the cohorts increased, the percentage practicing in solo practices increased (range, 21%-39%), as did the percentage serving urban areas (range, 31%-46%). Measures of physician productivity increased in the older age cohorts; however, age was not a significant factor after controlling for other variables. More patient-hours per week were associated with male sex (P < .001), solo practices (P < .001), and non-urban-based practices (P = .04), whereas a greater number of patients per hour was associated with non-rural-based practices (P = .02) and male sex (P = .03). As the cohorts progressed in age, more time was spent practicing medical dermatology. The number of hours spent practicing cosmetic dermatology peaked in the 41- to 50-year-old cohort (P = .03). Practice patterns differ significantly among dermatologists of different ages. As the current cohorts age and new dermatologists emerge from training, changes in scope of practice and generational differences in productivity are likely to cause a contraction in the effective supply of dermatologists, which has important implications for dermatology workforce planning.
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MacDermid, Joy C; Wojkowski, Sarah; Kargus, Cristin; Marley, Meghan; Stevenson, Emily
2010-01-01
Lateral epicondylosis (LE) is a common condition. Knowledge on practice patterns underlies identification of knowledge to practice gaps. The purpose was to determine the practice patterns and beliefs of hand therapists in managing LE. The study design used was a descriptive survey. A survey of Certified Hand Therapists and members of the American Society of Hand Therapists was conducted (n=693). Questions were framed around frequency and perceived effectiveness of interventions, examination techniques, outcome measures, and prognostic factors. More than 80% of therapists use education/activity modification, home exercise, LE orthoses, and stretching for both the acute and chronic LE. Therapists perceive education, orthoses and home exercise are the most effective for acute cases, whereas in chronic cases, orthoses dropped to ninth in ranked perceived effectiveness. Grip strength (80%) and numeric pain rating (71%) were the most commonly used outcome measures. Most (>70%) therapists perceived occupation and duration of symptoms are prognostic in terms of resolution of symptoms, whereas compliance with exercise (78%) and work factors are important for return to work. Therapists rely on impairment measures to evaluate hand therapy outcomes in patients with LE. Hand therapists are aligned with a number of recommendations from the available systematic reviews, although the use of outcome measures and optimal definition of education and exercise exhibit evidence to practice gaps. Level 5. Copyright (c) 2010 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.
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A post-processing study on aluminum surface by fiber laser: Removing face milling patterns
NASA Astrophysics Data System (ADS)
Kayahan, Ersin
2018-05-01
The face milling process of the metal surface is a well-known machining process of using rotary cutters to remove material from a workpiece. Flat metal surfaces can be produced by a face milling process. However, in practice, visible, traced marks following the motion of points on the cutter's face are usually apparent. In this study, it was shown that milled patterns can be removed by means of 20 W fiber laser on the aluminum surface (AA7075). Experimental results also showed that roughened and hydrophobic surface can be produced with optimized laser parameters. It is a new approach to remove the patterns from the metal surface and can be explained through roughening by re-melting instead of ablation. The new method is a strong candidate to replace sandblasting the metal surface. It is also cheap and environmentally friendly.
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An intelligent knowledge mining model for kidney cancer using rough set theory.
Durai, M A Saleem; Acharjya, D P; Kannan, A; Iyengar, N Ch Sriman Narayana
2012-01-01
Medical diagnosis processes vary in the degree to which they attempt to deal with different complicating aspects of diagnosis such as relative importance of symptoms, varied symptom pattern and the relation between diseases themselves. Rough set approach has two major advantages over the other methods. First, it can handle different types of data such as categorical, numerical etc. Secondly, it does not make any assumption like probability distribution function in stochastic modeling or membership grade function in fuzzy set theory. It involves pattern recognition through logical computational rules rather than approximating them through smooth mathematical functional forms. In this paper we use rough set theory as a data mining tool to derive useful patterns and rules for kidney cancer faulty diagnosis. In particular, the historical data of twenty five research hospitals and medical college is used for validation and the results show the practical viability of the proposed approach.
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Reich, Catherine M.; Hack, Samantha M.; Klingaman, Elizabeth A.; Brown, Clayton H.; Fang, Li Juan; Dixon, Lisa B.; Jahn, Danielle R.; Kreyenbuhl, Julie A.
2017-01-01
Objective The study was designed to explore patterns of prescriber communication behaviors as they relate to consumer satisfaction among a serious mental illness sample. Methods Recordings from 175 antipsychotic medication-monitoring appointments between veterans with psychiatric disorders and their prescribers were coded using the Roter Interaction Analysis System (RIAS) for communication behavioral patterns. Results The frequency of prescriber communication behaviors (i.e., facilitation, rapport, procedural, psychosocial, biomedical, and total utterances) did not reliably predict consumer satisfaction. The ratio of prescriber to consumer utterances did predict consumer satisfaction. Conclusion Consistent with client-centered care theory, antipsychotic medication consumers were more satisfied with their encounters when their prescriber did not dominate the conversation. Practice Implications Therefore, one potential recommendation from these findings could be for medication prescribers to spend more of their time listening to, rather than speaking with, their SMI consumers. PMID:28920491
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Best practices for missing data management in counseling psychology.
Schlomer, Gabriel L; Bauman, Sheri; Card, Noel A
2010-01-01
This article urges counseling psychology researchers to recognize and report how missing data are handled, because consumers of research cannot accurately interpret findings without knowing the amount and pattern of missing data or the strategies that were used to handle those data. Patterns of missing data are reviewed, and some of the common strategies for dealing with them are described. The authors provide an illustration in which data were simulated and evaluate 3 methods of handling missing data: mean substitution, multiple imputation, and full information maximum likelihood. Results suggest that mean substitution is a poor method for handling missing data, whereas both multiple imputation and full information maximum likelihood are recommended alternatives to this approach. The authors suggest that researchers fully consider and report the amount and pattern of missing data and the strategy for handling those data in counseling psychology research and that editors advise researchers of this expectation.
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Fourier phase retrieval with a single mask by Douglas-Rachford algorithms.
Chen, Pengwen; Fannjiang, Albert
2018-05-01
The Fourier-domain Douglas-Rachford (FDR) algorithm is analyzed for phase retrieval with a single random mask. Since the uniqueness of phase retrieval solution requires more than a single oversampled coded diffraction pattern, the extra information is imposed in either of the following forms: 1) the sector condition on the object; 2) another oversampled diffraction pattern, coded or uncoded. For both settings, the uniqueness of projected fixed point is proved and for setting 2) the local, geometric convergence is derived with a rate given by a spectral gap condition. Numerical experiments demonstrate global, power-law convergence of FDR from arbitrary initialization for both settings as well as for 3 or more coded diffraction patterns without oversampling. In practice, the geometric convergence can be recovered from the power-law regime by a simple projection trick, resulting in highly accurate reconstruction from generic initialization.
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Kampuansai, Jatupol; Kutanan, Wibhu; Tassi, Francesca; Kaewgahya, Massupa; Ghirotto, Silvia; Kangwanpong, Daoroong
2017-02-01
The migration of the Tai-Kadai speaking people from southern China to northern Thailand over the past hundreds of years has revealed numerous patterns that have likely been influenced by routes, purposes and periods of time. To study the effects of different migration patterns on Tai-Kadai maternal genetic structure, mitochondrial DNA hypervariable region I sequences from the Yong and the Lue people having well-documented histories in northern Thailand were analyzed. Although the Yong and Lue people were historically close relatives who shared Xishuangbanna Dai ancestors, significant genetic differences have been observed among them. The Yong people who have been known to practice mass migration have exhibited a closer genetic affinity to their Dai ancestors than have the Lue people. Genetic heterogeneity and a sudden reduced effective population size within the Lue group is likely a direct result of the circumstances of the founder effect.
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NASA Astrophysics Data System (ADS)
Gao, Xinya; Wang, Yonghong; Li, Junrui; Dan, Xizuo; Wu, Sijin; Yang, Lianxiang
2017-06-01
It is difficult to measure absolute three-dimensional deformation using traditional digital speckle pattern interferometry (DSPI) when the boundary condition of an object being tested is not exactly given. In practical applications, the boundary condition cannot always be specifically provided, limiting the use of DSPI in real-world applications. To tackle this problem, a DSPI system that is integrated by the spatial carrier method and a color camera has been established. Four phase maps are obtained simultaneously by spatial carrier color-digital speckle pattern interferometry using four speckle interferometers with different illumination directions. One out-of-plane and two in-plane absolute deformations can be acquired simultaneously without knowing the boundary conditions using the absolute deformation extraction algorithm based on four phase maps. Finally, the system is proved by experimental results through measurement of the deformation of a flat aluminum plate with a groove.
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Gender trends in dental practice patterns. A review of current U.S. literature.
Dolan, T A
1991-01-01
This paper reviews three recent reports of national gender trends in dental practice patterns. Although the three independent cross-sectional studies were conducted at different points in time, used different sampling strategies, and used similar but independent survey instruments, findings were consistent across studies. In summary: Women dentists are less likely to be married and have fewer children. Women are more likely to assume child rearing and household responsibilities. Women are less likely to be practice owners. Women worked slightly fewer hours per week and weeks per year, and were more likely to take a leave of absence for illness or child rearing. However, women dentists demonstrate a far greater professional work commitment than was previously reported in the literature. Women earn significantly less income from the practice of dentistry, even after controlling for age, practice ownership, hours worked per week, and other personal characteristics. The most current "Gender Wage Gap" estimates range from 57.7% for specialists to 75.4% for general practitioners (8). delta.
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Cultural practices to improve in-row weed control with cultivation in organic peanut production
USDA-ARS?s Scientific Manuscript database
Cultivation is a proven effective means of weed control in organic peanut. However, weeds in-row often escape control. Research trials were conducted in Ty Ty, GA to modify cultural practices to help peanut suppress weed emergence in-row. Modified cultural practices were three row pattern/seeding...
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Feeding practices of low-income mothers: How do they compare to current recommendations
USDA-ARS?s Scientific Manuscript database
Despite a growing consensus on the feeding practices associated with healthy eating patterns, few observational studies of maternal feeding practices with young children have been conducted, especially in low-income populations. The aim of this study was to provide such data on a low income sample t...
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Science Teachers' Proficiency Levels and Patterns of TPACK in a Practical Context
ERIC Educational Resources Information Center
Yeh, Yi-Fen; Lin, Tzu-Chiang; Hsu, Ying-Shao; Wu, Hisn-Kai; Hwang, Fu-Kwun
2015-01-01
Technological pedagogical content knowledge-practical (TPACK-P) refers to a unified body of knowledge that teachers develop from and for actual teaching practices with information communication technologies (ICT). This study attempted to unveil the longitudinal and multidimensional development of knowledge that teachers possess by interviewing 40…
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Image/Music/Voice: Song Dubbing in Hollywood Musicals.
ERIC Educational Resources Information Center
Siefert, Marsha
1995-01-01
Uses the practice of song dubbing in the Hollywood film musical to explore the implications and consequences of the singing voice for imaging practices in the 1930s through 1960s. Discusses the ideological, technological, and socioeconomic basis for song dubbing. Discusses gender, race, and ethnicity patterns of image-sound practices. (SR)
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Art and Design Practices in Nigeria: The Problem of Dropping Out
ERIC Educational Resources Information Center
Ogunduyile, Sunday Roberts; Kayode, Femi; Ojo, Bankole
2008-01-01
Despite interest in the arts, art and design practice in Nigeria continues to witness a downward trend. A new orientation and redirection of priorities, skills development, and patterns of practice that are not contradictory to the code of professional conduct and ethical procedures is contemplated. This paper groups the professionally trained…
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Travis, Frederick; Parim, Niyazi; Shrivastava, Amrita
2017-03-01
This study compared subjective experiences and EEG patterns in 37 subjects when listening to live Vedic recitation and when practicing Transcendental Meditation (TM). Content analysis of experiences when listening to Vedic recitation yielded three higher-order code. Experiences during Vedic recitation were: (1) deeper than during TM practice; (2) experienced as an inner process; and (3) characterized by lively silence. EEG patterns support these higher-order codes. Theta2 and alpha1 frontal, parietal, and frontal-parietal coherence were significantly higher when listening to Vedic recitation, than during TM practice. Theta2 coherence is seen when attending to internal mental processes. Higher theta2 coherence supports subjects' descriptions that the Vedic recitations were "not external sounds but internal vibrations." Alpha1 coherence is reported during pure consciousness experiences during TM practice. Higher alpha1 coherence supports subjects' descriptions that they "experienced a depth of experience, rarely experienced even during deep TM practice." These data support the utility of listening to Vedic recitation to culture deep inner experiences. Copyright © 2017 Elsevier Inc. All rights reserved.
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Effect of proctoring on implementation and results of elective laparoscopic colon surgery.
Bosker, Robbert; Groen, Henk; Hoff, Christiaan; Totte, Eric; Ploeg, Rutger; Pierie, Jean Pierre
2011-07-01
A steep learning curve exists for surgeons to become skilled in laparoscopic colon resection. Our institute offers a proctored training programme. The purpose of this descriptive study was to evaluate whether the course resulted in adoption of laparoscopic colorectal surgery into clinical practice, explore post-course practice patterns and analyse the outcome of surgical performance. Between 2003 and 2008, 26 surgeons were trained by our institute. The course consisted of 24 elective laparoscopic resections under direct supervision. A questionnaire and a prospective post-course web-based registration were used to analyse the effect of the training and the outcome of surgical performance. The response rate of the questionnaire was 85%. The majority had not performed any laparoscopic colon resections before attending the course. All 24 respondents successfully implemented laparoscopy into daily practice. After the course, 70% of all sigmoid resections were performed laparoscopically in contrast with 0% of all transverse colon resections. The results of the trainees after following the course are equal to results of other studies. A proctored training programme, consisting of 24 supervised cases, is safe and feasible. For adequate monitoring, participating in a post-course registry should be obligatory.
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NASA Astrophysics Data System (ADS)
Ames, D. P.; Peterson, M.; Larsen, J.
2016-12-01
A steady flow of manuscripts describing integrated water resources management (IWRM) modelling has been published in Environmental Modelling & Software since the journal's inaugural issue in 1997. These papers represent two decades of peer-reviewed scientific knowledge regarding methods, practices, and protocols for conducting IWRM. We have undertaken to explore this specific assemblage of literature with the intention of identifying commonly reported procedures in terms of data integration methods, modelling techniques, approaches to stakeholder participation, means of communication of model results, and other elements of the model development and application life cycle. Initial results from this effort will be presented including a summary of commonly used practices, and their evolution over the past two decades. We anticipate that results will show a pattern of movement toward greater use of both stakeholder/participatory modelling methods as well as increased use of automated methods for data integration and model preparation. Interestingly, such results could be interpreted to show that the availability of better, faster, and more integrated software tools and technologies free the modeler to take a less technocratic and more human approach to water resources modelling.
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Determinants of practice patterns in pediatric UTI management.
Selekman, R E; Allen, I E; Copp, H L
2016-10-01
Urinary tract infection (UTI) affects 10% of girls and 3% of boys by age 16. Both the American Academy of Pediatrics and National Institute for Health and Clinical Excellence Guidelines recommend urine testing prior to initiation of antibiotic treatment and the use of local antibiograms to guide empiric antibiotic therapy. Urine culture results not only provide the opportunity to halt empiric therapy if there is no bacterial growth, but also allow for tailoring of broad-spectrum therapy. Additionally, the use of antiobiograms improves empiric antibiotic selection based on local resistance patterns. However, execution of guideline recommendations has proved challenging. Understanding barriers in implementation is critical to developing targeted interventions aimed to improve adherence to these guidelines. The present study sought to investigate practice patterns and factors that influence urine testing and antibiogram use in the setting of empiric antibiotic treatment of UTI in children to ultimately improve adherence to UTI management guidelines. A random, national sample of physicians caring for children was surveyed from the American Medical Association Masterfile. Participants were queried regarding practice type, length of time in practice, factors influencing urine testing, urine specimen collection method, and antibiogram utilization. Logistic regression was used to assess factors associated with use of urine testing, bagged specimens, and antibiograms. Of respondents who acknowledged contact by surveyors, 47% completed the survey (n = 366). Most respondents (84%) obtain urinalysis and culture prior to treatment for UTI. Physicians report they would more likely order testing if the specimen were easier to collect (46%) and if results were available immediately (48%) (Table). Urine collection by bag was more common in circumcised boys (>30%) compared with girls (20%) and uncircumcised boys (20%) (P = 0.02). The most common reasons for collection by bag were parental refusal for (49%) and difficulty with (42%) catheterization (Table). Of the 70% of respondents reporting antibiogram access (n = 256), 50% report its use the majority of the time with empiric prescription (n = 128). While most practitioners report following guidelines to obtain urine testing prior to antibiotic prescription for UTI, urine collection by bag is common. Additionally, <50% of practitioners adhere to guideline recommendations for empiric antibiotic selection based on local antibiograms. Interventions to improve adherence to UTI management guidelines should focus on (1) improving catheterization practices, (2) educating parents regarding the value of catheterization, and (3) incorporating local antibiograms into electronic medical records. Copyright © 2016 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
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Adult urethral stricture: practice of Turkish urologists
Akyuz, Mehmet; Sertkaya, Zulfu; Koca, Orhan; Calıskan, Selahattin; Kutluhan, Musab Ali; Karaman, Muhammet Ihsan
2016-01-01
ABSTRACT Objectives: To evaluate national practice patterns in the treatment of male anterior urethral strictures among Turkish urologists. Materials and Methods: A survey form including 12 questions prepared to determine active Turkish urologists' approach to diagnosis and treatment of the adult urethral stricture (US) were filled out. Based on the survey results, the institutions which 218 urologists work and their years of expertise, methods they used for diagnosis and treatment, whether or not they perform open urethroplasty and timing of open urethroplasty were investigated. Results: Optic internal urethrotomy and dilatation are the most commonly used minimal invasive procedures in treatment of US with the ratios of 93.5% and 63.3% respectively. On the other hand it was seen that urethroplasty was a less commonly used procedure, compared to minimal invasive techniques, with the ratio of 36.7%. Survey results showed us that the number of US cases observed and open urethroplasty procedures performed increases with increasing years of professional experience. Conclusions: As a method demanding special surgical experience and known as a time-consuming and challenging procedure, open urethroplasty will be able to take a greater part in current urological practice with the help of theoretical education and practical courses given by specific centers and experienced authors. PMID:27256189
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Sen Gupta, T; Woolley, T; Murray, R; Hays, R; McCloskey, T
2014-01-01
The regionally-based James Cook University (JCU) School of Medicine aims to meet its mission to address the health needs of the region by combining selection and curriculum strategies shown to increase rural career recruitment outcomes. The School has graduated 536 students in its first seven cohorts from 2005 to 2011. This paper presents the early career practice locations and the specialty training undertaken by these cohorts, and describes the association between later practice location with both hometown at application and internship location. Hometown at application' data for JCU Bachelor of Medicine, Bachelor of Surgery (MBBS) graduates was retrieved from administrative databases held by the university, while postgraduate location and career data were obtained either from personal contact via email, telephone, Facebook or electronically from the Australian Health Practitioner Regulation Authority website. Practice location was described across Australian Standard Geographical Classification Remoteness Area (RA) categories. Data for the primary practice location of 536 JCU MBBS graduates across postgraduate years (PGY) 1 to 7 is 99% complete. A total of 65% of JCU graduates undertook their internship in non-metropolitan locations including 20% in RA 2 and 44% in RA 3-5, a pattern of practice different to that of other Australian clinicians. For the internship year, 'non-metropolitan-origin' JCU MBBS graduates predominantly worked in RA 2-5 locations, while 'metropolitan origin' graduates were more likely to work in major cities. However, by PGY 7, the distribution of 'rural' and 'metropolitan' origin JCU graduates across RA categories was similar. The RA category of internship location - either 'metropolitan (RA 1) or 'non-metropolitan' (RA 2-5) - was associated with the location of subsequent practice across PGY 2-7. This comprehensive data set provides the first real evidence from one of Australia's new medical schools on actual postgraduate practice location, as compared to 'intent to practice'. The geographic profile by RA of JCU graduates' hometown and patterns of postgraduate practice is different to that of other Australian medical students and doctors. This early evidence supports the JCU model of distributed non-metropolitan medical education, and suggests more regionally-located internship and specialty training places would further increase the medical workforce in northern and/or rural Australia. The workforce impact of the seven cohorts of graduates in this study is starting to be felt in rural and regional Australia, and, if these trends continue, will result in significant workforce improvements over the next decade. These results support further investment in regional and rural medical education.
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Referral Patterns, Diagnosis, and Disease Management of Patients With Axial Spondyloarthritis
van der Heijde, Désirée; Sieper, Joachim; Elewaut, Dirk; Deodhar, Atul; Pangan, Aileen L.; Dorr, Alexander P.
2014-01-01
Background Recognition, diagnosis, and management of axial spondyloarthritis (axial SpA) continue to advance. Objectives The objectives of this study were to compare referrals, diagnosis, and management of axial SpA in Western Europe (WE), North America (US and Canada), and the rest of world (RoW) in academic and community rheumatology practices and to identify areas for further education. Methods Rheumatologists responded online to the MAXIMA (Management of Axial SpA International and Multicentric Approaches) survey. Questions pertained to referral, diagnosis, and management of axial SpA. Results Rheumatologists (N = 809) from 56 countries completed the survey about patients with chronic back pain (≥3 months) starting before age 45 years. Responses from academic and community practice rheumatologists were generally similar. Most referrals were from primary care providers. Symptom duration of 3 years or more at referral was reported more frequently by WE and RoW than US respondents. More WE and RoW than US rheumatologists referred to the Assessment of SpondyloArthritis International Society criteria for axial SpA in clinical practice. Rheumatologists reported prescribing disease-modifying antirheumatic drugs for the management of axial SpA. Sulfasalazine was frequently prescribed across regions; methotrexate was more commonly prescribed by US rheumatologists compared with other regions. Conclusions Referral patterns, diagnosis, and disease management for axial SpA were similar among WE, North America, and RoW rheumatologists and in academic/community practices, although more WE and RoW rheumatologists referred to Assessment of SpondyloArthritis International Society criteria in clinical practice. Disease-modifying antirheumatic drugs were commonly prescribed for axial SpA patients, although it was unclear whether these were prescribed for axial or peripheral symptoms. PMID:25417676
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Greenberg, Elliot M; Greenberg, Eric T; Albaugh, Jeffrey; Storey, Eileen; Ganley, Theodore J
2018-05-22
Study Design Cross-sectional survey. Background Recovery from anterior cruciate ligament reconstruction (ACLR) requires an intensive course of post-operative rehabilitation. Although guidelines outlining evidence-based rehabilitation recommendations have been published, the actual practice patterns of physical therapists are unknown. Objectives To analyze the current landscape of clinical practice as it pertains to rehabilitation progression and the use of time and objective criteria following ACLR. Methods An online survey was distributed to members of the orthopaedics, sports and private practice sections of the American Physical Therapy Association (APTA) between January and March 2017. Results 1074 responses were analyzed. Supervised physical therapy was reported to last ≤5 months by 56% of the sample. The most frequent time frame for activity progression was: 3-4 months (58%) for jogging, 4-5 months (51%) for modified sports activity and 9-12 months (40%) for unrestricted sports participation. Greater than 80% of the sample reported using strength and functional measures during rehabilitation. Of those that assessed strength, 56% used manual muscle testing as their only means of strength testing. Single limb hop testing (89%) was the most frequently reported measure utilized to begin modified sports activity. Performance criteria for strength and functional tests varied significantly across all phases of rehabilitation. Of the 45% that reported utilizing patient reported outcome measures, only a small proportion of those concerned fear or athletic confidence scales (10%). Conclusions Considerable variation exists amongst APTA members with regards to rehabilitation following ACLR. This variability in practice may contribute to suboptimal outcomes and confusion among practitioners and patients. J Orthop Sports Phys Ther, Epub 22 May 2018. doi:10.2519/jospt.2018.8264.
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Rainwater harvesting and management in rainfed agricultural systems in sub-Saharan Africa - A review
NASA Astrophysics Data System (ADS)
Biazin, Birhanu; Sterk, Geert; Temesgen, Melesse; Abdulkedir, Abdu; Stroosnijder, Leo
Agricultural water scarcity in the predominantly rainfed agricultural system of sub-Saharan Africa (SSA) is more related to the variability of rainfall and excessive non-productive losses, than the total annual precipitation in the growing season. Less than 15% of the terrestrial precipitation takes the form of productive ‘green’ transpiration. Hence, rainwater harvesting and management (RWHM) technologies hold a significant potential for improving rainwater-use efficiency and sustaining rainfed agriculture in the region. This paper outlines the various RWHM techniques being practiced in SSA, and reviews recent research results on the performance of selected practices. So far, micro-catchment and in situ rainwater harvesting techniques are more common than rainwater irrigation techniques from macro-catchment systems. Depending on rainfall patterns and local soil characteristics, appropriate application of in situ and micro-catchment techniques could improve the soil water content of the rooting zone by up to 30%. Up to sixfold crop yields have been obtained through combinations of rainwater harvesting and fertiliser use, as compared to traditional practices. Supplemental irrigation of rainfed agriculture through rainwater harvesting not only reduces the risk of total crop failure due to dry spells, but also substantially improves water and crop productivity. Depending on the type of crop and the seasonal rainfall pattern, the application of RWHM techniques makes net profits more possible, compared to the meagre profit or net loss of existing systems. Implementation of rainwater harvesting may allow cereal-based smallholder farmers to shift to diversified crops, hence improving household food security, dietary status, and economic return. The much needed green revolution and adaptations to climate change in SSA should blend rainwater harvesting ideals with agronomic principles. More efforts are needed to improve the indigenous practices, and to disseminate best practices on a wider scale.
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Parenting Practices and Child Misbehavior: A Mixed Method Study of Italian Mothers and Children
Bombi, Anna Silvia; Di Norcia, Anna; Di Giunta, Laura; Pastorelli, Concetta; Lansford, Jennifer E.
2015-01-01
Objective The present study uses a mixed qualitative and quantitative method to examine three main research questions: What are the practices that mothers report they use when trying to correct their children’s misbehaviors? Are there common patterns of these practices? Are the patterns that emerge related to children’s well-being? Design Italian mother-child dyads (N=103) participated in the study (when children were 8 years of age). At Time 1 (T1), mothers answered open-ended questions about discipline; in addition, measures of maternal physical discipline and rejection and child aggression were assessed in mothers and children at T1, one year later (T2), and two years later (T3). Results Mothers’ answers to open-ended questions about what they would do in three disciplinary situations were classified in six categories: physical or psychological punishment, control, mix of force and reasoning, reasoning, listening, and permissiveness. Cluster analysis yielded 3 clusters: Group 1, Induction (predominant use of reasoning and listening; 74%); Group 2, Punishment (punitive practices and no reasoning; 16%); Group 3, Mixed practices (combination of reasoning and punishment, as well as high control and no listening; 10%). Multiple-group latent growth curves of maternal physical discipline, maternal rejection, and child aggression were implemented to evaluate possible differences in the developmental trends from T1 to T3, as a function of cluster. Conclusions Qualitative data deepen understanding of parenting because they shed light on what parents think about themselves; their self-descriptions, in turn, help to identify ways of parenting that may have long-lasting consequences for children’s adjustment. PMID:26877716
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van der Heijde, Désirée; Sieper, Joachim; Elewaut, Dirk; Deodhar, Atul; Pangan, Aileen L; Dorr, Alexander P
2014-12-01
Recognition, diagnosis, and management of axial spondyloarthritis (axial SpA) continue to advance. The objectives of this study were to compare referrals, diagnosis, and management of axial SpA in Western Europe (WE), North America (US and Canada), and the rest of world (RoW) in academic and community rheumatology practices and to identify areas for further education. Rheumatologists responded online to the MAXIMA (Management of Axial SpA International and Multicentric Approaches) survey. Questions pertained to referral, diagnosis, and management of axial SpA. Rheumatologists (N = 809) from 56 countries completed the survey about patients with chronic back pain (≥3 months) starting before age 45 years. Responses from academic and community practice rheumatologists were generally similar. Most referrals were from primary care providers. Symptom duration of 3 years or more at referral was reported more frequently by WE and RoW than US respondents. More WE and RoW than US rheumatologists referred to the Assessment of SpondyloArthritis International Society criteria for axial SpA in clinical practice. Rheumatologists reported prescribing disease-modifying antirheumatic drugs for the management of axial SpA. Sulfasalazine was frequently prescribed across regions; methotrexate was more commonly prescribed by US rheumatologists compared with other regions. Referral patterns, diagnosis, and disease management for axial SpA were similar among WE, North America, and RoW rheumatologists and in academic/community practices, although more WE and RoW rheumatologists referred to Assessment of SpondyloArthritis International Society criteria in clinical practice. Disease-modifying antirheumatic drugs were commonly prescribed for axial SpA patients, although it was unclear whether these were prescribed for axial or peripheral symptoms.
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The American Indian and Alaska Native Dentist Workforce in the United States
Mertz, Elizabeth; Wides, Cynthia; Gates, Paul
2017-01-01
Objectives The purpose of this paper is to describe the American Indian/Alaska Native (AI/AN) dentist workforce, the general practice patterns of these providers, and their contributions to oral health care for AI/AN and underserved patients. Methods A national sample survey of underrepresented minority dentists was conducted in 2012 and received a 34.0% response rate for self-reported AI/AN dentists. Data were weighted for selection and response bias to be nationally representative. Descriptive and multivariable statistics were computed to provide a workforce profile. Comparisons to Census data and published information on dental students and dentists were used to examine practice patterns. Results The AI/AN dentist workforce (weighted n=442) is very diverse with 55 reported individual tribal affiliations. Tribal heritage was provided by 96.4% of AI/AN dentists (n=426), and of these, 93.9% (n=400) reported an affiliation with only one tribe. The largest share of AI/AN dentists were born in the U.S. (98.2%, n=434), married (75.6%, n=333), and had dependent children under age 18 (52.0%, n=222). Only 0.9% (n=4) of AI/AN dentists spoke a traditional AI/AN language in patient care, while 10.6% (n=46) were raised on tribal land or reservation. Initial practice in the Indian Health Service was reported by 15.8% of AI/AN dentists while 16.2% report currently practicing in a safety-net setting, and 42.0% report working in a practice that primarily serves underserved patients. Conclusions AI/AN dentists provide a disproportionate share of care for AI/AN populations, yet the number of AI/AN dentists would need to increase 7.4 fold in order to meet population parity. PMID:27922723
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Padela, Aasim I.; Zaidi, Danish
2018-01-01
Objective: The objective of this study was to identify mechanisms by which Islamic beliefs, values, and Muslim identity might contribute to health inequities among Muslim populations. Methods: A systematic literature review of empirical studies in Medline from 1980 to 2009 was conducted. The search strategy used three terms covering health-care disparities, ethnicity, and location to uncover relevant papers. Results: A total of 171 articles were relevant based on titles and abstracts. Upon subsequent full-text review, most studies did not include religious identity or religiosity as explanatory variables for observed health disparities. Of 29 studies mentioning Islam within the text, 19 implicated Muslim identity or practices as potential explanations for health differences between Muslim and non-Muslim groups. These 19 studies generated six mechanisms that related the Islamic tradition, Muslim practices, and health inequities: (1) Interpretations of health and/or lack of health based on Islamic theology; (2) Ethical and/or cultural challenges within the clinical realm stemming from Islamic values or practices; (3) Perceived discrimination due to, or a lack of cultural accommodation of, religious values or practices in the clinical realm; (4) Health practices rooted within the Islamic tradition; (5) Patterns of health-care seeking based on Islamic values; and (6) Adverse health exposures due to having a Muslim identity. Conclusion: While there is scant empirical research on Muslim health-care disparities, a preliminary conceptual model relating Islam to health inequities can be built from the extant literature. This model can serve to organize research on Muslim health and distinguish different ways in which a Muslim identity might contribute to the patterning of health disparities. PMID:29404267
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Management and Survival Patterns of Patients with Gliomatosis Cerebri: A SEER-Based Analysis.
Carroll, Kate T; Hirshman, Brian; Ali, Mir Amaan; Alattar, Ali A; Brandel, Michael G; Lochte, Bryson; Lanman, Tyler; Carter, Bob; Chen, Clark C
2017-07-01
We used the SEER (Surveillance Epidemiology and End Results) database (1999-2010) to analyze the clinical practice patterns and overall survival in patients with gliomatosis cerebri (GC), or glioma involving 3 or more lobes of the cerebrum. We identified 111 patients (age ≥18 years) with clinically or microscopically diagnosed GC in the SEER database. Analyses were performed to determine clinical practice patterns for these patients and whether these practices were associated with survival. Fifty-eight percent of the 111 patients with GC received microscopic confirmation of their diagnosis. Of the remaining patients, 40% were diagnosed via imaging or laboratory tests, and 2% had unknown methods of diagnosis. Seven percent of patients who did not have microscopic confirmation of their diagnosis received radiation therapy. Radiation therapy and surgery were not associated with survival. The only variable significantly associated with overall survival was age at diagnosis. Patients aged 18-50 years showed improved survival relative to patients aged >50 years (median survival, 11 and 6 months, respectively; P = 0.03). For patients aged >50 years, improved overall survival was observed in the post-temozolomide era (2005-2010) relative to those treated in the pre-temozolomide era (1999-2004) (median survival, 9 and 4 months, respectively; P = 0.005). In the SEER database, ∼40% of the patients with glioma with imaging findings of GC do not receive microscopic confirmation of their diagnosis. We propose that tissue confirmation is warranted in patients with GC, because genomic analysis of these specimens may provide insights that will contribute to meaningful therapeutic intervention. Copyright © 2017 Elsevier Inc. All rights reserved.